Ask the Expert: Can helmets prevent concussion?

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Q: I have coached minor hockey for several years and always encourage safe and fair play. At the start of every season, I remind my players to wear all their protective equipment for every game and practice. I specifically stress how important helmets are for preventing concussions. At hockey school this summer my son was told hockey helmets don’t protect against concussions—is this true?
—Coach Tim

A: Dear Coach;
Thank you so much for volunteering to work in minor sports. Considerable research and millions of dollars have been invested into the design of protective helmets for many different sports. Despite this enormous investment there continues to be no such thing as a concussion-prevention helmet for any sport – it doesn’t matter how much money you are willing to spend on a helmet.

Having said the above, it is important to recognize that helmets continue to be important pieces of protective equipment. When properly worn, helmets are effective at preventing cuts to the scalp, brain bleeds, and skull fractures. Unfortunately they all have limited effectiveness against concussions, largely because of the way humans are designed.

Try thinking of the skull as nature’s hockey helmet. It has a hard bony exterior, a set of protective membranes, and the brain essentially floats in a pool of fluid. As a result of this design, when a person gets hit, the brain can move around inside the skull. If someone is hit hard enough the brain will bang into the bony walls inside the skull, and essentially get bruised at the points of impact. In addition, almost all hits apply some rotational force to the head, and this will subject the brain to sheer forces that can cause microscopic tears to the brain and its blood vessels. Experts agree that for a helmet to protect the brain from these types of forces it would have to be so big and awkward that it would leave the neck vulnerable to injury.

Bottom line is that helmets protect your head – they do not protect your brain. So even if someone is wearing a helmet, a hit to the head can do to the brain what a car crash does to the passengers. Rather than focussing on making a better helmet, a far more effective strategy to reduce the incidence of a concussion would be to focus attention on teaching athletes to play safer and smarter.

Exercise is medicine!

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