TACKLING SAFETY: FOOTBALL, CTE, AND WHAT ACTUALLY MAKES THE GAME SAFER

We are now in the middle of another football season, and the question, as asked every year: Is this sport safe enough for our high school, college, and professional athletes to play?


Football has always been a violent sport of collision, glory, and growing concern. Over the last decade, research tying repetitive head impacts to chronic traumatic encephalopathy (CTE) has shaken parents, players, and the game’s governing bodies. The central realities are straightforward but sobering: repeated head impacts — both diagnosed concussions and the many “sub-concussive” blows players take — are linked to later-life brain pathology; helmets and add-ons can lower impact forces, but no helmet or cover has been shown to prevent CTE; and rule and culture changes that reduce the number and severity of head impacts are where the biggest gains lie.

A normal brain (left) and one with advanced CTE (right)

Source: Wikipedia

Do the new “Guardian” helmet products reduce CTE risk?


Short answer: Not proven.


Guardian Caps and similar soft-shell helmet covers have laboratory and some real-world evidence showing they reduce head impact kinematics (peak linear and rotational accelerations) in controlled tests — a plausible biomechanical benefit. A 2023 kinematics study found reduced peak linear and rotational accelerations with after-market soft-shell padding.


But that mechanical improvement doesn’t equal proof they lower concussions across all settings or that they reduce the long-term cumulative exposure that appears to drive CTE. University of Wisconsin researchers found no reduction in concussion rates among 2,610 high school players who used soft-shell covers in practice during the 2023 season. At the same time, NFL reports and internal analyses indicate big drops in practice concussions after mandated use of Guardian Caps in certain sessions and seasons. The pro-level data suggest utility in that specific context, while high school evidence is mixed — likely because player size, play speed, exposure patterns, and how/when the caps are used all differ. Crucially: no peer-reviewed study has shown that Guardian Caps or any helmet upgrade prevents CTE.

Hassan Hall wearing a Guardian Cap in 2023

Source: Wikipedia

What the science says about risk

CTE is currently a post-mortem diagnosis; brain-bank studies from the Boston University CTE Center have found very high rates of CTE in samples of donated former NFL brains (e.g., 345 of 376 in one case series), and other work shows a dose-response: more years and more repetitive impacts mean higher odds of CTE and more severe disease. That dose-response is the key takeaway: reduce exposure and you reduce risk — even though we can’t yet say precisely by how much for any one intervention.

Members of the Los Angeles Rams wearing Guardian Caps during their 2023 training camp. Two years prior, team became an early adopter of the equipment.
Source: Wikipedia

Rules, culture, and policy changes that would make football safer


Technology helps, but it’s policy and practice that move the needle most:

  1. Limit full-speed contact in practice. Evidence repeatedly shows the majority of head impacts happen in practice. Rules and caps on live-contact reps — enforced and audited — lower exposure. (Example: many youth and college programs that limit contact report fewer concussions.)
  2. Aggressively enforce and expand targeting/helmet-to-helmet penalties. Studies show targeting rules reduced helmet-to-helmet concussions at the high school level. Better officiating, consistent discipline, and education of coaches/players about tackling technique are essential.
  3. Continue kickoff and special-teams reforms. Rules that reduce high-speed collisions on kickoffs have produced measurable concussion declines at the college and pro levels; similar protections at lower levels would likely help.
  4. Age and exposure restrictions for youth football. Given the dose-response risk, many researchers recommend delaying tackle football until the mid-teens and/or promoting flag alternatives for younger children. Reducing total years of exposure is a straightforward, high-impact idea.
  5. Standardize helmets and fit, and require high-performing models. Make objective helmet performance (STAR or similar ratings) part of procurement decisions; ensure every player has a properly fitted, certified helmet. Helmets reduce impact severity but are not magic bullets.
  6. Limit cumulative load with player monitoring. Track individual exposure (number of hits, high-g impacts) using sensors and use that data to limit high-risk players’ contact days and to guide return-to-play decisions.
  7. Better medical protocols and independent oversight. Mandated independent neurologic evaluation for suspected concussions, strict RTP protocols, and removal-from-play rules enforced by non-team medical staff reduce pressure to return early and reduce repeat injury risk.
  8. Culture change — reward safe play. Coaching incentives, rule enforcement, and public messaging should prioritize technique, smart tackling, and protecting defenseless players rather than glorifying helmet-first collisions.

An example of a helmet-to-helmet collision, a common cause for concussions
Source: Wikipedia

Practical bottom line for parents, players, and administrators

  • Helmets and caps may reduce impact forces and in some pro settings appear to reduce practice concussions, but no piece of equipment has been proven to prevent CTE. Treat equipment as one layer of risk reduction, not as a cure.
  • The strongest levers are rule changes and exposure reduction — fewer full-speed hits, safer kickoff rules, strict targeting enforcement, delaying tackle for young children, and better medical oversight. Those policy moves lower both concussions today and the cumulative load that appears to drive CTE.

Football can be made substantially safer — but it requires honest tradeoffs. If we value the long-term brain health of high school and college athletes as much as we value the spectacle at the highest level, we’ll invest in rules, coaching, enforcement, and youth alternatives as first priorities — with equipment improvements as important but secondary protections.

CHAOS AT THE CDC: A THREAT TO AMERICA’S HEALTHCARE SYSTEM

By Dr. Gerald Goldhaber • September 10, 2025
The Centers for Disease Control and Prevention (CDC) has long been viewed as the nation’s front-line defense against disease outbreaks, health emergencies, and public health threats. But today, the agency faces internal turmoil, political interference, and organizational confusion that experts warn could have dangerous consequences for the U.S. healthcare system—and for ordinary Americans.

TEXAS HILL COUNTRY FLOODS: DID WARNINGS FAIL VICTIMS?

By Dr. Gerald Goldhaber • August 7, 2025
From July 3–4, 2025, Central Texas—especially Kerr County and the Guadalupe River basin—experienced catastrophic flash flooding that claimed over 130 lives, including children and staff at Camp Mystic. As grief and outrage settle, survivors and officials alike are questioning whether enough was done to warn those most at risk.

TEXAS LEADS THE NATION: WARNING LABELS ON ADDITIVES

By Dr. Gerald Goldhaber • July 9, 2025
On June 22, 2025, Governor Greg Abbott signed Senate Bill 25 (SB25), known as the Make Texas Healthy Again Act. Beginning January 1, 2027, Texas will require prominent on-pack warning labels whenever food sold in the state contains any of 44 specific additives—including synthetic colorants like Red 40, Yellow 5, Blue 1, titanium dioxide, bleached flour, and partially hydrogenated oils. The mandated label must declare the following:

WARNING: FDA DELAYS IMPLEMENTATION OF RULE THAT WOULD REQUIRE NEW NUTRITION LABELING

By Dr. Gerald Goldhaber • May 27, 2025
The FDA is delaying implementation of a rule that would require food companies to print nutritional information on the front labels of their products. The proposed rule was developed by President Biden’s Administration, with a comment period scheduled to close on May 16. The rule is designed to help consumers make better choices to avoid chronic health problems. Such problems—and consumer choices about nutrition—are things President Trump’s Secretary of Health and Human Services, Robert F. Kennedy Jr., has repeatedly touted. Even though hundreds of comments have been filed about the proposed rule, Kennedy’s Food and Drug Administration is delaying the close of the comment period by 60 days. Most of the comments filed so far have come from food companies and food industry trade organizations. “ A 60-day comment period extension allows adequate time for interested parties to submit comments while also not significantly delaying rulemaking on the important issues in the proposed rule ,” according to the FDA’s announcement about the delay. 

WARNING: THE GENDER BIAS IN CAR SAFETY TESTING PRESENTS AN ONGOING DANGER

By Dr. Gerald Goldhaber • April 30, 2025
Car accidents are a leading cause of injury and death worldwide, yet the safety measures designed to protect occupants in these life-or-death situations have long ignored a critical reality: women are more likely to be severely injured or killed in crashes than men. This disparity isn't rooted in biology alone—it’s also a result of a troubling oversight in the automotive industry’s safety testing protocols. For decades, crash-test dummies, which serve as proxies for human passengers in simulated collisions, have been modeled after the average male physique, leaving women out of the equation entirely. The Alarming Data Gap The implications of this gender gap in safety testing are both staggering and infuriating. Women, on average, have different body compositions than men—they tend to be shorter, lighter, and have different muscle distributions and bone densities. These physiological differences mean that women’s bodies interact with car safety features—such as seat belts, airbags, and headrests—in distinct ways. When vehicles aren’t tested with dummies that accurately represent female anatomy, crucial data about how to better protect women in crashes is simply ignored. Studies have revealed the dire consequences of this exclusion. Research from the University of Virginia found that women are 47% more likely to sustain serious injuries in car accidents compared to men, even when accounting for variables like seatbelt usage and crash severity. Women are also significantly more likely to suffer whiplash injuries due to the positioning of headrests, which are often designed with men’s neck dimensions in mind. These statistics aren’t just numbers—they represent lives cut short, families broken, and untold suffering that could have been mitigated with equitable safety testing.

WARNING: ARE MUSK, KENNEDY, AND TRUMP IGNORING THE GRAVE CONSEQUENCES OF SLASHING PUBLIC HEALTH FUNDING?

By Dr. Gerald Goldhaber • April 14, 2025
Recent budget cuts at the Health and Safety Science Services (HSSS) have sent shockwaves through the scientific and public health communities, threatening the very infrastructure designed to protect us from disease outbreaks, food contamination, and medical crises. These cuts have affected food inspectors, vaccine scientists, Alzheimer’s researchers, and experts studying bird flu, among others—positions that are essential to ensuring public safety and advancing critical medical research. The consequences of these decisions will be dire, potentially reversing years of progress and exposing society to increased health risks.

WARNING: IS ELON MUSK'S DEPARTMENT OF GOVERNMENT EFFICIENCY JEOPARDIZING AIR SAFETY?

By Dr. Gerald Goldhaber • March 12, 2025
As Elon Musk's Department of Government Efficiency (DGE) pushes for sweeping reforms and cost-cutting across federal agencies, concerns are mounting over the impact on critical public safety roles. Among the most alarming areas affected is the Federal Aviation Administration (FAA), where staff reductions may threaten the lives of millions of air travelers. The DGE, established with a mandate to streamline government operations and reduce bureaucratic waste, has come under fire for its aggressive downsizing tactics. Critics warn that essential safety personnel, including air traffic controllers, are being cut under the guise of efficiency, leaving the nation's airspace dangerously understaffed.

WARNING: WILL TRUMP'S SURGEON GENERAL SUPPORT IMPROVED ALCOHOL WARNING LABELS?

By Dr. Gerald Goldhaber • February 11, 2025
Biden Administration former Surgeon General, Vivek Murthy, on his way out of office, issued a Surgeon General's Advisory calling for new warnings on alcoholic beverages related to the cancer risk from consuming alcoholic beverages. Given that most individuals are unaware of the connection that consumption of alcoholic beverages can increase the risk for at least seven types of cancer, Murthy said in his advisory: "Given the conclusive evidence on the cancer risk from alcohol consumption and the Office of the Surgeon General's responsibility to inform the American public of the best available scientific evidence, the Surgeon General recommends an update to the Surgeon General's warning label for alcohol-containing beverages to include a cancer risk warning."

WARNING: TRUMP'S RE-ELECTION MEANS A DEREGULATORY NIGHTMARE FOR CONSUMERS

By Dr. Gerald Goldhaber • December 2, 2024
In my best-selling book, Murder, Inc.: How Unregulated Industry Kills or Injures Thousands of Americans Every Year...And What You Can Do About It , I propose a safety triad consisting of three components: manufacturers, regulators and consumers. All three must function properly in order to keep us safe. Manufacturers must produce and market safe (or safe as possible) products and warn us about any potential hazards so that we can make informed choices about whether or not to purchase their product and/or how to use it safely. Regulators , by imposing and implementing necessary rules and regulations, should hold manufacturers accountable for the above stated actions and to endure that they engage in "principled disclosure" by warning us about any potential hazards and dangers associated with their products. And, finally, Consumers , especially in the absence of well-meaning manufacturers or competent, well-intentioned regulators, must be highly diligent by researching products and learning about potential hazards prior to buying and/or using them. All three, manufacturers, regulators and consumers, must perform their jobs or the safety triad may fail to protect us and our loved ones. Think of a three-legged stool that distributes the weight of a person sitting on the stool, equally among the three legs. But what would happen if we leaned heavily to one side of the stool, essentially spreading the weight that was once borne by three legs to the two legs remaining braced to the floor. Unfortunately the third leg is no longer contributing to the stability of the stool, which may actually collapse because the two remaining legs may not be able to handle the amount of weight that was intended to be equally distributed among all three legs. 

WARNING: FDA RECOMMENDS REMOVING POPULAR DECONGESTANT FROM MARKET

By Dr. Gerald Goldhaber • November 15, 2024
If you or anyone in your family has used, uses or plans to use such over the counter (OTC) remedies for the flu or common cold as Theraflu, Robitussin, NyQuil, DayQuil, Mucinex, Sudafed or even some versions of Tylenol or Advil, you may want to read this newsletter very carefully.
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