Monday, November 19, 2007

Headgear or mouthpieces

You may have read my previous post, Does headgear protect your noggin?, where I opine that headgear does little, if Mouthguard anything to prevent concussions. In fact, I believe that most headgear, by limiting peripheral vision, causes more damage to the wearer because he absorbs more shots. Part of my old sparring strategy, when I did more kickboxing and open-tournament-style sparring, was to cause an opponent to turn or cover up, then come around the blind side. I still do that, to a certain extent, but don't rely on the headgear (but still turn my opponent with checks and traps). Another subject worth mentioning is that of wearing a mouthpiece (or mouthguard).

Bob Patterson posted Head shots and tradition (read it!), which actually reminded me to do the follow-up to my original headgear post, but this time, on mouthpieces. I believe that mouthpieces actually do the most to protect your brain from concussion and your jaw from permanent damage than anything else. According to this ESPN article, though, at this point, it's just a theory.

In 1963, a team of dentists outfitted Notre Dame with custom-made pieces and reported a dramatic decrease in concussions. Today, the NCAA mandates mouthguards for all its football players. The American Dental Association and the American Academy of Pediatrics recommend them for high school players, too, in part because they "may reduce the severity and incidence of concussions." Last season, more than 2,000 football players in the Philadelphia school system wore "Brain-Pads," mouthpieces that are not custom-fitted but are designed to be clenched between the upper and lower teeth.

No biomechanical studies support the commonsense theory that keeping the jaw and skull separated helps reduce shock to the brain. For example, nobody has yet conducted controlled experiments to measure the difference in the force absorbed by skulls fitted with mouthguards and by those that are not. "The jury is still out, although, anecdotally, many people have said it makes a difference to have that shock absorption," says Kevin Guskiewicz, director of the Sports Medicine Research Laboratory at the University of North Carolina at Chapel Hill.

I think it's important to note that there may be plenty of research on this, and I haven't had the time to go to a university library and do real research. I keep seeing things like, "A properly fitted mouthpiece can reduce the risk of getting a head injury up to 50% in contact sports," but I don't see a lot of corroborating data.

My take is based only on my experience. It's what I advise - no, require - from my students.

  1. The jaw is the fulcrum of the brain, and is the target most susceptible to generating a true knockout, AKA concussion. Protect it with a mouthpiece, and make it a good one!
  2. Not wearing a mouthpiece/mouthguard means that you are preparing to lose teeth (expensive!), and to accept injury that may recur the rest of your life. I took a beautifully thrown spinning hook to the side of the jaw. Due to that, I still have a click every couple of days, and have to go through a painful and odd looking jaw adjustment. Don't let this happen to you!
  3. As Ross Enamait mentions, wearing a mouthguard for training and fighting also helps regulate your breathing and increases endurance. I have always advocated training in a mouthguard for running, sparring, and even calisthenics. ALWAYS wear it when doing medium or heavy contact!

To summarize: don't be stupid, spend the $20-$30, get a good mouthpiece, and wear it!


Bob Patterson said...

I totally agree on the mouthpiece: You should learn to spar with it because it reduces air intake. I forget the brand name of mine (brain pad? brain pan? some damn thing...?) but it has a bigger opening for greater air intake. It might have cost $10 more but I can tell it makes a big difference on my air intake!

Noah said...

Headgear helps to a degree with shock absorption but you are correct about eating more shots with it on--I think most of the value in headgear comes from preventing superficial damage like black eyes, cuts and cauliflower ear. Mouthguards, on the other hand, are more valuable. I actually have gone through about 3 of the cheaper ($10-$30 range) boil-and-bite mouthguards for various reasons and just recently forked over the money for a custom molded Gladiator brand one and I have to say that it's a lot more comfortable, I gag less and it feels just as effective so far but I haven't taken any hard kicks or punches to the face with it yet.

Nathan at TDA Training said...

Bob and Noah,

In my experience, it's a great idea to upgrade your mouthpiece like the critical gear that it is. An NFL player I trained had one that was custom-fitted by a dentist, and I realized at that time that I wasn't doing myself any favors with the cheap ones. It's much more likely to protect the brain, again, my opinion, than anything else.

I own, and have used Brainpad headgear, but have not tried the Gladiator, and appreciate the recommendation.

Noah said...

I used a BrainPad mouthguard for a while and had been able to get it to not gag me but it didn't feel all that effective at shock absorption. I considered the dentist-made ones but those are somewhere in the realm of $300-$450 and a Gladiator one that is made with the same basic process (they give you dental molding clay and trays, you mold your teeth and give it back, then they cast the mold and make the guard) but for $75 or so and then you have the casting so you get 50% off if you have to order a new one. I think Shock Doctor has a similar thing but theirs are more like $130 and I haven't tried them.

Nathan at TDA Training said...

Thanks again Noah! Great advice. I would add this to the bottom of the post, but some of the info may become dated. Appreciate it!