When I was a kid, helmets were for motorcyclists. Now I see children wearing helmets when they’re scooting down sidewalks, skating, skiing, sledding, and playing soccer. Last week one of my friends saw a helmeted kid power-walking in Prospect Park. You can even buy $40 baby helmets on Amazon, because, according to the product description, “babies will always fall taking their first steps.”
Putting aside the debate over whether helmets are truly necessary in all of these situations, there’s something about helmets that you might not know: They won’t protect your kids from common head injuries that may cause long-term problems. There’s no question that helmets save lives by preventing skull fractures and other lethal brain injuries. But according to a 2013 report on youth sports-related concussions by the Institute of Medicine and the National Research Council, “there is limited evidence that current helmet designs reduce the risk of sports-related concussions”—minor traumatic head injuries that have been tied, at least in adults, to long-term neurological problems including depression, chronic traumatic encephalopathy (a neurodegenerative disease) and chronic cognitive impairment.
Look, I’m no fan of alarmist parenting info. But the fact that helmets don’t protect against concussions might influence the choices we make as parents, so I think it’s important to know. I’m not advocating that we lock our kids in the house and don’t ever let them take physical risks. But just because you’ve slapped a helmet on your hockey-playing 8-year-old doesn’t mean he’s protected from long-term brain injury—so those drills his coach has been doing in practice that require him to ram head-first into his teammates? You might want to see if something less concussive could be substituted. (By the way, parents of girls, you aren’t exempt: Research suggests that concussion rates are actually higher among young female athletes than young male athletes in the same sports.)
That helmets don’t protect against concussions is particularly worrying considering that children and adolescents may be both more vulnerable to concussions and recover more slowly from them compared to adults. And statistics suggest that concussions are becoming more common among kids—one recent study, for instance, reported a doubling in concussion-related ER visits by youth between 1997 and 2007. Some of this increase is undoubtedly due to growing awareness about concussions and better diagnostic techniques, but concussions are still believed to be underreported: When researchers surveyed 12-to-17-year-old soccer players about their concussion history, only 7 percent of them ever reported suffering concussions, but a whopping 48 percent said they had experienced concussion symptoms at least once, which suggests that far more kids are getting concussions than are being diagnosed with them. There’s no good treatment for concussions, other than rest (for days, weeks or months, depending), but this rest is crucial: individuals who get concussions and then hit their heads again before they’re fully healed can suffer brain swelling and even die.
So why don’t companies start making concussion-proof helmets? I mean, if there’s a market for baby helmets, these puppies would fly off store shelves faster than quinoa on clearance. One problem is that there’s a lot the medical community still doesn’t understand about concussions. If you try to find a definition for concussion in the scientific literature, you’ll find a vague and confusing description along the lines of “a traumatically induced transient disturbance of brain function” that “involves a complex pathophysiologic process.” Concussions are typically diagnosed based on symptoms—headaches, dizziness, amnesia, nausea, and vomiting are among them—but as for what kinds of blows to the head cause them, that’s still largely a mystery. “I couldn’t even define the mechanism,” explains Adam Bartsch, Director of the Cleveland Clinic’s Head, Neck and Spine Research Laboratory. And we can’t come close to designing a concussion-proof helmet, he says, until we understand exactly how concussions happen.
Nevertheless, there are a few hints. For one thing, concussions typically develop after lower-impact head hits—ones that aren’t as forceful as those that crack skulls. Research suggests that concussions are also caused in part by impacts that cause the brain to rotate inside the skull, or what is called rotational acceleration. This kind of acceleration is believed to damage nerve fibers called axons, leading to concussion symptoms. So in theory, a helmet that mitigates this kind of acceleration at lower-than-lethal impact forces might help prevent concussions—and would be especially great for young athletes, considering that the many common blows to the head endured by high school football players induce rotational acceleration and are usually these lower-impact hits.
Problem is, current helmet standards—both for kids and adults, and for all sports— totally ignore rotational acceleration. As a 2013 paper by Virginia Tech researchers put it, “there currently is no federal or industry head injury safety standard that considers rotational acceleration, even though there is strong evidence linking it to injury.” Indeed, today’s sports helmets are designed to attenuate high-impact linear acceleration forces, which occur in a straight front-to-back line, like “if you hit the head through the center of gravity,” explains Robert Cantu, a neurosurgeon at the Boston University School of Medicine and co-author of Concussions and Our Kids: America's Leading Expert on How to Protect Young Athletes and Keep Sports Safe.