Children wear helmets when they're scooting down sidewalks, skating, skiing, sledding and playing soccer. You can even buy $40 baby helmets on Amazon, because, according to the product description, "babies will always fall taking their first steps."
Putting aside the debate over whether helmets are truly necessary in all of these situations, there's something about helmets you might not know: They won't protect your kids from common head injuries that may cause long-term problems.
There's no question that helmets save lives by preventing skull fractures and other lethal brain injuries. But according to a 2013 report on youth sports-related concussions by the Institute of Medicine and the National Research Council, "there is limited evidence that current helmet designs reduce the risk of sports-related concussions."
That helmets don't protect against concussions is particularly worrying considering that children and adolescents may be both more vulnerable to concussions and recover more slowly from them compared to adults.
And statistics suggest that concussions are becoming more common among kids. One recent study reported a doubling in concussion-related ER visits by youth between 1997 and 2007. Some of this increase is undoubtedly due to growing awareness about concussions and better diagnostic techniques, but concussions are still believed to be underreported.
There's no good treatment for concussions, other than rest (for days, weeks or months, depending), but this rest is crucial: individuals who get concussions and then hit their heads again before they're fully healed can suffer brain swelling and even die.
Concussions are typically diagnosed based on symptoms -- headaches, dizziness, amnesia, nausea, and vomiting are among them -- but as for what kinds of blows to the head cause them, that's still largely a mystery.
"I couldn't even define the mechanism," explains Adam Bartsch, Director of the Cleveland Clinic's Head, Neck and Spine Research Laboratory.
And we can't come close to designing a concussion-proof helmet, he says, until we understand exactly how concussions happen.
Today's sports helmets are designed to attenuate high-impact linear acceleration forces, which occur in a straight front-to-back line, like "if you hit the head through the center of gravity," explains Robert Cantu, a neurosurgeon at the Boston University School of Medicine and co-author of "Concussions and Our Kids."
Yet most hits to the head, whether they're from falling off bicycles or scooters or from team sports collisions, cause the brain to rotationally accelerate, leading to concussion.
It's just that the linear acceleration is more strongly associated with severe injuries, like cracked skulls, and when the National Operating Committee on Standards for Athletic Equipment was formed in 1969 -- a year in which 38 Americans died playing football -- the goal was to develop helmet standards that would mitigate only the most severe injuries.
And consider the standards set for bicycling helmets by the Consumer Product Safety Commission. Since people bike in different climates and conditions, the CPSC mandates that bike helmets have to pass drop tests from a height of 6 feet at temperatures as high as 127 degrees, as low as 1 degree, and after being immersed in water for up to 24 hours.
Few materials can maintain their performance in such a range of conditions; one that does is expanded polystyrene (EPS), which is the foam that comprises the inner liner of most bike helmets sold today. The problem is that EPS is so strong that it doesn't protect well against low-energy concussion-inducing impacts.
Obviously you can't protect your kid's head from everything. Nor would you want to, really, as over-protective parenting is not without risks itself.
But given the growing medical concern over the dangers of repeated concussions, common sense says that we might be wise to keep our kids' heads from smacking into things more than they absolutely have to. Helmets don't clear us of this responsibility.
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