Are head injuries something you worry about when cycling?

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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The utility cyclist
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Re: Are head injuries something you worry about when cycling?

Postby The utility cyclist » 5 Sep 2018, 11:46pm

Cheerleading helmets need to be a thing in the US. 1579 reported concussions in 2010-11 season within schools alone.
Gridiron has at least 70 direct neurological incidents per year that are unrecoverable, only one year in the time that records have been kept(since 1931) has there been zero directly related deaths due to trauma at college/high school level (that was 1990). The only way to reduce the head injury rates in gridiron has been to change the rules/environment by not allowing head to head for 'defenceless' players, spear tackles have been banned but still occur. Oh and they wear helmets far exceeding what cyclist or horse riders wear.
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drossall
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Re: Are head injuries something you worry about when cycling?

Postby drossall » 5 Sep 2018, 11:58pm

softlips wrote:I’ve seen massive damage to helmets after higher speed crashes and have been very impressed by the performance of the helmets involved. These patients have tended to have other major injuries just as likely to kill them. Most of the deaths I’ve known have been due to multiple injuries sustained by contact with other vehicles.

The problem is that helmets are designed to be destroyed in crashes. So, you can't really tell whether the helmet took 90% of the impact, so to speak, or 5%, since it should have been pretty badly knocked about either way. Everything else is assumption.

What we do know is that helmets are designed for very low-speed impacts - those involved in falling off sideways when not moving. So, and given that most of the relevant quantities in crashes seem to relate more to the square of speed than to speed itself, the high-speed impacts that you mention must massively exceed the design capabilities of the helmet. Which again leaves us wondering how much protection came from the helmet and how much from the skull. It does seem that they provide some protection against abrasions and the like, but that's not what most people are thinking of when they mention head injuries.

For an overview from a broadly medical background, I think you can't do much better than Ben Goldacre, of Bad Science fame, who describes the benefits of helmets as "...too modest to mention...".

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horizon
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Re: Are head injuries something you worry about when cycling?

Postby horizon » 6 Sep 2018, 12:30am

There's a Louis Theroux documentary currently showing/available on BBC2 about the "estimated one million people in the UK" who live with a debilitating brain injury. I've no idea where the figure comes from.

https://www.bbc.co.uk/programmes/b07c6fjk
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The utility cyclist
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Re: Are head injuries something you worry about when cycling?

Postby The utility cyclist » 6 Sep 2018, 12:38am

softlips wrote:
Cunobelin wrote:
softlips wrote:I always wear an helmet, modern ones let your head breathe well and I don’t overheat in them.

Do I worry about head injuries?

Not really, and I’ve worked in A&E and still work in hospitals. I have seen deaths from head injuries sustained in cycling, these have usually been non helmet wearing low speed accidents. In fact the most recent death I saw was a patient who had fallen off before actually moving off.

I’d be more concerned at a helmet minimising an impact enough for me to survive but not protect me from major head injury. I’d rather not survive such an incident.

I’ve seen massive damage to helmets after higher speed crashes and have been very impressed by the performance of the helmets involved. These patients have tended to have other major injuries just as likely to kill them. Most of the deaths I’ve known have been due to multiple injuries sustained by contact with other vehicles.


Why is it that everyone who works in A&E always works in that magic and special department that never seems to see all the other head injuries, just the cyclists?


The hospital I worked in A&E in was a specialist neurological and spinal unit so I saw loads, also saw people who’d gone through windscreens who would have been saved by seat belts while on the other side saw one young lady who was killed by her seatbelt. On the latter should we stop wearing seat belts? Should we remove airbags too? In the vast majority of accidents they don’t offer any benefit.

One paramedic came onto a forum elsewhere and stated that 95% of bad crashes where a seatbelt had saved the occupants from going through the windscreen the forces involved across the body caused serious internal injuries.
Observational/anecdotal only but more frequent/increased internal injuries at higher speeds from seatbelts or other parts of vehicle because being belted plus airbags, anti skid, traction control, side protection beams etc and even power steering lure drivers into thinking they are invulnerable.

It's a circular problem that the Ilses report made clear. You can mitigate to a degree but even with all those protections and design of junctions, better brakes, better/grippier tires, better road surfaces that aid motorists there are still circa 185,000 injured or dead on our roads annually in one of the safest countries in the world, that as a % people not in the tin cans are being killed at higher rates and being blamed at the same time for not having the tin can :twisted:

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Cunobelin
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Re: Are head injuries something you worry about when cycling?

Postby Cunobelin » 6 Sep 2018, 6:16am

The utility cyclist wrote:Cheerleading helmets need to be a thing in the US. 1579 reported concussions in 2010-11 season within schools alone.
Gridiron has at least 70 direct neurological incidents per year that are unrecoverable, only one year in the time that records have been kept(since 1931) has there been zero directly related deaths due to trauma at college/high school level (that was 1990). The only way to reduce the head injury rates in gridiron has been to change the rules/environment by not allowing head to head for 'defenceless' players, spear tackles have been banned but still occur. Oh and they wear helmets far exceeding what cyclist or horse riders wear.


There is also (disputed) evidence in footballers of brain injuries from heading the ball.

European Soccer is undoubtedly recognized as a contact sport with statistically comparable frequency of craniocerebral injuries as in American football and hockey (5, 6). The injuries may be severe and include skull fractures and in rare cases also contusions and hematomas. Head trauma is assessed according to a special sport-specific definition. The mildest level is a simple concussion, which does not require any other measures than a rest. In a complicated concussion, the symptoms last longer and manifest themselves as the disturbance of consciousness and long-lasting cognitive disorders. Such patients require the treatment of specially trained sport physicians and cannot expect to return to the field any time soon. To avoid the possibility of chronic cumulative negative effect of bouncing the ball with the head, different recommendations were created and the playing technique must be correct.


Why are footballers not wearing helmets?

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Re: Are head injuries something you worry about when cycling?

Postby rmurphy195 » 12 Sep 2018, 1:14pm

Yup, I do wear one - unless it too hot going up a hill! But I rearley actually worry about it when actually riding.

Goes back to my motorbiking days - I figured then, and later when I returned to cycling in the mid 90's, that I might have 2 arms, 2 legs, etc but only one head - and I needed that to earn a living! I also figured that I could bruise or break arms, legs, ribs etc. and they would heal, but less likely in the case of my head. So I took to wearing a helmet for cycling for that reason and partly to set an example to my children.

Have I ever used the helmet in anger? Not often, just once or twice. Well, 3 times that I can remember over the last 25 years

1) Off-roading and clouted an overhead branch, saved myself a headache at least

2) Sat up at a red light on my way to work, and banged head on the overhanging door mirror of a pickup that pulled up beside me. This was right in the centre of my bonce - the only other time I've done something similar I did end up with delayed concussion and was rather ill.

3) T-boned about 3 years ago by a pickup (another one!) Landed on my left side and ended up with bruisng/ribs etc (I flew about 20ft through the air I'm told, apparently). never felt a thing up top - but on arrival at the hospital my wife queried why I had a pink patch above my right eye. A quick look at the helmet gave the explanation for that one, with the scuffs and yellow paint from the top edge of the truck's windscreen/and roof panel on the right side of my hat, and some scuffs on the left, maybe where my head hit the ground when I landed.

So I've saved at least 3 headaches - or worse, certainly in the case of the 3rd incident above. In my youth - some very near misses.

Have I fell off without hitting my head? Yup,on icy roads, gravel, the usual stuff (how can you not if you've been cycling on-and-off for most of my 68 years). And once when I went out after recovering from an ear infection, turned around to see behind and simply fell over!

So there you have it, there's my experiences. Not many - but sometimes it only takes one.
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""You know you're getting old when it's easier to ride a bike than to get on and off it" - quote from observant jogger !

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philg
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Re: Are head injuries something you worry about when cycling?

Postby philg » 12 Sep 2018, 1:39pm

Cunobelin wrote:
Why are footballers not wearing helmets?

I believe they do in the straw man league :roll:

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Re: Are head injuries something you worry about when cycling?

Postby mjr » 12 Sep 2018, 2:10pm

philg wrote:
Cunobelin wrote:
Why are footballers not wearing helmets?

I believe they do in the straw man league :roll:

American Footballers wear helmets. Brain injuries seem to have increased because "when you put face and head protection on people, they’re not as worried about taking blows to that area. And so the aggressive nature of the activity is greatly enhanced"... but the concussive protection hasn't increased in line with the impact protection. It's another messy topic, which you can hear more about at "The Dangers of Safety" by Freakonomics with some updates at http://freakonomics.com/podcast/the-dan ... broadcast/
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Cunobelin
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Re: Are head injuries something you worry about when cycling?

Postby Cunobelin » 12 Sep 2018, 3:49pm

philg wrote:
Cunobelin wrote:
Why are footballers not wearing helmets?

I believe they do in the straw man league :roll:



It is always easier to dismiss than has a coherent discussion....