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Panel: Better Equipment Won't Prevent All Student-Athlete Concussions

While improvements in helmet design have helped reduce the prevalence of concussions in sports such as hockey, lacrosse, and football, it's unlikely that any amount of equipment improvements will entirely prevent concussions, a panel of sports-science professors says.

The panel spoke about design differences between football, hockey, and lacrosse helmets at the National Athletic Trainers' Association's annual meetings this week in New Orleans.

Helmets "certainly help to mitigate forces that are distributed by impact to the skull and the intracranial cavity and the brain," said Kevin Guskiewicz, a professor of sports science at the University of North Carolina. "But the brain is still going to move inside that cranial cavity regardless of whether there's a helmet on or not."

Guskiewicz stressed that improved helmet design can blunt the force of a straight-ahead impact, but can't prevent the head from rotating as a result of the impact.

Jason Mihalik, an assistant professor of sports science at the University of North Carolina as well, noted that despite some limitations, "helmets are doing very well at preventing really catastrophic crashes." Mihalik said that crash-test dummies traveling at 35 miles per hour absorb 80 times the force of gravity, and cited a statistic provided by Guskiewicz that student-athletes playing football, hockey, and lacrosse often receive twice that impact (if not more) while being tackled or checked.

Guskiewicz told the audience that football players receive anywhere from 950 to 1,000 of these impacts each season, while Mihalik said hockey players receive roughly 300 per year. (To read more about Guskiewicz's research, see Malcolm Gladwell's 2009 reporting on concussions for the New Yorker.)

In other words, it's a minor miracle that more student-athletes aren't walking off the field with scrambled brains on a daily basis.

Guskiewicz suggested that "behavior modification is perhaps more important in addressing the problem [of concussions]," such as teaching young football players to avoid leading with their heads when tackling. The NFL, for one, implemented new rules this spring that penalize a team by 15 yards when one of its players leaves both feet before contact to "spring forward and upward into an opponent and deliver a blow to the helmet with any part of his helmet."

The experts urged parents and coaches to let student-athletes fully recover from their concussions before sending them back into competition, largely to avoid the risk of re-injury. A study published in Pediatrics this week spoke to the dangers of returning prematurely from concussions, specifically noting that deaths from second-impact syndrome are entirely preventable.

"Parents are seeing the advertisements for these concussion-proof helmets. They look for the short and easy way out. Put this special helmet on, and that's going to be the answer to preventing the next concussion," said Guskiewicz. "I always tell them, 'Listen, if you're going to send them out there, make sure they're wearing a good helmet that fits right for him, that he's comfortable wearing. And have some serious conversations with him about how he's loading his head.' "

Mihalik touched on what criteria parents and coaches should use when selecting helmets for student-athletes: The helmet should fit properly, weigh as little as possible, and be small, comfortable, economical, and "look good."

He studied 18 hockey helmets and found that none of them fit properly, while seven of them could be removed without unfastening a single strap. More alarmingly, with one helmet, a study subject could still move his head inside despite being strapped down to a spine board.

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