LAUSR

Sport-related concussion is a major public health concern. In a recent BJSM publication, McGuine et al conducted a randomised controlled trial (RCT) to evaluate whether soccer headgear would reduce the rate or severity of concussions in adolescent athletes (nheadgear = 1505, nno_headgear = 1545).1 Both ‘control’ athletes (who wore no helmets) and the athletes who wore soccer headgear had similar concussion rates and recovery times after a concussion. In another study, headgear was also found to be ineffective in reducing concussion rates or recovery times in rugby union.2 Padding may seem like the most intuitive way to protect the head from injury. So why might this approach not be concussion-proof? Adding a foam pad can help ‘soften the blow’, by increasing the loading area and absorbing some of the impact energy. However, given a regular thickness pad, substantial impact energy is still transmitted to the head and produces a sharp head/skull acceleration. The skull acceleration in turn shakes and deforms its contents—the brain. Traditionally designed helmets and padding reduce focal loading and head linear accelerations that are associated with skull fracture risk.3 However, head rotation has been hypothesised to be a …