Not My Club Too???

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.
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Vantage
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Not My Club Too???

Postby Vantage » 14 Dec 2015, 9:36pm

Oh dear. This popped up on my clubs fb page. Not good.

This is from a guy that works at the same site as me, I thought it worthy of copying and posting here.

Stephen tells us how he survived a serious cycling accident.

What is your involvement in the world of cycling?
Cycling is my passion! As a cycling coach, master qualified bike frame builder and former competitive cyclist, I’m familiar with most things on two wheels. I have helped administer anti-doping controls for the national British Cycling Federation and I am a former National Commissaire.

I usually cycle the 20 mile return journey from my home in Preston into work every day.

What happened to you in you In July?
I was cycling home and decided to take a scenic route, taking the quieter back roads when I felt my bike suddenly jolt to the left.

I can’t remember anything from that point. I know there were no other vehicles involved, so I assume I must have struck a stone in the roadway and came off. The next thing I remember were the voices of the Air Ambulance paramedics . . .

The police estimated that I had lain unconscious on the ground for around 20 minutes before a passing cyclist found me and raised the alarm. I had sustained life threatening injuries. My ankle was cracked and my hip severely bruised, but the worst was my breathing. I had fractured two ribs both at the front and back in the accident; one of which had punctured my lung which caused severe internal bleeding. The paramedics had to act on the roadside by putting two holes in my chest to relieve the pressure and let the air escape. It was pretty grim.

But at least I was alive. Had I not been wearing my helmet, I would have been killed for sure. My helmet saved my life; there is no question about that. The large crack you can see in my protective headwear could have been my skull. I’m very, very lucky even to be here.

How is the road to recovery?
My journey to recovery is still ongoing. After being admitted to hospital a chest drain was inserted, it remained there for three days. After it was removed I was allowed to go home but for the first few weeks the pain in my chest was so bad I was unable to lie down and had to sleep in a chair. I also suffered from benign proximal positional vertigo; a sense of dizziness which affected my balance. As a result of my injuries, I was unable to work for 12 weeks and I am currently on a phased return. I am having regular physiotherapy, but it will still be some months before my ribs really heal and stop hurting.

How do you feel now about cycling?
My passion for cycling is undiminished and my aim is to get back in the saddle, although I dread to think what my wife and daughter will say when I first go out.

What advice have you got for cyclists and pedestrians, especially now the darker nights are here?
My accident should be a lesson to everyone. It’s astonishing how quickly it happened. Despite all my years of experience the accident happened in the blink of an eye and I was only a few moments away from dying. It was only luck and the prompt action of the passing cyclist and paramedics that saved me.

It frightens me when I see cyclists without lights, riding two abreast on busy or narrow roads, but especially not wearing a helmet.

They really are dicing with death. My message is, always wear your helmet and make sure it fits correctly. Any good bike shop can advise you on the best helmet for you and you don’t have to shell out a fortune. Don’t be tempted to buy a cheap copy of a helmet unless you are certain of the quality, it’s just not worth it.
Please remember that cyclists are the most vulnerable of road users. If you are you’re passing a cyclist in the car – be considerate and give cyclists enough space, just like you would when you pass someone on a horse. I don’t want anybody to go through what I have.


Maybe I missed it, but I can't see at which point the helmet prevented his ribs being broken and penetrating his lungs. Or where it prevented the loss of consciousness. Or how riding two abreast puts anyone at greater risk despite we all knowing the exact opposite to be true.
Bill


“Ride as much or as little, or as long or as short as you feel. But ride.” ~ Eddy Merckx
It's a rich man whos children run to him when his pockets are empty.

Phil Fouracre
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Re: Not My Club Too???

Postby Phil Fouracre » 14 Dec 2015, 9:57pm

Oh no, not another one! Me and the missus spent the weekend bombing round Dartmoor, grey and windy, but, great to be out. It's OK, we were quite safe, we wore our magic Buffs. Saved our lives I'm sure :-) :-)
Never attribute to malice that which is adequately explained by stupidity

sapperadam
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Re: Not My Club Too???

Postby sapperadam » 14 Dec 2015, 10:23pm

Vantage wrote:
Maybe I missed it, but I can't see at which point the helmet prevented his ribs being broken and penetrating his lungs. Or where it prevented the loss of consciousness. Or how riding two abreast puts anyone at greater risk despite we all knowing the exact opposite to be true.


Ok, the guy is clearly wrong about the two abreast thing, but why would you expect a helmet to protect him from broken ribs? The force of the accident was enough to do the chap some serious damage so why does it not stand to reason that the helmet did indeed save his life? Or at the very least prevent enough damage that the medical response was then able to actually succeed.

Broken ribs are eminently treatable, a punctured lung is life-threatening but again treatable. A mashed up brain means you're a goner no matter what is done. Lights out straight away. No it's not going to help in a major crash, (like the motorcyclist who headbutted a car near my work at a combined speed of about 100mph recently), however, a helmet probably did keep this chap from suffering a major head injury that wouldn't have been treatable and prevented the second cyclist from coming across a corpse.

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Vantage
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Re: Not My Club Too???

Postby Vantage » 14 Dec 2015, 10:32pm

How do we know the helmet didn't contribute to the injury?
As stated in other threads the increased girth and weight from the lid could very easily tip the balance from a light knock to the head to a full on skull masher. The pointy bit at the back of the helmet and/or vents and/or visor at the front could have dug into the road surface causing the impact to be greater.
Bill


“Ride as much or as little, or as long or as short as you feel. But ride.” ~ Eddy Merckx
It's a rich man whos children run to him when his pockets are empty.

drossall
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Re: Not My Club Too???

Postby drossall » 15 Dec 2015, 12:12am

sapperadam wrote:The force of the accident was enough to do the chap some serious damage so why does it not stand to reason that the helmet did indeed save his life?

In brief, because we have no idea what the outcome would have been without a helmet, and because statistics at national level don't really seem to support the idea that helmets usually make much difference. Of course the underlying concern that head injuries can be life-changing, or fatal, is very real. It's just a matter of whether you want to do something, or whether you want to do something effective.

Helmet made of paper: no-one would expect much effect. You'd expect riders to survive most accidents without serious injury though, just because they always have. Serious head injuries occur only in a minority of cases (or the roads would be littered with injured cyclists). Serious head injuries where injuries to the rest of the body are not also life-threatening are even rarer.

Helmet made of three inches of steel and twelve inches of rubber and other compressible material: pretty difficult to wear but, ignoring that, likely to offer good protection for direct blows (glancing blows with rotation are another matter).

Real helmets: somewhere between these two, but where exactly? They are "only" plastic, after all. They have to be nearer the paper end than the steel one.

So if riders usually survived without helmets (and I've had head-banging accidents without twice in my life, and survived both), how do we tell whether helmets are having any effect at all?

We look at the national stats, and look for differences before and after helmet-wearing became widespread.

Oh.

sapperadam
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Re: Not My Club Too???

Postby sapperadam » 15 Dec 2015, 12:36am

You're right. We can't KNOW what the outcome would be, but we can take an educated guess. He was concussed WITH the helmet on, you can bet that concussion would in all likelihood have been a whole lot worse without it.

Ok without referring to the actual statistics because I can't be buttocked with finding the references on my kindle at midnight, but there is a reason why motorcycling helmets are a law. During the second world war, thousands of soldiers were doing from head injuries in motorcycle accidents. Military brought in rules to wear helmets, thousands of injuries went down massively. Few years later the law was brought in and motorcycle deaths dropped. Yes I know you'll say motorcycles are different, but the mechanism of injury is not. It's only the speed that's different.

Now, I do not think that we should have a law requiring cyclists to wear helmets, but I see most anti-helmeters as being very evangelical about their view and that is the problem with this whole argument. The number of so called stats and reports that support the anti-helmet lobby out there is ridiculous but most are dismissed when you fully read them (I don't like helmet laws, but that is a different argument), on the other hand though, how many cyclists have walked away from an accident and that hasn't made statistics because of a helmet? Nobody knows, they didn't make the stats for that very reason. But there are plenty of anecdotes around that suggest that walking away wouldn't have been an option without a helmet.

beardy
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Re: Not My Club Too???

Postby beardy » 15 Dec 2015, 12:47am

Yes I know you'll say motorcycles are different,


They are! and motorcycle helmets are certainly different from cycle helmets as they are actually effective helmets rather than just pieces of expanded polystyrene that just crack in half on hitting something.

Bicycler
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Re: Not My Club Too???

Postby Bicycler » 15 Dec 2015, 12:59am

drossall wrote:We look at the national stats, and look for differences before and after helmet-wearing became widespread.

Oh.

sapperadam wrote:The number of so called stats and reports that support the anti-helmet lobby out there is ridiculous but most are dismissed when you fully read them (I don't like helmet laws, but that is a different argument), on the other hand though, how many cyclists have walked away from an accident and that hasn't made statistics because of a helmet? Nobody knows, they didn't make the stats for that very reason. But there are plenty of anecdotes around that suggest that walking away wouldn't have been an option without a helmet.

We don't need to measure the non-injuries. If helmets produce a significant reduction in head injuries then large increases in helmet wearing levels will produce a noticeable decrease in reported head injuries. Similarly there will be an easily spotted disparity between the number of reported head injuries of helmeted and unhelmeted cyclists.

Oh.

Bicycler
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Re: Not My Club Too???

Postby Bicycler » 15 Dec 2015, 1:13am

I must say I do like the way that sceptical individuals and cycling charities which oppose compulsion are now an "anti-helmet lobby". God, if we all have a whip-round we might be able to bribe a parish councillor :lol:

We must have all those with interests in helmet promotion/compulsion quaking in their boots!

irc
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Re: Not My Club Too???

Postby irc » 15 Dec 2015, 6:18am

It frightens me when I see cyclists without lights, riding two abreast on busy or narrow roads, but especially not wearing a helmet.

They really are dicing with death.


Riding without lights is illegal an an un-needed risk. But the actual risk level can't be that high or there would be carnage on the streets. We don't say pedestrians walking without lights are dicing with death.

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[XAP]Bob
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Re: Not My Club Too???

Postby [XAP]Bob » 15 Dec 2015, 7:27am

sapperadam wrote:You're right. We can't KNOW what the outcome would be, but we can take an educated guess. He was concussed WITH the helmet on, you can bet that concussion would in all likelihood have been a whole lot worse without it.

Yes we can - from the description the helmet did not work as designed - it failed catastrophically.

That would be as expected in an incident that was clearly at fairly high speed (multiple breaks and serious internal injuries is unlikely for a low speed incident). Helmets do not have the structural integrity to cope with collisions at much above 12mph - which is about the speed you'll achieve if you simply fall over.

(12mph is a little under 6m/s, height needed s=ut+1/2at^2, u=o, s= 1/2 . 9.8 . (6/9.8)^2 = 1.8m)

Helmets are designed to crush on impact, absorbing energy in the plastic deformation of the expanded polystyrene shell. If the helmet, as described, cracked rather than crushed, then it did not absorb significant energy and therefore prevented some grazes and other soft tissue damage.
It failed to prevent a concussion, and it may not have hit the deck at all if the head had been smaller....

Why on earth is he not suggesting chest armour - since the only really serious injury seems to have been to his lungs...
Ok, a broken pelvis is no fun either...

Riding two abreast would of course mean that his riding partner wouldn't have come off n the same way, and one of them could have phonened the appropriate help.... 20 minutes is a long time with a punctured lung....
A shortcut has to be a challenge, otherwise it would just be the way. No situation is so dire that panic cannot make it worse.
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drossall
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Re: Not My Club Too???

Postby drossall » 15 Dec 2015, 8:00am

sapperadam wrote:You're right. We can't KNOW what the outcome would be, but we can take an educated guess. He was concussed WITH the helmet on, you can bet that concussion would in all likelihood have been a whole lot worse without it.

But for that to be true in other cases as well, it's necessary for there to be a massive decrease in the injury statistics. The simple fact is that the number of people who have been saved by their helmets far exceeds any credible estimate of the number of people who would be injured if helmets did not exist, let alone the proportion of those whom a helmet might save. It's certainly possible that a helmet helped in a small percentage of these individual cases, but if you're going to claim that it helped in many then you have to start considering the possibility that the helmet has made things worse in others, just to account for the statistics.

And Bob's point is good too. Evidence of helmet failure is constantly quoted as evidence that a helmet worked, in defiance of the material physics.

There are no anti-helmeteers. No-one in my recollection has ever started a conversation, or even contributed to one, by asking why people wear helmets. There are simply people who dare to respond when someone wants to introduce a rule making everyone wear them.

And yes, it's complex, and the statistical case is not clear-cut. There are shades of opinion among those daring doubters. Some even allow that helmets might help somewhat, but then see that this is swamped by the loss of the safety-in-numbers effect. It's all different attempts to take figures seriously.

kwackers
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Re: Not My Club Too???

Postby kwackers » 15 Dec 2015, 8:29am

sapperadam wrote:You're right. We can't KNOW what the outcome would be, but we can take an educated guess. He was concussed WITH the helmet on, you can bet that concussion would in all likelihood have been a whole lot worse without it.

The evidence suggests that most concussion is caused by rotation. Sounds like he was moving forwards when his head hit the road, the helmet 'dug' in and spun his head most likely resulting in concussion.

Without the helmet hair and skin would have prevented rotation (if his head had hit the road at all, being smaller and lighter).
Natures a wonderful thing and knows a thing or two about preventing brain injuries.

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Re: Not My Club Too???

Postby MartinC » 15 Dec 2015, 8:44am

sapperadam wrote:...................................................but we can take an educated guess..................................


An educated guess may well be a good idea. There are several upthread.

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Re: Not My Club Too???

Postby pjclinch » 15 Dec 2015, 10:43am

sapperadam wrote:You're right. We can't KNOW what the outcome would be, but we can take an educated guess. He was concussed WITH the helmet on, you can bet that concussion would in all likelihood have been a whole lot worse without it.


If you believe what most people believe you may well assume that, but then lots of people believe (as explicitly stated in the account) that a cracked helmet is pretty much a sure case of a cracked skull without the helmet... and that just isn't the case. It's much harder to crack a skull than an inch of polystyrene foam.
Add in the notes about brittle failure pointed out by others that the helmet failed catastrophically, and we don't know whether it usefully deformed first or not, it's a big stretch to say "would in all likelihood have been a whole lot worse without it".

sapperadam wrote:Now, I do not think that we should have a law requiring cyclists to wear helmets, but I see most anti-helmeters as being very evangelical about their view and that is the problem with this whole argument.


Here we see that standard perceptions in this debate are mis-shaping it. Who is "anti-helmet" here? Consider the case that someone claims aspirin have proven themselves as great medicine, and that working from that they can be expected to cure cancer. If I say, "hang on, you can't expect that much of aspirin!", does that make me "anti-aspirin"? In the rhetoric of lots of people with a pro-helmet agenda it would... Despite the fact that I own and sometimes use a helmet (you can see me wearing one in the wee avatar pic, learning to off-road unicycle) I have often been labelled an "anti-helmet zealot". But any zeal isn't "anti helmet", it's stepping back and getting a realistic view of helmets. The evangelical folk are those trying to promote something designed for mitigating minor injuries as if they make a huge impact on cycle safety. This makes them, to quote Chris Boardman (who will sell you one, if that's what you want, so he arguably has a vested interest in their promotion), "a massive red herring".

So the problem is that what boils down to a safety footnote has taken over the safety debate. And that's not a good thing. My fellow "anti-helmet zealots" and I are trying to bring the debate on to things that actually make a difference, which pretty much boil down to not being scared off our bikes because it's ultimately good for us to cycle, and not colliding with fast/heavy motor vehicles. The rest of it's window dressing.

sapperadam wrote:The number of so called stats and reports that support the anti-helmet lobby out there is ridiculous but most are dismissed when you fully read them


I changed from being a committed helmet wearer (and at some level promoter) in to an "anti helmet zealot" at the back end of the 90s. I was involved in an Internet flame war about it (if you can imagine such a thing...) and I felt the guy saying helmets weren't up to much was obviously a numpty with some sort of weird libertarian agenda, but rather than just say that I felt as a science professional with a medical research library just along the corridor I could really do much better, so I went along to "fully read" the evidence so I could get back with citations about how wrong he was. But the more I "fully read", the more the very big holes in the helmet promotion case got, and the more reasonable the questions asked by sceptics seemed. So I came out of the library with my tail between my legs, and stopped going on about helmets being common sense, daft not to, etc.
In summary of "fully reading", the stuff that says helmets make a big difference are full of methodological holes so big you could drive a tank through them with the turret going round, and the stuff that says they're not all they're made out to be by the first category is very limited by its granularity (i.e., we can say they haven't done populations any good, but nothing much at the levels of specific individual risk) but brings up valid questions about why we're so obsessed by them as an intervention to the point of shaming (sometimes criminalising) those taking pat in a healthy activity.

To "fully read" the literature you need a lot of time, a lot of patience, a decent set of science smarts and a well stocked research library, and very few have really read the majority of it (I haven't, you do get to see a pattern after a few days ploughing though). It's not reasonable to expect that lot of most people. So most people have to decide who to trust. In the UK they're trusting FUD rather than the actual evidence, and some of us think that's a bad thing.

In the meantime, if you want to read up after someone else has done some sifting for you there's a couple of summaries I'd suggest from hopefully trustable sources without an axe to grind. First, a BMJ editorial by Ben Goldacre and David Spiegelhalter (see http://www.badscience.net/2013/12/bicycle-helmets-and-the-law-a-perfect-teaching-case-for-epidemiology/#more-3027) and second a discussion annex in a report of children cycling by Time Gill (see http://www.ncb.org.uk/media/443203/cyclingreport_2005.pdf from p31).

Pete.
Often seen riding a bike around Dundee...