In Preventing Concussions, Fancy Helmets Aren’t Always Fail-Safe

June 19, 2011, 7:01 pm

When Michael Higgins first started working with lacrosse players in Baltimore nearly two decades ago, protective headwear was a far cry from the high-tech helmets now found in college locker rooms around the country.

“Back then, it was suspension helmets—a couple pieces of cloth on top of the helmet,” says Mr. Higgins, who directs the Athletic Training Education Program at Towson University and specializes in research on helmets and brain injuries. “They didn’t have the harder shell as the ones do today, and the front cages were not as strong. None of them really had a chin guard the way the new ones do now.”

Major advances in the strength and design of lacrosse helmets have since made them safer and more effective in preventing major injuries like skull fractures. But Mr. Higgins thinks the helmets worn by male players in this fast-growing sport still lag behind the headwear of another game where colliding bodies are commonplace.

“Lacrosse helmets are behind football helmets,” Mr. Higgins says. “But they’re getting there.”

On Monday, Mr. Higgins will join two other experts on sport-related brain injuries, Kevin Guskiewicz and Jason Mihalik, both of the University of North Carolina at Chapel Hill, to talk about the role of helmets in reducing the risk of concussion at the annual meeting of the National Athletic Trainers’ Association in New Orleans. Their presentation is one of several focused on preventing, diagnosing, and treating head injuries among athletes of all ages.

Athletic trainers, in particular, have to be intimately familiar with all the quirks of various types of protective equipment, including helmets, Mr. Higgins says. Not only do these sports-medicine professionals need to understand the protective capabilities of headwear—they also need to know how to safely remove a helmet from an injured athlete without putting him at risk for spine injuries. That’s why a cordless screwdriver is often among an athletic trainer’s many tools: They can use it to remove a helmet’s face mask and administer CPR.

But that’s a worst-case scenario. A more chronic challenge, Mr. Higgins says, is the athletic trainer’s task of educating coaches, athletes, and parents on the limits of even the fanciest protective gear.

Helmets do not provide complete protection from concussions, says Mr. Higgins, who has also published research on the role of genetics in athletes’ risk for traumatic brain injuries. “You can get a concussion from shaking your head,” he points out. It’s not that the helmets aren’t doing what they’re supposed to—it’s that the precise causes of concussion still vex many medical researchers, even after years of energetic research. Indeed, as Mr. Higgins’s co-presenter, Mr. Guskiewicz, has found in his own research on the mysterious brain injury in football, sometimes the hardest hits to the head fail to cause a concussion—while jolts of a far lesser impact can cause concussions that linger for weeks.

Still, it’s tempting, for many people, to place far too much faith in helmets’ ability to prevent concussions altogether, Mr. Higgins says. “You can make the best helmet in the world,” he says. “Is it going to protect you from a concussion? Probably not. But people don’t understand that.”

In the lacrosse world, enthusiasm for protective gear has opened up a heated debate that Mr. Higgins plans to address at the athletic trainers’ meeting this week: Should women wear helmets?

Mr. Higgins thinks not. “If the game is refereed and played the way it should be played, there’s no need for helmets,” he says. Women, who wear protective eye gear but no helmet, do not body-check in their version of the game. Introducing helmets may make the game rougher and provide players with a false sense of security.

“If I have a helmet on, I’m going to be a bit more aggressive,” he says. “If you feel more protected offensively, a player may just dive through there and take chances they wouldn’t have taken if they didn’t have the helmet on.”

Research into the effectiveness of helmets continues as the technology progresses and as medical researchers learn more about this puzzling, but common, injury. Football still leads the way: Last month, researchers at Virginia Tech-Wake Forest University’s School of Biomedical Engineering and Sciences published findings from a study rating the effectiveness of five common football helmets in reducing concussion risk. Using a five-star system—“just like cars,” says Mr. Higgins, who would like to do similar research someday for lacrosse helmets—the researchers submitted each of the football helmets to more than 100 impact tests. Then, they calculated an athlete’s risk of sustaining a concussion if he were to wear the helmets for one year of a collegiate season.

One of the helmets that didn’t fare so well in the tests happened to be a model worn by more than three dozen players on the Hokies’ football team during spring practices this year. After the study was released, medical staff for the football program decided to switch to a better-performing model. Football helmets aren’t cheap, in many cases topping $200 apiece, but in this instance, that wasn’t a concern to the athletic department: The biomedical-engineering school paid for them.

(Rob Carr, Getty Images)

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linda22121

But isn’t that the point, “Ph.D. preferred”? Have you ever hired someone with a master’s over someone with a Ph.D.?
robjenkins

My institution has, many times. Once people make it to the interview stage, we’re just looking for the best teachers and colleagues.
tcolb01

Rob, your response to Lauren’s question is perfect. Successful completion of a master’s degree is a major accomplishment, not to mention additional coursework beyond the master’s.
richardtaborgreene

great piece of work
lawrencevillecco

As Gabby Johnson says in Blazing Saddles, “Ribbght!!”
11191774

I believe–but am not certain–that the “College is a match to be made, not a prize to be won” phrase came from Frank Sachs, former NACAC president and Director of College Counseling at the Blake School. He deserves credit for this gem, which I hear all the time.
lawrencevillecco

Yes, apocryphal, but attributed thus….
schindy

Excellent Mark. Your rumination asks us all to reflect on what has become casual language and questions whether trite terms really serve our students well.
11182967

This article is a good statement of a very important point. The concept of the “right fit” reflects the world of Match.com, Christian Mingle, and their ilk (not to mention “Bachelor” and the “Bachelorette”–can “The Widow,” “The Widower,” and “The Gay Divorce[e] be far behind?).

What is fundamentally perncious about the concept of the “right fit” are the twin presumptions that 18-year-olds are already so fully formed that they can wisely choose their associations and so finally formed that these associations–of interests, of persons, of ideas–cannot, will not, should not be challenged and changed. What better place to receive an education than a college which is in many ways not a good fit?–what challenge is there (other than that of boredom) in a place where everyone is the same?

When I went to college I assumed that I would be a different person when I graduated and that this would be a good thing (and I was and it was). Indeed, that was why one went to college. College was part of one’s “formative” years, a time of formation and frequent re-formation (we were serially Socratic, Platonic, Aristotelian, Augustinan, and so on, until we started to become ourselves), not conformation and affirmation.

For the individual and for society it is most fitting that college be not a fit, but fitful–and give us fits.
tippens

Well said! This essay demonstrates that “fit” can be easily be code for “whatever pleases my palate.” Sadly, this plainly consumerist approach to education may eliminate the exquisite pleasure of surprise, the encounter of the unknown. Yvon Chouinard, the environmentalist founder of Patagonia, said, “Adventure is the uncertainty of outcome.” Here’s to adventure.
collegeexplorations

Brilliant!
greatcollegeadvice

Very well done, Mark.

Amadis, Beatrice, the Holy Grail. Somehow kids–and their well-meaning parents–have romanticized university life to the point that we have to remind them that university life is mostly just “life.”

I force a lot of my students to read Robert Frost’s poem, “The Road Not Taken.” We talk about how one cannot know what is down which path. We talk about how life is full of choices, and many choices have to be made in conditions of relative uncertainty. And that what makes “all the difference” is how one takes advantage of whichever path one choose.

When I talk to parents, I generally compare the selection of a college to a choosing a spouse: is there only one person to whom you could be happily be married? Is there one ideal “fit” for you? After 20 or so years of marriage (or divorce), do you still hold on to romantic notions of the ideal spouse? Not surprisingly, most parents will shut up about “fit” at that point and talk about more important things, like “general compatibility.”

Thanks for demolishing the ideal of “fit.”
_perplexed_

Well then put it to the test: Evaluate each application, have an admissions officer rate each application on a 1-7 scale where 1=my gut says this applicant will do very poorly if admitted and 7= my gut says this student will excel if admitted, and then see whether this gut feeling has incremental validity when grades and test scores are in the mix– if so, then by all means, use that gut rating!
5768

Promotion of the idea “You get out of it what you put into it” would go further in serving students than the idea that universities are Burger King’s serving up satisfaction a la “have it your way,” ie., “we will fit you like a glove.” Let’s open student minds rather than close them onto the limitations of their current consumer expectations. Excellent article.
reineke

Although speaking as a Girard scholar, I am thrilled to see mimetic
theory applied in such a cogent and insightful way, I would not dismiss the
concept of “fit” out of hand. Key to
determining a solid fit is in getting inside the college experience rather than
looking at it from the outside. Tour guides and
admissions offices tend to focus on “fit”
as described in this article. But if a
visiting student (or the parent in tow) can cut through a student guide’s
canned speech to ask about the guide’s current classes and interactions with
professors and students in those classes, enormously revealing insights are
often forthcoming. So also can visits to
at least two classes during the campus visit be revelatory. Student guides’ attitudes about their classes
were THE deciding factor in my own daughter’s quest for “fit.” At one college, the tour guide’s passion for
learning (confirmed in her classroom visits as she observed other engaged
students) matched my daughter’s own desire for learning. Was it mimetic? Yes, but in embracing the inner scholar in
herself, my daughter drew on what should count most in making a decision for
college. Unfortunately, admissions
offices are often complicit in advocating fit for the wrong reasons. At my own institution, the academic experiences
of students are all but missing from the campus visit. An admissions office film featuring one of
my gifted students—a model for the kinds of students faculty wish dominated our
campus—shows my student talking about ice cream in the dining center, not about
how his classroom experiences and co-curricular leadership activities have
supported his extraordinary academic achievements.
josephofoley

A tiny point and perhaps an irrelevant one — in the Tobias Smollett translation of Don Quixote, Dulcinea does exist. She was the “hale, buxom country wench, called Aldonza Lorenco, who lived in the neighborhood, and with whom he had formerly been in love;…”
markcmoody

Thank you for the very kind comments. It is a nerve-wracking thing for a civilian like me to throw around scholarly concepts in the Chronicle! All the points made in these comments are valid– we tease some of this out to a greater degree in our spoken presentation. There are many directions to go from here. Reineke, it is exactly that distinction between “inside” and “outside” that we try to explore– the challenge in our work with kids is to guide them to an understanding of the things that will shape their lived “inside” experience in college. I’m still working on strategies to accomplish that! What I can say is that I think that the work of admission and guidance counselors should be rooted in an awareness of adolescent development, and that it should seek to encourage personal reflection and a growth in self-knowledge– even if it takes some discomfort to get there. The college decision process is for many students a significant rite of passage to maturity and a chance to gain some resiliency and a tolerance for healthy uncertainty and risk. As adults around them, we can very effectively derail that or we can work to support a process that allows for personal growth. Josephofoley– fair point. The most correct thing to say is that we never encounter Dulcinea as readers. Thanks again for reading carefully and commenting on this!
http://twitter.com/CharlotteKlaar Charlotte Klaar

One factor in determining fit has been left out of this excellent essay: student self-awareness. One of the things I do with my students is to help them develop this awareness of what they like, what they don’t like, what they are good at, and what they struggle with. Often, these lengthy conversations with students are the first time anyone has both asked the student these questions and challenged their responses. so that they dig deeper into their forming consciousnesses. From these discussions come realistic approaches to colleges (note the plural) that will provide a good fit for the student academically, socially, and emotionally. There are more than one college that is the Holy Grail. Often, it is key to remind the student and family that it is not just their choice; the colleges have a great deal to say about what opportunities you will be offered so a balanced list is important.
http://www.facebook.com/people/Olen-Kalkus/100002226426983 Olen Kalkus

Let’s not demolish the idea of “fit.” What needs demolishing is the idea of “perfect fit.” There are many colleges and universities that would be good fits for many students. The quest for the “perfect fit” is a romantic ideal similar to the idea of the one “perfect partner.” Students should be counseled /advised that there are many good fits for them out there.
In my opinion a quest for “fit” is preferable to a ridiculous obsession with rankings.
22074041

It sounds as if it is not so much policy as wise and effective implementation of sound policy that is required to prevent abuse of systems that are designed to achieve worthwhile goals. Naomi F. Collins, Ph.D.