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Collision Course: The Truth About Concussion Prevention

Everywhere that you turn, you’re hit with another report about concussions. However, both the equipment that’s supposed to minimize concussion risks and the tests that are meant to reassure that concussion victims are healthy are being criticized.

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Alexis Ball played soccer differently when she wore padded headgear on the field. The former University of New Mexico athlete played with more abandon. She was less concerned that a collision with another athlete would cause a serious brain injury, and it hurt her head less to whack the ball when she wore protective gear. “I’d go after any ball,” she says.

Regardless of whether her increased aggressiveness was in part responsible, she suffered her 10th concussion in 2009. The injury ended her playing career and showed that she remained vulnerable, even though she wore the headgear. As in the past, her headaches and dizziness quickly subsided, but Ball stopped sleeping soon after that. She cried frequently and struggled in class. Ball had post-concussive syndrome, which is a condition that’s marked by symptoms that include memory and concentration problems and sadness. 

Although Centers for Disease Control and Prevention (CDC) reports that falls and traffic accidents are the top causes of concussions, recent attention has focused more on young athletes. By some estimates, as many as 90 percent of concussions that are incurred by athletes go unrecognized.

Emergency-room visits for possible concussions jumped 62 percent in 2009 from 2001, according to CDC. This increase was in part because of increased awareness of concussion dangers but also because young athletes are bigger and faster than ever before, according to CDC. CDC also estimates that 3.8 million sports-related concussions occur each year in the United States. 

Two years removed from her last concussion, Ball says she has to work harder to memorize class material—a change that her neurologist says most likely is permanent. Now 22, Ball says wearing the headgear, which met international testing standards and which she and her coaches believed would help to protect her against concussions, gave her a false sense of security.

Ball wasn’t the only athlete to assume that certain sports equipment would protect her against concussions. In fact, Consumers Digest found that in some cases, sports equipment was tested poorly or was held to voluntary or nonexistent quality standards.

And questions abound about the tests on which thousands of concussed athletes rely to tell them whether it’s safe to resume normal activity. A slew of new state laws focus on how young athletes should be evaluated after a blow to the head, but the laws don’t address concussion prevention. Consequently, athletes don’t have any one-size-fits-all solution, and patience and caution are the bywords.

Concussion or Not, Head Blows Add Up

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ON THE BRAIN. Experts say not even the priciest of sports equipment can prevent much concussion risk because of the nature of the injury to the brain. A concussion occurs when a violent force—either abrupt acceleration or deceleration—causes the brain, which floats in fluid inside of the skull, to slam against the skull. Helmets and other padded headgear absorb some force, and that decreases some concussion risk, but no equipment can stop the brain from colliding against the inside of the skull.

Dr. Jeffrey S. Kutcher, who is a University of Michigan sports neurologist, says sports-equipment manufacturers who equate reduced impact with a similar reduction in concussion risk are oversimplifying. A complex interplay of forces causes concussions, according to Kutcher and other medical experts.

Someone can take a 10g hit—a blow that’s 10 times the force of gravity—and get a concussion, and somebody else can experience a 100g hit and have no injury, he says. “There is a disconnect in equating impact to the head with concussion risk.”

But preventing concussions isn’t what football helmets were originally designed to do, says Dr. Geoffrey Connor, who is an orthopedist and sports medicine doctor in Birmingham, Ala. The existing testing standard for sports helmets, which has changed little since 1973, is designed to evaluate how well they prevent fatal skull fractures and brain bleeding—not concussions.

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