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

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 no-helmet 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.