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| Q&A: Dr David Hartman on Head Injuries (824 Posts)
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helmets
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On 12/2/2005
THOR
wrote in from
United States
(66.213.nnn.nnn)
Dan I am glad to hear you are doing ok. The other night before I read your post I was watching a show on the History channel about auto racing safety. Much of the show talked about Bill Simpson founder of Simpson performance products and talked about his new company Impact race products and showed a segment of him testing his new helmets which got me thinking I need to send this guy an e-mail and see if he has any interest in designing a helmet for skateboarding. I have been reading on these message boards now for years with guys like me that can't find helmets to fit our big heads. What are we supposed to do, quit skateboarding I don't think that is a option for most of us. I am tired of wearing tight fitting helmets that are just barely better than wearing nothing at all. I sent Mr. Simpson a e-mail today I will post on hear if he e-mails me back.
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Thanks Dave as always!
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On 12/1/2005
Dan Hughes
wrote in from
United States
(208.187.nnn.nnn)
By the way, the Giro Switchblade wasn't a 35 dollar helmet...
Great idea about emailing the manufacturers. I'll do that.
Do you have a email list of manufactures that you'd recommend, or should I just randomly hit those that I'm able to email?
Certainly the designer didn't intend for us to cream our heads against the ground, and retain the ability to think afterward. However, this limitation doesn't mean it wasn't designed, the human mind inherently seeks intelligible order. Thus the conviction that such an order exists to be found is a crucial assumption in science, one that leads to the ultimate conclusion that it's source must be greater than the sum of the parts.
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Dan, the sequel
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On 12/1/2005
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Dan,
To answer your last two questions: No question we could do better. Whether we could do better on a 39 dollar helmet is unclear. And unfortunately, you can't design a helmet to keep your head injury free, because the brain is floating around in your head and can bounce and stretch and tear neurons from the g-forces. A 25 mph speed translated directly into the ground without a helmet equals about 2500 g's. . . .after which your wife and your parents get to fight over your death benefits. . .
Also, the inside of your skull has some pretty knife-like bony edges around the frontal and temporal regions that can slice and dice your Stupor-Computer like a Vegematic. Obviously the creation scientist who designed the inside of the human head wasn't designing us for boarding. So are skateboard brain injuries the ultimate proof of the non-existence of god? The mind boggles :)
Dr. Dave
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A Hard Fall for Dan
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On 12/1/2005
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Hey Dan,
You are right, there is no skateboard specific helmet standard, and there should be. That said, you are alive and non-handicapped because you did wear a decent helmet. In the absence of a helmet standard, I recommend full face motorcycle helmets for high speed or potential high impact collisions.
The description of your hit sounds like a concussion. The eye twitch may be mild nerve damage. Have you thought about seeing a neurologist for a checkup? Might be good to get a once over after a fall like that.
As for helmet standards, email the manufacturers that the first person who designs a helmet that satisfies safety standards AND takes boarders into account will get your and everyone elses business. Couldn't hurt. . as it were. . .
Sk8 Safe,
Dr. Dave
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Helmets and protection for a skater?
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On 12/1/2005
Dan Hughes
wrote in from
United States
(162.78.nnn.nnn)
Long story short. I fell. Well, I fell from the top of the vert ramp to nearly the bottom (hung on a fs air), slamming the left side of my head. I don't recall the whole situation clearly because well, I don't know why. I guess it has something to do with hitting my head?
After regaining my senses, I don't know if I was completely unconscious or not, but irregardless of that, I was "loopy" for the next hour or so. I kept asking what day it was. I felt like things that happened earlier in the session only happened in a dream, and didn't really happen. Then when I learned that they *really* happened, I started to become aware of how loopy I was.
I didn't and don't have any major pain in my head (only neck and shoulder pain). But, my left eye twitches, like it did when I hit my face two years ago (hence the reason for the full face unit). I surmise that there is some nerve damage, and it will go away after a while, at least it did last time…
Anyway, all this slamming got me thinking (paradoxical huh? Slamming one’s head/ thinking…) . When will we have a "skateboard" specific Helmet? It seems to me that skateboarders hit their heads in different ways than bicyclists. I was wearing a full face Giro “switchblade” helmet. Which is a great helmet. However, it seems to me that we could do better. Or can we? Is it unrealistic to think that a helmet can prevent injury from such a fall?
By the way, thanks Dave for being here!
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Young Buckets
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On 11/26/2005
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Gun-shy's post is a good one, especially the emphasis on getting a helmet that hasn't been recalled. Never ever take a tyke out on a bike or a board without a helmet. If they can't stand a helmet on their head, it's either the wrong helmet or they're too young. It has to stay on with a chin/neck strap, and fit firmly, so it doesn't wobble around. Look for the CPSC or equiv. rating.
A head injury at a young age not only injures the brain as it is now, but can prevent the brain from developing correctly in the future. The only thing as bad as your kid falling and getting brain damage without a helmet is how you will feel for the rest of your life if it happened to your kid.
Dr. Dave
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helmets for little ones
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On 11/21/2005
A little gun shy
wrote in from
United States
(130.132.nnn.nnn)
Gavin:
I'm a little gun shy about posting in this forum since I am the obvious idiot who broke his toe and had all my messages deleted. Putting that all aside, however, I have kids too, and thought I would pass on what I know. Best to start here: http://www.bhsi.org/index.htm Look carefully at the recall data for the models recalled for kids and toddlers.
Then go here and Ctrl-F (Search) Toddler: http://www.helmets.org/helmet05.htm
There are a lot of choices. I got mine a L'il Bell Shell, though I'd have done the Boomerang if the dealer had one.
I was interested to find that in Canada, there is a different energy management requirement for toddler helmets. A helmet meeting the Canadian toddler standard should provide a softer landing. I see the following in the link given below:
HeadStart Technologies has a line of Canadian-made EPP helmets selling for $7 to non-profits. EPP is a multi-impact foam, so you don't have to trash the helmet after every impact. They say the models for the U.S. are all ASTM certified. They also have toddler helmets made for either U.S. or Canadian (CSA standard) specs, which differ considerably for toddler helmets. Contact Headstart Technologies, 558 Massey Road, Unit 6, Guelph, ONT N1K-1B4, Canada. tel. 800-423-3409 or 519-836-6646.
Cheapies does not MEAN BAD Cheap... it means inexpensive... and good.
http://www.bhsi.org/cheapies.htm
Now... check this page out...
http://www.bhsi.org/child.htm
This is also excellent. My toddler is STOKED to wear a helmet. Be a good example. Wear your brain bucket.
I hope this helps.
Respectfull,
Shane
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helmets for little ones
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On 11/7/2005 gavin
wrote in from
United Kingdom
(86.131.nnn.nnn)
hi
can anyone advise what the best helmet would be for a 2 3/4 yrs old? a skate specific helmet (if i can find one that fits), or a cycle helmet that has more protection but less coverage?
cheers
gavin
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Messages erased?
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On 11/2/2005
Adam
wrote in from
United States
(198.144.nnn.nnn)
From the webmaster..
If your email wasn't bouncing then you would know why moderators removed your two toe injury posts from this head injury forum.
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Messages erased?
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On 11/2/2005
shane
wrote in from
United States
(130.132.nnn.nnn)
I keep posting and the messages get erased. perhaps that's why there is no traffic here?
Shane
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thx
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On 10/12/2005 dan@csu
wrote in from
United States
(216.17.nnn.nnn)
thanks, i'll try to find a non-pointed lightweight motorcycle helmet. anyone have suggestions where to get a deal on one? P.S. glad you're feeling better :)
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The Doctor is In. . . DAN
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On 10/10/2005
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Hey, you guys don't post a new question for several months. Cut me some slack if I don't catch the new one. . . :)
Dan, you are carving in motorcycle mph territory, so it makes total sense to get a full face motorcycle helmet. The standard short boarders helmets will NOT protect you in a 40 mph crash. If you decide on a mountain bike helmet (which I don't think is as good, get one which does not come to some weird point in the front, because if you land on that point, that's a good way to twist your head into paralysis mode.
Anyway, the faster you go, the harder you'll fall, if you fall, and the G-forces of a 40 mph fall are just not friendly. Upgrade that bucket.
Dr. Dave
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helmets
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On 10/8/2005
cfav
wrote in from
United States
(24.13.nnn.nnn)
dan.most guys i know(including myself)have upgraded to downhill mtn bike helmets that are full face for when we are bombing hills.Bell and Giro make good affordable versions and they are lighter than a motorcycle helmet.
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helloooo
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On 10/7/2005 dan@csu
wrote in from
United States
(216.17.nnn.nnn)
did the doctor come down with an illness or something?
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hekmet type
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On 10/6/2005 dan@csu
wrote in from
United States
(216.17.nnn.nnn)
i've been bombing around 40mph with a skate helmet on (plastic with foam inside). i know it's better than nothing, but is it important to upgrade to a motorcycle helmet like you see on some guys or will the one i have be fine? i also have a snowboard helet which is beefier and harder so another question would be, is it important that the helmet is full faced? thanks -dan
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Bob's Helmet Smackdown
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On 9/20/2005
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Hey Bob,
Yes, I can imagine the scenarios from landing on the back point of an aero helmet; most of those scenerios involve paralysis at best or ripping up the brainstem, which is your ticket to the Big Hill In the Sky.
It's simpler to imagine the outcome without a helmet: Lots of people wearing black and a headstone that says 'He raced up to heaven.'
And it occurs to me that the worst outcome is 'beating the odds.' Because if you don't wear a helmet and somehow survive, you can pretty much kiss the rest of your life over the next 40 plus years goodbye. If you recover from a severe closed head injury, you won't be the same person, even if you are able to walk around; your friends won't find you interesting anymore, your lover will leave, and there will be way too much time for watching Gilligan's Island reruns. So strap it on, people.
Thanks for the link and the post.
Dr. Dave
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Snoball and his Brain
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On 9/20/2005
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Hey Snoball,
Glad your using the safety stuff. Gotta protect the assets. Your neurosurgeon's comment about the brain remembering its injuries means that significant injuries add up. Even if your brain looks fine on scans, the scans don't always show the microscopic injuries or accomodations or rewiring of that gooey computer up there. Which is why, if someone is repeatedly injured, at some point, they or their doctor will conclude that it's time to hang up the spikes. Boxers, by the way, get that a lot. Many of them get what's called dementia pugilistica from having the brain slammed around time after time after time. While boarders don't get hit as much, they can get hit much harder, so the same principle applies: the less you get hit, the longer you can skate. Thanks for the props, Snoball.
Dr. Dave
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Helmet Smack Video
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On 9/10/2005
Bob Swartz
wrote in from
United States
(69.251.nnn.nnn)
Hey Doc, Here is a link to a video of a streetluge and speedboard event we had last month in Madison County NY. The crashing rider is no other than our Beagle Jarvis. As you can see this guy likes to throw himself into the hay..... often.
In this video you can hear a very distintive CRACK sound of the helmet hitting the road. Do you care to guess what may have happened if this helemt had a point on the back or worse. no helmet at all?
Click here for link
bob
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snoball's silly brain
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On 9/9/2005 snoball
wrote in from
United States
(65.35.nnn.nnn)
hi dr.dave...thanks for the reeeply ;)
I don't know anything about neuroscience so won't dare to argue
with you about it. I can only repeat what the neurosurgeon told
me and he's one of the top ten in the country. I had quite a team,
and feel if it weren't for him..um...something something. He's
tops.
He's the one that told me the brain 'remembers' its injuries. I have
scar tissue in my right temporal lobe and diffiuse damage over the
left hemisphere. But, she walks, she talks, she feeds herself ladies
and gentlemen, so in my book I'm quite alright. Anyway, that
remembering part of the med sci is also why he told me to 'keep
my films just in case' lol. Skateboarder, general rucuss pursuer etc
He's also humble enough to admit that when it comes to
understanding the brain and what it can take and can't or overcome
and can't is not easily predictable. He and the team called me
their miracle patient. It was a miracle they didn't kick me out ;-)
I don't think my wrist will ever be right like it was and I don't
expect it to be anymore. X-ray indicate a complete heal of the
bones but to me, well, pain and restricted movement are what
they are. I haven't done those tests you recommended because
there are other things I'd rather be doing than hanging around
doctors. I only want to see you guys if I'm broken, bleeding,
projectile vomiting...you get the picture ;-)
As for the psychoneurocognitive test ( sorry ), no, I never did that.
In fact, as soon as they let me out of ICU I checked myself out of
the hospital and went home. I did my obligatory followups and then
also released myself. No offense to the doctoring profession or anything.
I wear my helmet in bad conditions, and never fail to wear my wrist
guards at the very least. I totally and completely recommend these
two things as minimum restraints and preventitive measures against
self-inflicted injuries and the boredom of waiting rooms that ensue LOL
You're OK Dr.Dave. Don't let anyone tell you any different :-)
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Civ Lives
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On 7/6/2005
Dr. Dave
wrote in from
United States
(68.251.nnn.nnn)
People, take a look at Civ's helmet. Got cracked like an egg instead of Civ's head, so he has a picture and a story to tell us, instead of an obituary.
Very cool, Civ. Thanks.
Dr. Dave
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Lenny's Toe Jam
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On 7/4/2005
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Hey Lenny,
Turf toe can occur after a very vigorous upward bending of the big toe. It happens a lot when your shoe grips hard on the surface and sticks causing bodyweight to go forward, which bends the toe up. Turf toe is common in martial arts too, but I haven't seen anything about turf toe and boarders. You are more at risk if you have increased range of motion in the ankle and/or wear soft flexible shoes.
According to Jonathan Cluett, M.D., turf toe is a condition of pain at the base of the big toe, located at the ball of the foot. The condition is usually caused from either jamming the toe, or pushing off repeatedly when running or jumping. The most common complaint is pain at the base of the toe, but you may also have symptoms of stiffness and swelling.
A turf toe injury is a tear of the capsule that surrounds the joint at the base of the toe. Tearing this joint capsule can be extremely painful. Furthermore, tear of the joint capsule can lead to instability and even dislocation of the joint at the base of the toe. This may lead to accelerated cartilage wear and arthritis of the big toe (hallux rigidus).
Treatment of turf toe consists of resting the sore toe, icing the area, and elevating the foot; anti-inflammatory medications may be recommended by your doctor. Athletes diagnosed with turf toe should avoid their sport for about three weeks to allow the joint capsule to heal. Once returning to activities, special inserts can be used to limit the motion of the big toe and prevent further damage to the joint capsule. Unfortunately, turf toe can return, and rehabilitation may be slow. Surgery is rarely needed for treatment of turf toe, but in certain cases it may be helpful. If a bone spur forms, and severely limits motion of the toe joint, surgery to remove the spur may be helpful.
For boarding, you have to take a look at the shoes you are wearing. If the show is soft, it will allow your big toe to bend too far, so wear a stiff-soled shoe. Make sure your big toe isn't jamming against the top of the shoe during push-offs.
This kind of thing can take several months to heal, with the usual Rest, Ice Compression, Elevation (RICE) and anti-inflammatories. See if a podiatrist can give you a shoe insert that prevents your toe from getting the bends. If it doesn't heal or you re-injure it, see your ortho doc.
Best,
Dr. Dave
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Snoball all over the sidewalk
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On 7/4/2005
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Hey Snoball,
I'm sorry you are my new Poster Child for sk8 protection. If you are breaking bones and they're not healing, have you looked into electical stimulation? Have you had a dexa bone scan to see if bone density is a problem?
The scientific literature on concussion or mild traumatic brain injury says there is no good evidence that getting hit another time is worse than getting hit the other times, and there is no increased risk of early dementia. That being said, if you have or had an aneurysm or a prone to bleeds (hemophilia, taking blood thinners), etc., it is truly not a good idea to shake up the brain. Remember, the brain is kind of like a hemisphere of jello encased in a Hefty Trash Bag (the dura). You shake, it shimmies. Bad shimmy means torn neurons, blood vessels, etc...Kind of like your own personal Shaken Baby Syndrome. Your helmet-wearing now may not prevent another brain bleed, but its ALWAYS better than not wearing one at all.
Also, you are not going to be as quick on your feet, or good at correcting for unexpected problems, with the kind of brain damage you've described. I have to tell you, if I were you, I'd be thinking about passing down the boards to a kid who can't afford them, and taking up a sk8 coaching and/or a sport that doesn't play pituitary ping pong.
Your wrist thing is the other side of Wray's wrist guard injury. It's really tricky to fix wrist injuries because of all the tiny bones, muscles and nerves in that region.
Your "Last Run of the Day" injury is when most of these kind of injuries take place. It seems that when we're tired, but just want to do 'one more' - that's when it's Clobberin' Time.
Anyway, Snoball, take it easy. Another thing to think about is, that if you haven't had a neuropsychological exam, (which takes all your brain functions 'out for a drive' on behavioral tests) it might be a good idea, because then you could get a sense of what parts of your brain are working well, and which areas have hung up their spikes, as it were. . .
Best,
Dr. Dave
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broken bones and brains
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On 7/4/2005 snoball
wrote in from
United States
(65.35.nnn.nnn)
I shattered the end of my ulna and had a clean, horizontal break at the
end of my radius. This was a wrist fracture from two years ago and it is
STILL not quite 'right'. Breaking bones at 12 is one thing, breaking them
after 21 is another. I deserved this break in the sense I'd taken my guards
off and thought,"Eh, just one more run.". So of course that's when it always
happens. And the ortho said what you said. A wrist break is problematic because
of all those bones insert other medical stuff I don't understand.
I had a brain bleed in 2003 and was in ICU, not related to skating. Damaged the temporal lobe and diffuse damage over the left hemisphere. My neuro
shudders when I speak of skating and flat out told me the brain does NOT forget
injuries and another good smack to the head has increased my potential mortality
rate by 80%. IOW, a helmet will not be of that much use but I wear one
anyway. The point is, if a helmet can prevent your sustaining a brain bleed,
which will put you into all sorts of nasty new 'potential' categories and is
NOT fun to go through, then wear the fribbin' helmet! Healing a broken bone
is a heckuva lot easier than healing a broken brain.
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Turf Toe
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On 7/4/2005 Lenny- DHB
wrote in from
United States
(68.252.nnn.nnn)
This past winter, I attended a Sports Medicine Clinic in order to get licensed to coach in public schools. While there, they discussed turf toe. Hearing the symptoms, I realized that I've had that in the past. It struck me odd that I've not heard too much about it in skateboarding since it's primary cause is pushing off on hard surfaces and that's what we as skaters do.
After a weekend of hard skating, guess what, I think I have it again! I'm following the directions (ice, rest, OTC pain killers) to treat it, but when I was reseaching it last night, I read conflictung reports about turf toe prevention. One article said there were braces you could purchase which would support the toe, while another said there was no prevention, but a stiff-soled shoe may lessen the risk. What's your take on this? If there is a brace, what are the pros and cons of it and what does it look like? If it's just wearing stiffer soled shoes, what skate-shoes (or other shoes good for skating) would you recommend? For that matter, any insight on this matter would be a great! It's a bit painful.
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WRay's Wrist - Inside Edition
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On 7/1/2005
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Way cool, WRay. I think that's a first for NCDSA. . .putting your insides on display. Nice pins, by the way. You may want to carry those pics with you the next time you go through airport metal detectors. I'm serious.
Hey readers, got any pad recs for WRay?
Dr. Dave
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