UCLA Sports Medicine takes proactive approach to injury prevention
By Andrew Moncada
Oct. 26, 2011 12:55 a.m.
In fall 1894, the Yale Bulldogs visited the Harvard Crimson for one of the most violent football games ever played. Dressed in simple uniforms, worn-down cleats and strips of leather around their heads, these Leather Lids (a euphemism for football players back in those days) gathered at the line of scrimmage for what would be known as the “Bloodbath in Hampden Park.”
While the Bulldogs came away with a 12-4 win, the game included a broken leg, a shattered collarbone on a botched fair catch, crushed noses, several head injuries and gouged eyes. Bulldog tackle Fred Murphy suffered so many late hits that he had to be carried out on a stretcher, falling into a coma that lasted several hours.
Collegiate football turned more brutal as it entered the 20th century, peaking in 1905 with a reported 137 serious injuries and 19 deaths.
Even President Theodore Roosevelt intervened by bringing together Ivy League representatives to identify ways to make the game less violent. Soon there were stiffer penalties, the creation of the neutral zone to give more space between opposing players, and the forward pass.
But now consider the modern football helmet.
Introduced by Illinois high school coach John Riddell in 1939, the helmet was seen as revolutionary to the game of football. Its plastic shell formed to the contours of the player’s head, the padding provided extra cushioning on hard collisions and the facemask, introduced in 1940, meant that the entire head was protected.
No one, it seemed, would have to suffer any life-threatening injuries.
The immediate impact was promising as head-related injuries began to decrease. But as safety evolved, so did the style of the game.
Fitted with more advanced equipment, players adopted almost an entirely different game: Instead of laboring down in the trenches, players shot around the field like torpedoes, launching themselves headfirst into the opponent. Since the introduction of the modern helmet, fatal head injuries have decreased but neck injuries have tripled, the rate of cervical spine damage has doubled and concussions have steadily increased.
The game was supposed to become safer, but it has actually gotten worse.
“People would like to say that helmets make the game safer and better. But we’re talking about a hard shell that can only do so much to reduce impact to the head,” said Dr. Gerald Finerman, the head team physician for UCLA Athletics.
Instead of using helmets to protect themselves from hits, players feel encouraged to hit even harder and engage in riskier behavior. This phenomenon is known as risk compensation.
It explains why automobile drivers tend to drive closer to a bicyclist wearing a helmet than one who is not, why condoms haven’t reduced the spread of sexually transmitted diseases, and why drivers with anti-lock brakes are prone to speeding.
But this theory can also apply across sports: A batter with elbow protection is more likely to crowd the plate, a hockey defenseman with bigger pads is more likely to dish out harder body checks and a NASCAR driver with all the latest vehicle upgrades will have a higher probability of crashing.
So what, then, can protect these athletes?
That’s a question the members of UCLA Sports Medicine have been trying to answer. With a staff of 14 trainers and 12 physicians, the sports medicine team looks to find a new way to keep the Bruin student-athletes on the field.
“You’ll see injury trends across the board in different sports,” said women’s basketball and rowing trainer Pamela Guglietti.
“Water polo athletes have a lot of upper extremity and hip injuries. With football you have hamstrings, groins and ankles. In soccer and basketball, a lot of lower body issues.”
But for years, the solution has been better equipment and rehabilitation. For example, a zero-gravity treadmill sits out on the floor of the Acosta Athletic Training Center to help reduce body pressure and allow student-athletes with foot problems to continue conditioning.
But this has created another problem similar to the one with helmets.
Instead of using the equipment to promote safety, the effect has been an increase in risky behavior. As Finerman notes, athletes now have greater capabilities and more protective gear than ever before, providing a false sense of security.
And now, unlike other universities, the sports medicine team at UCLA is attempting to move away from relying on sophisticated space gadgets and the culture of fixing athletes after the injury. The group wants to prevent injuries altogether.
“It is a big attempt,” said Dale Rudd, the director of sports medicine. “But we are embarking on trying to change a paradigm from treatment and rehabilitation to prevention.
“If we have an inkling that someone could get hurt, we’re going to do something about it.”
With an emphasis on prevention, athletic trainers incorporate new techniques and strategies to assess student-athletes. One of them is functional movement screening, a series of body-pattern tests that identify any improper movements.
By identifying poor form ““ whether it is a bad pitching release, weak leg kicks or an unusual arm movement ““ the sports medicine team can reduce athletes’ likelihood of injury while also making them more effective on the field.
Along with the orthopedic and family physicians, the team also includes a dentist and a sports psychologist.
“It’s a holistic approach,” Guglietti said. “We identify risk factors and help these athletes along. And it’s not just the day-to-day responsibilities of getting them back on the court, but also the bigger issues that can help them later after their career.”
With more than 30 years of experience in the field, Rudd believes that the increased knowledge of the body and kinesiology can enable trainers and doctors to better prepare athletes.
“We work with people who come in with certain dysfunctions that we now know lead to injuries,” Rudd said. “And we know we can correct and eliminate a lot of those problems.”
At a time when athletes are bigger, stronger and faster, and when 190-pound running backs routinely meet 250-pound linebackers charging through the gap, the question of injury isn’t a question of if, but when.
“I read a story recently about two high school kids who died from getting hit in the head,” Rudd said. “It’s terrible news, but can that be prevented?”
“Yes,” he said, without hesitation. “Don’t play football.”
