Recent NFL and World Rugby News Stories About Guardian Caps and Smart Mouthguards Can Be Dangerous

By Ken Reed

There have been a couple news stories recently that have people excited about new technologies that could potentially significantly reduce the number of sports concussions.

Unfortunately, stories like these might actually do more harm than good. More on that in a bit. First, let’s do a quick recap of the stories.

World Rugby announced they would become the first sports governing body to start using smart mouthguards. Smart mouthguards, also known as instrumented mouthguards, are devices designed to measure the level of impact to the head athletes endure during sporting events. Trainers and doctors make an educated guess in picking a level of impact to the head that would lead to an athlete being pulled from a game to be checked for concussion symptoms.

In theory, it makes sense, but human beings are all different. As such, they can suffer concussions from widely different levels of impact, due to genetic differences, history of prior concussions, etc.

“I think one of the challenges with instrumented mouthguards is the idea that there is a numerical threshold of acceleration … that is indicative of a concussion. … We all have our individual threshold for injury … so it’s hard to draw a black-and-white line,” says Kristy Arbogast, research director of the Minds Matter Concussion Program at Children’s Hospital of Philadelphia.

Not long after World Rugby’s announcement, the NFL announced they had approved Guardian Caps for use by NFL players in games this coming season. The caps are soft shell covers that slip over football helmets to provide extra cushioning from blows to the head. NFL teams have been using the caps, to various degrees, in practices the past couple years. According to the league, the caps can reduce the force from head contact by 10% if one player is wearing a cap. The force reduction would be 20% if all players involved in a collision are wearing them.

A couple things to consider here.

One, there’s only one way to get CTE and that is from blows to the head. It’s important to note that those blows don’t need to be severe enough to cause concussions. The latest research shows that CTE is primarily caused by repetitive subconcussive blows to the head, not concussions. Guardian caps and smart mouthguards won’t eliminate the hundreds of subconcussive head impacts a given player endures during a football season.

Two, equipment like high-tech football helmets and Guardian Caps are great at preventing skull fractures and hematomas but not very effective at preventing concussions. That’s because the brain sloshes around in the skull like Jello in a bowl. And when the skull is impacted, the brain will crash into the side of the skull like jello smashing into the side of a bowl that is shook. It’s that impact, inside the skull, helmet and Guardian Cap, that is damaging. So, unless someone invents a way to put a protective covering over the brain inside the skull, brain trauma from blows to the head will continue to be a serious problem.

Bottom line, new high-tech helmets and shells like Guardian Caps placed over helmets will only be very minimally effective, if at all, in protecting the brain from repetitive subconcussive impacts. There’s also concern among some researchers that the bulkiness and added weight of any head covering may increase the whiplash effect upon contact, which would increase the risk of concussion, not reduce it.

As Chris Nowinski, a CTE researcher and co-founder of the Concussion Legacy Foundation, has said:

“Any real-world gains may be offset by greater impacts due to the added weight of the cap, greater rotational acceleration due to greater size of the helmet apparatus, or a player receiving a greater number of impacts due to the greater size of their helmet. In addition, if the softer padding changes player behavior because they perceive they are safer, players might be worse off than before. The use of the caps should be monitored closely, and users should be aware the potential benefit is limited.”

Nowinski touches on a big issue in that quote, and that is perceived safety. Due to misleading data, sloppy reporting, unethical marketing and PR practices, and coaches who want to reassure athletes and parents that things like smart mouthguards and Guardian Caps make the game of football safe to play, thousands of athletes will be misled and get a false sense of security about the risk of brain injury from playing football (or other high contact sports like hockey, rugby and soccer, which includes the negative impact of repetitive headers). As such, they will start to play — or continue to play — these sports, and by doing so put themselves at increased risk for CTE and the tragic impact CTE has on an athlete and his or her family.

To be clear, research on smart mouthguards and Guardian Caps can help us understand brain trauma better than we do today. And that’s a good thing.

But they’re far from the solution to the brain trauma crisis in sports. And players, coaches and parents need to know that.

— Ken Reed, Sports Policy Director, League of Fans