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Sports Health. 2016 May;8(3):238-43. doi: 10.1177/1941738116639027. Epub 2016 Mar 22.

Inadequate Helmet Fit Increases Concussion Severity in American High School Football Players.

Author information

1
Department of Orthopaedic Surgery & Sports Medicine, Temple University Hospital, Philadelphia, Pennsylvania dustin.greenhill2@tuhs.temple.edu.
2
Temple University School of Medicine, Philadelphia, Pennsylvania.
3
Department of Orthopaedic Surgery & Sports Medicine, Temple University Hospital, Philadelphia, Pennsylvania.
4
Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado Department of Pediatrics, School of Medicine, University of Colorado, Aurora, Colorado.
5
The Orthopaedic Center, Rockville, Maryland.

Abstract

BACKGROUND:

There is limited information on the relationship between football helmet fit and concussion severity.

HYPOTHESIS:

Poor helmet fit may predispose football players to a more severe concussion.

STUDY DESIGN:

Descriptive epidemiology study.

LEVEL OF EVIDENCE:

Level 3.

METHODS:

Data from concussion injury reports were obtained from the National High School Sports-Related Injury Surveillance System over a 9-year period. Symptoms, duration, and helmet parameters (fit, interior padding) were analyzed for all first-time concussions.

RESULTS:

Data from 4580 concussions were analyzed. Patients who suffered concussions with a helmet that did not fit properly (3.22%), as determined by an athletic trainer, had higher rates of drowsiness (RR, 1.46; P = 0.005), hyperexcitability (RR, 2.38; P = 0.047), and sensitivity to noise (RR, 1.88; P < 0.001); had more symptoms (5.34 vs 4.54, P = 0.004); and had longer symptom duration (P = 0.04). Athletes with helmets lined with an air bladder had greater rates of sensitivity to light (RR, 1.13; P = 0.02), sensitivity to noise (RR, 1.25; P = 0.009), and longer symptom duration (P = 0.004) compared with foam or gel liners.

CONCLUSION:

An improperly fitted football helmet is a risk factor for a concussion with more symptoms and of longer duration. Concussions of longer duration are also more common in players with an air bladder-lined helmet. Current high school football rules should mandate supervision and maintenance of helmet fit throughout the season, prior to impact.

CLINICAL RELEVANCE:

Team physicians, athletic trainers, coaches, and high school officials should ensure proper oversight of helmet fit in high school athletes to decrease concussion severity and duration.

KEYWORDS:

athletic trainer; concussion; football helmets

PMID:
27005467
PMCID:
PMC4981070
DOI:
10.1177/1941738116639027
[Indexed for MEDLINE]
Free PMC Article

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