Newswise — Charlottesville, Va. (Nov. 4, 2011) – Researchers in Ohio at the Cleveland Clinic and Case Western Reserve University, and in West Virginia at United Hospital Center, had a surprise in store for them when they performed impact tests on 21st-century American football helmets and compared them with the “leatherheads” used in the early 20th century. The authors subjected the helmets to biomechanical loads that simulated near-concussive and subconcussive head impacts from a variety of directions and found that the protection afforded by vintage leather helmets was often comparable to or better than that provided by 21st-century varsity helmets currently in use.

First author, Adam Bartsch, Ph.D., says the authors were “very surprised. We thought that the lighter leatherhead might reduce force and torque on the neck, but never suspected the head injury metrics would be comparable. We did not appreciate how stiff the modern helmets would be in common, everyday hits. Hence, the stiff modern helmet was often comparable to the minimalistic leatherhead.”

The study results have been published online on Nov. 4, 2011, in the Journal of Neurosurgery: Spine article “Impact test comparisons of 20th and 21st century American football helmets. Laboratory investigation,” by Bartsch and colleagues.

The authors tested 11 commonly used 21st-century varsity helmets and two early 20th-century leather helmets (leatherheads) to compare doses of head impact and risks of injury. Placed on a head form (to simulate the head of the athlete), each helmet was struck by a large adult-size varsity helmet affixed to another head form on a pendulum. Front, oblique front, lateral, oblique rear, and rear head impact tests were conducted. The contact points were selected to approximate the same ones used in tests conducted by the National Operating Committee on Standards for Athletic Equipment (NOCSAE). The simulated injuries were designed to mimic impacts of near-concussive and subconcussive head injuries sustained in football games. Studies have shown that “routine on-field head impact doses in high school and college were in the subconcussive range.”

The leading cause of sports-related concussion in the United States is American football. Today’s football helmets must meet standards set by the NOCSAE. These standards are based on avoidance of severe skull fracture and brain injury, and helmets currently in use have been optimized to protect the athlete’s head from these high-severity impact injuries. However, Bartsch and colleagues found that these helmets do not do as well in providing superior protection from lower-severity near-concussive and subconcussive head impacts. Although not so dramatic, these injuries may cause anatomical and functional changes in the athlete’s brain and repeated injuries can lead to impact dose accumulations, which may produce a variety of disorders such as depression, memory problems, Parkinson disease, and chronic traumatic encephalopathy.

Rather than suggest that football players return to leatherheads, Bartsch and colleagues strongly recommend the development of new safety designs and testing standards for helmets that will minimize doses of both high-severity and low-severity impacts and injury risks. This would be particularly important for helmets worn by children and adolescents.

Bartsch A, Benzel E, Miele V, Prakash V. Impact test comparisons of 20th and 21st century American football helmets. Laboratory investigation. J Neurosurg: Spine, published ahead of print November 4, 2011; DOI: 10.3171/2011.9.SPINE111059.

Disclosure: The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

The Journal of Neurosurgery: Spine is a monthly peer-reviewed journal focused on neurosurgical approaches to treatment of diseases and disorders of the spine. It contains a variety of articles, including descriptions of preclinical and clinical research as well as case reports and technical notes. The Journal of Neurosurgery: Spine is one of four monthly journals published by the JNS Publishing Group, the scholarly journal division of the American Association of Neurological Surgeons, an association dedicated to advancing the specialty of neurological surgery in order to promote the highest quality of patient care ( The Journal of Neurosurgery: Spine appears in print and on the Internet (