Isn’t Prevention One of Our Domains?

Football season is in full swing.  Fall is my favorite season, mostly because of the cooler temperatures and the ample amounts of college and pro football games to watch every weekend.  There is also nothing better than Friday night lights in a small town.  The place is electric, the whole town comes out for the game, and the kids play their hearts out every single down.

This is Nebraska’s first year of having LB260 in effect and also a football rule change that calls for a player to come off the field if their helmet comes off during play.  Because I cover small town football, I can tell you having a player come out for a series can really impact a game.  In an effort to take a proactive approach I discussed mouthpiece usage and helmets being aired up adequately with our coaches.   They were on board.

Keeping a focus on airing up helmets frequently and encouraging the use of good mouthpieces, or at least replacing any chewed and flat boil and bite style mouthpieces, was something I had implemented at the high school I was working at full-time before my current position1.  I’m not oblivious to the fact that there isn’t a lot of research to support mouthpiece use as a prevention tool for concussion.  But, I can tell you anecdotally it made a difference.  I can also tell you anecdotally that ten years ago, kids weren’t able to slide their helmets on and off so easily like they do now. 

At the same time another Athletic Trainer, who had started doing this a year prior to me and gave me the idea that it was working for her, was doing the same thing and getting the same results.

It floors me that we hear so much about concussion identification and management, but hear almost nothing about prevention.  Prevention is what a good majority of our job entails and one of our key domains of practice.  Keeping kids hydrated during hot practices, taping ankles to prevent injury and skin checks to prevent the spread of skin diseases.  Every time I see a kid with a boil and bite mouthpiece that is chewed down flat, I wonder why prevention isn’t just as much front and center for concussions.

I’m hopeful the researchers out there will pick up on this and start to look at prevention as a piece of the puzzle.  Maybe my mouthpiece theory has forty holes in it, but until then does it hurt a kid to have a decent mouthpiece and his helmet aired up once a week?  Absolutely not!

1 – I always recommended BrainPad mouthpieces which can be found at

Written By: Danielle Kleber, ATC

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