March 24, 2009

Helmets, Head Injuries, and Hotness

All The Cool Kids Are Wearing Them!
(OK, So Maybe Not).

Photo: Shay Haas

With the sad news of Natasha Richardson's recent death on the ski slopes, there is now of course much discussion of the Helmet Issue.

Apparently, the general public has pressing questions: could she have survived if she'd been wearing a helmet? Should all people who go skiing wear helmets? And which famous movie stars are mourning Natasha's tragic death and could we see some pictures of them, please?

So I read a CNN article which discussed the pro's and con's of wearing helmets while skiing or snowboarding. As it happens, I already have an opinion on the advisability of wearing helmets while skiing, bicycling, skateboarding, motorcycle riding, rock-climbing, or doing any other activity in which a smashed skull is a possibility. And while this article didn't change my mind, I did learn some very interesting things from reading it!

1. Ski Helmets Reduce Brain Injuries by 75%! (Or, They Don't Help at All).

It depends on whom you ask. One expert cited an unpublished study that showed ski helmets reduced the risk of brain injury by 75 percent. Other studies showed reductions of 50 percent to 80 percent.

But another expert who works for the NSAA, "a trade group that represents ski resorts as well as ski gear manufacturers," said that despite increases in helmet use, deaths on the slopes have remained fairly constant. He contends that the use of helmets did not reduce fatalities.

So, um, which is it? (I personally find it hard to believe that helmets wouldn't help at all in reducing fatalities).

2. More People are Wearing Helmets Than I Thought.

They're Everywhere!
Photo: drakegoodman

According to the NSAA, 43 percent of U.S. skiers and snowboarders were wearing helmets in 2008, up from 25 percent in 2003. Still less than half, but it's a big jump in five years.

3. Ski Slope Deaths Aren't All That Common.

Consider the source on this one, which is the NSAA again (the Ski Industry trade group). But according to them, in 2006 there were 2.07 skiing/snowboarding deaths for every million participants. This is fewer than for bicycling or swimming. They also note that a person is twice as likely to die from being struck by lightning as to die in a skiing or snowboarding accident.

This lightning thing sounds very impressive! That is, until you think about it a little more. Anyone who goes outside can be hit by lightning; but very few people are out skiing at any given time. It appears from the NSAA site that they're comparing total deaths per year from skiing and lightning strikes--which is sort of like comparing apples and oranges, if apples could ski but oranges kept getting hit by lightning. Or something like that.

Anyway, the bottom line is that skiing is not quite as dangerous as it sounds.

4. Helmets Won't Keep You Alive If You Hit Something Hard at High Speed

The NSAA rep said that helmets are most helpful in preventing lesser head injuries, like scalp lacerations or mild concussions. Recreational ski and snowboard helmets are only designed to provide protection at 14 mph or less, whereas most folks ski or snowboard between 25 and 40 mph. "So when you're going at that speed and you hit a fixed object like a tree, whether you're wearing a helmet isn't going to matter." NSAA guy suggests that skiers try not to act like reckless morons just because they are wearing helmets. (Not an exact quote).

Good advice! But, um, rather than just take for granted that recreational helmets aren't designed to do the job, might it not be a good idea to urge manufacturers to make them stronger? Or perhaps we could get recreational users into whatever fancy-ass expensive ski helmet technology is available for professionals, if that's what it takes to protect heads when people go normal skiing speeds. (Note: I'm not a skier, so I have no idea if such high-end technology even exists. But if I were a skier, I'd sure as hell want a helmet designed to actually protect my head).

This Might Not Do The Trick
Photo: furryscaly

5. Helmet or No Helmet, Some People are Just Dumb

The CNN article included an interview with a college student and first-time snowboarder about his choosing not to wear a helmet. He had already fallen and hit his head several times.

"That fall you witnessed was actually the first time I cracked the back of my head. Usually it's the front," he says. "Do I regret not wearing one? No, not really. It's not too bad and I know what a concussion feels like, so I know I'm good so far."

Crabby's Thoughts on The Wearing of Helmets

While I don't ski, I do ride a bike. The safety issues are similar, but there has been a bit more research on bike helmet safety--which of course is conflicting. But the vast majority of studies seem to say: wear a helmet, doofus, or you may die of a brain injury.

I think it's smart to wear a helmet and not-so-smart to ride around without one.

There is a great deal of variation in helmet usage. It depends on who you are and where you ride. The Bicycle Helmet Safety Institute estimates overall that usage rates are no better than 25%; however, white-collar commuters may reach up to 80%. I know that in our little beach town, where road conditions can be dangerous and hordes of wobbly tourists rent bikes during the summer, probably only 5-10% of riders seem to be wearing helmets.

So why do so many people spurn bike helmets even though they save lives?

Well, duh: helmets aren't Cool. Or at least not until we all decide they are.

Most people don't care about statistics. They know there is a "chance" that something bad could happen, and they know they're a lot less likely to end up brain dead if they have a helmet on. But that "chance" seems small enough to ignore.

Who wants to put an unflattering piece of plastic on their head and smoosh down their hair? Plus, helmets are sometimes uncomfortable. (Not nearly as uncomfortable as head trauma, but that's not something anyone wants to dwell on when going for a pleasant ride to the beach).

For most people, the most important consideration when it comes to helmet usage seems to be: what is "everyone else" doing?

In places like Provincetown, only dorks extremely cautious folks like me wear helmets. And as fetching as I might appear while wearing my helmet, I do not seem to be starting any sort of fashion trend.

(Just pretend there is a picture right here of me looking exceedingly attractive while wearing a bike helmet.)

(OK, pretend a little harder...)

However, if cooler people than me were to start wearing helmets, then maybe we could start a movement! Soon we'd all start feeling more like this:

Photo credit:kwc

And less like this:

Photo: Renon-san

What about you folks, do you wear helmets when skiing, cycling, skating, climbing, or whatever?


  1. i've never worn a helmet while skiing, but i always wear one while riding my bike. whenever i've gone rock climbing outside, i've worn a helmet.

    on the ice ... it's a partially different story. typically, helmets are required and whenever i play an actual game, i wear one. however, after that ... it sometimes gets iffy. free skating? i don't. but, when doing stick-puck sessions ... i would prefer not to wear one. however, given new rink rules, i do.

  2. I think helmets are a good idea. I don't do any of the above mentioned activities but if I were to, I'd probably protect my brain. I just wanted to comment on that last pic because it got a hearty snort out of me so thank you for scaring my cat. :)

  3. I've never even thought to wear a helmet while skiing so thanks for pointing it out.

    On the issue of bicycle helmets, I love all those people who hang them on their handle bars while they ride. A classmate actually broke his kneecap when his helmet got tangled in a fence as he rode past. At least he LOOKED cool right?

    And of course there are those people who believe that if it is on your head it doesn't matter if the straps are done up, because when you fall off, bicycle helmets *magically* stay on your head. I think it has something to do with the way they squash your hair!

  4. I read about a guy who finally went out and got a bicycle helmet after the second time he got hit by a car while riding. People like that, I don't get.

    When cycling I always wear a helmet.

    Never done so while skiing, but then I am capable of controlling my speed and avoiding large motor-driven machines whilst on the slopes. (I have to say that if I ever tried snowboarding I'd definitely wear a helmet; there doesn't seem to be the same ability to control your progress when both feet are strapped to one piece of wood.)

    When I was a little'un, nobody wore helmets for skiing, cycling, or other activities (except for football). Nowadays, it's common to see people wearing helmets when horseback riding. Unless they're riding Western style. Is the cowboy hat supposed to protect their head if they fall?

  5. I did once see a man driving down the road ... in a car... with a bicycle helmet on his head.

  6. Thanks for the ideas. I used to ski a lot and I am sure it would be smart especially on the large mountains to wear a helmet. I have heard of people dieing from ski accidents.

  7. Here in Australia, it is illegal to ride a bicycle without wearing a helmet and has been since the mid 80s.
    All helmets sold must pass rigorous safety tests. We take our helmet wearing rather seriously. :)

  8. First of all - that second helmet is the aweseomest thing I've seen all week. I want one (and the mannequin to go with it) so badly I can't even tell you. Can you imagine the practical jokes I could pull with that baby?!?!

    Second - I've been skiing since I was a wee lass and have never worn helmet unless I was back country. Although now that I'm a mom, I'm thinking my kids are going to wear them. I love double standards;)

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  10. Well my only experience with helmets is that it's a requirement for my boys to wear them while riding their bikes. No debate on that one. (In fact, I kind of wish I could just put them in helmets all the time...) I'm not sure how much it will actually prevent. But I couldn't live with the guilt if one of them did get seriously hurt and I could've prevented it by making them strap on that piece of plastic.

    But luckily their still young enough and the marketing and design of kid's helmets has gotten cool enough that they love them. They've got skeletons and flames and all sorts of jazziness on them that it's not too hard to enforce the rule. Yet.

  11. I totally support helmets, I always wear one when biking, roller skating (I've never been offered one or told to wear one on ice, odd), and outdoor rock climbing. Even so, I'm an avid skier and don't wear one. Why? It limits my hearing and sight, which are to two things I rely on to locate other skiers and my surroundings. I feel safer not wearing one that wearing one.

  12. Just yesterday my business partner wiped out on his mountain bike in the hills. His payout: A concussion, lots of contusions, lumps, stitches in the hand and a stitched up eyebrow. I shudder to think what might have happened to his skull had he NOT been wearing a helmet. Let me tell you something; I've seen first-hand how much his helmet protected him and I can't think of a good argument against wearing a helmet during any activity where massive head trauma is a possibility.

  13. Hi! Long time lurker here so I'm sorry this is my first comment.

    The helmet issue isn't as simple in cycling as you make out, i.e. wear a helmet and be safe.

    Perhaps have a look at the Copenhagenize Website for a broader view.

    The bottom line is that this should be a free choice and those choosing not to wear helmets when cycling shouldn't be vilified for their choice.

  14. What about flying infant car seats? No, I'm not dead but I got a terrible concussion when it fell of the shelf and whacked me in the head: CAT scan, missed days of work, etc, etc.

    There should be a warning label on those damn car seats.

  15. so so sad huh?
    My husband skis and I dont. I always used the (heartfelt) Im too old to learn---Id break a hip!
    Now I think that breaking a hip could be the best outcome.

    and Im wondering if Ill let the toddler learn PERIOD.
    helmet or not.

  16. I don't know. I always wear a bike helmet, in part because there are cars and other things around me that act unpredictably and are very dangerous.

    I haven't skied in years, but I never wore a helmet, and I probably wouldn't be inclined to, although I can kind of see where it makes some sense. But I used to fall a LOT, and I worried about leg injury far more than head injury. Most of the really bad skiing accidents that I know of have been, let's call it structural, not head.

    So probably I don't have a rational position on this. But for kids... I think start them from day one with a helmet, just like with a bike, don't make anything else an option, and they will just get used to it, and in the next generation, usage rates will be a lot higher.

  17. I always wear a helmet when I bike - way too much of a klutz to risk my noggin.
    Haven't been skiing in years, but I most likely will wear one if I do take it up again. My klutziness seems to get worse the older I get..

  18. With my experience as part of a trauma unit in the ER, I can easily support the use of helmets! You may only need one once in your life, but after that event, you will be the most grateful person in the world that you made that choice.

  19. I wear a helmet biking, as does my husband.
    I even wore one about 15 years ago when I went skating for the first time since forever was just a pup.
    I'm a klutz. I have a lousy sense of balance. I expect someday to fall and land somewhere other than my poor, abused knees and I intend to be ready.

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  21. I wear a helmet when I'm on a bike or when I'm rollerblading, but I haven't worn one while skiing, even though my sons do. I've seen them ruin a couple of helmets by cracking them on the pavement when biking or skateboarding, so I'm extremely thankful for the protection.

    My husband mentioned earlier this year that it would be a good example to start wearing ski helmets, and he's probably right especially considering how clumsy I am.

    Also, I want to take up snowboarding next year, and there is no way that I'd try that without a helmet.

    The only question I have is, where am I supposed to store all of these helmets?

  22. I don't wear a helmet for either skiiing (which I RARELY get to do) or biking (which I RARELY bother to do). When I am biking I am usually running some errands, and dont want to deal with carrying the helmet around while I shop. I dont want to have it cluttering my closet, either. And hey, haven't studies shown that helmet-wearers are more likely to crash in the first place? So maybe the people wearing helmets are the people who know they need them. Also, some (questionable) study has also shown that cars give riders without helmets more leeway. I ride cautiously. My friends without helmets do as well. My friends with helmets? Idiot bikers who think they can beat all the cars through the intersection when they run the light.

  23. I don't do any of those things, so I have no helmets. I bought one when I borrowed a friend's bike to try to learn gears, and found that my knee wasn't happy about this. Then I moved the helmet many times, and finally gave it to another friend when his was stolen. (Just the helmet. Not the bike it was attached to.) Now, if I get myself into good enough shape with the stationary bike to buy a real one, I'll have to buy another helmet.
    When I was riding without one as a child, I never fell off once I had passed the training wheel stage-BUT I wasn't coping with traffic, dogs, or potholes.
    If I could get a cat to ride on my helmet I'd wear it everywhere!

    Mary Anne in Kentucky

  24. Funny thing - I had to beg my mom for a bike helmet when I was younger. She thought they were a waste of money and only eventually got me one when I asked for it for my birthday.

    I always wear a helmet when I'm on my bike. Windy mountain roads (best cycling ever!) with inattentive drivers makes me paranoid enough WITH a helmet.

    I always wear my helmet on my motorcycle too. I can't fathom not wearing a helmet when you're going 60mph with nothing between you and concrete anyway. In fact, if I could efficiently wrap myself in bubble wrap first, I'd feel even better.

    Never worn a helmet snowboarding, but I've considered it. I've managed to face-plant and have my legs (strapped to the board) flip over my back into my head. Must have looked pretty funny, but it kind of hurt. I've just been too cheap to buy one.

  25. The prevailing ethic at climbing crags seems to be not to wear a helmet, in spite of falling rock, falling gear and the possibility of hitting one's head while taking a lead fall.

    I don't get it - the only thing that makes people more interesting than bovines is that 3 lbs of grey, squishy stuff in the cranium - so taking a simple step to protect it such as WEARING A HELMET seems so obvious.

    And if you think helmets are expensive, try ambulance rides, emergency rooms, hospital stays and multiple CAT scans, not to mention the misery and fear of losing a loved one. I've done it and I don't ever want to do it again.

    Helmets can't prevent every injury, but that's an excuse, not a reason for not wearing one.

  26. you know - It wouldn't even really occurr to me to wear a helmet while skiing. And since I suck so emphatically at it, it's a great idea really. I know a lot of snowboarders wear helmets. They seem to wear more gear in general. Perhaps because you fall down a LOT while learning not to fall down and actually snowboard?
    Bike helmets are a great idea. There's plenty of other things on you to scrape and break. Might as well protect the noggin, because those sexy aqua spandex bike shorts probably won't protect you much elsewhere!

  27. I never go out cycling without a helmet, although it's less motivated by my fear of falling than by the not always so savvy-of-bicycle motorists. I have been knocked off my bike twice, fortunately neither were serious.

    I ski 2 days of every week in the winter (yeaah... off again tomorrow and friday) - and never wear a helmet. Um... maybe coz there are no motorists to fear (unless you count snomobiles who I presumbe are pretty aware they're at a ski resort seen as they are usually staff.

    Richardson fell on a bunny slope and probably wasn't exactly going 20mph.

  28. I don't ski. I tried, when i was younger, and failed miserably. (Fortunately, I never fell and landed on the back of my head. I did a bunch of face plants.)
    i ALWAYS wear a helmet when I ride my bike. It drives me CRAZY when I see people out riding, especially in traffic, without a helmet. People get a little weird behind the wheel, and you just can't expect caution and courtesy from drivers. (Especially in L.A. Drivers HATE cyclists there! Seriously, they are MEAN!!!!!)

  29. I always wear my helmet when riding my bike.

    I never ski (due to an unfortunate incident involving the ski patrol when I was 13 - no helmet worn or necessary), or really do anything else that needs a helmet. Well, except exist. I've had 5-6 concussions in my life, none of which were sports-related. Maybe I just need a walking around helmet.

  30. It is essential to exercise some precaution whenever you can. Danger often plays with the daredevil and stubborn individuals.

  31. Lets not forget horse back riding! A helmet saved me from serious injury while taking lessons... It's crazy seeing all these people, who don't know or realize the "danger" in the sport, riding around in cut offs and sandals with no helmet. So not worth it - wear the helmet!

  32. I always wear a helmet when cycling, but I never wear one when skiing.

  33. An earlier poster states that helmet wearing should be a choice. You're right, it should be a choice. But if you choose not to wear one you need to be prepared to be accountable not only for injury that might have been prevented, but for the pain and anguish you may cause family and friends should you CHOOSE to go without one and end up disabled or dead as a result. Sometimes your choices aren't just about YOU. If you're prepared for the responsibility of depriving loved ones of your valued presence (especially if you have children), then by all means allow your ego to be bigger than your common sense and go bare-headed.

  34. Yes, when I do those activities, I wear a helmet. Unless the bike is a stationary one.

  35. I don't ski because of an unfortunate incident of running into a ski lodge (*smack* and *ow*). I won't even ride my bike around the block without a helmet, fastened correctly.

    It isn't as much that I fear death from hitting my head, it's that I fear I wouldn't die. I like my brain working as it does now, and spending several decades with a traumatic brain injury isn't on my agenda.

    It upsets me when I see a family out for a bike ride and while the kids are wearing helmets, mom and dad are not. Not only a bad example, but what would the kids do without mommy or daddy?

    And don't get me started on the boys wearing helmets without fastening the straps ...

  36. I think wearing a helmet should be a personal choice because as Anonymous said I'd rather people ride/ski than not, but personally I'm always going to choose to wear one when biking (I don't ski so I have no opinion there). I personally would rather be safe than sorry, but I'm not sure we should always regulate what people choose to do in their lives.

  37. Yeah, based on these articles, it's safe to say that there is a correlation between those who don't wear helmets and brain injuries/deaths. Meaning, it's usually the brainless who get brained. And it's usually the brainless who are careless enough to go without protection and put themselves in dangerous positions.

    In other words, it's Darwinism at work.*

    (*but that's not in any way to suggest that 'Tash had it coming. That was just tragic, and she was a beginner anyway)

  38. I wear a bicycle helmet and a aluminum foil deflecting beanie helmet whenever necessary.

  39. I always wear a helmet when I'm biking. I feel naked without it.

  40. I dont' wear a helmet. I'm a bad girl. I am extremely pro...well, anything that protects your most important body part (I'm in psychology...of course I value the brain). My big thing is that I don't think about it - couldn't tell you where my helmet is. Do I even still have one? It is uncomfortable, but I've also heard that tbi is a little uncomfortable as well. I don't ride my bike often, but it also only takes one time, doesn't it?

  41. I don't do sports that involve wearing a helmet but I guaranty you I would if I did ski or roller blade or any of the other sports where you might fall & hit your head. My husband plays roller hockey & he is never without his helmet & it saved his eye at one game!

  42. Fine, fine...I'll go get my bike helmet out and start wearing it!

    Yes, I agree helmets are a good thing. But I only ride around my dangerous can that be. Sigh. I know the answer. Helmet, meet my head.

  43. I'm with you--helmets make sense.

    In my wonderful state of Colorado, they don't even have a law requiring MOTORCYCLISTS to wear helmets. And I'll tell you, it makes me so nervous when I'm on the highway to see 2 people squeezed on a zooming motorcycle wearing no helmets.

    It's insane.

  44. Interesting post, Crabby! I'm a little late to the party, but some of your commenters make me shake my head a little (not too hard, though, because I don't want to give myself a contrecoup brain injury, which is apparently what killed Natasha, and, incidentally, my father).

    People who do not wear helmets when engaging in activities where the possibility of a serious head injury exists really need to have their heads examined!

    A helmet will not save your life if you hit a tree when skiing.

    A helmet will not save your life if you are hit by a speeding car while riding your bike.

    (Two women of my acquaintance have died in those circumstances - both were wearing helmets.)

    A helmet WILL save your life if you fall down and smack your head on the ground, regardless of whether you are skiing, riding your bike, skating or rollerblading (or, in the case of some of us who are, shall we say, co-ordinationally challenged, just walking around....)

  45. When biking, yep, I've got a helmet on my head. I don't want to get killed, especially not for a silly reason like that- there's too much to do in life to risk injury just because I "don't feel like wearing a helmet"!

  46. I do wear a helmet when I ride a bike (it is law in Australia to do so). However I don't like it and if I had a choice probably wouldn't wear one. I understand why they are important but I hate helmet-hair!

  47. Last spring my son went snowboarding in Vail for his sr. yr. spring break. None of the boys wore helmets. First day out he took a jump too fast; hit his head, out cold, spent the next 3 days in the medical center, admittedly ruined his spring break. No more boarding, no drinking, no hyjinx.....

    He now wears a helmet.

    What is more concerning is that the ski patrol told him he was fine and sent him back to his hotel. THis could have been more detrimental than not wearing a helmet.

    Fortunately, one of his friends' Dads is a neurosurgeon and when he heard what had happened, told the boys to take him to the ER immediately. The ER doc informed us that ski patrol should have called an ambulance.

    I think the ski patrol should ALWAYS call 911 when it comes to head injuries and let the ER docs decide.

    In my sons case he had a concussion and several small hemotomas.

    He is fine now...but the lesson is not only to wear a helmet..but visit the ER to follow up.

  48. last year when is started doing endurance riding with my shall we say "energetic arabian", I never leave home without myh "brain bucket"
    happy trails

  49. I wear one on my bike, but not skiing (of course I rarely ski). If I ever snowboarded I would definitely wear a helmet, as you're strapped to the board and tend to wipe out more.

    That being said, it's kind of like a motorbike helmet. It will protexct your head to a point but if you're going to fast and hit somethign big and hard, there's only so much it can do. I think it would be better. As long as they don't restrict your vision...that woulld opepn up a whole new problem.

    As a crotchety side point, I hope people stop talking about Natasha Richardson soon. Yes it was a freak accident. Yes she's dead. How this is major international news for weeks and weeks is beyond me. Regular people die of freak accidents too...and war...and famine...and...I know I know- Grumbling over...

  50. I don't bike much anymore, but after the bike accident I was in when I was 12, my mother went all "Helmet Nazi". Apparently she didn't like the concussion and skull fracture I got. I am also so clumsy that I don't do much in the way of outdoor sports, so it isn't really a problem for me. I have considered wearing one when walking since I trip over my own feet and fall down so much.

  51. I started wearing a helmet after a kid ran into me on his mini bike. I also made my husband wear one. He wiped out on his bike on a railroad track and broke his helmet. Since then, everyone in my family has been wearing helmets. Will they help? Who knows, but we decided that the broken helmet was a hint that maybe better to have a broken helmet than a broken skull.

  52. i don't wear a helmet, and i bike to work every day. i do not, however, ride in the street, because the drivers are crazy. i do not go very fast, either. it is a cheap walmart bike, wih a basket on the front.

  53. Sorry to be late to this party, but I do have a comment (like Crabby's opinions, I always have a comment). When my daughter was 7 she decided to try riding her bike with her eyes shut. She ran smack into my neighbor's mailbox, flew off the bike, knocked unconscious in the middle of the road. One "minor concussion." But... she was wearing her helmet! The doctor in the ER told my husband that he treats more kids who wear their helmets improperly, than kids who don't wear helmets at all. So, my point is... helmets don't take the place of common sense (and what 7 year old has much of that???). (By the way, 6 months later she decided to play tag at school with a blanket over her head and ran head first into a wall. No concussion, but another ER visit.) Still no common sense...

  54. Can you imagine Roy Rogers and Zorro with a helmet ?


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