Helmet Fit and Cervical Spine Motion in Collegiate Men's Lacrosse Athletes Secured to a Spine Board

Abstract

Context: Proper management of cervical spine injuries in men's lacrosse players depends in part upon the ability of the helmet to immobilize the head.Objective: To determine if properly and improperly fitted lacrosse helmets provide adequate stabilization of the head in the spine-boarded athlete.Design: Crossover study. Setting: Sports medicine research laboratory.Patients or Other Participants: Eighteen healthy collegiate men's lacrosse players.Intervention(s): Participants were asked to move their heads through 3 planes of motion after being secured to a spine board under 3 helmet conditions.Main Outcome Measure(s): Change in range of motion in the cervical spine was calculated for the sagittal, frontal, and transverse planes for both head-to-thorax and helmet-to-thorax range of motion in all 3 helmet conditions (properly fitted, improperly fitted, and no helmet).Results: Head-to-thorax range of motion with the properly fitted and improperly fitted helmets was greater than in the nohelmet condition (P , .0001). In the sagittal plane, range of motion was greater with the improperly fitted helmet than with the properly fitted helmet. No difference was observed in helmet-to-thorax range of motion between properly and improperly fitted helmet conditions. Head-to-thorax range of motion was greater than helmet-to-thorax range of motion in all 3 planes (P , .0001).Conclusions: Cervical spine motion was minimized the most in the no-helmet condition, indicating that in lacrosse players, unlike football players, the helmet may need to be removed before stabilization.Key Words: stabilization, emergency management, protective equipment Key PointsN In all 3 planes (sagittal, frontal, and transverse), range of motion between the head and thorax was greater in both the properly and improperly fitted helmets than in the no-helmet condition.N Head-to-thorax range of motion in the sagittal plane was greater with the improperly fitted helmet than with the fitted helmet.N Helmet-to-thorax range of motion did not differ between the properly and improperly fitted helmets for the 3 planes. N Greater range of motion was available between the head and thorax than between the helmet and thorax, regardless of helmet fit, indicating that the head was moving inside the helmet.

Lacrosse Helmet Facemask Removal

“…Although these results were not different, the increase in movement may be clinically important. This finding remains controversial because researchers 26 more recently have found that cervical spine motion was limited the most when lacrosse athletes wore no helmet rather than when they wore properly fitted or improperly fitted helmets. The authors concluded that the head can move inside the lacrosse helmet, making cervical spine immobilization of the helmeted lacrosse athlete difficult.…”

Airway Management in Athletes Wearing Lacrosse Equipment

“…If the helmet and shoulder pads were in place, the participant performing ventilations was not allowed to manipulate or remove the chinstrap because a properly fitted helmet provides stability to the head and neck with a suspected spine injury. 4,18 For trials involving the OPA or KA, members of the research team properly inserted the device. Participants received no feedback on performance after each data-collection trial.…”

Comparison of face mask removal times in lacrosse helmets

“…[24][25][26] There is a debate on whether helmet removal or FMR would be the best approach to access the airway. 19,24,25,27 Lacrosse helmet FMR can occur within a reasonable amount of time, to access the airway, in new helmets; 24,26 however, a failure rate of 22% has been shown in lacrosse helmets used for at least one season. 25 In a study that examined space available for the spinal cord in lacrosse athletes, it was noted that no significant difference existed between helmeted and nonhelmeted athletes.…”

“…25 In a study that examined space available for the spinal cord in lacrosse athletes, it was noted that no significant difference existed between helmeted and nonhelmeted athletes. 19 Also, head motion is best restricted on a spine board when the lacrosse helmet is removed, 27 suggesting that helmet removal may be more appropriate. However, no studies have examined how much motion occurs in the cervical spine with helmet removal.…”