Sports - Prevention

The Center for Disease Control and Prevention has produced a number of documents and kits about brain injury and prevention.  http://www.cdc.gov/concussion/

Heads Up to Clinicians:  Concussion Training by CDC & NFL http://preventingconcussions.org/

Head Injury Prevention - A rundown on risks and prevention of head injury in youth sports. http://www.publichealthdegree.com/resources/head-injury-prevention-in-youth-sports-an-online-guide/

Is a Helmet Worth It? How Brain Injuries Affect Different Body Functions

If you ride bicycles or motorcycles, you may have an idea of just how much crashing hurts.  Crashing or being hit while riding your bicycle can be anything from simply embarrassing to majorly painful.  New riders may think that they’re skilled enough to never crash, but there are many factors outside of their control, and the occasional crash is inevitable.  But while some crashes leave the rider with a few bruises and scrapes, some leave them with broken bones and other painful injuries.

This is why bike safety is so important.  There are so many ways that bike injuries can linger or lead to lifelong issues that to ride without the proper safety gear is very unwise.  This is especially true for those who live in a large city like New York City.  Because NYC has such a large population, there are many more people and vehicles on the streets.  It’s much more likely someone will run into you or get in your way and cause a crash.

While broken bones will hurt and take time to heal, a head injury can be even worse.  Damage to the brain can be irreversible and make it difficult to function.  It can lead to vision and hearing loss, difficulty with memory, a lack of coordination, and can even affect your heart rate and ability to breathe.   Because each section of the brain controls different parts of the body, a brain injury can affect just about anything.

Bicycle Injuries: Would they have been prevented with a helmet?

According to the Insurance Institute for Highway Safety, in 2009, 91% of all bicyclists killed in an accident were not wearing a helmet. That means out of the 628 riders who were killed that year, 573 of them weren’t wearing a helmet.  This wasn’t an abnormal year, either—the percentage of bikers who died in accidents and were not wearing a helmet has never been below 80% with the exception of the 2010-2012 statistics.  These statistics are actually the abnormality because, while 65 to 70% were not wearing helmets, another 16 to 17% are listed as “unknown,” meaning they may or may not have had some kind of protective headgear on at the time of the accident.

The most commonly injured bicyclist is a male over 16 years old riding without a helmet in an urban area.  Out of the 601 bikers who were killed in 2012, only 166 of them had a blood alcohol content level above .08 percent.  Most were completely sober.

What can be drawn from these statistics?  While it’s hard to say if any of the bicyclists would have survived their crash if they had been wearing a helmet (helmets cannot prevent neck or face injuries), it’s entirely possible some of them would have.

In many non-fatal crashes, there is a definite answer: helmets reduce damage to the brain.  According to a number of studies, head injuries account for over 60 percent of all bicycle-related injuries.  In a study done by the Bicycle Helmet Safety Institute, medical professionals reported that up to 88 percent of these head injuries that resulted in brain trauma could have been prevented had the bicyclist been wearing a helmet.

Brain Areas and Associated Functions

Damage to the brain can lead to many different difficulties and lifelong issues.  The brain controls everything about the human body.  As such, damage to the brain can affect any part of the body, even changing a person’s behavior and abilities.  The brain can be divided into six different areas.

The brain stem is the term for the lowest part of the brain that connects to the rest of the body.  Because it connects to the neck, the brain stem is fairly vulnerable.  Damage to the brain stem can lead to many different physical problems, including a loss of balance and the ability to sleep.  It can also cause an irregular heartbeat, breathing problems, and difficulty with swallowing.  The brain stem controls blood pressure, body temperature, sweating, and digestion, too, and any or all of these functions can be affected by damage.

The cerebellum is the part of the brain that coordinates movement, balance, equilibrium, and helps with reflexes.  Those who have damage to their cerebellum may have difficulty performing complex actions or, in the case of major damage, basic actions like walking.

The frontal lobe is where much of our thinking occurs.  It controls things like how we perceive our environment, our emotions, our language, and how we understand concepts and solve problems.  A head injury that affects the frontal lobe can make it very difficult to function.

The parietal lobe handles many of our senses, including touch perception and our ability to manipulate objects.  Damage here can throw off how the senses work together.

The occipital lobes are concerned with one function: vision.  Damage to these lobes can lead to a loss of vision and blurred vision.

Finally, the temporal lobes handle hearing, memory, emotion, and the processing of verbal information.  Light damage can cause a decrease in hearing or in memory, while major damage can leave someone unable to express emotion or remember much of anything.

Parts of The Brain and Their Functions – How will brain damage affect your functionality?

The Four Lobes – What they are and what they do.

Brain Structures and their Functions  - An online resource on the brain.

Damage to the Frontal Lobes – How an injury to the frontal lobe affects a person.

Parts of the Brain and Their Functions – Details the different sections of the brain.

Conclusion
While being injured in a bicycle crash may be inevitable, wearing a helmet can greatly reduce the chances or severity of brain damage.  In many cases, a brain injury doesn’t just affect one area—several parts of the brain can be damaged, leading to a number of different problems for the bicyclist.  Why risk that?  A helmet is a fairly inexpensive and easy to wear piece of equipment that can provide a great amount of protection.  It seems a risk that few people should be willing to take, yet many people ride their bikes without wearing a helmet.  Even worse, a number of parents let their children ride bikes without proper safety gear.  No one is too young or too old to wear a helmet.

Don’t open yourself up to brain damage from a bicycle injury.  Purchase and wear a helmet whenever you ride.

Head Injuries Sustained during Sports and Recreation  pdf: Hbn2-2.pdf

Sports and Recreation 

Sports are a valued pastime, but playing them safely is part of the game.

Scope

• The most common brain injury in sports is a concussion. According to a study released by the Centers for Disease Control and Prevention, there are an estimated 300,000 sports-related concussions in the United States each year. ( 1 )
• Brain injuries cause more deaths than any other sports injury. In football for instance, brain injury accounts for 65 to 85% of all fatalities. ( 1 )

Boxing

• Nearly 90 percent of professional boxers have sustained a brain injury. ( 2 )
• Because the objective of boxing is to make one's opponent unable to fight, it is not surprising that acute traumatic brain injury (ATBI) occurs in boxing matches and sparring sessions. Jabs and angled blows to the head may result in ATBI. In addition to ATBI, chronic traumatic brain injury (CTBI) is of concern in boxing. ( 3 )

Soccer

• Approximately 5 percent of soccer players sustain brain injury as a result of head-to-head contact, falls, or being struck on the head by the ball. ( 2 )
• Heading or hitting the ball with the head is the riskiest activity; when done repeatedly, it can cause a concussion. ( 2 )

Football

• Football injuries associated with the brain occur at a rate of one in every 3.5 games. ( 4 )
• Football is responsible for more than 250,000 head injuries in the United States. In any given season 10 percent of all college players and 20 percent of all high school players sustain brain injuries. ( 5 )
• Football players with brain injuries are six times more likely to sustain new injuries. ( 5 )
• A helmet helps prevent a brain injury from occurring.

Skiing

• The Consumer Product Safety Commission (CPSC) estimates that in 1997, there were 84,200 skiing injuries (including 17,500 head injuries) treated in U.S. emergency rooms. The CPSC also estimated that 7,700 of those head injuries, including 2,600 head injuries to children, could be prevented or reduced in severity each year by using helmets. About 11 skiing and snowboarding-related deaths would be prevented annually with helmets. ( 6 )
• Always wear a helmet when skiing for protection during falls and collisions.

Baseball

• The head is involved in more baseball injuries than any other body part. Almost half of the injuries involve a child’s head, face, mouth or eyes. ( 2 )
• The leading cause of injury and death is being hit by the ball, the second leading cause is collision. ( 2 )
• Always wear a helmet when batting.

In-Line Skating, Rollerskating and Skateboarding

• Brain injuries occur most often when skaters fall and hit their heads on the pavement.
• Skating on roads causes a risk of colliding with cars, bicyclists, pedestrians and pets.
• Always wear a helmet for protection from falling.

Horseback Riding

• Brain injuries account for 60 percent of equestrian related fatalities, and 17 percent of all equestrian injuries are brain injuries. ( 7 )
• Always wear a helmet when riding a horse.
• In 90% of the cases, injuries to equestrians that require hospitalization are caused from the rider being separated from the horse while riding or the rider falling with the horse. ( 8)
• In 1999, there were an estimated 6,000 horseback riding brain injuries. ( 9 )

Sources:

1. Concussion in Sports and Return to School Issues Following Concussion, James P. Kelly, MD and Ronald C. Savage, Brain Injury Source Pediatric Issue, Volume 3, No. 3, Summer 1999
2. American Association of Neurological Surgeons/Congress on Neurological Surgeons, 1998. http://www.neurosurgery.org/pubpages/patres/faq_sports.html ((February 5, 2001)
3. The Physician and Sportsmedicine - Vol 28 - No. 1 - January 2000, "Acute Traumatic Brain Injury in Amateur Boxing." http://www.physsportsmed.com/issues/2000/01_00/matser.htm (February 5, 2001)
4. Kelly JP. Concussion. LN Torg JS, Shepard RJ (eds.) Current Therapy in Sports Medicine, Philadelphia: Mosby, 1995.
5. Diagnosis and Management of Concussion in Sports, James P. Kelly, MD and Jay H. Rosenberg, MD
6. Centers for Disease Control, SafeUSA: Winter Sports Injury Prevention - Safety on the Slopes. http://www.cdc.gov/safeusa/slopes.htm (January 26, 2001)
7. National Electronic Injury Surveillance System, 1991-1992
8. American Medial Equestrian Association, Sept. 2000
9. National Electronic Injury Surveillance System, 1999.

This fact sheet was developed by the Brain Injury Association of America (April 2001)