I recently came across an interesting book by Greg Ip titled Foolproof: Why Safety Can Be Dangerous and How Danger Makes Us Safe. It’s a fascinating look at the balance between risk mitigation and risk adaptation, both of which compete to either make us safer, or more at risk than before.
When the levee breaks
One example of the interplay between risk mitigation and risk adaptation provided in the book is that of preventing floods. Engineers can build levees, which protect areas most at risk of flooding from being submerged. On the surface, this is a good thing – more homes can be built. But these homes are built in areas susceptible to hugely high-risk events; the 100-year or 1000-year rainfall that can cause the levees the break, leading to widespread flooding, death and devastation, such as that seen in New Orleans in 2005. So while the levees bring protection in one sense, they also bring more risk through a false sense of security that leads people to build deeper into flood zones.
There are countless other examples. Let’s take cyclists and helmets. I think its uncontroversial to state that, if you’re on a bike, wearing a cycle helmet seems like a good idea, as in the case of a crash it will protect your brain. But, there is some evidence that, on the roads, drivers will give cyclists who aren’t wearing a helmet a wider berth than if they do have a helmet on; subconsciously, the drivers see that the unhelmeted cyclist is more at risk, and so take greater protective measures. In this case, wearing a helmet might protect a cyclist from injury during a high-speed collision (which are very rare), but actually increase risk during a gentle pedal down a country lane (disclaimer: definitely still wear a cycle helmet).
Confronting risks in sport
We see this regularly in sport too. Let’s take american football, where players wear helmets as part of their game day uniform. The helmets are designed to protect the players brains from high impact collisions. Unfortunately, over time, the helmet on helmet hit became more popular. This was likely as a result of players feeling protected in their helmets, and taking more risks, leading to an increased number of collisions.
In rugby, a game similar to NFL in terms of high impact collisions, players don’t wear helmets; as a result, you hardly ever see head on head collisions. Over time, this lack of risk of acute, obvious head injury has led to something more insidious; the rise of Chronic Traumatic Encephalopathy (CTE), something which is a huge threat to the sport of American Football right now. Had the players never adopted helmets – seen as a sensible risk reducer – such a crisis might never have played out, because the players would have been more aware of the risks facing them, and avoided the risk-inducing behavior.
Similarly, in rugby union there is now considerable debate about contact head injuries, which often happen during a tackle. Interestingly, it is the tackling player, and not the player getting tackled, who appears to carry the highest risk of contact concussion in this case. One of the options here is to ban tackling in youth rugby, only introducing it later on. This could be problematic; if it’s the tackling player who is most likely to suffer the head injury, it indicates that there is perhaps a technical issue at play here. By reducing exposure to this risk in youth rugby, these players are robbed of the chance to develop their tackling technical skills. Potentially – and paradoxically – this could lead to increased levels of trauma when tackling is then re-introduced when the players are older, bigger, and faster.
A little risk makes you stronger
Perhaps the best example is that of hamstring injuries in sport. We know that high speed running is a significant risk factor for hamstring injury; these types of injury tend to occur at high speeds, and also later on in training or match situations, as fatigue sets in. One option here would be to reduce the overall high speed running load – after all, this is where the injuries occur, so by reducing exposure to the injury mechanism, the injury rate should reduce, right?
I’ve been told of an example of a Premier League football team in the UK who took this approach. They determined that a set velocity threshold would be deemed as high intensity running, and during training their players were not to exceed this threshold. They suffered their highest rate of hamstring injuries that season. By seeking to reduce their risk, they actually increased it. The recent work by Tim Gabbett and the acute:chronic training load helps to explain this; exposure to high speed running, if carried out sensibly and well monitored, has a protective effect against such injuries as it correctly conditions the muscle. Much like hormesis or Goldilocks, there is an exposure amount that is just right; too much or too little leads to an increase in risk.
Know the risk to assess it
Another such issue regarding risk is our irrationality surrounding it. This has long been known; Kahneman and Tversky created prospect theory in the late seventies using gambling games to illustrate this. In the real world, we can see a nice example; far more people are scared of flying than they are of driving, even though you are more likely to die in your car on the way to the airport than on the flight itself. Why is this? One of the reasons is exposure to the risk; we drive frequently, so we are less threatened by it. If we’re the driver, we also have more control than when we are on a flight, which again acts to reduce the risk. Exposure to risk in a managed, controlled environment leads to a more rational appraisal of the risk. This is also true in things like sprinting; instead of deciding to dispose of all high-speed running, which is irrational, we can make the rational decision that we need high speed running, but at a frequency that suits our tolerance at any given point in time.
Where does this leave us? Before making any large decisions during training, we need to consider the downstream risks. If I change this now, what is going to happen down the line? In addition, we need to decide what risks we face through exposure to our sporting competition, and figure out a best way to tolerate and manage that risk.
If you’re a sprinter, you’re going to have to run at maximal speed; you need to build up your tolerance to that. If you’re a rugby player, you need to be able to tackle with as low a risk as possible, which requires you to learn the skills in a safe environment. Avoiding risk isn’t by any means always negative; it can stop us from getting hurt. I’m not recommending that we start playing touch rugby with bears. However, by embracing risk sensibly, we can have more control over it.