Add-on helmet shells may not reduce risk of concussion in high school football players
Key takeaways:
- Use of Guardian Caps in high school football players did not reduced risk of concussion during practices or games.
- More research into evidence-based measures is warranted to reduce the incidence of concussions.
Results showed Guardian Caps (Guardian Sports), add-on helmet shells designed to reduce head impact forces in football players, were not associated with reduced risk of concussions during practices or games in high school players.
“The use of these devices was mandated during the preseason in certain position groups by the NFL in 2022,” Erin Hammer, MD, MPH, and colleagues at the University of Wisconsin School of Medicine wrote in the study. “Subsequently, the NFL attributed a significant reduction in concussion rates during the preseason to [Guardian Caps]. Laboratory studies investigating the efficacy of [Guardian Caps] to reduce impact forces have had mixed results, and no studies have investigated the real-world effectiveness of Guardian Caps to prevent sport-related concussion (SRC) in high school football players.”
Hammer and colleagues analyzed data from 2,610 football players from 41 high schools in Wisconsin during the 2023 season. Among the cohort, 1,422 athletes wore Guardian Caps, while 1,188 athletes did not wear Guardian Caps. Hammer and colleagues noted no athletes wore Guardian Caps during games. Team trainers recorded total practice and game exposures and total SRCs.
Overall, 180 athletes (6.9%) sustained a SRC during the season. During practice, 64 SRCs occurred, with 51.6% (n = 33) occurring in athletes who wore a Guardian Cap. After univariable analysis, Hammer and colleagues found Guardian Caps were not associated with a decreased risk of SRC during practice (RR =1.04; 95% CI, 0.58-1.86) or for athletes who had a previous SRC within the last year (RR = 1.01; 95% CI, 0.57-1.79).
During games, 116 SRCs occurred, with 58.6% (n=68) recorded in athletes who wore a Guardian Cap during practice. After univariable analysis, Hammer and colleagues found use of Guardian Caps during practice was not associated with a decreased risk of SRC during games (RR = 1.13; 95% CI, 0.72-1.78) or for athletes who had a previous SRC within the last year (RR = 1.13: 95% CI, 0.71-1.78).
“Furnishing a football team with equipment with unproven benefits may provide false reassurance to parents that their children are protected from SRCs,” Hammer and colleagues wrote. “Similarly, athletes may play more aggressively because they feel protected by wearing a [Guardian Cap]. It also might divert resources away from evidence-based measures that can reduce SRC incidence and improve health outcomes such as employing [athletic trainers] or considering rule changes.”
Perspective
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A recent study involving 2,610 high school football players from 41 Wisconsin schools examined whether Guardian Caps during practice reduce sport-related concussions (SRCs). The study reported 64 SRCs during practice and 116 during games, concluding that the use of Guardian Caps did not significantly decrease concussion risk in either practice or games. Helmet modifications alone do not effectively prevent SRCs.
The difference in SRC occurrences between practices and games suggests that factors such as game intensity significantly contribute to concussion risk. The study's limitations should be considered, including sample size, participant diversity and duration. Other variables, such as differing coaching styles between practices and games, player behavior, skill and effort, may affect the outcomes.
The findings emphasize the need for a comprehensive approach to concussion prevention beyond equipment. Proper tackling techniques, rule changes and education on SRC symptoms are crucial. While protective gear is important, relying solely on it is insufficient.
Future research should explore alternative protective strategies and technologies through longitudinal studies. These studies may influence policy decisions on mandatory equipment and practice guidelines in high school sports. It's essential to maintain a balanced perspective on sports safety, advocating for continuous innovation and evaluation of protective measures. Although Guardian Caps might not reduce SRCs as hoped, the caps remain part of broader efforts to safeguard athletes.
It is crucial to encourage coaches, parents, athletes and sports organizations to remain informed and proactive about concussion management and prevention. Examining these factors can help us better understand the study's implications and the broader context of concussion prevention in high school sports.
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