The results of a two-year study by researchers at the University of Wisconsin-Madison suggest that neither specific brand, age nor the recondition status of helmets were associated with fewer sport-related concussions (SRC) in adolescent athletes.
“It’s understandable why some parents who are already anxious about their kids playing high school football may want to buy the newest, most expensive equipment available in the hopes that it will considerably reduce their child’s risk of injury,” says lead co-investigator Dr. Alison Brooks, assistant professor in the UW Department of Orthopedics and Rehabilitation, Division of Sports Medicine. “However, there was nothing in our study to show that any specific brand of helmet performed better than another in the real world high school setting, despite what previous lab-based testing has suggested.”
The study, published online in the American Journal of Sports Medicine, involved 2,081 football players at 34 high schools in Wisconsin during the 2012 and/or 2013 football seasons. Players completed a pre-season demographic and injury questionnaire, and athletic trainers recorded incidence and severity of SRC throughout the year. A total of 206 players (nine percent) sustained a total of 211 sport-related concussions during the two-year study.
Helmets worn by players were manufactured by Riddell (n=1171 or 51 percent), Schutt (n=680 or 30 percent) and Xenith (n=436 or 19 percent). Of those helmets, 465 (26 percent) were being used during the initial purchase year, while 745 (33 percent) had been in service for five or more years. Mouth guards worn by players included generic models provided by schools (61 percent) and specialized mouth guards (39 percent) custom fitted by dental professionals or specifically marketed to reduce SRC.
The following are some of the study’s most important results:
- No difference in the rate of SRC across helmet brands, helmet age or helmet recondition status
- Custom-fitted mouth guards increased SRC risk by 60 percent, compared to generic guards
- The rate of SRC was nearly seven times higher during competition than practice, and four times higher during full-contact practice than no-contact practice
- Age, BMI, grade in school, or competition level was not associated with an increased risk of SRC. More years of previous tackle football experience was not associated with a decreased risk of concussion.
Another important finding was that players who sustained an SRC during the previous 12 months were almost twice as likely to sustain another one compared to players without a history of SRC.
“This was surprising because we found that the increased risk exists even when controlling for the players’ use of protective equipment, years of football experience and player characteristics, such as their grade in school and competition level,” said Tim McGuine, UW sports medicine researcher and co-author of the study. “These results highlight the need for medical providers to document a history of SRC in young football players and for more education among parents, coaches and the players about the increased concussion risk in these individuals.”
Aside from learning appropriate tackling and other on-field techniques, the researchers say properly maintained and fitted helmets remain one of the most important ways to prevent skull fractures and scalp lacerations in football players. Each year, approximately 40,000 sport-related concussions occur in U.S. high schools, which can often result in significant and long-term physical, academic and financial consequences.
The study was funded using intramural funds from UW-Madison. No industry support was received for this study. Other researchers include Scott Hetzel, associate researcher in the Department of Biostatistics and Medical Informatics at UW Madison, and Michael McCrea, director of brain injury research at the Medical College of Wisconsin.
University of Wisconsin Hospitals and Clinics Authority