Do Helmets Really Prevent Concussions?

The answer is a hedged, very qualified “maybe” – helmets can prevent some, but not all concussions. It is always a good practice to wear head protection when cycling, riding a motorcycle or ATV, or participating in contact sports like American football, soccer, baseball, and hockey.

At the same time, everyone should be aware that helmets don’t (and cannot) offer complete protection from concussions. As we start a new school sports season, some key points for parents and student athletes to consider:

1. Helmets are evolving from “dumb” head protection into sophisticated concussion detection and analysis devices

Helmets are now available with embedded accelerometers and other impact sensing devices that can provide accurate estimates on how much force a player’s head sustained during impact. This is useful information that can be used by physicians for concussion management. However, concussion detection should never be confused with concussion prevention.

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2. Repetitive “minor” knocks to the head can be just as damaging as a major concussion

A recent study on concussions in team sports (football and soccer) pointed out a couple of stunning numbers:

American football players, depending on position, can receive more than 1,500 hits each season
Soccer players can receive more than 1,000 hits per year, through the act of “heading” the ball

The American Academy of Neurology (AAN) has looked at the possible consequences of athletes sustaining multiple subconcussive hits in detail. The results indicate that athletes who receive several subconcussive blows to the head during a playing season have significant brain “white matter” abnormalities compared to their peers who didn’t encounter head hits.

This finding is significant because the white matter in our brains is the wiring that connects different brain regions together, allowing for planning skills, reasoning, language, etc. The AAN study also indicates that athletes who received multiple hits to the head also scored worse on standard cognitive tests compared to unaffected players.

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3. Some people may have “brain vulnerability” genes that expose them to far greater risk from concussions and other head trauma compared to people who don’t carry these genes.

This is an emerging area of research that will have profound legal, ethical, and societal implications in the years ahead.

There is growing evidence that several genes that act directly on brain development and brain health may confer either added protection or added weakness to a person’s brain. One gene in particular, apolipoprotein E (APOE), is implicated in a number of brain maladies, including Alzheimer’s disease and chronic traumatic encephalopathy (CTE), a degenerative brain disorder that has affected several professional football players, along with military veterans who have been exposed to brain trauma.

Bottom line: Athletes, parents, and students can make informed choices about the relative risk of concussions from any activity, including contact sports. Special attention should be paid to the negative brain health effects of repetitive “minor” hits to the head. Future research may also lead to a standard method screen for certain genes that indicate heightened risk of brain disorders from concussions.