August 29, 2006

Football Helmets Not Always Fitted Properly

By Charnicia E. Huggins

NEW YORK (Reuters Health) - High school football players may run a lower risk of sustaining a head injury if their helmets are fitted by certified athletic trainers rather than coaches or other individuals, new study findings suggest.

"While professional and college teams have people trained in how to properly fit an athlete with a helmet, most high school and youth programs do not," study co-author Dr. Eugene Hong, of Drexel University College of Medicine in Philadelphia, said in a statement.

Athletic trainers, who receive textbook training on proper helmet fitting techniques, appear to be more likely to secure the players' helmets properly than are coaches, who may have not received such training.

Proper fitting helmets may not prevent all concussions, Hong told Reuters Health, but "if we can improve even a tiny bit, then I'll feel good about that as a professional," he said.

Each year, over one million students participate in high school football. These players experience from 30,000 to as many as 250,000 concussions annually in this country alone, according to Hong. While little is known about the best way to treat a concussion, "prevention of concussion is really the best treatment," Hong said.

A concussion occurs when a jolt to the head jostles the brain within the skull, sometimes tearing nerve fibers, and leading to symptoms such as headache, dizziness, disorientation or nausea within minutes or hours afterwards. Longer-term problems, which may appear days or weeks after the brain injury, include chronic headache, poor concentration, memory loss and sleep disturbances.

In the current study, Hong and co-author Dr. Tracey Covassin of Michigan State University, explored helmet fitting techniques and concussions among high school athletes. They analyzed responses from 289 surveys of directors of athletics from Pennsylvania and New Jersey high schools.

A total 286 concussions were reported among 22,888 varsity, junior, and freshman football players -- 3.5 injuries per 100 players -- during the 2001 season, Hong and Covassin report.

On most teams (43.4 percent), helmets were fitted by high school coaches, while 23.6 percent were fitted by athletic trainers, 21.2 percent were fitted by both coaches and athletic trainers, and 11.8 percent by other individuals.

Coaches did "a good job" of fitting helmets, but they did not use proper fitting techniques as frequently as the certified athletic trainers, according to Hong.

In roughly one out of four (25.5 percent) instances, for example, they failed to fit players' facemasks properly, two inches away from the nose. Also, in 17.5 percent of cases they did not place helmets one inch above player's eyebrows, and 17.5 percent of the time they didn't place the helmet's chin straps an equal distance apart.

"Certified athletic trainers trained in proper fitting were employing more techniques to fit helmets than coaches were," Hong said.

Most of the high schools surveyed employed certified athletic trainers but the majority of them did not use these professionals to fit helmets on their football players, Hong said.

In light of this, Hong advised that parents, coaches and other school officials shouldn't rush to the Internet or other sources to discover the proper fitting techniques for helmets, but rather that they "utilize the resources they already have in their school districts."

Hong and Covassin's current findings, presented recently during the annual meeting of the American College of Sports Medicine, will be published in an upcoming issue of the ACSM's journal, Medicine and Science in Sports and Exercise.