For high school football players, the best defense against concussions is a good offense—and that means a well-fitted football helmet, according to Dr. Eugene Hong.
But many high school athletes don't receive a proper helmet fitting, which can put them at increased risk for concussion during play, said Dr. Hong of Drexel University, Philadelphia, in an interview.
Certified athletic trainers specially trained in gear fitting are most qualified to perform that task, Dr. Hong said. But his survey of 289 high schools in Pennsylvania and New Jersey showed that although 90% of schools have a certified athletic trainer available, only 44% of those schools use the trainer to fit helmets. Coaches or other individuals (including parents) do the fitting the rest of the time and make mistakes up to 25% of the time.
The overall concussion rate in Dr. Hong's survey was 3.5%, and it wasn't significantly different between players fit by trainers and those fit by coaches or others. However, Dr. Hong said, athletic trainers were fitting helmets a little better than coaches were, with significant differences in 3 of 10 recommended fitting techniques.
The three most commonly missed fitting techniques among coaches were not having the facemask 2 inches from the nose (25.5%), not positioning the helmet 1 inch above the eyebrows (17.5%), and not having the chin straps equidistant from each other (17.5%).
Parents and student athletes should be reminded at the preparticipation physicial examination of the importance of properly fit gear, Dr. Hong said.
Proper follow-up with conservative return-to-play decisions are vitally important for athletes recovering from a concussion, he added. Receiving a second blow to the head before a previous concussion has completely resolved can lead to second-impact syndrome, a usually fatal brain swelling.
Dr. Hong presented his data at the American College of Sports Medicine's annual meeting; the study will be published in the journal Medicine and Science in Sports and Exercise.