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| Q&A: Dr David Hartman on Head Injuries (824 Posts)
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Into the time slip
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On 9/5/2002
Dr. Dave
wrote in from
(12.249.nnn.nnn)
George,
My first thought would be that with a surge of adrenalin, you are getting a huge jolt of brain activity prior to hitting the ground. This lets you see the "big picture" very quickly and as a result everything else seems slowed. Interesting question. I'll see what else I can find for you, assuming that you are still compos mentis after more of these time-slowing crashes of yours. . . .
Sk8Safe, drD
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time?
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On 9/5/2002
george gould
wrote in from
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i got a question for Dr. Dave, when i wipe out why sometimes does time seem to slow way down, don't get me wrong sometimes it happens so fast i don't think i remember, but sometimes it all goes slow motion. is there an explaination for this? thanks George.
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Head injuries
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On 9/5/2002
Dan Hughes
wrote in from
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I say that head injuries are nothing to take lightly. Example, Girl at age 10 dies after practicing football, wearing a helmet.
Full story:
http://www.guardian.co.uk/uslatest/story/0,1282,-1992548,00.html
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dumb kids...
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On 9/4/2002 Patio Mendino
wrote in from
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you can ask kids to wear a helmet, but like us Catholic school kids "the tighter you try to grip 'em, the more they squeeze out between your fingers".
Parents can accompany the kids to the skatepark.(they really should anyway, as this sport involves a good chance of injury. I saw a little girl get her ankle taken out last weekend at Vans, and they wanted to know where her mom was and she said "iiiIIII doooooonnnn't knoooooowwwwww" in a pitiful little 7yr old girl sob). but when the kids are street skating, it has to be up to them, along with positive adult reinforcement.
when I started racing mountain bikes, many were too cool to wear helmets. now, everybody does.
it's a curve, and I see helmets getting used alot more by skaters lately.
I had broken many bones from skating by the time I was 16. My mom suggested "for my own good" to stop skateboarding. I started surfing alot more, but a skateboard was always in the trunk of my car. I hit ramps and curbs and parking lots regularly. a few scraped knees needed intricate stories that I'm sure mom never believed. It's hard to hide a "hipper limp" from mom. but I wasn't "really" skateboarding(that much)...
I did my head injury at 21. If I had obeyed mom...doh!
P@io
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helmets etc
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On 9/4/2002 snoball
wrote in from
(65.32.nnn.nnn)
Well, if my tax dollars are actually doing some good,
and giving medical care for those who can't afford I'm
fine with that. At least there's some assurance,
thanks to your medical experience, that it's happening
and they're being used for their intended purpose.
I have skated for most of my life and the one sport
that made me wish i'd had a helmet available was snowboarding.
You're correct about that heel edge Patio. I hit the
back of my head so hard one time, it literally popped
the lenses out of my goggles. I could deal with spilling
forward, but you catch a heel edge and BAM! your just
looking up at the sky wincing before you know it. After
a few times of that, I just layed there and made snow
angels :-)
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helmets
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On 9/4/2002
Patio
wrote in from
(207.16.nnn.nnn)
anyone who stands/rides with a (snow)board strapped to their feet NEEDS a helmet. Catch your heel edge going downhill, your body becomes a "hammer" and your head will "nail" the ground. you gain more head smacking speed with the downhill added in...
George, I am so happy you were wearing a helmet.
slalom...you are close to the ground, when you begin to fall, you have already hit the ground.
mini ramps, more or less the same thing.
downhillin' you usually know when you're falling and have some reaction time.
Vert, same as above.
be safe, but have FUN!
P@io
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Decisions, Decisions
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On 9/3/2002
Dr. Dave
wrote in from
(12.249.nnn.nnn)
I have a couple of arguments against the laissez-faire belief that everyone is entitled to make their own helmetless mistakes.
1. Adult judgment doesn't really get fully wired in until late teenage years or even later. That's the age when the frontal lobe - the major site of executive judgment - gets fully myelinated (and fully working). A kid's judgment is not the same as an adult's and shouldn't be treated as such, from both a neurological view and a parental view.
2. Most people who decide not to wear a helmet have absolutely no idea how badly a fall can damage a brain, even in new school moves. Just ask my friend and helmet posterboy Patio.
3. Finally, if nothing else convinces you that mandatory helmets are a good idea, consider who pays for the millions of dollars of neurosurgery, rehab, nursing care, etc. for all those uninsured kids and adults who are taking the helmetless risk. You do, from taxes that get taken from your paycheck. So, when someone decides not to wear a helmet, they are not only making decisions about their own health risks, they will spend your money in doing so.
Just a few late night thoughts for all you libertarians out there (g).
skateSafe drD
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lid laws
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On 9/3/2002 snoball
wrote in from
(65.32.nnn.nnn)
Thanks for your perspective Dan. I tend to waffle myself
about helmets I'm afraid.
As far as helmet laws go, I look to bikes and can see
it's nearly uninforceable (sp?). In my state it's
THE LAW, but people ride around frequently without them
and don't get ticketed. For the police, it's a low
order of priority. Pull over the bicyclist or pull over
the dude going 90mph in a 35 zone. And a variety of other
decisions on the crime scale that must be made I'm sure. The helmet law for bikes was instituted for the same reason people want a law passed for skaters, but it hasn't had much *real* affect from what I can see.
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required helmets
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On 9/3/2002
sk8nwolf
wrote in from
(152.163.nnn.nnn)
I usually only sk8 with a neighbor kid, but being older than he is, I talked to his mom and told her that I WILL NOT skate with him unless he has a helmet. I didn't care if it was his rollerblades or borrowing my board, I knew he could afford it (he just got a nice chunk of $ from petsitting for me), so there was no excuse. I don't want to go to his house or call his house from the hospital and tell his mom 'your son hit his head on the ground, and well...'
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Kids and Safety Equipment
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On 9/3/2002
Dan Hughes
wrote in from
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On the topic of knee pads, etc, check out the safety equipment section and scroll down to:
My .02 on Pads On 8/22/2002 Spat wrote in from 152.163.
He has a good deal of information on knee pads. On his post alone, I ordered some pain cheaters.
On the topic of kids and safety equipment, ie helmets. I have a 16 year old, and there is a lot of difference between a 12 or 13 year old, and a 16 year old. I can tell him that he's not going to skate unless he's got a helmet, however, I'm not able nor am I interested in monitoring his every move. If I take the board away, he can walk down to the local public skatepark, and borrow a board. So, at this point, parenting changes. It becomes more of a "strong guidence" than total control of the child. So, I made him read Pateo's experience, and all he had to go through from just one fall, on the street. And I tell him that no one skates unless they have a helmet, on my street!. But, when I'm not here, I can't enforce that rule. Parenting from a childs perspective looks simple. But, it's not, and it changes or evolves as the child gets older.
Because I skate, I think it's a little easier for me to lead by example.
But, my original point was if making a law would solve the problem of kids not wearing helmets, then great, let's do it, but I don't think it's that simple.
dan
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Required helmets etc
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On 9/3/2002
Uxorious
wrote in from
(12.152.nnn.nnn)
I must admit I don't like the idea of *requiring* protection. Most sane people should know that you need to wear a helmet if you do dangerous stuff, but if you're just out messing around in the park on skates/board I don't think it's neccesary. Sure an accident could happen - but so could it when you walk to the mailbox.
If you ban dangerous things and/or enforce too much protection then the kids stop thinking about their actions - they will think "I'm allowed to do this so it must be safe. Let me try this crazy thing then".
Getting bruises and stitches is part of growing up and learning your limits. Most of us adults have scars from some stupid thing we did - and most of us got smarter in the process.
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Recommendation for pads
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On 9/3/2002
Uxorious
wrote in from
(12.152.nnn.nnn)
I'm a big guy (6'3" - 230 lbs) and recently I tested my trusty old pads to the limit (hit a vert knee-first with decent speed).
What pads can you recommend so that I won't have to limp around for 3 weeks next time that happens?
(Most pads I try at stores are WAY too small for a bigun like me - I usually don't fir my leg inside them and will have to live with just strapping them on.
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lids
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On 9/3/2002 longboardbuddha
wrote in from
(194.117.nnn.nnn)
i have this conversation with kids all the time but i dont "tell" them anything and thats the trick...kind of like osmosis you have to plant seeds in their heads that make them "think" its cool to wear helmets and pads...that means wearing them yourself,laughing at clowns who dont wear them, cussing unhelmeted and sponsored skaters style (ie they might have a good style but cuss them anyway)you know what i mean?
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parents without persuasion
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On 9/3/2002
snoball
wrote in from
(65.32.nnn.nnn)
Dan, I *have* to ask this:
Why don't you just tell your son,"No helmet, no board. Period." ?? No offense, but I have to wonder what's going
on with parents who see themselves as helpless to their
children's whims/wants/demands. I'm not implying you have
this problem, but I see it alot. I've heard mothers say,"Oh,
he just won't wear it. He doesn't like it."
Huh?
If helmets were an option when I was a kid, and my mom
were educated to them, there is NO WAY I would've been
allowed on my board without one and all mad hell would've
busted loose on me if I defied her.
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Helmet topics cont.
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On 9/3/2002
Dan Hughes
wrote in from
(162.78.nnn.nnn)
(don't hit the tab and then the space bar...opps)
Anyway, my cell phone rings, and my son tells me that his buddy got the speed wobbles and was pitched. Hit his head/shoulder/arm/etc. I asked him if he tried to foot break. He said no. So, Jacob, is taken to the clinic by his angry/concerned parents. He gets 4 staples in his head and appears to be alright.
His father calls me later, telling me that he's going to break his board, and that he's not going to be able to play football for a couple of weeks.
One of the things I've been thinking about, is the idea of making wearing a helmet a requirement. This was one of the recomendations by one of those studies, quoted by Dr. Dave.
Sure, this would an ideal situation. But making kids wear helmets is a nearly impossible if they don't want to.
Just my .02 cents.
dan
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Helmet topics.
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On 9/3/2002
Dan Hughes
wrote in from
(162.78.nnn.nnn)
I've been telling my son and his buddies (who are 16, but think they know more any of put together), that they need to wear their helmet. Even while street skating (flips tricks). But, alas they fight me tooth and nail.
Last saturday I'm out shopping with my wife, my
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snowboarding and helmets
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On 9/3/2002
stevep
wrote in from
(64.81.nnn.nnn)
glad you are alright, you brought back memories of my SL accident 8 weeks ago (broken collarbone, 1 good hit on the helmet).
re: boarding and helmets. i won't step on a hill without a helmet - those other people are idiots. a out of control skiier/boarder can gather a whole bunch of speed and take you out of the game completely! i got clipped from the side at Pico last year on an empty slope - a skiier was bombing the hill and didn't look right or left.
this year, i'm adding a chin guard - better safe than sorry.
cheers!
steve
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crashed
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On 9/3/2002
george gould
wrote in from
(159.87.nnn.nnn)
Sun, I was running cones on a pretty big hill. i sucked a cone under my deck and flew, when i blow off at a park i usually know what is going to happen and ride it out on my knees. but slalom is a different animal and i took off, i know i felt my helmet hit the ground hard two times. as i laid there with this huge adrenaline rush and realized i was basically alright, i actually thought of Dr. Dave! amidst a whole bunch of other thoughts. i completely blew away a triple 8 wrist guard (you know those things are bomb proof) and my helmet has but two small scratches, i know i wouldn't have walked away without it. (my wife said she heard my helmet hit and she will buy new stuff for me, is she cool or what)just a few bruises on my hip. after this fall and reading Sept Ski magazine i will probably end up wearing a helmet this snowboard season too, if for no other reason that a collision with another person would be devastating, i figure fully equipped, i weigh in excess of 250 lbs (water, jacket, boots, etc) with a helmet the old noggin has a better chance, i can kill brain cells easy enough on my own...
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Scientists on Skateboards cont.
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On 8/30/2002
Dr. Dave
wrote in from
(12.249.nnn.nnn)
Here's another study abstract related to U.S. boarders, from Sports Medicine 1996 Dec;22(6, 360-6
Skateboarding injuries.
Fountain JL, Meyers MC.
Department of Health and Human Development, Montana State University, Bozeman, USA. Jodi911@aol.com
Skateboarding has experienced intermittent periods of popularity since the 1960s. Along with this popularity, there have been concomitant increases in numerous types of injuries. Most documented cases occur in boys aged from 10 to 14 years, with injuries ranging from minor cuts and abrasions to multiple fractures and, in some cases, even death. Although head injuries account for approximately 3.5 to 9% of all skateboarding injuries, fractures of both upper and lower extremities account for 50% of all musculoskeletal trauma. Not surprising is the fact that 33% of those injured on skateboards are injured within the first week of skateboarding. Most individuals experience some form of trauma during the initial attempt at skateboarding. Because of the nature of skateboarding, encompassing both high speed and extreme manoeuvres, injuries often occur when the skateboarder collides with an immovable object, falls from the skateboard or is involved in vehicular traffic. Most injuries occur when the skateboard strikes an irregularity in the riding surface, projecting the skateboarder in the direction of travel. Despite traffic legislation, 65% of injured adolescent skateboarders sustain injuries on public roads, on footpaths, and in parking lots. Several organisations have recommended safety guidelines and restrictions based on age and common sense. Use of a helmet, knee and elbow pads, and wrist guards should be required of all skateboarders, as well as some type of formal education. The American Academy of Pediatrics recommends that children under 5 years of age should not be allowed to ride skateboards. At an early age, injuries occur due to several reasons. These include high centre of mass, immature skeletal development, an undeveloped neuromuscular system, and simply poor judgement. Skateboarding injuries are expected to rise with the increasing number of participants, high-tech equipment development and renewed advertising. Although limited preventative measures exist which will totally eradicate skateboarding trauma, some thought to actual restrictions may decrease the incidence and severity of injuries.
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Interesting conclusions
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On 8/28/2002 Antti S. Brax
wrote in from
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Conclusions say collisions with motor wehicles are an issue even though the numbers say nothing about it.
- Most children were injured while skateboarding in parks
- Only 12 (9%) were injured while skateboarding on roads
- Falls caused by surface irregularities resulted in the highest proportion of the moderate injuries.
My conclusions: build better parks.
Also remember that this study was made in Sweden where skateparks are not like in the U.S.
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Fresh from the Stacks
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On 8/26/2002
Dr. Dave
wrote in from
(12.249.nnn.nnn)
From the British Journal of Sports Medicine 2001 Oct;35(5):325-8
Skateboarding injuries of today.
Forsman L, Eriksson A.
Section of Forensic Medicine, Department of Community Health and Rehabilitation, Umea University, Umea, Sweden.
BACKGROUND: Skateboarding injuries have increased with the rise in popularity of the sport, and the injury pattern can be expected to have changed with the development of both skateboard tricks and the materials used for skateboard construction. OBJECTIVE: To describe the injury pattern of today. METHODS: The pattern of injuries, circumstances, and severity were investigated in a study of all 139 people injured in skateboarding accidents during the period 1995-1998 inclusive and admitted to the University Hospital of Umea. This is the only hospital in the area, serving a population of 135 000. RESULTS: Three of the 139 injured were pedestrians hit by a skateboard rider; the rest were riders. The age range was 7-47 years (mean 16). The severity of the injuries was minor (AIS 1) to moderate (AIS 2); fractures were classified as moderate. The annual number of injuries increased during the study period. Fractures were found in 29% of the casualties, and four children had concussion. The most common fractures were of the ankle and wrist. Older patients had less severe injuries, mainly sprains and soft tissue injuries. Most children were injured while skateboarding on ramps and at arenas; only 12 (9%) were injured while skateboarding on roads. Some 37% of the injuries occurred because of a loss of balance, and 26% because of a failed trick attempt. Falls caused by surface irregularities resulted in the highest proportion of the moderate injuries. CONCLUSIONS: Skateboarding should be restricted to supervised skateboard parks, and skateboarders should be required to wear protective gear. These measures would reduce the number of skateboarders injured in motor vehicle collisions, reduce the personal injuries among skateboarders, and reduce the number of pedestrians injured in collisions with skateboarders.
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Agony of de Feet
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On 8/25/2002
Dr. Dave
wrote in from
(12.249.nnn.nnn)
Kevin
Two pieces of advice (1) Try a skateshoe with airbags in the heel (2) see a sports podiatrist - they are really good at this sort of thing.
skate-on
drD
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Heel pain
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On 8/23/2002
Kevin
wrote in from
(209.179.nnn.nnn)
I have noticed after a session of bank riding or hill
carving that only my heel on my pushfoot/backfoot
is stiff for a few days. I really do stretch before
and after. I can do all regular activities just fine
with a little stiffnes only on the ball of the ankle.
Time seems to be the only cure.
Can I speed up the healing or stretch differently?
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Hip Advice
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On 8/19/2002 Al
wrote in from
(67.82.nnn.nnn)
Dr. D / Patio thanks for the advice - in reflection I realize an interesting characteristic of miniramps (where I usually take a hip) - on a larger ramp/pool of 6/8 feet or higher you have time to swing your body around to take the slam on your knees - but on a 4' mini - the flat comes up AWFUL quick.....thanks again................Al
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hip pads
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On 8/19/2002 patio
wrote in from
(63.65.nnn.nnn)
go to sports authority, or your local sporting goods store that caters to high school football too.
a pair of foam hip pads will cost $6-12$(pro-designed has the same sorta thing for $20+)
sports authority has "bike" brand pads. get the adult hip pad set($12). when you stick them in the sides of your shorts, the waistband holds them in place until you slam, then they will need re-adjusting.
or you can run a "belt" through the pads for more stay-up power.
I mainly fall on my leading hip, so I always use one there.
hope this helps...
p
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