Athletic Training and Sports Health Care

Original Research 

The Effect of Football Helmet Facemask Styles on Perceived Player Behavior: A Pilot Study

Erik E. Swartz, PhD, ATC, FNATA; Johna K. Register-Mihalik, PhD, LAT, ATC; Ashley Bartlett, ATC; Kevin Guskiewicz, PhD, ATC, FNATA

Abstract

Purpose:

To examine perceived playing behaviors and attitudes in American football players concerning a novel, overbuilt-style football helmet facemask.

Methods:

Thirty-four collegiate-aged current or former football players reported to a one-on-one session to complete an 11-item survey to gauge what effects there might be on their attitudes or behaviors during football.

Results:

Fifty percent of current or former football players agreed they would be more intimidated by an opposing player wearing an overbuilt facemask and 53% felt they would be more intimidating to opposing players. Nearly 40% reported that they would feel safer wearing the overbuilt facemask, despite no evidence that it affords enhanced protection.

Conclusions:

The preliminary data suggest player perceptions of overbuilt facemasks may negatively influence playing behavior.

[Athletic Training & Sports Health Care. 2019;11(6):273–279.]

Abstract

Purpose:

To examine perceived playing behaviors and attitudes in American football players concerning a novel, overbuilt-style football helmet facemask.

Methods:

Thirty-four collegiate-aged current or former football players reported to a one-on-one session to complete an 11-item survey to gauge what effects there might be on their attitudes or behaviors during football.

Results:

Fifty percent of current or former football players agreed they would be more intimidated by an opposing player wearing an overbuilt facemask and 53% felt they would be more intimidating to opposing players. Nearly 40% reported that they would feel safer wearing the overbuilt facemask, despite no evidence that it affords enhanced protection.

Conclusions:

The preliminary data suggest player perceptions of overbuilt facemasks may negatively influence playing behavior.

[Athletic Training & Sports Health Care. 2019;11(6):273–279.]

Risk compensation theory describes the homeostatic mechanism an individual experiences in response to risk.1 According to Wilde1 and Hedlund,2 an individual calculates his or her level of perceived risk in a given situation by weighing the benefits and consequences of careful behavior versus risky behavior. The theory posits that if the perceived risk surpasses his or her threshold, the individual will act more carefully. Conversely, if the perceived risk falls below that threshold, the individual will take more risks. For example, earlier studies involving automobile accidents suggested that the implementation of safety measures such as anti-lock braking systems2 and seatbelts3 made individuals feel a greater sense of protection while driving, therefore decreasing the perception of risk. Individuals then drove more carelessly, subsequently increasing the rate of injury. Risk compensation theory has also been explored with injury patterns in sport and recreational activities. For example, whereas cyclists wearing helmets were reported to be more compliant with traffic laws,4 Adams and Hillman5 argued that use of helmets increased risk-taking behavior. Similar research has studied the use of helmets in skiing and snowboarding.6

All sports present some level of risk for injury; those with higher levels of contact, such as American football, carry a higher risk of serious and catastrophic injury.7 In these high-contact sports, protective equipment, such as padding and helmets, are often mandated in an attempt to minimize injury incidence and severity. Undeniably, this protective equipment plays an important role in mitigating injury. Paradoxically, however, some have reported8 that the protective athletic equipment (ie, the helmet) also decreases one's perceived level of risk, negatively influencing an athlete's behavior in his or her sport. For example, in a recent study of collegiate-aged rugby players, a sport that involves frequent tackling, players' misperceptions about protective headgear's capability to prevent concussion was felt to increase aggressive behaviors during play.9

More specifically, risk compensation in football elucidates that, although football helmets are designed to protect the player from traumatic head injury, they actually enable participants to initiate and sustain head impacts because of the protection the helmet affords. This explains the new behavior of “spear-tackling” that developed in the 1950s as helmets began integrating a hard outer shell and more comfortable interior padding.10 This behavior brought an associated dramatic rise in catastrophic head and neck injuries and fatalities.11 Catastrophic injuries and fatalities did not decrease until after 1976 when spear-tackling was banned.10 Despite rule changes and penalties to address initiating contact in football with the head, current in vivo data collected during non-contact, or “shells,” practices in collegiate and high school football players further illustrate risk compensation as players experience head impact accelerations that are higher than those they experience in games.12 In these non-contact practices, players continue to make head-to-head contact with teammates during drills, perhaps because their head is the only body part that is protected.

Initiating contact with the head in football continues to occur13 in parallel with continual enhancements to the football helmet, purportedly in an attempt to further prevent concussions.14 This is of concern not only because a football helmet is unable to completely prevent a concussion,15 but also because persistent improvements in a football helmet's materials (ie, comfort and weight) may only serve to proliferate the risk compensation phenomenon. Enhancements to the football helmet have included significant changes to the football helmet facemask. A specific style of facemask, referred to here as an overbuilt facemask, differs from a traditional facemask because it has an increased number of vertical, horizontal, or oblique bars (Figure 1).

An example of an overbuilt-style facemask on a football helmet.

Figure 1.

An example of an overbuilt-style facemask on a football helmet.

Historically, this is not the first time bars have been added to the facemask. In 1950, the facemask consisted of just one bar, with additional bars added over the years.14 The original purpose for this equipment's implementation was to aid in the reduction of nasal fractures and other facial injuries, two injuries commonly occurring in the game at that time.10 Similar to the helmet, the introduction of the facemask was thought to contribute to the unintended consequences of a rise in catastrophic injuries and fatalities. Players exhibited the behavior of using not only their helmet to tackle, but also their face-mask, due to the enhanced sense of protection from their complete, helmet–facemask combination.10

Given the history in American football related to the potential phenomenon of protective equipment for the head and risk compensation, it is plausible to believe that an athlete would feel an increased false sense of security when wearing a helmet with an overbuilt-style facemask. Therefore, the purpose of this study was to survey current and former football players to gauge how their behaviors might be influenced in response to wearing an overbuilt-style facemask. Secondarily, we explored whether there was any difference in these perceptions between former high school players and current collegiate players.

Methods

Thirty-four current National Collegiate Athletic Association (NCAA) Division I college football players and former high school football players (Table 1) recruited from a sample of convenience participated. Approval to conduct human subject research was obtained by the institutional review board at the host institution. The football player participants had never worn a helmet with an overbuilt facemask prior to the study.

Participant Demographics (N = 34)

Table 1:

Participant Demographics (N = 34)

A short, 11-item survey was created to determine football players' perceptions of overbuilt facemasks and how they perceived player behavior might be influenced when worn during participation in football. The first item, a single word response question, asked participants, “What are the first two words you would use to describe this facemask?” The second item included answering a “yes” or “no” question with an open-ended follow-up question, “Would you wear a helmet with this style facemask while playing football? Why or why not?” The remaining questions (Table 2) were answered using the Likert scale with scoring of 1 to 5, with 1 indicating strongly disagree and 5 indicating strongly agree.

Likert-Scaled Survey Questions

Table 2:

Likert-Scaled Survey Questions

Four content experts were given initial drafts of the survey to determine face and content validity. Using their feedback, revisions were made where appropriate. Following adjustments, the completed survey was given to three former high school football players to assess survey repeatability. These individuals completed the survey two separate times within a 48-hour period and were instructed not to refer to their original answers when completing the survey the second time. Results of this assessment (Table 3) demonstrated strong agreement between the first and second responses, indicating the instrument was reliable. Cronbach's alpha (0.617) suggested the survey questions were consistent measures of player perception.

Agreement Summary by Question for Athlete Overbuilt Facemask Perceptions (N = 3)

Table 3:

Agreement Summary by Question for Athlete Overbuilt Facemask Perceptions (N = 3)

Following informed consent, a non-identifiable participant number was assigned to each participant and demographic information (age, gender, height, mass, playing experience, position, and football level) was collected. Prior to starting the survey, the football player participants were instructed to observe and try on three helmets, two with different styles of an overbuilt facemask and one with a traditional facemask. Participants then completed the survey using a paper-and-pencil format with instructions to answer all survey questions comparing the overbuilt-style facemask to the traditional facemask. Following data collection, the non-identifiable survey results for each participant were entered into spreadsheet format for reduction and analysis.

Data Reduction

To measure the nine quantitative questions on the same scale, five of the questions (1, 2, 3, 4, and 7) were inversely scored. This was done to indicate that the higher the individual's agreement, the more positive his or her perception of the overbuilt-style facemask. Following this, both the minimum and maximum composite scores were generated for the nine quantitative questions. The minimum composite score was 9, calculated by multiplying the lowest a participant could answer on each question (1 = strongly disagree) by the total number of quantitative questions (9). The maximum composite score was 45, calculated by multiplying the highest number a participant could answer on each question (5 = strongly agree) by the total number of quantitative questions (9). The composite scores were used to measure the study participants' overall perception of the overbuilt-style football helmet facemasks. The greater the composite score, the more positive the perception, whereas the lower the composite score, the more negative the perception. A positive perception of the overbuilt-style football helmet facemask was not necessarily interpreted as a good thing. Rather, a more positive perception would be deemed more likely to drive negative playing behaviors.

Statistical Analysis

Using SPSS software (SPSS, Inc., Chicago, IL), descriptive statistics were calculated for all demographic information and qualitative questions. For open-ended questions 1 and 2, frequency tables were generated based on commonly used words or terms. For the quantitative (Likert-scaled) questions 3 to 11, frequency tables, means, and standard deviations were generated. Independent sample t tests were run for all individual responses and composite scores to compare the level of football (high school vs college) for overbuilt-style facemask perceptions.

Results

Each of the 34 participants completed one survey. Tables 45 provide the frequency and percentages for the words participants used to describe overbuilt facemasks. The most common word used to describe the overbuilt-style facemask, both as the first and second word, was “intimidating,” representing 35.2% (12 of 68) of all responses. Other words used related to “intimidating” included “beastly,” “badass,” “sick,” and “protective.” Twelve of the 34 participants responded that they would choose to wear this style of facemask for reasons that included, but were not limited to: “I would feel more protected when using this facemask” and “because it looks intimidating.”

Frequencies and Percentages for First Word (N = 34)

Table 4:

Frequencies and Percentages for First Word (N = 34)

Frequencies and Percentages for Second Word (N = 34)

Table 5:

Frequencies and Percentages for Second Word (N = 34)

Fifty percent of football players (17 of 34) agreed or strongly agreed that they would be more intimidated by an opposing player wearing an overbuilt facemask, and a similar percentage (52.9%) reported that they themselves would be more intimidating to opposing players while wearing an overbuilt facemask. Twenty football players (58.8%) either agreed or strongly agreed they would feel more protected wearing an overbuilt-style of facemask, and 13 players (38.2%) reported that wearing that style of mask would make them feel safer. Table 6 provides the frequency and percent responses for each of the remaining questions that were answered using the Likert scale.

Frequencies and Percentages (%) for Likert-Scaled Survey Questions

Table 6:

Frequencies and Percentages (%) for Likert-Scaled Survey Questions

The independent samples t test for all of the quantitative questions suggested no significant difference (P > .05) between participant survey responses and level of football. The composite score created from all quantitative questions to summarize the overall perception of the facemask was also not significantly different (P > .05) between high school (24.92 ± 3.62) and college (26.14 ± 2.95).

Discussion

The findings of our study suggest that former high school and current college football players' perceptions of overbuilt-style facemasks have the potential to influence their behavior. Indeed, almost 60% of players agreed with the statement: “I would feel more protected wearing this style of facemask”; almost 40% of players agreed with the statement: “Wearing this style of facemask would make me feel safer when I play”; and more than 50% of players felt they would be more intimidating during play while wearing an overbuilt facemask. These results may seem benign in and of themselves. However, when they are superimposed over the sense of protection players are already afforded by the helmet, an added sense of security through a change in facemask style is compounded. This could serve to further enhance the phenomenon of risk compensation in football players, increasing the risk of head or neck injury to the wearer or to an opponent through behaviors previously associated with such injury.10

The theory of risk compensation (risk homeostasis) served as the study framework because the potential consequences that could occur while wearing this style of face-mask may be similar to problems previously reported.10 With the addition of more bars to a football facemask, it was reasonable to believe that players could react in a similar manner, especially considering risk compensation's suspected role in the history of catastrophic injury rates in the game of football.7,10 As such, concern exists regarding whether these changes in facemask style, particularly in that they are constructed of additional material, negatively affect a player's behavior while participating in football. The term “behavior” in this context refers to intentional or unintentional changes in how a player might normally play (technique), whether overall or in certain situations (going into contact). Specifically, the concern is whether the more protective the facemask appears, the more likely players may be to initiate and sustain head-first contact while playing, placing themselves at increased risk for cervical spine and traumatic brain injuries. However, 50% of respondents disagreed when asked whether the overbuilt style facemask would make players more likely to lead with their head while blocking or tackling.

Findings also suggest players felt they would have a more intimidating presence on the field, a design element not necessarily valued or intended for protective equipment. It is difficult to quantify how, and to what extent, one's behavior or risk of injury might be influenced as a result of feeling more intimidating because this was not directly measured. It is logical to conclude that more material would provide additional protection. Prior research comparing half-shield to full-shield face guards in ice hockey found the full-shield to provide enhanced protection from concussion.16 Yet, there is limited empirical research available on injury incidence and severity related to football helmet facemasks from which to derive inferences. Indeed, epidemiological studies on the high school17 and collegiate18 level do not report on injury mechanisms involving opponents grabbing face-masks of other players. The incidence of facial injuries, which an overbuilt facemask may theoretically offer protection from, are often combined with head injuries,17 are extremely low,19 or are entirely absent. Finally, other concerns about these style of masks have been raised,20 such as whether the additional smaller spaces in the mask could entrap an opponent's digit(s) during play or whether the additional material in the facemask could negatively influence the performance capabilities of the helmet to mitigate force.

Noticeable trends among participant responses are apparent after reviewing the results of the survey. In regard to the first item question, three phrases were consistent: intimidation, protection, and safety (ie, “Yes, my face would feel safer and I would look like an animal on the field.”). Similarly, results from the three Likert-scaled questions aimed at measuring perceptions of intimidation, safety, and protection revealed that many, but not all, participants felt these facemasks provided such qualities. It is understandable why an individual may feel more protected or safer while wearing an overbuilt-style face-mask because more of the facial region is covered. However, when such perceptions are combined with the protection already provided by the helmet, there is a greater potential of lowering one's perceived level of risk, intentionally or unintentionally influencing playing behavior. These recurring themes from the results are not surprising. Previous studies regarding the evolution of football helmets and facemasks indicate that perceptions such as “increased protection” and “feeling more safe” have occurred before in response to alterations of protective equipment or safety measures contributing to an increase in injury risk, incidence, and severity.10,14

The results suggested no significant difference between high school and college player responses on the Likert-scaled questions. This is important because no matter how many years an individual had been playing football, or what his or her skill level was, players/former players had similar perceptions of these facemasks. It is important to note that overbuilt-style facemasks have been banned from the National Football League, NCAA, and Football Canada and the Canadian Football League. However, these facemasks are still permitted at high school and youth levels in the United States, although their prevalence is unknown. Therefore, future research should study the youth football population level to determine whether their perceptions compare to those in this study and how these perceptions may translate into actual playing behaviors. Until then, coaches, players, and parents should be educated on the potential implications of the overbuilt-style facemask. This is especially crucial at a young age because how an individual initially learns to how to play football has the greatest potential to influence them throughout his or her career. If a young player adopts improper behaviors or techniques from using overbuilt facemasks, he or she may be more likely to continue these behaviors as he or she progresses in the sport, possibly increasing the risk for injury.

There are limitations inherent to this study. Most important, we did not directly measure player behaviors while actually participating in football activity. Because participants had never worn an overbuilt-style facemask prior to this study, their responses were based on how they assumed they would behave while participating in football. If actually playing, perceptions and behaviors may differ from what they were at the time of completing the survey. Also, our sample size was small, and because only former high school and current college athletes were surveyed these results cannot be generalized to other football population levels. Finally, although our open-ended question raised valuable insights into players' perceptions, this was not a true qualitative study design and we are limited in our ability to identify any themes that are representative of the population.

Implications for Clinical Practice

As previously mentioned, to our knowledge there are no epidemiological data available in regard to injuries using overbuilt-style facemasks. However, findings from this study suggest perceptions of these facemasks could have a negative influence on one's behavior and cause a change in playing behavior toward more risky actions. For a sport that already has a higher degree of risk of serious injury, there should be careful consideration for any factors that could enhance this risk. Therefore, because there are no data to suggest that an overbuilt-style facemask offers superior protection to that offered by a traditional facemask, and to avert an additional increase of risk compensation in football, overbuilt-style football helmet facemasks are not recommended for use in the sport at this time. Future research is encouraged in this area to provide additional findings to consider.

References

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Participant Demographics (N = 34)

ParameterValue
Mean age (y)21.21 ± 1.34
Mean height (cm)179.95 ± 7.28
Mean mass (kg)92.07 ± 19.08
Mean years of football experience8.46 ± 3.58
Gender (M/F)33/1
Football level
  High school13
  College/former college21
Position
  Offense12
  Defense11
  Both11

Likert-Scaled Survey Questions

No.Question
3.I would be more intimidated by an opposing player wearing this style facemask.
4.I would be more cautious to avoid incidental hand contact to the face of an opposing player wearing this style facemask.
5.I would be more likely to get my finger caught in this style facemask worn by an opposing player.
6.I would be more intimidating to other players while wearing this style facemask.
7.I would feel more protected while wearing this style facemask.
8.I would feel able to hit an opponent harder when wearing this style facemask.
9.I would be more likely to lead with my head while tackling or blocking when wearing this style facemask.
10.Wearing this style facemask would make me feel like a better football player.
11.Wearing this style facemask would make me feel safer when I play.

Agreement Summary by Question for Athlete Overbuilt Facemask Perceptions (N = 3)

No.100% Agreement T1 to T2Within 1 Point of T1 to T2Within 2 Points of T1 to T2Within 3 Points of T1 to T2
13 of 3NANANA
21 of 31 of 3NA1 of 3
32 of 31 of 3NANA
41 of 32 of 3NANA
53 of 3NANANA
62 of 31 of 3NANA
72 of 3NA1 of 3NA
83 of 3NANANA
91 of 32 of 3NANA

Frequencies and Percentages for First Word (N = 34)

WordFrequency (%)
Intimidating6 (17.6)
A lot of bars1 (2.9)
Badass1 (2.9)
Big1 (2.9)
Bulky2 (5.9)
Clunky1 (2.9)
Cool3 (8.8)
Crazy2 (5.9)
Creative1 (2.9)
Different1 (2.9)
Excessive1 (2.9)
Gate-like1 (2.9)
Heavy1 (2.9)
Intense1 (2.9)
Large3 (8.8)
Overbearing1 (2.9)
Safe1 (2.9)
Solid1 (2.9)
Sturdy1 (2.9)
Thick1 (2.9)
Too much2 (5.9)
Tough1(2.9)

Frequencies and Percentages for Second Word (N = 34)

WordFrequency (%)
Intimidating6 (17.6)
Beastly1 (2.9)
Bulky1 (2.9)
Cage-like1 (2.9)
Cool1 (2.9)
Fence1 (2.9)
Fullback1 (2.9)
Heavy2 (5.9)
Intense1 (2.9)
Little1 (2.9)
Modern1 (2.9)
Nice1 (2.9)
Over-built1 (2.9)
Overprotected1 (2.9)
Powerful1 (2.9)
Protective1 (2.9)
Safe1 (2.9)
Shiny1 (2.9)
Sick2 (5.9)
Small gaps1 (2.9)
Strong1 (2.9)
Style1 (2.9)
Too much1 (2.9)

Frequencies and Percentages (%) for Likert-Scaled Survey Questions

QuestionStrongly Disagree (1)Disagree (2)Neutral (3)Agree (4)Strongly Agree (5)Median
3. I would be more intimidated by an opposing player wearing this style facemask.4 (11.8)5 (14.7)8 (23.5)14 (41.2)3 (8.8)3.5
4. I would be more cautious to avoid incidental hand contact to the face of an opposing player wearing this style facemask.5 (14.7)15 (44.1)6 (17.6)7 (20.6)1 (2.9)2
5. I would be more likely to get my finger caught in this style facemask worn by an opposing player.2 (5.9)8 (23.5)8 (23.5)12 (35.3)4 (11.8)3
6. I would be more intimidating to other players while wearing this style facemask.1 (2.9)4 (11.8)11 (32.4)15 (44.1)3 (8.8)4
7. I would feel more protected while wearing this style facemask.0 (0)7 (20.6)7 (20.6)14 (41.2)6 (17.6)4
8. I would feel able to hit an opponent harder when wearing this style facemask.9 (26.5)10 (29.4)13 (38.2)2 (5.9)0 (0)2
9. I would be more likely to lead with my head while tackling or blocking when wearing this style facemask.11 (32.4)11 (32.4)6 (17.6)6 (17.6)0 (0)2
10. Wearing this style facemask would make me feel like a better football player.21 (61.8)7 (20.6)5 (14.71 (2.9)0 (0)1
11. Wearing this style facemask would make me feel safer when I play.5 (14.7)7 (20.6)9 (26.5)12 (35.3)1 (2.9)3
Authors

From the Department of Physical Therapy and Kinesiology, University of Massachusetts Lowell, Lowell, Massachusetts (EES); the Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (JR-M, KG); and the Department of Athletics, Becker College, Worcester, Massachusetts (AB).

The authors have no financial or proprietary interest in the materials presented herein.

Supported by the National Football League. Inc. (New York, NY).

Correspondence: Erik E. Swartz, PhD, ATC, FNATA, Department of Physical Therapy and Kinesiology, University of Massachusetts Lowell, 3 Solomont Way, Lowell, MA 01854. E-mail: Erik_Swartz@uml.edu

Received: April 11, 2018
Accepted: October 29, 2018
Posted Online: February 26, 2019

10.3928/19425864-20190131-01

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