Helmets

A snowHead

My story....

About 18 months ago I suffered a low speed cycling accident which through an unfortunate set of circumstances resulted in a broken collarbone, a broken wrist, 12 stitches in a head wound, concussion and slight but permanent, brain damage. It's easy to be complacent about wearing a helmet for activity sports until something happens to you.

If I could turn the clock back and choose to wear a cycle helmet the day I came off that bike, I'd do it in a heartbeat.

A snowHead

Thanks for sharing that Clive. I was involved with the charity 'Headway' many years ago, and have seen the effects of severe brain trauma at first hand. Not something a victim recovers from like a broken bone, but people don't always realise that.

Well, the person's real but it's just a made up name, see?

kevinrhead, www.skihelmets.com - 'nuf said snowHead

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stevepick,
Why are people more likely to ski into you with a helmet on - it still probably hurts both people? Why is the less than 1Kg of helmet going to hurt you any worse than my rock hard (probably solid right through!) head?

I've skied with lots of people who have hit their heads, some with helmets some without.
The reason I bought a helmet was because someone I skied with was hit and knocked into a bridge - pretty unfornunate, but it ruined her day in a big way.
Skied with a friend who's a qualified instructor but still managed to do a comedy fall (on possibly the easiest green run in the resort) and land on his head (with helmet) and end up going to the med centre and having to repeat "big blue bus" every few minutes to make sure he was OK - he was glad he had a helmet.
Skied with someone else who slipped on a double black (a good skier who definitely should have been there) and dented his helmet in a big way on a rock on the way down.

Personally I've never hit my head (not from want of trying!!), except by the rapid chairlift bar operators and by falling debrit from above (yes, this happens skiing as well) , but have messed up a run I skied several times before no problem and stopped some rocks with my ribs - after that I always wear body armour for more challenging stuff (needless to say I also always wear a helmet - feel vunerable without it) - the first day I used my armour I misjudged clearing a ditch I thought I could get out of no problem, and backflipped into a tree.

I've worn a helmet for a long time, mostly because most of my skiing has been done in the US and Canada where it seems normal - the first time I skied in France (Val Despair) I must have been the only person in the resort wearing one, guess looking 'good' with a nice headband is more important?. I don' t mind whether other people wear helmets or not - it's their choice (except Mrs H, who I badgered into wearing one when she started skiing trees a lot snowHead

) - I know what I'd do.

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Find this discussion bizarre.

If we were to look at the wearing of seat belts then its fair to say that barring legislation a vast number of people would not wear one.

Its proven (statistically) that seat belts save lives, yes you'll find comments like 'if I'd been wearing my belt I would have been dead....'. But there are a lot of people who owe there lives to the legislation.

I like the rest of my party didn't wear a helmet. Then few seasons ago we saw the effects of a 'trip into the trees'. Now its impossible to say if a helmet would have changed the outcome. However, the individual involved was refused to be accepted as fit to fly due to his head injury (so off the plane and we all waited for his luggage to be off loaded) and his friends said he has no insurance anyway.

Still wonder what the wearing of no helmet and no insurance cost this individual.

I've no axe to grind to make helmet wearing compulsory, but if you've a modicum of common sense then to object on the fashion/I don't like them ticket is nonsense. Like insurance you'll never appreciate the benefit except in the rare occasion you need it.

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In Hintertux yesterday I remember noticing and commenting how many people were wearing helmets. Certainly an increasing trend ...

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the ice perv,

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If I'm reiterating points made by others on earlier pages I apologise.

It is insane really that we don't wear helmets. The really odd thing is that I possess one and have never worn it. I find it a tad uncomfortable, how lame a reason is that! I certainly don't endorse regulation on these matters because at the end of the day we all know the risks whether or not we truly acknowledge them. I'm sure we've all knocked our head at one time or another?

As I'll be spending more time in the park this year (i.e. the two sets of weeks I go away) I will be taking my helmet with me. But then should I be taking body armour, knee pads, wrists guards... Anyone ever heard of the 'Precautionary principle'?! Puzzled

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You know it makes sense.

Otherwise you'll just go on seeing the one name:

stevepick, I do think that part of the reason for helmets' proliferation these days is the fact that they can now be made light enough and cheaply enough for people to think that, despite the small likelihood of suffering a head injury, it isn't a waste of money to buy them and it isn't too inconvenient either

climbing helmets aren't intended to deal with the same types of impact as skiing helmets so they are probably better than nothing but still not that good for skiing

but the point remains, it's totally up to you what you want to do. like you, i take issue with the first post where one adult is basically trying to take the decision for another adult

A snowHead

you could make an arguement for wearing a crash helmet nearly everywhere.. crossing the road, using the stairs, getting out of the bath, having more than 5 pints..

A snowHead

stevepick, I struggle to understand your view that people only wear helmets because its fashionable. I cannot understand what you are basing this opinion on, but if this was the case then surely their use would be more prolific. I definately don't feel particularly fashionable when wearing mine in Europe. Indeed, one can sometimes feel very self-conscious. All the same, if it were just the fashion, then so what? People like to look good when they go on holiday don't they?

Well, the person's real but it's just a made up name, see?

its probably more likely you'll smack your bonce on a push bike than on the slopes.. mind you i find that kind of hypocrisy highly impressive and i commend you sir.. Cool

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I find that alot of folks wearing hemets are the less experienced and often less confident ones. The people who most frequently wouldnt wear them are those who are much more confident and of the opinion they dont need them.... just another spin on things....

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I wear a helmet and I'm less experienced (compared to some people) but more experienced (compared to some other people).

It doesn't really matter how 'experienced' you are the nature of 'accidents' is that they can happen to anyone.

The 'it only happens to other people' attitude is very prevelant, after all look at the number of people who still won't wear a seat belt.

Its fine that everyone has a freedom of choice but its obvious that in some circumstances people need to be compeled to do something even if its for their own safety. Whether helemt wearing needs to be compulsary is something thats driving this thread.

As I've posted before the reason I wear a helmet was the after effects of another skiers trip into the trees. It seems he was skiing on piste and was hit by another skier which sent him off piste and into the trees. His head injuries were pretty bad. Wether a helmet would have made a difference is of course hard to say but it seems reasonable to expect that his injuries would have been reduced.

Its surprised me how few ski injuries I've seen over the years and all the other people I know that ski never seem to have had a problem. But one day it could happen and it could be any of us and to spend a few quid and possibly look a bit daft (though helmets look OK to me) seems a small price to pay.

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antoeknee,
Your point about seat belts is interesting and possibly pertinent to whether or not wearing helmets is likely to reduce injuries.

Whereas there is little doubt that if you are involved in a car crash wearing a seatbelt reduces your chances of injury Risk Compensation
Suggests that you may not reduce injuries by introducing seat belt legislation. The injuries in some places shifted from drivers to pedestrians as more people drove faster with seat belts on killing those walking on the roads.

The possibility that you may transfer a very small risk of serious head injury to a greater risk of injury to another part of your body or to other piste users remains a real one. It is one of the reasons I would question those who condemn us non users of helmets who judging from photos on the snowMedia zone remain the silent majority. snowHead

I'd be more worried about several Kg's of ski flying through the air (whether still attached to a skiers boot or not). The impact from a helmet, spread over a larger area, would be less traumatic. And poles would seem to be a good candidate for causing damage.

Then of course there is the skier himself, imaging 100+Kg crashing into you especially if your unlucky enough to have an elbow/knee as the leading contact.

Injuries to the head are by far the most serious and anything that takes away a risk should be considered carefully.

Hopefully you realise that I'm happy to let people decide for themselves. Just seems that those same people are condeming users of recklessness (seems a strange on this as I'm still aware that I have arms and legs that can suffer), risk to other users (lots of other things to consider here) and fashion item (seems a bit spurious as the last thing you can say about helmets is that they are fashionable).

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I only meant the point about experienced skiers as to suggest that it is that group who would be most complacent, not that they are necessarily at any different risk in the situation we are speaking. The silly factor I see is that this is the group who should best realise best that the unexpected does happen. It is the same as kids in helmet. Those who should traditionally be at least knowledgeable seem to have little dispute of the helmet logic, where as those with most experience very much seem to dispute.

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FWIW, to back up the poster who was in Austria, when we were in Zurich on Saturday it was very noticeable how many people were buying helmets. We did too, but mostly because we had loyalty points to spend by the end of the year and free helmets seemed a sensible idea.

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buns, if what you say is true, doesn't it suggest to you that maybe the inexperienced people have got the helmet logic wrong?

You know it makes sense.

in the same way that wearing them to cross the road is... yes..

Otherwise you'll just go on seeing the one name:

So the skier that died this month in Banff, on the groomed piste, would have.......

Ah. What the hell. It's like trying to change someone's skiing. Impossible unless they have an open mind and are ready to change.

A snowHead

A snowHead

I think that having an open mind works both ways. The choice to wear a helmet or not is a personal one. To be able to know whether it is effective to wear one is a public health issue which needs analysis of the statistics.

From a medical point of view, to say that a skier would have died if they hadn't been wearing a helmet, or would have died if they hadn't, is absolutely meaningless. It is impossible to make a statement like that about an individual case, as trauma cases just don't work like that. I can say this based on my previous experience working as a trauma surgeon.

So when I look at the evidence for wearing helmets, I would have to say that the story is not as clear as everyone in the pro-helmet lobby seems to think that it is. Although wearing a helmet may protect you from some head injuries, the incidence of significant head injuries when skiing is low enough that the net benefit of wearing a helmet is likely to be small in terms of your overall safety on the slopes.

As for helmets being in fashion, I think that it's a reasonable thing to say if you take the meaning of fashion to mean a "prevailing custom", which is not the same thing as being a fashion accessory! There are fashions in everything, from computer programming to medical science. In the medical world drugs come in and out of fashion, often driven by the marketing departments of the drugs companies, I imagine that the helmet industry is much the same, although likely to be less well regulated.

Well, the person's real but it's just a made up name, see?

Just what kind of low risk are we talking about 1 in a 100, 1 in a 1000 or greater?

Personally I'll wear my helmet and be thankful when the 1 in whatever event comes along.

Whilst its impossible to say if a helmet made a difference surely the same argument could be applied to any safety equipment, if someone’s survives can we prove the equipment saved his/her life. Well no, its entirely possible someone can survive an accident (even a very bad one) and survive. Sometimes without any injuries as some of the sensationalist TV shows catalogue.

Seems like everyone should take a step back and respect the decisions of both the pro and anti brigades.

In a chaotic scenario such as skiing we'll only have anecdotal evidence and not proof.

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Kramer wrote:

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antoeknee, if enough data is collected and analysed then we will eventually have "proof" as to whether helmets are helpful or not. The whole ethos of public health research is to try and find out what the truth is in cases like these. One thing that we can say for certain is that anecdotal evidence is not a reliable way of assessing a health intervention quantitively, and if you are basing your decision to wear a helmet on anecdotal evidence, it cannot truly be said to be a logical decision.

You are right, you can never prove that any safety equipment saved someones life in an individual case, that's why you need to collect data to look at the overall picture. Over many incidents you can assess the effectiveness or not of any given intervention. Generally if something does make a marked difference it is relatively easy to prove, if it makes a small difference it is a lot harder. It is very difficult to prove something makes no difference at all. So far the evidence would seem to show that helmets probably make a small difference.

It seems to me that it is the helmet wearing people who tend to get wound up about other people's decisions to not wear helmets rather than vice versa. The people who don't wear helmets only seem to get wound up when a helmet wearer tries to tell them what to do. I've seen quite a few threads on this site started by people who feel that they should persuade others to wear a helmet, none the other way round.

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pam w, you should replace your helmet every time it gets a bang for it to remain effective according to the manufacturers, which would seem to put the price up significantly. The cost is not just monetary as well, it's also in terms of convenience. Some people don't find it a hassle to wear them, some people do. For the people who do, the cost is probably not worth the benefit.

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It is actually not possible to do a scientific study on this...... by the very nature, a helmet will protect. We can all argue whether it simply shifts an injury in a high speed incident, but nobody can argue that a 'bump' on the head is going to cause less hurt with a helmet on (this i suspect we can prove scientifically!). So that means that lower speed crashes with a helmet may simply never be reported..... so your data set is incomplete

Adam

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Just been reading some ot the info on ski-injury.com. This doesn't make things any clearer really as there is a lot of poorly collected data.

Some interesting points though.

Quote
American Medical Association's report "Helmets for Recreational Skiing and Other Winter Sports in Children and Adolescents". Personally, I agree with its conclusion that there is insufficient evidence to support mandatory wearing of helmets on the slopes. Yes, injuries may occur and yes, helmets may help reduce them. But the fact remains that the risk of such an injury is far too small to insist that everyone wears a helmet. Personal choice at the end of the day.

Quote
The take home message is that the majority of those who currently wear helmets are a defined group of younger, male and more aggressive skiers – the group well known to be at high risk of injury anyway. Many of the high speed impacts with solid objects lead to multiple injuries that no helmet could prevent or reduce. The wearing of a helmet should not be viewed as a panacea against fatal injury and should not give the wearer a false sense of security. Whilst helmets may help reduce the incidence of more minor head injuries and lacerations (especially the ones we see in Scotland) they are less able to protect the foolhardy skier who pushes his or her limits and who (inadvertently) ends up wrapping themselves around a tree. To give a stark example, biomechanics have demonstrated that in order to protect the head against a direct impact blow at 30 mph, with currently available materials, a helmet would need to be at least 18cm thick, 50cm wide and weigh 5kg+. Hhhmm….stylish. Radar data collected from ski areas suggests most intermediate skiers regularly travel at between 24-38 mph.

And the conclusion

So, to conclude, helmets are a good idea and will protect you against many of the common injuries that the head is susceptible too. They are especially important for children, who are at highest risk of snow sport injury. In addition, there is no evidence to date that helmets predispose the wearer to a higher risk of neck injury or cause injury to others. However, it must be remembered that wearing a helmet will not protect you if you have a high speed impact - so go careful, especially if there are trees near the pistes you're on.

This echos what we have all said, make up your own mind and respect other decissions.

buns, it's not possible to do double blind RCT on this, but there are other methods, which are used in public health research all the time.

Secondly in medicine, every intervention has unexpected effects, unwanted as well as wanted. The biomechanics suggest that wearing a helmet may be beneficial, but cannot be taken as proof that they work.

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Kramer, as you are well aware from your profession, one of the concepts that are used to evaluate the usefullness of an intervention (e.g.wearing a helmet) is the "number needed to treat" (NNTT) - in this case this could be defined as the number of skiers needed to wear ski helmets for 1 week to avoid one serious head injury.
This concept can be applied to smaller specific sub-groups (like antoeknee, 's

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