Bottom Line Up Front (BLUF): Helmets don’t stop concussion!
Working in a Sports Medicine Department for a collegiate athletics program and being a Soldier in the United States Army and Florida Army National Guard, I cannot begin to tell you how many times I have heard an athlete, coach, parent, Soldier, etc. make a statement along the lines of, “My helmet will keep me safe from concussion.”
The sad part here, is that this bit of misinformation could be lethal…
The National Athletic Trainers’ Association, in their Position Statement on Concussions (2014), has began pushing for Athletic Trainers to support the use of certified helmets. The go-to in the field now is the National Operating Committee on Standards for Athletic Equipment, or NOCSAE, and according to them:
“Serious brain and neck injuries leading to death, permanent brain damage or quadriplegia (extensive paralysis from injury to the spinal cord at the neck level) occur in football. The toll is relatively small but persistent, averaging 1.44 fatal or severe, nonfatal brain or spinal cord injuries annually for every 100,000 players. HELMETS DO NOT PROTECT THE NECK, and none of these injuries can be completely prevented due to the tremendous forces occasionally encountered in football collisions; but they can be minimized by manufacturer, coach and player compliance with published rules of play, proper coaching, and in the case of head and brain injuries, compliance with accepted equipment standards.”
It is safe to take this quote to the bank! NOCSAE takes on certifying athletic headgear for various sports in its ability to protect from skull fracture or other dangers to the external portions of the head, it has no chance of protecting the brain against any of the proposed mechanisms of injury that have been known to cause concussion, the coup-contrecoup, axonal torsion, concussive blast, or even non/sub-concussive cumulative impacts. No matter how much padding you put around the head it wont stop a concussion!
So, where does this lead us? The 5th International Consensus Statement on Sports Related Concussions, held in Berlin (2017), addressed the use of protective equipment in an attempt to stop concussion. When it came to helmets, here is what they had to say:
“The evidence examining the protective effect of helmets in reducing the risk of SRC is limited in many sports because of the nature of mandatory helmet regulations.”
Further, compare this to the National Athletic Trainers Association’s Position Statement on Concussion, and here are their thoughts on helmets:
“…although such helmets help to prevent catastrophic head injuries (eg, skull fractures), they do not significantly reduce the risk of concussions”
Looking at two predominant official statements by major players in concussion research and seeing what they think, It seems clear that super-sizing helmets or the wear of any headgear will truly stop the frequency of concussions!
Another major concern, is that research suggests that athletes wearing protective headgear may have a false sense of security against injury or even be more prone to use their head as a weapon, a dangerous thing in sport that can put them in danger of far worse injury than a concussion (Swartz et al, 2015). Swartz’s research posed a training concept for tackling in practice only without headgear on, they designed a process of slowly increasing intensity from static training through walking to tackle, to full speed once ready, and their research showed great potential in decreasing head-down tackling in football athletes! The group with the helmet-less tackling training decreased their head impacts by 30%.
Knowing this information, we may start to ask, “Well, if helmets don’t protect against concussions, then why does my son/daughter need to wear one?” That is a valid question, but we must always remember that while helmets don’t protect against concussions, they do keep our children and Warfighters safer from skull fractures!
In the end, helmets are a necessary evil. They may not prevent or reduce concussions, but they do help in decreasing skull fractures and lacerations. It takes proper training in tackling form, concussion education, rule enforcement, and good sportsmanship to limit the rate of concussions. Remember tackle with your head up!
By: Jeremy D. Howard, MS, LAT, ATC, CSCS, CES, PES, ITAT
Broglio, S.P., Cantu, R.C., Gioia, G.A., Guskiewicz, K.M., Kutcher, J., Palm, M., and Valovich McLeod, T.C. (2014). National athletic trainers’ association position statement: Management of sport concussion. Journal of Athletic Training, 49(2), 245-265.
McCroy, P., Meeuwisse, W., Dvorak, J., Aubry, M., Bailes, J., Broglio, S., …, and Vos, P.E. (2017). Consensus statement on concussion in sport– the 5th international conference on concussion in sport held in Berlin, October 2016. British Journal of Sports Medicine, 0, 1-10.
National Operating Committee on Standards for Athletic Equipment [NOCSAE]. (2011). Statement of shared responsibility. Retrieved from http://nocsae.org/nocsae-standard/statement-on-shared-responsibilities/.
Swartz, E.E., Broglio, S.P., Cook, S.B., Cantu, R.C., Ferrara, M.S., Guskiewicz, K.M., and Myers, J.L. (2015). Early results of a helmetless-tackling intervention to decrease head impacts in football players. Journal of Athletic Training, 50 (12), 1219-1222.