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| Q&A: Dr David Hartman on Head Injuries (824 Posts)
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Helmets
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On 7/29/2004
george g.
wrote in from
United States
(159.87.nnn.nnn)
After seeing some vicious crashes at Elsinore Giant Slalom last year I went ahead and bought a Downhill Mountain Bike helmet. With the visor removed it was much better and I have used it at all of the G/S races. I use an open face for T/S because for me it is easier to see. Ramp starts cause me to really look down. But I really liked my full face for G/S, it causes me to focus. Well this weekend I shattered my full face-but I walked away! It was money well spent and will be buying a new one shortly. I have no doubt that I would have been seriously injured. I was really going for it and slammed hard. The helmet was a pro-rider with all certifications. the interior looks like a broken egg shell-It looks really cool with my trashed ICK Stick sticker and will proudly reside in the garage. I am a believer! Wear helmets!
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Helmets
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On 7/27/2004 Old and Gray
wrote in from
United States
(69.63.nnn.nnn)
Helmet
Never leave home without it!
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Good volley
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On 7/6/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
Not much for me to add to this backandforth, except that a skatepark that doesn't enforce helmet regs is asking for a major lawsuit. Nothing like a skull hitting concrete to make the lawyers happy.
Haim, have you had a bone density scan? Take your calcium, bwana. Search the list about electrical stimulation of bones to enhance healing of fractures. Maybe your local hospital has a unit you can use. Might help you heal faster.
It takes a while for bones to heal, and I wouldn't go back to skating before a docs says the bones are knitted. You may also need some physical rehab to get your muscles back in shape before skating again. Don't try it early, or you'll regret it. You've dodged a bullet with the MS, so heal up and rehab the leg after. If your hearing continues to worsen, see a neuro-otologist. Sometimes, there are surgeries to replace part of a damaged inner ear. Let us know on all counts.
DrD
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Helmets and MS Posts
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On 7/6/2004
North Carolina Longboarder
wrote in from
(63.167.nnn.nnn)
MSK: Thanks for the info. So basically, helmets are required but not inforced...ok..well, that's probably a boom for the transplant surgeons.
Haim: Dude! I had the ringing in the ear too! I forgot about that...and guess the freakin' what? Brain "scar tissue"! (turns out it was from a the time I got hit by the car on my road bicycle in 1981 and I slammed my head into a telephone pole). I am glad you are alright ...good luck with it all.
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re: Helmets in parks
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On 7/4/2004
msk
wrote in from
(68.190.nnn.nnn)
In order to be free from liability, California's liability law requires parks to require helmets. The first line reads:
"(a) No operator of a skateboard park shall permit any
person to ride a skateboard therein, unless that person is wearing a
helmet, elbow pads, and knee pads."
Most of the parks I've skated are not staffed, so in order to comply (as described in the law), the city has to enact an ordinance requiring helmets and pads, and post signs warning that violators can be fined. Some cities are very aggressive in enforcing these ordinances, while others basically look the other way...
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wrong forum, sorry
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On 7/2/2004 steve
wrote in from
(68.127.nnn.nnn)
Since nobody reads the safety equipment forum, I'll ask this here. If its location is horribly offensive, just rate it as abuse and it'll go away!
Does anybody know where I can get a Dangersticks Duce helmet? Their internet page is GONE. Is it CPSC rated? I saw it in the CW Buyers' Guide.
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The MS scare
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On 7/2/2004 Haim
wrote in from
(81.218.nnn.nnn)
my right ear started ringing, and then I did a hearing test which showed some pretty severe loss of the 3000-5000 decibel range. I did the brain CT (no tumors) and MRI - which showed lesions which could be MS. The neurologist was pretty sure that it was MS, but the other tests - VEP and spinal tap - were fine. Since the hearing does not seem to be deteriorating and I don't have any of the usual tell-tale signs of MS, they think that the MRI was simply too sensitive a tool, and the hearing loss is unrelated. Probably from all these years playing soldier - I'm a sniper in the Israel Army reserves. Interestingly, a friend who has MS, told me that 20% of 40-yr-old males will have brain MRI with lesions looking like mine...
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North Carolina Longboarder
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On 7/2/2004
MRI and suspected MS
wrote in from
(63.167.nnn.nnn)
Haim: I had the same scare a few years ago with MS. What symptoms were you having that led the doctor to look that direction? I was having burning in my face and jaw and in my ear, especially after heavy activity...I was racing mtn bikes at the time. My doctor, however, was looking in the wrong direction because it turned out to be a bad disk in my neck that was pressing on some nerves...unfortunately, we found that out by having to have an MRI of my neck when I did a two footed over the handlebar dismount with a one point landing (my head) during a race. Blew the disk between c6 and c7 to pieces and now I have a titanium plate and bone graft there. I am not a doctor but you may want to see if the symptoms you are having are related to an issue with your neck....
Sorry to hear about your leg. Get well soon and back on the board. FYI-I'm 41 and try to stay real fit...it helps with recovery for sure!
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Broken Fibula
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On 7/2/2004 Haim
wrote in from
(62.219.nnn.nnn)
Hi Dave,
I wrote in a while ago about an MRI and suspected MS....Thank God that has not panned-out as all the other tests came-in negative. Anyway, last night I came down hard on my right ankle, and broke the fibula. So I'm sitting here with my cast-on, bummed, and trying not to get depressed. The orthopedist said it was not bad but to expect about 6 weeks in-cast. What determines the speed of return to normal activity (which includes skating...)? I'm 39, and fit, by the way.
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Helmets In Parks
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On 7/1/2004
North Carolina Longboarder
wrote in from
(63.167.nnn.nnn)
Well, I have always been one to be the first to step up and say I'm wrong when I'm wrong but it appears my last post was incorrect. According to another poster in the Parks and Pools forum California has a law that basically relieves park owners from any liability whatsoever. I still believe that riding without a helmet is not a bright idea but I guess I will just be the old dork wearing all the gear...
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SkateParks and Helmet Rules or Lack There Of
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On 7/1/2004
North Carolina Longboarder
wrote in from
(63.167.nnn.nnn)
Dr Dave: Here is a clip from an article that was was posted by Michael Brooke on his forum that was taken from an article in a St Louis newspaper regarding older skaters that disturbed me:
"My wife says that if I break my arm, she'll break the other one," says Graf, who joins fellow veterans as among the few in the skatepark wearing protective helmets."
My question is this: How is it this day of ridiculous litigation in this country where people can sue freakin Mc D's because their coffee was too hot that skateparks of any type can and willingly allow skaters to skate without helmets? This makes absolutely no sense whatsoever and I find it incredibly irresponsible of the parks to do so. And before the readership goes off on me about how the use of helmets should be a personal choice and not "mandated" or "dictated" or "decried" by "the man" consider this point- if the insurance industry decides that it is too risky to insure skateparks for liability the cost of that insurance will skyrocket past the incredibly high rates that they probably already are now. That means for us skaters the less likelyhood that other parks will be built and that the few that remain will begin to have overhead cost that make doing business much more difficult. That means higher user fees or parks closing all together.
Do I think everyone should wear helmets when they ride? Absolutely. If you have read any of my previous posts you will probably remember that I had a major head injury while cycling without a helmet. Do I think it should be a matter of choice by the rider? Also absolutely.....but only in the case where their lack of concern for their own well being does not potentially have a greater impact on the skating community as a group. In my humble opinion, skate parks are not doing any one in the skating world a favor by condoning irresponsibility and the risk of rising liability costs.
And for you out there that feel that waivers are the way to mitigate this liability you may want to discuss that with a personal injury attorney and ask him or her how many times they have won cases for their clients when a waiver was in place....
Dr Dave, what is your opinion on the matter?
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No Pain
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On 6/29/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
SM
No pain is no pain: standing on it, moving it, twisting the leg from side to side, climbing stairs, etc. If it hurts on any of these, it's not fully healed. If it hurts bad or you hear rubbing, clicking or popping in the knee joint, there's a knee doc needing to be seen. Let us know how you do.
DRDH
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Knee Damage
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On 6/28/2004 Sketchmaster
wrote in from
(4.22.nnn.nnn)
Negative on the aggravating symptoms. Do you have any tips on evaluating knee injuries? One of my friends has a permanent issue that he had treated professionally. He showed me some sideload type evaluations including one where he laid on his back with the bottom of his foot against a wall to partially load the joint. That was the one where his injury was found. I would like a good solid way of determining that I'm "pain free" before I start back up again.
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Doin' the boneless chicken dance with Sketchmaster
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On 6/26/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
SM,
I can't tell whether anything's going on with you, and I can't officially recommend drugs in this venue, but Non-Steroidal Anti-inflammatories (NSAIDS) like Advil, Aleve, etc. are good for reducing inflammation if you are not sensitive to them. Ditto Glucosamine/Chondroitin.
If your ankle or knee is weak, if there's pain, swelling, limited range of motion, skin feels hot over the affected area, hie thee to your leg doc. I think you should give things a week or two or when you are pain-free before you do the boneless chicken or whatever again. Let us know how it goes. Sounds like it could have been a lot worse.
DrDH
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And now for mine...
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On 6/25/2004 Sketchmaster
wrote in from
(4.22.nnn.nnn)
Thanks Dr. Dave. I specifically mentioned the high pain threshold for the reason you are referencing. Pain is often incorrectly used as a criterion in injury analysis. I personally had a doctor tell me my femur was not broken because if it were I would not be able to tolerate the pain, etc... The X-Ray disagreed with his opinion.
Anyway... I wanted to shake my injury out for the day before I bothered you with it so I would have a better idea of what I've got. I bonelessed down a flight of stairs yesterday at the Wedge. I hit the last stair; Bad news. From a spectators point of view I imagine it was pretty mundane. From my point of view it involved all of my weight coming down on my right leg. I went into the "chicken dance" as all of my ranges of mobility bottomed out because I was so well centered that I never fell. I wish I would have stacked. At the end of the event I could feel my ankle torquing and then my knee; All in expanded time for my pleasure. The ankle is not a serious concern because I have twisted it way worse before and I recovered to better than 100% after going through a few months of excercises that I picked up off of another medical professional (Does anyone remember SIO Barry?). My main concern is the knee. I was able to limp off to the truck and drive home. I slept it off and when I woke up this morning it was almost as if it had been a bad dream. I had zero pain. Then I stood up. The pain was bearable and diminshed throughout the day. I probed all over the joint and the only way I can induce pain is by forcing my calf diagonally in and to the rear. I don't think I have a permanent injury here. If there's anything I can do to speed up the healing process I am motivated to do so. The excercises Barry gave me for the ankle were astounding and I would greatly appreciate any info in that direction. Thanks.
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Doin' the Twist with Sketchmaster's Buddy
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On 6/25/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
Well, yes, I have some ideas - the joint or the lining of the joint may be injured/inflamed. Sounds like it's worth a trip to an orthopod for an x-ray, steroid injection or whatever. These things are slow to heal, and you want to help it along. Having a high pain threshold is not necessarily a good thing if you let stuff like this continue to hurt. Injured joints can become arthritic and limited in range of motion more easily, so early treatment is a good thing. And another idea to tell your buddy: A SK8 wrist guard.
DRDH
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Torqued Thumb
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On 6/25/2004 Sketchmaster
wrote in from
(4.22.nnn.nnn)
I have a friend that did a full blown superman and when he landed he torqued his right thumb back way further than it should have gone. There was significant swelling at the time of the injury. After three weeks the swelling seems to have subsided. However, when I probe this thing the joint is significantly larger than the joint on the other thumb. Theres nothing soft and squishy left and the thumb doesn't appear to be broken. He still has some pain but he does have a high pain threshold. Do you have any ideas regarding the enlarged joint?
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Cranium Conundrum
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On 6/12/2004
North Carolina Longboarder
wrote in from
(63.167.nnn.nnn)
Ken: Great advise on the helmet! No worries on the mail order. I actually do almost 85% of my shopping online. Last Christmas I actually didn't go into any stores at all to get the list of stuff I was responsible for! And, yes, keeping the CFO happy makes it alot nicer around the house!
Just a point on the Giro helmets: I took a major crash in '99 wearing a Giro in a mountain bike race and I believe it saved my life. I did however blow out the disk between C6 an C7 vertrabrates and now have a bone graft and titanium plate and 4 screws in its place...but heck, its titanium! I am stronger and lighter now!
Thanks again for the advise.
Roll on Brothers and Sisters Roll on.
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Possible Helmet to Fit NCLB's Dome
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On 6/11/2004 Ken
wrote in from
(66.80.nnn.nnn)
I've been reading your posts on the Longboarding forum with interest and now I finally have something to add. I too have an extra large melon to the point that when I was a kid and played Boy's Club football, they had a helmet set aside in the equipment closet specifically for me! Maybe I grew into it (my head) 'cuz now extra large helmets sometimes fit me but not always. Anyway I recently picked up a Giro S4 snowboard helmet from REI's website marked down from $70 to $30 in extra large and it fits great. The workmanship is good and all you have to do is remove the insulation from the vent holes (there are plenty of vents for that NC humidity)and remove the little googles strap from the back with a metric allen wrench and you're all set. I just checked and they've still got 'em in a light grey color. You probably can even run this by your CFO (hey hey) without much protest. I know mailorder is a less than ideal mode for such a purchase, but at this price it's well worth a try for a nice helmet. Good luck in your search and keep rollin' the long planks!
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Helmets for Big Skulls!
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On 6/11/2004
North Carolina Long Border
wrote in from
(63.167.nnn.nnn)
Dr Dave,
Thanks dude. We are doing some research. I am also a cyclist and for those you out there in skate land that also ride bikes for road cycling the best fitting helmets I found for large craniums are made by Giro.
Thanks again for your reply and this forum.
Roll on Brothers and Sisters! Roll on Roll on! (wearing a helmet)
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Fit Your Head
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On 6/11/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
Thanks, NCB. Really appreciate these stories. The best advocates have been there and done that and come up pro-helmet. Thanks for your story. Tell as many boarders as possible.
As for helmets, hey, I know from personal experience it's tough to find a helmet for a big head. Helmets that fit everyone else just don't work. But for the same reason, I can only say that there's no one recommendation for you. Everybody's head shape is unique. There are just 3 things to look for: Let's call them the 3 C's (1) Comfort - it's got to be comfortable or you won't wear it. (2) Certification: i.e. CPSC, Snell or ASTM (3) Coverage: Back of head, side and forehead. Those lame pointy vented bike helmets are probably not a good bet for a boarder.
Any Mr. Bigheads lurking on this list who can vouch for a good big vented bucket for North Carolina Longboarder? Let us know.
DrDH
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Helmet Suggestions
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On 6/10/2004
North Carolina Longboarder
wrote in from
(63.167.nnn.nnn)
Dr. Dave: While we are on the subject of helmets, I want to buy a new one but am not sure what's the best going out there. I don't ride street luge or do serious downhill racing but I do ride a few really big hills where the speeds are pretty darn fast. I am 41 years old and have a pretty large cranium. Live Matt, I live in North Carolina and it gets damn hot here in the summer so something with good ventalation would be great. Carving, longboard park riding, and bombing medium grade hills are my main skating focuses.
Got any suggestions? I don't mind spending the bucks for a good helmet.
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Helmets and Matt's Crash
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On 6/10/2004
North Carolina Longboarder
wrote in from
(63.167.nnn.nnn)
Matt: Dr. Dave is right on commending you on your story and I applaude you on your interest in spreading the word. I am both a skater and cyclist and in 1981 a lady in a white Ford LTD decided I would make a good hood ornament while I was riding my bike, helmetless! The result was a major skull fracture, a broken vertabrate in my neck, a broken jaw, broken ribs, fractured hip and one hell of a concussion. She actually drove me into a telephone pole at about 40 mph! My head injury was not as severe as yours but could have been. Unfortunately, I permanently lost all of my hearing in my right ear. I am reminded every minute of my life how important it is to wear a helmet especially when someone on my right says" Hey dude, aren't you listening to me"? Can't you hear? You deaf or something, etc?" Your right when you say people don't think it will happen to them. Guess what? It can and it WILL!
Thank you for your story. Spread the word. Helmets can save your life! I am just glad you didn't get killed or become like a food item in the line at a K & W Caferia-plain, tasteless, vegatable!
Roll on Brothers And Sisters! Roll on Roll on! (wearing a helmet that is!)
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Lucky Matt
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On 6/3/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
Hey Matt,
Really appreciate your writing in. You are, in fact, a very lucky guy. The kind of hit you took could easily have caused you to be an ex-human, or nursing home material. I think that your having the guts to tell your story here goes a long way toward helping people see that helmets aren't just some abstract option.
Your story is a lot like Patio Mendino's who fell and took a long time to recover. He's won't ride without a helmet now. Google his website. He has a copy of the article I wrote about him for International Longboarder.
Anyway, keep doing what you're doing. Contact your local city or town newspaper, local Y's and any public youth group organizations. You've got a scary story to tell and I hope you tell as many people as possible. I'm glad you're alive, and I think I speak for my readers that we all wish you good karma for the future. Let us know how you're doing and how your talks go.
Best regards, DrDH
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CRACKED CRANIUM
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On 6/3/2004
MATT
wrote in from
(66.169.nnn.nnn)
I was riding some neighborhood hills close to my buddies house in asheville, nc on my longboard around 2 or 3am and was bomming this hill comming out of an apartment complex onto a main road wich intersected forming a 90 deg angle. Going for the ultimate rush and not prepared for what I had comming, I was flying down this hill at an appoximate 30-40mph says my friend who was riding his short board in front of me and he had to bail due to his speed. Needless to say I was going a little too fast. I don't remember exactly how it happened, but I hear that as I tried to make the left turn I lost it and did a flip using the back of my head to pivit. My buddy who was already at the base close to the spill was shocked he came to find after he reached behind my head that I was bleeding badly called 911 and saved my life. I was unconscious in critical condition, it was not looking good, to say the least. After 5 days in ICU and another week in the local hospital I had to have my right bone flap removed due to my brain swelling. I still wait for the second surgury to get the flap put back in. There is no question in my mind that I got extremely lucky in this accident, and believe more than ever that I have a purpose for walking on this earth today. I continue rehab weekly and have beat many odds on where I am today. I feel that going threw this tramatic event has made me stronger and I would like to help somebody just like myself who thought it couldn't happen to them not go threw what I am being forced to go threw today. I am planning some local speaches to the neighborhood kids about helmet saftey and preach the importance to all my peers who ride something, "Protect your head!" I am hopeing that my words will impact a kid more than his mother or father telling him to wear a helmet. I am living proof that helmets are made for reasons and if you choose to skate you should also choose to wear a helmet. If you know of any organizations that would be interested in my story I would love to spead the word and even if I save one life all my time will have been well spent
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