Researchers examined helmet fit for 273 players ranging in age from 7 to 12 years old who were on teams in four recreational youth football leagues in the southeastern United States. To assess helmet fit in the new youth football study, researchers used a 13-criteria checklist:
The helmet appears in good conditionAll padding is in placeAll snaps and screws are in placeNational Operating Committee on Standards for Athletic Equipment (NOCSAE) football and sticker or logo is visibleHelmet fits head snugly all sidesHelmet covers the base of the skullCrown of helmet is 1 to 2 fingers above eyebrowsHelmet does not impinge neck movementHelmet does not cover eyes when pressing downChin straps have equal tensionFace mask does not slip when pulled left to rightFace mask does not slip when pulled up and downSkin on forehead moved with helmet front to back and left to right
They classified the helmet as fitting improperly if it failed to meet all 13 of these criteria. The study was not peer reviewed, a method used in the scientific community to verify findings, and it has not been published in a medical journal. Overall, only 17 percent of helmets met all 13 criteria for a proper fit, the study found. Most often, the reason for an ill-fitting helmet was the chin strap, which wasn’t centered and evenly snug to the face on both sides of the chin in 46 percent of cases. Some of the other common reasons helmets didn’t fit included the face mask slipping up and down, which occurred in 36 percent of cases, followed by lack of snugness on all sides and the crown of helmet not positioned within 1 to 2 fingers above the eyebrows, which both occurred in 26 percent of cases. Poorly fitting helmets put players at unnecessary added risk for injuries, says lead study author Susan Yeargin, PhD, a certified athletic trainer and associate professor of exercise science at the University of South Carolina in Columbia. “If the helmet fits properly, a young athlete may not have as many or as severe symptoms when they get a concussion,” Dr. Yeargin says. “A properly fitted helmet is more likely to disperse head impact forces.” Based on the study results, it makes sense for parents and coaches to focus their efforts first on evaluating the chin strap when they don’t have an athletic trainer who can do a more detailed fit assessment, Yeargin advises.
Helmets Don’t Need ‘Room To Grow’
Coaches or parents should also measure the player’s head circumference then make sure this is in line with the sizing recommendations provided by the helmet manufacturer. “We saw many helmets that were too loose and when you held the face mask, moved it side to side, and up and down the helmet slid around the head,” Yeargin says. “Instead, it should be snug against the head and not slide.” Another common mistake is giving kids room to grow. “Helmets are not something that should be purchased a size bigger so the child can grow into it,” Yeargin says. “It should fit at the time of purchase.”
Previous Studies Link Poor Helmet Fit To Worse Concussions
One study. published in March 2016 in Sports Health, examined data on 4,580 concussions sustained by high school football players and found that patients who wore helmets that didn’t fit properly suffered concussion symptoms for longer and experienced more symptoms overall — 5.34 on average compared with 4.54 among athletes with helmets that did fit. In addition, players with poorly fitted helmets were 46 percent more likely to experience excessive drowsiness, 88 percent more likely to have sensitivity to noise, and more than twice as likely to be hyperexcitable after concussions. Another study, published in February 2016 in the American Journal of Sports Medicine, suggested that athletes may be fine in reconditioned helmets, or wearing helmets for multiple seasons as long as the gear still fits. This study examined data on 2,900 concussions sustained by high school football players and found players had a similar number of symptoms as well as similar severity and duration of symptoms with both new and reconditioned helmets. Helmets can be worn multiple seasons, Yeargin says. But they should be checked by an athletic trainer to ensure that they still fit properly to avoid any increased risk of injury.
Helmet Fitting Criteria Are Voluntary, Not Enforced
Even though there are standards for maintaining helmets and other athletic equipment, checklists like the one used in the study are voluntary and are not consistently enforced, says Monica Vavilala, MD, director of the Harborview Injury Prevention and Research Center at the University of Washington in Seattle. Some schools recondition and rectify their football helmets every year to ensure they still function properly and fit athletes correctly, says Dr. Vavilala, who wasn’t involved in the new helmet study. Other schools do this every two years. To ensure kids don’t wear an ill-fitting helmet, particularly at schools where gear is inspected less frequently, parents should know the manufacturer of young players’ helmets and check the fit following instructions from the manufacturer, Vavilala advises.
Guides for Proper Helmet Fit
There are several excellent guidelines for helmet fit, including from the Centers for Disease Control (CDC) and professional organizations like the National Athletic Trainers Association, says Kristy Arbogast, PhD, co–scientific director of the Center for Injury Research and Prevention at the Children’s Hospital of Philadelphia. Helmets should get a quick fit check before every game, especially when kids have a new hairstyle or wet or sweaty hair that might change how the helmet sits on the head, says Dr. Arbogast, who wasn’t involved in the new helmet stud. These include checking to ensure that:
The helmet doesn’t slide or rotate on the headThe helmet doesn’t sit too high or low on the headThe chin strap fits snugly
“Once the helmet is put on and the chin strap is fastened, it should not easily move in any direction,” Arbogast advises. “Grab the face mask and give it a tug in multiple directions.” None of this should move the helmet. And helmets should be checked again for damage after every game, and replaced if anything appears amiss.
Helmet Fit Just One Part of Concussion Prevention
To keep players safe from injury, parents and coaches need to focus on more than just kids’ helmets, Arbogast says. “Concussion prevention is multifaceted; there is no one intervention that is the single solution,” Arbogast notes. Properly fitting and maintained equipment is one of those solutions. But it’s just as important to remove players from practices or games as soon as an injury is suspected, develop rules to minimize high severity collisions especially among young athletes, and to enforce a gradual return to play for any players who do sustain concussions, Arbogast says. RELATED: Early Treatment for Concussion May Reduce Recovery Time “All of these factors are key parts of a strategy to reduce the risk of concussions and the burden of the injury on the child and family when they do occur,” Arbogast says.
