Dear John: I liked the helmet article in the Times today. “Pushing back the frontiers of ignorance”— Keep it up. There was a comprehensive article on this very issue, biking helmets and rotational impact forces, in the June 2013 issue of Bicycling Magazine. — Thomas Thiel
Tom: I read the article to which you refer. I’m not sure the idea regarding two layers of inside padding, one able to slide on the other, would translate well to football helmets. Your opinion on my column is not unanimous. Read on.
Dear John: The paper you reference from U Wisconsin is not in a journal nor is it publically available. So, we cannot tell what helmets were actually used. It is our guess that only ‘newer’ helmets were used, which means that they were all likely 4 and 5 star helmets in our rating. I doubt that they had any Riddell VSR-4 helmets, which are 1-star helmets, or many Schutt Air Advantage at 2-stars. To this end, you cannot say ‘any’ of those helmets, as it is likely they only used newer and better helmets.
Second, we have published a series of papers showing the difference ‘on the field’ for better and worse helmets. At Virginia Tech, we saw an 85 percent reduction in concussion risk for our players when comparing the VSR-4 to the Revolution.
In the end, there is a very big difference between the best and worst helmets. Until we see the actual paper from U Wisconsin, it is not accurate to write the story as you did. — Stefan Duma, PhD; Harry C. Wyatt Professor and Department Head, Virginia Tech - Wake Forest University School of Biomedical Engineering and Sciences
Dear Dr. Duma: The paper I referenced, while not yet published in a scientific journal, was presented at the annual meeting of the American Orthopaedic Society for Sports Medicine. After receiving your letter, I spoke directly with one of the co-authors, Alison Brooks, MD, MPH and she confirmed there were VSR-4s and other older helmet models in her study.
Dear John: I believe (your column) fairly states the issues that parents and coaches are facing when it comes to making helmet use or purchase decisions.
The Virginia Tech system is a good concept and Dr. Duma and the other experts there are doing some very innovative and cutting edge work, but they are the first to recognize the limitations of their system. I believe they may eventually provide some useful information to the decision process, but their ranking is limited to adult large helmets only, and as you correctly stated, is based only upon linear or g forces in trying to assess concussion risk. Without a reliable and scientifically based consensus on a concussion threshold for linear or rotational accelerations, any system or standard that attempts to make a claim or rating will be very limited in application.
There is no basis for anyone to conclude that a 5 STAR adult large model is also a 5 STAR in smaller or bigger sizes.
Parents and players need to keep in mind that helmet fit and condition are likely individually more important than a STAR value when it comes to protection against head injury of any kind. More importantly, changing behavior and avoiding the avoidable hits to the head will make an immediate and measurable reduction in the number and severity of concussions in collision sport like football. — Michael Oliver, Executive Director and General Counsel NOCSAE®; Overland Park, KS 66210
John Doherty can be reached at firstname.lastname@example.org. Follow him on Twitter @JDohertyATCPT.