American Football has been rocked by stories about concussion and serious brain injuries for years.
Now the outcome of significant research is beginning to be seen on the field in NFL regular season games, with the introduction of so-called guardian caps, which go over the helmet and offer more protection to the head from big hits.
But so far the uptake of guardian caps in the regular season has been limited, with players struggling to get used to the idea and others feeling they take away their competitive edge.
Use of the caps has been made compulsory for certain positions during training in a bid to reduce head injuries. It is optional for games. Whether more players begin to use the device in games remains to be seen, as future health concerns collide with the macho world of American Football.
Former Germany player Roman Motzkus, now a leading NFL pundit on DAZN and NFL Gamepass, believes the use of guardian caps is little more than a token gesture.
"I find the whole thing more of a campaign just to be seen to be doing something," he told DW.
"I would say that it has no influence on the playing quality of the individual players. But the benefits are questionable for me. I don't see a soft layer outside the helmet as being very effective."
The big danger from heavy plastic helmets clashing into each other is chronic traumatic encephalopathy, or CTE. A catalogue of former American Football stars either had or fear they have the disease. Its symptoms include a fuzzy memory, tiredness, aggression, dizziness, depression and eventually dementia.
It can only be diagnosed after death through a brain autopsy. CTE is also a major issue in rugby, which has similar charateristics to gridiron but without helmets. Boxing and soccer have also been heavily affected.
'For me it was a no brainer'
Indianapolis Colts tight end Kylen Granson is one of the biggest exponents of the caps, having tried them out in training camps. He believes concussion rates have dropped significantly in the sport.
"For me it was a no brainer, I just said yes I want to wear it the whole season. I've never really had a problem with the guardian caps, they don't really limit my vision, they dont add any extra weight that's noticeable. Why would I not add a safety measure onto my helmet?," he said on social media.
Granson believes the culmination of small hits to the head over time are just as worrying as the big hits which might occur once or twice a game.
"Anything I can do to mitigate any sort of brain injury or long term health effects...takes precedence. As a professional athlete who plays at the highest level, it is also part of my duty to advocate for my own health and safety and try to encourage others to also make the choice to continue wearing these," he said.
His Colts teammate Rodney Thomas II also wore the cap in preseason games and Week 1 alongside three other players on different teams.
But Colts star running back Jonathan Taylor decided against wearing it in regular season games, having tried the cap out in preseason matches.
The problem is that NFL teams want their crest to be seen, so thin covers with the badge on go over the additional padding and the helmet.
"I was trying to see how much it could hinder me, if a defender would be able to (grab it)," he told the Indy Star.
"I don't really want to test it out in the regular game, something happens and I'm getting yanked."
Bad publicity
Granson's mantra as he tries to spread the word is "you are not soft for wearing one". Unfortunately for the Colt, his message isn't getting through to all players — even on his own team.
Linebacker Grant Stuard said: "I felt like it was making me play a little softer.
"For some reason, it was discouraging my aggression, I think, when I had the guardian on."
The NFL wants to be seen as trying to make a difference with regards to head injuries. Flag football, a version of the sport which is non-contact, will appear at the 2028 LA Olympics.
As far back as 2013, the league reached a $765 million settlement with thousands of retired full-contact players and the families of those who died over concussion-related brain injuries. But earlier this year the Washington Post reported that the NFL was finding loopholes to avoid always paying out. The league's attorney rejected the findings.
The NFL wants to avoid further lawsuits and bad publicity. But making the guardian caps compulsory in regular season games, even for specific positions which receive more hits to the head, looks unlikely in the near term without more proof they actually work.
Motzkus added: "We need to wait for the scientific evaluation. So far there is probably not enough real data."
