Helmet Injuries

Doctors and researchers encourage use of helmets for certain activities, but with the understanding that the protective devices are designed only to reduce the risk of severe injuries to the head and neck areas. However, it is important for consumers to understand that a helmet is not a fail-safe against injury.

Helmets were originally designed to protect against the kind of head-on collisions that can cause penetrating injuries, in which an object penetrates the skull and damages brain tissue. But there are many other types of head and neck trauma that may occur even if a person is wearing a helmet.

While professional groups frequently update helmet standards, more research is necessary for doctors and others to understand how brain trauma occurs, what technological advancements can better protect against those causes, and how to treat the injuries more effectively when they do still arise.

In the past, some helmet manufacturers misled consumers about the efficacy of these devices in protecting the head and neck areas. In 2013, the Federal Trade Commission ruled against one such manufacturer, Riddell, and cautioned other manufacturers about making similar claims. The alleged false claim cost Riddell $11.5 million.

Common Helmet Types

Helmets used for sports and other recreational activities:

Helmets for professional use:

  • Military
  • Fire Fighters
  • Law Enforcement
  • Construction


Common Helmet Injuries

Injured person in stretcher with a neck braceTraumatic Brain Injury (TBI) – TBI occurs when a sudden trauma – such as a violent blow or jolt to the head or body – causes damage to the brain. TBI can be caused by closed head injury (when the head suddenly and violently hits an object but the skull remains intact) or by penetrating head injury (when the object pierces the skull and enters brain tissue). The most common form of TBI is concussion, caused by a bump, blow, or jolt to the head that can alter the way an individual’s brain normally works. TBI can also occur from a fall or a blow to the body that causes the head and brain to move quickly back and forth.

Symptoms of TBI may include loss of consciousness for a few seconds or minutes, but not always. The person may also continue to feel dazed for days to weeks after the injury. Additional symptoms may include trouble with memory, attention, concentration, or thinking; confusion; headache or lightheadedness; blurred vision or tired eyes; ringing in the ears; fatigue; behavioral or mood changes; or altered sleep patterns. Later, TBI sufferers may develop high blood pressure, a low heart rate, pupil dilation, and irregular breathing.

Concussion – Also known as a mild traumatic brain injury, is caused by a blow to the head or body, an impact against a hard surface, shaking, or spinning. Concussion occurs because the body suddenly stops, causing the brain, which floats in cerebrospinal fluid, to be jarred against the skull. Concussions literally cause changes in how the cells of the brain function. James Kelly, M.D., professor of neurosurgery and rehabilitation medicine at the University of Colorado Health Sciences Center in Denver, Colorado, describes the impact of a concussion as a biomechanical force that causes “random and highly disruptive” electrical discharge from nerve cells. The nerve cells cause a chemical imbalance, revving up the metabolism of other nerve cells. “The physiological demand on the cells can damage them, and some of them die,” Dr. Kelly says. “It’s like blowing the engine of a car.”

Helmets were originally designed to protect against the kind of head-on collisions that can cause penetrating injuries, in which an object penetrates the skull and damages brain tissue. However, most concussions do not involve penetrating head injury. Instead, they occur when the brain continues to move inside the skull while the head has stopped, scraping over the uneven surface of the inner skull and finally colliding with the skull. In addition, concussions are caused by a combination of linear force (such as in a head-on collision) and rotational force, which involves impact at an angle. Rotational force can actually cause more serious damage to the brain by breaking the connections between brain areas.

Researchers conducted 330 tests to measure how well 10 popular football helmet designs protected against TBI. Some of the helmets are used by NFL players and some by college players; some are the newest models, and some are older models. Six of them failed to protect against rotational force adequately to prevent life-threatening TBI. Researchers say helmets reduced the risk of TBI by only 21 percent on average.

Helmets were never designed to protect against concussion,” explains Francis Conidi, M.D., D.O., a sports neurologist also involved in the study. Dr. Conidi is director of the Florida Center for Headache and Sports Neurology in South Florida, team neurologist for the Florida Panthers hockey team, and assistant clinical professor of neurology at Florida State University in Tallahassee, Florida. “Our understanding of the long-term effects of concussion is relatively recent,” according to Dr. Conidi.

Degenerative Brain Disease / Chronic Traumatic Encephalopathy (CTE) – According to the Mayo Clinic, CTE “describe[s] brain degeneration likely caused by repeated head traumas.” CTE is a diagnosis only made at autopsy by studying sections of the brain. CTE is a very rare condition. It has been found in the brains of people who played contact sports, such as football, as well as others. Some symptoms of CTE are thought to include difficulties with thinking (cognition), physical problems, emotions and other behaviors. CTE is a very controversial condition that is still not well-understood. Researchers do not yet know the frequency of CTE in the population and do not understand the causes. There is no cure for CTE.

Other Head Injuries

  • Hematomas
  • blood clots
  • contusions (bruising of brain tissue)
  • cerebral edema (swelling inside the skull)
  • stroke

Neck Injuries – Neck injuries mostly occur in motorcycle accidents or with skiers and snowboarders, but studies show that the helmets don’t necessarily increase the risk of neck injuries.

  • Skiers and snowboarders – Helmets reduced the risk and severity of head and neck injuries without increasing risky behavior in skiers and snowboarders, researchers found. (MedPageToday.com)
  • Motorcyclists – Helmeted riders were no more likely than unhelmeted riders to suffer spinal cord injuries. Nor were they more likely to suffer fractures of the cervical spine or subluxation/dislocation injuries at C1-C2. (Motorcycle Safety Foundation)