Recent coverage of the NFL has renewed the discussion about football and the consequences of head injuries. While this topic runs high with emotion and misinformation, the topic of helmets remains misunderstood.  Antonio Brown of the NFL’s Oakland Raiders had petitioned the NFL for permission to wear a specific helmet and was denied. Patriot great Tom Brady was forced to change his helmet of choice based on new requirements of the NFL’s industry standards. Despite the political and liability issues surrounding head injuries, the players have a good point. While this may simply seem like a player safety issue, the truth is that over the last several decades, advances in helmet technology have not been shown to be protective against concussions and other head trauma.

Why, you might ask? There are likely several reasons that helmets have a limited ability to protect the brain. First off, helmets are very good at protecting the head from the impact forces — think hammer hitting nail — that can create minor injuries such as contusion and more serious injuries like skull fractures. However, many injuries — including concussions — are thought to be caused by a shearing force created by rapid acceleration and deceleration of the human body. Think about a crash test dummy in a car. The cage of the car — the helmet — absorbs the impact force of the collision but the dummy still flails around in the car. Hence a seatbelt and airbags are still needed to protect the individual. Several recent studies on skiing and snowboarding have shown increased rates of bleeding and other serious brain injuries in helmeted versus non-helmeted skiers and riders. While these studies have limitations, they highlight the fact that behavior — risk taking — may outweigh the benefits of protective gear in some cases. It has been argued, and I think with some merit, that if you want to remove the issue of head injury from football, then take away the helmets. It does seem likely that making helmets “feel” safer may lead to riskier behavior and, in some cases, inadvertently increase the risk of more serious injury. Teaching better tackling techniques, such as keeping the head out of the tackle, and rule changes are likely to have a much greater impact on the risks associated with football. Our advice is to always wear a helmet, but don’t stop using your head!

For more information regarding helmet use in sports, check Helmet Use: Fact and Fallacy, and Helmet Use in Alpine Skiing and Snowboarding

Matthew Gammons, MD
Vermont Orthopaedic Clinic
Killington Medical Clinic
iSPORT Training