"Helmets don't eliminate concussions" American Football

This sub-forum all discussions about this "lively" subject. All topics that are substantially about helmets will be moved here, if not placed here correctly in the first place.
tim-b
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Re: "Helmets don't eliminate concussions" American Football

Postby tim-b » 11 Sep 2019, 7:56am

Hi
So by definition helmets have had a detrimental affect to overall safety in the pro ranks...

An item of Personal Protective Equipment insisted upon by the UCI to increase safety that has been taken up by professional cyclists in their thousands since becoming mandatory in 2003 has a detrimental effect to overall safety, and none of the pros have noticed this?
Not only have they not noticed it, but neither have the very experienced medical staff behind those teams, which is clearly why pro-cyclists haven't gone on strike like they did in 1991
I wouldn't wear an item of PPE that can be shown to reduce my safety at work, and neither would you, so why would a pro-cyclist? Sponsorship money isn't everything
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tim-b
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pjclinch
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Re: "Helmets don't eliminate concussions" American Football

Postby pjclinch » 11 Sep 2019, 8:17am

Mike Sales wrote:Risk homeostasis is essentially a balancing of risk against reward.


Not that simple. While there's an element of that there's also an element of people just run at a level they think is safe.
So, if a driver goes on The School Run pickup and leaves 15 minutes contingency for bad traffic, but traffic's much clearer than usual they'll still drive at the speed limit and arrive early, even though all they get to do is wait longer. They do that because they're confident and perceive themselves to be safe at the limit they're used to driving to, even though they could be safer by slowing down and not losing anything.

Mike Sales wrote:The risk of losing a race may be important to a professional cyclist, but the risk of a disabling head injury or death weighs rather more heavily.


That's more at the calculating end of it. Commenting on technical descents David Millar has noted that younger riders tend to show rather less fear than older ones, as Neil Peart's lyric to "Dreamline" suggests, "learning that we're only immortal for a limited time", so people do tend to become more risk averse with age, and also responsibility. I know a few folk who decided winter climbing wasn't such a good idea once they'd become parents, for example.
But at the sharp end the calculating aspect is more whether the risk-taker believes it will go or whether it won't. People have an inbuilt aversion to disaster and will not court it unless they have good reason to think they'll get away with it, but "safety gear", even if that's a St. Christopher medallion on a staunch catholic, will warp the idea of where the line is. Here is where the idiocies of helmet promotion culture really come up, in suggesting that "safety" and "wearing a helmet" are the same thing. They're not, but you could think otherwise looking around at UK perceptions, and the bigger the perception of safety the more warped the perception of the actual risk can be.

It's important that people understand the limits of their "safety equipment", and the degree of stupidity surrounding cycle helmets is huge. I read a post once of a cycle trainer who'd noticed a disconnected brake and reported it back to the parent who said they'd done that as the brake was rubbing but it was okay as the child had a helmet. Wasn't sure whether to believe that, but then came across exactly the same thing myself. But this is an information and culture problem, not so much a helmet problem.

American Football has some different issues to cycling because the helmet has been used to actively change the way the game is played. People started to use their heads as battering rams. There was nothing stopping us doing that back when I played rugby, only nobody did it much because it would really hurt! With a padded helmet on it doesn't really hurt, no obvious perception of self-harm, so people did it to score points. So cycle helmets are different in a way because although they can encourage pushing the risk envelope they don't encourage you to do it by deliberately banging your head in to things. So concussions, while a potential issue for cyclists, are not directly comparable to the gridiron football issue. Playing the game effectively encourages you to go out of your way to hit your head. In cycling, playing it to best advantage encourages you to get over the line without crashing.

Pete.
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Wanlock Dod
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Re: "Helmets don't eliminate concussions" American Football

Postby Wanlock Dod » 11 Sep 2019, 8:25am

tim-b wrote:An item of Personal Protective Equipment insisted upon by the UCI to increase safety that has been taken up by professional cyclists in their thousands since becoming mandatory in 2003 has a detrimental effect to overall safety, and none of the pros have noticed this?
Not only have they not noticed it, but neither have the very experienced medical staff behind those teams, which is clearly why pro-cyclists haven't gone on strike like they did in 1991...

The experienced medical staff are doing no better than much larger numbers of their peers who routinely fail to recognise the potential benefits of motoring helmets, whilst at the same time proclaiming the life saving abilities of cycle helmets despite cycling not actually being demonstrably safer as a result of their use.

Society in general is convinced that cyclists need helmets, often based largely on the obviousness of their benefits. Perhaps if the skills of professional cyclists were more closely aligned to analysing and interpreting epidemiological studies they would be researchers rather than racing bikes. There is no shortage of examples of professional cyclists who have recommended mandatory helmets for all cyclists only to swiftly change their minds, Wiggly Braddins and that Welsh lad are just a couple of recent examples.

Mike Sales
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Re: "Helmets don't eliminate concussions" American Football

Postby Mike Sales » 11 Sep 2019, 8:30am

pjclinch wrote:
Mike Sales wrote:Risk homeostasis is essentially a balancing of risk against reward.


Not that simple. While there's an element of that there's also an element of people just run at a level they think is safe.
So, if a driver goes on The School Run pickup and leaves 15 minutes contingency for bad traffic, but traffic's much clearer than usual they'll still drive at the speed limit and arrive early, even though all they get to do is wait longer. They do that because they're confident and perceive themselves to be safe at the limit they're used to driving to, even though they could be safer by slowing down and not losing anything.

Mike Sales wrote:The risk of losing a race may be important to a professional cyclist, but the risk of a disabling head injury or death weighs rather more heavily.


That's more at the calculating end of it. Commenting on technical descents David Millar has noted that younger riders tend to show rather less fear than older ones, as Neil Peart's lyric to "Dreamline" suggests, "learning that we're only immortal for a limited time", so people do tend to become more risk averse with age, and also responsibility. I know a few folk who decided winter climbing wasn't such a good idea once they'd become parents, for example.
But at the sharp end the calculating aspect is more whether the risk-taker believes it will go or whether it won't. People have an inbuilt aversion to disaster and will not court it unless they have good reason to think they'll get away with it, but "safety gear", even if that's a St. Christopher medallion on a staunch catholic, will warp the idea of where the line is. Here is where the idiocies of helmet promotion culture really come up, in suggesting that "safety" and "wearing a helmet" are the same thing. They're not, but you could think otherwise looking around at UK perceptions, and the bigger the perception of safety the more warped the perception of the actual risk can be.

It's important that people understand the limits of their "safety equipment", and the degree of stupidity surrounding cycle helmets is huge. I read a post once of a cycle trainer who'd noticed a disconnected brake and reported it back to the parent who said they'd done that as the brake was rubbing but it was okay as the child had a helmet. Wasn't sure whether to believe that, but then came across exactly the same thing myself. But this is an information and culture problem, not so much a helmet problem.

American Football has some different issues to cycling because the helmet has been used to actively change the way the game is played. People started to use their heads as battering rams. There was nothing stopping us doing that back when I played rugby, only nobody did it much because it would really hurt! With a padded helmet on it doesn't really hurt, no obvious perception of self-harm, so people did it to score points. So cycle helmets are different in a way because although they can encourage pushing the risk envelope they don't encourage you to do it by deliberately banging your head in to things. So concussions, while a potential issue for cyclists, are not directly comparable to the gridiron football issue. Playing the game effectively encourages you to go out of your way to hit your head. In cycling, playing it to best advantage encourages you to get over the line without crashing.

Pete.


Of course it is not as simple as that. But at bottom that is what it is about as you go on to illustrate with examples.
I hope I do not need to go on to explore every implication of the theory whenever I mention it.

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Re: "Helmets don't eliminate concussions" American Football

Postby Mike Sales » 11 Sep 2019, 8:46am

tim-b wrote:An item of Personal Protective Equipment insisted upon by the UCI to increase safety that has been taken up by professional cyclists in their thousands since becoming mandatory in 2003 has a detrimental effect to overall safety, and none of the pros have noticed this?
Not only have they not noticed it, but neither have the very experienced medical staff behind those teams, which is clearly why pro-cyclists haven't gone on strike like they did in 1991
I wouldn't wear an item of PPE that can be shown to reduce my safety at work, and neither would you, so why would a pro-cyclist? Sponsorship money isn't everything
Regards
tim-b


"Taken up by professional cyclists"?
As you note, not voluntarily. Pros even demonstrated against helmets at first.
The UCI is not noted for reasonable decision making.
Professionals and their mentors have taken up all sorts of deleterious practices, from strychnine and alcohol to EPO, and they once believed that it was better not to drink on long rides.
Helmets cannot be shown to have increased safety. See Spiegelhalter and Goldacre.
Myself, I don't believe they have decreased safety, just not increased it, but using the practices of the professional peloton to justify them is not good evidence.

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Re: "Helmets don't eliminate concussions" American Football

Postby Vorpal » 11 Sep 2019, 8:55am

tim-b wrote:Hi
So by definition helmets have had a detrimental affect to overall safety in the pro ranks...

An item of Personal Protective Equipment insisted upon by the UCI to increase safety that has been taken up by professional cyclists in their thousands since becoming mandatory in 2003 has a detrimental effect to overall safety, and none of the pros have noticed this?
Not only have they not noticed it, but neither have the very experienced medical staff behind those teams, which is clearly why pro-cyclists haven't gone on strike like they did in 1991
I wouldn't wear an item of PPE that can be shown to reduce my safety at work, and neither would you, so why would a pro-cyclist? Sponsorship money isn't everything
Regards
tim-b

The UCI are the only organisation in the world with detailed statistics about safety in cycle racing and the effect of helmets and they are not publishing any details, nor making the information available to folks who want to analyse it, unlike the NFL.

We don't have any way of knowing if this is just one more item in their protectionist lack of sharing information, a lack of ever looking seriously at it, or there is a reason for withholding the information.

Cyclehelmets.org think they know the answer, but there are far too many confounding factors to sort it out without the detailed statistics. Also, they are using Wikipedia as a reference, and Wikipedia is unlikely to have accurate data for all cycle racing prior to 1990ish. It is unlikely that all deaths were publicised. Also, some deaths in non-UCI races are included.

Other factors that need to be considered include numbers of races and participants and course selection & design. There are likely other things as well, such as weather, or the time of year that races are held that could affect risks taken by participants.

IMO, if there was a clear benefit, they'd make sure everyone knew about it.
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Tigerbiten
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Re: "Helmets don't eliminate concussions" American Football

Postby Tigerbiten » 11 Sep 2019, 9:23am

Wanlock Dod wrote:The experienced medical staff are doing no better than much larger numbers of their peers who routinely fail to recognise the potential benefits of motoring helmets, whilst at the same time proclaiming the life saving abilities of cycle helmets despite cycling not actually being demonstrably safer as a result of their use.

Why would the advantages of motoring helmets to save lives outway the increased risk to other road users from wearing one.
Think it through ..........
Even now modern seat belts actively work to reduce head movements in a crash.
More mass on the head from the helmet equals higher forces involved and greater head movement.
Unless the helmet is restrained by a HANS device, the risk of a broken neck from whiplash injuries is greatly increased.
But once you use a HANS device, you start to limit the turning movement of your head.
Now you cannot turn your head as far and you've lost a lot of the peripheral vision that's needed at junctions due to the helmet shape anyway.
Just watch motorbike riders and how far they have to twist their whole body to safely see sideways at a junction.
Now try doing that in a car seat.
It will make every T junctions a lot more just "pray it's safe and go" ........ :twisted:

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Re: "Helmets don't eliminate concussions" American Football

Postby Mike Sales » 11 Sep 2019, 9:29am

Tigerbiten wrote:
Wanlock Dod wrote:The experienced medical staff are doing no better than much larger numbers of their peers who routinely fail to recognise the potential benefits of motoring helmets, whilst at the same time proclaiming the life saving abilities of cycle helmets despite cycling not actually being demonstrably safer as a result of their use.

Why would the advantages of motoring helmets to save lives outway the increased risk to other road users from wearing one.
Think it through ..........
Even now modern seat belts actively work to reduce head movements in a crash.
More mass on the head from the helmet equals higher forces involved and greater head movement.
Unless the helmet is restrained by a HANS device, the risk of a broken neck from whiplash injuries is greatly increased.
But once you use a HANS device, you start to limit the turning movement of your head.
Now you cannot turn your head as far and you've lost a lot of the peripheral vision that's needed at junctions due to the helmet shape anyway.
Just watch motorbike riders and how far they have to twist their whole body to safely see sideways at a junction.
Now try doing that in a car seat.
It will make every T junctions a lot more just "pray it's safe and go" ........ :twisted:


Seat belts increased danger for vulnerable road users, so car helmets probably would too, for the same risk homeostasis reason.
On the other hand, the failure of medical staff to recommend car helmets (or pedestrian helmets) does reveal an aberration in their thinking.

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Re: "Helmets don't eliminate concussions" American Football

Postby mattheus » 11 Sep 2019, 9:37am

I can't agree with that post TB.

Mass of helmet - really?? Look at the mass of a skull (living!) and the mass of a bike helmet.If this was a problem, why isn't it injuring cyclists in all the minor tumbles they have every day?

As for all the peripheral vision stuff; if that is true, then just mandate them for passengers (or even just back-seat passengers. Or just children.)
Whatever it takes - lives are at stake here!!!

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Re: "Helmets don't eliminate concussions" American Football

Postby Vorpal » 11 Sep 2019, 9:45am

Maybe collar supports, such as those used on motor racing helmets should be recommended, to reduce neck injuries, as well as driving helmets?
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Re: "Helmets don't eliminate concussions" American Football

Postby pjclinch » 11 Sep 2019, 10:58am

Mike Sales wrote:Risk homeostasis is essentially a balancing of risk against reward...

Of course it is not as simple as that. But at bottom that is what it is about as you go on to illustrate with examples.
I hope I do not need to go on to explore every implication of the theory whenever I mention it.


I went in to further detail because it's not abundantly clear that "going as hard as you think is reasonably safe" is always a "reward".

I think that the balancing of risk is often not so much against "reward" as against "perceived probability of things going pear shaped". I think that's quite a significant difference. It's not always about "because if I do that, I get this"; it's often "I do that, because I think I can".
Often seen riding a bike around Dundee...

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Re: "Helmets don't eliminate concussions" American Football

Postby Mike Sales » 11 Sep 2019, 11:13am

pjclinch wrote:
Mike Sales wrote:Risk homeostasis is essentially a balancing of risk against reward...

Of course it is not as simple as that. But at bottom that is what it is about as you go on to illustrate with examples.
I hope I do not need to go on to explore every implication of the theory whenever I mention it.


I went in to further detail because it's not abundantly clear that "going as hard as you think is reasonably safe" is always a "reward".

I think that the balancing of risk is often not so much against "reward" as against "perceived probability of things going pear shaped". I think that's quite a significant difference. It's not always about "because if I do that, I get this"; it's often "I do that, because I think I can".


Risk is in essence about the future and so about estimates of possible outcomes as perceived by the actor.
Winning, or exhilaration, or getting there sooner, or assuaging impatience etc. are all "rewards" which are balanced, even if unconsciously, against the adverse outcomes.
Risk is the possibility of things going pear shaped. The estimate of this is an input too.

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Re: "Helmets don't eliminate concussions" American Football

Postby Wanlock Dod » 11 Sep 2019, 11:35am

Tigerbiten wrote:Why would the advantages of motoring helmets to save lives outway the increased risk to other road users from wearing one.

Are there any medical professionals arguing against the use of seat belts on this basis?

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Re: "Helmets don't eliminate concussions" American Football

Postby Tigerbiten » 11 Sep 2019, 1:26pm

mattheus wrote:I can't agree with that post TB.

Mass of helmet - really?? Look at the mass of a skull (living!) and the mass of a bike helmet.If this was a problem, why isn't it injuring cyclists in all the minor tumbles they have every day?

Different scenarios.

In a car the body is restrained and he head is free to move.
So in a crash, all the force needed to stop the head moving it taken by the neck.
From wiki, a head weighs roughly around 4.5-5kg and an open face motoring helmet around 1-1.5kg.
So in a crash your neck would have to stop very roughly 25% more force.
More force equals more risk of whiplash.

On a bike neither are restrained.
So in a crash you fly through the air with the greatest of ease with little force on the neck.
But there is a growing body of evidence that with a helmet on your head hits the ground with more force due to the increase in size and weight from the helmet.
This can result in the hidden concussive type damage similar to the damage shown in this paper.
On a motorbike, due to the higher speeds, the benefit of not splitting your head open outweigh the risk of concussive injuries.
On a pushbike it's still very 50-50 as to which gives the greater long term benefit.

Don't ask me to quote sources, I don't go into this subject in that great detail ........ :P

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Re: "Helmets don't eliminate concussions" American Football

Postby Wanlock Dod » 11 Sep 2019, 1:54pm

I couldn’t find any information on the actual weight of the helmets which were promoted for every day motoring, but I suspect that they are appreciably lighter than those used in motor racing where speeds might be higher and the risks taken rather greater.