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In 2016, a US appeals court upheld a $1bn (£700m) settlement between the NFL and a group of retired players who had suffered brain damage as a result of concussions.
Since then, says NFL chief medical officer Dr Allen Sills, the organisation has instilled a “very aggressive programme to try and reduce those injuries”.
In fact, Sills says, the league was able to “reduce concussions by 29%” last year.
“That doesn’t mean we have solved the problem but we are moving in a positive direction,” he added.
With rugby, football and boxing under the spotlight around head injuries this year, Sills spoke to BBC Sport about what British sports can learn from the NFL about dealing with head traumas and concussion.
Prevention is better than treatment
Sills says a lot of research has taken place over the past five years to identify what is causing concussions, who is being injured and by what type of play.
“We have attacked that over a couple of different fronts,” he told BBC Sport.
“We’ve looked at rules and how that can be applied; we’ve seen some changes – for example the new kick-off rule, a rule about blindside blocks and the lowering of the head – rules that came directly out of our work around health and safety.
“We have also worked a lot on helmets – the design and the testing of helmets to improve their safety.
“Lastly, we’ve done a lot with education, specifically for coaches and players, showing them what techniques lead to injury and how alternative techniques may be safer.”
He says that league-wide effort has helped reduce the number of concussions being suffered.
“We still have work to do to continue to reduce avoidable head contact,” he added.
“In medicine, prevention is always better than trea
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