More padding the issue of concussions and better helmets

• Guardian Cap%2C a padded shell with foam rubber%2C is a product touted as improving helmet safety
• Reducing concussions and the after-effects is a prominent concern for college football and the NFL
• As companies vie for that safety market%2C an arbiter of helmet standards warns vs. %27quick solutions%27

When the University of South Carolina opens preseason football practice Friday night, the plan is to have the Gamecocks, including defensive star Jadeveon Clowney, outfitted in Guardian Caps. The padded shells, made of polyurethane fabric, are designed to fit over helmets and reduce impacts to the head.

There's controversy whether the caps violate helmet certification standards. But South Carolina tried 32 of them on linemen in the spring, liked them and bought 75 more to go team-wide for practice, says athletic trainer Clint Haggard.

"I've talked to our team physicians and discussed all that stuff, and I've talked to a bunch of people around the country," says Haggard. "And we're still going to use them. ... It seems like it will help."

Player safety has become the catch phrase for colleges and pro football, with the NCAA and the NFL also facing lawsuits over concussions. Punishment in college football this season for "targeting" -- taking aim, especially at the head or neck, with apparent intent beyond a legal tackle or block -- will include ejection. The NFL is requiring players to wear more pads and will penalize running backs who lead with the crown of their helmets.

Lee Hanson, founder of the firm making the Guardian Cap, says his product reduces head impacts "up to 33%" in lab tests. He gave out the caps for testing in 2011, sold about 8,000 in 2012 ($55 individually with team discounts) and anticipated about 12,000 being used among youth, high school and college teams across the USA and Canada this year. Thirty-five states have schools and/or leagues using at least 20 Guardian Caps.

The Guardian Caps have compartments padded with foam rubber that are arranged on top of the helmets, and Hanson says using these compartments dissipates energy better than a solid shell. One issue is whether soft shells might stick together or be more easily grabbed and cause neck injuries. Hanson says his caps "just slip off of each other."

"Our goal," Hanson says, "is to provide the best protection to a kid as possible. ... If you want to protect your shoulders, you wear shoulder pads. And if you want to protect your head, you put more padding. More padding on anything is better."

Build a concussion-proof football helmet and the world will beat a path to your door. Shy of that wishful goal, there's a surge in the business of trying to protect the brain.

*A Pennsylvania firm offers extra head padding that includes bullet-proof vest material.

*Riddell, official helmet of the NFL and a co-defendant in the concussion lawsuits, is introducing this season a sensor system in the helmet that transmits when impacts exceed a player's history on hits, geared for youth and high school teams.

*Reebok has a new impact sensor that flashes when impacts exceed certain thresholds.

So why does the Colorado High School Activities Association warn that any school using the Guardian Caps in games will not be in compliance with the National Operating Committee on Standards for Athletic Equipment (NOCSAE), which sets helmet certification, and cautions groups to "seek more information" before using caps at any time.

Indeed, Hanson says he has lost an order for 500 caps from a California youth league and other orders from various U.S. school districts, and at least one league is returning its 300 in use.

"There are coaches and athletic trainers and parents that have seen Guardian on their children for the last two years, and they've seen the number of injuries decrease on those teams," says Hanson. "Now, you're going to tell them to take them off?"

Standards in question

Makers of sensors don't claim they diagnose concussions; the sensors are promoted as screening tools. Makers of extra padding don't claim to prevent concussions, but they say they the padding reduces impacts.

NOCSAE recently stated that add-ons to helmets could void certification and warned It warns against "quick solutions." It says the primary focus should be limiting "unnecessary" hits and medical handling of concussions.

"Equipment changes are probably fourth or fifth on the list of things that are going to make the biggest difference. Maybe even further down," says Mike Oliver, NOCSAE executive director.

NOCSAE sets test standards, which involve using sensors to measure impacts on dummy heads inside helmets. Helmet makers do the tests -- Oliver says each model needs its own testing and that changes mandate new certification.

"If you talk to any doctor out there, you're going to get 14 different opinions on what causes a concussion," Hanson says. "We don't know if it's a big hit or if it's a whole bunch of little hits. ... We can prove scientifically (Guardian Caps) reduce that amount of impact."

But Oliver says the caps are in "a little bit of a gray area" according to NOCSAE's position that a helmet addition that "changes or alters the protective system by adding or deleting protective padding … or which changes or alters the geometry of the shell or adds mass to the helmet, whether temporary or permanent, voids the certification of compliance."

Nonsense, says Haggard: "The way that thing was written, anything you put on there, whether it be a face shield or anything like that, falls under that category."

Last year, Unequal Technologies of Kennett Square, Pa., introduced helmet padding "fortified with Kevlar." The padding, with a sticky surface, fitted over existing pads. Unequal still has that product. But this year it also has padding designed to be fit inside the helmet but not affixed, the Gyro (at $79.95). There is also a padded skull cap, the Dome ($89.95).

Robert Vito, president of Unequal, says Philadelphia Eagles quarterback Michael Vick will use the skull cap, that roughly 100 NFL players use Unequal head padding and about 10,000 players at all levels use it. Vito has issues with NOCSAE.

"To blindly say that anything that goes in, on or around the helmet will now void the certification needs to be recanted," says Vito, who urges NOCSAE to make sure "we're not leaving a lot of great products on the sideline."

Haggard says linemen at South Carolina with the Guardian Caps in the spring had no concussions.

"They could tell the difference in the perceived impact," he says. "I actually had some of our linebackers and some of our fullbacks come to me and say, 'Hey, I want to try this out, too.' "

At the June annual meeting of the National Athletic Trainers' Association, University of North Carolina concussion researcher Kevin Guskiewicz told attendees said there is no such thing as a concussion-proof helmet. He said while Helmets prevent fractured skulls, he said, but the brain is still "sloshing around" after a hit.

"So those neurons are still being stretched," Guskiewicz said, "86 billion neurons that we have in the human brain. ... There are no studies ... to show that in fact these devices (extra helmet padding) reduce concussion."

Sensors to monitor hits

Hits happen. Assorted devices are designed to sense them and measure them.

Riddell's InSite Impact Response System includes a sensor pad in the liner of the helmet that transmits when certain impact levels are exceeded to a handheld "alert monitor" on the sideline. Software stores data on player histories of exposures to hits. It's priced at $150 per helmet (if you already have a helmet) and the monitor is free with 12 helmet units ($200 if bought separately). The product is an offshoot of Riddell systems used by college teams and researchers.

X2 Biosystems of Seattle has the X-Patch, a small, sensor-equipped patch to be worn behind the neck. It transmits hits data to a mobile device. Now used by college athletes in research, it will be sold commercially in 2014, says company co-founder Rich Able.

"Our tools are not going to make a diagnosis," he said. "Our tools are just giving data to the people who are highly knowledgeable about head injuries."

Reebok's new CheckLight ($150) has an impact sensor in a skull cap. An LED light on the rear is designed to flash yellow or red (more severe) when impacts meet hit certain thresholds. It does not transmit data but displays how many hits occur in practice or a game.

"It's just an extra set of eyes ... to just pull the athlete off the field as soon as possible after a light is triggered to assess the athlete," says Bob Rich, Reebok director of advanced concepts.

Chris Nowinski, co-founder of Boston's Sports Legacy Institute, advocates a "Hit Count" to keep head impacts, especially in youths, at a minimum: "Simply trying to get fewer yellows and reds (with CheckLight) is important."

Patrick Kersey, medical director of the USA Football national youth organization, says sensors are promising but not yet of proven value.

"A lot of the newer products we have out there are very exciting," he says. "The problem we have in the medical world is that we don't have validation that states if they are actually helpful tools -- or are they neat and flashy tools?"