Jan 9 5:30 PM

NCAA head games: The ‘very skewed’ concussion data in college football

Florida State wide receiver Kelvin Benjamin catches a touchdown late in the fourth quarter of Monday's Vizio Bowl Championship Series National Championship Game. Benjamin was one of six Seminoles whose concussions were made public knowledge this season.
AP Photo/Doug Benc

Already up 35-0 in an early November game at Wake Forest, Florida State called a play for wide receiver Kelvin Benjamin to run a crossing route over the middle of the field. He caught the ball for five yards, but took a shot that sent him to the locker room. During the game, Florida State announced that the sophomore had suffered a concussion.

Almost two months later, Benjamin’s teammates mobbed him in the south end zone of the Rose Bowl after he caught what would be the winning touchdown of Monday’s Vizio Bowl Championship Series National Championship Game.

The final score was Florida State 34, Auburn 31. But on the topic of head injuries among college players, this season's tally was much more decisive. The Seminoles reported six players who suffered from concussions – the second-highest amount among 126 Football Bowl Subdivision programs. Only the University of Hawaii reported more concussions, with nine instances. Auburn, on the other hand, reported none. This gap says nothing about differences in the safety, equipment or strategy of the two teams, however, and everything about the ad-hoc way player concussions are publicly reported.

For this college football season, America Tonight has been tracking all the publicly reported concussions in the 10 FBS conferences and the independent teams. Auburn was one of 42 FBS programs to not publicly report a single concussion this season, accounting for exactly one-third of the 126 FBS programs. The group includes Rose Bowl and Big Ten champion Michigan State and Big 12 champion Baylor.

In fact, in the 10 conferences and the independents, coaching staffs and media outlets only reported 192 concussions at all among more than 10,000 players, according to data compiled from early August 2013 to Dec. 27, 2013, in the America Tonight Concussion Map. That's an average of fewer than two reported concussions per team.

“One-hundred and ninety-two seems pretty low for us,” says Thomas Dompier, president of the Datalys Center for Sports Injury Research and Prevention, which conducts the NCAA’s Injury Surveillance Program. “I’d expect a lot more, to tell you the truth.”

The actual number is difficult to guess, but it’s estimated to be in the thousands. The NCAA’s Injury Surveillance Program found that there are now about 4,000 concussion cases a year throughout all levels of college football, Dompier says.

“We are getting a very skewed representation of how much concussions are out there,” says Robert Cantu, co-founder of the Sports Legacy Institute and co-director of the Boston University Center for Study of Traumatic Encephalopathy. “It’s nobody’s fault. It’s just reality.”

Public data and perception

The athletic trainers and medical experts interviewed for this article said that, on average, it’s normal for a college football program of 80 or more scholarship players to suffer somewhere between 10 to 12 concussions in games and practices in a season. Mounting evidence that concussions are linked to long-term brain damage has led to increased scrutiny of player health and calls for better data on the extent of the problem. But through the federal Health Insurance Portability and Accountability Act, coaches and colleges don’t have to disclose those numbers, and “protected health information” cannot be disseminated without the permission of each student-athlete.

Dustin Fink, a certified athletic trainer in Illinois and the founder of The Concussion Blog, believes that the concussion information that is made public is a reflection of how advanced a program’s training staff is on the issue.

“The schools that publicly report more concussions probably understand the injury more, and are probably less fearful and have more control,” Fink says. “They aren’t worried about perceptions.”

Both the Mountain West Conference, which led FBS conferences with 27 reported concussions, and conference member Hawaii, the nation’s leader in reported concussions this season, however declined requests for comment.

The Southeastern Conference, which, before Monday’s win by the Seminoles, had won the last seven BCS championships, had half of its teams not publicly report a single concussion this season.

'Smoke-screening' the numbers

Whether to publicly report concussed players remains a sensitive topic for head coaches and head trainers at many programs, amid what can be, at times, a toxic relationship. More than half of the 101 major-college football athletic trainers polled in a September survey from the Chronicle of Higher Education said that they have felt pressure from football coaches to return concussed players to action before they were medically cleared to return. Forty-two of the 101 polled said they felt pressure to return a player even after he had suffered a concussion.

If players who are not on the active roster, like walk-ons or redshirt freshmen, suffer concussions in practice, their injuries are often not publicly mentioned, says Arnold Gamber, an NCAA athletic trainer for 17 years at top-25 stalwarts Auburn and Texas Tech under coach Tommy Tuberville.

Gamber says there were instances where players who were concussed were ruled out for games, but the staff agreed not to publicly state that the injuries were concussions.

“There are times we covered it up – not in the sense of a cover-up, but in that we just didn’t tell the media they had concussions,” Gamber says. “You smoke-screened it a little bit.”

America Tonight found that “smoke-screening” is not an uncommon practice. At West Virginia University, there were five cases of concussions that were publicly reported this season, tied for fourth among FBS programs. But that figure was not even half of the real number of concussions this season among Mountaineer players.

There are times we covered it up – not in the sense of a cover-up, but in that we just didn’t tell the media they had concussions. You smoke-screened it a little bit.

Arnold Gamber

Head athletic trainer, University of West Florida

Dave Kerns, West Virginia’s head football athletic trainer, told America Tonight that the Mountaineers had 12 concussions – seven in games and another five in practices. The annual totals have yo-yoed in the last three years, Kerns says, with the team having just four concussions in 2012 after experiencing 11 in 2011.

“Are we entirely up front and honest? No, I don’t think so,” Kerns says about the degree in which concussion information is made public knowledge. “But what right does the public have to know a kid’s health situation? These kids are playing collegiate football. It’s not their job.” He adds: “Are we more honest than others? I’d say we’re about middle of the road.”

Purdue's program publicly reported three concussions in 2013, but there were really 10 players treated for concussions during games and practices from August to this month, says Doug Boersma, Purdue’s director of sports medicine. He contends that, for the sake of the student-athlete’s future after sports, there’s no need for concussion information about football players to be made public.

“When you get into head trauma, there’s potential that if a kid has a concussion and the severity of it is affecting him in classes, then that has potential to affect his future in football or his future for employment in other jobs, period,” Boersma says. “That’s something you consider for how much the public really needs to be informed.”

The need for more data

But the call for more public information is growing louder every year. Last spring, Gamber decided to track the number of times one offensive lineman hit his head during the course of a normal two-hour practice at Texas Tech. Gamber had been to a million practices, but he was curious to see exactly how many times a lineman hits his head in a day.

Arnold Gamber has been an NCAA athletic trainer for close to 20 years. He says that a great number of concussions are often not made to be public knowledge.
Courtesy: Texas Tech Athletics

Throughout the practice, the player’s helmet would connect with pads during drills, crash into his teammates on tackles and land on the turf. By the end of the practice, Gamber counted that the offensive lineman had hit his head 100 times. He says that although the player was “perfectly fine by all accounts,” it was a stark reminder of the number of head hits players take in a single practice.

“It wasn’t like [the coaching staff] was killing them,” says Gamber, now the head athletic trainer for the University of West Florida, a Division-II program in Pensacola. “It was a just a normal day, a typical day that happens on 400 campuses a year across the country.”

The long-term effects of taking non-concussive hits to the head, much like the ones in the instance Gamber described, were brought to light in a March study from researchers at the Cleveland Clinic that found that college football players are likely to experience long-term brain damage even when they don’t suffer a concussion.

The need for more comprehensive statistics became even more apparent after an October report from the Institute of Medicine warned how football’s “culture of resistance” at the youth level could carry over to the college game. Robert Graham, chairman of the IOM committee on youth sports-related concussions, says that improved, more accurate concussion data needs to be made available at all levels, including the NCAA.

“It was very clear to us that you need a better base of surveillance epidemiology to understand how frequently these injuries are taking place,” Graham says. 

Encouraging signs

There’s already a sense that the recent period of concussion awareness is, in some respects, paying off. This year saw a significant spike in concussion-related retirements. Between 2010 and 2012, there were 12 players from FBS programs who took medical retirements due to concussions. This season, eight players were forced to retire following concussions, the highest single-season concussion retirement total in the FBS since 2010.

Concussions forced 10 players to miss most of or the entire season, and caused another five players to be knocked out “indefinitely,” with only one of them coming back to play a game this season. 

And there’s evidence that the numbers are rising slightly, or as others have pointed out, beginning to even plateau. From 2009 to 2013, the concussion rate for NCAA athletes was 6.3 for every 10,000 athlete exposures, says Dompier, which is up from the 6.0 rate that happened from 2004 to 2009, when the NCAA was still conducting its own injury surveillance.

But Datalys’ data gathering doesn’t come without criticism. With about 20 percent of NCAA member institutions participating, trainers and medical experts have described Datalys as presenting a look at NCAA concussion data that’s anything but comprehensive, and accused it of offering no incentive for trainers to participate.

“Some universities are more finicky about submitting data than others,” Dompier says. “I think we’ll increase numbers of participation over the next year or two, but we’ll always have a smaller sample than we would like to have due to technical or logistical limitations.”

One of those limitations is simply the culture of the game. Shortly after Monday’s game, Benjamin, now immortalized on the cover of Sports Illustrated, reflected on what the win meant for the Seminoles. Once a data point, Benjamin, who didn’t miss a game because of his concussion, was now a champion.

“We put Florida State back on the map,” he said.

AP Photo/Rodrigo Abd, File

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