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Meet the Neurosurgeon Behind a Safer Super Bowl

Nicholas Theodore, in the Carnegie Center for Surgical Innovation with a helmet signed by former Arizona Cardinals QB Kurt Warner. (Photo by Mike Ciesielski)

Thanks to a new rule against unnecessary roughness supported by a Johns Hopkins neurosurgeon, the upcoming Super Bowl will be technically safer for football players than any of its predecessors.

When the New England Patriots and Los Angeles Rams take the field on February 3, they will be the first Super Bowl teams subject to a Use of the Helmet ruling, which declares a foul if a player lowers his head to initiate and make contact with his helmet against an opponent. Such a move triggers a 15-yard penalty and possible ejection from the game for the player.

“This rule pertains to all players on the field and to all areas of the field,” says Nicholas Theodore, head of Johns Hopkins’ Neurosurgical Spine Center and chair of the National Football League’s innovative Head, Neck and Spine Committee. “We hope that this change will translate into fewer injuries.”

In April 2018, the NFL appointed Theodore to lead the committee of independent and NFL-affiliated physicians and scientists, including advisers for the NFL Players Association. The committee brings together some of the foremost experts in brain and spinal trauma to advise the league on neuroscience, concussion, and other health and safety issues.

Before joining the Hopkins faculty in 2016, Theodore was the director of neurotrauma at the Barrow Neurological Institute in Phoenix. He also was the team neurosurgeon for the NFL’s Arizona Cardinals and a consultant to the Arizona Diamondbacks baseball team and the Phoenix (now Arizona) Coyotes hockey team.

From 2001–2003 he was chief of the neurosurgery division at the Naval Medical Center San Diego, the Navy’s largest neurosurgery complement. There he learned that head injuries outside the battlefield were more common than he had expected.

“It was amazing to see that some patients could be so severely affected even though they had relatively normal brain imaging” in their computerized tomography (CT) or MRI scans, he says.

In Arizona, he discovered that people — especially high school athletes — sustained brain injuries without showing any outward signs.

“I realized that sports-related concussion was a real problem and decided to get involved on many fronts,” Theodore says.

He helped establish Arizona’s concussion program for high school athletes and became involved in even wider preventive advocacy and education efforts. He served as medical director and president of the board of directors of ThinkFirst, a nationwide organization that provides information on the prevention and treatment of brain and spinal cord injuries.

In 2016, when Theodore became chief of Hopkins’ spine division, his dedication to improving prevention and treatment of athletic neurological injuries, and to educating physicians and the public about the injuries, was well established. This led Allen Sills, the NFL’s first chief medical officer (and a 1990 Johns Hopkins School of Medicine graduate), to name him chairman of the Head, Neck and Spine Committee.

Theodore believes football is becoming safer every year. “Outside of the NASA space program, there is no better medically evaluated population than the professional football players,” he says.

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