Why Helmets Don't Prevent Concussions
The most prevalent method of preventing or minimizing traumatic brain injury (TBI) is helmet use. Helmets are one of the earliest and most long-standing methods of personal protection in the history of human civilization. They provide protection from head trauma by absorbing the impact energy and diffusing that impact over a greater surface area of the head, rather than to one localized region.
What is the purpose of a helmet?
Why is it that helmet use has been in existence since the beginning of time and yet the rate of concussions continue to rise? The most effective method of protection against concussion and TBI is prevention but is there anything we can do to better the production of helmets in order to decrease the likelihood of experiencing a concussion? Helmets are not designed and tested for the efficiency of preventing concussion but for the ability to prevent skull fractures. If you take a look at the brain and how it is situated within the skull you will see that there is a small amount of space within the cranial vault which allows for movement of the brain within the skull, particularly during jarring events of the head and or body. What this means is that by simply placing a helmet on top of ones skull you are by no means decreasing the amount of space located between the inside of the skull and the brain itself. Therefore still allowing for the ability of the brain to move within the skull leading to the rotational and sheering forces that we discussed in the article “What happens during a Concussion”.
What does the evidence say?
“In this review of helmet efficacy against TBI and concussion, we report that helmets do not fully protect against concussion. The majority of studies showed that helmet use did not result in a statistically significant reduction in concussion incidence and symptoms. Wide varieties of helmets were unable to protect against the impacts of simulated directional forces that would induce concussion in human subjects.”(1)
So what can we do?
In a recent study they came to the idea that since placing a helmet on top of ones skull did not prevent concussion because of the amount of room still within the cranium allowing for the ability of the brain to move around, how can we decrease the amount of space within the cranium so that the brain is limited in the amount of motion it can undergo? With this idea in mind they came up with the idea of a neck collar that athletes would wear that places a slight amount of pressure on the jugular veins leading to a backup of fluid within the cranium acting as a cushion for the brain. In this study they took 48 soccer athletes and divided them into two groups; one in which wore the collar and one that did not. Throughout the study they completed pre and post season testing. What they found was that the group that wore the collar showed significantly greater positive changes on imaging as well as during a working memory task. What this shows is that by decreasing the amount of space within the cranial vault, inevitably limiting the amount of space the brain can travel lead to a more favorable outcome in regards to concussion prevention. There is still a lot to learn about how we can create better devices to protect our brain so that we can continue performing the things we love without having to experience the long term adverse effects that come along with it; but this seems to be a great start.(2)
I hope you were able to learn something in this article and that it made you excited about the immense possibilities that are to come in the future around protecting our brains. If you or someone you know has recently sustained a concussion click the contact us button at the top of the page and schedule a complimentary phone call with the doctor to learn more about how we can help.
References:
1. Sone JY, Kondziolka D, Huang JH, Samadani U. Helmet efficacy against concussion and traumatic brain injury: a review. J Neurosurg. 2017 Mar;126(3):768-781. doi: 10.3171/2016.2.JNS151972. Epub 2016 May 27. PMID: 27231972.
2. Yuan, Weihong et al. “Mild Jugular Compression Collar Ameliorated Changes in Brain Activation of Working Memory after One Soccer Season in Female High School Athletes.” Journal of neurotrauma vol. 35,11 (2018): 1248-1259. doi:10.1089/neu.2017.5262