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| Q&A: Dr David Hartman on Head Injuries (824 Posts)
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Sprains
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On 8/10/2004
G
wrote in from
United States
(64.207.nnn.nnn)
I sprained my ankle pretty bad about 10 days ago at the skatepark and had a question. I am racing in two weeks so I need a speedy recovery (ha!) and I was wondering what's best. Is it better to just stay off it and let it recover or is it better to get right back into it and start skating? I think if I don't try to skate it will get weaker, but someone told me to stay off it; either way I'm still putting ice on it at night...
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Cool is Cool
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On 8/8/2004
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Cool is good. Parents, remember, your kid will not wear even the best helmet, if it makes his head look like a dorkmelon. Shop for Michael's 4C's, but even if you can't find a Snell-cert helmet, the other agency labels still mean that you are getting a pretty effective brain-bucket.
Great post Michael!
DRDH
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the Four C's - Wearing a cool helmet is easy
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On 8/8/2004 Michael
wrote in from
Canada
(66.36.nnn.nnn)
How to get 'em to wear that helmet:
4 C's? Comfort, Certification, Coverage and COOL.
Moms and Dads, if you want your kid to wear a helmet, pick up the BEST-FITTING, then, COOLEST - LOOKING HELMET you find.
If you and yer kid FEEL cool with it on, 'cause it's a cool-looking helmet and, well, you could actually feel PROUD showing it off, you might protect your head way more often than, say, a white hockey helmet.
Chrome ones are cool (everybody, like motorcyclists, girls, guys at the track, check out my Bell chrome full-face helmet (on sale!) with a chrome visor -'' Oo.. shiny '')
Black ones with a CLEAR COAT look cool, blood-red ones with a shine look cool, too. Forest green fading to black looks cool, too, if you're not sure where to start.
If your kid's friends give crumby advice so THEY get the goods, shop alone with yer kid and watch his face for light-ups. Consider THAT helmet- but, not if it's too big, 'cause then, it's not safe and absorbtive of shock.
Try fitting one: Can you jam your thumb between it and your head, anywhere? Can you fine one that fits a bit closer to yer head's contours just over there, on the rack? If it tips back and forth, no prob. because the straps will take care of that when you buy the helmet (have the salesman help you out for five or so minutes). What's important, is that it can't bobble around on your skull. It should touch everywhere without pressure. Right?
And that the straps tug the helmet down when you open your jaw. Not tight, snug and won't slide back or whatever when your melon slides across the avenue.
A helmet, with a SNELL rating might be safer. On the Web, I found -I think- that they smash it harder than other standards organizations.
And, it's gotta cover up front. Forehead: adjust the straps so that it sits kinda close to the brow when the straps are flush against your head. Bigggie for bikers.
And out back, 'cause THat's a super-common place to hit your head, right? (sits FAR from neck, though)
- If it LOOKS COOL, YOU WON'T FEEL LIKE A DUMMY. (and won't slur after the accident, right?) COol paint, cool shape, not huge and ridiculous.
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Just click on the link for Slide technique information
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On 8/5/2004 Cliff Coleman
wrote in from
United States
(64.171.nnn.nnn)
Thanks for the help Dr. Dave! Here is the link: http://www.geocities.com/sk8sanjose/
Big thanks go to HC for his web-site.
Cliff Coleman
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Advice from the Master
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On 8/4/2004
Dr. Dave
wrote in from
United States
(68.74.nnn.nnn)
O.K. People:
You are hearing about slide gloves and their benefits from The Master of the Coleman Slide himself. You can't get much closer to a sermon from the SK8 mount than that! Get the gloves and learn to slide, or if you can't, get some wrist protector gloves with those shock-absorbing plastic "springs" on the palm. 'nuff said. And thanks Cliff! If you can point our readers to some web info on your technique that would be cool.
SK8 on,
DRDH
SK*
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Crashing and injuries
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On 8/4/2004 Cliff Coleman
wrote in from
United States
(64.171.nnn.nnn)
Dr. Dave.
Please help me to incourage more riders to wear slider gloves! Through four years + of Slalom racing where most everyone is pushing it to their limit, riders with slider gloves have yet to injure themselves seriously. I'm not even aware of any road rash occuring to racers with slider gloves. However, for those without the slider gloves, there is a growing list of broken bones and hospital visits. These slider gloves are a cheap investment in your future and it is not necessary to have sliding skills to use them. They are the only safety equipment that helps in a crash, but also helps to prevent crashes from happening. For riders who don't have sliding skills, they allow the rider to slide when transitioning from a fall to their hands on the surface of the road. This stops tumbling and therefore most impact injuries.
Come on people, time to get on board! These slider gloves let me at the age of 54, nearly 55, to charge the Giant Slalom at La Costa this year with no fear and to qualify 21st out of 102 racers. I slipped in 1998 on wet tile and broke my foot. Without insurance it has never been fixed. I can still race and ride at about 80 to 90% of what I might be able if my foot were ok. These glove are what let me skate at all. I sure wish I could afford the insurance!
Two people at the race broke bones and are hopefully recovering fully now? They were not using slider gloves, ouch!
Timeship racing has very good slider gloves as do other manufacturers. Save yourself, save your skating children, and help save your friends. I'm not selling a glove at the moment, This post is not motivated by possible income, I just want to see a safer sport.
Sincerely,
Cliff Coleman
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Helmet Display
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On 8/3/2004
Dr. Dave
wrote in from
United States
(68.74.nnn.nnn)
Hey George G.
Sounds like your helmet bit the big one instead of your face. Good deal. Ever consider going down to your local Container Store and getting one of those transparent plastic cubes to display that helmet? Makes for a nice coffee table conversation piece and a good advert for helmet use :)
SK8 on,
Dr. Dave
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Helmets
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On 7/29/2004
george g.
wrote in from
United States
(159.87.nnn.nnn)
After seeing some vicious crashes at Elsinore Giant Slalom last year I went ahead and bought a Downhill Mountain Bike helmet. With the visor removed it was much better and I have used it at all of the G/S races. I use an open face for T/S because for me it is easier to see. Ramp starts cause me to really look down. But I really liked my full face for G/S, it causes me to focus. Well this weekend I shattered my full face-but I walked away! It was money well spent and will be buying a new one shortly. I have no doubt that I would have been seriously injured. I was really going for it and slammed hard. The helmet was a pro-rider with all certifications. the interior looks like a broken egg shell-It looks really cool with my trashed ICK Stick sticker and will proudly reside in the garage. I am a believer! Wear helmets!
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Helmets
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On 7/27/2004 Old and Gray
wrote in from
United States
(69.63.nnn.nnn)
Helmet
Never leave home without it!
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Good volley
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On 7/6/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
Not much for me to add to this backandforth, except that a skatepark that doesn't enforce helmet regs is asking for a major lawsuit. Nothing like a skull hitting concrete to make the lawyers happy.
Haim, have you had a bone density scan? Take your calcium, bwana. Search the list about electrical stimulation of bones to enhance healing of fractures. Maybe your local hospital has a unit you can use. Might help you heal faster.
It takes a while for bones to heal, and I wouldn't go back to skating before a docs says the bones are knitted. You may also need some physical rehab to get your muscles back in shape before skating again. Don't try it early, or you'll regret it. You've dodged a bullet with the MS, so heal up and rehab the leg after. If your hearing continues to worsen, see a neuro-otologist. Sometimes, there are surgeries to replace part of a damaged inner ear. Let us know on all counts.
DrD
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Helmets and MS Posts
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On 7/6/2004
North Carolina Longboarder
wrote in from
(63.167.nnn.nnn)
MSK: Thanks for the info. So basically, helmets are required but not inforced...ok..well, that's probably a boom for the transplant surgeons.
Haim: Dude! I had the ringing in the ear too! I forgot about that...and guess the freakin' what? Brain "scar tissue"! (turns out it was from a the time I got hit by the car on my road bicycle in 1981 and I slammed my head into a telephone pole). I am glad you are alright ...good luck with it all.
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re: Helmets in parks
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On 7/4/2004
msk
wrote in from
(68.190.nnn.nnn)
In order to be free from liability, California's liability law requires parks to require helmets. The first line reads:
"(a) No operator of a skateboard park shall permit any
person to ride a skateboard therein, unless that person is wearing a
helmet, elbow pads, and knee pads."
Most of the parks I've skated are not staffed, so in order to comply (as described in the law), the city has to enact an ordinance requiring helmets and pads, and post signs warning that violators can be fined. Some cities are very aggressive in enforcing these ordinances, while others basically look the other way...
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wrong forum, sorry
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On 7/2/2004 steve
wrote in from
(68.127.nnn.nnn)
Since nobody reads the safety equipment forum, I'll ask this here. If its location is horribly offensive, just rate it as abuse and it'll go away!
Does anybody know where I can get a Dangersticks Duce helmet? Their internet page is GONE. Is it CPSC rated? I saw it in the CW Buyers' Guide.
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The MS scare
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On 7/2/2004 Haim
wrote in from
(81.218.nnn.nnn)
my right ear started ringing, and then I did a hearing test which showed some pretty severe loss of the 3000-5000 decibel range. I did the brain CT (no tumors) and MRI - which showed lesions which could be MS. The neurologist was pretty sure that it was MS, but the other tests - VEP and spinal tap - were fine. Since the hearing does not seem to be deteriorating and I don't have any of the usual tell-tale signs of MS, they think that the MRI was simply too sensitive a tool, and the hearing loss is unrelated. Probably from all these years playing soldier - I'm a sniper in the Israel Army reserves. Interestingly, a friend who has MS, told me that 20% of 40-yr-old males will have brain MRI with lesions looking like mine...
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North Carolina Longboarder
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On 7/2/2004
MRI and suspected MS
wrote in from
(63.167.nnn.nnn)
Haim: I had the same scare a few years ago with MS. What symptoms were you having that led the doctor to look that direction? I was having burning in my face and jaw and in my ear, especially after heavy activity...I was racing mtn bikes at the time. My doctor, however, was looking in the wrong direction because it turned out to be a bad disk in my neck that was pressing on some nerves...unfortunately, we found that out by having to have an MRI of my neck when I did a two footed over the handlebar dismount with a one point landing (my head) during a race. Blew the disk between c6 and c7 to pieces and now I have a titanium plate and bone graft there. I am not a doctor but you may want to see if the symptoms you are having are related to an issue with your neck....
Sorry to hear about your leg. Get well soon and back on the board. FYI-I'm 41 and try to stay real fit...it helps with recovery for sure!
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Broken Fibula
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On 7/2/2004 Haim
wrote in from
(62.219.nnn.nnn)
Hi Dave,
I wrote in a while ago about an MRI and suspected MS....Thank God that has not panned-out as all the other tests came-in negative. Anyway, last night I came down hard on my right ankle, and broke the fibula. So I'm sitting here with my cast-on, bummed, and trying not to get depressed. The orthopedist said it was not bad but to expect about 6 weeks in-cast. What determines the speed of return to normal activity (which includes skating...)? I'm 39, and fit, by the way.
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Helmets In Parks
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On 7/1/2004
North Carolina Longboarder
wrote in from
(63.167.nnn.nnn)
Well, I have always been one to be the first to step up and say I'm wrong when I'm wrong but it appears my last post was incorrect. According to another poster in the Parks and Pools forum California has a law that basically relieves park owners from any liability whatsoever. I still believe that riding without a helmet is not a bright idea but I guess I will just be the old dork wearing all the gear...
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SkateParks and Helmet Rules or Lack There Of
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On 7/1/2004
North Carolina Longboarder
wrote in from
(63.167.nnn.nnn)
Dr Dave: Here is a clip from an article that was was posted by Michael Brooke on his forum that was taken from an article in a St Louis newspaper regarding older skaters that disturbed me:
"My wife says that if I break my arm, she'll break the other one," says Graf, who joins fellow veterans as among the few in the skatepark wearing protective helmets."
My question is this: How is it this day of ridiculous litigation in this country where people can sue freakin Mc D's because their coffee was too hot that skateparks of any type can and willingly allow skaters to skate without helmets? This makes absolutely no sense whatsoever and I find it incredibly irresponsible of the parks to do so. And before the readership goes off on me about how the use of helmets should be a personal choice and not "mandated" or "dictated" or "decried" by "the man" consider this point- if the insurance industry decides that it is too risky to insure skateparks for liability the cost of that insurance will skyrocket past the incredibly high rates that they probably already are now. That means for us skaters the less likelyhood that other parks will be built and that the few that remain will begin to have overhead cost that make doing business much more difficult. That means higher user fees or parks closing all together.
Do I think everyone should wear helmets when they ride? Absolutely. If you have read any of my previous posts you will probably remember that I had a major head injury while cycling without a helmet. Do I think it should be a matter of choice by the rider? Also absolutely.....but only in the case where their lack of concern for their own well being does not potentially have a greater impact on the skating community as a group. In my humble opinion, skate parks are not doing any one in the skating world a favor by condoning irresponsibility and the risk of rising liability costs.
And for you out there that feel that waivers are the way to mitigate this liability you may want to discuss that with a personal injury attorney and ask him or her how many times they have won cases for their clients when a waiver was in place....
Dr Dave, what is your opinion on the matter?
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No Pain
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On 6/29/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
SM
No pain is no pain: standing on it, moving it, twisting the leg from side to side, climbing stairs, etc. If it hurts on any of these, it's not fully healed. If it hurts bad or you hear rubbing, clicking or popping in the knee joint, there's a knee doc needing to be seen. Let us know how you do.
DRDH
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Knee Damage
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On 6/28/2004 Sketchmaster
wrote in from
(4.22.nnn.nnn)
Negative on the aggravating symptoms. Do you have any tips on evaluating knee injuries? One of my friends has a permanent issue that he had treated professionally. He showed me some sideload type evaluations including one where he laid on his back with the bottom of his foot against a wall to partially load the joint. That was the one where his injury was found. I would like a good solid way of determining that I'm "pain free" before I start back up again.
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Doin' the boneless chicken dance with Sketchmaster
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On 6/26/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
SM,
I can't tell whether anything's going on with you, and I can't officially recommend drugs in this venue, but Non-Steroidal Anti-inflammatories (NSAIDS) like Advil, Aleve, etc. are good for reducing inflammation if you are not sensitive to them. Ditto Glucosamine/Chondroitin.
If your ankle or knee is weak, if there's pain, swelling, limited range of motion, skin feels hot over the affected area, hie thee to your leg doc. I think you should give things a week or two or when you are pain-free before you do the boneless chicken or whatever again. Let us know how it goes. Sounds like it could have been a lot worse.
DrDH
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And now for mine...
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On 6/25/2004 Sketchmaster
wrote in from
(4.22.nnn.nnn)
Thanks Dr. Dave. I specifically mentioned the high pain threshold for the reason you are referencing. Pain is often incorrectly used as a criterion in injury analysis. I personally had a doctor tell me my femur was not broken because if it were I would not be able to tolerate the pain, etc... The X-Ray disagreed with his opinion.
Anyway... I wanted to shake my injury out for the day before I bothered you with it so I would have a better idea of what I've got. I bonelessed down a flight of stairs yesterday at the Wedge. I hit the last stair; Bad news. From a spectators point of view I imagine it was pretty mundane. From my point of view it involved all of my weight coming down on my right leg. I went into the "chicken dance" as all of my ranges of mobility bottomed out because I was so well centered that I never fell. I wish I would have stacked. At the end of the event I could feel my ankle torquing and then my knee; All in expanded time for my pleasure. The ankle is not a serious concern because I have twisted it way worse before and I recovered to better than 100% after going through a few months of excercises that I picked up off of another medical professional (Does anyone remember SIO Barry?). My main concern is the knee. I was able to limp off to the truck and drive home. I slept it off and when I woke up this morning it was almost as if it had been a bad dream. I had zero pain. Then I stood up. The pain was bearable and diminshed throughout the day. I probed all over the joint and the only way I can induce pain is by forcing my calf diagonally in and to the rear. I don't think I have a permanent injury here. If there's anything I can do to speed up the healing process I am motivated to do so. The excercises Barry gave me for the ankle were astounding and I would greatly appreciate any info in that direction. Thanks.
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Doin' the Twist with Sketchmaster's Buddy
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On 6/25/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
Well, yes, I have some ideas - the joint or the lining of the joint may be injured/inflamed. Sounds like it's worth a trip to an orthopod for an x-ray, steroid injection or whatever. These things are slow to heal, and you want to help it along. Having a high pain threshold is not necessarily a good thing if you let stuff like this continue to hurt. Injured joints can become arthritic and limited in range of motion more easily, so early treatment is a good thing. And another idea to tell your buddy: A SK8 wrist guard.
DRDH
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Torqued Thumb
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On 6/25/2004 Sketchmaster
wrote in from
(4.22.nnn.nnn)
I have a friend that did a full blown superman and when he landed he torqued his right thumb back way further than it should have gone. There was significant swelling at the time of the injury. After three weeks the swelling seems to have subsided. However, when I probe this thing the joint is significantly larger than the joint on the other thumb. Theres nothing soft and squishy left and the thumb doesn't appear to be broken. He still has some pain but he does have a high pain threshold. Do you have any ideas regarding the enlarged joint?
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Cranium Conundrum
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On 6/12/2004
North Carolina Longboarder
wrote in from
(63.167.nnn.nnn)
Ken: Great advise on the helmet! No worries on the mail order. I actually do almost 85% of my shopping online. Last Christmas I actually didn't go into any stores at all to get the list of stuff I was responsible for! And, yes, keeping the CFO happy makes it alot nicer around the house!
Just a point on the Giro helmets: I took a major crash in '99 wearing a Giro in a mountain bike race and I believe it saved my life. I did however blow out the disk between C6 an C7 vertrabrates and now have a bone graft and titanium plate and 4 screws in its place...but heck, its titanium! I am stronger and lighter now!
Thanks again for the advise.
Roll on Brothers and Sisters Roll on.
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