Sports Medicine Research: Helmets and Concussions

UW Health Sports Medicine researchers are studying the effectiveness of helmets on preventing concussionsUW Health Sports Medicine is leading a research study to assess the effect of helmet brand on the incidence of sport related concussion in high school football players. The study is being lead by Alison Brooks, MD, MPH, UW Health sports medicine physician, and Tim McGuine, PhD, LAT, UW Health athletic trainer and senior scientist.


Background and Significance


Sport-related Concussion (SRC) is now recognized as a major public health concern. While the exact number of cases of SRC is unknown, an estimated 300,000 concussions occur annually in the U.S. with 40,000 concussions occurring annually in high school football alone. High school football is popular with approximately 1.1 million participants nationwide and 28,000 participants in Wisconsin. Impacts to the head are common in collision sports such as football, and the primary piece of equipment utilized to prevent a player from sustaining SRC is the football helmet.


Football helmets have evolved a great deal over the last 50 years. Current helmet designs are heavier, larger and designed to absorb and dissipate impact forces to a greater extent than earlier models used by football players. Currently, each type of football helmet used by high school football players must be evaluated by the National Operating Committee on Standards for Athletic Equipment (NOCSAE). NOCSAE performs a series of laboratory drop and impact tests on each specific helmet brand and model to ensure that each helmet meets or exceeds the standards deemed necessary to offer an acceptable level of protection for the user.


In recent years, football helmet manufacturers have modified existing helmets and introduced new helmets with claims from laboratory testing that their "helmets offer the maximum protection" or "reduce the risk of concussion." Sports medicine professionals are often being asked to weigh these conflicting claims to recommend and use the so called "best helmets" or helmets that "should be used by players following a concussion."


Unfortunately, there is little, if any, evidence that the use of a specific football helmet brand will make it more or less likely that a high school football player will sustain a SRC while actually participating in high school football. Some SRC experts have indicated that other factors such as previous concussion history or years of playing contact football actually play a greater role in SRC susceptibility than the type of helmet worn by the player. This lack of information also directly impacts school administrators and football coaches who must make decisions for which type of helmet their players should use.


Further complicating the issue of which helmets to use is the fact that the price of the helmets marketed for use in high school players varies a great deal. While each helmet meets NOCSAE standards, depending on the helmet brand, the price for an individual helmet can range from $160 to $400. School officials have stated that their ability to replace helmets on a regular basis is affected by how many new helmets they are able to purchase in any given year. The ability to replace older helmets is crucial since each manufacturer states unequivocally that new helmets provide better protection than older, reconditioned helmets.


While the helmets currently worn by high school football players have been tested in laboratory settings, there is little data on the incidence of SRC in players wearing a specific brand of helmet. Documenting the incidence of SRC would benefit sports medicine professionals who are working to prevent these injuries in young football players.




UW Sports Medicine has initiated a prospective cohort study in order to determine the association of various demographic factors and type of equipment utilized with the incidence of SRC in high school football players.




Data collection is being completed by licensed athletic trainers (LATs) at public and private high schools in Wisconsin during the 2012 and 2013 football seasons. An estimated 1,750 to 2,100 high school football players, will participate in the study.


Data Collection


During the pre-season, research subjects will complete a questionnaire to measure age, height, weight, year in school, level of competition, years of football experience and SRC history. LATs at each school will record the helmet brand, model and purchase year as well as the type of mouth guard (generic, specialized or custom fitted) worn by each player. During the season, LATs and coaches will record the number and type of exposure (practice and competition) that each player participated in as well as all SRCs sustained throughout the season.


Data Analyses


At the conclusion of the 2013 season, the researchers will compare the incidence of SRC between the three helmet brands.




Preliminary results suggest there are no differences in the rate of concussion by either the type of helmet worn or the helmet's age. Depending on the final results of the data analysis, several stakeholders (i.e. football players, coaches, administrators, etc.) may benefit from the findings if any statistically significant variables are found that decrease the frequency of SRC in high school football players.