This past Monday, the American Academy of Pediatrics released their findings of a research project on helmets and mouth guards in high school aged football players, the lead was this;
High-tech helmets and custom mouth guards do not reduce concussion risk for high school football players any more effectively than low-cost helmets or off-the-shelf mouth guards, a new study says.
This is a point we have been trying to hammer home since the inception of the blog; simply Physics does not allow for current technology to reduce or attenuate the true forces that cause concussion in the vast majority of the cases. Those would be: acceleration, deceleration, rotation and angular vectors that cause the brain to shift inside the skull.
The most important thing about a helmet is that it’s well-maintained (regularly reconditioned) and has a proper fit. Certainly there is some merit to the newer helmets padding designs for helping with the true linear forces reaching the skull; however helmets are doing what they’re designed for – preventing skull fractures and facial injuries.
It is unlikely that a helmet – as we currently know it – will abate those pesky forces attributed to concussion. In reality if that is where the fix needs to come from then we will most likely be looking at some sort of apparatus that is attached to the shoulders that basically harnesses the head down. The issue there, of course, is the range of motion to allow a player to see and move in a safe way. Regardless this information presented by the AAP is nothing new but wonderful because it comes from a group that has “clout”.
What is more interesting to me – and a bit of an endorsement of our words – is that simple boil-and-bite mouth guards provide better protection in terms of concussion than the custom mouth gear that some companies still tout as concussion reducers. First of all if any company is trying to sell you a mouth guard that will prevent or reduce concussions RUN THE OTHER WAY! That is nothing more than simple snake oil. Those reasons have been hashed out many times on this blog, Secondly, the information from the AAP;
Players with custom-fitted mouth guards actually suffered a higher concussion rate than those who used generic models.
Brings credence to the theory that player with equipment that is supposed to be concussion abating play with greater risk. We theorize that players with such equipment believe they are better protected in all circumstances and choose to practice behaviors that would otherwise predispose to injury because of this false belief.
To this day, I still find it amazing that people can’t quite understand the relationship of a helmet and ones brain. I find it asinine that some would sell and promote a product for the teeth and in some cases the jaw as concussion “busters”. We should all understand what a concussion truly is and how it occurs. We should all be less fearful of the injury of concussion, because with or without sports they will continue to occur on a daily basis. Concussions are not going away. Where we can make the biggest and most important impact is on the proper management of the injury once it does occur.
All of this being said, if some genius out there wants to create a product that will attenuate the forces that create concussion for all or any sport, PLEASE DO SO! I will be one of the first to promote your product!!!
The helmet news is very important, but the AAP also FINALLY released a statement on RETURN TO LEARN on Oct. 27. Way overdue. See Science News Daily : http://www.sciencedaily.com/releases/2013/10/131027123551.htm
I am also glad for the statement regarding return to academics. You would think it would be another “no brainer” that if the brain is injured, then it needs to rest and the schools need to be willing to give it the time to rest and heal. It’s great to see the AAP getting on board with the important and potentially life-changing issues facing our student athletes and those who have suffered concussions!
No mouth guard can prevent cou contra cou concussion, nothing can stop the brain from sloshing inside the skull. but a properly designed oral appliance may benefit other types of injury to the lower skull or cervical spine region. No research has linked cou contra cou type of concussion to CTE. Mcrae, the researcher in this recent study, has not revealed what type or brand of mouth guards that were used or more importantly, if these custom mouth guards were randomly fitted n relation to the Temporal mandibular joint dysfunction. A custom tooth guard that ignores noted deficiencies of the Tmj, may result in trauma to the temporal bone or limitations of nerve energy to the Trigeminal region, weakening and creating imbalances in the neck. Cantu stated in congressional testimony, CTE originates in the medial temporal lobe merely millimeters from the end of a misaligned jawbone. Regarding League of Denial, don’t throw the baby out with the bathwater til properly designed independent research is finally done. The most recent research shows a benefit to upper/neck extremity strength gain in those with Tmd and a neuro muscular appliance, Clearly a standardization of dental mouth guards and Tmd is needed. Currently there are no standards in place for neck strength evaluation or mouth guards. Screening for Tmd in those who are post orthodontic is needed.
What this study makes clear, improperly fitted mouth guards that may randomly position the condyle dangerously close to the medial temporal lobe or create imbalances in the trigeminal region and much more research is needed.
And why does anyone keep trying to purport the myth that equipment, any equipment, can protect one’s brain from injury???? Every time the experts take us two steps forward in our understanding, somebody wants to take us to steps back! I know student athletes that all wore helmets, mouth guards, and various kinds of safety equipment but when they took that hard hit, their brain still hit the side of their skull and they are still concussed…some with life long consequences. Helmets are great for preventing skull fractures that can cause even more significant injury but lets start being honest across the board about the inability to protect from concussion. Kudos to the AAP for taking a stand!
Interesting video on Tmd and how a mouth guard should be made for those candidates who diagnose with Tmd or have had orthodontics. They have no effect on cou contra cou concussion and more focus is needed on their benefits and their limits in athletes.