Play it Safe: Basics of Proper Helmet Use

February 4, 2020

Henry Ford Health System

If you or your child plays sports or participates in physically risky activities, wearing a helmet could be lifesaving. While no helmet is concussion-proof, wearing one can help reduce the risk of serious head injuries.

"Helmets are made with materials that help reduce impact to the head, protecting the skull from damage," says Jeffrey Kutcher, M.D., a sports neurologist who treats athletes at the Henry Ford Kutcher Clinic for Concussion and Sports Neurology. "You should be wearing a helmet whether you're playing a contact sport or riding something on a hard surface, such as a bike, scooter, skateboard or rollerblades."

Head Injury Prevention 101: Helmet Buying Basics

All helmets are certified at the same level for multi-use recreational activities. So there's no need to search for a specific seal or rating. Instead, when you're purchasing a helmet — or getting one second-hand — focus on these four factors:

How you’ll use it:

Pay attention to the risks involved with the activity you're doing. If you're biking, skiing or snowboarding, for example, you're wearing a helmet in case you get hit, not because you'll get hit.

There are two types of helmets: single-impact and multiple-impact. Single-impact helmets are made with foam materials that break down when hit as part of their force mitigating strategy. These helmets work well for bicycling, skateboarding, skiing or snowboarding. Multiple-impact helmets, such as those designed for sports like football, hockey and lacrosse, can withstand many hits over an entire season. The materials in these helmets don't break down, but rather compress and regain their original form.

"A helmet may perform better in the lab — for example, the dummy brain will experience 98Gs of force instead of 100Gs — but 2Gs of force probably won't make enough of a difference with a one-time injury," Dr. Kutcher says. "But 2Gs less force per hit for a linebacker who suffers multiple blows on a daily basis for many years? That could make a big difference.”

If football is your sport, the National Football League provides a helmet rating system that assesses helmets based on their ability to mitigate force over time.

How it fits:

Helmets fit differently depending on the make, style and type of sport they’re made for. "The key is making sure the helmet covers the entire skull and doesn't move around when in use," Dr. Kutcher says. The helmet should sit on the head without falling forward or backward. If you're relying only on a chinstrap to keep it in place, you don't have the right fit.

How comfortable it is:

Not all helmet brands fit every head. Helmet designs vary just like running shoes do. When you're shopping for a helmet, make sure it's snug, but not tight or uncomfortable. Comfort is critical, especially for kids. "You don't want a child to develop a negative association with wearing a protective helmet," Dr. Kutcher says.

What condition it’s in:

To get the most protection, your helmet should be in top condition. Do not wear a cracked or broken helmet, or one that has been involved in a crash or similar event (unless it's a multiple-impact design). An impact can crush foam materials. And don't allow the helmet to get too hot or cold — that can cause the materials to break down over time.

Get the Best Helmet Fit for Your Head

Properly wearing a helmet provides the greatest defense against injury — more than any style or brand. To make sure your helmet is secure, follow these rules:

· Measure head circumference: Every helmet brand provides a size chart, along with instructions about how to select the best fit. To get the best measurement, use a cloth tape to measure your head circumference. Place the tape about an inch above the eyebrows, keeping it level from front to back. If the measurement falls between sizes, select the smaller size.

· Pay attention to hairstyles: Make sure to try the helmet on with the hairstyle you'll have during the activity. A long-haired bike rider who gets a short haircut may require a helmet adjustment.

· Watch your vision: The helmet should not block your vision. You should be able to see straight ahead and side to side.

To Wear a Helmet or Not To Wear a Helmet: When to Play It Safe

There are several sports that don't require wearing a helmet. But if you or your child is involved in rugby or soccer, or another sport where helmets are optional, that doesn’t mean you're in the clear.

"It's important to base any decision about whether or not to wear a helmet in conjunction with your sports neurologist," notes Dr. Kutcher. "Your past medical history and current health status may still warrant the use of a helmet."

Unsure whether you're at risk of sustaining a head injury? Get a brain health baseline evaluation. Proper consideration of your brain health includes a physical examination, along with a personal and family medical and neurological history. It also offers you an opportunity to learn how to best protect your head.

Related Topic: 7 Tips for Recovering Mentally After a Sports Injury

Dr. Jeffrey Kutcher is a sports neurologist at the Henry Ford Concussion and Sports Neurology Clinic and the global director of the Kutcher Clinic.

Want to learn more? Henry Ford Health System sports medicine experts are treating the whole athlete, in a whole new way. From nutrition to neurology, and from injury prevention to treatment of sports-related conditions, they can give your athlete a unique game plan.

Visit henryford.com/sports or call (313) 972-4216 for an appointment within 24 business hours.

Symptoms of a Meniscus Tear — and When to Seek Treatment

April 2, 2024

Meniscus tears are not one size fits all: Sometimes they cause no pain, other times they’re excruciating.

Henry Ford HealthOnce in a while they heal or adapt on their own, but more often than not they require physical therapy or surgery.    

“Your meniscus is a fiber elastic cartilage that acts as a shock absorber for the knee,” says Ahmad Bazzi, M.D., a sports medicine physician at Henry Ford Health. “It also helps stabilize the knee joint. But when it tears — which can occur in young athletes after a pivot injury or in older people who have arthritis — it can be painful.”

Here, Dr. Bazzi shares symptoms of a meniscus tear and when to see a doctor. 

What Does A Meniscus Tear Feel Like?

Depending upon the level of injury and type of tear, meniscus tears can either be asymptomatic or cause symptoms like:

  • Locking. When the meniscus tears, a piece of it might move into the knee joint, causing mechanical issues like stiffness and locking of the knee joint.
  • Catching or clicking. This often feels like a sudden ‘click’ in the knee joint, where it suddenly gives out while you’re walking or doing certain movements. 
  • Localized pain on the inner or outer part of the knee. In young athletes, a meniscus tear often causes an impaired range of motion and localized pain on the inner or outer part of the knee. 
  • Pain and swelling. In older people, a meniscus tear often causes swelling and an overall aching pain in the knee.  

Treatment Options For Meniscus Tears

A meniscus tear can only heal on its own if the tear is on the outer part of the knee where it has better access to blood supply. If you’re experiencing pain a few days after injury and you have limited range of motion, instability and/or swelling in the knee, Dr. Bazzi recommends seeing a doctor to get an examination and, if needed, an MRI for diagnosis. 

“It’s hard to tell what type of meniscus tear you have if you haven’t seen a doctor,” says Dr. Bazzi. “If you have a mechanically unstable tear and it goes untreated, it could lead to worsening range of motion and stiffness, or worsening arthritis. It’s important to get seen by a doctor to get an accurate diagnosis and the proper treatment. It may take one to three months for a full recovery.”     

Here, Dr. Bazzi shares treatment options:

Surgery

If someone is having mechanical symptoms like locking or catching, surgery may be considered right away, especially if it’s an athlete younger than 40 years old. “Meniscus tear surgery has a shorter recovery compared to other knee surgeries,” says Dr. Bazzi. “Surgery could either consist of a meniscectomy, which is partial or complete removal of the meniscus, or sometimes just a meniscus repair.”  

Hyaluronic acid or cortisone injections

Non-operative treatments are often recommended for older people who have degenerative tears due to arthritis. “This is because meniscus surgery doesn’t often relieve their pain since they have underlying arthritis, meaning they have cartilage loss in the meniscus,” says Dr. Bazzi. 

Instead, a cortisone injection, which is an anti-inflammatory medication that can be injected into the knee, can reduce inflammation, swelling and pain caused by arthritis.

A hyaluronic acid injection may also be considered, which adds cushioning in the knee. “Hyaluronic acid is one of the substances that make up our cartilage, so this injection helps us mimic the lost cartilage,” says Dr. Bazzi. “It also has anti-inflammatory properties.” 

Physical therapy

Physical therapy is another great option, especially for older people who need non-operative treatment options. It can help the knee adapt to the tear, reduce pain and encourage full range of motion. “Physical therapy for meniscus tears focuses on balance exercises and exercises to strengthen the muscles around the knee,” says Dr. Bazzi. “This helps to uphold the knee joint to achieve full range of motion and strength while being pain-free.” 

To find a sports medicine provider at Henry Ford Health, visit henryford.com/athletes or call 313-651-1969.

Reviewed by Ahmad Bazzi, M.D., a sports medicine physician who sees patients at Henry Ford Medical Center – Fairlane.