This season the NFL changed the kickoff rules, and concussions on kickoffs dropped by 60% in the regular season.
Over the past five years, the NFL has also used data from game video and sensors from gear like mouth guards to improve helmets and protect players from head injuries and the degenerative brain disease chronic traumatic encephalopathy, or CTE.
"From the Friday night lights to the NFL field, the impact of hard hits is a major health concern the National Football League continues to tackle," said Jeff Miller, vice president of player health and safety at the NFL.
"Unfortunately, there are injuries in football. That's not a surprise to anybody. Our work is to try to identify areas where there are greater risks and find ways to modify those," he said.
The NFL documented 219 concussions in the 2023 preseason and regular season, up from 213 in 2022. That includes injuries from practices and games.
In terms of helmet innovation, biomechanical engineers test NFL helmets the same way as car crash tests. They use data from each hard hit from games in the evaluations, taking into account force, speed, velocity, player position and movement.
Each year, the league prohibits lower-performing helmets as safer ones are made. This season, seven of the top helmets from 2020 were banned.
Each hard hit — as is now known — is extremely dangerous, no matter where the player is in their career. That's because of CTE, which doctors have found in the brains of 345 former NFL players. The diagnosis comes only after death because of the way brain tissues must be examined to definitively confirm the disease.
With CTE, the brain's nerve cells die, causing symptoms like memory loss, impaired judgment, poor impulse-control, aggression, and even suicide.
Shortly before the start of the 2023 season, scientists shared new research that showed that repeated hard hits to the head — not just concussions, as previously thought — drive up CTE risk.
"Over two-thirds of head impacts for a football player occur in practice, typically. And so, if we eliminate half of the head impacts that occur in practices, we could decrease the risk of CTE for an average, say, offensive linemen, by about 50% over eight years," said Dr. Daniel Daneshvar, assistant professor at Harvard Medical School.
This season, the NFL says they slowly ramped up preseason contact conditioning. The league also added more requirements for the use of protective Guardian Caps, which are padded helmet covers that provide impact reduction. For all preseason practices with helmets and regular season contact practices, they saw a 50% reduction in concussions. The league also added position-specific helmets, including for quarterbacks.
"There are players in both teams who will be wearing those helmets in the Super Bowl. Going forward for next season, we will see up to eight new models again of offensive and defensive linemen and quarterback-specific helmets," Miller said.
Some of these innovations will help protect the next generation of professional football players. Guardian Sports says about 4,000 colleges, high school and youth programs use their Guardian Caps. Some youth leagues are teaching tackle techniques to avoid the head, too.
Health advocates say more should be done to limit hard hits for children playing the sport.
"We can do more to promote, for example, flag football rather than tackling at younger ages — things that would decrease the repetitive impacts through a career, and really encouraging athletes as well to report these injuries," said Julie Stamm, a neuroscientist at the University of Wisconsin-Madison.
The Centers for Disease Control and Prevention (CDC) says a young tackle football athlete has a median of 378 head impacts in a season, which is 15 times more than flag football.
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