Helmet Use - My Thoughts And Opinion -- Ski Rex Says

It would seem that the Dartmouth-Hitchcock Medical Center report on injuries versus helmet use in skiing and snowboarding is still kicking around. It's been at least a couple of weeks or more now, but it's still spurring conversation on helmet use and media coverage. Even Unofficial Networks did an article on it this week.

Now, I've been avoiding doing a story on that study, but since others are still talking about it and I happen to be sitting in a waiting room at Dartmouth-Hitchcock Medical Center today, why not talk about it?

You see, I have been starting to think that bringing up the topic of helmet use on a media outlet for skiing and snowboarding is like bringing up politics at the Thanksgiving table (or another family holiday for those not in the United States). People are either going to get pissed off, offended, or just straight alienated, which is not something that I want to happen with the friends and fans of Ski Rex Media.

With that said, I am going to try to keep this short and sweet, even though I'm thinking that I have gone beyond that already. Let's be honest, if you listen to or watch the podcast, you know that I sometimes get a little too long-winded and it just turns into a rant. But, here we go.

The Dartmouth-Hitchcock Medical Center Study

Now, if I had planned a little better, I might have been able to take a few minutes of my time here to find those who wrote the study and ask them all about it in person. I can, however, give you a summary of what the study said, via pubmed.gov.

RESULTS: Seven hundred twenty-one patients (65% helmeted, 35% unhelmeted) met inclusion criteria. Helmet use doubled during the study period (43% to 81%, p < 0.001), but the rate of any head injury did not significantly change (49% to 43%, p = 0.499). On multivariable regression, helmeted patients were significantly more likely to suffer severe injury (odds ratio [OR], 2.01; 95% confidence interval [CI], 1.30-3.11), intracranial hemorrhage (OR, 1.81; 95% CI, 1.10-2.96), chest injury (OR, 1.66; 95% CI, 1.05-2.61), and/or lumbosacral spine injury (OR, 1.84; 95% CI, 1.04-3.25) than unhelmeted patients. Helmeted patients were half as likely to suffer cervical spine injury (OR, 0.51; 95% CI, 0.30-0.89) and a third as likely to sustain skull fracture and/or scalp laceration (OR, 0.30; 95% CI, 0.14-0.64). More patients who hit a stationary object were helmeted compared with those who fell from standing height onto snow (70% vs. 56% respectively, p < 0.001). After adjustment, hitting a stationary object was the injury mechanism most significantly associated with severe injury (OR, 2.80; 95% CI, 1.79-4.38).
CONCLUSION: Helmeted skiers and snowboarders evaluated at a Level I trauma center were more likely to suffer severe injury, including intracranial hemorrhage, as compared with unhelmeted participants. However, they were less likely to sustain skull fractures or cervical spine injuries. Helmeted patients were also more likely to hit a stationary object. Our findings reinforce the importance of safe skiing practices and trauma evaluation after high-impact injury, regardless of helmet use.

In short, people are wearing helmets more often, but in some cases suffering more severe injuries of certain types and most often when hitting a stationary object, like a tree. On the flip side, helmet users are suffering other types of injuries less often, just as one would expect.

But, Why Would That Happen?

That's an interesting question to attempt to answer. Even one of the authors of the study, Dr. Andrew Crockett, made a comment to Vermont Public Radio saying it was a difficult question to answer.

“The ‘why’ is a tough tough question to answer,” Crockett said. “Just looking at our numbers and anecdotally, the best solution is just that despite the use of helmets, in the patients that we’ve seen at our facility, they’ve received so much traumatic energy that the helmets hasn’t proven to be as effective as we would like.”

Now, when I talk about the subject, I feel the "why" really comes from what people think while wearing their helmets. I agree with the idea that some people get a false sense of security when using extra gear. A similar argument was made during an increase in backcountry avalanche victims. Though new and wonderful technologies are available, victims either didn't know how to properly use the equipment or got cocky. Helmet use could be looked at the same way.

I'm not saying that everyone who puts on a helmet now thinks they are invincible or doesn't know how to strap it on correctly. However, with an increase in injuries in some cases, mostly involving stationary objects, it seems to me that people are strapping on their helmets and then heading into a glade run when they aren't on that level of skiing or riding yet. That perhaps the skier or snowboarder is now riding in a more unsafe manner due to thinking they are protected. Again, this is just my opinion. I'm not a doctor, nor do I have a statistic to back that up. It's really only a theory.

It could very simply be that helmet technology still needs some time to evolve, not unlike the helmets used in the NFL. Over the years football helmets have been redesigned based on new technology and study to make the players safer. Similarly, the ski helmet might need some time to grow into the sports they are used for. There may come a time when a skier or rider can go headfirst into a tree or lift tower and walk away with zero issues. 

So, Should People Be Using Helmets?

The answer that I have for that question comes in two parts and the second part will be given in the final section of this piece. As for the first part, the numbers given in the study were about injuries, not fatalities. Though more serious injuries of certain types were sustained, it could be theorized that some of those injuries could have turned into fatalities. True, I can't say that for sure, but it is also true that lives have been saved by helmets.

Even the authors of the study said they absolutely advocate for the use of helmets during the Vermont Public Radio interview. This study was not an attempt to get people to not use them. Anytime a person uses safety equipment and uses that equipment correctly, they are helping to prevent injuries or death. This study just showed that there was an increase in specific types of serious injuries on those who said they were wearing a helmet, which could be for other reasons, as stated above. 

Ski Rex Media Final Thoughts

As for the second part of the answer to the above question, should people wear helmets, the fact is, it's up to them.

From a personal standpoint, I would never tell someone they should or should not wear a helmet. For me to say either way would make me a hypocrite and just foolish in some cases. I have never worn a helmet while skiing, though I have worn one while mountain biking and inline skating. In fact, I avoided getting cut up because my helmet took the damage during a fall while skating. So, even I can say that I see the pros of wearing one.

Yes, I did say pros, because just like anything else, there are cons that could be argued for when it comes to wearing a helmet. Now, I like to think I'm good when it comes to the sport of debate. I can argue both sides equally as well, but I'm not going to do that, because as I said, in the end, it's up to each person to make up their own mind about it. Plus, it's that kind of debate that can alienate or push people away, which something I don't want to happen.

But, it's no different than a motorcycle rider that takes off their helmet in the states that don't require one or even for those that don't use their seatbelt. I'm not here to tell you what to do in either of those cases. You and I both know that safety equipment is a good thing. But, for whatever reason, we just don't use it sometimes. Some would call that dumb, though some of those that would call it dumb would also be a hypocrite in some ways. Just so it's said, if someone calls you stupid for not wearing a helmet, ask them if they have chest protection. There are more than a few serious injuries to the chest or upper body that can also cause a fatality. We know that's true because those who ride mountain bikes in the offseason, depending on their choice, will wear chest protection, as well. So you see, if a person is wearing one and not the other, they could be looked at as a hypocrite and shouldn't be calling anyone else dumb for not using either. Again, just an opinion based on the idea of debating the topic.

So, in closing, I'm just going to say this. I try to keep my opinions and arguments as balanced as possible. To do that here, I can only say that it really is up to each person to decide if wearing a helmet is right for them. Will I start to wear one? I don't know. I have other physical issues that I have to solve before I can get back on the hill. Right now, I don't need to decide on a helmet. But, I would never tell someone they should or should not use it. If you do...great. I'll even autograph it for you. If you don't...great. I hope to have a Ski Rex Media hat that you can wear instead. No matter what you do, though, try to be as safe as you can be. Keep those eyes up, ears listening, and follow the rules. That will help get you through the day safely and any equipment that you can add will only help.


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