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Helmets are a necessity, not a fashion accessory

Dr. Ferdinand Liotta

Skiing is upon us and our thoughts turn to the health and safety of the skiers and riders who frequent our local resorts.Skiing and snowboarding have always had an inherent risk component; they also have an excellent safety record. Skiers and snowboarders have less than a one-in-a-million chance of being seriously injured or dying on the slopes. When injuries do occur, they are minor and not life-threatening. Five to 10 percent are injuries to the head, which can be devastating and lethal. Most severe head injuries occur from collisions with trees, lift poles or another skier. Sports-related brain injuries account for approximately 300,000 injuries a year, with winter sports such as skiing, snowboarding and ice-skating making up approximately 20,000 of those injuries. In comparison to other injuries, brain injuries are more likely to result in death or permanent disability.Over 1,000,000 Americans are treated and released from hospital emergency departments as a result of traumatic brain injury; an estimated 50,000 die from such injuries each year. Physical, cognitive, behavioral or emotional impairments, either transient or permanent, can be caused by traumatic brain injury. They range from subtle to severe and can result in seizure disorders. Men are more likely to sustain a traumatic brain injury than women. The highest rate of brain injuries occurs in 15- to 24-year-olds.How to protect your headNo longer just for downhill racers, the helmet is a rapidly growing and accepted piece of protective gear. Five years ago almost no one wore a helmet, and now it’s estimated that 10 percent of skiers and boarders are wearing them. Helmets are lightweight, warm, comfortable and provide the wearer peace of mind that they are doing the most to ensure a safe ski or snowboard experience.The controversy lies in their efficacy. The issues involved in helmet use during winter sports are not simple. One group of experts state that everyone should wear a helmet, while others say it is the skier’s or snowboarder’s choice. Some promote the use of a helmet, but make the Skier/Snowboarder Code of Responsibility education the priority. Finally, some even say that a helmet is unnecessary and possibly dangerous. Currently, there is no legislation requiring mandatory helmet use on the slopes. Therefore, the choice we make as skiers, snowboarders or parents of these snow-sports enthusiasts is the final determinant.In skiing and snowboarding, traumatic brain injury is secondary to impact energy to the head transferred to the brain from a fall onto or collision with snow, rocks, trees, man-made objects or other skiers/snowboarders. The type and seriousness of the injury are dependent on many variables such as the force of impact, the angle of impact in relation to the head, and the protective features in place.Limitations of helmetsStudies have shown that helmets provide little protection from direct blows above 12 mph (this is the standard speed for the testing laboratories); however, direct blows to the head above 12 mph in winter sports are rare. The vast majority of falls involve glancing blows during which the skier or snowboarder may be moving faster than 12 mph, but during the fall the head glances off a surface. Collisions with trees and other upright stationary objects are much different, as direct blows with full absorption of the force to the head is more likely. However, the shape of the helmet and its hard surface make it more likely that a glancing blow will occur, not a direct blow.Helmets do provide significant protection. They dramatically reduce forces applied to the skull and the brain and thus reduce the potential for traumatic brain injury. The outer shell of a helmet protects against penetration while the inner energy-absorbing liners reduce the forces that are transferred to the head. New materials, with even more energy absorption characteristics, are being developed and these promise even more protection.In 1999, the Consumer Product Safety Commission (CPSC) published a position statement on the use of skiing helmets. It found that safety helmets for motorcycling and bicycling provide effective protection against head and brain injuries, including severe brain injuries. It is also reasonable to suggest from the bicycling and motorcycling experience that a skiing helmet that meets a suitable standard could provide effective protection against head and brain injuries in many types of skiing-related accidents involving head impact. Based upon this information, as well as the assessment presented in this report, the CPSC concluded that the use of skiing helmets would reduce the risk of head injury associated with skiing and snowboarding.Protecting yourselfChildren often view the world as a challenge. While some are extremely timid on the slopes, many others believe faster is “better.” Judgment is not always part of their decision process. Some have argued that if youth participating in winter sports wear helmets, they will assume greater risks because they may feel invincible. In fact, some recent studies demonstrate that with an increased use of safety equipment an increased risk of injuries can be seen.One shouldn’t interpret this as an excuse to not wear a helmet. Rather it emphasizes that one’s behavior is the best protection against an accident, even while wearing a helmet. In other words, one should both ski responsibly and wear a helmet.An effective tool for the prevention or reduction of injury from falls or impacts are helmets. This author and his family wear helmets, and all skiers should.Ferdinand Liotta practices with Orthopaedic Associates of Aspen and Glenwood.


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