threeteas

This is a good analysis. I've always thought that if I hadn't had my helmet on in my particular previous case I would have at the very least had a fractured skull and probably pretty bad bleeding on the brain. I just ended up with a nasty concussion.

Still, I'm going to give MIPS a try. And I must admit I do not take undue risks or contest sprints anymore.

Ghrumpy

This is my experience. I don't think helmets "prevent" concussions. They only mitigate the consequences of a severe impact.

I've broken five helmets. Three of those impacts resulted in concussions of varying severity. One of those caused a positive loss of consciousness. I have little doubt that those three impacts would have resulted in far more serious injuries had I not been wearing a helmet.

FWIW, three of those impacts happened while racing. But the worst two were while commuting and trail riding.

threeteas

Yeah, I've never actually been badly hurt in a race. My most serious crashes were in group training rides--most notably while contesting city limit sign sprints. Don't do those anymore.

mstateglfr 

If my head is going to hit somethong so hard that it causes a concussion, it would hit that object with or without a helmet. The argument that a helmet makes for a larger impact area and is therefore less safe, which i believe you are claiming, is absurd.

A helmet is impact protection. When it comes to concussions, between having a helmet and not, you are no worse if you wear the helmet. Increased torque?...come on.


Your decision to not wear a helmet is one that makes no sense to me, but more importantly here, i think it helps highlight the biased nature of your post.

Being as talented as you are, professionally speaking, im surprised you choose to not protect the one thing that is so vital.

A brain slamming into bone will happend with or wothput a helmet. Reducing how hard it slams into bone is a good thing.

JohnJ80

MIPS is the main technology out there but POC is introducing their SPIN Technology and someone else is coming out with another. All of them are designed to reduce rotational acceleration that lead to torn neurons (i.e. shaken baby syndrome).

No. An oblique hit to the head (which is almost all crashes where you hit your head), put a spinning moment on the brain. The brain is anchored by the spinal cord so the gelatinous brain tissue gets (essentially) whiplash. When this happens neurons tear which damage the pathways in the brain.

Exactly. We went through a severe TBI (traumatic brain injury) with our son from a skiing accident. He was wearing his helmet which was unmarked. He had no skull fractures or other damage but the tumbling led to small ruptures over the surface of his brain (DAI = Diffuse Axonal Injury) that showed up as a torn netting appearance on an scan. He spent 3 weeks in a coma, 7 weeks in in-patient rehab and a year in outpatient rehab before he got back to relatively normal condition. 3 years later he still had issue and there are still deficits after 5 that probably won't go away - the damage is permanent but the brain finds a way around it using unused neurons and pathways (part of the magic of evolution). In our case, our son is doing well and in grad school now for a graduate engineering degree. But getting there took a tremendous amount of work on his part and support from us as well as an understanding university. Had this happened to someone older with a brain with worse plasticity (happens as we age), changes for full recovery go down fast.

The damage that the brain sees is nonlinear with acceleration. In other words, below some threshold of acceleration, there is limited or no damage. When you hit that magic point where damage occurs, the damage goes up rapidly with acceleration since the brain hits the skull and then rebounds (and rotates) to hit the opposing side of the skull. So if you can find a technology which reduces the acceleration even a little that the brain experiences, you get big dividends in reduced damage. That's what Mips and the other technologies are trying to do.

Prior to these technologies, the primary purpose of the helmet was to prevent fractures and penetrations to the skull. That is a good thing since these injuries carry a high rate of mortality. However, they don't do much (if anything) to reduce or eliminate or even mitigate concussion (TBI). So getting a helmet that has one of these technologies is a good idea. At best it could be a life saver. At worst it does no additional harm.

J.

canklecat

Most helmets that are practical for cycling won't consistently protect all riders from concussion on impacts hard enough to damage the helmet. They're designed to reduce the risk of skull fracture and open head injury.

Concussion effects vary tremendously among different people. There's no way to predict what works best for everyone. I boxed for years, including sparring and a couple of competitions against much bigger guys. Never knocked out or had a concussion. And I had poor defense. My main defense was a hard head. My brother got knocked out easily and had concussion side effects for days or weeks from boxing and football.

Aging increases the risks. Our brains shrink about bounce around more easily inside our skulls. So at age 60 I don't assume I can absorb the same head shots I could at 20. I've had a few minor spills on the bike the past three years, and a few years ago including in my first or second crit (I think I wore one of those padded hairnet things that were so fashionable in the early 1970s -- and totally useless). No head impact, no indications of concussion. I wear a helmet, almost every ride (occasionally I'll cheat on short hops to the nearby stores). Scrapes, bruises, busted ribs, yup. No concussions. Just pure dumb luck of the genetic draw. It doesn't run in the family, unfortunately.

My mom experienced multiple concussions after age 50 from falls, even those that didn't impact her head directly. Her brain rattled around inside her skull when she landed ker-plop on her butt. With each concussion her balance suffered and she was more prone to falling. She finally had to use only a walker or wheelchair to get around, mostly to reduce the risk of falling. The long term effects were devastating as she declined into dementia in her late 70s.

And, nope, you can't depend on rolling with the fall or any other such well meaning nonsense. Look at some crashes by experienced pros. If anyone could roll with the fall it would be them. But those folks konk their heads all the time in crashes. Fortunately helmets are reasonably effective in glancing blows.

Get the best helmet you can afford. But carefully weigh the risks and benefits of racing.

RobotGuy

As you can see in this thread alone, the whole issue is contentious. IMHO, respecting the fact that members here are intelligent and well read, approximately zero of us are the correct people to be asking this. Sort of like asking an F1 driver about the latest crash protection technology.

canklecat

As a Navy Corpsman working in the ER and ICU I saw plenty of head injuries. Sailors and Marines are often injured in training. And some live pretty recklessly in their free time. Combat helmets, motorcycle helmets, you name it -- these helped minimized skull fractures and open head injuries, but did little or nothing to prevent concussions.

And nobody knows why some folks experience concussions and subsequent consequences, including personality changes, while other folks don't. Probably the way brains rewire themselves to compensate.

A somewhat comparable situation is boxing headgear. There's a misconception that padded headgear protects boxers from concussion. It doesn't. Not even close. The most devastating and frightening knockout I've personally witnessed was in the 1970s during an amateur bout between two top level amateurs: Ronnie Shields from Texas (now a successful trainer) and the Arkansas state Golden Gloves champ. The fellow from Arkansas wore full sized padded headgear. Ronnie knocked him out cold with one shot. The poor guy didn't flinch or move for awhile.

Boxing headgear is to protect boxers from cuts and bruises. That's all. It's used during training. Occasionally amateur bouts would require them but some competitions have eliminated that requirement because headgear doesn't protect boxers from concussion, and can limit their peripheral vision, making them more vulnerable to being hit. Some amateurs will still wear headgear during multi-fight tournaments to reduce the risk of cuts and bruises in the early bouts. Then they'll omit the headgear during the finals.

Boxer David Reid was America's only gold medalist in the 1996 Olympics and was expected to have a stellar career. But he suffered a permanent eye injury (injured eyelid muscle and nerve) during the 1995 Pan-Am games, and was aggravated during the Olympics, despite the headgear and precautions. The eye continued to swell in every fight in which he took a punch, which wasn't often due to his excellent defense. Knowing his career would be shortened by the injury they fast tracked him into a world title. He had a ton of potential but was in over his head against the far more experienced Felix Trinidad.

Anyway, pardon the digression. As a former amatuer boxer in a town once the home of some great amateurs and pros, I've seen the effects firsthand of concussions, many times. Many of my boxing acquaintances from the 1970s-'80s suffer permanent brain damage from concussions, despite headgear in the amateurs, heavily padded gloves, etc. Some have struggled with depression, substance abuse and erratic behaviors that tested the limits of their loved ones. Fortunately most of the folks I knew from that era are doing well now.

Remarkably and mysteriously, others do not show any ill effects. Including me (as far as I know! -- but I retired early from the amateurs in my early 20s). George Foreman took at least as many blows to the noggin as his contemporaries Joe Frazier, Muhammad Ali, Ken Norton and others, but as of very recently Foreman showed no evidence of concussion related effects -- slurred speech, etc. Just luck of the genetic draw.

RobotGuy

Great insight. I’ve always read that boxing gloves are designed to protect the hands, not the head.

canklecat

Exactly. Get 8 to 20 ounces of padded leather moving and it hurts anything being impacted. The mostly heavily padded training glove will still produce concussions in the fighter on the receiving end.

The extra padding more common now does help reduce facial injuries -- bruises and cuts (actually splits from flesh compressing against bone). That was necessitated by changes in boxing over the decades.

In the early days fighters did a lot of wrestling and maneuvering for position. The most skilled boxers like Joe Gans, Jack Johnson and others of the early era could have done well in Greco-Roman wrestling because they melded striking with grappling above the waist. Muhammad Ali was a master of that style and even Big George Foreman was a remarkably adept grappler and tactician, a skill he doesn't often get credit for. Ditto Floyd Mayweather Jr, easily the most skilled of the modern boxer/grapplers in that long lost art. And Bernard Hopkins, who extended his career to 50 years of age, mostly by playing the spoiler, punching less and frusrating opponents more often with jab and grab and maneuvering tactics. Ditto Andre Ward. As a longtime fan of classic boxing, I prefer those techniques. But most fans nowadays want more clobberin' time, as The Thing used to say.

In that era of boxing the 6 ounce gloves were ideal for parrying, manuevering and grappling. Relatively fewer punches were thrown. Boxing was still controversial, still illegal in some places in the U.S., so referees would stop bouts quicker before they became too bloody and gruesome. They were trying to improve the sport's reputation.

But audience tastes changed. They didn't have the patience for 50 round fights. They wanted 15 round or shorter bouts with more action, more punching, less grappling and maneuvering for position. In that era the 6 ounce gloves led to some brutal injuries. So 8 ounce gloves became the norm. Then even more padding was permitted in sanctioned bouts, and boxers were permitted to choose their preferred gloves to suit either punching power or fragile hands.

But the only concession to minimizing injury to the fighter on the receiving end was to minimize seams, like the old style Seyer gloves from Mexico ("Reyes" backward, for the owner) that were notorious for producing bloody fights in the 1970s. And thumbs were attached to the gloves to minimize deliberate or accidental thumbing of eyes. Some boxers used open-hand catch and parry defenses, which led to accidental and probably some intential thumbing.

threeteas

Great insight--thanks! I have no idea why my concussion symptoms were so prolonged after my head injury a few years ago. I would say I'm 100% now but it took 14 months to really get going again. Perhaps it was because I was 45 when it happened? It was also a dreadful blow that blew up my helmet into many pieces. I actually had to go down to part-time at work for quite some time the year I was recovering. It was a mess.

But I do know that playing competitive soccer and some football + downhill skiing in my teens that I had smaller head hits as well that didn't even really phase me.

Actually, your comments have given me pause about racing again. Although I've never been badly hurt in a racing accident, I do know some guys that have. There are definitely some things out of ones control, especially in a crit.

DiabloScott

This.

It's what MIPS is intended to mitigate... yet to be proven how well it does in that regard.

Helmets are pretty good at reducing skull fractures for impacts; and that's why most people who wear them wear them.

joejack951

If my head misses the ground by any amount as I'm sliding along the pavement, my head experiences far less torque (~0 in.*lbs.) than if my now several inches larger head makes contact with the pavement (>0 in.*lbs.). Having watched people fall doing all sorts of things it is quite amazing to see how frequently contact between head and ground is just narrowly avoided with an unhelmeted head. Maybe it's confirmation bias, but I gotta believe it also has something to do with evolution and neck strength and one's ability to control and preserve their own head. Add a heavy helmet and things change.

First, whether warranted or not, thanks for the compliment

Second, I do take lots of precautions to protect my brain, mainly staying physically fit. In addition to cycling on the roads, I also run on the roads some times at speeds that match my cycling speed (downhill run, uphill bike). No one would ever suggest I wear a helmet for running. I even run on snow and ice (and have biked on snow and ice, though not recently). Even describing how treacherous the footing was to people, no one has ever suggested a helmet to me. Puttering around the neighborhood with my son on a bike is a different story.

Kontact 

You could probably design a helmet the decreases concussions, but it would look like a beach ball. The problem of decelerating your skull slowly enough to not bang your brain around inside it is a really distance problem, not a materials problem. If the helmet isn't huge and soft it can't start to decelerate your head early enough.

canklecat

I haven't seen any evidence that concussions are more likely to result from torquing or twisting than other types of impacts. If anything the evidence seems to indicate straight-on blows are more likely to produce concussion -- although that may be because the dominant contact sports involve mostly straight-on impacts: boxing and football.

If anything the twisting motion seems to protect boxers from the brunt of head blows. Many of the best defensive masters would twist their heads to ride with the impact. They still got hit, just not as hard. Roberto Duran was a master of this technique. To an inexperienced observer it appeared that Duran's twisting head and flying hair spraying sweat everywhere indicated he absorbed heavy blows. In slow motion it's apparent he was riding with the shots, moving away from the brunt of the impact. Despite one of the longest careers in a brutal sport, Duran appears to have suffered little brain damage. He speaks clearly and quickly and, as far as I can tell from interpreters, stays on topic during interviews and when training other fighters.

On the flip side, James Toney, another defensive master who usually rode with the punches to avoid absorbing the full impact, has deteriorated from speaking clearly and quickly in his youth to slurring almost incomprehensibly. He seems clear headed, but his speech was impaired. Most of the damage appears to have occurred late in his career when he moved up to heavyweight. He had less mobility and began to absorb more blows directly to the top of his head, both straight-on and from the sides. He'd tuck in his chin, lowering his head to present less target, but would still take shots from heavy punchers like Samuel Peter. Toney was a natural middleweight or light heavyweight at most, and fought his late career well above his natural weight and strength, usually overweight, yet was so incredibly skilled he got away with it and was never stopped in a conventional boxing match (I think he was submitted once in an ill-considered MMA match). But it came at a high cost.

But boxing offers only a limited perspective, not entirely comparable to cycling and helmets. Many knockouts in boxing come from glancing blows to the jaw and neck. Those short-circuit and disconnect the body and brain temporarily, without impairing the boxer's situational awareness. I experienced that once in sparring, when I was struck behind the ear on the neck. My mind was perfectly clear but for a moment I couldn't move my body -- I just stood there frozen. Fortunately my sparring partner -- who happened to be my younger brother -- stopped. In a competition that could have been disastrous. An aggressive fighter would recognize that frozen-moment symptom and poured it on.

A classic example in a competition occurred when Zab Judah was stopped in a bout against Kostya Tszyu. Judah was dominating the bout but caught a right from Tszyu right on the tip of the chin, snapping his head sideways. Judah fell and bounced up immediately but did the infamous spastic dance, resulting in the referee stopping the bout immediately. Judah argued and even assaulted the ref, something that rarely occurs after a stoppage due to a concussion type head blow. In the latter the boxer is too dazed to argue. But Judah experienced that peculiar nerve disconnect that left his head clear but his body uncooperative.

That type of blow is unlikely to occur in a bike crash. Every video I've seen of bike crashes with the head striking the ground was directly to the front or side of the top of the head, right on the helmet edges. Makes me wonder why helmet impact tests even bother with those top-down impact tests, although I suppose they're concerned about cyclists sliding into curbs and striking the top of the head. But that seems far less common than the impact to the edge of the helmet.

I'm not sure that running is comparable in risk to cycling. Most of my bike falls occurred at slow speed, including after braking hard to reduce speed. In almost every instance I almost pulled it out and avoided a fall, but got tangled up in the frame, even when I wasn't using foot retention, and flopped over sideways. Frustrating because if something similar occurred while running I probably wouldn't have fallen. A young, experienced and agile runner can easily adjust and avoid most falls from stumbling. That's much harder on a bike.

Coup/contrecoup impacts may be more likely to produce concussion and brain injury, but that only describes the action of the brain rebounding inside the skull. Older people are more vulnerable to coup/contrecoup injuries from any impact because their brains shrink a bit and rattle around inside the skull.

But most of this remains a mystery. It's informed conjecture by experts based on backtracking from the concussion to the types of head blows that may have contributed. Understanding precisely why some people experience concussions and others show few or no symptoms would require studies with ethical complications -- using live human subjects as lab rats.

redfooj

My research has shown that the best way to prevent concussions is to not crash

79pmooney

And the best way ot not crash is to not ride.

Some of us just aren't willing to be that smart.

Ben

Fiery

Seems to me that there is quite a difference between the intentional rotating motion of someone rolling with a punch and the uncontolled rotating motion induced by an unchecked or unexpected punch (or a fall). It’s the second type that’s expected to cause more damage than a hit that doesn’t induce much motion of the head. So, for example, a cross to the cheekbone that violently rotates the head would be expected to cause more damage than a straight to the forehead that barely knocks the head backwards, even if the forces of the two punches were the same. Does this make any sense in your opinion?

canklecat

I wouldn't disagree only because there isn't enough scientific evidence. Any conclusive evidence from studies would involve deliberately subjecting human subjects to head blows, or allowing them to subject themselves to head blows, for the purpose of evaluating any damage or side effects. That's ethically problematic even if, for example, boxers and football players were to volunteer for studies throughout their careers and post-sports lives.

But the available evidence seems to indicate both frontal and temporal lobe involvement, based on the behavioral changes observed in athletes and others who've suffered repeated concussions or traumatic brain injury. A classic example would be Jimmy Thunder, an exciting heavyweight with devastating power but a reckless approach and poor defense that left him open to punches. Since retiring he's been in trouble quite a bit, with arrests, charges of abusing family members, and facing deportation. His family and friends say brain damage from boxing changed his behavior. That's a common story -- athletes who've suffered repeated head blows changing personalities, becoming unpredictable, self destructive and often unexpectedly violent even when they didn't seem to be angry.

Regarding this proposition
I'd be inclined to say it doesn't matter how much the head appears to move in response to a punch. As a former boxer, and longtime fan and armchair analyst, I've spotted a few tells in the careers of some boxers that indicated to me they'd have short careers or suffer brain damage if they stayed in the game too long.

One notable tell is the boxer who absorbs a frontal blow to the face or forehead (rather than the tip of the chin or jaw) that barely moves the head back, but the boxer freezes for a split second. In every instance where I've noticed that quirk, the fighter's ability to recover from punches rapidly worsened throughout the remainder of their careers and some ended up with brain damage, slurred speech and behavioral problems if they didn't retire early.

The most notable example I can think of offhand was Fernando Vargas, former light middleweight champion. Due to his dominating and exciting style, some Vargas bouts were televised before he won the title. In one of his bouts just before defeating Yori Boy Campas for the title, an opponent connected with a pretty good straight shot directly to the front of Vargas' face or forehead, barely moving his head back, and Vargas froze for a split second. I had a bad feeling about Vargas after that. He did well his next few bouts in successfully defending his IBF title (although the decision against Winky Wright was controversial -- I thought Wright won).

But Vargas was badly beaten by Felix Trinidad and never fully recovered from those head blows and knockdowns. Vargas seemed destined for early retirement and sure enough after that loss was able to win only against inferior opponents and was stopped a few times whenever he stepped up in class. Vargas had the talent but not the genetic ability to absorb head shots without some sort of brain damage.

At the opposite end of the spectrum, the late great light welterweight champion Aaron Pryor had a superhuman ability to absorb punches and recover almost immediately from knockdowns. A highlight of his bouts against the equally great Alexis Arguello, often discussed by sports analysts and fans, occurred when Arguello hit Pryor so hard with a straight right it snapped Pryor's head back so violently it almost looked like his head was in danger of being ripped off his neck. But Pryor showed almost no signs of even being stunned and went on to stop Arguello in both fights. Later Pryor said he thought he was seeing stars from that punch and then realized it was the overhead ring lights -- that's how far back his head was snapped. But no knockdown.

Much later Pryor did seem to show some symptoms of the effects of repeated head blows. But it's difficult to compare the older Pryor with his brash, younger self. He put on a big show of being hyperactive and mouthy during his prime in an attempt to market himself like Muhammad Ali. And he was known to abuse cocaine, which may have contributed to his rapid decline and death from heart disease at age 60. So the more reserved, quieter speaking Pryor in his older years may not have been evidence of brain damage. I didn't know him personally and have no basis for comparing other than his televised interviews.

f4rrest

Folksam insurance company in Sweden tested and published results of MIPS vs. non-MIPS helmets in 2015.

I chose a POC based on the results.

Be sure to download the full study (14 pages) from the following page.

https://www.researchgate.net/profile...na-Stigson.pdf

threeteas

I've ridden (and raced once at a pretty high level) for 33 years. If you are a serious bike rider of any sort--you are going to crash. It's as simple as that.

canklecat

Yeah, it's a challenge to avoid crashing even riding solo. I finally got over a two-month bout with flu, so the past couple of weeks I've been pushing harder to see whether I can get in good enough shape for some time trials this year.

A couple of favorite training routes have some tricky bits in the pavement and twice last week I just barely averted disaster by missing my preferred line by inches. The bumps jostled the front end into wobbling for a moment, both times at 30+ mph.

And in those split seconds I wasn't thinking about head impact or concussions. I was thinking how much my knees, elbows and ribs were gonna hurt if I went down, and wondering whether I'd be able to reach my phone in my zippered rear jersey pocket to call 911.

And I decided the best course of action is to stop worrying about being courteous to vehicles behind me, take my preferred line and let them wait a dang moment, just one or two seconds longer, while I take the lane rather than the rumpled and rippled edge pavement.

San Pedro

Take that like especially if you're going over 30mph.

canklecat

Yup. I don't normally manage 30+ mph on those sections, so the front wheel wobble was a new experience. One day was heavily wind assisted on a 1% grade where I've never managed better than 20 mph. That ripply pavement didn't bother me then.

The other was sprinting rather than loafing down a -4% hill on an access road that usually sees very little traffic. Normally I take the lane but that evening I noticed headlights a couple hundred yards behind me and instinctly moved a bit to the right, forgetting that the car had two complete empty lanes and no other traffic.

There's a seam in the pavement running perpendicular to the approach. There are a couple of spots a few inches wide with a smooth transition between the fog sealed pavement and the striated concrete, sort of like miniature ramps. The rest is mostly a 1/2" high ledge, not a huge deal just a bit of a jolt. But there's one serious lump that I'd forgotten about and managed to hit it perfectly. Closest I care to come to a death wobble.

Didn't even come close to the KOM, which is 44 mph for that downhill. Only managed 39 mph. And a hearty adrenaline boost for the effort.

But a better helmet wasn't on my mind at that moment. I suppose if we worried too much about that during a ride we'd never get above a proper gentleperson's 12 mph.

Litespud

I don't think any standard helmet is going to protect you from concussion, which is essentially your brain suffering from the rapid acceleration/deceleration of your head hitting something or being hit by something. A helmet will protect you from penetrating injury or abrasions. Helmet deformation may mitigate this somewhat, but any impact that results in significant helmet deformation/damage is a potentially concussive event. My sons ex-girlfriend took a ball to the head during dodgeball, and a year later, she's still on concussion protocol and still dealing with symptoms.