Ashley Wagner discusses head injuries

[skategeek]

Maybe head protection will get a little more attention now.

http://www.mercurynews.com/2017/01/19/ice-skating-and-concussions-ashley-wagner-lived-in-silent-terror-after-head-injury/

[riley876]

Lost cause.

Figure skating will wither and die rather than see head protection as acceptable.

In the end no one (who matters) cares what happens to the skaters.  Especially after they're no longer competitive.

[lutefisk]

Lost cause.

Figure skating will wither and die rather than see head protection as acceptable.

In the end no one (who matters) cares what happens to the skaters.  Especially after they're no longer competitive.

The same was once said about hockey.  In my day none of the pros wore head gear.  Now helmets are universal.  F1 motor racing has also come a long way since the 60s.  And say what you will about lawyers, but litigation followed by high $$$ settlements often "paves" the way towards better safety innovations.

[Query]

The same was once said about hockey... litigation followed by high $$$ settlements often "paves" the way towards better safety innovations.

The injury rate in hockey, as in many other sports like (American) football, has gone up since the introduction of helmets and other safety gear:

  http://bjsm.bmj.com/content/36/6/410.full

This is a very important point that people who push safety gear, for one reason or another, choose to ignore.

That's not surprising - people who are less afraid of injuries play more aggressively. If figure skaters wore helmets, the same thing would almost certainly happen there.

The simple fact is that people enjoy taking risks. Further, competition and performing before an audience both drive people to take greater risks.

"Litigation followed by high $$$ settlements" really just paves the way towards greater sales of safety gear, but increases injuries.

I don't think it inconceivable that something minimalist along the lines of the Ice Halo, and minimalist padding elsewhere might someday be required in figure skating. I just don't think that it will achieve the injury reduction goal for competitive skaters. However, it might be helpful to beginning skaters. Some rinks and lesson programs require or encourage beginners to wear such things now.

(On the other hand, the death rate in (American) football and a number of other sports has gone done since the introduction of helmets and other safety gear...)

One of the most intriguing results of safety gear has been that American football (which uses a lot of safety equipment) has more injuries per hour of play than Rugby (which uses none, but is otherwise substantially similar), but they have about the same injury rate per game. That suggests that athletes and coaches have an "acceptable" fraction of time being injured.

[lutefisk]

One of the most intriguing results of safety gear has been that American football (which uses a lot of safety equipment) has more injuries per hour of play than Rugby (which uses none, but is otherwise substantially similar), but they have about the same injury rate per game. That suggests that athletes and coaches have an "acceptable" fraction of time being injured.

Our son played rugby (hooker) in high school.  There were a fair number of injuries during his time on the team.  Fortunately he "retired" with all his teeth and without any broken limbs or major concussions, but that's a tough sport.  I'm glad he no longer plays.  He once did get kicked in the head and I figured at that point he'd be perfect for crew but he didn't fancy rowing.  He witnessed enough carnage that I think it influenced his choice of occupation.  He's an RN now and works the ER at a local hospital.

[ChristyRN]

I had to get my second concussion on ice before I started wearing a Crasche band. A helmet would probably be better, but I wouldn't wear it consistently. I did not wear it when I competed this past summer.

[skategeek]

Here's another article. The issue is getting some attention now.  It'll be interesting to see if anything comes of it. 

http://www.eastbaytimes.com/2017/01/19/concussion-protocols-not-uniform-at-skating-rinks/

[Query]

From that article:

Robert Cantu, co-founder and medical director of the Concussion Legacy Foundation, said the two most recognized ways of reducing concussions in sports is to make practices safer and strengthen neck muscles.

Why would strengthening neck muscles reduce concussions?

[riley876]

Why would strengthening neck muscles reduce concussions?

Because when you fall over, especially backwards, though you might hit body first, you might hit your head too.  But if your neck muscles are strong enough you might be able to hold your head up enough off the ice.   Though I personally have my doubts about this theory.   I think it's like saying that if you hold onto that baby really strongly in the car crash it won't go flying through the windshield*

*Name the movie, and win GOE points!

[AgnesNitt]

Because when you fall over, especially backwards, though you might hit body first, you might hit your head too.  But if your neck muscles are strong enough you might be able to hold your head up enough off the ice.   Though I personally have my doubts about this theory.   I think it's like saying that if you hold onto that baby really strongly in the car crash it won't go flying through the windshield*

*Name the movie, and win GOE points!

Dead Calm

[icedancer]

Because when you fall over, especially backwards, though you might hit body first, you might hit your head too.  But if your neck muscles are strong enough you might be able to hold your head up enough off the ice.   Though I personally have my doubts about this theory.   I think it's like saying that if you hold onto that baby really strongly in the car crash it won't go flying through the windshield*

*Name the movie, and win GOE points!

Fearless - with Jeff Bridges and Rosie Perez

[Query]

I find that I just have to mostly relax my neck muscles, and the head bends forwards, and stays forwards, with almost no neck tension. Even a full backwards sommersault - and even on harder surfaces than ice, like concrete, or rolling down stairs backwards - is gentle - as long as the head doesn't hit first, and you roll through your whole torso first.

At least from standing height, at normal speeds.

I also admit that the technique requires you stay calm. If you panic, and your neck stiffens upright, of course everything goes wrong. But in that case, strong neck muscles would just make things worse. It also helps a lot if you practice enough to make the response a reflex. Before many hours of deliberate relaxed practice, my initial reflex was to stiffen all over instead of relax.

And I also admit that I can't jump very high, and therefore haven't tested it on high backwards landed jumps.

In addition, everybody's body is different.

[Bill_S]

I use neck muscles to tuck my chin when going over backwards and falling on your back. It takes MAJOR neck strength to keep the whiplash forces from "cracking the whip" with your head. I've come away from these kinds of falls with sore/pulled neck muscles in front, but haven't bonked a noggin.

[Backtotheice]

I had to get my second concussion on ice before I started wearing a Crasche band. A helmet would probably be better, but I wouldn't wear it consistently. I did not wear it when I competed this past summer.

I did not know Crasche bands were a thing. I need to go look at those! I hit my head this week, not bad and no symptoms at all but still shook me up a little.

[ChristyRN]

I did not know Crasche bands were a thing. I need to go look at those! I hit my head this week, not bad and no symptoms at all but still shook me up a little.

I wound up in and ICU and two plus years later, still have no memory of that day, nor the three or four before. My first memory is about six hours later, in the ICU, with a neck brace, two IVs, and a very worried hubby and daughter on either side of my bed. Needless to say, they were pretty dead set against me setting skate back on the ice. They insisted that if I did, I had to protect my head. Since a helmet would be too hot, I tried a Crashe band. I still don't like it in the summer (I sweat under it) I feel naked on ice without it. I've fallen and had two minor head knocks, but the band was on and it didn't feel like my head hit the ice hard--the band just popped off my head.

[Backtotheice]

I've fallen and had two minor head knocks, but the band was on and it didn't feel like my head hit the ice hard--the band just popped off my head.

Wow, scary stuff.

Do you have to replace it after it takes a hit, like you do with a bike helmet?

[Gina10179202]

Because when you fall over, especially backwards, though you might hit body first, you might hit your head too.  But if your neck muscles are strong enough you might be able to hold your head up enough off the ice.   Though I personally have my doubts about this theory.   I think it's like saying that if you hold onto that baby really strongly in the car crash it won't go flying through the windshield*

*Name the movie, and win GOE points!

Managed to confirm this myself yesterday. I took a ridiculous, out-of-the-blue fall whilst doing nothing but skating back to the boards. When I fall on a jump I hold my head steady by habit, but because I wasn't expecting this fall my neck was relaxed and I ended up with a whiplash concussion. Although in this case, being whiplash and not impact, head protection wouldn't have helped.

Does Wagner wear head protection during training now?

[dlbritton]

Wow, scary stuff.

Do you have to replace it after it takes a hit, like you do with a bike helmet?

The Crasche "pads" have a layer of hard plastic with a neoprene rubber lining so I don't think it would compress like the foam in a bike helmet.

[riley876]

The Crasche "pads" have a layer of hard plastic with a neoprene rubber lining so I don't think it would compress like the foam in a bike helmet.

Which is a pity, because a purely elastic material (like neoprene) is worse than a collapsible material (like polystyrene*).   Elastic materials return the absorbed energy to your head,  i.e. accelerating it back in the opposite direction,  effectively doubling the impact time (and thus doubling the Head Injury Criteria (HIC) etc metrics), for only the dubious benefit of being able to reuse the item. 

*Though having said that, from my testing, polystyrene is actually worringly elastic too.

[riley876]

Does Wagner wear head protection during training now?

No idea, but I really wish someone talented, beautiful and high profile would start doing this.  To get the ball rolling to make it acceptable, and even fashionable.   Even if it is just in training.

[Query]

I wound up in and ICU and two plus years later, still have no memory of that day, nor the three or four before.

That could be due to concussion - but an anasthesiologist told me that total anasthesia for surgery almost always includes drugs that suppress short-term memory, unless you request otherwise. The idea is to make you forget any pain that does occur. I was told that people differ in response to those drugs, so some people forget more time than others.

Because I too had a memory problem after waking from surgery, that caused some problems - though not several days - I will request in any future surgeries that they not use such drugs on me.

[Gina10179202]

No idea, but I really wish someone talented, beautiful and high profile would start doing this.  To get the ball rolling to make it acceptable, and even fashionable.   Even if it is just in training.

Definitely. I feel like her saying "I've suffered these terrible consequences.....but I'm still not going to wear head protection" is almost worse than not saying anything at all! 

[ChristyRN]

That could be due to concussion

I'm an OR nurse. I know that you either get the memory back or you don't. It's called amnesia, and mine was near total for a couple of days. At this point, it's never coming back and it's not at all like surgical memory loss. Surgical memory loss is deliberate.  I also have slight memory issues post-concussion that are the same things I had problems with before, just a little worse. I was apparently pretty close to a craniotomy because they were worried about the amnesia.

[Nate]

You an fall and get a concussion without hitting your head.



That's something a lot of skaters, parents, and coaches need to learn.


"Did you hit your head?" is not proper concussion protocol, but it's pretty much the only protocol that I've seen employed in the rinks I've skated in.

[Query]

I'm an OR nurse. I know that you either get the memory back or you don't. It's called amnesia, and mine was near total for a couple of days. At this point, it's never coming back and it's not at all like surgical memory loss. Surgical memory loss is deliberate.  I also have slight memory issues post-concussion that are the same things I had problems with before, just a little worse. I was apparently pretty close to a craniotomy because they were worried about the amnesia.

So it is your belief your memory loss was due to the concussion, not the anaesthesia?

Is "surgical memory loss" defined to be loss due to the surgery itself, or due to the drugs?

https://www.sciencedaily.com/releases/2014/11/141103192130.htm suggests that anesthetics causes a lot of memory problems too.

When I had my bike accident, which apparently included a head impact, I was apparently able to function after the accident. I talked to the EMTs, I talked to someone who allowed me to keep my bike in their yard, and presumably I gave permission for the plastic surgery.

Yet, post surgery, I remembered none of that, and nothing of the accident itself. The last think I remembered was starting the bike trip. My next memory was waking up in a hospital bed, with my shattered (lightweight polystyrene) helmet beside me on the bedside.

My memory was never that great - but I think it got permanently worse after the accident. It seems to me that if the impact did the damage, I wouldn't have been able to function pre-surgery as well as I apparently did, so I think it must have been due to the drugs.

I may or may not be right about that - but I will never let a anesthesiologist give me memory suppression drugs again. (I will also stay away from minimalist polystyrene helmets - if I use a helmet, I want something that will hold together in an accident.)