Good Football Helmet Fit Key to Preventing Brain Injuries

FRIDAY, Feb. 17 (HealthDay News) — While football helmets don’t
prevent concussions, good helmet fit might help reduce loss of
consciousness that can follow a blow to the head, a new study finds.

Expensive, high-tech helmets with air-lining systems aren’t much better
than vintage “leatherheads” for preventing concussions, the researchers
said.

“The occurrence of concussion has been constant for the past 30 years:
whether it was a leather helmet, whether it was a plastic helmet with web
suspension, whether it was a plastic helmet with foam, or one with the new
combination air cells and padding,” said study author Dr. Joseph Torg, an
adjunct professor of orthopedic surgery at Temple University in
Philadelphia.

The researchers looked at data from the U.S. National High School
Sports-Related Injury Surveillance System from 2005 to 2009. Of the
nearly 1,400 kids who sustained a concussion, 44 lost consciousness and
267 experienced amnesia.

Injury reports addressed helmet fit, type of inner-helmet padding and
whether the helmet was new or reconditioned.

“Youngsters who had a concussion, if the helmet fit, they had 82
percent less chance of loss of consciousness,” Torg said. “Helmets — and
advanced helmet technology — do not prevent against concussions or the
severe intracranial injuries of hemorrhage [bleeding] and brain
swelling.”

The researchers also analyzed previous studies comparing types of
helmets.

Older, reconditioned helmets did as well as new helmets. But
unpublished data suggested that helmets with air-bladder linings might be
a risk factor, because they tend to leak and can deflate if not maintained
properly.

Wendy Norris, head athletic trainer at DeMatha Catholic High School in
Hyattsville, Md., said her responsibility for player health includes gear
safety, and it’s standard practice to inspect helmets before each game.

“We have helmets certified every year, and the day before games we
always check them to make sure they’re fitting well,” said Norris, a
certified athletic trainer. “It’s an ongoing process. Sometimes I’ll see
somebody on the field and say, ‘Hmm, I don’t like how that looks.’ And we
adjust it.”

Higher-tech helmets with improved air-cell systems cost about $250 to
$350 each, Norris said. An advantage is that company representatives come
out to the schools and educate trainers and coaches on proper fit.

Torg said the big question is, beyond helmets, what sets apart the four
to six football players who suffer catastrophic injuries from concussion
each year?

“Our thesis: there’s a combination of factors that predisposes those
small numbers of youngsters,” he said. The factors are mostly
unidentified, he added, noting they could be congenital, anatomic, or even
related to air temperature.

“A kid who has a severe concussion has a number of predisposing
factors, one of which is probably a helmet that doesn’t fit,” Torg said.
“If you remove that component, then maybe the problem is solved.”

Torg’s study was presented at this month’s annual meeting of the
American Orthopaedic Society for Sports Medicine in San Francisco.

Athletic trainer Norris suggested some “easy landmarks that parents can
look for,” with helmet fit:

  • Players’ eyes should be visible.
  • Helmet ear holes should line up with players’ ears.
  • Cheek pads should sit next to the skin, without a big gap.
  • The back of the skull should be covered.
  • Mouth guards shouldn’t be chewed up and hanging out of players’
    mouths. They should fit past the second molar on both sides. Molded is
    better because that helps absorb the shock when players get hit in the
    head.
  • The helmet shouldn’t shake or rattle. If you grab the facemask and the
    chin strap is tightened up all the way, you should not be able to move
    the facemask left or right. It should stay neutral.
  • Find out if helmets are recertified every year. “They should be,”
    Norris said. “But a lot of schools can’t afford that.” One way you can
    tell: there should be a sticker at the back of the helmet with the
    year.

If you think something’s wrong, ask the trainer or the coach, she
advised.

Players also have a role, the trainer stressed.

“We tell them for sure not to customize the helmet in any way,” Norris
said. “A lot of them want to cut the forehead pads or cut the cheek pads
to make them thinner. We definitely discourage that.”

And, she added, “they should also have their coaches check their
helmets at least every week or two weeks, just to make sure everything’s
good.”

The data and conclusions of research presented at medical meetings
should be viewed as preliminary until published in a peer-reviewed
journal.

More information

Visit the U.S. Centers for Disease Control and Prevention to learn
about concussion in sports.

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