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NCAA Medical Officer References Biological Passports in Concussion Plan

Jon Solomon of the Birmingham News has an in-depth interview with Dr. Brian Hainline, a neurologist recently hired as the NCAA’s first ever chief medical officer. Most of Dr. Hainline’s focus so far appears to be on concussions, for good reason. The threat to college athletics from concussion is both financial (potential for massive liability lawsuits) and existential (football needs to continue as a major sport for college athletics to continue more or less as they are now).

To that end, the NCAA is working on the issue on a number of fronts. Contact limits in practice are a big topic, with the Pac-12 introducing their own alongside the Ivy League and the SEC calling on the NCAA to take the lead. Dr. Hainline notes one of the big hurdles to overcome:

“If you’re looking for when the NCAA will say across the board two full practices a week, we don’t even have agreement yet what that means,” Hainline said. “The Ivy League concept I don’t think is the same as what the Pac-12 is. If you look at details in the (Pac-12) announcement, you don’t find them.

More interesting though is Dr. Hainline’s discussion of advancements in data gathering. Teams are beginning to use helmet sensors to measure head impacts, which could lead to “hit count limits”, compared in the article to a pitch count limit in baseball. But Dr. Hainline is imagining something grander:

Hainline’s hope: In a couple years, college sports will use the HIT system, genetic markers, MRI studies and clinical medicine to create a risk-assessment factor for players. Along with that assessment could be a head-hit count in football, similar to pitch counts in baseball.

“I do envision that,” Hainline said. “I think decisions will be guided by brain imaging and biomarkers and combining that.”

What Dr. Hainline is talking about sounds a lot like the biological passports that are mostly notably used in cycling. Rather than simply testing for performance enhancing substances, a biological passport establishes a baseline, normal range for a number of biological markers. If an athlete’s markers stray outside of this range, they can be sanctioned or prevented from competing, even without a positive test for a performance enhancing drug.

So beyond simply counting and limiting impacts to the head, football players may need to establish and maintain normal markers in other concussion tests like brain imaging and cognitive testing. An athlete who fails a cognitive test may be sidelined, regardless of the number of hits taken or the lack of a concussion diagnosis.

But aside from brain imaging advances, Dr. Hainline’s full vision is waiting on another bit of technology to catch up:

“We have a pretty easy way to measure linear acceleration, but we don’t have a good way of measuring rotational acceleration,” he said. “Most experts agree rotational may be the more important of the underlying factors of concussions.”

Rotational accelerometers exist, the likely problem is reducing their size and cost to something that can fit into every football helmet sold to universities. But the consumer electronics industry should take care of that. Not to long ago, accurate linear accelerometers were too large and expensive for tiny devices like fitness trackers, but another product helped a great deal:

β€œIn the last couple of years sensors like accelerometers and altimeters have gotten a lot better. The Nintendo Wii is the first mass-market product that really used accelerometers and it drove the price way down.”

That quote is from Fitbit Chief Revenue Officer Woody Scal. As smartphones, game consoles, and wearable electronics add more sensors, their size and cost should go down while accuracy goes up, theoretically to the point where any type movement or impact to a helmet could be accurately recorded.

The question is not whether football teams will be able to accurately measure head trauma. Real-monitoring is inevitable at this point. And the question is not whether football will have the necessary rule changes to reduce head trauma and chronic brain injury because eventually there will be such changes. The question is whether these innovations and changes will happen quickly enough to prevent the sport from losing its spot at the top of the American sports landscape.

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