The Association of the Type of Football Helmet
and Mouth Guard With the Incidence of Sport Related Concussion in High School Football
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
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
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