Head injuries - How often have you seen them?

[twinskaters]

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

Hence the controversy about traumatic brain injury in football, where everyone wears a helmet! The difference there, of course, is that those helmet-covered heads experience impact much more often than even the clumsiest figure skater.

[Isk8NYC]

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

Completely accurate, but helmets do stop external scalp/skull injuries. 

[JSHalo]

Completely accurate, but helmets do stop external scalp/skull injuries.

Yes, of course! That's a product of this statement I made:

"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."

Which brought about the question of a helmet's effectiveness in preventing/lessening concussion. But it bears repeating.

[ChristyRN]

Completely accurate, but helmets do stop external scalp/skull injuries.

Maybe I wouldn't have bashed my scalp open if I'd had a helmet on?   

[skategeek]

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.

So do you think that the more compressible protection like the Ice Halo or RibCap might actually be better for the low speed impacts that might be more common for beginning skaters?  (I've wondered about the Crasche, which I also have- hard outer layer but a very thin foam lining that doesn't seem like it would do anything at all to affect deceleration.)

[riley876]

So do you think that the more compressible protection like the Ice Halo or RibCap might actually be better for the low speed impacts that might be more common for beginning skaters?  (I've wondered about the Crasche, which I also have- hard outer layer but a very thin foam lining that doesn't seem like it would do anything at all to affect deceleration.)

They probably would be better.  But the ribcap's foam is only 11mm thick and it's not a desirable "crush and stay crushed" type.   

Here's a review from a great bike helmet site:  http://www.bhsi.org/ribcap.htm

11mm of compression doesn't protect past VERY low speed impacts,  but 11mm is still WAY more cushioning than the 0mm of compression you'll likely get in a standards approved 250G helmet in a standard trip over backwards, half save yourself, land on your posterior then knock head type scenario.    But once you get to higher speed impacts,  say a totally uncontrolled head-first impact, the mere 11mm of very soft looking foam will bottom out,  leaving it only barely better than a hard foam helmet (i.e. barely better than nothing).    But on this basis I'd probably use it over a standards approved skateboard or equestrian type helmet.   Hard to say for sure without knowing just how soft the foam is.   But I'd probably replace the foam inserts with the hardest grade of EVA foam I could get a hold of.   Or maybe polyurethane.   Actually I wouldn't bother with it all, even if I wanted the look, I'd just buy a suitable XL woolly hat and sew some pockets for foam inserts in myself.   It isn't rocket science.

The crasche looks too thin too.

The ice halo looks better, simply because the foam looks significantly thicker than the ribcap.   But again if the density is too low, then it'll be no better at handling serious knocks.

It's a sad fact of physics that protection here requires a decent thickness of foam.  Because people hate the "mushroom head" look, the manufacturers have to compromise their helmets/hats to sell them. 

I'm *really* glad I worked out something for myself to bypass this whole mess.     But even my custom helmet is still a compromise on both "killer hit" impacts and minor knocks to improve performance on more likely damaging medium hits.   The style isn't flattering though.  Though it is de rigueur for roller derby

[karne]

No helmet is foolproof. Ask Michael Schumacher or Jules Bianchi.

I certainly don't take head injuries lightly, but I rather think having a helmet on would probably cause me to fall more times than it would protect me. (I'm just that clumsy.)

[Isk8NYC]

Maybe I wouldn't have bashed my scalp open if I'd had a helmet on?   

I don't know, nobody knows, nobody told me.     You would have needed a new helmet, at minimum, lol.

[JSHalo]

riley876, thanks for sharing all of this great info.

I actually just got a Crasche, and they are pretty thin. I'll probably wear it during public skates (as I try desperately to avoid falling children).

Just as a side, I've been reading that the general public has been losing interest in figure skating. In the horse world, dressage is suffering the same fate. There's a joke among equestrians that helmets make the sport more... sporty, and if that doesn't help convince the gp, we should start lighting our riders on fire to make it more interesting. Maybe if skaters start wearing helmets like football players people will take it more seriously 

[riley876]

Just as a side, I've been reading that the general public has been losing interest in figure skating. In the horse world, dressage is suffering the same fate. There's a joke among equestrians that helmets make the sport more... sporty, and if that doesn't help convince the gp, we should start lighting our riders on fire to make it more interesting. Maybe if skaters start wearing helmets like football players people will take it more seriously 

Ha! maybe.

As an aside, actually I think both figure skating and dressage are suffering from the same root cause:   Both are finesse sports that appeal to grown ups, but the population is growing more childish.  Therefore the attraction is towards simple infantile things that go bang! and crash! instead.  e.g. in the skating world:  hockey, roller derby,  crashed ice.

[Loops]

Ha! maybe.

As an aside, actually I think both figure skating and dressage are suffering from the same root cause:   Both are finesse sports that appeal to grown ups, but the population is growing more childish.  Therefore the attraction is towards simple infantile things that go bang! and crash! instead.  e.g. in the skating world:  hockey, roller derby,  crashed ice.

You know, I agree with this.  Can't state it eloquently right now, but I've seen similar trends in education as well.  Anything that requires people to think too much/hard gets left by the wayside.

[Query]

No safety equipment, no matter how well it meets anyone's standards, can protect you completely from all possible hazards. Helmets do protect you to some extent, even minimalist ones. Likewise for gloves. Any helmet reduces surface abrasion, and reduces impact acceleration, and therefore can be good for some people and purposes. I.E., they may not prevent the bouncing brains, but they do reduce that - except in sports where the wearing of helmets has caused people to be more careless of their heads. (Which is why introducing helmets to a sport, as I mentioned before, invariably increases injuries - a statement you will find in any athletic training manual. As an example, more injuries / hour of play occur in American football than in rugby.)

I once took a bike ride, wearing a very lightweight minimalist (foam only, Giro brand) bike helmet. I awoke in a hospital room, post-surgery. (No memory of what had happened - hospitals deliberately give you drugs during anesthesia designed to destroy your short term memory, so you won't remember the pain.) The helmet was in pieces on the bedside table. The helmet hadn't protected me completely - but I believe it probably saved my life. So if someone tells me that helmets that don't pass ANSI construction worker protection standards are worthless, I won't believe them.

I personally happen to believe that fall and collision training are more important to preventing injury than safety equipment. But protective gear, whether or not it meets anyone's formal standards, can still be very useful, especially to those without such training. I personally don't wear a helmet (for figure skating). But I almost always wear gloves, long sleeve shirt or jacket, and long pants, which provide a lot of abrasion resistance. Abrasions are a lot more common than concussions, and I know from experience that they can lead to severe infections. And I have used helmets while bicycling, whitewater kayaking, rock climbing, and caving.

BTW, War and other contact "sports" aren't just a recent trend.

[AgnesNitt]

I haven't seen any, but I've heard a couple.

[riley876]

I once took a bike ride, wearing a very lightweight minimalist (foam only, Giro brand) bike helmet. I awoke in a hospital room, post-surgery. (No memory of what had happened - hospitals deliberately give you drugs during anesthesia designed to destroy your short term memory, so you won't remember the pain.) The helmet was in pieces on the bedside table. The helmet hadn't protected me completely - but I believe it probably saved my life. So if someone tells me that helmets that don't pass ANSI construction worker protection standards are worthless, I won't believe them.

I agree.  For 99% of cases,  a hard shell doesn't achieve anything useful.   i.e. when the prime injury mechanism is a fall onto a flat surface.  There's lots of helmets available now that are essentially just expanded polystyrene foam with a big vinyl sticker over it,  even in skate(boarding) styles.  They are exceptionally light, almost unbelievably so.  I'd happily wear one of these for either skating or bike riding,  but like any polystyrene helmet,  only after I'd viciously attacked it with an apple coring tool first to reduce the effective foam density down to around 20kg/m³ for skating or 30kg/m³ for on-road biking.     For comparison, I've measured a CSPC rated skate/bike helmet (Pryme V2) that had 90kg/m³ foam.   I could jump up and down on this foam on one foot and it wouldn't compress a jot!   With this level of crapola out there, I'm not surprised the consensus is that helmets don't stop concussions.   This one sure wouldn't!   

If anyone wants to test foams themselves, here's a rough way:  Drop a 12lb bowling ball from 1 meter up onto the foam sitting on a concrete floor.  If it compresses all the way (thud!), it's too soft.  If it compresses only a touch or not at all (also thud!) it's too hard.   If it compresses most (but not all) of the way,  you've got foam that's good for medium impacts, like you might expect in skating falls.     

Alternatively use a brick on it's end.  The impact pressures are similar.  But harder to arrange consistent "flat end" drops without a chute like I made.

Remember the more compression you get, the softer the hit will be,  but only if it doesn't bottom out.

[Query]

ANSI standard construction hard hats use a re-usable suspension system (using stretchable webbing) instead of foam to protect the top of the head. Type two ANSI standard hardhats also use foam to protect the sides of the head.

Do you think an all-around suspension system would make more sense then foam, because ice skaters fall a lot, and it isn't practical to throw away the helmet every time?

I assume there have been studies of this sort of thing...

[riley876]

There is this:  http://www.xenith.com/products/football-helmets/x2-varsity-football-helmet/#better-protection

Which is effectively a suspension system.  I haven't seen test results, but the theory looks good. 

[JSHalo]

There is this:  http://www.xenith.com/products/football-helmets/x2-varsity-football-helmet/#better-protection

Which is effectively a suspension system.  I haven't seen test results, but the theory looks good.

That is REALLY interesting. But I wonder what the repercussions of grabbing the mask are? Of course, it's penalized, but that doesn't stop the players from doing it. I would think that a helmet so fitted would potentially cause a greater threat of neck injury. Thoughts?

There is a company I work with that has tried "cone head" technology: http://www.devonaire.com/Devonaire-1014-Matrix-patented-Conehead-technology-Helmet-Brand-0-CPath-5-pid-1317.html

I haven't seen the helmet in person (not really "in style," so I haven't bought any), but it would be interesting to know if it works the way they claim it does, and if it makes a difference. I almost want to buy one just to open it up. A German company, Uvex, uses a suspension system. It gave me a terrible headache (most helmets do, but this one was particularly bad). I haven't fallen in it, so I can't report on if it helps! It's supposed to be one of the safest helmets on the market. (aren't they all?)

[riley876]

The idea of diverting the impact energy sideways, rather than having to absorb it all directly "head-on", really intrigues me.  But I can't see how this conehead design actually achieves that.   I can see how it could for external small radius external impacts (and the website:  http://www.coneheadhelmets.com.au/about_c.html  shows that).   But would a full head pressing into the foam from the inside produced this spreading effect?   I'm sceptical.

The fact that it's dual-stage foam makes me a bit nervous too.   Dual stage or rising rate foams aren't optimal for reducing peak G loads.   The optimal is the foam producing a constant force pushback for the whole compression distance.   Though admittedly they do widen the range of speeds at which the foam provides some protection.

The optimal is a velocity sensitive system.  i.e. doubling the impact velocity should double the push back force, and halving should halve - so as to be able to compress significantly at any impact speed.   The only tech I know of that's fully capable of that is air bladders.   Though there's a few designs I've seen involving honeycombed silicone or plastics that might achieve that to some extent.   Links escape me right now though.     

[Query]

I'm not quite sure what " Cone Head" is trying to achieve.

The way you protect bone from injury is very clear. You want a relatively uniform compression, which bone (a form of limestone) resists very well, but very little tension, sheer or torque, which have a strong tendency to fracture bone. It looks like they are trying to avoid skull fractures by squishing the skull from all sides. Good standard physics or engineering, based properly on the known physical properties of the materials involved. That much makes complete sensing.

But protecting the brain from bouncing around INSIDE the skull is a lot different. Unless you assume the skull compresses so much there is no room inside of it for such motion (which might do a lot of damage, because most soft tissue, probably including the brain, takes excess compression relatively poorly - it tends to burst.) About the only thing you can do is to reduce the acceleration, by using compression to slow down the impulse absorption over a longer distance. You also don't want the padding to bounce back much - you want something close to critical damping.

What you might really want is a foam that is partway between a close cell foam and an open cell foam, perfectly molded to fit the head, (how would you do that on a growing child?) that gradually accepts the compression at just the right speed to just barely finish compressing at the smallest possible size. It should be flexible and fully but gradually return to original shape, so you can take impacts many times.

It shouldn't weigh anything, or interfere with sweat and the movement of air when not protecting you.  It also should do nothing to reduce visibility.

In other words, it is the stuff of pipe dreams.

[skategeek]

Out of curiosity, what do you folks with more background in this area think of this one?  http://www.forcefieldheadbands.com/testdata.html

[riley876]

My take:

I like that they've bothered to at least test and publish the results.   But the test results really aren't showing it will protect against concussion,  though it'll probably reduce the severity of one.   How well it performs at other impact speeds is anyone's guess.   Almost certainly better than a hard foam helmet for the vast majority of skating incidents (which isn't saying much).   On the face it, it looks pretty similar to the ribcap, ice halo, crache etc.    About the same (inadequate) thickness of foam.   But still absolutely positively better than nothing.

[jbruced]

But protecting the brain from bouncing around INSIDE the skull is a lot different. Unless you assume the skull compresses so much there is no room inside of it for such motion (which might do a lot of damage, because most soft tissue, probably including the brain, takes excess compression relatively poorly - it tends to burst.) About the only thing you can do is to reduce the acceleration, by using compression to slow down the impulse absorption over a longer distance. You also don't want the padding to bounce back much - you want something close to critical damping.

What you might really want is a foam that is partway between a close cell foam and an open cell foam, perfectly molded to fit the head, (how would you do that on a growing child?) that gradually accepts the compression at just the right speed to just barely finish compressing at the smallest possible size. It should be flexible and fully but gradually return to original shape, so you can take impacts many times.

It shouldn't weigh anything, or interfere with sweat and the movement of air when not protecting you.  It also should do nothing to reduce visibility.

Reading this made me think of memory foam. It may not meet the last few requirements about sweat and air movement though.

[dlbritton]

Yesterday a young woman went down hard on the back of her head at adult skate. I didn't see what she was doing at the time but she had been working on spins. She hit hard enough that she was bleeding. A hockey trainer came over and gave her a quicky evaluation for a concussion, then told her boyfriend he didn't think she had a concussion but they should see a doctor anyway.

Really getting me to thinking about the Crasche head band.

Several of the other skaters wear knit hats doubled up that would give at least a little padding. I sweat so much in a helmet or cap that I really just want a headband. A few skaters wear hockey helmets, but I figure those are more for protecting your head against flying pucks that for protecting you against falls.

[skategeek]

I ordered the Ice Halo HD; it should arrive this week.  I've already got a Crasche middie and RibCap.  If folks can suggest some simple things I could do at home to compare them (besides putting them on and banging my head on the floor) I'm happy to try it and report back. 

[twinskaters]

I ordered the Ice Halo HD; it should arrive this week.  I've already got a Crasche middie and RibCap.  If folks can suggest some simple things I could do at home to compare them (besides putting them on and banging my head on the floor) I'm happy to try it and report back.

I am dying imagining you banging your head on the floor!