Independently of our age, skill level, or experience, we must always wear a protective helmet while riding our bikes, motorcycles, skating, even skiing. Children of all ages should also wear helmets while riding a sled or inner tube down a snowy slope. The reason is the same: in most sporting activities, our heads are always vulnerable to injury; bruises, skin abrasions and cuts, even broken bones will heal, while brain damage may last a lifetime.
It could happen in a few seconds—we could fall and hit our head against a tree, post, the sidewalk, etc., and sustain an injury that could even be fatal in a few hours or days. A blood clot may slowly form (intradural or extradural hematoma) from a torn, bleeding vessel, increase pressure inside the skull, and if it goes untreated, cause unconsciousness and eventually death.
How do helmets work? Properly designed helmets absorb much of the force of impact that would otherwise cause head injuries. Thick plastic foam inside the hard outer shell of a helmet cushions the blow; the helmet actually absorbs the energy that otherwise would reach our head.
Each year, even minor bicycle accidents kill hundreds of people in the U.S. and cause brain damage and other injuries to more than half a million riders. Even with wide availability of inexpensive helmets and proper information on how and why to use them, it is estimated that only approximately half of over eighty million bike riders would wear them all the time. Many riders do not wear them at all ... even when statistics show that helmets prevent brain injuries in about four out of six serious crashes.
Bicycle shops and many department stores sell several models of affordable helmets. The Consumer Product Safety Commission and the Snell Memorial Foundation have offered safety guidelines for effective helmets. We should choose one with the right size and fit: it should fit snugly and not slide around our head, fit squarely on top, and cover the top of the forehead. Once in place, it should feel comfortable and not slide or tilt in any direction; the chinstrap should keep the helmet from moving around. The helmet should be smooth and round; many models are ventilated, lightweight, and fashionable in color. For children, helmets must fit them properly; avoid those that they “will grow into.”
We must teach children by example and always wear our helmet when playing sports with potential for collisions and head injuries. Children are more likely to wear helmets if they like the way they look; cool-looking helmets are worn more often.
Bicycle helmets do save lives and prevent injuries, but should not be worn while climbing trees or around playground equipment because they may get stuck and actually cause neck injuries and even strangle a child.
Ski helmets are slowly becoming more popular now; they will prevent many injuries, even when they would not be able to absorb the high energy of trauma caused by high speeds on the slopes.
Helmets’ integrity must be carefully examined after a crash and replace them when dented and when the protective lining is torn or disrupted. Chinstraps should also be replaced if they are torn, the buckle is broken, or they are weakened in any way. We should remember that if after an accident our helmet does not fit as it used to be, becoming somewhat loose, we may easily drop it and with it, something that may keep us from sustaining a devastating brain injury ... even if we are involved in a minor accident.
By Colleen S. Mills, MD