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Impact Sensors: One Step Forward, Two Steps Back

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If you follow the subject of sports-related concussions, you've probably seen a flurry of news on the subject of impact sensors in the last couple of weeks. As someone who has been writing about and beta testing impact sensors for the past five years, I have, of course, been monitoring developments, too.

On February 16, 2015, my local paper, The Boston Globe, came out with a powerful editorial in which it urged college, high school, and recreational leagues in contact and collision sports to consider mandating use of impact sensors, or, at the very least, experimenting with the technology, to alert the sideline personnel to hits that might cause concussion, and to track data on repetitive head impacts, which, a growing body of peer-reviewed evidence suggests, may result, over time, in just as much, if not more, damage to an athlete's brain, as a single concussive blow, and may even predispose an athlete to concussion.

The Globe editorial viewed as "shortsighted" the reluctance of players and coaches to adopt the use of impact sensor technology out of fear that sensors, if they triggered an alert, might result in a player's removal from the game (that, after all, is the whole point) or the player being labeled a wimp (what the Institute of Medicine has labeled the "culture of resistance"), and it called on professional leagues, like the NFL, to follow suit, suggesting that star players, by using the devices, could help break down barriers to their more widespread use.

Unfortunately, on February 19, 2015, just three days after than the Globe went on record as urging the NFL to set an example for colleges, high school, and youth leagues to follow by equipping its players with sensors (as the Arena Football League has already done), the league did exactly the opposite.

As first reported by Sports Business Journal and, later that same day, by The New York Times, the NFL decided to suspend a pilot program using sensors in players' helmets for the 2015 season because data collected during the 2013 season was not considered reliable enough (for what, they didn't say), and because the N.F.L. Players Association questioned whether the data would be kept private and not used against a player.

Researchers who have collected data for years, including Stefan Duma, who runs the biomedical engineering department at Virginia Tech and helped develop the STAR helmet rating system, were quick to say that the league was being too careful, and that, while not perfect, even with a 10 to 20 percent error rate, the sensors were valuable and give reasonable data that is useful, not only in football, but in analyzing head hits in sports like soccer and hockey. I agree.  (After all, if a 10-20% error rate hasn't prevented the widespread use of neurocognitive tests such as ImPACT, why should it be any different with sensors?)

Duma speculated that one reason the N.F.L. and the players' union might be ambivalent about the use of sensors was because they could show that players were receiving more blows to the head than was commonly thought. He feared that the decision could dampen research efforts by others and didn't acknowledge "all the good things" that sensors do.

I agree with Duma on that point as well. Indeed, preserving the status quo and making it harder to use impact sensors is a theme explored in a law review article published yesterday in the University of Maryland's Journal of Business and Technology Law, which I co-authored with MomsTEAM Senior Editor Lindsey Straus.  While our article is primarily about the role organizations such as the National Operating Committee on Standards for Athletic Equipment ("NOCSAE")  play in setting performance standards for add-on equipment, such as impact sensors (it is our position that such standards should be set either by governmental agencies, such as the Consumer Product Safety Commission, or by truly independent standard-setting groups, such as ASTM International, and not by groups such as NOCSAE and Sports Legacy Institute funded, primarily or in part, by the equipment manufacturers whose products are subject to the performance standards they set), we also address the same concerns raised by Dr. Duma: that groups like NOCSAE, NFL, and its players have a vested interest in protecting the status quo, which, in the case of impact sensors, means trying to put the brakes on widespread adoption of sensor technology, not because their use is unlikely to make sports like football safer (I think it will), but for fear that it may open Pandora's box by making it clear just how hard and how often players are getting hit, and scare off parents from letting kids play the sport.

What motivates my desire to see widespread adoption of  impact sensor technology? I can trace it back to my childhood. In the early 1960's, before seat belts were standard equipment in every automobile, I remember a time my mother, a now retired emergency room nurse, was driving my three sisters and I in our old station wagon on some errands when we were rear-ended. No one was hurt, thankfully, but the accident prompted her to begin working for enactment of a law requiring car companies to include seat belts as standard equipment in every new car. (By the way, my mom was also an early advocate for installing defibrillators in every ambulance and on banning smoking in public places.) My father, on the other hand, was a gifted athlete who excelled at a variety of sports (baseball, hockey, golf, skiing, tennis), who introduced my sisters and I to every sport imaginable, and never held us back.

No wonder, then, as the product of a mother who, as a result of her work in the ER, was understandably obsessed with safety, and a very athletic father who loved sports and encouraged us to play them with gusto, that when I became a mother raising athletic triplet sons I did everything I could to protect them while playing sports, but at the same time encouraged them to play whatever sport they loved, even ones like football, lacrosse, soccer, and skiing/snowboarding which came with the risk of head injury. In 1999, when my son Spencer sustained a concussion playing high school football (after suffering at least two earlier concussions, one snowboarding and one sledding), I began to focus more on the safety side of the sports equation, especially with respect to concussions.

About five years ago, I started to write about companies who were developing impact sensors, not just for research, but for use at the youth, high school, and college level; sensors that, while not as sophisticated as the ones used for research - which cost upwards of $1,000 per player - could be used to alert sideline personnel to athletes who had sustained hits hard enough to cause concussion, and identify athletes whose poor technique caused them to sustain an unusually large number of high force impacts. 

In 2012, when I was asked by the high school football program in Newcastle, Oklahoma for help in implementing an evidence-based concussion risk management program (one which we now call The Six PillarsTM, it seemed like, pardon the pun, a "no-brainer" to see if a impact sensor manufacturer wanted to beta test its sensors by donating them to the school for installation in some of the Newcastle players' helmets. (We left it up to the players and their parents whether the sensors would be installed in their helmets).


My experience with impact sensors during the filming of "The Smartest Team: Making High School Football Safer" convinced me that they had value as a technological "end run" around the persistent problem of chronic under-reporting by athletes of concussion symptoms, and would, as the cost came down and the reliability went up, eventually become standard equipment in contact and collision sports.

From talking candidly at length with the players in Oklahoma after a duck-hunting trip (next to playing football, their favorite activity), I learned that they actually  wanted to wear the sensors. Why? Because they knew that, if they took a heavy hit, it would register on the iPad the athletic trainer or his assistant was holding on the sideline. In other words, knowing that they would be checked out if the sensor alerted sideline personnel to a blow with the potential to cause a concussion, they felt more comfortable, if they were experiencing concussion symptoms, reporting them to the AT without fear of being labeled a wimp by their teammates or the coach.

Is the technology perfect? No, it's not. But, like Dr. Duma, and others, I believe that, in hitting the pause button on the use of sensors, the NFL is essentially throwing the baby out with the bathwater, and sending out exactly the wrong message about sensors. Our experience at MomsTEAM Institute in field testing seven different impact sensor models over the past three football seasons, at both the high school and youth level, is that they are, at this stage, a bit of a mixed bag. Admittedly, the technology is still in its infancy.

In my view, however, equipping players with sensors does not, as one critic has suggested, turn them into crash-test dummies. With appropriate safeguards in place to ensure that the privacy of the players is protected, and that access to the data the sensors generate is restricted to those who can use that data intelligently (such as an AT or coach), I continue to believe that the best way to refine and improve impact sensor technology, and educate players, coaches, parents, and ATs about their advantages, is, well, to use it. Sadly, the NFL's decision to stop using impact sensors is likely to set back the kind of widespread use MomsTEAM have been advocating for years (not because we have a dog in this fight, but solely because we believe in the technology). How much of a setback remains to be seen. More on this later.

Here are some of our articles on impact sensors:

Impact Sensors: Frequently Asked Questions

Underreporting of Concussions: Is Monitoring Head Impact Exposure A Way Around The Problem? 

Impact Sensors: Many Benefits Of Real-Time Monitoring

AFL Becomes First Professional Sports League to Require Helmet Impact Sensors

Conflict of Interest Statement on Impact Sensors