Helmets Save Lives

I have been doing some research for a training video I am putting together on “Concussion in School-Aged Children” and I came across an alarming statistic reported on www.neurosurgery.org that 52% of children did not use a helmet while riding a bike and that only 41% did (the other 7% apparently had a helmet with them but were not using it). These statistics came from an observational study undertaken in 2003 in which 8159 children and 1396 adults where observed in 549 sites in 46 states. Of further concern was that of those who were wearing helmets, a third of them were not wearing them correctly (they were too loose or were too far back on the head). The year that these observations were made (2003) there were 626 bicycle deaths - in 2008 that number was 714.

Currently 21 States and the District of Columbia have laws requiring helmet use by children and five states require helmet use for other wheeled sports (scooters, skateboards and inline skates). Helmet use is significantly higher in places with enforced helmet use laws. There is also evidence that the rate of serious head injury is lower in places where there is greater helmet use. A report from the National Highway and Traffic Safety Administration (NHTSA) reported that 9 out of 10 adults support a law requiring children to wear helmets when cycling and about 60 percent support a helmet law for adults (this number dropped to less than 50% among adults who identified themselves as bicyclists).

The question of why people do not wear helmets is an interesting one and an important one to understand. The following table is from the same NHTSA study.


It seems to me that another reason is that most people do not fully understand the risks involved and the potential consequences of even a minor blow to the head. I also think that many believe that something bad could not happen to them or their loved ones. As a neuropsychologist, I have seen firsthand the devastating consequences of injuries that could have been prevented by helmet use and I am committed to trying to help others understand the need for regular helmet use by adults and children.

My children (8 and 9 years old) understand that they never ride their bikes, scooters or a skateboard without a helmet. My wife and I have reinforced this to the point that we no longer have to remind our children about it. Children will not make these important safety decisions on their own and many will avoid wearing a helmet if they can. It is up to us as adults to reinforce the need to be safe and to set a good example. Children are more likely to wear a helmet if they are riding with others who are wearing them. As parents it is our responsibility to make sure our children have the right safety equipment for all of the activities that they engage in and to make sure they use them.

NFL's new PSA airs tonight during Steelers and Browns Game

Tonight during the Steelers - Browns game the NFL will air a new PSA aimed at increasing awareness among players, coaches and parents about the importance of recognizing the symptoms of concussion and responding appropriately. The NFL has received a lot of criticism recently about past practices related to the management of concussion, but this is a very positive step. There is still a lot of work that needs to be done to educate those involved in all sporting activities about the danger on repeated concussion. If a young athlete, after suffering a concussion, can be removed from play and the from risk of a second concussion, he/she can avoid the danger of more serious and long-term injury. I applaud the NFL for release of this PSA and hope that other sporting organizations will follow suit.

A Personal Experience with Concussion

In 1991 I graduated with a Ph.D., in clinical psychology with an emphasis in neuropsychology. I completed additional training in neuropsychology at the Cambridge Hospital (a training hospital for Harvard Medical School) and then at the University of Michigan Medical School. I was in my fourth year as a staff neuropsychologist at a residential brain injury facility in East Lansing when I had my first and only concussion.

I was at the Michigan Athletic Club, a sprawling recreational facility in East Lansing, where I spent several hours every day playing basketball and lifting weights. There was a regular crowd of us that played pickup basketball there daily and we all knew each other pretty well. On this particular day there were not yet enough of us to play a full game so we were messing around playing a kind of half-court free for all.

I remember jumping and reaching for a ball that was coming off the hoop when a good friend of mine got under me. As I started to fall, he tried to help me but in his effort to do so he tied up my hands so I could not use them to help break my fall. With my hip on his shoulder and my momentum going sideways I quickly pivoted and hit the back of my head on the floor with significant force. I remember a bright flash of light and some localized pain at the site of the impact. I did not lose consciousness (only about 10% of concussions involve loss of consciousness) and I remember feeling alarmed that I had hit my head with such force.

As a neuropsychologist I had seen many people whose lives had been devastated by trauma to the head and as I got up off the floor a wave of apprehension swept over me. I walked over and sat on the stairs by the court and began a kind of self-examination. I was not entirely sure what day it was, my mind felt kind of foggy, but other than that I seemed to be OK. After about 15 minutes of sitting and continuing my self-examination I walked to the locker room, gathered my belongings and went home.

As concussions go, mine was relatively minor. I had some residual fogginess through the evening, I developed a low grade headache, and I definitely did not feel as sharp mentally as I usually did. That lack of mental sharpness persisted for a couple of days, but lucky for me it was the weekend and by Monday morning I felt fine resuming my normal duties.

When I think back on this experience I am grateful that I knew enough to not put myself at further risk of injury before I was fully recovered. It is these additional injuries that occur before the initial concussion is resolved that seem to do the most severe damage.