We all share the responsibility of keeping sports as safe as possible because there is no single measure that can do the job as well as promoting an environment of safety—and by taking seriously all rules and guidelines. Positively, athletes can expect that sport leaders have taken reasonable precautions through rules of play, and sport injury data is continuously analyzed to improve safety measures. Yet even so, participation in sports requires acceptance that there is a risk of injury.

The precautions mandated via rules books and equipment standards cannot be effective without respect on everyone’s part for the intent and purpose of the rules and guidelines. In addition, reliance on officials to enforce compliance with the rules and equipment warning labels cannot be wholly effective in bringing about compliance with precautionary guidelines.

1. Serious brain and neck injuries leading to death, permanent brain damage or quadriplegia (extensive paralysis from injury to the spinal cord at the neck level) occur in football. The toll is relatively small but persistent, averaging 1.44 fatal or severe, nonfatal brain or spinal cord injuries annually for every 100,000 players. HELMETS DO NOT PROTECT THE NECK, and none of these injuries can be completely prevented due to the tremendous forces occasionally encountered in football collisions; but they can be minimized by manufacturer, coach and player compliance with published rules of play, proper coaching, and in the case of head and brain injuries, compliance with accepted equipment standards.

2. It is important that athletes comply with the purpose of the NOCSAE standard by reviewing and following the helmet’s safety guidelines, ensuring a helmet’s proper fit, not modifying its design, and by having the helmet reconditioned and recertified when warranted and appropriate, and replacing it when necessary.

3. The rules against intentional butting, ramming or spearing the opponent with the helmeted head are there to protect the helmeted person much more than the opponent being hit. The athlete who does not comply with these rules is vulnerable to catastrophic injury.

 For example, no helmet can offer protection to the neck. The typical scenario of this catastrophic injury in football involves lowering ones head while making a tackle. The momentum of the body tries to bend the neck after the helmeted head is stopped by the impact, and the cervical spine cannot be supported as well by the neck’s muscles with the head lowered as it can be with the preferred “face up, eyes forward, neck bullied” position.

When the force at impact is sufficient, the vertebrae in the neck can dislocate or break, cause damage to the spinal cord they had been protecting and thereby produce permanent loss of motor and sensory function below the level of injury.

4. Because of the impact forces in football, even the “face up” position is no guarantee against head or neck injury. Further, the intent to make contact “face up” is no guarantee that that position can be maintained at the moment of impact. Consequently, the teaching of blocking/tackling techniques that keep the helmeted head from receiving the brunt of the impact are now required by rule and by coaching ethics. Coaching techniques that help athletes maintain or regain the “face up” position during the course of a play must be respected by athletes.

Other sports and other concerns within football can be similarly approached. Coaches should acquaint athletes appropriately with the risks of injury and the rules and practices they are employing to minimize the athlete’s risk of significant injury while pursuing the many benefits of the sport. The athlete and the athletic program have a mutual need for an informed awareness of the risks being accepted and for sharing the responsibility of controlling those risks.

Helmet Warning Statements

As early as 1979, the NOCSAE Board of Directors recognized the importance and need for a warning statement and label to be put on football helmets certified to the NOCSAE standard.  NOCSAE developed a warning statement, model adaptations of which are found on all football, baseball/softball batting, baseball/softball catcher’s and lacrosse helmets certified to NOCSAE standards. The warning label requirement has long been a part of each standard and is intended to warn participants of the possibility of head or neck injury despite the fact a certified helmet is being worn. The helmet is designed to help protect the head. Neither football, baseball/softball batting, baseball/softball catcher or lacrosse helmets protect a players’ necks.

NOCSAE urges that the warning statement be shared with members of the football, baseball, softball and lacrosse squads and that all coaches alert participants to the potential for injury. The wording of the warning label as set forth in the NOCSAE standard specifies the core information that must be conveyed by the label, but permits a manufacturer to add or supplement the content as it determines necessary.