Yahoo Sports AM: The future of head injuries

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🚨 Headlines

⚽️ Mexico 2, USA 0: Mexico beat the USWNT for just the second time ever on Monday night at the Gold Cup, ending a run of 33 straight shutouts for the Americans in official CONCACAF matches, during which they outscored opponents 158-0.

🏀 New-look Clippers: The Clippers are rebranding for the 2024-25 season, and they're fully embracing the nautical history of their name with a new logo featuring a "Clipper" naval ship.

⛳️ Rory wins The Match: Rory McIlroy won the ninth edition of The Match, claiming 10 skins in the four-person competition. Lexi Thompson came in second with two skins.

🏀 History in Chapel Hill: RJ Davis scored 42 points in UNC's 75-71 win over Miami, the most ever scored at the Dean Smith Center, which opened in 1986.

🎓 UMass to MAC: UMass appears set to join the Mid-American Conference in 2025. The Minutemen currently compete in the Atlantic-10 for most sports, excluding football (independent) and men's hockey (Hockey East).

🏉 Feature story, Part I: Rugby, mouthguards and the future of head injuries

Last month, World Rugby became the first governing body in the world to mandate smart mouthguards in all elite competitions, a landmark decision that could change how head injuries are identified and treated across all contact sports.

How it works: The mouthguards measure the force of every impact to the head, enabling medical staff to instantly identify possible concussions and determine when players should be taken off the field for an evaluation.

• The technology was developed by Prevent Biometrics, a Cleveland Clinic spinoff, which has collected data on millions of head impacts across rugby, football, hockey, lacrosse and other contact sports in recent years.

• The mouthguards are currently being worn by all players at the 2024 Six Nations, the oldest rugby competition in the world.

• Four matches into the tournament, Scotland's George Turner triggered the sport's first ever tech-driven Head Injury Assessment.

Inside the assessment process: World Rugby has spent years using Prevent mouthguards to gather impact data, which has helped determine the threshold for a "large impact event" that warrants review.

• When Turner's mouthguard registered an impact above that threshold of 70 Gs (linear force) or 4,000 radians per second squared (rotational force), an alert was sent via Bluetooth to the sideline doctor's iPad app.

• Turner was then removed from the pitch to undergo an assessment. He was ultimately cleared to return to action, but the doctor still evaluated him again after the match, and again two days later, per World Rugby protocol.

Data beats eyeballs: In the past, matchday doctors relied on their own eyes and video replays to trigger Head Injury Assessments, which resulted in 15% of rugby concussions not being diagnosed until after the match.

• Now, they have data that unequivocally says, "this player needs to be checked out now." There's no risk of them missing something.

• "We want to know about these injuries when they happen," says World Rugby's chief medical officer Eanna Falvey, citing research that suggests that for every minute you play through a concussion, you add 7-8 days of recovery.

Trickle-down effect: While World Rugby's mouthguard mandate only covers elite competitions, Falvey believes the technology will eventually be used at all levels. "I see a future where you have a [youth] coach with an iPad who's able to monitor his players."

🏈 Feature story, Part II: Could the NFL be next?

America's most popular sports league has been using its own impact-monitoring mouthguards for several years during NFL and college games, but that data isn't being used to assess head injuries in real time, and there's been no talk of a mandate.

• "I think [smart mouthguards] should be mandated in the NFL," says Dr. Joseph Maroon, the longtime neurosurgeon for the Steelers and co-creator of ImPACT, a widely-adopted concussion test.

• "The NFL has long set the standard for concussion management, but I think in this instance, it's rugby [leading the way]," says Dr. Maroon, who serves on Prevent's advisory board.

An imperfect system: The NFL currently relies on spotters — certified athletic trainers positioned above the field with access to video replays — to identify possible concussions. Sometimes, they fail. "I see this as a major adjunct to 'The Eyes in the Sky,'" says Dr. Maroon. "Those trainers would know within seconds the G forces of every hit."

One major hurdle: 94% of elite rugby players already wore mouthguards before the World Rugby mandate. That number is much smaller in the NFL, where some players have turned the protective piece of equipment into a fashion statement.

🧠 Feature story, Part III: Understanding the long-term effects

In addition to identifying "large impact events," World Rugby is also using Prevent's technology to monitor subconcussive blows (hits below the concussion threshold), which means players must wear mouthguards during training sessions, too.

The goal: To better understand the cumulative effect of hits to the head, whether or not they result in concussions.

• "What we're trying to do is help people understand what it actually means to play rugby," says Falvey. "So how often they bang their head, how hard they bang their head — across a week, across a season, across a career."

• "I consider this mouthguard the first 'dosimetry badge' for contact sports," says Dr. Maroon, referencing the badge that X-Ray doctors wear to measure the amount of radiation they've been exposed to over time.

This information is crucial: The largest study to date of chronic traumatic encephalopathy (CTE) found that cumulative force to the head — not diagnosed concussions — is the best predictor of future brain disease.

• In other words, focusing on concussions misses the point of how harmful subconcussive hits can be as they start to add up over time.

• This is why football linemen, according to the study, are the most likely to develop CTE: They sustain fewer big hits than, say, wide receivers, but they experience more G forces of impact each season due to near-constant collisions in the trenches.

Mike Shogren, CEO of Prevent: "This leap that World Rugby has taken is a game-changer, and it's going to effect what everybody else does. Whether it's football, wrestling, hockey … people want to know the true exposure of the sport."

📊 Feature story, Part IV: The power of good data

Given the growing concern about head injuries, one might presume that Prevent's mouthguards — and World Rugby's mandate — will only add to the panic.

But Shogren doesn't see it that way: In fact, he believes the data will show that contact sports are much safer than we've been led to believe.

• Shogren says past methods to measure head impacts — like helmet sensors — were unreliable and "created a lot of confusion and fear."

• "All of the data you've ever seen about how dangerous football is, is about five times too many impacts," he told Sports Business Journal.

Reality check: Studies have shown a clear link between contact sports and brain disease; and thousands of retired athletes — from rugby to football to hockey — have filed lawsuits because their sports are more dangerous than they were led to believe.

• Shogren's underlying point, of course, is that we want the most accurate data possible so that the concussion/CTE narrative doesn't outpace the science.

• "Leagues are changing rules, parents are deciding whether to let their kids play … When you give them good data, good decisions are made," he says.

The bottom line: We've come a long way in regards to head injuries — from "shake it off" to "follow the protocol." Now, it seems we may be graduating to the next stage: "Trust the data."

📆 Feb. 27, 1955: The NBA's lowest scoring game

69 years ago today, the Celtics beat the Hawks, 62-57, in the NBA's lowest-scoring game of the shot clock era (1954-present), Jeff writes.

Fun fact: Eight of the 16 players who saw the court in this game made the Hall of Fame: five Celtics (Bob Cousy, Bill Sharman, Ed Macauley, Frank Ramsey, Don Barksdale) and three Hawks (Bob Pettit, Chuck Cooper, Alex Hannum).

More on this day:

• 🏀 1992: Prairie View completed its winless campaign, falling to 0-28 to set the D-I record for most losses* in a season.

• 🥇 1994: The Lillehammer Olympics came to a close, concluding the first Winter Games ever held in a different year than the Summer Games.

*Wild coincidence: Just last night, Mississippi Valley State finally won its first game of the season to avoid matching Prairie View's 0-28 mark. And who did the Delta Devils beat? Prairie View!

📺 Watchlist: The NBA's best

Tonight's TNT doubleheader features two teams riding long winning streaks to the top of their conference, Jeff writes.

• 76ers at Celtics (7:30pm ET): Boston (45-12) has won eight straight to extend its lead over the Cavs to 7.5 games.

• Rockets at Thunder (10pm, TNT): OKC (40-17) has won five straight to pull even with the Timberwolves.

More to watch:

• 🏀 NCAAM: Cincinnati at No. 1 Houston (7pm, ESPN2); No. 16 Kentucky at Mississippi State (7pm, ESPN)

• 🏒 NHL: Golden Knights at Maple Leafs (7pm, ESPN+)

• ⚾️ Spring training: Nationals at Astros (1pm, MLB); White Sox at Dodgers* (3pm, MLB.TV)

• 🏒 PWHL: Toronto at Minnesota (8pm, YouTube)

*Sho-Time: Shohei Ohtani makes his Dodgers debut today.

🏀 College hoops trivia

Houston is No. 1 in this week's AP men's poll, becoming the fifth team to hold the top spot this season.

• Question: Who are the other four?

• Hint: They're all in different conferences.

Answer at the bottom.

🏈 American ice football

Meet "American Ice Football," which despite the name is actually a German game show that has recently gone viral because, well, it's football on ice, Jeff writes.

Move aside, "Puppy Bowl": RTL Deutschland, which has exclusive rights to broadcast NFL games in football-mad Germany, produced the show that debuted ahead of this year's Super Bowl.

Watch the games on YouTube.

Trivia answer: UConn (Big East), Purdue (Big Ten), Kansas (Big 12), Arizona (Pac-12)

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