A new concussion study shows helmets might not offer the head protection you think they do.
While they can help prevent skull fractures, they don't stop concussion.
Horse rider and trainer Jamie Halpin says her helmet is her lifeline. But she learned early on, at the age of 12, the protection they offer is limited.
"It was a really simple fall," says Jamie Halpin. "Hit the back of my head, cracked my helmet open.
"I actually had a delayed concussion so I didn't know for half an hour - and then I was vomiting, couldn't see, couldn't speak."
It took her three years to fully recover.
A new study of 1500 equestrians across New Zealand showed there's still a lot of misunderstanding around the function of a helmet.
Only 17 percent of study participants correctly identified that helmets do not prevent concussion.
"Helmets are really important to prevent a serious injury like a skull fracture, so it's really critical people are wearing their helmets," said Professor Alice Theadom, lead author of the study and TBI Network director at AUT.
"But what it's not able to do is fully prevent against a concussion."
A concussion happens when the brain moves around inside the skull following a knock or jolt.
"A helmet that sits on the outside of your head can't actually stop that happening," said Prof Theadom.
The study, published in the Journal of Science and Medicine in Sport, analysed knowledge, attitudes, and behaviour towards concussion among adults engaged in equestrian activities, and was carried out in partnership with ACC.
In 2018, ACC received 22,000 claims for concussion, costing the corporation $415 million.
"Approximately 30 percent of concussions go unreported every year," said Nat Hardaker, ACC Injury Prevention Partner.
"This study suggests that this underreporting is in part driven by a lack of understanding about how concussion can happen and highlights opportunities to raise awareness and provide further education."
ACC encourages all New Zealanders involved in sport to learn the three Rs of concussion:
- Recognise the signs, symptoms and possible mechanisms of concussion.
- Remove the player/athlete from the activity.
- Refer to a medical doctor for further assessment and recovery advice.
One in five Traumatic Brain Injuries are sustained in sports or recreation, with rugby, cycling, and equestrian activities having the highest risk.
Falling from a horse isn't the only danger; being knocked over or kicked in the head is also a risk, so wearing a helmet when grooming and tacking up is also recommended.
Prof Theadom says sports helmets haven't changed much in 20 years and she's calling for independent safety-testing.
"We need to be doing more testing to see 'are helmets necessarily designed in the best way to prevent concussion and absorb those falls?'" she said.
"Because at the moment they're very hard structures which is good for skull fracture, but it doesn't absorb the impact of a fall very well."
Halpin has learned to better protect herself: "I've learned to fall off and not land on my head, but there's still the chance that I do."
While not all the risk can be removed from sport, better information and education can help minimise it.