Helmet use is a heated topic among cyclists. Whenever discussions take place, the emphasis falls on helmet use for prevention of death. Surprisingly, there is little discussion about the role of helmets in preventing non-fatal head injuries.
Absent is consideration of the long-term health affects of less severe injuries including concussions resulting from blows to the head. This type of injury is more prevalent and can lead to debilitating symptoms. Some people have begun to pay more attention to such injuries and have taken steps to address them.
For instance, to reduce the severity of head injuries in cycling and other action sports where helmets are used, Biju Thomas, a professional chef, came up with the idea of combining a safety device with a special fabric to monitor injury impact. The device, called the SenseTech HALO, was created by a team of scientists, designers and cyclists. It is in the final stages of prototyping and is expected to start beta testing this fall.
A wireless device designed to fit into the air vent on the top of a helmet is used in combination with sensors in the fabric of the helmet. Specific data analysis algorithms process injury information from the sensors to quantify clinically significant impacts. Then the wireless device transmits a signal to the user’s smartphone via Bluetooth technology. The phone is programmed to alert medical services. The SenseTech hardware will also use data from compatible personal IDs to provide emergency contact information and medical information. This is particularly useful when a cyclist is riding alone.
“Initial recognition of traumatic brain injury [TBI] is difficult, but doctors repeatedly stress quick medical attention. It is critical that, after trauma, any person receive medical attention as soon as possible. This is well documented in the research literature on TBI and other types of brain injuries such as stroke… [she] spoke of the Golden Hour – the one hour after the injury that is considered crucial in saving lives.”
The necessity for such safety devices opens a new area of discussion about helmet use in cycling. Many cyclists refuse to wear helmets on the pretext that they are too experienced to hit their heads, even if they fall. If it were true that sports participants could control the position of their heads at all times, no one would ever sustain a head injury. Head injuries are not just about who lives and who dies – a fact which those cyclists don’t understand.
A concussion can result from an impact to the head. It’s not a life-threatening injury, but it can cause short-term and long-term problems. A concussion results from a closed-head injury and does not include injuries where there is bleeding under the skull or into the brain. Another type of brain injury involves visible bleeding which can be seen on a CT scan.
Mild concussions can result in no loss of consciousness or a very brief loss of consciousness. In severe concussions, prolonged loss of consciousness with a delayed return to normal may be seen.
A person who has one concussion typically doesn’t suffer long-term side effects. But short-term side effects can include: postconcussive syndrome (a persistent headache lasting from a couple of weeks to months after the injury), dizziness, nausea, vomiting, and difficulty concentrating. These symptoms usually stop on their own, but may persist for months after the injury.
Keep in mind that with each concussion comes a higher risk of developing another concussion in the future. Repeated concussions can lead to long-term problems such as psychiatric disorders, memory loss or various neurological (brain) abnormalities.
Maybe if cyclists understood better how a non-life-threatening head injury could affect their lives, they would change their minds about the value of using a helmet. Personal accounts are sometimes best for driving home a point.
While researching this issue, I came across many compelling stories written by patients who have suffered head injuries similar to those sustained when falling off of a bicycle. One is from a young man in his twenties:
“I was hit on the head four years ago. I was diagnosed with post-concussion syndrome, post-concussion migraine and epilepsy. I live everyday one day at a time. I cannot make plans to do things because it just depends on how bad the migraines get or if I can actually function that day. I feel for anyone out there who is in my situation. This has turned my world upside down. I have lost my job. I have a hard time spending time with friends and family. I get irritable and so sensitive to light and noise that I most have to stay to myself. But life goes on no matter what and I learned that you have to make yourself better and live with it because after you feel this for so long, you know that you just have to push yourself to do things. Good Luck!”
Another account, written by a 26 year old man, further elucidates the issue:
“I was told I had a concussion on December 8th 2009 where I was in a major car accident. I was out of work for two weeks and went back to work for a day and a half. I began to suffer from stroke like symptoms, blurred vision, my left side went limp, my blood pressure was 188 over 122 (I’m 26), and I was extremely disorientated. My doctor put me on multiple prescriptions where I pretty much turned into a zombie. It is now February 10th 2010 and I’m still missing work due to headaches, cold sweats, and the shakes. I hope I get better soon. My headaches are extremely painful and I still have short term memory issues. My symptoms were headache, lost consciousness, nausea, and dizziness.”
If a cyclist were to fall in the vicinity of an object such as a parking meter or fence, it would be easy to knock his/her head against the object when falling off of the bike. Sustaining a concussion under these circumstances would not be out of the question.
Mandatory helmet use laws may not be the answer to reducing cycling related head injuries. Dictating helmet use under the pretense that it will guarantee head protection is disingenuous since helmets can’t adequately protect the head in all circumstances. And, cyclists should have the freedom to determine their own risk tolerance. Nonetheless, given the high probability of suffering short and/or long-term symptoms from even a minor blow to the head, cyclists would be wise to consider whether bucking the current helmet wearing trend is worth the risk of enduring debilitating medical problems.