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If we want to cut down on football concussions, should we bring back the leather helmet? Not quite, says a new study in the Journal of Neurosurgery, though the noggin-protectors of yore do at least as good of a job as modern helmets at staving off concussions.
Modern helmets do a much better job of preventing deadly skull fractures. But on the type of lower-impact hits to the head you typically see in college and high school games — the constant subconcussive blows that can also cause brain damage — leatherheads do a comparable, and sometimes better, job of reducing concussion risks than today's helmets, according to Cleveland Clinic researchers.
“The fact that leather helmets were even in the neighborhood with modern helmets was surprising,” says Adam Bartsch, the study's lead researcher and director of the Spine Research Laboratory at the Cleveland Clinic's Center for Spine Health.
To reach this conclusion, Bartsch says his team basically “smashed some helmets together.” In the experiments, 11 widely-used high school football helmets and two vintage turn-of-the-century models were placed on the heads of crash-test dummies. The researchers simulated head impacts at gravity-force (Gs) levels of 75 Gs or less, which are typically encountered in high school and college games. They simulated impacts at different angles – a head-on collision, a hit to the side of the head, a hit to the back of the head – and measured their effects on skull rotation, neck force, neck torque and other head movements.
MORE: Study Ranks 10 Football Helmets for Concussion Safety
This data was input into a software program that estimates risk of brain contusions, acute subdural hematoma (bleeding on the surface of the brain), and diffuse axonal injury (DAI), which causes the shearing of nerve cells within the brain. “Overall,” the study concludes, leather helmets and modern helmets provide a “similar protectiveness profile” during subconcussive hits. In fact, under one testing scenario, a leather helmet provided a lower level of DAI risk than any of the modern helmets.
How could a leatherhead possibly be more protective? One reason, Bartsch says, probably has to with the stiffness of today's helmets. While these helmets are effective shields against catastrophic skull fractures, they don't do as good a job absorbing energy from a lower impact hit. These hits might not break the skull, but they can cause the brain to shift a little bit within the skull. And such jiggling causes concussions.
Bartsch offers a useful analogy: Think about hitting your thumb with a hammer. If you put, say, a piece of a padded gym mat on your thumb, that padding will absorb the impact from the hammer, and dull the pain. Now, imagine putting a two-by-four on top of your thumb. Whack the hammer against that stiffer surface; your thumb will probably hurt more than the gym mat. Think of the leatherhead as the gym mat, and a plastic helmet as the two-by-four. The hammer is like a football hit, while the thumb is like your head.
MORE: Study: Boys, Girls Suffer Different Concussion Symptoms
Still, we won't be returning to the leather helmet days; no one wants fatalities on the football field. Yet it's worth considering whether today's football helmets might benefit from a slightly softer outer shell.
For inspiration, Bartsch suggests that the sporting-goods industry look at car companies. “Unlike cars, in which seat belts, airbags and crumple zones make the choice between a 1920s Model T and the modern mini-van a no-brainer," said Bartsch in a release that accompanied the study, "these results tell us that modern helmets have ample room to improve safety against many typical in-game hits."
Sean Gregory is a staff writer at TIME. Find him on Twitter at @seanmgregory. You can also continue the discussion on TIME's Facebook page and on Twitter at @TIME.
ATLANTA (AP) — The number of athletic children going to hospitals with concussions is up 60 percent in the past decade, a finding that is likely due to parents and coaches being more careful about treating head injuries, according to a new federal study."It's a good increase, if that makes any sense," said Steve Marshall, interim director of the University of North Carolina's Injury Prevention and Research Center."These injuries were always there. It's not that there are more injuries now. It's just that now people are getting treatment that they weren't getting before," said Marshall, who was not involved in the new research.Bicycling and football were the leading reasons for the kids' brain injuries, but health officials said that could be at least partly related to the popularity of those activities. For example, it's possible many more kids bike, so a larger number of bike-related injuries would be expected.The Centers for Disease Control and Prevention study is based on a survey of 66 hospital emergency departments that was designed to be nationally representative. The CDC looked at non-fatal data for the years 2001 through 2009 for kids and teens ages 19 and younger.The agency looked at traumatic brain injuries, a category of injuries that mostly counts concussions but also includes skull fractures and bleeding in the brain.The estimated numbers of kids coming into ERs with these brain injuries rose dramatically, about 153,000 in 2001 to nearly 250,000 in 2009. The rate also rose, also by about 60 percent.However, there was not a significant increase in the rate of kids who were immediately admitted to the main hospital for further treatment. That suggests that more so than in the past, more coaches and parents have been bringing kids to the ER with mild concussions and blows to the head, said Dr. Julie Gilchrist, a CDC epidemiologist who led the study.That's probably due to more awareness of the formerly under-appreciated long-term hazards of concussions, she added.In 2003, the CDC started a "Heads Up" youth concussion awareness campaign targeting doctors. Since then, the agency has expanded the focus to coaches and school officials.That effort was bolstered by a series of studies that began to appear around 2005 that showed damage in the brains of former National Football League players. Media coverage of such studies has intensified in the past four years, too, with reports focusing not only on football players but also the actress Natasha Richardson, who died in 2009 from a brain injury from a skiing accident.At the University of Rochester Medical Center in New York state, nearly all of the kids who come in with concussions are brought in by their parents. Such visits have been increasing, and many parents seem to have become aware of the danger of concussions by reports on television, said Dr. Jeffrey Bazarian, an emergency physician there."I think the TV specials on this have them spooked," he said.Parents may also be motivated by recently passed state laws in New York and elsewhere that require student athletes with concussion symptoms to be cleared by a medical professional before being allowed to participate in sports, Bazarian said.In 2011, bills were introduced in at least 39 states that were aimed at better management of traumatic brain injuries, and most targeted sports-related concussions in youths, according to the National Conference of State Legislatures.Other highlights from the CDC study:—About 70 percent of the ER visits were by boys.—About 70 percent were kids ages 10 to 19.—Younger kids commonly got their injuries on the playground or from biking. Older kids were more likely to get them from sports, with football being the leading source for brain injuries in older boys, and biking, soccer and basketball for older girls.—The estimated number of traumatic brain injuries in athletic kids held about steady from 2001 to 2004, but then shot up afterward, rising most dramatically from 2008 to 2009.—Overall, about 15 percent of such traumatic brain injuries each year was from bicycling, on average, making that the leading cause. Football was a close second.Health officials have long advocated the use of bicycle helmets as a way to reduce the severity of head injuries, but helmet use dropped after the early 1990s and has been holding at a fairly low rate for more than a decade. About 85 percent of youths say they rarely or never wear a bicycle helmet, according to one government survey.___Online:CDC report: http://www.cdc.gov/mmwrAssociated Press 
U.S. Sen. Robert Menendez, right, stand next to U.S. Rep. Bill Pascrell, left, and football players from Nutley High School to announce that the Centers for Disease Control and Prevention will be developing national guidelines for managing sports-related concussions for student athletes, Tuesday, Sept. 27, 2011, in Nutley, N.J. According to the politicians, the CDC has agreed to adopt a key element of stalled legislation they sponsored which would have made such protocols mandatory. The lawmakers say the CDC protocols will be ready by 2014. (AP Photo/Julio Cortez)
U.S. Rep. Bill Pascrell of New Jersey announces the Centers for Disease Control and Prevention will be developing national guidelines for managing sports-related concussions for student athletes, during a news conference at Nutley High School, Tuesday, Sept. 27, 2011, in Nutley, N.J. Pascrell and U.S. Sen. Robert Menendez said the CDC has agreed to adopt a key element of stalled legislation they sponsored which would have made such protocols mandatory. The lawmakers say the CDC protocols will be ready by 2014. (AP Photo/Julio Cortez)
U.S. Sen. Robert Menendez of New Jersey stands next to Nutley High School football players while announcing the Centers for Disease Control and Prevention will be developing national guidelines for managing sports-related concussions for student athletes, Tuesday, Sept. 27, 2011, in Nutley, N.J. Menendez and U.S. Rep. Bill Pascrell said the CDC has agreed to adopt a key element of stalled legislation they sponsored which would have made such protocols mandatory. The lawmakers say the CDC protocols will be ready by 2014. (AP Photo/Julio Cortez)
U.S. Sen. Robert Menendez of New Jersey announces the Centers for Disease Control and Prevention will be developing national guidelines for managing sports-related concussions for student athletes during a news conference at Nutley High School, Tuesday, Sept. 27, 2011, in Nutley, N.J. Menendez and U.S. Rep. Bill Pascrell said the CDC has agreed to adopt a key element of stalled legislation they sponsored which would have made such protocols mandatory. The lawmakers say the CDC protocols will be ready by 2014. (AP Photo/Julio Cortez)
U.S. Rep. Bill Pascrell, center left, of New Jersey stands next to Nutley High School football players as he announces that the Centers for Disease Control and Prevention will be developing national guidelines for managing sports-related concussions for student athletes, during a news conference, Tuesday, Sept. 27, 2011, in Nutley, N.J. Pascrell and U.S. Sen. Robert Menendez, center right, said the CDC has agreed to adopt a key element of stalled legislation they sponsored which would have made such protocols mandatory. The lawmakers say the CDC protocols will be ready by 2014. (AP Photo/Julio Cortez)eval("var currentItemd57851005a80479aaeeb90a12c70b9ff = 1;");eval("var nextd57851005a80479aaeeb90a12c70b9ff = 0;");eval("var previousd57851005a80479aaeeb90a12c70b9ff = 0;"); 
