There is no concussion-proof football helmet, but manufacturers in the U.S. may soon have to meet new testing standards against certain concussion-causing forces – a step in the quest for more protection.
It's just one part of a movement to try to make contact sports safer, as concern about concussions is growing. There's even a new smartphone app to help parents and coaches recognize right away if a player may have a brain injury.
Football helmets were designed to protect against catastrophic injuries such as skull fractures and bleeding in the brain, and are considered highly effective at that. They're tested for how they withstand direct blows, so-called linear forces that can make the brain bump back and forth.
The proposed new standard would add an additional test of how helmets perform when an impact also makes a player's head suddenly spin, causing the brain to stretch and twist inside the skull as it changes direction. Scientists call that rotational acceleration, and brain specialists say limiting both kinds of forces is important.
"We're plowing new ground here," said Mike Oliver, executive director of the National Operating Committee on Standards for Athletic Equipment.
The hope is that the standard might eventually spur safer helmet designs.
"I don't believe helmets will ever be the sole solution for concussion," said Boston University neurologist Robert Cantu, a leading sports-concussion expert and vice-president of the athletic equipment standards committee. But he said "it puts us on the road to developing helmets that will lessen the chance for concussion."
Once the standard goes into effect, in about a year, it would apply only to new helmets.
"We don't foresee any need to replace all the helmets that exist with new and different helmets," Oliver said. "This is a first step."
Concern about concussions is growing amid headlines about former professional players who suffered long-term impairment after repeated blows to the head. It's not just football; concussions occur in a range of sports, from hockey and lacrosse to soccer and wrestling. Children and teens, with their still developing brains, appear to be at special risk.
The Institute of Medicine, an independent organization that advises the American government, warned last fall that too many young athletes still face a play-at-all-costs culture that discourages reporting the injury and staying off the field until it's healed.
Although millions of children and teens play school or community sports, it's not clear how many suffer concussions, in part because many go undiagnosed.
"Parents and coaches need to be prepared and educated about what the nature of this injury is," advised neuropsychologist Gerard Gioia of Children's National Medical Center in Washington, who is a medical adviser to USA Football.
The federal Centers for Disease Control and Prevention's "heads-up" campaign teaches signs of concussion – which may not appear right away – and what steps to take. Symptoms include confusion, weakness, appearing dazed or stunned, lack of co-ordination, mood or behaviour changes and even a brief loss of consciousness. Recent guidelines say anyone suspected of having a concussion should be taken out of play immediately and not allowed back until cleared by a trained professional.
Gioia helped turn that advice into the "concussion recognition and response" smartphone app to offer guidance on the field.
As for safety gear, last fall's Institute of Medicine report found little scientific evidence that current helmet designs reduce the risk of concussion. Indeed, while football helmets have gotten bigger and heavier in recent years, "our concussion problem has not gotten better," said Dave Halstead, a sports biomechanics specialist at the University of Tennessee and the Southern Impact Research Center testing laboratory, who advises the athletic equipment standards committee.
To test rotational acceleration, labs will put helmets onto a crash test dummy-like head with a movable neck. A machine then positions a ram to hit the head from different directions, at different speeds and as if different-sized players were behind the impact.
"It's about time," was the reaction from concussion researcher Steven P. Broglio of the University of Michigan and National Athletic Trainers' Association. Broglio wasn't involved in the NOCSAE move, but compared it to how car-crash ratings focused first on head-on collisions and then on side impacts. "We're adding another layer to get a better understanding of what helmets are capable of," he said.
It's not clear whether helmet changes really will help, cautioned Dr. Thom Mayer, medical director of the NFL Players Association. But "we're committed to making sure we look at what are the most cutting-edge helmet testing standards available. This is a step in the right direction," he said.
Helmet standards can't affect rotational acceleration caused by strong tackles to the body rather than a hit to the head, Halstead said.
He also emphasized other steps, such as teaching players not to lower their heads during a hit. Oliver agreed, adding: "Helmets are a small part of the efforts that need to be undertaken to protect players against concussion."