There is a great article over at the New York Times (http://www.nytimes.com/2014/01/01/sports/on-slopes-rise-in-helmet-use-but-no-decline-in-brain-injuries.html) about how helmet use is not lowering brain injuries or fatalities:
Ski Helmet Use Isn’t Reducing Brain Injuries
By KELLEY McMILLAN
Published: December 31, 2013
BEAVER CREEK, Colo. — The fact that Michael Schumacher was wearing a helmet when he sustained a life-threatening head injury while skiing in France on Sunday probably did not come as a surprise to experts who have charted the increasing presence of helmets on slopes and halfpipes in recent years. The fact that the helmet did not prevent Schumacher’s injury probably did not surprise them, either.
Schumacher, the most successful Formula One driver in history, sustained a traumatic brain injury when he fell and hit his head on a rock while navigating an off-piste, or ungroomed, area at a resort in Méribel, France. Although he was wearing a helmet, he sustained injuries that have left him fighting for his life in a hospital in Grenoble, France.
Schumacher’s injury also focused attention on an unsettling trend. Although skiers and snowboarders in the United States are wearing helmets more than ever — 70 percent of all participants, nearly triple the number from 2003 — there has been no reduction in the number of snow-sports-related fatalities or brain injuries in the country, according to the National Ski Areas Association.
Experts ascribe that seemingly implausible correlation to the inability of helmets to prevent serious head injuries like Schumacher’s and to the fact that more skiers and snowboarders are engaging in risky behaviors: skiing faster, jumping higher and going out of bounds.
“The equipment we have now allows us to do things we really couldn’t do before, and people’s pushing limits has sort of surpassed people’s ability to control themselves,” said Chris Davenport, a professional big-mountain skier.
Read the rest of the article here
And again, we come across examples of how risk-taking behavior takes over and trumps reason. With better equipment, people take more risks — like football players who treat their protective gear like armor to protect them as they turn their bodies — including their heads — into weapons.
Additionally, the article says:
In fact, some studies indicate that the number of snow-sports-related head injuries has increased. A 2012 study at the Western Michigan University School of Medicine on head injuries among skiers and snowboarders in the United States found that the number of head injuries increased 60 percent in a seven-year period, from 9,308 in 2004 to 14,947 in 2010, even as helmet use increased by an almost identical percentage over the same period. A March 2013 study by the University of Washington concluded that the number of snow-sports-related head injuries among youths and adolescents increased 250 percent from 1996 to 2010.
So, dangerous sports continue to be dangerous, and may become even moreso, when the participants are “assured” that they will be protected from injury by a helmet.
But a helmet won’t protect your brain from smashing against the inside of your skull, and that’s where the real injury takes place. It’s inside – where the sharp bone impacts the soft brain… as well as deep within the brain where axons are twisted and sheared and torn, like roads being torn up by a twister or a flash flood.
The Crash Reel has a lot of people talking about TBI and snowboarding. Whether people are listening — and changing their behavior — is anyone’s guess.
Even more questionable, is whether people are actually asking the right questions about what makes this kind of risk-taking seem so attractive to people. They’re not always taking seriously the real need for a reward in life — and the rewards that dopamine and the adrenaline rush offer, can be “just what the doctor ordered” for someone who struggles with attentional issues, low dopamine levels, confusion, alienation, and a general sense of not really fitting into a larger community.
As long as risk-taking that can get you seriously injured is the only option offered to folks who need those neurotransmitters to feel whole and alive, you’re going to continue to see this sort of thing.
And helmets aren’t going to make a whole hell of a lot of difference. If anything, they can make things worse.
Broken Brain - Brilliant Mind 
Only attitudes changing will ever make a difference..we must let every person know how life changes, only then will attitudes towards dangerous play change!
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Obviously people believe themselves to be more injury proof with helmet use. I fear for our children, within this false paradigm. The myth of full protection of the brain, when using a helmet, is as you have pointed out! Thank you for writing of the impact of the brain and head against any solid immovable object, having the brain organ moving inside the brain case itself. To repeat it as I have understood it regarding my own situation.
When the brain is moved inside the brain case with force, although the skull stops, the brain continues to move, first slammed against the side of the case in foward motion, then shaking as jelly inside the case.
The resulting microscopic tears, even cuts may occur, causing scar tissue to form. That built up sclerotic tissue over time is enough to throw off the electical and rhythmic function of the brain may often result in secondary diagnoses such as seizures. Long term epilepsy, as mine (at times a very difficult situation to treat and control after the originating tbi,) or other known secondary diagnoses of tbi, may result. The secondary diagnoses of TBI are the offending and difficult diseases to overcome and control.
I believe TBI needs to be considered at all times, perhaps posted as warnings and in contracts, avoided at all costs. This is a preventable disease, when in avoidance of high-risk activities to the pursuit of dopaminergic and adrenalin rushes, perhaps early career pursuits with a history of brain injury and assaults to the brain organ. We humans, have the ability to consider “Brain safety first” options. We have the ability to educate and facilitate continued best health behaviors.
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I have to agree (seems I’m agreeing with you a lot lately).
When I had my ATV accident, I was wearing a full-face helmet. I wasn’t riding risky or anything because I was being followed by someone very inexperienced. But it still caused a lot of damage. I can’t say if I would have been worse off if I hadn’t been wearing a helmet – possibly, since it was a very rocky area. But I can say that wearing a helmet doesn’t make you invincible anymore than wearing a seatbelt does.
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You know, I got my TBI in a motorcycle wreck, hit from behind, I landed some 15 feet away on my forehead. Numerous skull and facial fractures. A “severe traumatic brain injury.
In therapy I was told that a helmet probably would have made me a quadriplegic or dead, with the lower back of the helmet impacting my neck. So it goes.
But I also wonder…if like football players…the brain get shaken so badly in an accident that the helmet protects one from road rash, from something poking the face/head, but does it really project one from a TBI?
Like the poor race driver, even with a helmet, his head struck a rock…and he apparently has a very severe TBI. Wish him all the best, my prayers are with him.
But I have to ask, as you do, is a helmet really the life-saver that many think?
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Thanks for writing. I think it’s a bit of a toss-up. I know riders who refuse to wear helmets, because it keeps them from hearing and seeing everything around them, and they feel a lot unsafer with a helmet on. I also know of someone who was not wearing a helmet when they had a motorcycle accident, and their face got the worst of it against the cement road divider. I also hear that in skiing helmets save lives and that the race driver would have been dead without his helmet. On the other hand, if he’s completely incapacitated by his injury, even though he’s not technically dead, is that any life to have? I sincerely hope he can recover and have a decent life, if he makes it through. My thoughts are with him as well. I think that people who push limits will push limits, no matter what, and protective gear cannot save someone 100% from themselves. It’s really the mindset inside the mind that determines a lot, not only the protective gear on the outside. And when it comes to those heavy-duty risk-takers, who are at the greatest risk, I’m not sure any protective gear is going to compensate for their mindset and habits. People who push the limits till they can’t go any farther, will just do that, until they learn better — it’s a question of whether they’ll live long enough to learn.
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Well, it’s good you were wearing the full-face helmet, because if you hadn’t been, it might have made your injury even more complex. The inside of the brain is where TBI takes place, and I think what’s inside your mind also can — unless of course you’re dealing with folks who are inexperienced, which makes things even more “
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I totally agree — and I believe the real changes need to happen at the top — with the networks and executives and the extreme sports announcers and all those who lead the way in making extreme sports even more dangerous than they inherently are. The article makes a good point that ski resorts and other facilities are making terrain even more dangerous than ever, so there is some responsibility there. And there’s the fact that the brains of some of the highest-risk players (young men between 12 and 24) are not fully formed to make proper decisions — so they are placed even more danger by the lure of risk and the euphoria of successful conquest. It really is a recipe for disaster. And until someone steps up to make the right decisions about what is and is not allowed, accidents will continue to happen.
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Thank you for writing. This is incredibly important, especially at this time of the year when skiing and snowboarding are picking up, as well as snowmobiling. The mechanisms of brain injury are well-hidden, and people are very adept at fooling themselves into a false sense of security — and that includes parents as well as kids. The kids literally don’t know any better, and personally I believe that it’s making the situation even more dangerous for parents to constantly be shielding their kids from the real dangers of life. Kids need to learn to face and surmount challenges in the real world, but parents these days are constantly protecting them from difficulty. So, I believe they seek out even more difficulty to get the necessary sense of reward and accomplishment.
Also, facilities and resorts and sports promoters are responsible for the increased dangers, as they make their courses more difficult and make their half-pipes even bigger. They want to make money — who doesn’t? But at what cost? People need to be educated about TBI — especially parents — so that they can take steps to protect their kids from the artificial extreme dangers that their kids seek out in life. Somebody signs off on them doing the things they do — and someone could stop them, if they tried.
The casualty toll of skiing and snowboarding among young people is not a problem that needs to happen nearly as much as it does.
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I guess I’m concerned about what you are saying about changing attitudes. Are you saying we need to change attitudes so that no one takes risks? That’s not how our world got to where it is today. It was by taking risks, pushing boundaries, and moving ahead.
But on the other hand, should we be insisting that all rocks be removed from ski slopes? That would probably be a good thing! Should we insist that ski area boundaries be fenced to keep people from skiing out of bounds? Maybe.
Motorcycling? Hmmm…so many accidents are the result of another driver not paying attention. Lets see…we won’t outlaw using a cell phone while driving. We won’t outlaw texting while driving. We’ve done away with having to take the drivers test every three years…so that we know you’re up to date on new laws. Our law enforcement refuses to enforce the laws already on the books. So those of us that love to see this country on a bike, out in the elements, able to see and smell so much more than the inside of a car…should just stay home? That doesn’t make sense, and if the risk occurs so many time due to poor driving on another’s part. What do we do about them?
Yeah, I’m very unhappy that my passion, biking, has been taken out of my life by inattentiveness on the part of another.
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But then I wonder…how many of those that suffer a TBI in a twelve month period…are not due to risk taking? If Michael Schumacher had been “just another joe” there would be no publicity, no “talking heads” making such a big deal out of it. How many of us even knew who Michael Schumacher was until the Talking Heads put it on the news?
Those of us that are not famous get hurt in an accident, Suffer a severe TBI…and the police did not ticket the offending party, “Because the city doesn’t want their police officers spending time in court”. HUH??? An the police report was so poorly written it was awful!! The accident didn’t even make the paper, let alone national and worldwide television… I wasn’t taking extreme risk, my wife and I were riding up the frontage road to turn into a business, made the turn and boom hit from behind. Who created the risk? How should we deal with those whose refusal to stay focused on the situation and thus created the risk?
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You’re asking for way too large of a change to make what you write happen. Do you really think parents involved enough in their children’s lives to talk about brain injury and how best to minimize the risks?
Come on now! I’m 59. From the time I entered the 7th grade, my parents were too busy with their own lives to have a clue what I was doing! Dad was a physician and busy with his practice. Mom became so busy with so many church groups. Talk about risks? Talk about life planning. Spend time being present at the activities I was involved in? Nope.
Let’s take a different track…lets talk about how poorly American children are doing in school. Is it the fault of the education system? The fault of the teacher? Or is it the fault of parents who couldn’t, didn’t spend the time with their children before school age…so that those children showed up for Kindergarten knowing how to read, knowing their ABCs, knowing basic math.
So a paradigm change in risk taking has to start a long time before risk taking in sports appears on the horizon.
Just my thoughts
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Hm. Well, changing attitudes is one thing. I think being aware of the issues at stake and making a conscious choice about what we do, is a start.
With regard to motorcycling, I think every car driver should spend an afternoon riding as a passenger on a motorcycle. That could change some perceptions and attitudes about how to handle yourself on the road. I know that after I spent a beautiful Saturday afternoon as a passenger, riding through some very scenic territory, and having some tricky situations in town traffic, my attention and focus during car driving changed dramatically.
Personally, I think that knowing more, understanding the risks, and accepting the chance of real harm will go a long way.
Then again, there is so much that we do not know. So, there will always be gray areas we need to deal with. Just part of being human, I guess…
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I think you make a valid point here – there is a difference between “active” TBIs that come from risk-taking and pushing the limits, and “passive” TBIs that happen because of someone else’s choices and behavior. I think that the experience of each is very different, and each has its own follow-up challenges. For those of us who have “self-inflicted” TBIs because of risk taking and choices and behavior, there can be a real need on our parts to take another shot at what we were doing, when we got hurt, because — by God — we just didn’t do it quite right, and if we just try again, we’re sure we’ll get it right. I think this is especially true of athletes and active folks who refine their skills by trial and error. Because we are so accustomed to falling and getting back up and trying again (both driven internally and by others around us, including coaches or trainers), there’s a conditioned response on our part to get back in the game ASAP and make it work “this time”. I see that reflected in the behavior and inclinations of Kevin Pearce, the snowboarder, who was pushing to get back on his board almost from the start.
He’s famous. He’s getting attention for what he’s been through, which might just keep him out of danger if he can get sufficient stimulation from being safely out of harm’s way.
I was that way — all rarin’ to get back in the game — after several sports-related concussions in high school. In the football game where I got hit the wrong way and afterwards saw stars and could barely stand, let alone walk in a straight line or hold onto the ball, I was convinced that I just needed to keep playing and shake it off, because – by God – I could DO THIS, and I wasn’t going to let a little tackle stop me. Same thing in the soccer game, when I got tackled and went down, and then fought to not sit out, even when I was seeing double and couldn’t run in a straight line.
And then there are those situations where we get hurt because of someone else. I’ve been in multiple car accidents, thanks to other people’s inattention and NOTHING that I did, myself. In each case, the other party was going too fast and not paying attention. And there I was – in their way. For the record, the police report for the one collision was really terrible, and I got blamed for the accident, even though the other driver struck me while speeding. I couldn’t function well enough to realize I was getting the short end of the stick, and I wasn’t able to understand a co-worker who offered to advocate for me with the police. So, my insurance went up, I got extra points on my license, and there you have it.
I wasn’t even fully aware of how I was affected by those automobile collisions — after being concussed so often during my earlier years, it was just the same-old-same-old, and I figured it would just pass. If I had never been hurt while I was a kid, if I hadn’t already had a bunch of mTBIs, by the time I was old enough to drive, I’m sure it would have felt incredibly unfair and suck-ful, and I would have been at a loss about what to do.
But when you’ve gotten hurt a bunch of times because of choices you’ve made and things you’ve done, it changes how things look. And it can become more about figuring out how to just move on and improve and get back whatever you can, than have the injury recognized for what it is and have some sort of justice around it. I gave up on justice a long time ago. I’m actually too busy trying to put my life together, to worry much about it. I’ve just got to move on, take my lumps, and make the best of things.
Of course, this is me on a good day 😉
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This is an interesting perspective. I’m 10 years behind you, but there are some parallels — my parents were too caught up on their own lives to pay much attention to me, till I was nearly majority age. Frankly, unless I was of use to them in doing chores or helping out with things that needed done, they didn’t have much interest in me. And they almost never showed up at any of my activities, unless it was church-related (they had to be there, anyway). My parents did value reading and writing, and there were always books around, so I benefited from that. And I was also taught to do the right thing, regardless of what others thought, so I learned early to develop habits that I knew were right, rather than going along with the crowd, as everyone seems to want to do, today.
I’m not sure what the answer is for poor performance in school. I just don’t know.
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Another thought that keeps occurring to me…is why some of us do very well after a severe TBI and some do not.
I have learned through my Neurologist and the testing done…that a third of my brain is now scar tissue and five areas are active for seizures. So I take my meds religiously.
Its been five and a half years now, and yet I can do nearly everything I could pre-TBI and there are things I think I can do better. I feel I am more creative now than ever in the past.
I cannot multi-task very well at all now. Used to be 6 or 8 projects as the same time.
My left optic nerve was traumatized and I’m completely blind in my left eye…that’s a challenge I don’t appreciate. But I find ways to work around it. If I’m on uneven or rocky terrain…I take my cane with me.
One question along this line. My cognizant skills therapist told me I was about the most driven individual she had ever worked with. So with TBI is recovery a function of how much effort one puts into his/.her recovery? I really don’t know. I attend a Brain Injury Survivors group and I feel good and bad that I seem to be doing the best of anyone that participated. I don’t know. I do not recognize other TBI survivors on the street, I’m sure there are lots of us out there, but where? Are they doing as well as I am? Are the withdrawn from life? Thoughts?
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I don’t know what the answer for education is either. I know that I struggled terribly in High School and neither parent even commented. I struggled in college, I was told I would go and sent away from home for school. I was on academic probation more semesters that I care to remember. But suddenly I had to pay for my own education, so I worked full time and continued classes. I finally developed some study skills and graduated with a good GPA. But how did I get all the way through High School without developing study skills? I don’t know. But I know after finally graduating with an engineering degree…every other class I’ve taken was an “A”. I’ve often thought if I could go back to school and “learn about how my brain learns”…I would love to do that!
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Interesting – maybe it was actually that high school was not challenging enough for you. Back in the day, lots of people didn’t give much weight to high school, because it was just a precursor to real life. Once you got out and integrated into the mainstream, then it was time to pay attention to performance. When I was a kid, grades were just expected to be at a decent level — no huge pressure like there is today. I struggled with a lot of things, too — silently. But I did well enough in certain areas, and I had enough “smarts” to get by, so I did.
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These are great questions. I also wonder a lot of times why it is I am doing as well as I am. I mean, I have a ton of really annoying problems that can really drag me down when they get out of whack. Some days, I do not recognize the raving lunatic I seem to be. Other days, the good days, I feel better than I ever have.
I have a theory that people who recover well from trauma, including traumatic brain injury, face up to life, rather than running from it. They take their challenges as just that : challenges to be met and learned from. The fact that you are taking your meds religiously because of the situation in your brain, shows that your ability to learn and respond to your environment is intact, and you have the ability to adapt. I think the folks who don’t adapt are the ones who have the most trouble.
I say this about anyone who has difficulties to overcome — people who lose their homes, health, loved-ones, jobs, sense of security… whether by act of God or human or dumb luck. I know a lot of people who have overcome tremendous odds — one of my best friends was born missing parts of their hands, and their body is twisted and lop-sided because of a congenital defect, but they have risen to the top of their field, they have a beautiful family, and they are at a very high level in a sport that few people can master. This… after doctors told their parents that they’d never be able to walk or develop intellectually.
Adaptation is key, and the more we get out of our way and let life take its course, while adapting and learning from all the new situations, the better we do, I think.
I also know a number of people who treat their challenges like they are death sentences. Because they have had bad things happen in their lives, they are convinced they have no future. It is truly tragic. There is no need for that, but that’s what they choose to believe.
As for drive, I have been told I am the most driven person some people know. They call me a courageous warrior, but from where I’m standing, that’s just the best way I know how to get through life. I think all my TBIs have made me more resourceful (learning how to function while hacking through the jungle of all the sensory issues, exhaustion, confusion, etc.) as well as more hard-headed. I am stubborn. I’m also full of energy, which I think I inherited from my non-stop parents. It’s a blessing and a gift, I believe, and I’m fortunate.
At the same time, the results I’ve achieved have a lot to do with what I’ve done with my gifts. Anybody can have high energy and be stubborn — what we do with it, is what makes the difference. And those of us who are doing something 100% are often too busy doing, to make a show of it.
So, I think that when it comes to brain injury, people are either so busy getting their acts together and/or covering for their deficits and/or just trying to live their lives, that their TBI status is well-concealed. For those of us who are “mainstream rebounding”, that hiding is imperative.
Have a great day – good questions — good food for thought! Thanks.
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Perhaps it was that High School wasn’t challenging enough. But like you, I did have enough “smarts” to get through. I’ve thought also that perhaps the teachers didn’t relate it to real life examples so that it drew students in. I did well in Algebra because “Coach” always tried to relate the problem to something in life. Same for Trig. I’ve coached my wife’s kids on taking Trig as it provides tools for solving lots of problems you come across in real life.
I’ve thought a little about being a volunteer mentor to study groups so that I can share real life examples to help students grasp the concepts of math and engineering.
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Very interesting. Yup, we are driven. Getting to where, at 5 years post, that I don’t mention my TBI anymore. I do like to sit in restaurant booths, next to the wall with my left side to the wall. That way wait staff don’t scare me by doing things on my blind side!
I developed anger issues after the TBI, and I’ve read that is very common. I really came to the surface afterwards when I “lost” all my biking friends. I believe they just didn’t want to talk about riding around me. Maybe it was my behavior. Then 14 months post, I had another seizure, struggled to find a Neurologist that saw TBI patients. But did. Then was started on Keppra for seizure prevention. Then retired and lost all the friends from work. About two months later the wheels began to fall off and the anger issues became problematic. Two and half years later the whole wagon collapsed! Anger was a real issue. Wife was always afraid I would have another “meltdown”. Got so bad in October 2014 that I reached out to 911 for help. Everybody showed up…fortunately for me…a Captain on the Sheriff’s Office that I know. Wife transported me to the emergency room…hmm…then admitted on a 72 hour Mental Health hold…surprise!
But it was probably the best 72 hours of my life!! Couldn’t have anything in my pockets, no shoelaces, nothing. First night I was wide awake reflecting on my life and where it had gone. Next day I participated in all the various groups, walked the halls of the psychiatric floor being introspective. Next day I say the staff Psychiatrist. Talked about what was going on in my life, learned that even as well as I had prepared for retirement, financially and activities its a lot harder than you think.
Also learned that Keppra slows the synapse in the brain, so when frustration begins the brain is not able to stop before I go into a rage.
So…Psychiatrist added Oxcarbazepine. An epilepsy medication that is a seizure preventative and also a “mood stabilizer”. Was counseled to discuss with Neurologist. Also my anti-depressant Venlafaxine was doubled from 75 to 150 mg per day. Neurologist agreed with all the changes and Keppra was phased out over a week.
I have not felt this good for five years!! I haven’t gotten angry since being admitted on the Mental Health hold. Wife keeps asking how hard I have to work at it…not at all! Life is so good. I’m getting more done in my shop that I have for a while and I’m enjoying life.
I guess my thoughts are that the Mental Health hold was a good thing. And that being my own advocate and talking honestly with my physicians is a very good thing!!
I see 2013 as the worst year of my life and truly looking forward to 2014.
Onward!!!
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Yes, sounds familiar — I used to get so frustrated with teachers who were “just showing up” and couldn’t put anything more of themselves into their work, than just giving us multiple-choice tests. But who knows what their lives were really like?
I think it’s a great idea to do some volunteer mentoring or tutoring. You could really help others, and build some community and widen your world. Is this something you can do in your area?
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That’s a pretty intense progression – and not at all uncommon, I believe. Anger is still an issue for me, nearly 10 years after my last TBI, and my spouse is (yet again) walking on eggshells around me and fearful of my outbursts. I have recently re-started doing sitting meditations — za-zen, where you simply sit and breathe at a regular cadence. 5 seconds in, 5 seconds out balances the autonomic nervous system, so I’m not in constant fight-flight mode. And sitting still and not letting my head get going, and not reacting to slight discomforts that come and go in the course of my sitting, gets me out of a reactive state.
Losing all your friends is hard. Anger becomes even more of an issue, when you feel alone. Of course, if you find a good medication, as you have, that can certainly help. That’s great that you are levelled out and enjoying your life again. There’s nothing like getting things done in your shop, to improve your life – that’s for sure.
Yes, 2013 was a tough one. I look forward to this new year as well.
Onward!
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