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| Q&A: Dr David Hartman on Head Injuries (824 Posts)
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Ankle complaints
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On 4/6/2005
aengus
wrote in from
United Kingdom
(193.113.nnn.nnn)
Hi Dr Dave, sorry to lump this one on you without talkin here before but I was wondering if you could advise:
I came off my board doin one of those homosexual kickflips-never again- and my right ankle came down with my weight on it with the foot bent inwards. The pain was pretty full one but subsided after a min to a mere nag everytime I put my weight on it. There was a popping noise when I did first put my weight on it. The foot then swelled up to twice its size over the day that followed. Its the outside ankle thats the swollen part, that and a little forward of that. Theres been a little blood pooling below the outside ankle and the swelling has slowly and I mean slowly reduced over the last week and a half. I've been elivating the foot as much as possible but its still a nagging complaint. I was wondering if I should get it checked or if you reckon I've done all I can and it'll just take time.
After 11 days it occasionally feels weird and gives way and the outside ankle is still mildly outta shape and a little painful (like a new deep bruise) to probe. Cheers.
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Dan's Switchblade....
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On 3/10/2005
North Carolina Longboarder- DownHill Billies
wrote in from
United States
(166.82.nnn.nnn)
Dan,
One thing to keep in mind is Giro basically says that helmet is a "one hit wonder" and supposedly is compromised if there is an impact even though there is no visable sign of damage. Of course, you can't find the darn things so until it cracks I would still wear it myself.
Back in my mountain biking days I was sponsored by a local bike shop and we got our helmets replaced after a crash. But that was back then, and not now.
I am still looking for a Switchblade for this summer. They are alot cooler than my Giro Flint.
Marion Karr
North Carolina Longboarder
Proud Member of the DownHill Billies
15 DAYS UNTIL DOWNHILL BILLIES SKATE JAM II
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Shouldering the pain
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On 3/10/2005
Dr. Dave
wrote in from
United States
(68.253.nnn.nnn)
b-a-r,
If you've got chronic pain and the usual antiinflammatories, rest and ice don't do it, you may have an inflammed/irritated lining of the joint. In that case, yeah, I'd see an ortho guy. In the meantime, can the pushups.
Let us know how it goes.
DrDave
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Dan's Head
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On 3/10/2005
Dr. Dave
wrote in from
United States
(68.253.nnn.nnn)
Dan,
You've had good luck so far with the helmet, but if it were me, I'd still feel safer in the round-shape full face helmets. Also, that helmet of yours has taken a few pretty hard knocks. How about giving your head a break, as it were and getting a new one to be sure that the cushioning stays up to par.
Best, DrDave
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Shoulder
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On 3/10/2005 bean-a-reano
wrote in from
United States
(216.89.nnn.nnn)
Hey doc, I seem to have aggrivated my shoulder. whenever I do pushups the part in front of my socket where the shoulder and pectoral muscle (i think) meet gets sore. Only on my right arm. I don't rrember injuring it, it just started a couple of weeks ago. Should I go see a physician?
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Pointy fronts on full face helmets
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On 3/9/2005
Dan Hughes
wrote in from
United States
(66.52.nnn.nnn)
I've ridden with this helmet for probably two years. I've hit my face, hard twice, maybe three times. Never had the "twisting" phenomena that you have described as being very bad. I think the main reason for this is that in order to hit like you described, you'd almost have to hit straight on, and a persons instinct is to turn away from the impact.
Even when I bent my teeth, I hit just on the side of my face or cheek bone (before I started wearing the switchblade).
As a side note. I hit the back of my head one time really hard, with this helmet. Backside air to hook up, slam. The "pointy" part of the back of the helmet actually cushioned the blow, instead of forcing my head to twist.
Just my experience.
dan
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Greg's ACL
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On 3/7/2005
Dr. Dave
wrote in from
United States
(69.212.nnn.nnn)
Greg,
Choice of what surgical repair to try is complex and depends upon a number of factors that are too complicated.. . even for this forum. Shelbourne's procedure is well known, but whether it is right for you is something you need to check out with the time-honored practice of Second Opinion. I would haul your knee and xray's to the sports medicine surgeons used by your local pro football team and see what they have to say. I would also stay closer to University or teaching hospitals, since they have to be up on the state of the art. The site below talks about various ACL procedures for those who really want to get technical. Best of luck and let us know what you choose and how you're doing. We're with you.
http://www.orthoassociates.com/ACL_grafts.htm
DrDave
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ACL
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On 3/7/2005
Fadell
wrote in from
United States
(68.43.nnn.nnn)
Just found out the result of my MRI on my left knee - Complete ACL tear and minor MCL tear. I was wondering if you know of the "Shelbourne Protocol" for ACL reconstruction and what you think of it? It seems like a very tested procedure with a "very" pro-active rehabilitation that sets a time line of a mere 3 - 4 months before normal activity can resume. Also, It uses buttons intsead of screws, so god forbid it were to happen again, there are no screws to remove or replace.
Any info you have on the latest ACL reconstruction would be of help.
Thanks,
Greg
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Giro Flint
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On 3/7/2005
North Carolina Longboarder- DownHill Billies
wrote in from
United States
(166.82.nnn.nnn)
Dr. Dave,
I appreciate your comments on the Giro Flint and the Azonic but I was under the impression that the Flint was a snowboarder's helmet. Wouldn't they run the same risk from the pointy chin piece?
I just bought a Flint and I hope I don't have to get something else. The Giro Switchblade is a very popular helmet as well and it has the same shape. The Meta does as well. Almost all of the mountain biking helmets (which take their design primarily from motocross) have this basic shape. All of the Troy Lee Designs have that shape as well.
Dr. Dave, this forum is very informative. Thanks for all of your input.
Marion Karr
North Carolina Longboarder
Proud Member of the DownHill Billies
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Son of Pointy Helmet
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On 3/7/2005
Dr. Dave
wrote in from
United States
(68.251.nnn.nnn)
Took a look at that helmet. The price is great, but I won't recommended it to boarders because the shape will cause neck twists/breaks if you land slighlty off axis on the front of the helmet. I think MC helmets or any helmet with a round shape is the preferred shape for boarder helmets.
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Azonic - AZX
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On 3/6/2005
deano
wrote in from
United States
(209.181.nnn.nnn)
Here is a great deal on a lightweight fullface helmet. It is Snell bicycle rated and I have soem speedboarding friends who use them. I just got one for slalom.
A hell of a deal at $75
Beyondbikes.com
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Chin Warning
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On 2/28/2005
Dr. Dave
wrote in from
United States
(68.251.nnn.nnn)
Personally, I would not wear or recommend a helmet for a boarder that has a pointy chin front, like the Flint. Reason is that if you fall forward and hit the ground on the point, it has the potention to either break your neck or mess with your brainstem. If the point twists your neck off axis, well, think any number of cheap fight movies where the one guy quickly twists the neck of another. Neck or brainstem, either way you are toast, or worse than toast. Paralyzed from the neck down, even if you were Chris Reeve and can get a few TV roles, is pretty bad.
Boarders are basically on a forward and backward fulcrum on the board. If they go down hill and the board stops, they pivot forward and down. If the board shoots out from under, they pivot back and down. Think of a hammer on a hinge and you have the image. So you really want a rounder helmet - no points in front or back. And if you are in that elite group that worries about aerodynamics -- get the round helmet and an aerodynamic body suit.
Dr. Dave
Dr. Dave
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Big Headed Helmets
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On 2/24/2005
Dan Hughes
wrote in from
United States
(66.52.nnn.nnn)
This is the GIRO FLINT SC SKI HELMET-S,M,L,XL, XXL
I have a question. It says that it has "Impact-absorbing EPS liner." What is that? And how does it compare with Polystrene?
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RE:Sac'd
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On 2/23/2005
Jim R
wrote in from
United States
(67.100.nnn.nnn)
Cool... then I guess I'll just monitor it... been taking it pretty easy on it the last week or so and can definitely see improvement... and I can definitely feel the lumps under there.. although it is not the most comfortable thing in the world to do so :)
thanks a ton,
Jim
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Sac'd in the front
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On 2/23/2005
Dr. Dave
wrote in from
United States
(68.251.nnn.nnn)
Jim, thanks for the clarification. Swelling in FRONT of the kneecap is called
Prepatellar bursitis. This causes pain and swelling in the area in front of the kneecap and just below. It may be very difficult to kneel down and put the knee on the floor due to the tenderness and swelling. If the condition has been present for some time, small lumps may be felt underneath the skin over the kneecap. Sometimes these lumps feel as though something is floating around in front of the kneecap, and they can be very tender. These lumps are usually the thickened folds of bursa tissue that have formed in response to chronic inflammation.
The bursa sack may swell and fill with fluid at times. This is usually related to your activity level, and more activity usually causes more swelling. In people who rest on their knees a lot, such as carpet layers, the bursa can grow very thick, almost like a kneepad in front of the knee.
Treatment usually conservative, i.e., let it go down on its own, but if it is infected or chronic, that buys you a trip to the doc.
Dr. Dave
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MRI Sit Stand Position of Pain Scans
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On 2/22/2005 Beverly
wrote in from
United States
(209.240.nnn.nnn)
http://www.uprightmri.com 1-888-NEEDMRI
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RE: Sac'd
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On 2/22/2005
Jim R
wrote in from
United States
(67.100.nnn.nnn)
OK.. I have heard about the Baker's Cyst deal, but this is right on the FRONT of my kneecap.. I was under the impression that the baker's cyst is only on the back of the knee ..am I correct? Could this just be a busted bursa or some bursitis (guess maybe they are close to the same thing) ... kinda the knee variant of the ever-dreaded swellbow? I just found it odd it took a couple weeks to pop up.. hmmm, it's going down, though.. finally .. supposed to go race some slalom this weekend... might have to reconsider...
thanks for the advice!
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Large Helmets
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On 2/21/2005
msk
wrote in from
United States
(68.190.nnn.nnn)
I've had the same problem finding helmets. Anything I've ever seen in a skate shop is too small. What I've found is that many BMX helmets are available in larger sizes. I'm currently using a Bell Trailrider (out of production, but I still occasionally see them around). Vigor has some that are not quite as large as the Trailrider, but will still fit me. Check your local bicycle shops...
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and another thing
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On 2/21/2005 chris B
wrote in from
United States
(204.78.nnn.nnn)
...and by the spelling in my last post, you'd think i fell on my head one too many times....sorry...working on a laptop today....smaller keys...
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Dome protection
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On 2/21/2005
Chris B
wrote in from
United States
(204.78.nnn.nnn)
Fro the larger faster hills, i go with a protec snowboard helmet with a face shield, but to be honest, i still wear my FLYAWAY for the TS and milder hybrid stuff....
but...
The original foam lining is nothing more than a bath sponge. I've replaced it with higher density, non-memory ceuluar foam that springs back better and offers the protection of modern helmets. You can cut out the old foam (if it hasnt crumbled to pieces already) with a hobby blade and use contact cement to glue the new foam in. The ones i just had made are cut to match the dimensions of the originals exatly width and length, and are aobut 1/4" thicker. If you'd like to buy a set, drop me a line.
At least that way, you can still wear that old flyaway without worrying about busting your noggin (plus the stuff i made absorbs sweat, so it wont run into your eyes anymore)
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Giro Flint Helmet XXL Thor This Is The Deal
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On 2/21/2005
North Carolina Longboarder-DownHill Billies
wrote in from
United States
(166.82.nnn.nnn)
Thor,
Here is the best bet going on helmets out there...it's the Giro Flint snowboard helmet and it has a removable full face guard. David Hackett had recommended it for super G slalom racing. I got the XL and it fits my head well..the only negative it is tight going on...once it is on it is comfortable.
Here is the best deal out there right now price wise:
http://cgi.ebay.com/ws/eBayISAPI.dll?ViewItem&category=36260&item=7135868347&rd=1&ssPageName=WDVW
This helmet is NOT Snell rated, however.
Marion Karr
North Carolina Longboarder
Proud Member of the DownHill Billies
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Mr. BigHead
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On 2/21/2005
Dr. Dave
wrote in from
United States
(68.251.nnn.nnn)
Thor,
Trash that helmet. It's long past any reasonable level of protection. It's time for a new one. Here's a copy of a post last year when this issue was raised. If readers have other suggestions for xxxtra large helmets, post 'em for Thor. After all a Norse Thunder God needs good protection. drdh
On 6/11/2004 Ken wrote in from 66.80.xxx.xxx:
. . .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 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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Neuro-otologist
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On 2/21/2005
Dr. Dave
wrote in from
United States
(68.251.nnn.nnn)
soc D.
Your best bet for a specialty as narrow as that involving neurological conditions of the ear/auditory system is to contact one of the Bay Area's hospitals and see who is listed. You should be able to find one directly or through the department of Neurology.
DrDH
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Sac'd
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On 2/21/2005
Dr. Dave
wrote in from
United States
(68.251.nnn.nnn)
Jim,
Your symptoms sound like what is called "Baker's Cyst." This is a fluid build up that occurs due to some other problem in your knee, e.g., injury, tear of your meniscus etc. The injury causes swelling and fluid to build up in your knee. Fluid becomes trapped inside the knee's joint capsule. Even when the injury has healed, you may still have the swelling in the back of your knee. This is associated with pain usually described as dull and aching.
Anyway, treatment is often with rest, cold, and anti-inflammatories. Don't massage it or try to drain it yourself. See a sports medicine doc or orthopedist and let us know. And as far as skating on it --- You know the old joke "Doc, it hurts when I do this!" and the doc reples "Well don't do this!" (BaDUM - cymbal crash here). Don't skate until you've seen your doc and done some treatment. If you go back on the plank there's a chance of further injury, surgery, etc. Trust me, you do NOT want knee surgery if you can avoid it.
Let us know how it goes. Best of luck,
Dr. Dave
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