Play it Safe: Basics of Proper Helmet Use

Health & Safety

June 8, 2021

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.

Health & Safety

Women & ACL Injuries: Know Risks, Steps for Prevention

By Henry Ford Health System

August 10, 2021

Whether you’re a casual jogger or elite athlete, you’re at risk for an injury to your anterior cruciate ligament (ACL). If you’re a woman, you are at even greater risk for these injuries.

But there are steps you can take to prevent them.

“Among athletes, women are more than twice as likely to have an ACL injury than men,” says Nithin Natwa, M.D., a sports medicine specialist and primary care physician at Henry Ford Health System. “Once you have an ACL injury, you are at greater risk for having further soft tissue injuries in the future. That’s why it is important to prevent these injuries and follow your treatment plan if injured.”

What Is An ACL Injury?

An ACL injury is a strain or tear in the ACL, one of the four major ligaments that support the knee so it can flex and bend. The ACL is a strong band of tissue that helps connect your thigh bone (femur) to your shin bone (tibia). “An ACL injury usually occurs without contact when you turn suddenly while running or land off-balance on one leg. These actions overload the knee joint and cause the ACL to be torn,” says Dr. Natwa.

In the United States, 100,000 people have ACL injuries each year. Anyone can experience an ACL injury, though athletes participating in sports like football, basketball, soccer and gymnastics are at highest risk. And summer is a peak time for outdoor sports injuries.

Seek immediate care if you have any of these signs of an ACL injury:

• An audible “pop” in the knee

• Intense knee pain and rapid-onset swelling (within hours)

• Loss of range of motion

• An unstable feeling or locking of your knee

The most common treatment for ACL injuries is surgery followed by physical therapy. After treatment, you can expect to return to normal activities in 6 to 9 months. However, peak athletic performance can take up to two years.

Why Are Women At Higher Risk For ACL Injuries?

According to Dr. Natwa, the differences in athletic training techniques for males versus females have left women at greater risk for ACL injuries. “There has been more emphasis on overall conditioning and mechanics for boys participating in sports compared to girls,” he says.

As a result, women are at greater risk for ACL tears and sprains due to:

• Differences in neuromuscular control: Without conditioning from an early age, women may not have the same ability to land and perform athletic motions that men do. For example, women are at higher risk for an ACL injury after landing from a jump.

• Strength imbalance for muscles that support the knee: Female athletes tend to have more defined quadriceps muscles but weaker hamstrings than men, putting them at greater risk for injury.

According to Dr. Natwa, there are many theories about women’s risk for ACL injury that lack scientific evidence, including:

• Width of the pelvis: Some people have suggested that the wider width of a woman’s pelvis puts more pressure on the knee joint and increases the risk for injury. However, this difference has not been shown to impact a women’s risk for ACL tears or sprains.

• Knee anatomy: The ACL runs through a section of the femur called the intercondylar notch. Women tend to have a narrower notch than men. Regardless of gender, individuals who possess smaller notch dimensions appear to be at greater risk for injury than individuals with larger notches.

• Hormones: Men and women have different hormone levels. But there is currently no concrete evidence that female hormones place women at higher risk for ACL injures.

Steps To Prevent ACL Injuries – Conditioning Early, Often

“The best way to prevent ACL injuries is to begin and maintain regular conditioning exercises at an early age,” Dr. Natwa says. “The more frequently you engage in proper exercises, the lower your risk for injury.”

Consult with a sports medicine specialist, physical therapist or athletic trainer to develop a training routine to prevent ACL and other injuries. Your training program should include exercises that:

• Strengthen the muscles that support your knee: Add strength training to build up your calves, hamstrings and quadriceps muscles. These muscles help stabilize your knee as you move. By strengthening these muscle groups evenly, you can lower your risk for injury.

• Improve overall neuromuscular control: Focus on adding neuromuscular exercises that train your nerves and muscles to react and communicate. For example, you may work on your balance by standing on one leg or sit upright on an exercise ball for short periods of time. And core exercises can strengthen the muscles that support your abdomen and back and help improve your posture as you move. These moves can strengthen your joints and help you learn appropriate balance and technique.

“Exercise really is the best medicine. It can improve your balance and agility as you participate in a sport or prevent injury as you move through your daily activities,” says Dr. Natwa. “Consider adding these exercises to your wellness program.”

Dr. Nithin Natwa is a sports medicine doctor who sees patients at Henry Ford Macomb Health Center in Chesterfield and Henry Ford Macomb Orthopedics and Wound Care in Clinton Township.