title: Football face-mask removal with a cordless screwdriver on helmets used for at least one season of play.
abstract: BACKGROUND
  The Inter-Association Task Force for the Appropriate Care of the Spine-Injured Athlete recommends leaving a football player's helmet in place and removing the face mask from the helmet "as quickly as possible and with as little movement of the head and neck as possible." Although 2 groups have studied face-mask removal from new equipment, to our knowledge no researchers have investigated equipment that has been previously used. A full season of play may have a significant effect on football equipment and its associated hardware. Countless impacts, weather, playing surfaces, sweat, and other unforeseen or unknown variables might make the face-mask removal process more difficult on equipment that has been used.
  
  
  OBJECTIVE
  To determine the percentage of face masks that we could unscrew, with a cordless screwdriver, from football helmets used for a full season.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Three New England high schools.
  
  
  METHODS
  All football helmets used at 3 local high schools were tested (n = 222, mean games, 9.7 +/- 1.2; mean practice weeks, 13.7 +/- 1.2).
  
  
  METHODS
  Each helmet was secured to a board, and a cordless screwdriver was used to attempt to remove all 4 screws attaching the face mask to the helmet.
  
  
  METHODS
  Variables included overall success or failure, time required for face-mask removal, and success by screw location. Data were analyzed with chi2, analysis of variance, and Tamhane post hoc tests.
  
  
  RESULTS
  Overall, 832 (94%) of 885 screws were unscrewed, and 183 (82.4%) of 222 face masks were removed. Mean removal time was 26.9 +/- 5.83 seconds. Face-mask removal success was significantly different between school 1 (24 [52.2%] of 46) and schools 2 (84 [91.3%] of 92) and 3 (75 [89.3%] of 84; F(2,219) = 24.608; P < .001). The removal success rate was significantly higher at top screws (98%) than at screws adjacent to ear holes (90%) (P < .001).
  
  
  CONCLUSIONS
  Based on our results and previous findings that demonstrated quicker access time and reduced head movement associated with the use of the screwdriver compared with cutting tools, the former may be a good tool for face-mask removal. However, an appropriate cutting tool must be immediately available should the screwdriver fail. Helmet hardware adjacent to ear holes was more vulnerable to failure, perhaps because it is protected by less padding than the top hardware. Possible causes of the higher failure rate at school 1 are the use of hardware materials subject to rust and corrosion and differences in helmet brand; these areas warrant future research and rules consideration.
authors.affiliation: New Hampshire Musculoskeletal Institute, Manchester, NH 03101, USA. Laura@nhmi.net
authors.forename: Laura C
authors.initials: LC
authors.lastname: Decoster
authors.forename: Chandra P
authors.initials: CP
authors.lastname: Shirley
authors.forename: Erik E
authors.initials: EE
authors.lastname: Swartz