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Dr David Hartman on Head Injuries

 
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Q&A: Dr David Hartman on Head Injuries (824 Posts)
Topic Comment
Better Helmet Tech is Possible
On 1/10/2006 Dr. Dave wrote in from United States  (24.13.nnn.nnn)

People. Here's some proof that better helmet technology can reduce concussions. The new helmets don't change recovery patterns if you actually have a concussion anyway, but it looks pretty sure that they make getting a concussion less likely in the first place. Let's hope the skateboard helmet makers get a clue from this research:

PITTSBURGH, Pennsylvania (AP) -- Newer helmet technology could reduce the risk of high school football players getting concussions, but not the severity of the injury, according to new research. A three-year study by the University of Pittsburgh Medical Center found that athletes who wore a helmet with more protection for the temporal area of the head and jaw had fewer concussions than those wearing a standard helmet, said university neuropsychologist Micky Collins, the study's principal investigator.


The study, published in the February edition of the scientific journal, Neurosurgery, looked at 2,141 high school football players from 2002 to 2004. Of those, 1,173 wore the improved helmet and 968 wore standard helmets through both the pre- and regular seasons.


The study, funded by helmet maker Riddell, is the first to look at whether helmet technology can reduce the severity or number of concussions, Collins said.


The study showed the annual concussion rate was 5.3 percent in athletes wearing the new Revolution helmet and 7.6 percent in the older version. Revolution wearers were 31 percent less likely to sustain the an injury, compared with wearers of standard helmets, the study showed. The Revolution helmet was introduced in 2002.


However, helmet type made no difference in the recovery time of athletes suffering from concussions, Collins said.


Investigators used a test developed by UPMC to check the athletes' reaction and memory skills before and after concussions.


Collins said 50 percent of the athletes who had concussions did not recover within one week, 30 percent did not recover within two weeks and 15 percent did not recover within three weeks.


This is crucial because reduced cognitive skills also hurt the athletes in the classroom, Collins said.


"There's no such thing as a concussion-proof helmet," Collins warned. "The biggest mistake anyone can make is saying, 'This kid has a concussion. Put him in this helmet and send him out there.' ... Any athlete who has a concussion and goes back to play too soon, that's when the risk levels are high."
Experts studying sports-related brain injuries welcomed the study.


"(It) supports what we have anecdotally been discovering over the past few years," said Kevin Guskiewicz, chairman of the Department of Exercise and Sport Science at the University of North Carolina at Chapel Hill.
Fewer concussions were reported among UNC players wearing Revolution helmets, he said.


Stefan Duma, director of the Center for Injury Biomechanics at Virginia Tech in Blacksburg, called the UPMC study "a critical aspect in improving player health."


Duma and Guskiewicz are involved in separate studies to measure the acceleration of football players' heads in real time by installing wireless transmitters in their players' helmets, both Revolution and standard.


Guskiewicz said he hopes studies like his and UPMC's help researchers to better protect the brain from sports related injuries.


"The exciting part is it indicates there are design factors that can be modified to reduce your risk of concussion," Duma said. "Just showing they have shown a reduced risk with design change, maybe they can change the design more and keep improving."

 
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Richards Foam Dome Hard Lesson
On 12/27/2005 Dr. Dave wrote in from United States  (24.13.nnn.nnn)

Hey Rich,

10 years is several lifetimes for a helmet, so I agree, time for a new one. I'm not sure that your ramp dome was 'certed by anyone, but I would definitely not try to cram some styrofoam peanuts or sharper image pillows or whatever up there. As cushy as it might seem, unless you've got the testing equipment, you've got no guarantee that if the rubber meets the road, that your brains will not join it. 'Feel' or look unfortunately is no guide. Remember the 1950's Corvette? Looked like it would drive through a wind tunnel like a dart? When they finally tested it, it had all the aerodynamics of a boat anchor. So my best advice is find a helmet shop and find a comfy and certified bucket. I know some of the ski helmets have some cushier material on top of the harder foam, so you may like that better. The dense foam is there for a reason. Under high 'g's, the harder foam will absorb the energy of impact, where the soft foam would just give a nice soft area for your brain to sit after the skull cracks open like a hard boiled egg. As for the helmet as clothing, well, even Doonesbury's "BD" had to take his off sometime. . . :) Seriously, I think you'll find something you like, but you'll have to get something a little different than your old lid. Don't ditch the hard foam. it's definitely there for a reason.

Let us know what you decide,

Dr. Dave

 
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Lids
On 12/19/2005 Richard wrote in from Canada  (70.49.nnn.nnn)

Since you are well aware of the fact some of us wear helmets as regular clothing, I wonder if you could offer your opinion. I wear a protech ramp lid that has foam inside, not styrofoam. I find this has more "give" and seems to be more forgiving than the styrofoam. My helmet is getting ratty as it is about 10 years old but I can't seem to find a replacement. I really don't like the styrofoam but is it better? is there a reason I cant find my foam padded lid, or is it more expensive to produce or some other reason? I would rather make a new incert for my old shell than wear the "explode on impact" stuff.

 
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helmets
On 12/16/2005 herbn wrote in from United States  (152.163.nnn.nnn)

cool tv ad, guy kisses his wife ,walks out his house puts on a helmet and base dives down to his honda suv,takes off his parachute and helmet and drives away...... think about it.

 
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The Knee of Travis
On 12/7/2005 Dr. Dave wrote in from United States  (69.212.nnn.nnn)

Travis

Your doctor probably knows something, so it's unlikely your knee is broken. If your knee is getting better, well, you know the old joke about the guy who comes into his doctor, puts his arm between his legs from the back and touches his nose, and says 'it hurts when I do this' what should I do?. . .and the doc replies 'don't do this', , ,(insert cymbal crash here. Well the moral of the story for you is don't put your leg under weird stress or strain while it's healing. If it's really bothering you, though, you might want to consider going to an orthopedist, better yet, a sports medicine orthopedist. Sprains can take longer than three weeks to heal. Second opinions are good.

Let us know what happens,

Dr. Dave

 
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My knee hurt's when I stretch it pass 90^
On 12/4/2005 Travis Torres wrote in from United Kingdom  (172.208.nnn.nnn)

About three to four weeks ago,I was skating in fron of my house and I tried to do a trick over a gap when I missed it I was on the ground wondering what happen.When,I attempted the trick and I fell everything happened so fast and I didn't know what happen althought I couldn't really walk.After a couple of day's,I went to my doctor and she told me that it will take up to three week's until my knee will heal.Well,it's been three week's and still hurt's when I do certain things like sitting on my left leg or when I stretch it pass 90^ degree's.I was wondering if I broke something,torn something,or if I just sprained.
Please write back because I'm starting to freak out if I need surgery.

 
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Some pointed helmet ideas from Thor
On 12/2/2005 Dr. Dave wrote in from United States  (24.13.nnn.nnn)

Good idea, Thor. For that matter, email Tony Hawk. He's probably rich enough to fund a high tech helmet development team. One thing though, even the 20 dollar styro-helmets from Walmart are WAY WAY better than nothing at all. Even a cheap helmet can reduce head injury big-time.

And remember to trash the helmet after it saves your skull. Never re-use a crashed helmet. Bury the crashed one with honors, because if it weren't for that helmet, it might be you doing the impersonation of a 6 Feet Under extra. . .

Dr. Dave

 
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helmets
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!
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
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
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?
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
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
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
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?
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?
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
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
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
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
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
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
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
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
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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