How to choose the right helmet: the best protection from a traumatic brain injury

Wearing a helmet during activities that involve speed, a risk of high-impact falls, or collisions is one of the best ways to protect the brain. While the human skull is the brain's natural protection, Miguel Lopez-Gonzalez, MD, a neurosurgeon at Loma Linda University Health, says activities that include speed, height, or balance-dependent movements increase the risk of traumatic brain injury (TBI).

"Helmets provide an added layer of defense, helping absorb impact and reducing the force transmitted to the brain," he says. "With the popularity of bicycles, e-bikes, scooters, skateboards, and other motorized devices, wearing a helmet has never been more important."

A helmet should be worn anytime on riding activities that involve speed, balance, or a risk of falling, regardless of how safe someone feels or how slow they think they're going.

During cycling activities, ensuring the helmet is the right fit is an important safety aspect.

Choosing the right helmet

Not all helmets are the same, and choosing the right one matters. Lopez-Gonzalez recommends starting with these basics:

1. Make sure it's certified: Always choose a helmet approved by recognized consumer product safety regulatory bodies. Certification ensures the helmet meets minimum safety standards for impact protection and is indicated on product labels.

2. Match the helmet to the activity: There are different helmets for road cycling, mountain biking, motorcycles, and other sports. Mountain bike helmets, for example, tend to be thicker to account for uneven terrain and higher fall risk, whereas regular bicycle helmets are lighter and have more vents and aerodynamic shape to decrease wind resistance.

3. Get the right fit: Helmet sizing isn't one-size-fits-all. Try multiple sizes until you find one that fits snugly, neither too tight nor too loose. The helmet should stay in place when you move your head, and the chin strap should be snug, with enough room to fit a couple of fingers between your chin and the strap for comfort.

4. Look for ventilation: Helmets should have adequate airflow, especially for bicycles. Proper ventilation helps regulate body temperature and reduces the risk of overheating or heat-related illness.

Read: "Wear a helmet": doctors urge families to put safety first on e-bikes and scooters

Is a helmet always necessary?

Many people assume that helmets are just for extreme sports or high speeds, but the truth is that even standing still, if someone falls and hits their head, they can suffer a skull fracture with possible permanent brain injury.

"Even movement at five to ten miles per hour carries a significant risk of brain injury," Lopez-Gonzalez says.

One of the most concerning activities Lopez-Gonzalez sees is the widespread use of motorized scooters and e-bikes without helmets.

"We occasionally see young patients come in after falling from scooters or electric devices with no helmets. They have their whole lives ahead of them, and unfortunately, a single moment can permanently affect their future," Lopez-Gonzales says.

Even when injuries don't require surgery, internal brain bruising or bleeding can have lasting consequences.

Read: Think smart, wear a helmet

Prevention starts with thinking first

The ThinkFirst Foundation, a national and international injury prevention initiative founded in 1986 by request of the joint efforts of the Congress of Neurological Surgeons (CNS) and the American Association of Neurological Surgeons (AANS), that were concerned about the high number of brain and spinal cord injuries with limited public awareness on its prevention.

The community of Loma Linda is fortunate to have the ThinkFirst Inland Empire Chapter. The program focuses on educating children, teens, and adults about preventing injuries, including wearing helmets, avoiding falls, avoiding impaired driving, and recognizing unsafe situations.

"Once a brain injury happens, we do everything we can medically and surgically, but sometimes it's not enough to fully restore function. Awareness, education, and prevention are the cornerstones where we can make the biggest difference," Lopez-Gonzalez says.

Wearing the right helmet, fitted properly, can significantly reduce the severity of brain injuries and, in many cases, prevent them altogether.

"It should be a must," Lopez-Gonzalez says. "Think first. Protect your brain. It's the one thing you can't replace."