Making sure that football helmets fit properly, and that those with air bladder linings are properly inflated, may be two of the simplest but most effective ways to minimize the risk of concussion and catastrophic brain injury, say researchers in a paper1 presented to the February 11, 2012 meeting of the American Orthopaedic Society for Sports Medicine.
The paper by researchers at Temple University, the Orthopedic Center in Rockville, Maryland, and the Nationwide Children's Hospital in Columbus, Ohio, found that:
The paper found that the percentage of high school and college football players sustaining concussion has remained relatively constant over a 30-year period and is relatively small (4 to 6%); that the number of those experiencing post-concussion syndrome or a protracted recovery is very small; and that the number sustaining an intracranial injury is extremely small (4 to 8 per season, or 0.6 per 100,000),
That such percentages have persisted despite improvements in helmet technology led the paper's authors to question whether they were having any protective effect. Consistent with previous meta-analyses, the paper found no definitive data to support the view that advanced football helmet technology and design is more protective against concussion or intracranial hemorrhage.
"It is well recognized that air bladders deflate on a regular basis and helmet fitting, particularly in high schools, is haphazard. Yet many thousands of youngsters with poorly fitting helmets and/or deflated bladders receive multiple heat impacts without injury," noted lead author, Joseph Torg, MD, of Temple University. This "strongly suggests" that those who suffer concussion (mTBI) or experience a protracted recovery are predisposed to injury.
The paper thus suggest that the "first and currently unappreciated step" in resolving both acute brain injury problems should be to identify the factors that make an athlete more susceptible to mTBI/concussion and intracranial injury and take steps to disrupt the predisposing injury combinations, including:
Possible Factors Predisposing Players To Concussion Or Catastrophic Brain Injury
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"As we look at preventing concussions and minimizing risk, it is important to realize that it is the responsibility of the athletic director and head football coach to have policies that: Insure that each player has a properly-fitted helmet and that a responsible adult supervises and oversees proper helmet air bladder inflation on a weekly basis," Torg said. (Think this isn't a problem? Think again. A February 9, 2012 story [3] in the Boston Globe reports that players letting the air out for comfort, making their helmets too loose is such a common problem at one local high school that the coach "often walks around with an air pump to reinflate the helmets.")
The protocol, believed by the authors to be the first published protocol for appropriate headgear fitting, was developed with the assistance of Paul Kelly, Athletic Equipment Supervisor at Temple University and a certified member of the Athletic Equipment Manager's Association.
The guidelines recognize, as a preliminary matter, that:
Before beginning any helmet fitting session, all the helmets should be properly prepared.
Ask if athlete has ever had any prior concussions or a broken nose. Find out what kind of helmet was worn before and if there were any issues. Ask how did it fit and how it felt?
Check for any physical abnormalities on athlete's head.
Using a cloth tape measure, begin at the side of the head and wrap around about 1 inch above the eyebrow and around the occipital lobe to obtain head circumference to determine
Helmet size.
This is based on product knowledge and information from the last 2 steps. There will be variance.
The chinstrap simply keeps the helmet on the head while playing. The chinstrap is not a means to adjust the fit of the helmet. With the cup centered on the chin, the front or high should first be adjusted and buckled followed by the rear or low hook straps.
There should be equal tension on all the straps.
When you have completed the fitting, ask whether the athlete is comfortable with the helmet, and let the athlete know that you are pleased with the fit. Record all pertinent information about the athlete's helmet and be sure it is specifically distinguished for the respective athlete.
Be sure to explain to the athlete what you are doing through each step and why. This serves 2 purposes. The athlete's trust in you is reinforced and will be confident not worrying about getting hurt when playing. More importantly it educates the athlete to quicker troubleshoot any problems that may occur with the helmet.
Posted February 12, 2012; updated November 13, 2014
Links:
[1] https://mail.momsteam.com/node/150
[2] https://mail.momsteam.com/node/201
[3] http://www.boston.com/yourtown/arlington/articles/2012/02/19/many_high_school_athletes_suffered_concussions_in_fall_sports_data_show/
[4] https://mail.momsteam.com/basic_information_football_helmets_reconditioning_recertification_concussion
[5] https://mail.momsteam.com/sports/old-football-helmets-will-no-longer-be-reconditioned
[6] https://mail.momsteam.com/health-safety/concussion-evaluation-management-return-to-play-decision-involves-many-factors
[7] https://mail.momsteam.com/2014-Virginia-Tech-Star-football-helmet-ratings-helpful-but-view-with-caution
[8] https://mail.momsteam.com/health-safety/type-and-age-of-football-helmet-does-not-affect-concussion-risk-2014-study-finds