What You Should Know About Helmets

Helmets can help prevent serious injury or death. Jason, Jenna, and Jeff learned the hard way.

When Jason was 12, he was a pitcher on the All Star Little League team and played competitive soccer. He was also an honor student. Jason loved to ride his bike, but he didn’t like to wear his bike helmet. One Saturday afternoon, to avoid a confrontation with his mom over wearing a helmet, Jason rode out of the yard with his helmet on. But when he was a few blocks away, he took it off and put it in his backpack.

Shortly afterward, Jason was hit by a van. The shaken driver called an ambulance, and within minutes Jason, unconscious, was speeding toward Valley Memorial Hospital. Jason went into a coma and suffered traumatic braininjury because he hadn’t been wearing a bike helmet.

Jason is now 16. It’s been four years since his accident, and he has made an amazing recovery, but he’s not the same as he was. “I am a different person since the accident,” says Jason. “I will never pitch again because my left [pitching] arm doesn’t work. I can’t play soccer because my speed and balance are impaired. I have to attend special education classes because my brain is now too slow to keep up with regular classes, and I will never be able to drive a car or ride a bicycle. I still have to go through painful physiotherapy sessions every week.”

Jenna, 14, loves to snowboard. She’s a great athlete and a real risk-taker. Last winter while doing a 180-degree turn, she lost control and came down hard on her head and neck. She was knocked unconscious for a couple of minutes. When she came to, she had a headache and slight tingling in her right arm and fingers. A member of the ski patrol checked her out at her friends’ insistence, and he recommended she go to the local hospital for a thorough checkup.

At the hospital, Jenna had an MRI and was “chilled” by the words of the physician who attended to her. She said, “You are extremely lucky, Jenna. You have only a slight concussion, but if you had fallen about a half an inch over to the right, you would have severed your spinal column and would never have been able to walk again.” Since that day, Jenna wears a helmet when she snowboards.

Jeff, 16, loves, in-line skating; he’s been doing it since he was 10. Every day after school he heads out with his friends to skate around the city. He loves the feeling of freedom being on skates gives him. It’s also a great way to spend time with his buddies.

Jeff learned about the importance of wearing a helmet the hard way. His good friend, Devon, died at age 12 when he caught his skate in a sewer grate, flipped over, hit his head, and ended up with a cerebral hemorrhage.

Since Devon’s death, Jeff wears a helmet he bought at the local sports shop. He did a lot of reading about the safety features of various helmets and decided on one that met his needs, looked cool, and felt good on his head.

If you enjoy cycling, in-line skating, or snowboarding, here are some important safety tips about helmets:

* Wear a helmet every time.

* The helmet should be worn low and level on your head, and the chinstrap should be snapped and fit securely.

* All bike helmets now made in or imported to the United States must meet the U.S. Consumer Product Safety Commission (CPSC) safety standards.

* If you hit your head in a crash, throw away the helmet worn during the crash and purchase a new one. While the outer shall of the helmet may Still be intact, the inside cushion may be damaged and will not provide enough protection to prevent future head injuries.

Getting In-line

The most common cause of in-line skating falls, according to the International In-Line Skating Association, are due to hazardous road conditions such as potholes, sewer grates, or unexpected conditions such as hills and heavy traffic. Wearing the proper protective equipment can help prevent injuries.

Follow these safety tips from the Massachusetts Governor’s Highway Safety Bureau:

* Always wear a helmet whenever you skate.

* Check your skates before each use. Tighten wiggly wheels, adjust or replace worn brake pads, and clean or replace bearings when you hear a wheel grinding.

* Skate in control.

* Skate on the right, pass on the left.

* Don’t wear headphones; they prevent you from hearing the traffic around you.

* Avoid skating through sand, oil, water, and road debris, and over sewer drains.

For more information on inline skating and how to prevent injuries, check out the International In-Line Skating Association (lISA) Web site at www.iisa.org.

What You Can Do

Take action on helmet use. Here’s a list of suggestions to get you started:

1. Organize a head injury safety week at your school. Get ideas from the National Youth Sports Safety Foundation Web site at www.nyssf.org.

2. Invite a well-known sports figure who wears a helmet for his or her sport to speak about head injuries and helmet use at a school assembly.

3. Negotiate with a helmet supplier so that a percentage of each helmet sold locally goes to your school’s activity fund.

4. Collect stories from your friends and classmates about people they know who have suffered sports-related headinjuries.

5. Ask classmates or friends who don’t wear helmets when doing sports why they don’t, and note these on a flipchart. Ask those same friends what it would take for them to change their behavior and begin wearing helmets while cycling, skateboarding, and snowboarding. Offer to write the results of your investigation in the school paper.

You may or may not know a Jeff, Jason, or Jenna. If not, it’s only a matter of time. Head injuries due to recreational sports are on the increase among U.S. teens. Most of these injuries may be prevented by the simple act of wearing a well-fitting helmet. What will you do, if anything, to improve the statistics?

TO REVIEW AND DO

1. Why do you think that so many young people resist wearing protective headgear? (Answers should include recognition that young people see themselves as invincible.)

2. How much of a problem is the issue of head and neck injury? In what ways could this issue affect you and your friends, considering your lifestyles and activities? Assign students to groups to do research on the subject (see Web sites suggested below). When groups have completed their research, have them find creative ways to present the results to motivate people toward the use of protective headgear. (Remind them to think of the answers to question #1.)

a) www.cdc.gov/epo/mmwr/preview/mmwrhtml/ss4905al.htm–You will find an article on the Youth Risk Behavior Surveillance System. Students can look at head injury-related behaviors–perhaps even find data related to their state in the most recent YRBS completed in May 1999.

b) www.cpsc.gov (U.S. Consumer Product Safety Commission)–Assign students to outline exactly what the criteria are for safe, protective headgear products and for their use, and then find a way to communicate this–perhaps in a slide show, a Power Point presentation, or posters.

c) www.thinhfirst.org. (the National Brain and Spinal Cord Injury Prevention Program)–Find out if there is a local or state chapter of Think First in your area. They locate speakers who can attest firsthand to the problems associated with brain and spinal cord injuries. Their message is prevention. Have students plan a classroom presentation or obtain administrative permission for an assembly.

Tips for bikers Choosing and Using a Safe Helmet

Dr. Frederick Rivara, physician-researcher and director of the Harborview injury Prevention and Research Centre in Seattle, has spent the last 15 years persuading Americans to wear bike helmets. Rivara’s latest study shows that wearing a bike helmet is not enough. “In a study of 3,400 riders, people wearing helmets that didn’t fit correctly (by their own accounts) were twice as likely to suffer head injuries as cyclists with a proper fit.”

A helmet that fits properly, according to Randy Swart, director of the Bicycle Helmet Safety Institute in Arlington, Virginia, should:

* comfortably touch the head all the way around

* sit level on your head, stay in place, and be able to resist hard blows or violent shakes to the head

* be fastened snugly by the chin strap to prevent the helmet from rocking back and forth. It also shouldn’t pinch your chin.

Keep the foam pads that come with new helmets. They allow for a more customized fit, particularly at the sides of the head, as your head grows or as you change your hairstyle. For additional information, check out www.helmets.org.

Did You Know?

* More than 750,000 Americans each year report injuries received during recreational sports, with 82,000 involving brain injuries. Brain injuries cause more deaths than any other sports injury.

* About 130,000 children a year go to hospital emergency rooms with head injuries suffered in bike crashes.

* Bike helmets can reduce the risk of head injury by 85 percent.

* About 60 percent of all bike-related deaths involve head injuries.

 

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Knee injuries are happening more often

It happened in a matter of seconds. “I was playing for my high school soccer team,” explains 18-year-old Laura Soto. “I twisted on my leg, and just then I was pushed down. I heard three quick pops and suddenly felt a lot of pain. An ambulance took me to the emergency room.”

Laura had torn her ACL, the anterior cruciate ligament, and her meniscus. The ACL is a ligament that runs through the middle of the knee joint and connects the femur (thighbone) to the tibia (shinbone). It allows a person to twist and turn. The meniscus is cartilage that sits between the leg bones to act as a shock absorber.

“I had to have surgery,” Laura says, “and the doctor had to make a new ACL for me out of a graft from my hamstring. I also have two biodegradable screws my knee.”

Recovery has been difficult. The brace she had to wear reached from her upper thigh to her ankle and she dealt with a lot of pain. “For eight hours each day, I had to put my leg in a Continuous Passive Machine, which would bend my leg a little more each day. I would do it for four hours, rest, then do if another four,” she says.

“It has been hard,” she admits. “Soccer was my life, and I’d had a scholarship to Northern Michigan University.” Laura still goes to physical therapy once a week and works with weights to strengthen her new knee and the muscles around it.

Is It an Epidemic?

Laura’s story isn’t unusual. According to recent statistics, there are thousands of knee injuries like Laura’s annually. Doctors and researchers are beginning to call these injuries the new epidemic in the sports world. Girls are four to six times more likely to have a knee injury. Just ask 16-year-old Megan Okui.

“I was a guard for my high school basketball team,” she says. “I was at practice and went up for a shot. When I came down, I felt like I’d landed funny. I twisted sideways and couldn’t get up for about 15 minutes. It felt like my leg weighed a million pounds, and it didn’t want to work. I finally got up and walked on it a little. I iced it overnight, but in the morning it still hurt, so I went to the hospital. They said it was a sprain and to stay off of it. I went back to playing basketball, but it kept hurting. Sometimes it would give out.” Three months after the injury, Megan found out why. “The doctor told me I’d torn my ACL. I had surgery, followed by six months of physical therapy. Now I’m back on the team and feeling strong.”

“The sports that can cause the most damage,” states Dr. Ronald Navarro, chief of orthopedics at Kaiser Permanente in California, “are soccer, basketball, and football.” The primary causes are direct blows, falls, jumps, and twisting on one foot.

Why So Many Girls?

Reasons vary, but one of the main theories is a simple one: Girls and boys are put together differently. Girls have wider hips and smaller ligaments, first of all. After jumping, girls tend to land on their feet, rather than their toes, putting the knee at greater risk. Also, to stabilize themselves, they seem to use their quadriceps (muscles on the front of the thigh), which are weaker muscles, while boys use their hamstrings (muscles in the back of the thigh) and calf muscles, which are stronger. Another factor is something called the Q Angle, which means that girls’ thighbones angle inward more than boys, stressing the knee joint. Also an increasing number of girls are getting involved in sports.

The Solution?

Whatever the reason, it’s obvious that knee injuries are becoming a real problem. The answer is twofold. First, there’s prevention. “Proper prevention is a combination of building endurance and strength through training, plus stretching and warming up the muscles,” says Dr. Navarro.

Dr. Kevin Stone, an orthopedic surgeon and founder of The Stone Foundation for Sports Medicine and Arthritis Research, agrees. “To avoid an injury,” he says, “you need strengthening, flexibility, and preparation. I always try to communicate to my patients that world-class athletes train for their sport and then cross train with activities like weightlifting, yoga, and so on. I also believe proper nutrition plays a part,” he adds. “It leads to good muscular development and appropriate weight.”

Here are additional tips for keeping your knees strong:

* Warm up before playing sports.

* Never push through fatigue.

* Wear appropriate shoes for the sport.

* Pay close attention to pain signals.

* Build up the hamstrings and quadriceps.

* Learn how to land properly.

* Do specific knee exercises.

If you already have been injured, don’t ignore it and hope it will go away. Dr. Stone says: “If you heard a pop and there’s swelling, there’s a 95 percent chance you have torn a crucial structure.” The next step is usually an examination and tests to determine the extent of the injury.

Hurting your knee is no small thing. But if it happens, Laura advises, “Take it in stride and deal with it. Things will get better!”

Exercises to Strengthen the Knees

Often the key to strong knees is doing regular knee exercises, Dr. Kevin Stone suggests the following:

* Quad sets: Leg straight out in front of you (either oil ground or seated on the edge of a chair), tighten thigh muscles focusing oil inner thigh just above kneecap and hold for 5 seconds. Repeat 10 times, three to five times a day.

* Adduction sets: sitting in a chair with knees bent to about 90 degrees and a pillow between knees, squeeze pillow evenly with both knees and hold for 5 seconds. Repeat 10 times, three to five times a day.

* Leg raise: Start with sets of 10 repetitions and work up to two sets of 25 reps.

Lying back on elbows with right knee bent and left leg out straight in front, tighten thigh muscle of left leg and actively lift leg in front to the level of the opposite knee and then lower.

Lying on right side with legs out straight, tighten thigh muscle of left leg and lift to the side, making sure to keep foot level with the ground.

Lying on stomach, tighten thigh muscle and lilt leg behind you a few inches off the floor, then lower, making sure to keep hips on floor.

Lying on left side with right leg bent and rigid foot on the floor in front of left leg, tighten thigh and lift leg toward the inside, keeping foot level with ground.

 

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How to Use Waist Trainers in a Healthy Way?

Waist trainers are very useful outfits and have been used for over a hundred years in order to make the waist narrower in shape and the bust and hips more prominent. With the best corset waist cincher you can get a curvier body shape. But overuse or improper usage of these dresses can lead to problems like dehydration. You may also be prone to physical problems like Glenard’s disease – which a deformed condition of the lower ribs – and even organ failure in worst cases. Naturally, it is important that you use trainers in a healthy way in order to attain a voluptuous figure but without any severe health risks. The following tips can help you in this regard.

Go for trainers with orthopedic features

The shapes of waist trainers are being changed by trainer manufacturers with changing choices and with the passage of time. Trainers that are more advanced in type are smoother, shinier and more flexible. These are also easier to wear under a variety of dresses. These outfits make your waist narrower and more attractive with time and can help you to get the attention of the opposite sex with ease. Some trainers come with orthopedic features that can provide your spine with enough support and assist in improving your overall posture. These kinds of trainers are generally made of strong fabric like Lycra or nylon and consist of flexible ribs having plastic or metal stitched into them. These offer shape to the outfits and help in waist compression. Women tend to wear trainers under other outfits and these can be tightened with a belt or a band in order to get the extent of compression that is needed.

Do not add compression too fast

Most women like to wear trainers due to the fact that these help them reduce the last couple of inches from the waist which appear highly difficult to get rid of with diet or exercises (Source). But in their hurry to lose weight, many women wear an outfit with a tighter compression. There are many tighter trainers to be found in the market. However, these need to be used with much care. Many waist trainer makers recommend adding compression slowly over a time period in order to offer enough time to the body and help it get accustomed to the pressure. This eliminates any risks of health problems such as dizziness or back pain.

Choose one with proper support

One of the greatest benefits of these trainers is the postural support that they offer. These dresses can hinder your movement to some extent. You have to bend in a manner that keeps the firmness of your trainer intact. While wearing a trainer with metal bones and a proper structure, you will find it impossible to have a bad posture and slouch at any time. Women who wear these types of dresses each and every day get extra support for their posture due to the usage. The additional support can help them minimize back problems and pains. While performing various activities and even while walking, they can get a lot of support.

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An Alert Response to Head Injury

A small child playing on the sofa falls forward, hitting his head on the edge of the coffee table. He has a bump, almost immediately, but no cut.

A 12-year-old-boy, riding his bike with no helmet, hits a pothole and loses control, hurtling him headfirst into a pole. He is unconscious and bleeding from the scalp.

A soccer player, running toward the goal, loses his balance and falls into the goalpost, hitting his head. He is unconscious for a minute or two, but then insists he is fine. An hour later, on the sideline, he suddenly falls from the bench, unconscious, and cannot be awakened.

Leading Cause of Death

Accidental injury is the leading cause of death between the ages of 1 and 44; 50 percent of all accidental injuriesare related to motor vehicle accidents. Head injury is the primary cause of death in 70 percent of fatal auto accidents and 50 percent of fatal motorcycle accidents. Even more important, the age group most affected by head injuries is young adults. The three accidents described above are typical of the kind that occur most commonly. How can you as a first aider determine which are serious and which are minor?

If you are on the scene when a head injury occurs, you should do the following:

  • Survey the scene for immediate danger to you or the victim. In a car accident, for example, is traffic stopped? Is all danger of explosion eliminated and debris removed from around the victim? Also, try to determine what happened.
  • Have a primary check of the victim’s condition. Is the person breathing? Have a pulse? Do the pupils of the eye react to light? (Often they don’t, with serious head injuries.) Are both pupils the same? Is the victim bleeding from the nose or ear? This could be a dangerous sign if there is not a direct injury to the face.
  • Control any bleeding.
  • Ask the victim about any symptoms to deteermine if there is any need for professional medical help. Also try to determine if the victim is alert and fully aware of his or her surroundings.
  • Check for any neck injury before attempting to move or reposition the victim. Ask about paralysis or numbness in the extremities.
  • Keep constant watch on breathing and the level of consciousness. If the victim loses consciousness, record the length of time the person was unconscious and give this information, along with the time of the injury, to paramedics when they arrive.

Head injuries can be minor, requiring only an ice bag and bandage. But some can be life-threatening. One of your tasks as a first aider is to quickly determine the seriousness of a head injury. The following descriptions may help.

Lumps and Bumps

Bumps on the head that cause a lump to form are the most common minor head injuries. The cause of the lump, technically called a hematoma, is the leakage of fluid from broken blood vessels. The swelling is followed by a bruise, and the victim does not lose consciousness.

First aid for this type of head injury is ice for about 15 minutes to reduce swelling and pain. The best position for this victim is sitting up to reduce swelling.

Cuts

A small shallow cut on the head, with no other symptoms such as blurred vision of dizziness, can be treated as a cut elsewhere on the body. To stop the bleeding, wash the wound, place a clean gauze pad over the cut, and apply gentle pressure. A pressure bandage is also effective. Keep the victim’s head and shoulders elevated. If, however, the cut appears long enough to need stitches or deep enough to cause heavy bleeding, the victim should have immediate medical treatment. When in doubt, check it out!

The are some symptoms that can signal a more serious head injury. If the victim starts vomiting, complains of dizziness or headache, has a sudden loss of memory, or becomes uncontrollably sleepy, medical attention is urgently needed.

Conclusion

Loss of consciousness is also a symptom of a serious head injury, and the longer the victim is unconscious, the more likely that the injury is serious. Unconsciousness from a concussion occurs when the soft tissue of the brain bangs into the hard surface of the inside of the skull. The victim may vomit, seem drowsy, become pale, or be unable to recall events leading up to the injury.

Victims of concussion may also develop seizures in which the brain sends out abnormal electrical signals that cause the muscles to twitch. First aid for this injury:

* Turn the victim on the side to open the airway and allow for drainage of blood, vomitus, or saliva.

* Remove nearby objects the victim could bump into.

* Project the head by using a pillow or other soft object to cushion contact with the ground.

* Do not restrain the victim’s movements.

* Do not put anything in the victim’s mouth.

* When the seizure stops, keep a close eye on breathing and protect the victim until help arrives.

It is usually advised thta victims of concussion have skull X-rays. There may also be damage to the neck; use caution in handling this victim–don’t move the person if you suspect a neck or back injury.

After medical treatment, the physician may suggest that the victim be kept awake for a few hours in order to monitor whether any new symptoms develop. These could include a plainful headache or difficulty moving the limbs. These symptoms may indicate serious brain damage or bleeding under the skull; quick medical treatment will be required.

Skull Fracture

Occasionally a blow to the head results in a crack in the skull, known as a simple fracture. Victims of skull fracture often develop dizziness, headache, vomiting, and memory loss. If symptoms persist, they should be taken to a hospital and may be kept there for a day of observation. Physicians want to be sure there is no bleeding into the brain, which could be life-threatening. Once released, rest at home for several days will be required, as well as avoiding exercise and contact sports for four to six weeks.

A com pound fracture of the skull involves a wound in addition to the crack. It is a very serious problem because germs may have entered the brain. Do not clean such a wound yourself; get medical attention immediately.

Now go back to the original three situations. Think through how you would handle each one. Which is most likely to be serious? How would you know that? Giving first aid for head injuries requires that you use your head to make the right decisions.

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A crucial message about bicycle safety

Since 12-year-old Mick Harte has an after-school meeting at a friend’s house, he asks his older sister, Phoebe, to ride his bike home for him. But she has soccer practice and can’t help him out. So Mick rides it himself. He never makes it to his meeting. When his bicycle is struck by a passing truck, Mick dies from a head injury. He was not wearing a bicycle helmet.

This is the tragic starting point of Barbara Park’s Mick Harte Was Here which Knopf published on April 15. Unlike the author’s previous novels–notably the perennial favorites Skinnybones and The Kid in the Red Jacket–humor is not the point here. The poignant, penetrating narrative (told in Phoebe’s voice) and unequivocal mandate to readers to wear bicycle safety helmets mark this as Park’s most resonating and important book to date.

Park notes that two separate experiences inspired Mick Harte Was Here, which concludes with an urgent, personal note from the author: “I urge all of you who do not wear bike helmets to please reconsider your decision. Today. Please. It’s your life.” The first incident occurred several years ago, when she and her husband were taking a walk in their neighborhood outside of Phoenix. “We came across a reenactment of an accident that had happened earlier that day,” she recalls. “There was a vehicle pulled over to the side, and police were measuring skid marks to determine how fast it had been going. And then I saw the bicycle. A child had been killed by that car. I never got over this. I have never again passed that spot without thinking of that child and what the family must have gone through.”

Though much affected by this episode, Park didn’t realize that there was a novel in it. Then months later, she read a newspaper article about bicycle helmet safety. “It contained a quote from a father who had lost his son in a bicycle accident,” she recalls. “The boy was not wearing a helmet. What his father said, in essence, was that there was not a scratch on his son’s body and that an inch of styrofoam would have saved his life. Over the next year these two events meshed in my mind somewhere, and I decided to tackle this subject.”

It was not an easy task. Writing Mick Harte Was Here took Park far longer than any of her previous books. “The hardest part was taking on such a depressing subject,” she says. “I kept asking myself, ‘Who is going to want to read this?’ I was afraid that kids would put it down if it was too sad, so I tried to add light touches in with all the heavy moments. I decided to include happy, funny remembrances of Mick. But I still needed to address all that his sister and parents were going through. I knew I couldn’t soft-pedal the painful, real parts.”

Spreading the Word

Park spent the last week in April and the first week of this month–National Bicycle Safety Month—on an eight-city tour promoting her novel and its message. Kelly Grunther, manager of public relations for Random House’s juvenile and merchandise group, has prepared an extensive press kit–which includes an endorsement of the book by the Long Island Head Injury Association—that encourages booksellers as well as media to underscore the connection between the novel and bicycle helmet safety. In hopes of further bonding the book and the issue, the publisher has joined forces with Cycle Products Company, which has donated a hefty number of bicycle helmets to be used in the book’s promotion. These will be given away by booksellers whose stores Park visits as well as by the 20 to 25 radio stations across the country that will be airing a satellite interview with the author.

Retailers have been quick to embrace Park’s critical cause. One stop on the author’s itinerary is Hicklebee’s in San Jose, where a window display featuring a bicycle has for several weeks been setting the stage for the novelist’s visit. Customers purchasing any Barbara Park novel can put their names in for a drawing to win one of the bicycle helmets that have been donated by local bicycle shops. On the day of Park’s signing, anyone who comes to the store wearing a helmet is eligible for another drawing–this One for an autographed copy of Mick Harte Was Here.

At The Library Limited in St. Louis, marketing director Nancy Higgins organized what she describes as a “family event” on May 5, when Park visited this bookstore. Staffers from a local bike shop gave a demonstration on bicycle safety and a helmet was raffled. Higgins remarks, “We are tying a number of events during May into Mother’s Day, and this fits perfectly. We chose to focus on how mothers can teach their children safe biking habits.”

Park is thrilled to be able to take her mission on the road. “This is, truly, the most exciting thing that has happened to me through one of my books,” she says. “I’ve always made it a point not to be a moralizing, finger-waving, ‘I’ve-got-something-to-teach you’ kind of author. But this is an exception. I intended from the very beginning to get kids to do one specific thing: to wear a bicycle helmet, even if they don’t think it’s cool. I know this sounds very corny, but it is the truth: my biggest hope is that someday I’ll get a letter from a youngster who will tell me, ‘I read Mick Harte Was Here and went out and got a bicycle helmet. I was in an accident, but I was wearing my helmet. I’m okay–because of your hook.'”

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