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| Q&A: Dr David Hartman on Head Injuries (824 Posts)
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The Road to Snell is Paved with Good Intentions
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On 2/4/2006
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Snell allows up to 300 g's in a multiple strike accident. This is considered to be a dangerous amount of force transmitted to the brain, and there are concerns that a single impact standard that is "softer" i.g., lets fewer g forces into the brain is safer than a "harder" multi-impact helmet. Some of the newer testing suggests that non-snell helmets may be safer.
This is from www.motorcyclistonline.com. "Dr. Jim Newman, an actual rocket scientist and highly respected head-impact expert—he was once a Snell Foundation director—puts it this way: "If you want to create a realistic helmet standard, you don't go bashing helmets onto hemispherical steel balls. And you certainly don't do it twice.
"Over the last 30 years," continues Newman, "we've come to the realization that people falling off motorcycles hardly ever, ever hit their head in the same place twice. So we have helmets that are designed to withstand two hits at the same site. But in doing so, we have severely, severely compromised their ability to take one hit and absorb energy properly.
"The consequence is, when you have one hit at one site in an accident situation, two things happen: One, you don't fully utilize the energy-absorbing material that's available. And two, you generate higher G loading on the head than you need to. "What's happened to Snell over the years is that in order to make what's perceived as a better helmet, they kept raising the impact energy. What they should have been doing, in my view, is lowering the allowable G force.
"In my opinion, Snell should keep a 10-foot drop [in its testing]. But tell the manufacturers, 'OK, 300 Gs is not going to cut it anymore. Next year you're going to have to get down to 250. And the next year, 200. And the year after that, 185.'"
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Teeth
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On 2/4/2006
RyanR
wrote in from
United States
(65.19.nnn.nnn)
David,
I know all about knocking out teeth. Last year I was doing some downhill racing and on my last run, my rear left wheel fell off going about 40mph. I was wearing knee and elbow pads. Gloves and a helmet, but the one place that hit the pavement was my face. I would still have my front 3 1/2 teeth if I would've had a full face helmet.
So on that note...Does anyone have any suggestions for a good Snell/DOT rated full face helmet. I have been looking at quite a few helmets for downhill racing but haven't had much luck. Dr.GoFast and Icaro helmets are not Snell approved and for the Timeship Racing Series they require a Snell approved helmet.
I have looked at some Motocross helmets but I am really looking for something with a face sheild and good peripheral vision. Please let me know if anyone has an idea.
Thanks.
Also, I read something about Snell testing not being right for skateboarding. What would that be about. Is CPSC certified enough?
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Blake
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On 2/4/2006
RyanR
wrote in from
United States
(65.19.nnn.nnn)
Check out SKATEBOARDSAFETY.COM. There might be some info there or maybe some links you could use.
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Full Face Solution
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On 1/26/2006
David
wrote in from
United States
(69.150.nnn.nnn)
Thanks for the replies everyone. Dr. Dave, there was no negotiation regarding the helmet and full face mask. The injuries were very bad but he is healing. He even looks the same except for the braces(which he was getting anyway). I don't ever want to see that again and, therefore, there was zero room for discussion.
Nevertheless, and despite the counter suggestions, I ordered a full face hockey helmet last night. My reasoning is that hockey players hit ice and boards at high rates of speed and are hit by pucks, sticks, etc. at even higher rates of speed. They have their cages rattled, no doubt, but they receive very little significant damage. These helmets are relatively light so his athleticism will be impaired in only a minor way and the vision is excellent.
In any event, this will get him back on a skateboard and I will be able to sleep at night. There is little, if any chance, that the board can penetrate the mask and when I look at his previous hockey helmet versus his previous skateboard helmet, I sleep even better.
I wholeheartedly agree with your comments about the culture. To those who think that Ryan's injuries were rare, I've learned through some research(some included postings from this site) that they are more frequent than you might know. I can not recommend strongly enough, that any skateboarder at least consider the full face mask, regardless of how good you think you are. Ryan is good enough that he has been approached by sponsors. It was just a freak accident and one that could, and does, happen to anyone who enjoys the board.
My sincere hope is that some pro will convince his sponsor to make a skateboard standard and skateboard looking helmet that can be fitted with a full face mask. I then hope that same pro will wear it in an effort to show that culture should at least consider common sense.
I apologize for the editorial but it is important for everyone to strongly consider the downside to this wonderful sport. It does get closer to the edge all the time and the risk and degree of serious injury must, by definition, increase proportionally. Believe me, and I know it's heavy and corny, but there is no parent that wants to see someone they care about hurt as bad as Ryan was and I will spread my message as long as I still see good kids on boards without proection.
Thanks for your help and patience.
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The Wind In Your Hair; Your Brains on the Ground
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On 1/25/2006
Dr. Dave
wrote in from
United States
(68.251.nnn.nnn)
Blake:
I think those 'no-helmet' sites have a minor point. It's true that if you fall in a certain way in a helmet, you can sustain an injury you wouldn't get without a helmet. It's even more true that helmets save far more lives than they damage. As far as I know, every state that has repealed motorcycle helmet laws has seen increased head injury death rates.
Think what happens to a boarder if the board stops and he or she keeps going. Every bit of kinetic energy that was built up going forward is redirected into whamming your head into the ground. Even an inch of helmet padding can the difference between massive brain injury and walking away. Your skull is NOT a helmet! In fact, the front of the skull has a set of knife-like edges that can slice and dice your brain if it rams into it. The hard foam in a helmet can absorb 100's of g's.
Go to the Snell Foundation's website and take a look around, not to promote Snell, but just to get a feel for the scope of the injury. The "freedom" helmet sites just don't get it. Yes there are some trade-offs and yes,even some freak injuries from helmets, but wearing one is overwhelmingly safer than not wearing one. I would vote against a helmet "freedom" measure every time, both for brain-injury-related grounds as well as the fact that my taxes will be paying for that person's "free" choice to get bashed into a persistent vegetative state. Something to think about.
Dr. Dave
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A mouthful
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On 1/25/2006
Dr. Dave
wrote in from
United States
(68.251.nnn.nnn)
David.
I'd go with a dual certified helmet, esp a BMX helmet, which looks pretty cool, and prevents snapped off teeth. Even BMX isn't the best for speedboarding, which is getting into motorcycle helmet territory.
As far as helmets not being 'part of the culture' well, I haven't seen anyone parading broken teeth as part of a culture either. And if your son watches the X-games, he knows that nobody goes up on the half-pipe without full pads and helmet.
You know, being a parent is a lot like what Holden Caulfield wanted to do in the book they made us read in school, 'The Catcher in the Rye." Your job is to watch the kids run around and pull them back only if they get too close to the cliff. Boarding is close to the cliff; it's not just an extreme sport because of marketing. It's an extreme sport because you can get hurt badly, even when you're pretty good. You can explain the logic and all of that to kids, but if they are under your care, sometimes the only thing you can do is say 'no helmet, no board.' I'm not going to tell you they'll thank you later. They may hold a grudge forever. But you'll sleep better.
Let us know what you guys decide.
Dr. Dave
I can't recommend hockey helmets because they are not certified for board-related sports and injuries.
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face guard for skating
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On 1/24/2006 herbn
wrote in from
United States
(205.188.nnn.nnn)
wow, that's got to be pretty rare.i used to just wear fullface helmets,but only on my rather serious DH bike excursions,no helmets otherwise, i used to say i 'd feel real silly breaking my jaw while wearing a helmet . I've increased helmet use,a regular lightweight giro for most biking. I think i'm gonna go fullface for downhill skating,but i think a fullface helmet would really be a hassle on tech level street riding,switch varial heelflip(for instance),inside a full face? i don't think the really serious helmet advocates on this page can even come remotely close to relating to this type of move and how a slightly bigger hole to look through doesn't help all that much, i know skaters that flip wheels graphic in,because a swirling spitfire graphic is to distracting.Sad to say the womans' kid who took out his teeth on a "simple kickflip" should probabely switch over to biking,or some other sport that's more condusive(sp?) to fullface helmet use.
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Full Face
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On 1/23/2006
Shane Anderson
wrote in from
United States
(130.132.nnn.nnn)
A great place to start for data on helmets is: http://www.bhsi.org/helmetxx.htm
Many of the full-face helmets out there are intended for BMX (Bicycle Motocross) applications, but some are also dual certified to include Skateboarding specifically. The Bike standard is the CPSC standard and the Skate standard is ASTM F1492.
I have several helmets for different applications. All of mine are dual certified. I am starting to wear my full face helmet more and more often. I originally purchased it because I wedged a rock one night freeriding and skinned the hell out of my face. I used to laugh at people who couldn't get their face out of the way. No more.
I wear this:
http://us.st11.yimg.com/store1.yimg.com/I/hardheadedsports_1877_46634 Available here http://store.yahoo.com/hardheadedsports/pracespfubmx.html (I am not affiliated).
This helmet is dual certified and will withstand multiple impacts. I am not going to go into all of the reasons why I did not buy a Giro, just the main one... they did not have one that fit me at the time.
I have also started to wear a mouth guard. You know, the old mouthguards that they made you wear when playing football... The reason? One of the major causes of concussion is apparently blows to the jaw. It may save my teeth too, though that is not my main reason for wearing it.
Hope this isn't off topic, nor construed as a hijack. I'd like to hear what others are using, and their impressions as well as Dr. Dave's overall take on full face helmets. Thanks.
Respectfully,
Shane
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Follow-Up to Mouth Injury Below
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On 1/23/2006
David
wrote in from
United States
(69.150.nnn.nnn)
I've now read many of the postings. It appears that a great many skateboarders are now considering, and even using, full face helmets. These appear to be designed for bikers, skiers, etc. but are stil being used. What about hockey helmets? They have to be light-weight and they must have great vision and ventilation. They are reasonably priced. Has anyone tried? Is there any reason that I shouldn't consider these for my son?
Thanks for any reply.
Very interesting site and one that I will definitely show my son. I'm guessing that he will see that maybe, just maybe, the culture regarding the use of helmets(with or without face shields) is definitely changing.
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Skateboard Mouth Injuries
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On 1/23/2006
David
wrote in from
United States
(69.150.nnn.nnn)
My son is an experienced skateboarder. Over X-Mas, he was performing a simple kick-flip and sent the skateboard through his mouth. No details necessary other than he suffered major injuries to teeth and gums. I will not allow him back on a skateboard unless he has a helmet with a facemask. He says that it is not part of the culture but I assure him neither were full face hockey helemts not so very long ago. I can't seem to find any full face skateboard helmets. Any help from anyone? My son loves the sport and I want him to be able to participate but not at the risk of even further damage or worse.
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Anti Helmet websites
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On 1/22/2006
Blake
wrote in from
United States
(216.223.nnn.nnn)
Dr Dave,
My skate injury research has lead me to stumble into a bunch of "helmets aren't important" websites and studies, many are related to bicycling and skiing but basically say that helmets might help a little with minor injuries, but really don't prevent serious ones and might make things worse by increasing risk-taking behavior from a false sense of secutity. On the surface these seem crazy, but they are fairly convincing and well written. The paint a picture of a helmet crazed society where people would be better off not wearing helmets and paying more attention to what they are doing. What are these folks up to? Who bennefits from less helmet use?
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Mea culpa? Or youra culpa?
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On 1/20/2006
Adam
wrote in from
United States
(198.144.nnn.nnn)
JBH, Very good point.. change made.
Thanks for the good idea. Many off-topic posts have been removed from this forum over the years, but I sometimes made an exception when a mod wasn't able to catch them before DrD responded and a thread ensued. Now DrD will no longer be responding to off-topic posts and mods will simply remove them.
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Mea culpa? Or youra culpa?
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On 1/20/2006
JBH
wrote in from
United States
(165.134.nnn.nnn)
Adam, when I posted my knee question that was removed, I was unaware of this forum's change to a focus strictly on head injuries and protection, um, therefrom. I admit I was a bit curious as to why Shane A. mentioned that a post about his toe was removed, but I had read back a page or two and saw that Lenny had posted (and received an answer about) "turf toe," so I figured maybe Shane had just asked a really gnarly toe question. ;-)
However, I bet I'm not the only person who wasn't aware of the "head-only" focus--which is not made clear by the "link" title, which is simply "Dr. Dave's Corner," (and which it has been for some time now, I believe?). So Adam, unless you want similar "off-topic" posts to continue to be made in error (?), would you please consider changing the title of the forum on the link so it more clearly indicates the "head" focus? You do it for Chaput, Cliff, Hackett/Olson and Yandall--why not for Dr. Dave?
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Forum topic: Head Injuries
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On 1/20/2006
Adam
wrote in from
United States
(198.144.nnn.nnn)
From the webmaster..
Dr. D has been with us for going on 4-years now and has been an invaluable resource by helping Ncdsa.com members better understand the seriousness of brain injuries and the importance of helmet use. While he has, on occasion, graciously replied to off-topic questions, it was not, and is not, the aim of this forum to attempt to delve into such topics.
Effective immediately, any off-topic post will simply be removed without notification. My hope is that this will re-focus the forum on its intended goal, namely skateboarding related head injuries. Thanks, Dr. Dave, and thanks to our members for their understanding.
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Pro-Tec "SXP" foam?
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On 1/20/2006
Jonathan Harms
wrote in from
United States
(165.134.nnn.nnn)
I've got two questions for you, Dr. Dave. I'll post them in two separate posts.
The first is about helmets. After reading that the "hard foam" type of helmet offered better protection about two years ago, I bought and have been wearing an inexpensive "hard foam" helmet with the Kryptonics brand name on it. It's lightweight and comfortable, and I have no complaints, except that the fabric liner on the foam is coming off. But every now & then I check to see what's new in helmet-land, and today I decided to check the Pro-Tec Web site at www.pro-tec.net.
I'm wondering if you or others can comment about the "SXP" foam (Surface activated eXpanded Polypropylene) that Pro-Tec is using. How do you think it compares to the "hard foam" (is it expanded polystyrene?) that seems to be the standard?
In this case, I'm thinking of it more for ramp/pool/park riding, but perhaps also for slalom. I may eventually go full-face for slalom, but would like to hear your opinion on the Pro-Tec nonetheless. Thanks.
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No Helmet Horrorshow
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On 1/19/2006
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Dee,
It's tough to convince teens that helmets are necessary. They are all immortal, of course. . . What does your son say about the X-gamers, who are all close to his age and padded to the max? Some kids listen to logic, but most say 'it won't happen to me.' I think the best thing you can do is say 'if it's good enough for the X-games its good enough for you,' and let the argument stop there. It only takes one unprotected fall to bash your brains out, literally. You might want to ask him how he would feel if he *does survive something like that and is strapped to a wheelchair the rest of his life? But in the short-run a black-and-white 'no-helmet-I repossess your board' rule may be the way to go.
I wrote an article about skateboard injuries for the defunct 'International Longboarder' a couple of years ago. If you send me an email, I'll shoot it to you.
You too Blake, send me your email at drdavidhartman@hotmail.com and I'll send you a copy. Contact the Snell Foundation http://www.smf.org/ for other helmet related information. While there's some dispute about whether Snell's standards are the best for boarders, you can get a lot of useful information there.
And Blake. Your personal helmet story made my day, because I have a good idea what might have happened if you hadn't worn it. Good job. . .
Dr. Dave
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son not wearing helmet
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On 1/17/2006
dee barclay
wrote in from
United States
(66.190.nnn.nnn)
Dr. David, Please help me find info. to share with my son on why he is made to wear a helmet- injury pictures ect. This is a constant fight at our house because none of his "friends are made to wear helmets while skateboarding. Any help you could give would be great, I will not "cave" on the helmet issue and my son is a very bright young man so I feel with a little bit of scare tactics i will be able to convince him (and maybe his friends) that it is imperative to wear a helmet.
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Injury research
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On 1/16/2006
Blake
wrote in from
United States
(216.223.nnn.nnn)
Dr. Dave,
I'm working on a skateboard safety equipment ad campaign (promoting its use, not selling it) for a graduate graphic design class. Do you have resources for good research that would include: number and type of injury, age of victim and whether they were wearing gear or not? I was planning to do this project anyway, but bouncing my helmeted head off the asphault while practicing gymnastics at the end of a slalom run this weekend really made me more committed to doing the project and seeing if I can make it a real campaign, not just for school.
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Better Helmet Tech is Possible
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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
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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
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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
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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
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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^
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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
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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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