Musings on Head Injuries

[TrishandAlex]

Tim ( and other cyclists) -- I'm not disagreeing with anything you've written. I totally trust your insights and agree with your observations regarding cyclists and drivers -- especially in the Boston area!

Again, they key word is subconscious. Assuming the research is valid and the statistics were properly analyzed, then the less-careful factor probably applies to a small fraction of cyclists, certainly not to everyone. Just enough to make a difference in the statistics of the study (which, again, I haven't read or analyzed....just going on a thought experiment here).

I'm not advocating for no helmets, and I certainly agree that we'd all be much better off if people biked instead of drove, whenever and wherever possible.

FWIW, my kids wear helmets when they (attempt) to ride their bikes. I do as well -- and I don't THINK I'm any less careful than I would be otherwise.

I'm the type that enjoys mentally chewing over studies which show results that at first appear counter-intuitive. That's just me.

I'm not suggesting that we all throw away our helmets based on this study.

 

[Maddy]

Assuming the research is valid and the statistics were properly analyzed, then the less-careful factor probably applies to a small fraction of cyclists, certainly not to everyone.

I'm not suggesting that we all throw away our helmets based on this study.

You just said a mouthful Trish.
IMHO, helmets are just plain common sense.
Our peer, who suffered such a fatal head injury, had the best helmet money could buy and a rock solid mountain bike. The state police conducted an investigation and determined that his equipment was not faulty. He had biked for years so lack of experience was not a factor.
It brought home to a lot of us the grizzly fact that even with the best hi tech gear we are still vulnerable.
I would equate not wearing a helmet to not wearing a seat belt because there is a slim chance that it could trap you in the car and cause your demise.
Or....you will relax and let the candles in the house burn through the night while you sleep because you have fire detectors.
Too often I think lack of common sense is the route cause of why we need so many laws.
The one thing I really do not like about studies who boast things like "helmets do not prevent injuries and in fact might even be responsible for causing them" is that young folks with little or no life experience read this and now have the perfect excuse for leaving their helmet at home.
Personally, I don't think I would have elected to not wear my helmet that sweltering summer day but there is a slim chance that if I just read something like this, I might have opted to leave it in the car. I had been trying very hard to convince myself that it was not needed on such an easy trail, as I pondered what on earth could possibly happen there. An hour later I experienced exactly what could happen there.
I think we can read all the studies we want but in the end I think it is often just plain old common sense that will save us from ourselves.

 

[Little Rickie]

Many people have trouble accepting the conclusions of these studies--the results certainly are counterintuitive. But the data says what the data says and if the studies were done properly they shouldn't be ignored.

A cracked helmet is dramatic, but actually has absorbed very little energy. If it didn't absorb the impact energy, it didn't protect the victim. (Helmets are designed to absorb impact energy by crushing, not cracking.)

One study in England showed that vehicles gave more clearance to a helmet-less rider than a helmeted rider. This alone could account for lower accident rates for helmetless riders.

The wikipedia article that I referenced has a fairly balanced overview of results on both sides of the issue. It is worth a full read if you are interested in the topic. http://en.wikipedia.org/wiki/Bicycle_helmet

Doug

Studies are biased at best. Just because someone(s) writes something that gets onto the internet doesn't make it accurate or correct. Opinions are as common a grains of sand. I can find anything and everything I want to back up my beliefs or what I want to be true. It's a big world of information and data out there. All of which can be interpreted many different ways. It is our nature. It allows us to think outside of the box and at times boxes us in.

I simple believe helmets help prevent serious injuries. To believe other wise is like saying seat belts and air bags don't work as well.

Of course I biased. I wasn't wearing a helmet, fell off my bike and hit my head. If I had a helmet on my injury would have been far less.

Yes, some people will read this and say that explains a lot.

 

[TCD]

From earlier posts:

>There have been epidemiologic studies that support the use of helmets while bike riding.

>There have also been epidemiologic studies that found no reduction in injury rates when the use of bicycle helmets was mandated.

In interpreting data, please note that these studies may be testing two different things. A study of the effect of wearing a properly fitted, appropriate helmet vs. not wearing a helmet is very different from a study of the effect having a helmet law vs. not having a helmet law. The second study is potentially far more complex, with all sorts of social and legal interactions.

These two study results do not necessarily represent contradictory findings.

TCD

 

[J.Dub]

I run along the roads around my house and I am constantly amazed at the number of drivers I see that are not paying any attention to the road and are careless; on cell phones, looking at the person next to them while talking, dealing the the kids in the back seat, eating, drinking, smoking, both hands off the wheel and my favorite, driving down the shoulder of the road.

All the more reason to trail run.

True, when road running you tend not to get whacked in the face with branches, as happened to me on Saturday, but I'll take that over an MVA any day...

 

[Stan]

Anyone who ever visits a head injury recovery room, for those fortunate enough to survive that far, will probably be a lot more cautious in whatever activity they undertake, including wearing a helmet on certain risky activites.

The debate over whether a helmet is wise or necessary on a bicycle seems to center on whether "studies" are valid and on the practical implications of wearing a helmet.

I would never put complete trust in studies and statistics but then I wouldn't put complete trust in other people's common sense either. Public policy cannot be made on the sole basis of one or the other. In the end, it is your individual choice that really matters ... but visit a head trauma center sometime.

I won't spend time reading those studies but I wonder if they addressed the issues some have raised here, like a proper helmet properly fitting, impact on behavior or even impact on the senses that may adversely effect hearing, vision or balance. Anyone who's worked with statistics also knows how easy it is to make false correlations.

Maybe when helmets are mandated for certain activites there ought to be an exemption, in the name of individual choice, for those who have an insurance endorsement taking financial responsibility for head injuries. The public cost, as well as the individual impact, has a lot to do with the reasoning behind such mandates. Let's see what the green visored statistical gurus say to that.

 

[DougPaul]

Studies are biased at best. Just because someone(s) writes something that gets onto the internet doesn't make it accurate or correct. Opinions are as common a grains of sand. I can find anything and everything I want to back up my beliefs or what I want to be true. It's a big world of information and data out there. All of which can be interpreted many different ways. It is our nature. It allows us to think outside of the box and at times boxes us in.

Some studies are biased. If you had checked out the references in the Wikipedia article, you would have seen that a number of them were articles in peer-reviewed British medical journals. (Peer review tends to find and fix biases and errors in studies.) Not just something that someone wrote on the internet...

Common wisdom (shared belief without evidence) is far less accurate and much more likely to be biased than properly done data-based (scientific) studies. (Eg "the earth is flat", "the earth is the center of the universe",...)

Many people have the belief that helmets improve bicyclists' safety. I was simply pointing out that the scientific evidence did not always agree with this piece of common wisdom. There are factors which people often fail to consider: poor helmet design, poor helmet use, changes in driver behavior, changes in bicyclist behavior, strangling by helmet strap (it has happened to young children), increased rotational leverage on the head and neck, etc. Properly taken epidemiological data will take all factors into account. (The different results from different studies are often due to different methodologies implicitly taking different sets of factors into account and random variations in finite data sets.)


I personally wear a helmet when cycling, but I am also aware that the evidence says that the apparent protection from serious injury may or may not be real.

Doug

 

[bikehikeskifish]

FACT: I once crashed my bicycle (during a race) in such a way that the area above and forward of my ear hit the stem (the L that connects the handlebars to the steerer) with enough force to leave a 3/4" deep impression of the stem in the foam of the helmet. In this case, the helmet certainly saved me from a serious headache (best case) and possibly from death (worst case) due to a sharp blow near the temple.

Sometimes I wish I'd saved the helmet, but all good manufacturers have a crash replacement policy where they get to study the impacted helmet.

NOTE: If you do impact a helmet in more than a trivial or glancing blow, you should submit it for crash replacement as in general they are only good for one impact, and due to exposure to the sunlight and other elements, only good for about 3 years (depending on use.)

Tim

 

[Little Rickie]

Some
I personally wear a helmet when cycling,
Doug

I'm glad you do.

I have no problems with science.

Words, whether scientific, leagal, medical etc attempt to explain the unexplainable.

There is far more things we don't know than we will ever know and there are other ways of knowing than just science.

Some are more comfortable with the "facts" and others are comfortable with the more intuitive understandings. One does not exclude the other.

Common sense if far from common but it still works well for must of us.

Science isn't definitive, it oftens corrects itself, as it should.

My common sense says, after I read the articles, that wearing a helmet doesn't prevent serious injury is poppycock.

 

[hikes-with-him]

I would be interested to hear how this discussion would go in another forum...say, MBpost.com (summitpost for mountain bikers...It's blocked here at work).

Personally, I think that all of these safety devices are only as good as the person wearing them...and how well they use the BEST safety tool of all...your brain!!! Do you KNOW what you're doing...have you studied, asked, learned, read, taken classes, etc.? Are you making decisions based on this knowledge? Would you know what to do if something did go wrong? As the code goes...can you save yourself?

 

[skiguy]

IMO aside from the studies of wether they save you from TBI or not.... they look kool....so why not where one? Not to mention there ability to make a statement about yourself

http://blog.mlive.com/michigan/2008/01/medium_h3-ap-080126-ski-helmet-winter-x-games.jpg

 

[Aviarome]

Of course, DougPaul has pointed out some interesting points, and I knew of the controversy of helmets, but I was not aware of the heated debates there are.

I also, while taking into account short-comings and problems, tend to follow and believe evidence from scientific journals or high-impact journals such as BMJ. But it is also important to point out that peer-reviewed journals do occasionally make errors and it's up to the scientific community to critique and reproduce the data. Point in case - and this is not to go off topic and too controversial - was a vaccine study associating autism with a certain type of vaccine. The BMJ later retracted this article and apologized when they learned that a lot of the information was falsified, and the study was found to be of poor quality. The issues of vaccines and autism is way off topic, but I just wanted to point out what happened to a particular BMJ article.

I did read much of the references that DougPaul pointed out. The Wikipedia article did a decent job of pointing out the different bias and problems associated with certain studies. I also agree with TCD that many of the outcomes measured for each study is different and needs to be accounted for. Also in the same journal issue of the BMJ article that DougPaul cited are a number of other articles that refute the evidence/arguments.

Of note, one of the articles did talk about risk compensation, ie people have riskier behavior when wearing protective equipment. The author cites a couple of references that do not support that claim, but if it were true, this would suggest evidence that helmets prevent serious injury is actually underestimated.

There are a lot of political, health, and social issues involved, and it's difficult and maybe out of place to debate these issues here. But as far as hiking with protective equipment is concerned, I think each individual has to assess their risk of injury - whether they perform riskier behavior, are hiking in the presence of rock falls, or if they tend to fall down a lot, etc - and then decide if head protection is necessary. Kind of like footwear. A huge trend is moving towards trail runners, but some people who are prone to spraining their ankles and such will still wear sturdier, leather boots.

aviarome

 

[DougPaul]

Of course, DougPaul has pointed out some interesting points, and I knew of the controversy of helmets, but I was not aware of the heated debates there are.

<rest of a good post snipped...>

I knew of prior heated debates on the topic and was aware that I was probably starting another. But informing people that the evidence does not universally support the common wisdom seemed to transcend the risk...

BTW, Peter J. Clinch, one of the authors referenced by the Wikipedia page, is also the author of "Pete's Pole Pages" which I have referenced in other threads, http://www.personal.dundee.ac.uk/~pjclinch/poles.htm.

Doug

 

[Paradox]

It's a subconscous thing -- a tiny fraction of an influence in one direction that can make the difference in collision vs. non-collision.
.

I had a pretty bad accident on my bicycle last August.

August thread

I have given some consideration to the idea that I would not have been going the speed I was going on an unknown road if I had not had a helmet on. I have always been a bit of a speed freak, so who knows?

 

[Paradox]

I think the image of the Special Ed kids on the bus is what keeps many from considering wearing a helmet. Vanity. When I was a kid we would not be caught dead wearing a helmet biking or boarding and now that's expected, cool even. Several references to the speed of hiking or walking have been made. Falling is faster than walking. Anybody that thinks helmets are too bulky or heavy or don't layer well hasn't spent much time in a helmet. Do what you want.

As I recall the hikes I have been on with you, you have had a balaclava covering your face. Clearly you do care about vanity

 

[Chip]

Wait until you see me in my new Fog Evader'Clava (same profile as mask) ! It makes me look just like Dr Ziogberg.

I'm psyched !

 

[skiguy]

Wait until you see me in my new Fog Evader'Clava (same profile as mask) ! It makes me look just like Dr Ziogberg.

I'm psyched !

Now that thing could have some definitive effect on your safety..I hope you wear your helmet in conjunction with that piece.

 

[Pete_Hickey]

A few years ago, I had a bit of an accident on my bicycle. I was wearing a helmet. I went down, the helmet cracked. I had been thinking that if I didn't have the helmet, I would have been dead or brain-damaged.

About 6 months after that, while hiking, I had a freak accident and fell off a cliff. I fell 30-40 feet, although I may have bounced on rocks on the way down. I don't know. I was alone and only remember waking up in a pool of blood. OK, I did have broken bones in my head, a concussion,etc., but it was a FAR greater impact than my bike fall.

My hiking fall was MUCH worse than my bike fall. If I had been wearing a helmet, it would have flown apart, instead of just cracking. I didn't end up dead, or brain damaged. (I was like this BEFORE the fall)

One thing that these two accidents did convince me of.... That all of those.. "helmet saved my life" stories are just stories.

It took me a few years to get rid of my fear of hiking on steep, slippery ice, but I did. I don't and won't wear a helmet hiking.


Fefo

 

[Trainwreck]

Hiking is the ONLY SPORT I do that does not require a helmet!!!

 

[Stash]

Enough of this study stuff...

Enough of the studies. Let's do some real life testing! Just like those guys on youtube.

I'll wear the helmet of my choice (I have quite a collection) and get someone to drop a 2x4 on my head from 10 feet.

Someone else do the same thing without the helmet.

We'll compare the results.

Okay... Who wants to be "someone else"?