Special Football Helmets Didn't Lower Concussion Risk

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Football helmets and mouth guards differed little in high school concussion risk

October 28, 2013 / Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

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(dailyRx News) As more parents and schools become aware of the dangers of concussions in high school football, they seek ways to reduce the risk. But special helmets or mouth guards may not help.

A recent study found that the brand name or the year a football helmet was made little difference in students' concussion risks.

Meanwhile, specialized mouth guards were actually linked to more concussions than generic, school-issued ones were.

Approximately 40,000 concussions resulting from high school football activities occur each year in the US, according to the study's information.

Apparently, investing in newer helmets that claim to protect players better may not help reduce that number, the authors found.

"Learn the symptoms of a concussion."

This study was led by Margaret Alison Brooks, MD, MPH, of the Orthopedics and Pediatrics departments at the University of Wisconsin in Madison.

The researchers wanted to find out whether different types of helmets or mouth guards could affect how often or how badly kids experience concussions.

They followed 1,332 football players from grades 9 through 12 at 36 high schools during the 2012 football season.

About half the players (52 percent) wore helmets manufactured by Riddell. Just over a third (35 percent) wore helmets manufactured by Schutt, and 13 percent wore helmets made by Xenith.

Only 39 percent of the helmets had been purchased during the 2011-2012 school year.

One third of the helmets had been purchased in 2009-2010 while 28 percent had been purchased between 2002 and 2008.

Most of the players (61 percent) wore generic mouth guards provided by the schools while 39 percent wore specialized mouth guards that had been custom fitted by dental professionals or had been marketed to reduce concussion risk.

At the start of the football season, all the participants filled out questionnaires about past injuries and the children's basic demographic information.

Among the participants, 13 percent (171 players) had experienced a sports-related concussion within the previous year.

Throughout the 2012 season, the number and severity of sports-related concussions experienced by the players were tracked by athletic trainers. Then the researchers compared the players who sustained injuries and those who did not.

During the season, 8.6 percent of the participants (115 players) experienced a total of 116 sports-related concussions.

The researchers did not find any patterns or differences across the players' likelihood of concussion based on the manufacturer of their helmet or the year the helmet had been purchased.

The severity of the players' concussions also did not vary based on the helmet manufacturer or the year the helmets were bought.

Interestingly, the rate of concussions among players who wore specialized or custom-fitted mouth guards was actually twice as high as the rate among players wearing generic mouth guards.

"Contrary to manufacturer claims, lower risk and severity of sports-related concussions were not associated with a specific helmet brand," the researchers wrote. "Rates of sports-related concussions were similar for players wearing newer versus older helmets."

The researchers therefore advised purchasers to be cautious about buying specific preventive sports equipment based on the manufacturers' claims about better safety or reduced concussion risk.

Kevin Crutchfield, MD, a neurologist at Sinai Neurology Associates in Baltimore, said the study findings and the researchers' caution about helmets "makes all the sense in the world."

"Helmets do what they've done for decades — prevent head fractures and hematoma," he said. Hematoma is bleeding in the brain.

"Helmets are not designed to prevent concussions and all this hoopla about their design doesn't prevent concussions either," he said. "But it sells more helmets, which, at the end of the day, is what it's all about."

Dr. Crutchfield said there needs to be more clinical trials looking specifically at the claims helmet manufacturers make regarding their product.

"It's marketing hype. They need to do the clinical trials," he said. "They need to show that the intervention – wearing their helmet – reduces the clinical condition called concussion, and nobody is stepping up the plate to do that because it costs money."

Further, he said, the companies have no motivation to do those trials.

"They're busy making millions of dollars of year selling helmets and not putting any of that into research and true clinical reduction of concussions," he said.

Dr. Crutchfield said that this study is great because it is a clinical trial showing the effects – or the lack of effects – of a helmet on protecting against concussions. He added that there are ways to reduce concussions on the field.

"The best thing is to wear helmet because it does reduce other catastrophic injuries and accidents are going to happen," he said. "But if we truly want to mitigate concussions, we have to play within the rules and use proper technique."

This study was presented October 28 at the American Academy of Pediatrics National Conference in Orlando.

This study has not yet been published in a peer-reviewed journal, and its findings should be interpreted with caution.

Information regarding funding and conflicts of interest were not available.