We Count Pitches to Save Arms. It’s Time to Track Hits to Save Lives

As the risks of brain trauma from playing football have become clearer, leagues have cracked down on the bone-rattling thwacks that were once celebrated by cheering spectators. Yet researchers increasingly believe that head trauma is more likely to result from multiple–and often perfectly clean–hits rather than a single shot. Which means the danger of playing football is as much in the accumulation of small hits to the head as it is in the stomach-churning big one. And yet no major organization at any level of the game limits the number of blows players take to the head.

So here’s a modest proposal: regulate hits to the head in football just as we count pitches in baseball.

The concept of limiting a pitcher’s throws to prevent injury has become gospel, from Little League–where kids must leave the game after reaching set caps–to the pros, despite a lack of scientific consensus on how it actually preserves vulnerable arms. Yet in football, where brains are at stake, there is no similar system for counting hits. The current high school season reinforces the tragic case for why that needs to change.

On Sept. 11, Ben Hamm, a junior at Wesleyan Christian School in Oklahoma, collapsed on the sideline after being involved in a tackle. The play appeared routine, according to Rocky Clark, the school’s superintendent. Eight days later, Hamm died, having suffered an apparent head injury. (The medical examiner has yet to announce a cause of death.) He was 16. In Seattle less than a month later, Kenney Bui, 17, died of a brain injury three days after hurting his head in a game. Earlier this season, Bui reportedly had what his school called a mild concussion but was cleared by a doctor to resume playing.

“I don’t see how a reasonable person would argue that we should count pitches to protect the elbow but not count hits to protect the brain,” says Stefan Duma, a professor of biomedical engineering at Virginia Tech. Duma’s research has shown that football players as young as 7 have sustained head impacts at forces similar to those in a car crash.

Here’s how hit counts would work. The goal is to track every hit to the head at a certain level of force in both practices and games. That can be done by outfitting helmets with sensors. Then we need to determine how many shots a player can sustain before sitting out. There is no magic number, but a good starting point could be limiting high schoolers to 90 blows in a week exceeding 20 G’s–roughly equivalent to the whiplash from a mild fender bender. Eric Nauman, a biomedical-engineering professor at Purdue, suggests that number on the basis of the school’s brain-imaging research, which found that almost every high school player hit at this rate or greater showed evidence of brain injury, even if he didn’t have concussion symptoms.

None of the leading football organizations is ready to sign on. Dr. Mitchel Berger, a neurosurgeon and member of the NFL’s Head, Neck and Spine Committee, says, “It’s a leap of faith to assume that this is going to provide us with any definitive information to help us right now better determine things like return to play or whether a player is susceptible to another concussion or not.”

On the college level, the NCAA’s chief medical officer, Dr. Brian Hainline, said it was researching the effectiveness of sensors “so that we can make a science-driven decision about head-impact exposure.” Pop Warner, which runs youth leagues across the nation, says it’s open to the idea but doesn’t believe the technology is ready.

Recognizing that the very act of playing can have lasting consequences cuts to the heart of football’s problem with traumatic brain injuries. “Football culture is resistant to counting hits, since people don’t think they’re worth counting,” says Chris Nowinski, a former college player who runs the Concussion Legacy Foundation.

The science makes it clear that they are. Last month, researchers at the Department of Veterans Affairs and Boston University said 87 of 91 brains of deceased NFL players showed signs of CTE, a devastating neurological disease believed to result from blows to the head. “There’s more than enough evidence to say we need a hit count, right now,” says Nauman. No hit-count proposal will be perfect. But neither are pitch counts. Baseball started somewhere. Why can’t football do the same?