Chris G. Koutures, MD, FAAP Pediatric and sports medicine specialist

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Comprehensive blend of general pediatric and sport medicine care with an individualized approach that enhances the health and knowledge of patients and their families



Proud physician:
USA Volleyball Mens/Womens National Teams
CS Fullerton Intercollegiate Athletics
Chapman University Dance Department
Orange Lutheran High School

Co-Author of Acclaimed Textbook

Pediatric Sports Medicine: Essentials for Office Evaluation

Orange County Physician Of Excellence, 2015 and 2016


Best Football Helmet to Reduce Concussion Risk- The One that Fits!

Want to know the best type of football helmet to protect against concussions in high school football?

How about the helmet that fits properly?



The findings of a study in Sports Health identify "an important new potential intervention that may reduce concussion severity and even concussion incidence."

Using Athletic Trainers to evaluate helmet fit in high school players around the United States, the authors discovered that athletes with poorly fit helmets:

  • Averaged more symptoms with a concussion
  • Experienced symptoms lasting greater than a week 

The study also evaluated the type of internal helmet liner (air bladder, foam, or gel) and found that liner type was not associated with either number of symptoms or proportion of helmets with improper fit.

Neck muscle activation has been previously studied as a protective mechanism for reducing concussion, and a poorly fit helmet may limit this protective aspect:

  • If the helmet is not secured properly to the head, the neck muscles may not be able to reduce rotational forces transmitted from the helmet to the brain.
  • A loose helmet may also delay neck muscle contraction response to an impact 

Click here for more information on the role of neck muscle activation in reducing concussion

Particular challenges in maintaining proper fit include:

  • Varying fit with sweat or playing in wet conditions
  • Altering hair styles (including shaving of head after initial helmet fit)
  • Articles worn under helmet or liner (bandanas, hoods, google or glasses straps)
  • Potential leakage of air bladder resulting in insufficient inflation
  • Damage to internal liners from direct impact or improper care of helmet

Click here for an instructive PDF on a step-wise evaluation for proper helmet fit

Bottom line: Helmet fit is not just an early season exercise- players and team officials should ensure that helmets are checked weekly, including inflation of loose air bladders, to help reduce concussion severity and duration.