Why don't we wear helmets?

[jdk99]

Forgive me if this has been addressed in a previous thread but we had this question come up the other day.

 

A friend blew his ear drumb on a bad OTF. As he got back into the boat holding his ear, I pointed to the wakeboard helmet with ear protectors that we make our kids wear and asked, "huh, I wonder why we skiers dont wear helmets when everyone else does?"

 

Thoughts?

[Than_Bogan]

Does "I donewanna" count as a good reason?

 

Being a bit more serious, the risk of serious head injury seems to me to be quite low. Because the water isn't very hard, even in a face plant it's usually something else that takes the brunt of it. In fact, with the neck being vulnerable in this type of crash, I'd worry about anything that added mass to the head potentially increasing the risk.

 

I HAVE seen folks wearing ear protection gear to prevent ear drum damage, though.

[OKSkier]

We have about 5 out of eight skiers in our group all wearing helmets.

Its awesome. Prevents ear and head impact issues and also prevents head going through handle

[Than_Bogan]

Maybe some very low weight anti-concussion setup could be a good idea?

[Chef23]

My son got a concussion slaloming last year. I am not putting him in a helmet this year but I did give it some thought. He is 16 though so I imagine it would be a battle. I don't know if the helmet would have prevented the concussion or if it was just his brain rattling around in his skull. I am can't imagine it would have hurt though.

 

Joel Howley wore a helmet when he first came to the states but he doesn't any longer.

[jdk99]

I'll buy "I donewanna" @than_bogan - that's my reason. Not sure I buy the neck injury argument.

 

I guess you could argue a skiers angle of entry is more horizontal than the wakeboarders which lessens the force of impact. Just seems interesting to me that in this day and age when everyone's got 'em all wadded up over concussion that it hasn't really hit our sport.

[klindy]

@jdk99 there's a reason jump helmets are made the way they are. They are designed to prevent bucketing which would potentially cause a worse injury. In the old days (pre-full face helmets) the snaps were plastic so they would come off easier if it did bucket, etc. u realize a typical (good) landing you're facing and traveling forward and flopping back into the water causes the best chance of bucketing but a similar theory could apply to slalom. New helmets are quite light and the foam won't absorb water but it hurts, a lot, when the helmet grabs the water and acts as a sea anchor.

[Wish]

Ear drum blow outs are more common then concussions. Preventable with custom molded earplugs from your local audiologist. If this injury has already occurred ...highly recommend.

 

.

 

 

[jhughes]

As the unofficial, self-titled "King of Eardrum Blowouts" (I've had at least 5, most from barefooting but a couple from slalom in the early days) I can tell you for 100% certain that the helmet with ear flaps does not prevent the injury. In 2007 I had a huge OTF in ski school with an Ace Wake helmet, with flaps, and blew out my eardrum. After that I ditched the helmet.

 

What I have hooked to the back of all of my life vests is a set of vented Docs Pro Plugs, connected to a leash that goes through the tag of the vest. These have been more effective than the helmet though I've even gotten a blown eardrum with these as well. In that case, however, I fell so abruptly that the plug came out before impact (this was barefooting on the short rope in very rough water).

 

I have not had an OTF for ages, and my barefooting days are behind me, however I always always ski with Doc's Pro Plugs.

 

Ski-to-head contact does worry me a little bit, but not enough to wear the helmet every set.

 

 

[Than_Bogan]

Ok, time to be a lot more serious.

 

Wakeboard falls are typically MUCH worse that slalom falls, especially as it relates to forces directly on the head. The main reason I almost never wakeboard is that if you catch that edge it's like a giant grabbed you by the feet and slapped you on the water. That's for the young and/or foolish. :smile:

 

Slalom falls are almost never like that, BUT may be paired with a 3-4x increase in velocity (in the plane of the water's surface). So something "grabbing" the water is a huge risk -- the grabbed thing decelerates rapidly while the rest of you doesn't. I know I am super-careful to get my arms and legs in ASAP when things are going south.

 

Contextual background about myself: I wear a seatbelt even if I am just reparking my car and moving it less than foot. I spent most of last season getting comfortable on OB4s because I believe they offer a safety improvement. I will not use my ski partner's handle that is identical except for the lack of cross-bar. No kid rides in my car without a properly fitted carseat. When it's really cold, I wear a life vest under my drysuit just in case the outer shell punctures. I change out the treble hooks that come with crankbaits to larger single hooks that are less likely to penetrate my skin beyond the barb.

 

It is my sincere opinion, based on helmet designs I have seen so far, that the net risk of injury to a slalom skier is increased by wearing a helmet. However, the specific risk of a concussion is clearly reduced, so I would wear one if I wanted to do some easier passes while still under "concussion protocol" after having had one. (I don't think I've ever had a concussion, but of course when I was young nobody was really looking for that.)

 

I will, of course, keep an open mind to the possibility that I am just plain wrong or to technological advancements that change my conclusion.

[RazorRoss3]

I've personally never done this (knock on wood) and don't plan to any time soon (knock on wood) but the most detrimental and helmet requiring crash I can imagine would be to scorpion the tail of the ski into the back of your head (knock on wood).

 

Other than that (and the rope over head thing) it seems that a headband would be nearly enough to prevent ear injury. Not sure how to prevent the rope thing other than letting go of the handle when you should. Because that's what all of us are so good at doing in a tournament.

 

 

[PatM]

I have blown out my eardrum 3 times (over 20 years ago now). I have since used cheap foam earplugs ($25 for a box of 200). No problems since. Only problem I can't ski without them because the wind noise is so distracting.

[Than_Bogan]

Also, Pat can't hear us very well while he's on the starting dock or in the water :smile:. But he may consider that a feature.

[Billbert]

I wear one. Full face LAX helmet and a motocross neck brace in case the water catches it. I took the tip of the ski to my face in an OTF, Several fractures of the face, blew out my orbital cavity and almost lost an eye. Two surgeries and a month in the hospital are my reminder to put it on before I get in the water.

 

[Chef23]

@Billbert my son plays lacrosse and hockey. I think a hickey helmet with a full cage would be much lighter and provide similar protection for water skiing as a lacrosse helmet.

[mwetskier]

i personally think the vast majority of concussions from slalom falls are not preventable with a helmet. in jumping the primary danger is head impact with the ramp or with one of two huge skis. in slalom concussions are most likely caused by the head suddenly decelerating upon hitting the water while the brain has to stop itself by hitting the inside of the skull. no helmet can prevent that scenario.

[supersonicus]

If a properly slalom helmet would be designed, I'd wear one in a heartbeat. I'm surprised that one has not been developed and mandated for competition. That water can be really hard...

[pgmoore]

@supersonicus - Man... I couldn't agree more. You know what's more important than your brain? Nothing. There is nothing more important than your brain.

 

I'd wear one in a heartbeat too.

[jdk99]

@mwestskier…what you've described is precisely what happens with all blunt force trauma to the head/brain and helmets do help prevent that.

 

@Than_Bogan…agree it is a risk/benefit question. Again, not sure I buy that the modestly increased weight of a helmet increases the mass at the end of the lever enough to make that big a difference in terms of c spine injury risk. Conversely, the possibility of the edge of the helmet being "grabbed" and decelerated with subsequent cervical hyperflexion/extension does make sense.

 

Perhaps the solution is a release system where the helmet would pop off in a "grabbing" situation but stay in place with a direct impact to the head.

[eleeski]

If you really want to be safe just sit on your couch - and die of obesity.

 

Helmets (or handle guards) are unreasonable fear paranoia. Accidents are rare and usually not severe. The occasional severe waterski trauma makes a scary story but real life threats are far more important and affect far more skiers.

 

If you really want to live long and healthy do the five things that really matter:

1 Wear your seatbelt (when you aren't just parking @Than_Bogan)

2 Don't smoke

3 Don't get fat

4 Be wealthy

5 Choose your parents well

 

Creating barriers or unreasonable fears can do significant damage to our sport. Get real!

 

Eric

[cragginshred]

@eleeski let me know when you want to go rock climbing with me. You will not get a harness or rope though! Helmet optional

 

[Stevie Boy]

I don't wear a Helmet because it will not fit in my ski bag, if it did, I would buy a smaller ski bag.

 

[Texas6]

I don't wear and won't Dont see myself wearing one. Having said that, I felt pretty darn bad for my eleven year old boy last Saturday when I dragged him out of the lake and into the boat with blood dripping down both sides of his face after the ski hit him in the head and knocked him silly.

[Stevie Boy]

Ah , now young or novice skiers that are just learning, could be different, just maybe there is a argument for wearing helmets until they become established enough on the ski, remembering when skiing at low speeds the wake is considerably bigger, skiers are less likely to fall clear of the ski at low speed.

[Than_Bogan]

@jdk99 I misspoke when I referred to mass. That would be easy to address witb extremely light material. The issue is catching on the water.

[oldjeep]

I think I'll just wrap myself in bubble wrap before leaving the house each day. At some point you either have to decide that you are going to take the risks that come with doing active things, and realize that most of us grew up before you only wore helmets for football and maybe hockey - we all must have survived.

[thager]

I've had at least 6 concussions in my life time. All but one I was wearing a helmet. I find wearing a helmet slalom skiing uncomfortable and worry more about the dam thing bucketing and snapping my neck. Also can't afford all that bubble wrap so I am just going to stay inside and browse" Space Look" and play video/digital games so I can fatten up and have a heart attack.

[The_MS]

@eleeski Don't forget about wearing a full contact body condom.

[Than_Bogan]

I must reject all arguments that come down to "life has tons of risks so ignore them all."

 

That's just not good logic. Unfortunately, good decision making is more complicated. So much so that I DO accept "I'm not willing to give that a lot of analysis" as a valid decision. We can't spend our entire lives analyzing risks.

 

But there are many situations where a small investment (in money, time, thought, etc.) can significantly reduce a risk, even if that risk is small or its occurrence improbable. And there are risks that are either so likely or so catastrophic that we should be willing to accept some inconvenience to help address them.

 

On the other hand, we must always keep in mind why we're trying to be safe: To live on in a healthy state so that we can keep doing the things we love to do. It's that second part that we have to careful not to give up by over-pursuing safety, which would completely ruin the point of being safe in the first place!

[jdk99]

Geez guys! We (myself included) sound like a bunch of grumpy old men. "idonewanna", "get real", "bubble wrap", "body condom"…. I couldn't agree more that we've evolved into a wuss society but I do think it rational and intelligent to at least weigh the pros/cons of safety gear in a sport where we reach velocities of 50+ mph with the potential for serious injury. For the record, I am not advocating for or against helmets just asking the question.

[The_MS]

Why do we not wear helmets in the car? You are more likely to bang your head in a fender banger then crossing a wake.

[dchristman]

@Than_Bogan I reject the notion that "We can't spend our entire lives analyzing risks." ... in fact I believe that's all we do! Unfortunately we often poorly assess the risk because we don't have all the necessary information and rely on our often inaccurate beliefs.

 

I have assessed my risks and I decided I'm heading to the lake now.

[jdk99]

Characteristics of water skiing-related and wakeboarding-related injuries treated in emergency departments in the United States, 2001-2003.

Hostetler SG1, Hostetler TL, Smith GA, Xiang H.

 

Analysis of injury diagnosis was consistent as wakeboarders had significantly more traumatic brain injuries (12.5% of all injuries) than did water skiers (2.4%) (P < .05; relative risk [95% confidence interval], 5.27 [2.21-12.60]). Strains or sprains were the leading injury diagnoses for water skiing (36.3% of all injuries), and the majority (55.7%) were to the lower extremity. Lacerations were the most common diagnoses for wakeboarders (31.1% of all injuries), and the majority (59.6%) were to the face.

 

http://www.ncbi.nlm.nih.gov/pubmed/15888722

[supersonicus]

@jdk99 I venture to guess that shoreline slalom skiers accounted for a small percentage of the injured skiers sampled. Consistently crossing the wakes at 50+ mph (just guessing at the speed) does significantly increase the risk of head injury.

 

Overall, IMHO "I don't want to wear a helmet" is just plain foolish if given a properly engineered protection option. Although an extreme comparison, I've known to many people who have said the same thing before having their brain roll down the street shortly after climbing on their motorcycle.

 

Sounds like a nice little niche opportunity for a helmet manufacture...

[Horton]

I jumped over a hundred sixty feet in the eighties without a helmet. at this point in my life my hair is my helmet

[andjules]

I'm hesitant to get into a thread like this, but it seems to me that you or someone you know (or someone you heard about) will eventually have a skiing injury. One day it will be a head injury and you'll think about a helmet. Another time it will be a hand through a handle and you'll think about getting a handle guard.

 

As others have pointed out, those incidents mean little without some kind of statistical context.

 

Anecdotally (and I realize that's a funny way to lead a paragraph after mentioning the importance of statistical context), having skied for many years, and taught at summer camps for a few years:

- as a wild oversimplification, slalom skiers strain their lower backs (especially when their stack isn't great & aren't in good shape). Sometimes they hurt their ankles. Again, as a wild oversimplification, it seems to me every other injury (and I've had some of them) are incidental/not statistically significant. So if you want to invest in safety equipment, get a lumbar support and bindings with a good release system (and get in shape).

- (advanced) wakeboarders, show skiers, barefooters, trickers and jumpers all have different injury patterns and risks, and frankly, they are all significantly riskier activities (with the possible exception of trickers). They all regularly get themselves in situations where their joints aren't aligned. While that's somewhat true of slalom skiers, it's much less so, which I think is at the heart of why there are so many 40-70 year olds on BoS and not on wakeboarding forums.

 

Also, as to @jdk99's original question, and as @mwetskier hints... is there any evidence that a helmet really prevents concussions when impacting the water at our speeds? The helmet is meant to absorb shock. Even at high speed, doesn't the water absorb way more shock than almost any helmet? Am I wrong in assuming jumpers wear helmets to absorb shock when impacting with a ramp? Helmets—and 99% of the 'facts'/data we have about helmets—are designed around protecting the head from high speed impact with unforgiving solids, NOT liquids. Yeah, yeah, I've taken enough high speed falls to know that water gets pretty unforgiving above 40mph, but just because it feels that way, it doesn't mean it's really comparable to solid asphalt or glass windshields ("things I don't want to hit my head against at high speeds").

[mwetskier]

@jdk99 -can you help explain how a helmet can help prevent brain injury during a slalom skiing fall? unlike a bicycle or motorcycle helmet any helmet with enough internal *give* or cushion would have to be way too large to prevent bucketing neck injury. the water stops the head faster than the brain can take and a concussion follows and i cant see how any helmet can prevent that. please enlighten me.

[jdk99]

@mwetskier - to be clear, i never said a helmet would prevent brain injury during a slalom ski fall. That remains to be seen.

 

Now, as to your request: Non penetrating brain injury (blunt trauma) is the result of rapid deceleration and rotational forces that result in macroscopic injury (torn vessels, contusions,etc) and microscopic injury known as diffuse axonal injury (essentially torn neurons). Helmets serve to decrease the rate of deceleration of the head as it impacts a solid and hence the brain as it strikes the inner service of the skull irrespective of what the source of the deceleration is. This has been demonstrated objectively and applies to all blunt trauma to the head. i.e. helmets are effective in prevention of blunt head trauma - that is not in question.

 

The questions here are 1) are the head - water impacts of sufficient enough force that a helmet could make significant reduction in the rate of injury and 2) is any benefit a helmet offers in blunt force brain trauma offset by the increased risk of neck injury.

 

My response to your post was not to inflame but rather to point out that helmets do in fact prevent brain injury in the deceleration mechanism you describe (blunt head trauma). If we are going to have a rational debate, factual errors must be addressed. No offense intended.

[supersonicus]

@Horton I don't have enough hair for that.

[mwetskier]

@jdk99 -i interpreted from your first post you believe a helmet can protect a skier from impact with the water in the same way it can protect a bike rider from impact with a tree. you reinforced that interpretation with your response but still havent addressed my core question -which is *how* can a helmet accomplish that for a water skier? i have a great interest in this due to my related profession and i am not looking to debate with you but rather to understand what you believe the protective mechanism to be. not ' does it or doesnt it? ' but ' how does it? '

[thager]

@Horton And the other helmet?

[Chef23]

@andjules at the speeds slalom skiers and jumpers are going when crossing the wakes the water is essentially a solid. My son skipped/cartwheeled multiple times when he got hurt last year that wouldn't have happened if water was as soft as you think.

[6balls]

Water at speed is harder but not a solid...energy dispersion into the water occurs for sure in a way that doesn't happen against a true solid. A little energy dispersion in a potential head injury situation is a big deal. For jumpers hitting the ramp...totally understand the helmet.

 

Would be nice to have a flavor for incidence of head injury (specifically concussion or longer-term TBI) due to slalom water skiing. Further was it head to water or head to ski? For head to ski were they primarily facial lacerations/fractures (which I suspect) or brain injuries?

 

My guess is the incidence of brain injury (concussion/TBI) is low in slalom and when it occurs it is due either to drastic deceleration or rotational injury. Not sure a helmet would save either of those. Helmet without face shield isn't going to save ski to the face.

 

Helmet to ramp??? Yah gonna be happy about that helmet.

 

Interesting topic but without data we're all just anecdote and speculation.

 

 

[Chef23]

@6Balls my son's was drastic deceleration/rotational. I am not sure a helmet would have made a difference.

[drewski32]

Head hitting the water you're probable best without the helmet. It would have more drag than just your head and could cause neck injury. It could help if you hit the ski though, which I personally have never done

[Billbert]

@Chef23 I actually started with a hockey helmet and cage. I was worried about issues with bucketing and decided to add the neck brace to the mix. To work effectively with the neck brace the helmet requires a good chin bar. I thought about MX or BMX full face helmets and rejected them due to weight. Stumbled upon the Cascade R LAX helmet. Its lighter than my old hockey helmet, the lining is closed foam so it doesn't absorb or retain water, the chin bar works with the neck brace and the lines of sight are reasonable.

 

I admit helmets are not for everyone, have my doubts that they would prevent concussions from contact with the water but after taking a ski to the head twice in two years (first was minor, some stitches and a tooth) I decided that if I am going to continue in this sport I would wear a lid. Not sure they could put my face back together a second time and don't want to find out.

 

 

[Chef23]

@Billbert my son plays in the R and it is heavier than his hockey helmet the newer hockey helmets are lighter than the lax helmets but don't address the need for the chin bar.

 

As an Fyi there was a recall this fall on the R helmets where they added some padding to the top of the helmet. If you are mostly concerned about protecting your face it probably isn't an issue.

[Billbert]

@Chef23 your comments above likely provide direct evidence to the age of my hockey helmet. The R seams so light to me.....one way or another it doesn't matter, the LAX helmet provides enough piece of mind to ski without fear of injury.....to my face at least.

 

I was aware of the recall, thanks. You are correct in your assumption I was not worried about it as I figure the extra padding will not provide any moe protection from taking a ski to the face.

[Than_Bogan]

@Billbert Sounds like a very good decision for your particular circumstances.

[swc5150]

I would never wear a helmet, as I'd be more concerned with the effects it catching the water on impact, resulting in a twisting or pulling motion on the neck.