Canadian adolescent tackle football coaches’ helmet fitting experience, procedures, and beliefs for helmets and mouthguards effectiveness against injury

Wearing a helmet and mouthguard are mandatory for adolescent (ages 14–18) tackle football (American football) players. Coaches are usually responsible for fitting player helmets despite many organizations not mandating/providing training. This structure may create a significant concern for player safety, as 60% of adolescent players wear a poor fitting helmet and wearing a poor fitting helmet may be associated with a higher risk of concussion. We conducted a cross-sectional survey to examine Canadian adolescent tackle football coaches’ current helmet fitting procedures and their beliefs towards the effectiveness of helmets and mouthguards for injury prevention. Amongst the 101 coaches from three leagues, most coaches (51%–88%) believed that wearing a mouthguard could protect against concussions, dental injuries, and/or other orofacial injuries. Helmet fitting procedures were highly variable within and between teams, with coaches using between 1 and 7 criteria. Despite 78%–92% of coaches believing that wearing a proper fitting helmet could protect against concussion and/or reduce its severity, 31%–96% of coaches who fit helmets have never received any training. Lack of formal helmet fit training was reported as the largest barrier to fitting helmets, which supports that tackle football organizations should take immediate action to provide coaches with formal helmet fit training.