Helmet companies: "little to get excited about"
The reaction to the study from football helmet manufacturers was mixed, ranging from to-be-expected praise from Riddell, whose helmets were the subject of the study (and which, not coincidentally, has been urging college and pro players to switch from the VSR4 to a Riddell helmet with more padding and a larger shell), to caution against interpreting too much into the results and pointing out the study's limitations from a spokesperson for SG Helmets, to sharp criticism by Schutt. (Efforts to obtain comments from the remaining two helmet manufacturers, Rawlings and Xenith, were unsuccessful) Erin Griffin, Senior Communications Manager for Riddell, said the company was "pleased that this study continues to show the value of more advanced helmet technology." She said, however, that Riddell continued to "recommend that parents and players consider multiple data points when choosing a football helmet," including the Virginia Tech STAR rating system, which, she noted, awarded the highest possible, 5-STAR ranking in its latest ratings to two Riddell helmets, the 360 and Revolution Speed.
"We are supportive of credible scientific research like this study that can help educate parents, players and the broader football community about some of their head protection options and about the advancements in football headgear," Griffin said.
Less positive were the comments of Ashley Quintero, National Sales Manager for SG Helmets, a new football helmet manufacturer with a background in designing race car helmets. The adult SG helmet made an impressive debut in 2013 at the top of Virginia Tech's 4-STAR list.
Quintero emphasized the study's limitations and cautioned against painting the results with too broad a brush. "We believe the most informative research is comprehensive and unbiased. In our opinion, the recent Virginia Tech study was not comprehensive, as the study limited its exploration to the products of just one manufacturer."
She expressed concern that, unless those limitations were considered, "there exists the potential for coaches, parents, and athletes to assume these results reflect all football helmets," and she cautioned "consumers against expanding the findings of one study and generalizing that its outcome holds true for all products, " and urged coaches, parents and athletes to make a "well-informed decision based on the advantages and disadvantages of every available product."
Most critical of the new study was Schutt's Chief Executive Officer, Rob Erb. "Stripped of the headline grabbing claims of double-digit concussion reduction, there is little here to get excited about," asserted Erb in a lengthy email to MomsTEAM's Brooke de Lench.
The best that can be said about the published Technical Note, Erb said, based upon what he characterized as a "limited data set," is that it suggests that players who wore large standoff shelled Riddell Revolution helmets were diagnosed with fewer concussions than their counterparts who wore the much smaller standoff VSR helmets. However, even this conclusion, he argued, "would have to be taken with a grain of salt, because the statistical differences can be accounted for by a number of factors not discussed by the authors."
"What is striking is that we continue to give great deference to those that take the most simple and extreme positions when we know that the truth is often complex and less likely to be the subject of a headline," Erb concluded.
[For the full text of Erb's email, dated February 10, 2014, click here]
Other research suggests concussion risk not affected by helmet brand or age
Timothy McGuine, a Senior Scientist in the Department of Orthopedics and Rehabilitation at the University of Wisconsin School of Medicine and Public Health, said he viewed the Rowson study as "excellent" and with an "outstanding" roster of authors. "I agree with its finding that current helmet designs are better than those from 6 to 10 years ago," McGuine said.
The findings of the Rowson study appeared at odds with those of his 2013 research paper (McGuine T, Brooks, et al 2013). That paper, which has not yet been subjected to the rigors of peer review required to gain publication in a medical journal, reported that the risk of sustaining a concussion in high school football was not affected by the brand or age of the helmet.
McGuine said the findings of the Rowson study and his paper, however, were not irreconcilable, but likely due to important differences betweenthe two studies in objectives and data collection methods.
First, he said, the Rowson study was a "retrospective study that went back and looked at SRC [sport-related concussions] using impact data (HITS system) and medical records. Their data collection took place over a 5-year range in college players [and] compared the VSR-4 and Revolution models. They had excellent data reporting at the university level with outstanding medical staffs and unlimited access to medical records and imaging."
"On the other hand, our study looked prospectively at helmets brands currently being used in 2012 and 2013, two-thirds of which had been purchased since 2010, and included only a total of 11 old VSR-4 helmets. Our goal was to look at the rate of SRC in helmets available and being purchased now, so school ATC's, coaches and parents would have information they could use to help guide their decision-making processes. These [are] people [who] are not asking if the Riddell Revolution is better than a VSR-4 [which is no longer on the market]. They want to know if one helmet brand, currently available, that may cost $400+ dollars, is better than a helmet costing $200."
McGuine said he agreed that measuring impacts with the HITS sensor arrays provides "a better picture of the actual helmet performance," which his study was not able to provide and hence listed as a limitation. "I would love to use the HITS system to do a study on actual brands/models being used currently by high school players."
In addition, he pointed to the difficulty of collecting data in 50 communities. In contrast to the 1,800 athletes involved in the Rowson study, all of whom were seen the same 8 team doctors, "the kids in our study who were injured did not all see the same medical provider or undergo the exact same diagnostic procedures."
Further, Implementing that level of data collection in 50+ high schools was cost-prohibitive, costing between $1 and 2 million, said McGuine.
\"If someone is willing to give us that level of funding, we would do it. Unfortunately, we could not get any external support for this research, and were limited to using $50,000 of our own money and could only report data that such level of funding would allow."
Nevertheless, McGuine expressed "confidence in our data collection procedures and results, given the variables we could control. The scope of the variables we measured also gives us insight into other factors that may play a role in SRC susceptibility. I see these data as being just as important for high school ATC's coaches and parents," and I don't see those other variables mentioned in [the Rowson study]."