Concussion Toolkit

Engineering, Equipment and Environment

This section involves initiatives that address equipment, facility design and the role of the human body in sports in ways that help reduce the risks for concussions.

If the helmet fits…wear it! Helmets prevent skull fractures, brain contusions and lacerations, and blood clots in and around the brain.  There is no such thing as a concussion proof helmet. They do not prevent concussions.

How to fit a helmet 

Every helmet comes with manufacturer’s instructions on how to fit the helmet properly. Unfortunately, many still end up using an incorrect helmet that is not suitable for the specific sport being played or does not fit well. Teaching proper helmet fitting techniques early on, and reinforcing it regularly, is an important step in preventing head/brain injury incidents in your community. Also, never put stickers on your helmet.

Steps to a great fit

You want a helmet to touch the head at the front, back, top and all sides to achieve a fit that is snug, level and stable enough to resist even violent shakes and hard blows. Anything less than this reduces the ability of the helmet to protect in the event of a collision or crash. The helmet should sit low on the head, about two fingers or so above the eyebrows and the straps done up as tightly as possible (without being painful or limiting breathing). 

Step One

Adjust the helmet on the head.  Some bicycle helmets come with a fitting ring, or a sliding fitting band. These helmets should be opened to their largest setting while fitting the straps and buckles. Once the other components are properly adjusted and secured, the band or ring can be tightened to a comfortable, snug fit. Sometimes, these fit systems require the ring or band to be so tight that they feel binding. If loosening the fit system produces a sloppy fit, this helmet is not for you. Choose another style.

If the helmet does not have a ring or sliding band, they generally come with foam pads that are used to customize the fit.  The top pad can be removed, or the thinnest pad used, to make the helmet sit in the safer, lower position on the head.  The fit can be adjusted further by using thicker pads on the side if your head is narrow, or thinner pads in the back for longer heads. The pads should touch your head evenly all the way around, without being too tight.

Once the helmet is snugly in place, it should be level on the head, with the front edge about two finger widths above the eyebrows, or just above the frame of your glasses.

(HINT:  If you walk into a wall, the helmet should hit before your nose does).

Step Two

Adjust the side straps. Once the helmet is in place, fasten the chin buckle and look at the side straps. The side buckles should rest just beneath the ears. If they are not in place, undo the chin buckle and adjust the straps by first moving the rearmost strap, then the front strap so that they meet at the side buckle, forming a  “V” under the earlobes. Once they are properly adjusted, the side buckles should sit just under the earlobes and slightly behind the jaw line.

Step Three

Adjust the chin buckle so that when it is fastened there is room for only one finger to squeeze between the strap and the underside of the chin. When the person opens their mouth widely, the jaw should pull slightly on the chinstrap. Tighten the fitting band or ring to a comfortable level, and you’re done!

Helmet Standards and Certification

Helmet “standards” tell us the level of protection that should be afforded to the wearer of the helmet. Organizations that are involved in setting standards, for helmets sold in Canada include:

  • Canadian Standards Association (CSA)
  • United States Consumer Product Safety Commission (CPSC)
  • American Society for Testing and Materials (ASTM)
  • National Operating Committee on Standards for Athletic Equipment (NOCSAE)
  • SNELL Memorial Foundation (SNELL)
  • European Committee for Standardization (CEN)

Helmets that make the claim of meeting a standard are either done so by the helmet manufacturer or by a third party test laboratory. No other sticker should be attached to helmet; it can negate the warranty. Helmets bearing a CSA, SNELL, or CEN (CE) sticker are third party tested. The manufacturer has tested helmets with stickers that make the claim they meet ASTM, CPSC, or NOCSAE standards.

Using the wrong helmet in a particular activity can actually increase one’s risk of being seriously injured in a collision.

Before a helmet can be certified by a standards agency, it must be tested.  This is done in a lab where researchers or technicians place helmets on an instrumented head form (model of a human head), turn it upside down, and drop it for a measured distance onto an anvil. The anvil can be flat, round or another shape like a curb-stone, a skate blade or a horse's hoof.  Drop distances vary but are generally between one and two metres (3.3 to 6.6 feet). Different tests using forward acceleration in combination with drop impact may also be performed. There are instruments inside the head form that measure the acceleration of the impact.

Before setting the performance criteria, the association creating the standard considers issues such as type of activity, the population that will be using the helmet and the most likely kinds of crashes the helmet should protect against. Standards also specify how much of one’s head must be covered, depending on the activity the helmet is designed for.  Motorcycle helmets, compared to bicycle helmets for example, cover more of the face and head. There is always a strap and buckle strength requirement, and sometimes a "roll off" test to see if the helmet will stay on the head form when yanked around.  Most of the differences among standards are due to the different drop heights, forward acceleration tests, strap and buckle strength tests, requirements for head coverage etc., that the different organizations established for various activities.

Exercise caution when considering when and wear to cut corners with respect to equipment.  Second-hand helmets sold at garage sales may come with an attractive price tag but cannot offer you or your young athlete the assurance of quality. 

How helmets work: single vs. multiple use and single vs. multiple impact helmets

Sometimes helmets are described as either “single” or “multiple” impact.  This can be confusing, since we also hear about “single” or “multi-use” helmets.  These terms mean different things.  To clarify: 

  • Single USE helmets mean that the helmet is only made for one activity (e.g., baseball).
  • Multi-USE helmets are made for more than one activity. 
  • Single IMPACT means that the helmet is designed to protect you against a single crash, after which you must replace the helmet. Bicycle and most ski/snowboard helmets are often single impact.
  • Multiple IMPACT means the helmet can withstand multiple hits before losing its protectiveness. Hockey helmets are multiple impact helmets.

For more information, consult which helmet for which activity.  

Recreation Facilities Guidelines for Fields and Ice/Arenas

In Canada, there is no unified means of sourcing specific legislation that covers all recreation facility operations, indoor and outdoor, field and ice. There are a variety of legislative requirements that must be considered and met. We calculate that there are as many as 40+ pieces of specific legislation that can affect recreation operations while Codes and Regulations bring the responsibilities above 100 documents. Although the Ontario Recreation Facilities Association (ORFA) publishes a series of guidelines and best practices for recreation facility operation, they are available to ORFA members only.  Contact ORFA or visit the ORFA to inquire further about accessing these resources.

Resources are also available from other provincial facility associations.  Please visit the Canadian Recreation Facilities Council (CRFC). 

Physical Activity Safety Checklists

Various national and provincial sport organizations along with municipalities offer a range of checklists.  These lists inform sports team coaches and managers about what to be aware of with respect to ensuring the safest possible playing environment. It is not sufficient to assume all is well. Just as the weather conditions can change, so can surface conditions and equipment. Download the sport specific checklist for use at your home and away playing surface.  These checklists also address a range of risk management strategies including the role of instruction, supervision, equipment, clothing and footwear.

Conditioning the body and mind

Physical and mental training are important components of the fitness and well being of athletes. When it comes to injuries and rehabilitation from concussion, considering a multidimensional approach is important. For an athlete, physical fitness is a lifelong commitment and when an athlete is concussed, rest is an important part of rehabilitation and so is taking steps to minimize activity.

To maintain fitness and a structured physical program that does not aggravate the problem, considering strategies such as yoga and Pilates at early levels of rehabilitation may be valuable. Implementing mental training techniques and participating in activities such as support groups, may help with educating athletes, preventing isolation while dealing with concussion and reducing anger, frustration and depression. Download additional information on physical/mental conditioning and concepts in concussion rehabilitation

Long term stages of athletic development 

Children, youth and adults need to do the right things at the right time to develop in their sport or activity – whether they want to be hockey players, dancers, figure skaters or gymnasts. Long-Term Athlete Development (LTAD)  describes the things athletes need to be doing at specific ages and stages.