Putting Their Heads Together

Despite an increasingly hard-to-ignore dialogue about the effects of head trauma on athletes -- particularly in the National Football League, which is facing a massive lawsuit from former players and their families -- the colleges where these players begin their careers on the field have done little to address the issue.

But a new partnership between two Division I athletic conferences -- one best known for football, the other for its players' academic prowess, and both powerhouses in research -- promises to put head trauma more squarely on the college sports agenda.

The Big Ten Conference and the Ivy League announced Tuesday that they, along with the Big Ten’s provost-run Committee on Institutional Cooperation, will together conduct research and share data on head trauma in college sports that could lead to a far greater knowledge base than what’s available now.

“One of the things I’ve learned in the past few years of being focused on this is, we need more research…. We know enough to be concerned, but we don’t have the answers,” said Robin Harris, executive director of the Ivy League. “We can’t say, ‘O.K., put a sensor in a helmet and after X number of hits to the head at a certain force, you’re done.' We don’t know what that is. We don’t know what X is.”

Doctors do know that concussions and other forms of head injury affect a person’s judgment, attention span, emotions, and ability to anticipate and plan. What they don’t know, the project's research director Dennis Molfese said, is how a person’s history relates to head trauma and its effects. Molfese hopes that by tracking large groups over time from the conferences’ 20 colleges and 17,500 athletes, researchers will be able to better determine, for instance, when it’s safe for a concussed athlete to rejoin a game, or how the effects of concussions can be minimized or can change over time.

“We will learn more in just a year or two about concussions than we have learned in the last century” by pooling the data this project can gather, said Molfese, who is also director of the University of Nebraska Center for Brain, Biology and Behavior. This will be the largest long-term concussion study that’s ever been attempted, he said. “I think what’s important in this illustration is that this kind of collaboration between the athletic and academic side can generate new insight into concussions.”

Some conferences have done what they can. The Ivy League last year limited the number of allowable full-contact football practices, reducing opportunities for traumatic hits. The Big Ten was the first to adopt a conferencewide concussion management plan, a document that the National Collegiate Athletic Association mandated for all institutions in 2010. And just this month, the Southeastern Conference announced a new working group of head trauma specialists, physicians and athletic trainers from SEC colleges to make recommendations to league officials.

“The question in these kinds of circumstances always is, does one wait to act until there’s more data, or do you go ahead just based on what you have?” said David J. Skorton, president of Cornell University and co-chair (along with Dartmouth College president and soon-to-be World Bank head Jim Yong Kim) of the Ivy League Multi-Sport Concussion Committee, which developed the recommendations that led to that conference’s new practice rules. “I personally think more as a physician than as a university president. I think the potential downside for waiting to gather more data, the potential downside of an individual young person, is too high to wait for more data to be gathered. That doesn’t mean we shouldn’t gather more data – we definitely should.”

In the meantime, there won’t be a lot (if any) immediate changes as a direct result of the research, given its longitudinal nature. Once the results start taking shape, others might start feeling pressure to act as well – to the other conferences running major football programs, or to the NCAA, which beyond the concussion management plan mandate has been silent on the issue. Association officials have said that if the group's members bring legislation to a vote, it could issue some decree that way.

Skorton, a former Big Ten president (he spent a quarter-century as a faculty member and administrator at the University of Iowa) who recently wrapped up a term on the NCAA's Division I Board of Directors, has spoken with many officials about the topic. He said that, “understandably,” other conferences may act “at different rates.” But he has noted a uniform interest and concern about head trauma, he says.

“I really believe that the vast majority of leaders in higher education and in intercollegiate athletics have the health and welfare of students at the very top of their list, so yeah, I expect people will act throughout the country in good faith on information that is gathered,” Skorton said. “My prediction is you will see more interest and more efforts to broaden the database and understand things better.”

The Big Ten/Ivy League collaboration will create a network of neuroscientists and sports medicine staff and athletic trainers at the colleges, who will track head trauma of athletes who volunteer from pre- to post-college sport. Research from Dartmouth College, Brown University and Virginia Tech in 2007 identified an average of 14.3 head impacts per athlete per game, and up to 1,444 throughout the season. And that was just in football. Taken together, the Big Ten and Ivy League offer 240 sports, Molfese said, including high-impact ones such as lacrosse, hockey and soccer.

“Really, this is an incredible opportunity to track a very, very large population,” he said. “My bias is, the more the merrier. The more people we have studying the problem, the more advances we’re going to make – and more rapidly.”