Play it Safe: Basics of Proper Helmet Use

If you or your child plays sports or participates in physically risky activities, wearing a helmet could be lifesaving. While no helmet is concussion-proof, wearing one can help reduce the risk of serious head injuries.

"Helmets are made with materials that help reduce impact to the head, protecting the skull from damage," says Jeffrey Kutcher, M.D., a sports neurologist who treats athletes at the Henry Ford Kutcher Clinic for Concussion and Sports Neurology. "You should be wearing a helmet whether you're playing a contact sport or riding something on a hard surface, such as a bike, scooter, skateboard or rollerblades."

Head Injury Prevention 101: Helmet Buying Basics

All helmets are certified at the same level for multi-use recreational activities. So there's no need to search for a specific seal or rating. Instead, when you're purchasing a helmet — or getting one second-hand — focus on these four factors:

How you’ll use it:

Pay attention to the risks involved with the activity you're doing. If you're biking, skiing or snowboarding, for example, you're wearing a helmet in case you get hit, not because you'll get hit.

There are two types of helmets: single-impact and multiple-impact. Single-impact helmets are made with foam materials that break down when hit as part of their force mitigating strategy. These helmets work well for bicycling, skateboarding, skiing or snowboarding. Multiple-impact helmets, such as those designed for sports like football, hockey and lacrosse, can withstand many hits over an entire season. The materials in these helmets don't break down, but rather compress and regain their original form.

"A helmet may perform better in the lab — for example, the dummy brain will experience 98Gs of force instead of 100Gs — but 2Gs of force probably won't make enough of a difference with a one-time injury," Dr. Kutcher says. "But 2Gs less force per hit for a linebacker who suffers multiple blows on a daily basis for many years? That could make a big difference.”

If football is your sport, the National Football League provides a helmet rating system that assesses helmets based on their ability to mitigate force over time.

How it fits:

Helmets fit differently depending on the make, style and type of sport they’re made for. "The key is making sure the helmet covers the entire skull and doesn't move around when in use," Dr. Kutcher says. The helmet should sit on the head without falling forward or backward. If you're relying only on a chinstrap to keep it in place, you don't have the right fit.

How comfortable it is:

Not all helmet brands fit every head. Helmet designs vary just like running shoes do. When you're shopping for a helmet, make sure it's snug, but not tight or uncomfortable. Comfort is critical, especially for kids. "You don't want a child to develop a negative association with wearing a protective helmet," Dr. Kutcher says.

What condition it’s in:

To get the most protection, your helmet should be in top condition. Do not wear a cracked or broken helmet, or one that has been involved in a crash or similar event (unless it's a multiple-impact design). An impact can crush foam materials. And don't allow the helmet to get too hot or cold — that can cause the materials to break down over time.

Get the Best Helmet Fit for Your Head

Properly wearing a helmet provides the greatest defense against injury — more than any style or brand. To make sure your helmet is secure, follow these rules:

· Measure head circumference: Every helmet brand provides a size chart, along with instructions about how to select the best fit. To get the best measurement, use a cloth tape to measure your head circumference. Place the tape about an inch above the eyebrows, keeping it level from front to back. If the measurement falls between sizes, select the smaller size.

· Pay attention to hairstyles: Make sure to try the helmet on with the hairstyle you'll have during the activity. A long-haired bike rider who gets a short haircut may require a helmet adjustment.

· Watch your vision: The helmet should not block your vision. You should be able to see straight ahead and side to side.

To Wear a Helmet or Not To Wear a Helmet: When to Play It Safe

There are several sports that don't require wearing a helmet. But if you or your child is involved in rugby or soccer, or another sport where helmets are optional, that doesn’t mean you're in the clear.

"It's important to base any decision about whether or not to wear a helmet in conjunction with your sports neurologist," notes Dr. Kutcher. "Your past medical history and current health status may still warrant the use of a helmet."

Unsure whether you're at risk of sustaining a head injury? Get a brain health baseline evaluation. Proper consideration of your brain health includes a physical examination, along with a personal and family medical and neurological history. It also offers you an opportunity to learn how to best protect your head.

Dr. Jeffrey Kutcher is a sports neurologist at the Henry Ford Concussion and Sports Neurology Clinic and the global director of the Kutcher Clinic.

Want to learn more? Henry Ford Health System sports medicine experts are treating the whole athlete, in a whole new way. From nutrition to neurology, and from injury prevention to treatment of sports-related conditions, they can give your athlete a unique game plan.

Visit henryford.com/sports or call (313) 972-4216 for an appointment within 24 business hours.

When Can I Walk Off Knee Pain — And When Should I See A Doctor?

June 7, 2022

Henry Ford Health System

Whether you wake up with a stiff knee, sustain an injury, or start feeling knee pain for seemingly no good reason, you might wonder what to do. Should you immediately rush off to the doctor? Can you just ignore it and hope it will get better? Can you treat it yourself? Knowing when you need a doctor’s intervention can be a tricky decision to make.

We see people at the start of injuries and after they’ve been ongoing,” says Nancy White, M.D., a sports medicine physician at Henry Ford Health. “While the sooner you see an expert, the better, there’s really no right or wrong to it. However, there are a few key signs that it’s a good idea to get it checked out.”

Dr. White recommends seeing a doctor if:

You are waking up with consistent knee stiffness. If there’s no history of an injury involved, it could be due to osteoarthritis or rheumatoid arthritis.

If your knee pain isn’t going away.

Your knee is swollen and you can’t bear weight on it.

You can’t fully flex or extend your knee.

Your knee is warm to the touch. This could signal inflammation.

If your pain is mild — or you’re trying to decide whether to see someone — Dr. White recommends icing it on a scheduled basis. “That means two to three times a day,” she says. “Apply the ice to your knee. It will get cold. It will burn, then it will get numb. Remove the ice when it gets to the numb stage.” 

She also recommends elevating your leg and putting a compression wrap or sleeve on your knee. If the pain is bad, you can try taking ibuprofen or naproxen for a few days.

Common Causes of Knee Pain

But if your knee is not getting better, it’s a good idea to see a doctor, as common causes of knee pain include: 

► ACL sprains and tears. Short for anterior cruciate ligament, the ACL is one of four ligaments in the knee that allows it to flex and extend. The ACL can tear when your foot is firmly planted in place, and the knee locks and twists or pivots at the same time.

► MCL sprains and tears. Short for medial collateral ligament, the MCL connects your shinbone to your thighbone. It can tear when landing after a jump, or after an exterior blow to the knee (usually during contact sports). Luckily, most MCL injuries heal on their own.

► Meniscal tears. The menisci are your knee’s shock absorbers; they're two discs made of soft cartilage. Abrupt movements (like pivots, stops, turns, squats or lifts) can cause them to tear.

► Kneecap dislocation. A direct hit to the knee — or a sudden twist or pivoting of the leg — can make the kneecap can shift out of place. 

► Patellar tendonitis. This is also known as Jumper’s Knee, as it’s a common injury in basketball and volleyball players. The patellar tendon connects the bottom of the kneecap to the top of the shinbone, and can become inflamed from overuse, excessive force or repetitive stress. 

Knee bursitis. The bursa is a small, fluid-filled sac located near the knee joint. Knee bursitis occurs when the bursa becomes inflamed, often because of a knee injury or overuse from frequent kneeling. 

How to Help Prevent Knee Pain

And if you want to help prevent knee pain in the future? “Exercise regularly so that you’re strengthening your quadriceps, hamstrings and gluteal muscles,” says Dr. White. “It’s also important to stretch to increase quadricep and hamstring flexibility.”

Wearing shoes with sturdy soles and proper arch support can also help ease pain and issues you may already have, says Dr. White. “I would say the top reasons people get into trouble with their knees are things they could prevent by changing lifestyle habits. This includes maintaining a healthy weight, as being overweight can also lead to increased wear and tear on the joints.

To learn more about your orthopedic condition or to find a provider, visit henryford.com/ortho.

Dr. Nancy White is a sports medicine physician at Henry Ford Health. She sees patients at Henry Ford Medical Center – Novi, and Henry Ford Medical Center — Bloomfield Township.