Head injuries - How often have you seen them?

[riley876]

In the last month I've seen 2 falls with head knocks from figure skaters at the ice rink.   One was minor and the other not so minor (but not involving a loss of conciousness)  Both involved going over backwards after catching the heel corners during general footwork (i.e. not during jumping or spinning).

It's a horrific thing to watch and hear - it literally sounds like a coconut on concrete,  it's left me a little unsettled.  Though I do wear a helmet, always have done, and always will.

It strikes me that I have never seen a head smack during my last 3 years at the inline rink.  It's true that not many people do anything fancy on inlines generally at my usual rink,  and it's also true that on wheels you can pull slightly wayward skates back underneath one self, and going over backwards happens a split second slower than on ice figure skates (i.e. no picks or heel corners to vault you into the floor).    But still 2 in a month vs none in a 3 year it makes me wonder.   Especially about the need to have sharp cornered heels on blades.

Anyway, just kinda needed to talk about it a bit.   

What's your experience seeing (or experiencing first hand) head smacks during your skating?

[Bill_S]

Yeah, that sound (head hitting ice) is scary.

I bonked my head once fairly hard. I was still learning the basics, and I used to be quite fearless. I decided to just try an axel, and hit my head pretty hard in the attempt. I've generally been lucky, and have avoided hitting my head  - mostly by tucking my chin strongly on the way down. If I land on my back, the force pulls very hard against my neck muscles, and I'm sore in the front neck muscles the next day. But I don't hit my head, which is the goal.

I've seen a couple of moderate head bangs during our freestyle sessions that required an ambulance. No one was unconscious though, but needed to be checked for concussion.

The worst I've seen have been during public sessions where beginners have something go wrong. They don't yet know how to fall to minimize damage. One woman was hit from behind  by a too-fast, out-of-control guy on hockey skates, and went down so hard she didn't gain consciousness while we waited for the ambulance. That was a bad one. I've seen other people who black out for a few minutes after a fall, and they get a ride also. One woman fell, hit her head, but said that she was OK.  She started skating again, but you could tell that something was going wrong. She began to look very wobbly, so the rink guards made her get off the ice and wait for an ambulance.

Unlike you though, I've seen people at a roller rink require an ambulance because of falls. Even I have fallen and hit my head at the roller rink. I split my eyebrow on a forward fall on my inlines during a 3-turn at speed. I absorbed most of the energy using my arms (not locked), but tapped my face hard enough to bleed profusely. They had to get out the mop to clean up after me, but it wasn't a medically serious injury.

[rd350]

I've seen 2, though 1 was a kid on hockey skates running crazy circles when he lost it and went into the boards.  He did lose consciousness very briefly.

The other was a friend who was skating around pairs with another friend and they were across the rink and although I saw it, I wasn't close.  They were taking a corner and I think one of them may have been in a turn forward<> back and I think they just caught their blades.  I'd never seen them fall before but she went down on the back of her head, hard.  She was down quite a while but did not lose consciousness and was fine.

I ordered my RibCap soft helmet the next day and always wear it.  Glad to report it hasn't been tested!

@ChristyRN, here went down and blacked out a few months ago and had some amnesia but I think she is back on the ice again just recently - with head protection.

It's good you're wearing protection.  That's about all you can do if you want to skate and move skills forward.  Protect yourself at the level that makes you more comfortable.  I wear the RibCap, Se_Ku ProTech pants with padding at the hips and coccyx and Se_Ku knee pads.  I know wrist guards would be smart but I like having my hands free.  Although it might stop the crazy things my wrists want to do sometimes!  Hmm....

[Neverdull44]

My daughter hit her head real hard, made the sound.  Probably a mild concussion and she was ok the next day.   A hockey player at our rink hit his head real hard and lost consciousness during a public skate.   He hasn't been back to the rink.

    Head protection is very useful.   I have this one and I like it. I don't wear it enough.   http://crasche.com   But, working on my next moves in the field, I will break it out.   

[riley876]

It's good you're wearing protection.  That's about all you can do if you want to skate and move skills forward.  Protect yourself at the level that makes you more comfortable.  I wear the RibCap, Se_Ku ProTech pants with padding at the hips and coccyx and Se_Ku knee pads.  I know wrist guards would be smart but I like having my hands free.  Although it might stop the crazy things my wrists want to do sometimes!  Hmm....

LOL, maybe it will.  They certainly restrict mobility a bit, but not enough to say not be able to do up laces whilst wearing them.  What I found immediately was that wrist guards stopped my dumb instinct to use my fingers to catch myself.    Unlike the rest of my padding kit, I think they don't look unflattering at all, I don't know why they aren't more popular.

I suspect my level of paranoia might top everyone else's here: I wear the full kit:

- Skateboarding type helmet, custom modified**
- 187 Roller derby style knee pads (with 40mm thick foam! - it's like falling on kittens!)
- 187 Roller derby style elbow pads
- 187 Wrist guards, with extra foam shoved between palm splint and hand
- 20mm hip pads sewn into my (slightly baggy) skating pants
- Triangle of 20mm foam strategically shoved down the back of pants

Pretty much the whole roller derby setup.  I regularly get asked if I play.  Good for a conversation starter if nothing else I suppose!  People also ask how I can do crossovers with those huge knee pads.   The answer I give is that I employ magic. 

Downside is that I guess no coach would touch me should I ever decide to get semi-serious.  But oh well, all risk mitigation has a price.

** See http://www.skatelogforum.com/forums/showthread.php?t=45084   - my conclusion was that you can't buy a helmet suitable for the level of impacts that you're likely to get whilst skating - so I made my own.

[ChristyRN]

@ChristyRN, here went down and blacked out a few months ago and had some amnesia but I think she is back on the ice again just recently - with head protection.

Three months ago yesterday. I've been back on ice once, last week. I was going to go yesterday, but had too much other stuff to do instead. I'm planning on going Saturday to make that up.

I still don't know what happened. I do have the Crasche Middie band and it wasn't uncomfortable, just weird as I don't generally wear things on my head unless I'm at work (scrub hats).

It wasn't my first on-ice concussion, but the first one was about three months in. I was standing on the goalie crease, then I was on the ice surrounded by coaches. I should have gone to the ER then, but actually got back on for the group lesson. If I hadn't, I probably never would have skated again.

Most of what I see is toe-pick chin hits. Blood everywhere.  Not nearly as bad, but you can get a concussion that way too.

[lutefisk]

I've had one.  I fell backwards and smacked my head hard enough that my eye glasses flew to the other side of the rink.  My head was pounding but I jumped up and skated over and grabbed them up before some kid ran over them.  Head hurt for a couple days but fortunately just a "light" smack.  I no longer wear eye wear when skating.  Since then I've witnesses two other skaters going down and hitting the backsides of their heads.  One was a young coach the other was an ice tourist.  The young coach had to stay off the ice for a couple weeks and not watch tv or read during her recovery period.  She probably returned to the ice too soon but skates today without any obvious effects.  The ice tourist lady went down hard and had to be removed from the ice by EMS personnel.  I've never seen her again and don't know her out come.

[Live2Sk8]

I've hit my head 3 times, and seen adult skaters hit their heads multiple times.  Also saw a father fall backwards on public - he was unconscious briefly.  He resisted ambulance but I think he was convinced to go by family.  Never saw the family again, unfortunately, and they had looked like they were having such a fun time together.  2 of the adult skaters who hit their heads were very confident on returning to the ice after many years off.  They went into awesome sit spins but slipped backwards and whacked their heads.  (This has contributed greatly to my difficulties with the sit spin, even though people tell me that won't happen.  Sorry, I have personally witnessed it twice.)  A third was learning sit spin in LTS and fell backwards.  Her tailbone was sore more than her head so I don't think she whacked her head too hard. 

My head hits were all flukes.  One, I tried shoot-the-duck for the first time and LTS coach did not say to reach your arms forward so I didn't, and slipped backwards off my blade.  The next one, I was thinking about what to practice next and somehow hit a condensation bump while basically standing in place and fell backwards like a log.  That made a horrible noise on the ice.  The third time, I was in a spin and went off the back of my blade and again fell backwards like a log.  Actually maybe I didn't hit my head on that one - think I knew enough to tuck my chin by this point.  I did not have medical attention for any of these.  I felt really sick after the shoot-the-duck fall but it might have been fear.

I wear an Ice Halo when I do moves in the field or when learning something new.  Another adult skater hit his head while wearing his Ice Halo and he is positive it helped reduce the impact. 

I did have a bad fall while rollerskating on the sidewalk as a child.  I must have done the roller skate equivalent of a toepick because I fell forward and scraped a lot of skin off my nose from momentum.  No broken bones, but it really hurt.

[amy1984]

I saw a fall one time between two skaters that caused one of them to ram her head into the boards.  She sat there, startled for a couple seconds, then started to cry (I would too!).  Was able to get up and off the ice and seemed okay, just a little scared I think.

I think it's amazing that in almost 20 years of skating, I can count the number of times I've seen someone hit their head on one hand.  I think I've hit my head all of one time.  We figure skaters are like cats I guess.

[Loops]

We figure skaters are like cats I guess.

I think we have to be, or we'd be done after the first fall.

I'm pretty sure I gave myself a concussion (when I was around 6?  Just started with groups and was showing off to my friends....slammed into the boards, came to in the warming room.  Got what I deserved).  And saw a fellow skater fall backwards out of a layback.  That was bad, but she was fine.  Like Amy1984's experience, she was stunned for a little bit, then started to cry.  There was no medical attention.  I think she left the ice, perhaps for the rest of that session, but was back pretty soon afterwards.

Probably the worst injuries that happened were one girl who broke her leg, I think on an axel attempt (I wasn't around when that happened), and of my fellow skaters who fell during patch.  She was working on her 8th, so deffo not a beginner;  went down straight onto her bum and broke her tailbone.  So it can really happen at any time and without warning. 

So counting the tail bone, that's 3 pretty big falls in probably around 9 years.  This all happened when I was a kid/teen.  Haven't seen anything yet since I've been back on the ice as an adult.  Most falls really aren't so bad.  Somewhere on this forum is a thread where we share our own injuries.....if you're worried about it, you can read what many of us have done and lived to tell the tale, AND laugh afterward.   Big injuries are thankfully pretty rare, and I think head injuries are a small percentage of those.

At my rink, I'm pretty much the only adult who falls, but I'm a little more fearless than my fellow skaters.  I don't wear head protection- my naturally well padded bum takes most of the impact when I go down, although I did bellyflop out of a camel attempt earlier this year (got right back up, and did the camel correctly, like those cats).    I keep thinking about getting a Crasche midi or IceHalo.....you never know when you're going to go down like that.  But I already take skating so much more seriously than my peers, so do "weird" things....like actually skating during warm up and stretching afterwards.   And I'd be the only one wearing anything on my head, even if they didn't know it was protection.  [sigh] Conformity.

[davincisop]

I've thankfully never seen one, but I have been victim of one. I was spinning and just went off my balance. Didn't even know I was going down until I hit. Ended up bashing my knee and hitting my chin, nose and forehead (twice, my face bounced....). I went to the clinic and they said if I had a headache or anything to go to the ER. I didn't, probably should have. I feel like my short term memory hasn't been as great since I hit my face....


One woman at my rink stepped out of the music box without looking and collided with a skater going backwards, and she got knocked down and was unconscious for a moment.

[TreSk8sAZ]

I must be pretty odd, because I really haven't seen much. I've hit my head falling on footwork once, but I had a ponytail in and hit that so no damage at all. The only one I've really seen was an adult beginner in hockey skates. He was skating to the boards and fell. As he fell, he reached out for the boards and missed so hit his head on the boards. If he would have just fallen, he probably would have been fine. Other than that, really nothing. Maybe it makes a difference that I'm on freestyles with people who generally are working on an axel or higher. A few lower than that, and many upper level skaters, but I don't do publics so maybe that's why I haven't seen any.

[rd350]

Had a very short skate today (to get to that next level of break-in time on new boots, to go up to the next hook tying) and not doing much during the break in.  No spins or jumps.  Still, as I was about to step onto the ice I realized I forgot my RibCap and I went back and got it out of the locker.  No falls but I somehow tangled both blades on some footwork and remember being happy I had the hat.  Luckily no fall!  Whew.  This thread pushed me to use it though, even on ice for 40 minutes doing nothing too difficult.  But we know many falls happen when you're just standing still!

[Christy]

When I was around 8 I went skating with my Dad and he fell and got a nasty gash on his forehead. He didn't black out or anything but was a little shaken, however he get back on the ice then drove home. Sadly my mother wouldn't let him skate after that.
Recently some local rinks have started to make helmets mandatory at public sessions after an older man fell and had to be taken to ER. I have seen two other people fall and hit their heads and the sound was horrible. Fortunately neither blacked out and one has skated since.
It definitely makes you think and I do need to find a solution. I got the crasche midi but it's so slippery it's too distracting, so maybe the ribcap.

[PinkLaces]

There were enough concussions at my old rink that they now do baseline concussion testing every year. I, myself, tripped, fell, and hit the back of my head (after avoiding a collision with another skater). Had it checked out by the doc. No concussion but had to take 2 weeks off ice.

[Query]

A skater at my rink was jumping a cone, and wound up face down on the ice. I skated over and asked him if he was alright. He was completely non-responsive for at least a minute - probably unconscious from a concussion. He got himself up after a few minutes, but needed two people's help to get himself to the edge of the rink, and seemed dazed an confused at first. 

Fortunately he wasn't driving himself home.

It was quite scary.

[karne]

Faceplant onto the ice. I guessed I probably had a concussion because when I get them I get stupidly fixated on one tiny thing - in this case it was my glasses. Where are they? Someone might skate over them. They're broken. I don't have my spare. I have to tape them up so the screw doesn't fall out. Please don't take my glasses off, I need them.

I was more worried about the fact I couldn't move my arm though. That was the time I learned you can actually sprain your shoulder. I had no idea this was possible.

Funnily enough, riding a bike without a helmet is against the law here, and I'd have never rollerbladed without one, but it's never occurred to me to wear a helmet on the ice.

[cbskater]

I've seen a lot of beginner kids fall, bump their heads, cry & then they are fine. I haven't witnessed a bad head injury. I hit my head once when I stepped on the ice with my hard guards on. I actually hit my head on the threshold where you step on the ice, not the ice itself. Didn't pass out, held ice on my head for a while then skated. Had a bump on my head for a couple of weeks that was sore to touch, but otherwise nothing hurt but my pride. I was cautious for a couple of weeks while skating also. I didn't want to hit it again. I also never step on the ice anymore without looking down at my skates.

@rd350- I didn't wear wrist guards either until I watched my friend fall & break her wrist doing a 3 turn. I now wear the Red wrist guards. I don't even notice that I'm wearing them. They are not bulky & don't restrict me in any way, other than I cant do the floppy hand thing that my coach would yell at me for anyway. 

[JSHalo]

Okay, I'm going to be "that person." (sorry in advance)

You can still sustain a severe concussion without loss of consciousness. I would argue that most people who sustain a concussion do not know they have one. My first concussion was fairly mild. I got back up as soon as they'd let me (they were concerned about an injured spine... there was no EMT there, so my coach tried her best), and it wasn't until five minutes later that I became nauseated. Onlookers were fond of saying it was "the adrenaline," when in reality I'd hit my head pretty hard. It took years to put two and two together.

My fifth concussion involved 20 minutes of memory loss, but I was able to sit up (but not stand) immediately. I responded with a thumbs up when I was asked if I was okay. I wasn't, but nobody knew it because I responded. No one walked up to check on me, just let me sit; after an undeterminable amount of time, I was able to get up and stumble to a nearby seat. A year later, I actually asked if I had really given the thumbs up, because I remember thinking I wanted to do it, but wasn't sure if I had succeeded. I should have been carted off to the ER immediately, because it was only ~3 months after brain surgery.

Symptoms can be as mild as a headache ("well, I hit my head, so...") or a general fuzzy feeling (not necessarily dizziness). I think it has been said, but head protection will not stop a concussion... only, potentially, a skull fracture. All but one of my concussions occurred while wearing a helmet.

I'm not a doctor, but if you hit your head, please give yourself a 15 minute break to wait for symptoms before proceeding back onto the ice. Some symptoms don't appear (or are not noticed) for 24 hours. If you feel not quite right, go home and do something mindless (bonus points if you can get someone else to drive you or take public transport). Try to avoid mentally taxing activities, like reading or studying. You need to let your brain rest. If you have blurred vision, or nausea, go to the ER. They can't DO anything for a concussion except monitor you and do a CT scan, but it's best to go. If you see someone hit their head and begin to vomit, call an ambulance immediately - this is a sign of a brain bleed. Same if they are unable to stand. Experts say to never move an unconscious person... always suspect the spine has been injured. It's very, very important to not hit the head again once it has been concussed. This can easily lead to death. Every time you sustain a concussion, you are x% more likely to sustain another. The percentage only goes up as you accumulate more head injuries.

I had to fight to go to the ER after one of my worst concussions. Nobody would take me to the hospital, but everyone offered to drive me home (or follow me). I had to call my parents an hour away to take me. It's the responsibility of those who witness the head injury to speak up for the injured and make sure they receive proper care or are okay to continue on. Typically, they are not okay to do that on their own. I'm guilty of pulling the "I'm totally okay" card (case in point: My thumbs up story). Many people don't know the signs of concussion, and can't recognize when someone has been injured; I really advocate for people educating themselves on the signs.

I'm sorry to be preachy (truly) but concussion awareness is one of my soapbox subjects. I've had 5, plus brain tumor, plus brain herniation. I take head injury very seriously, always.

To answer the original question, I haven't witnessed any head injuries on the ice. I've seen many related to horseback riding that would make your hair curl.

[riley876]

I think it has been said, but head protection will not stop a concussion... only, potentially, a skull fracture. All but one of my concussions occurred while wearing a helmet.

I'm very interested to know about the helmet(s) you were wearing at the time of your concussions?  Particularly what standards it was approved to, and secondly if there was any sign of the foam being compressed at all, either during the hit or permanently.

From my testing, I've come to the conclusion that most helmets are really awful, and only one step away from being completely useless.  Either the foam is too hard to compress at all in real world impacts, or the foam is too soft to stop it "bottoming out". 

Usually they're designed to just sneak under a regulatory limit of 300G @ 5m/s or so, and totally ignore any lower speed impacts  (i.e. lower speed impacts are ALSO in the hundreds of Gs, just experienced for a shorter time).   On the other side of the spectrum,  un-regulated helmets, like soft-foam skate or kayaking helmets (and I'd guess others like ribcaps) are just too soft and thin to provide any decent amount of controlled deceleration.    I'd put most hockey helmets in this category too - their foam is too thin.  10mm is just not enough, no matter how high tech it is.   So I'm not surprised the average helmet is poor at stopping concussions.   

Then there's the theory than sudden rotational jerks are more to blame for concussions than linear decelerations are.   Haven't found any solid references proving this either way yet though.

[JSHalo]

I was wearing a riding helmet; mine are always ASTM certified (as required by the rules set forth by USEF).

Here is one brand of helmet I wore:
http://onekhelmets.com/helmets-certification/

The other brand was an International Riding Helmet, which is held to the same standards. I'm very picky about helmet fit. No wobbling, no gaps, and no perching on the head. This is why I'm unable to wear the most popular name brands - they don't fit!

My helmets are replaced after every fall, every 4 years, and if I accidentally leave it in the hot car (which I've done... whoops!) The One K was one of my later, worse, concussions... it was about 2-3 weeks old. We can send them in for inspection, but I did not do this with this particular helmet. I actually still have it, but obviously don't use it.

The interior is designed to crush under impact - you rarely see the exterior damaged, but when you open them up, they can be pretty grisly. This is why, unlike football or hockey helmets, we have to replace them when we fall.

I was told that no helmet can stop a concussion, as your brain bouncing in your skull is what causes the concussion. Not the impact itself.

[riley876]

I was told that no helmet can stop a concussion, as your brain bouncing in your skull is what causes the concussion. Not the impact itself.

Cheers for the info regarding your helmets.  All good data.

A concussion isn't a yes-or-no thing (though there may be a diagnostic cutoff level).  It's a matter of severity.  So any reduction in forces applied to the brain surely have to help to reduce the severity.    Maybe a "perfect" helmet that could eliminate it altogether isn't practical, but isn't any significant reduction in severity is good to have?   Though like you, I don't think current helmets achieve that very well.    But not because of a physics or biological constraint.

I believe the current crop of helmets standards are to blame.   All the ASTM and EN standards specify only a G limit (250G-400G) at a high fixed (usually 20-30MPH) impact speed.   They simply don't test for low speed impacts.   So they get engineered with INCREDIBLY hard foam to be able to pass only this rather severe test,  but that hard foam doesn't compress enough to reduce ANY impact, no matter how low speed,  to below the 50G-ish threshold for concussion damage.   

i.e. 250G is a "you die or not" level of impact protection, rather than a "concussion or not" one.   

[Query]

Usually they're designed to just sneak under a regulatory limit of 300G @ 5m/s or so, and totally ignore any lower speed impacts  (i.e. lower speed impacts are ALSO in the hundreds of Gs, just experienced for a shorter time).   On the other side of the spectrum,  un-regulated helmets, like soft-foam skate or kayaking helmets (and I'd guess others like ribcaps) are just too soft and thin to provide any decent amount of controlled deceleration.

Even if all helmets were better at controlling deceleration, there is also the matter of protecting everything that matters. I've had two kayaking accidents in which I hit an eyebrow on a rock - because, last I checked, no existing kayak helmets that fit me cover my eyebrows. Most part, kayak impacts occur underwater, but one of those occurred above the water, and almost made me unconscious - in which case I would probably have drowned.

That said, imperfect helmets can often be a lot better than nothing.

But you can't expect protective gear to protect you from everything, and people often take advantage of protective gear too much - athletic training texts say that sport helmets invariably decrease the number of deaths, but increase the number of injuries.

In practice, figure skating is an appearance sport, and people like the feeling of freedom that comes from minimalist gear. Most figure skaters would not choose to wear helmets.  It is frequently hard to tell kayaking guys from gals, and I don't think most figure skating gals would want that.

I was told that no helmet can stop a concussion, as your brain bouncing in your skull is what causes the concussion. Not the impact itself.

A ridiculous statement. The impact causes the deceleration, which causes the bouncing. Who came up with that?

[riley876]

In practice, figure skating is an appearance sport, and people like the feeling of freedom that comes from minimalist gear. Most figure skaters would not choose to wear helmets.  It is frequently hard to tell kayaking guys from gals, and I don't think most figure skating gals would want that

Totally agree, and I would be shocked if helmets ever became anything other than "nervous beginners" wear.

I may be a (very) little bit beyond "nervous beginner", but I've already made peace with the realisation that I'll never be anything but painful to watch on ice, so I figure what does it matter if I don't look the part?   To some extent it's an "idiot filter".   i.e. if people don't want to know me because I don't look "normal", then I consider it a bonus that they aren't going to interact with me.   I don't test and I don't compete, so I'll do what I please to protect myself.   It doesn't change how skating feels to me, and that's the #1 thing.   And if random strangers can't figure out my gender,  that's not my problem

I fully understand that most people here have other priorities.

[JSHalo]

A ridiculous statement. The impact causes the deceleration, which causes the bouncing. Who came up with that?

Sorry, I guess that was poorly worded. Simply put: A helmet does not prevent your brain from moving inside of your skull.