The Association of the Type of Football Helmet and Mouth Guard With the Incidence of Sport Related Concussion in High School Football Players
McGuine, T. Brooks, A. Hetzel, S. Rasmussen, J. McCrea, M. Orthopaedic Journal of Sports Medicine 2013 1:4 DOI: 10.1177/2325967113S00027 (AOSSM 2013 Annual Meeting Abstract)
Take Home Message: Preliminary results suggest that no particular brand of helmet reduces the risk of sustaining a sports-related concussion or reducing the severity of sports-related concussion symptoms compared with other brands. Furthermore, mouth guards that are marketed to reduce the risk of concussion may not reduce the risk of concussion.
With increased public awareness of sports-related concussions, different football helmet and mouthguard manufacturing companies have begun advertising campaigns claiming their model reduces head impact forces and thus reduces the risk of sports-related concussions. To determine the accuracy of these claims, the authors of this abstract conducted a prospective study of 36 Wisconsin high schools during the 2012 football season to determine if any particular brand of helmet or mouthguard may be associated with a reduced risk of sports-related concussion or symptom severity. The athletes completed pre-season demographic surveys detailing the type of helmet and mouth piece they would wear. School athletic trainer reported incidence and severity of concussion. The authors defined severity of concussion as the number of participation days lost. Overall, 115 athletes sustained 116 sports-related concussions. The breakdown of helmet manufactures in the study were Riddell (52%), Schutt (35%), and Xenith (13%) purchased in 2011-2012 (39%), 2009-2010 (33%), 2002-2008 (28%). Mouth guards were either generic models (61%) or customized mouth guards (39%) that were custom fitted by a dental professional or specifically marketed to reduce the risk of concussion. The results showed no difference in rates or severity of sports-related concussion by type of helmet or year of purchase. Interestingly, the rate of concussion for players who wore a generic mouthguard was lower than the rate for those who wore a specialized or custom-fitted mouthguard.
The preliminary results of this study are noteworthy because they contradict claims by helmet manufacturing companies that products now exist that can reduce the risk of sports-related concussion. The results also importantly show that using an older helmet does not lead to increased risk of sports-related concussion. The results went one step further to challenge the claims of mouthguard companies who market specialized products that are reported to reduce the risk of concussion. In a market where parents are trying to find any way to help protect their children, knowledge is power. Additionally, these results support the statements by the most recent International Conference on Concussion in Sport that there is no evidence that any particular helmet or additional type of padding can reduce the risk of concussion. This doesn’t take away from the fact that helmets are designed to reduce impact forces and the risk of skull injuries while mouth guards reduce the risk of oral and dental trauma. A parent can make better educated decisions about his/her child’s participation and protection in football by understanding that the risk of concussion is inherent to the game and that no particular helmet or product has been shown to reduce the risk of concussion,. If this study is reported in a full-length article it will certainly be discussed again on Sports Med Res since the full-length article will likely provide a better understanding of these findings.
Questions for Discussion: Have you found any particular brand of helmet or mouthguard that possibly reduces the risk of concussion? Do you think there should be more strict marketing requirements that regulate the claims sports equipment manufacturers can make with regards to injury risk reduction?
Written By: Stephen Stache, MD
Reviewed By: Jeffrey Driban
Consensus Statement on Concussion in Sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012