"The Duty of Their Elders" - Doctors, Coaches, and the Framing of Youth Football's Health Risks, 1950s-1960s.

After World War II, organized tackle football programs for boys younger than high school age grew enormously in popularity in the United States, prompting concerns from pediatricians and educators about the sport's physical and emotional health effects. At the same time, sports medicine was emerging as a sub-specialty. Examining how American sports medicine doctors and football coaches established their professional authority on youth football safety in the 1950s and 1960s reveals how their justifications for this collision sport were connected to broader cultural trends. Doctors and coaches, who were virtually all men, emphasized their firsthand knowledge of an all-male sport that was widely promoted as a means of teaching boys to become men. They insisted that proper supervision and equipment were sufficient to protect young athletes. Their arguments for youth football's benefits were based on the belief that men best knew how to impart desired values such as loyalty, patriotism and discipline to boys. In framing football's health risks as manageable with adult supervision, coaches and sports medicine doctors played a crucial role in promoting the vision of American manhood associated with tackle football.

A Historical Perspective on Sports Concussion: Where We Have Been and Where We Are Going.

The approach to sports concussion diagnosis and management has been evolving at an unprecedented rate over the last several years. So much so, that committees at all level of sports have implemented concussion protocols and made adjustments to certain league rules in an effort to minimize the risk of head injury. With this newfound attention has come an even greater push by the scientific community to address the many questions that remain. The aim of this review article is to present the topic of sports concussion by means of discreet eras. It begins by introducing the very first mentions of concussion, dating back to ancient Greece, to present day, highlighting important periods along the way. It then goes on to review emerging scientific data, from biomarkers and serum studies, to imaging modalities, and brain networking. All of which will hopefully contribute to both the diagnostic and therapeutic approach to sports concussion.

The first concussion crisis: head injury and evidence in early American football.

In the early 21st century, sports concussion has become a prominent public health problem, popularly labeled "The Concussion Crisis." Football-related concussion contributes much of the epidemiological burden and inspires much of the public awareness. Though often cast as a recent phenomenon, the crisis in fact began more than a century ago, as concussions were identified among footballers in the game's first decades. This early concussion crisis subsided-allowing the problem to proliferate-because work was done by football's supporters to reshape public acceptance of risk. They appealed to an American culture that permitted violence, shifted attention to reforms addressing more visible injuries, and legitimized football within morally reputable institutions. Meanwhile, changing demands on the medical profession made practitioners reluctant to take a definitive stance. Drawing on scientific journals, public newspapers, and personal letters of players and coaches, this history of the early crisis raises critical questions about solutions being negotiated at present.

DNA statistics in the Simpson matter.

On 3 October 1995, O.J. Simpson was acquitted of two murders in spite of very strong DNA evidence linking his blood to the crime. Although numerical statements describing the strength of this evidence were made, the DNA profiles included so many loci that the need for presenting numbers in this case, and in others using similarly high numbers of loci, is probably unnecessary. If numbers are to be presented, however, they should be given in the form of likelihood ratios. One thing the verdict in the Simpson case makes clear is that it is essential that the integrity of DNA evidence (with regard to collection, potential contamination or tampering) be beyond doubt.

"The strength of Nebraska": Boyd Epley, Husker Power, and the formation of the strength coaching profession.

Boyd Epley was hired as the first full-time strength and conditioning coach at the University of Nebraska in 1969. Epley's hiring was the result of his extensive knowledge of strength training, an injury, and several disappointing seasons for the Cornhusker football team. An enterprising young coach, Tom Osborne, recognized that injured football players who trained with Epley, then an injured varsity pole-vaulter, returned to the team stronger than when they left. Osborne and Epley were able to convince head football coach and athletic director, Bob Devaney, that his belief that weight training was detrimental to athletic performance was unfounded. After starting the Husker Power program, Epley consistently worked to make it more scientific and specific to the demands of football. The results of Epley's work speak for themselves, over a career that spanned 35 years, football teams under his tutelage recorded 356 wins, 5 national championships, and a host of national player of the year award winners. In addition to his work as a practitioner of strength and conditioning, Epley also played an integral role in organizing a disparate group of individuals into a recognizable profession. He was the driving force in founding the National Strength and Conditioning Association in 1978. The organization would go on to fund and disseminate research in the field, resulting in the highly skilled practitioners of strength and conditioning practicing today.

[The O. J. Simpson case. Guilty or innocent?]. / Sprawa O. J. Simpsona. Winny?

On October 3, 1995, one hundred million of Americans gathered at their TV sets to learn the verdict in the ex-football player O. J. Simpson case. The verdict was the consequence of a skilful defense and numerous mistakes made by prosecution. Despite copious evidence, including DNA test results indicating the guilt of thedefendant, the jury decided that O. J. Simpson was not guilty. The aim of this paper is to present the unique character of this trial and defense strategy used by a group of six attorneys, who worked on that case.

Reflections on 40 years as a sideline physician.

OBJECT: In this study the author presents his personal observations concerning football injuries in a historical perspective with additional literature citations. METHODS: Aspects of brachial plexus and cervical spine injuries, neurapraxia, face mask infractions, concussion, acute subdural hematoma (SDH), and the so-called second-impact syndrome are addressed. CONCLUSIONS: The list of conclusions presented in this paper is as follows: there is more than one kind of brachial plexus injury; wedging of cervical vertebrae may be normal; neurapraxia presents a problem for return to play; face mask injuries are rarely serious; definitions of concussion vary; acute SDH requires immediate transfer to a hospital; and the second-impact syndrome may be a myth to some.

Neurosurgeons and their contributions to modern-day athletics: Richard C. Schneider Memorial Lecture.

Neurosurgeons in the last half-century have had considerable influence on modern-day athletics. In this article, the authors address the contributions made by neurosurgeons as clinician-scientists, particularly as these relate to the understanding and reduction of the incidence and severity of injury to the nervous system during athletic competition. American football has been a proving ground for the ability of the craniospinal axis to withstand and, in unfortunate cases, succumb to tremendous impact forces; in this way, it has served as a model for translational research and was the arena in which Dr. Richard Schneider made his greatest contributions to sports neurosurgery. Therefore, in his memory and in the spirit of the Schneider lectureship, the authors outline the notable contribution to modern-day athletics made by neurosurgeons as it applies to American football. Neurosurgeons have had considerable influence on reducing injury severity, and this cause has been championed by a few notable individuals whose efforts are discussed herein.

Junior Seau: An Illustrative Case of Chronic Traumatic Encephalopathy and Update on Chronic Sports-Related Head Injury.

BACKGROUND: Few neurologic diseases have captured the nation's attention more completely than chronic traumatic encephalopathy (CTE), which has been discovered in the autopsies of professional athletes, most notably professional football players. The tragic case of Junior Seau, a Hall of Fame, National Football League linebacker, has been the most high-profile confirmed case of CTE. Here we describe Seau's case, which concludes an autopsy conducted at the National Institutes of Health that confirmed the diagnosis. CASE DESCRIPTION: Since 1990, Junior Seau had a highly distinguished 20-year career playing for the National Football League as a linebacker, from which he sustained multiple concussions. He committed suicide on May 2, 2012, at age 43, after which an autopsy confirmed a diagnosis of CTE. His clinical history was significant for a series of behavioral disturbances. Seau's history and neuropathologic findings were used to better understand the pathophysiology, diagnosis, and possible risk factors for CTE. CONCLUSIONS: This high-profile case reflects an increasing awareness of CTE as a long-term consequence of multiple traumatic brain injuries. The previously unforeseen neurologic risks of American football have begun to cast doubt on the safety of the sport.

Birth and evolution of the football helmet.

OBJECTIVE: To review the advent and evolution of the football helmet through historical, physiological, and biomechanical analysis. METHODS: We obtained data from a thorough review of the literature. RESULTS: Significant correlation exists between head injuries and the advent of the football helmet in 1896, through its evolution in the early to mid-1900s, and regulatory standards for both helmet use and design and tackling rules and regulations. With the implementation of National Operating Committee on Standards for Athletic Equipment standards, fatalities decreased by 74% and serious head injuries decreased from 4.25 per 100,000 to 0.68 per 100,000. Not only is the material used important, but the protective design also proves essential in head injury prevention. Competition among leading helmet manufacturers has benefited the ultimate goal of injury prevention. However, just as significant in decreasing the incidence and severity of head injury is the implementation of newer rules and regulations in teaching, coaching, and governing tackling techniques. CONCLUSION: Helmet use in conjunction with more stringent head injury guidelines and rules has had a tremendous impact in decreasing head injury severity in football. Modifications of current testing models may further improve helmet design and hence further decrease the incidence and severity of head injury sustained while playing football.

Les Horvath: dental student Heisman Trophy winner.

For over a century, the Ohio State University football program has produced legendary coaches, national championship teams, epic games, explosive, electrifying running backs and six Heisman Trophy winners. Perhaps the most famous dentist ever to graduate from Ohio State was Dr. Les Horvath, Class of 1945, who won the 1944 Heisman Trophy while he was a senior dental student. Horvath was the tenth person to recognized as college football's top player and the first Heisman recipient from Ohio State University. Although he was relatively undersized, Horvath was a disciplined team player who met each challenge with determination, stamina and drive. He was an outstanding breakaway runner and a good passer and blocker. Because of his all-around ability and savvy on the gridiron, he was called "a coach on the field." As a result of his 1944 dream season, Les led Ohio State to its first undefeated, untied campaign in twenty-eight years, and he set a Big Ten rushing record. After his college and pro football days were ended, Les practiced general dentistry in the Los Angeles area for 41 years. This is his story.

Change in size and impact performance of football helmets from the 1970s to 2010.

Linear impactor tests were conducted on football helmets from the 1970s-1980s to complement recently reported tests on 1990 s and 2010 s helmets. Helmets were placed on the Hybrid III head with an array of accelerometers to determine translational and rotational acceleration. Impacts were at four sites on the helmet shell at 3.6-11.2 m/s. The four generations of helmets show a continuous improvement in response from bare head impacts in terms of Head Injury Criterion (HIC), peak head acceleration and peak rotational acceleration. Helmets of 2010 s weigh 1.95 ± 0.2 kg and are 2.7 times heavier than 1970s designs. They are also 4.3 cm longer, 7.6 cm higher, and 4.9 cm wider. The extra size and weight allow the use of energy absorbing padding that lowers forces in helmet impacts. For frontal impacts at 7.4 m/s, the four best performing 2010 s helmets have HIC of 148 ± 23 compared to 179 ± 42 for the 1990 s baseline, 231 ± 27 for the 1980s, 253 ± 22 for the 1970s helmets, and 354 ± 3 for the bare head. The additional size and padding of the best 2010 s helmets provide superior attenuation of impact forces in normal play and in conditions associated with concussion than helmets of the 1970s-1990 s.

Family violence and football: the effect of unexpected emotional cues on violent behavior.

We study the link between family violence and the emotional cues associated with wins and losses by professional football teams. We hypothesize that the risk of violence is affected by the "gain-loss" utility of game outcomes around a rationally expected reference point. Our empirical analysis uses police reports of violent incidents on Sundays during the professional football season. Controlling for the pregame point spread and the size of the local viewing audience, we find that upset losses (defeats when the home team was predicted to win by four or more points) lead to a 10% increase in the rate of at-home violence by men against their wives and girlfriends. In contrast, losses when the game was expected to be close have small and insignificant effects. Upset wins (victories when the home team was predicted to lose) also have little impact on violence, consistent with asymmetry in the gain-loss utility function. The rise in violence after an upset loss is concentrated in a narrow time window near the end of the game and is larger for more important games. We find no evidence for reference point updating based on the halftime score.

Wartime rugby and football: sports elites, French military teams and international meets during the First World War.

The First World War is traditionally considered in history as a temporary halt for cultural and sporting activities. If the Olympic Games and the Tour de France were actually cancelled, football and rugby were in fact stimulated by the circumstances of war. Indeed, the gathering of allied nations behind the Western Front emerged as the main factor in the development of these two sports. Reading the sporting press and military archives shows that international sporting exchanges were stimulated during the Great War. To be specific, France benefited from the golden opportunity provided by the presence of the masters of the game to strengthen its practices and affirm its status as a sporting nation. Inter-allied sporting exchanges were primarily characterised by informal encounters between military selections. Then, following the recognition of these sports by the military authorities, the number of exchanges increased. At the end of 1917, the official status acquired by sport within the military forces created the conditions for the structuring of the French sporting elite. From that point, we can witness the birth of the first French military rugby and football teams, as they demonstrate, through their good performances during the demobilisation period, the progressive build-up of the international dimension of French sport during the war years.

Race, punishment, and the Michael Vick experience.

Objective. The relationship between race and crime has been contentious, focusing primarily on offending and incarceration patterns among minorities. There has been some limited work on public perceptions of criminal punishment, and findings show that while minorities believe in the role and rule of law, they simultaneously perceive the justice system as acting in a biased and/or unfair manner. Two limitations have stalled this literature. First, research has focused mainly on criminal punishments to the neglect of noncriminal punishments. Second, most studies have not examined whether race remains salient after considering other demographic variables or discrimination and legitimacy attitudes.Methods. Using data from 400 adults, we examine how race affects perceptions of criminal punishment and subsequent reinstatement into the National Football League in the case of Michael Vick, a star professional quarterback who pled guilty to charges of operating an illegal dog-fighting ring.Results. Findings show that whites are more likely to view Vick's punishment as too soft and that he should not be reinstated, while nonwhites had the opposite views. Race remained significant after controlling for other variables believed to be related to punishment perceptions.Conclusion. Attitudes toward both criminal punishment and NFL reinstatement vary across race such that there exists important divides in how individuals perceive the system meting out punishment and subsequently reintegrating offenders back into society. These results underscore that white and nonwhites perceive the law and its administration differently.