# How common are concussions from mtbing



## mattmers (Apr 13, 2013)

I read this article on theverge and it talked about helmets not being designed for preventing extreme impacts and not lighter ones that can cause concussions. Are concussions really that common for mountain biking? What do you guys think?

Why bicycle helmets are failing riders, and how to fix them | The Verge


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## manmythlegend (May 21, 2012)

It doesnt take much to get concussed. 
I would wager helmets are more for avoiding severe blood/fracture trauma. There isnt anything soft in them that would slow down your head from impact making concussion still a high likelyhood. MIPS are designed to keep moving after helmet hits the ground...interesting but super pricey for helmets at the moment.
((no you cant put a price on safety but people wont know or maybe cant afford $200 over a $50 helmet))


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## ooctrl (Aug 7, 2006)

In ten years of riding, I've concussed myself once when I went head first into a tree after sliding out during the landing of a small jump. Cracked my helmet and was dazed for a day while recovering my wits.


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## cyclelicious (Oct 7, 2008)

Interesting article to add

SENSELESS | Bicycling Magazine

Bike helmets protect the scalp and skull by preventing lacerations and fractures. - I've crashed and I am thankful for my helmet

Concussions are tough to deal with - in essence helmets do little to de-accelerate the head and the brain when it really wants to come to a sudden stop. The crush design of current bike helmets helps a little - but only a little. The forces involved are just too large for any kind of crash at speed.

On the other hand I play it safe and always wear a helmet


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## icecreamjay (Apr 13, 2004)

I gave myself a concussion a few years back. Took a hard fall due to diagonal roots on a steep downhill. It was January and the ground was frozen. The helmet didn't crack, I still use it as a spare (well, now its my backup spare). 

In retrospect it sounded pretty funny ( I don't remember any of it ). I kept asking my friend where we were. He kept trying to describe what trail and what part of the woods, but I was like " No, what park are we riding in? Where am I? " He explained, then we rode on and 30 seconds later I asked "Wait, where are we again?" So he volunteered to drive me the hour home and the whole way I asked "Why are you driving my truck? I have a concussion?!? OK, Wait a minute, why are you driving my truck?"

Got a CT scan and everything was fine. Rested up and took it easy for awhile. Luckily I didn't whack it again anytime soon, they're finding that to be a real danger.


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## dru (Sep 4, 2006)

I think concussions from MTBing are quite rare. However some people are much more prone to them than others. 

I've been punched in the head many times in my younger days and have never had a concussion. I've never been knocked out either. Other folks aren't so lucky, and concussions have finished their careers.

I hope I've dodged a bullet and don't get boxers dementia when I get older. That would suck!

Drew


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## shiggy (Dec 19, 1998)

mattmers said:


> I read this article on theverge and it talked about helmets not being designed for preventing extreme impacts and not lighter ones that can cause concussions. Are concussions really that common for mountain biking? What do you guys think?
> 
> Why bicycle helmets are failing riders, and how to fix them | The Verge


I have had 3-4 concussions in 30 years of mtbing. All while wearing a helmet. Would have had greater injuries without it.

Hit my helmeted head many more times without it resulting in concussions.


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## Darth Pinche (Feb 19, 2013)

I've had 2. The first was part of a crash that landed me in a 3 day coma. My cross country style helmet was cracked for and aft, left and right, all the way across like a plus all the way over the helmet. The front was abraded away since I landed and skidded on my face. I have no memory of the whole incident and am lucky to be alive and without brain damage. This happened in 1993.
My doctor said I was more liable to get more concussions after such a brain injury. In 1996 I crashed again, downhill at about 30mph. I never lost consciousness, but was very groggy and with hindsight, it was clear I got another concussion.

Since then, I never stopped riding, but I usually ride with a full face. Concussions are serious stuff and I've heard more recent studies suggest they are cumulative.


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## Old Ray (Sep 5, 2010)

2 concussions here. Both occurred when I was wearing a helmet. I figure they would been worse if I was not wearing one. I think that concussions are more frequently in mtb'ing than a lot of people want to believe. 

By comparison, 40+ years of martial art training, including a few years as a sparring partner for a Muay Thai fighter, only got me one concussion, but it was a doozie. 
It's nothing to take lightly, as all the evidence does point to cumulative, progressive damage from them as time goes by.


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## solidass (Jan 20, 2013)

My skull is triangular shaped because it has two sharp corners in the back as a result of childhood concussions. Back then I didn't wear a helmet, so if you can imagine full street speed going directly to a concrete curb was quite an oweee.

I believe rocks are just as hard.

What are the chances that there could be rocks in mtn biking?


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## STT GUY (May 19, 2009)

dru said:


> I think concussions from MTBing are quite rare. However some people are much more prone to them than others.
> 
> I've been punched in the head many times in my younger days and have never had a concussion. I've never been knocked out either. Other folks aren't so lucky, and concussions have finished their careers.
> 
> ...


^^^^ THIS ^^^^

Like Drew, Ive been hit in the head a ton and taken my share of spills. Some people are more prone to concussions than others. I've never had one in spite of some pretty hard crashes (moto and mtb). I have friends who have had several and one friend who decided to give up motorcycle roadracing because of chronic concussions. Every time you get a concussion it does permanent damage and it seems from the latest research that this is cumulative.

A polystyrene helmet is good for one very severe impact and that's it. Even though the shell may not look compromised the material which absorbs the impact (the liner...not the shell) is compromised. Helmets are cheap.....closed head injuries not so much!


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## ColinL (Feb 9, 2012)

Rode motocross as a youth, age 6-14. Many crashes with helmets, no concussions. Been doing MTBing about 4 years now. Fewer crashes, all with helmets, no concussions. I've never had a helmet totally destroyed but I did have some that have been retired because they didn't look fine.

If you see someone riding without a helmet they are really stupid. The likelihood of crashing can be debated, but the severity of head injury following a crash cannot.


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## Niner_Boy (Sep 4, 2012)

Fractured a vertebrae in my neck after I went OTB and hit a tree at least 20mph. The helmet cracked, but no concussion (although I'm sketchy about whether I hit the tree or the ground) despite no concussion. Man did I see stars right after! 

So as others have already mentioned, I think some are more prone to concussion than others.


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## terrasmak (Jun 14, 2011)

STT GUY said:


> A polystyrene helmet is good for one very severe impact and that's it. Even though the shell may not look compromised the material which absorbs the impact (the liner...not the shell) is compromised. Helmets are cheap.....closed head injuries not so much!


Best thing said in this thread so far.

They help, they help a lot. I havn't had one on a bike yet, but a few racing motorcross and a few roadracing motorcycles. Long term effects, i'm not going into mine, but yes it can cause different problems.


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## TwoTone (Jul 5, 2011)

Look into the newer MIPS helmets. They are more expensive, but the latest tech in helmets.
MIPS | Take a look in the latest issue of Popular Science


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## HIP-TEC (Aug 14, 2013)

We have plenty new things to say about protection and what's inside your helmet. We're not trying to shamelessly self-promote our brand, so don't take this thread as marketing BS. HIP-TEC has created a new protective interior helmet technology, but we also want to raise awareness around current helmet standards and how they have stalled the progression of helmet protection. Most bike and ski helmets provide good protection against big impacts, at least in the range of 12 - 14 mph, what we are really trying to understand is how concerned are you about lower speed impacts and their effect on the brain. In full disclosure we are a company really trying to change the paradigm of head protection from just focusing on the larger impacts, to focusing on all of the different types of impacts that cause injuries. It's going to get techy, but let's talk about it because it's important. You only have one brain.


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## Old Ray (Sep 5, 2010)

HIP-TEC said:


> We have plenty new things to say about protection and what's inside your helmet. We're not trying to shamelessly self-promote our brand, so don't take this thread as marketing BS. HIP-TEC has created a new protective interior helmet technology, but we also want to raise awareness around current helmet standards and how they have stalled the progression of helmet protection. Most bike and ski helmets provide good protection against big impacts, at least in the range of 12 - 14 mph, what we are really trying to understand is how concerned are you about lower speed impacts and their effect on the brain. In full disclosure we are a company really trying to change the paradigm of head protection from just focusing on the larger impacts, to focusing on all of the different types of impacts that cause injuries. It's going to get techy, but let's talk about it because it's important. You only have one brain.


Good stuff, HIP-TEC. Thanks for shamelessly spamming! :thumbsup:


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## HIP-TEC (Aug 14, 2013)

Hey Ray we don't want to spam. Thanks for calling us out though. That was kind of a junk fabricated paragraph. Admitted. We want to join this conversation and talk about ways to bring awareness to riders, that current helmet standards are not helping progress helmet technology. Most helmet companies make helmets to pass an old (40-year-old) standards test. It's pretty simple. Put a dense, hard foam inside a helmet…drop test it at a certified testing facility and if it absorbs the g's associated with maximum impact... Pass it...then produce it. This goes for that kids helmet you see in Wal-Mart or a high-end brain bucket you see in your local shop. 

People are going bigger, riders are going faster and new research is getting better at identifying how and why head injuries and concussions are happening at such an alarming rate. Low impact repeated blows or even a single impact at low speed can create 150 g's of force to the head. That's major concussion g force. Compare that to 170 g’s which is the hardest hit recorded in football. You may think you just received a dazing hit from that small fall, but those small hits are really leading you down the path to something bad, possibly when you take that big hit. Make sense? A majority of helmets with dense hard foam inside are made to stop skull fractures, not concussions. Why not use a technology made to lessen and absorb the impact of low, medium and high impact blows? Demand more from helmet companies and ask questions about why they have not adapted their helmet technology to new research and tech on the market. Lot's to digest here, but we want this conversation to start now. There are a lot of great helmet companies doing a lot of great things, but we need to push protective technology to the next level now.


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## OldManBike (Apr 16, 2011)

I hope lots of different companies start getting serious about improving mtb helmet safety to better protect against concussions not just skull fractures. I hope riders look back 10 years from now and shake their heads at what stone age helmets we all are wearing now. None of this reflects well at all on the helmet industry over the past 20 years.

MIPS has gotten most of the press I've seen about this, and there a few helmets out now with their stuff. I've never heard of Hip-tec before and their website is short on details at this point, but hopefully they'll be part of the solution too.

One concussion here, but subsequent minor impacts weeks later keep reviving minor symptoms which is unsettling.


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## Old Ray (Sep 5, 2010)

HIP-TEC said:


> Hey Ray we don't want to spam. Thanks for calling us out though. That was kind of a junk fabricated paragraph. Admitted. We want to join this conversation and talk about ways to bring awareness to riders, that current helmet standards are not helping progress helmet technology. Most helmet companies make helmets to pass an old (40-year-old) standards test. It's pretty simple. Put a dense, hard foam inside a helmet&#8230;drop test it at a certified testing facility and if it absorbs the g's associated with maximum impact... Pass it...then produce it. This goes for that kids helmet you see in Wal-Mart or a high-end brain bucket you see in your local shop.
> 
> People are going bigger, riders are going faster and new research is getting better at identifying how and why head injuries and concussions are happening at such an alarming rate. Low impact repeated blows or even a single impact at low speed can create 150 g's of force to the head. That's major concussion g force. Compare that to 170 g's which is the hardest hit recorded in football. You may think you just received a dazing hit from that small fall, but those small hits are really leading you down the path to something bad, possibly when you take that big hit. Make sense? A majority of helmets with dense hard foam inside are made to stop skull fractures, not concussions. Why not use a technology made to lessen and absorb the impact of low, medium and high impact blows? Demand more from helmet companies and ask questions about why they have not adapted their helmet technology to new research and tech on the market. Lot's to digest here, but we want this conversation to start now. There are a lot of great helmet companies doing a lot of great things, but we need to push protective technology to the next level now.


I wasn't calling you out. I'm genuinely interested in the subject of head injuries. I've been around hundreds of them in my lifetime. Literally.


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## HIP-TEC (Aug 14, 2013)

We are hoping to be part of the solution as well. It is an interesting time in head protection as it seems that there has finally been enough acknowledgement from the media (mainly it seems through football) that there are larger, potentially more important issues than just fracturing your skull. MIPS has definitely taken a step in the right direction by getting information out there relative to how rotation impacts the brain during a fall. We are trying to take that a step further and increase the protective properties for both rotation and blunt impacts. We are really not trying to spam for pure sales purposes as there won’t be a HIP-TEC helmet available until late 2014 (Just the issue of being included as a part of the manufacturing of the helmet rather than an insert).
Our main goal with the post on this forum is to gauge what athletes are thinking about head protection and hopefully to engage in some meaningful dialogue on how to push technology along in the same way that bike technology has been pushed along.

Also, we are trying to get more info up on the website, but it is incredible how much time it seems to take.


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## skewe (Sep 30, 2010)

Happened to me once, woke up and found out that my bicycle was like 5-10 feet away.
Helmet was all dirty up. I don't think I would have faired better if I was not wearing a helmet in a 7-10ft accidental drop.

Just high praises for a $40 Giro helmet


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## edubfromktown (Sep 7, 2010)

I've had zero concussions in my life and have never been unconscious. Played soccer for 30 years... my head made contact with a lot of things- other players heads, an occasional goal post, elbows, blocked a lot of shots on goal (had ball imprints on my face among other exposed skin areas for a couple of days sometimes). Also hit my head on other things off the pitch when I was young and "indestructible" aka stoooopid (more than 100 stitches in my head).

In ~13 years of riding I've damaged 5 (Bell) helmets and I am thankful that I was wearing one in each instance. I also agree that some are more prone to concussions than others.

This one was the hardest hit and I ended up with a Type II+ AC joint separation in my right shoulder. Cracked the helmet nicely.


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## thorkild (Jul 22, 2008)

I've read the statistics somewhere, but cycling is one of the most common ways to get a concussion. And, as mentioned above, helmets really aren't designed to prevent them. I've suffered two. One in the fall of 2011 while racing. Took three weeks to heal. I got a second in an accident working on a bike inmy garage this April. I'm still not back on a mountain bike yet. Head injuries are not o be taken lightly.


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## OldManBike (Apr 16, 2011)

thorkild said:


> I got a second in an accident working on a bike inmy garage this April. I'm still not back on a mountain bike yet.


Yikes. That's four+ months recovering.


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## Old Ray (Sep 5, 2010)

thorkild said:


> I've read the statistics somewhere, but cycling is one of the most common ways to get a concussion. And, as mentioned above, helmets really aren't designed to prevent them. I've suffered two. One in the fall of 2011 while racing. Took three weeks to heal. I got a second in an accident working on a bike inmy garage this April. I'm still not back on a mountain bike yet. Head injuries are not o be taken lightly.


Lemme guess....were you removing an air spring cartridge, of something like that?


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## TwoTone (Jul 5, 2011)

thorkild said:


> I've read the statistics somewhere, but cycling is one of the most common ways to get a concussion. And, as mentioned above, helmets really aren't designed to prevent them. I've suffered two. One in the fall of 2011 while racing. Took three weeks to heal. I got a second in an accident working on a bike inmy garage this April. I'm still not back on a mountain bike yet. Head injuries are not o be taken lightly.


As I mentioned earlier, take a look at the MIPS helmets. There are designed specifically to help reduce the chances of a concussion.


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## offroadcmpr (Apr 21, 2012)

Niner_Boy said:


> Fractured a vertebrae in my neck after I went OTB and hit a tree at least 20mph. The helmet cracked, but no concussion (although I'm sketchy about whether I hit the tree or the ground) despite no concussion. Man did I see stars right after!
> 
> So as others have already mentioned, I think some are more prone to concussion than others.


Similar thing to my father. Went OTB and landed on his head. No concussion, but he broke a vertebrae in his neck.


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## skewe (Sep 30, 2010)

offroadcmpr said:


> Similar thing to my father. Went OTB and landed on his head. No concussion, but he broke a vertebrae in his neck.


is he Ok from that?


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## RickBerg (May 1, 2012)

My two cents here. A couple weeks ago I hit a 12 footer and bumped my head pretty good. Was wearing a cheaper full face (661 comp). I went to the hospital and they said it was just a mild concussion. Been totally fine. I would say they are " moderately common" but generally not "serious".


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## TwoTone (Jul 5, 2011)

RickBerg said:


> My two cents here. A couple weeks ago I hit a 12 footer and bumped my head pretty good. Was wearing a cheaper full face (661 comp). I went to the hospital and they said it was just a mild concussion. Been totally fine. I would say they are " moderately common" but generally not "serious".


Sorry but is that your professional medical opinion? Seems the EXPERTS in the field tend to disagree with you.


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## RickBerg (May 1, 2012)

TwoTone said:


> Sorry but is that your professional medical opinion? Seems the EXPERTS in the field tend to disagree with you.


Well... the doctor, who i believe is an EXPERT, said it wasn't serious, as there was no bleeding. Repeated concussions are indeed a problem, as are more severe concussions.


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## Old Ray (Sep 5, 2010)

offroadcmpr said:


> Similar thing to my father. Went OTB and landed on his head. No concussion, but he broke a vertebrae in his neck.


With just about any older guy who has led an "active" life, a C-spine x-ray tends to look like a disaster zone. Even when the owner is symptom-free.


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## TwoTone (Jul 5, 2011)

RickBerg said:


> Well... the doctor, who i believe is an EXPERT, said it wasn't serious, as there was no bleeding. Repeated concussions are indeed a problem, as are more severe concussions.


Your wording on the first post sounds like you're saying concussions in general aren't serious. Considering the evidence is showing that the damage is cumulative, any concussion is serious.


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## Niner_Boy (Sep 4, 2012)

Although I can't speak of the Trabec Race MIPS, since my accident, I bought the Trabec which I do not think has MIPS, but I must say, it's an extremely comfortable helmet to wear, and since it offers more around-the-ear protection as well as more protection on the back of the head, I feel as safe as I can be when I'm out riding. 

I hope I never have to test this one as I did my $30 Specialized, but I feel confident that I have the best protection I can get, even though it does not have MIPS. 

No matter what helmet you get, a concussion is always possible- the price we pay doing the things we love...


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## OldManBike (Apr 16, 2011)

RickBerg said:


> My two cents here. A couple weeks ago I hit a 12 footer and bumped my head pretty good. Was wearing a cheaper full face (661 comp). I went to the hospital and they said it was just a mild concussion. Been totally fine. I would say they are " moderately common" but generally not "serious".


I understand what you're saying. I might have said the same thing a couple weeks after my mild concussion. But here I am 3 months later getting fairly debilitating concussion symptoms from minor head bumps. So even if you feel 100% now, my advice (and I'm not an expert) is to be extra careful for a while yet and don't assume you're good as new. (Which may be what TwoTone was getting at.)


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## OldManBike (Apr 16, 2011)

Niner_Boy said:


> I feel as safe as I can be when I'm out riding.
> 
> ... I feel confident that I have the best protection I can get, even though it does not have MIPS.


It may be 100% fine for you, but if its not a MIPS helmet, its not the best concussion protection you can get today.


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## offroadcmpr (Apr 21, 2012)

skewe said:


> is he Ok from that?


That happened a few years ago. He had to take a few months off the bike before the doctor would let him back on again. But no real issues with it otherwise.

Recently he crashed again and broke his collar bone and lower vertebrae. I assume in a couple of months he will be able to get back out again.

One the one hand, biking has saved his life because his strong heart kept him from having any permanent damage from a heart attack due to a genetic disorder. On the other hand, he has broken several bones from crashing(partly due to the genetic disorder).


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## BoiseBoy (Mar 1, 2006)

As a concussion specialist, I can tell you a few things. 

First, I know many things first hand because I have had a number of concussion from my football days and from cycling. I have had two while mountain biking in the past ten years. One rather benign and another that was more impactful where I lost consciousness and was in-and-out for the better part of an hour during a race.

Second, there is no way to accurately predict or completely prevent concussions, short of not participating in cycling. The truth is, there are populations that appear more at risk, such as females, the younger athlete, and those with previous concussions, but these are just statistical pools.

True, there is a relationship between forces, acceleration, and deceleration and its effect on the brain, however, at this time there is no predictive way to accurately suggest who will have a head injury from what force/event. The truth is that some athletes are concussed with the slightest of impact while being tackled in a football game whereas, another guy that gets lit up with a vicious hit will have no injury at all. 

There are statistics that show no reduction in head injuries with women soccer players wearing head gear when it comes to concussions. Statistically, there are more head injuries in contact sports (football and hockey). Given similar sports, such as soccer and basketball, women have a higher frequency of head injuries. 

There has been a lot of talk, clinically and in sports, of the true reasoning of wearing head gear protection. Mostly, helmets were developed to reduce the risk of skull fractures and serious injuries. Helmets have not yet been designed to statistically reduce the risk of concussions. 

With all of that being said, I would not ever risk going for a mountain bike ride without my helmet. 
There is a slough of research going on at the present time on head injuries. I believe that there will never be a way to completely prevent head injuries, however, advances in patient screening along with R&D by manufacturers and sporting entities will reduce the risk and frequency of them.


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## BoiseBoy (Mar 1, 2006)

My patients will tend to disagree with you. They believe that ALL concussions are serious!



RickBerg said:


> My two cents here. A couple weeks ago I hit a 12 footer and bumped my head pretty good. Was wearing a cheaper full face (661 comp). I went to the hospital and they said it was just a mild concussion. Been totally fine. I would say they are " moderately common" but generally not "serious".


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## TwoTone (Jul 5, 2011)

BoiseBoy said:


> As a concussion specialist, I can tell you a few things.
> 
> First, I know many things first hand because I have had a number of concussion from my football days and from cycling. I have had two while mountain biking in the past ten years. One rather benign and another that was more impactful where I lost consciousness and was in-and-out for the better part of an hour during a race.
> 
> ...


Might want to look at the MIPS and 6D helmets.


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## Old Ray (Sep 5, 2010)

TwoTone said:


> Might want to look at the MIPS and 6D helmets.


They are gettin' there. One of those will no doubt be my next helmet purchase. I only recently bought a Giro Xen on closeout, just before I learned about the MIPS development. It's for sure a significant step up.


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## BoiseBoy (Mar 1, 2006)

What you see is engineering data, not medical research. There is a big difference between the two. A lot of things look good in a lab or in theory. 

I will repeat, helmets have not yet been designed to statistically reduce the risk of concussions.

The challenge is not the engineering behind the helmet, but the variability and complexity of the human body. Although we have come to a generalized, worldly consensus as to what a concussion is, there are still many things that we don't completely understand about the brain and concussions. Again, there is not a threshold force that is found to elicit the chemical/metabolic cascade that we believe is a concussion. X amount of Newtons or Y degrees/second is not the same for each individual. One athlete may be concussed and suffer from Post Concussion Syndrome with a ball peen hammer while the next may not have any symptoms from a sledge hammer.

As I mentioned before, I choose to ride with a helmet and maybe a person would have a bit more piece of mind with one of the aforementioned helmets. Unfortunately, their research is limited to computer models, not humans. No "real" research has been done, clinically speaking, with these helmets. I commend these companies for working on our problem, but as of right now, all I see is marketing data from them, not clinical research.


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## Old Ray (Sep 5, 2010)

BoiseBoy said:


> What you see is engineering data, not medical research. There is a big difference between the two. A lot of things look good in a lab or in theory.
> 
> I will repeat, helmets have not yet been designed to statistically reduce the risk of concussions.
> 
> ...


I see. Kinda like cardiac stents, eh?


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## BoiseBoy (Mar 1, 2006)

I am certainly not a cardiologist, however, I do believe that the CLINICAL research now supports the use of stents, does it not?

My point in the previous posts is that nothing that the helmet companies have done up to this point show that they decrease the frequency or severity of mild TBI's.

I am not saying that there won't be evidence in the future, I am just telling you that nothing is proven as of to this point. Currently, there is only engineering lab data, which hasn't shown shown to carry over to clinical evidence, yet.



Ray Raton said:


> I see. Kinda like cardiac stents, eh?


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## TwoTone (Jul 5, 2011)

BoiseBoy said:


> I am certainly not a cardiologist, however, I do believe that the CLINICAL research now supports the use of stents, does it not?
> 
> My point in the previous posts is that nothing that the helmet companies have done up to this point show that they decrease the frequency or severity of mild TBI's.
> 
> I am not saying that there won't be evidence in the future, I am just telling you that nothing is proven as of to this point. Currently, there is only engineering lab data, which hasn't shown shown to carry over to clinical evidence, yet.


I don't see how it ever will. As you said each individual is different, so how are you going to have a clinical trail showing the MIPS works? or any other improvement? You can't. You cant have group A wear non MIPS helmets and group B wearing MIPS helmet and then compare. Every crash is different and every individual is also.

The best you can do is take the evidence that shows rotational energy is a large factor in concussions and produce a helmet to reduce those forces.

I chose to think of it as crash test dummies for rating cars, I'm sure it takes varing force to break a bone in individuals, yet they have come up with a standard and measure to that.

So until dis-proven, I'll gladly spend a little more on a MIPS helmet vs a non.


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## BoiseBoy (Mar 1, 2006)

Actually, you answered your own question.
With a large enough sample size over a long enough period of time you will get your clinical answers. 

You have samples wearing the MIPS technology and another sample not wear this technology. You have on group, position, team, league etc. wearing this technology and compare it against the normative group or against previous statistics.

I doubt that you will ever get this data from cycling for many reasons. These statistics will likely come from organized, team sports and be carried over to cycling. Some of the biggest challenges with mild TBI's are coming to a consensus as to what a concussion is, and how they are reported. We are seeing a huge uptick in the number of concussions over the past few years, however, it is likely due to the fact that we have better awareness of concussions and the reporting of concussions is much better. 

Another factor that is nearly impossible to account for is often brought up in football. If one wears a helmet where they feel protected against injury, they often put themselves in more vulnerable situations with the helmet that they would not have if sans helmet. This is an interesting thought when it comes to MIPS helmets. I wouldn't be surprised if concussion rates are actually higher while using them. 

I have been apart of many conversations, conferences, and presentations on just these topics. I still choose to wear a helmet and advise all to wear helmets when riding. The fact of the matter is, there is not proof that the MIPS helmet is any better than a $15 Bell helmet from Target.


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## OldManBike (Apr 16, 2011)

BoiseBoy said:


> If one wears a helmet where they feel protected against injury, they often put themselves in more vulnerable situations with the helmet that they would not have if sans helmet. This is an interesting thought when it comes to MIPS helmets. I wouldn't be surprised if concussion rates are actually higher while using them.


I would be. I think the idea that folks will start riding more recklessly because they're wearing a MIPS helmet instead of a non-MIPS helmet is silly. But I guess time will tell.



BoiseBoy said:


> I doubt that you will ever get this data from cycling for many reasons. . . . The fact of the matter is, there is not proof that the MIPS helmet is any better than a $15 Bell helmet from Target.


But if more probative testing isn't forthcoming, it seems prudent to accept the less probative testing in the meantime. The engineering data is relevant, even if its not conclusive. Tobacco companies did the same quibbling for decades about lack of scientific proof, and gazillions died in the meantime. Maybe the extra $25 or $50 books spent on MIPS will one day be proven to have provided little or no benefit. But in a world of incomplete information, it seems to me like a reasonable investment. At a minimum, it all helps create a market for concussion-targeted designs.



BoiseBoy said:


> I will repeat, helmets have not yet been designed to statistically reduce the risk of concussions.


I suppose. It's a misleading statement whose accuracy relies on ambiguous meanings of "designed" and "statistically." Your posts add a lot to this thread and I appreciate your contribution, but this statement just seems inflammatory.


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## 1362 (Sep 12, 2010)

TwoTone said:


> As I mentioned earlier, take a look at the MIPS helmets. There are designed specifically to help reduce the chances of a concussion.


Don't go all get your panties in wad, this stuff is not proven anything yet.
Seems to me, this helmet will be proven to add a secondary wave bashing like whiplash to the brain. Then to boot, a pretty good number of scalp tears. 
If football players start using this on the field in games, at the pro level, then ring the bell.


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## TwoTone (Jul 5, 2011)

1362 said:


> Don't go all get your panties in wad, this stuff is not proven anything yet.
> Seems to me, this helmet will be proven to add a secondary wave bashing like whiplash to the brain. Then to boot, a pretty good number of scalp tears.
> If football players start using this on the field in games, at the pro level, then ring the bell.


Who's got their panties in a wad, sounds like your reading comprehension is pretty poor if you took that from the quote.

Doesn't really sound like you looked at too much of the data. I'd love to hear your hypothesis on the scalp tears.


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## provin1327 (Mar 31, 2013)

The helmet does nothing to keep the brain from impacting the skull. It will take a lot of the energy out and prevent major cuts and trauma, but the main problem is the brain hitting the inside of the skull.


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## OldManBike (Apr 16, 2011)

BoiseBoy said:


> The fact of the matter is, there is not proof that the MIPS helmet is any better than a $15 Bell helmet from Target.


Is there that sort of "proof" that fullface helmets and kneepads reduce injury risks to mtb DH riders? If not, do you encourage folks to stick with their $15 helmet there, too?

Is there "proof" that gloves reduce MTB injury risks? Do you encourage everyone to skip on gloves until those studies emerge?

Should such research be done? Yeah. Is it fair to hold the helmet industry accountable for failing to do it over the past couple decades? Certainly. But I think its irresponsible for someone who's holding himself out as an expert on all this to encourage the world to stick with their Target specials until clinical studies are done. That's not the appropriate standard.


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## 1362 (Sep 12, 2010)

TwoTone said:


> Who's got their panties in a wad, sounds like your reading comprehension is pretty poor if you took that from the quote.
> 
> Doesn't really sound like you looked at too much of the data. I'd love to hear your hypothesis on the scalp tears.


Do not try to demean to justify your apparent one sided view,your reading comprehension is pretty poor, back at you! 
My post was more tongue in cheek, that people are jumping on bandwagon on something that truly is not proven on the concussion aspect. Period. "Looks" promising and nobody on this thread has said don't wear a helmet.


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## ColinL (Feb 9, 2012)

BoiseBoy said:


> First, I know many things first hand because I have had a number of concussion from my football days and from cycling. I have had two while mountain biking in the past ten years. One rather benign and another that was more impactful where I lost consciousness and was *in-and-out for the better part of an hour during a race.*


It sounds as if you attempted to continue the race. Is that so?

Would it be your professional opinion that someone attempt to continue a race, or be allowed to continue any strenuous activity after losing consciousness?


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## swildnm (Aug 23, 2012)

I've only recently become aware of MIPS and concussion prevention, but here is my take.
MIPS clearly isn't a complete solution, and I doubt that one will ever be found. But my next helmet will be a MIPS, or whatever the latest version of MIPS is, simply because I would rather give my money to people who are trying to make a better helmet rather than those that have been only interested in meeting an out of date standard.


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## TwoTone (Jul 5, 2011)

View attachment 830696


1362 said:


> Do not try to demean to justify your apparent one sided view,your reading comprehension is pretty poor, back at you!
> My post was more tongue in cheek, that people are jumping on bandwagon on something that truly is not proven on the concussion aspect. Period. "Looks" promising and nobody on this thread has said don't wear a helmet.


So find my post where I've said it's been proven? You still haven't answered the scalp tearing question. There is data that as you said looks promising as far as MIPS helping reduce concussion. If knowing that you still want to run around in you $15 helmet go ahead, I've had more than one concussion so for me $200 on a helmet is nothing, my pedals cost more.

I've been down this road, once your face looks like this, you might even start reconsidering FF vs. half dome for XC riding.

View attachment 830695

View attachment 830695


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## 1362 (Sep 12, 2010)

ColinL said:


> It sounds as if you attempted to continue the race. Is that so?
> 
> Would it be your professional opinion that someone attempt to continue a race, or be allowed to continue any strenuous activity after losing consciousness?


I would say that if a person competing was K.O., the director should pull that person out. And that does not include somebody who wrecked and hit his helmet head, as long as that person has a replacement helmet.


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## BoiseBoy (Mar 1, 2006)

No, I "finished" the race by coasting the last mile or two of the course to get to the finish where medical assistance was located.

It is now standard medical practice to pull all individuals who have been concussed or show signs of concussion. Athletes are not to return that same day. It is now protocol that all athletes be symptom-free at rest prior to beginning their 5 step (5 day) return to play protocol.

As far as your "strenuous activity" question, the answer is no. As noted above, they should rest until symptom free while at rest, then gradually begin returning to activity.



ColinL said:


> It sounds as if you attempted to continue the race. Is that so?
> 
> Would it be your professional opinion that someone attempt to continue a race, or be allowed to continue any strenuous activity after losing consciousness?


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## ColinL (Feb 9, 2012)

BoiseBoy said:


> No, I "finished" the race by coasting the last mile or two of the course to get to the finish where medical assistance was located.
> 
> It is now standard medical practice to pull all individuals who have been concussed or show signs of concussion. Athletes are not to return that same day. It is now protocol that all athletes be symptom-free at rest prior to beginning their 5 step (5 day) return to play protocol.
> 
> As far as your "strenuous activity" question, the answer is no. As noted above, they should rest until symptom free while at rest, then gradually begin returning to activity.


Yes, that is pretty standard stuff these days.

Down the street about 4 blocks from me is a hospital. I see nurses and docs outside all the time on a smoke break. Fewer now than in years past, but it's non-zero.

During competition, some athletes lose the ability to make intelligent long-term decisions whether concussed or not, kind of like those smokers. Your first post that I quoted gave me that impression because 'the better part of an hour' seems more like continuing the race than coasting the last mile or two, and I've seen people attempt and actually finish events after a hard crash. I've heard many athletes say they don't remember events.

It hasn't happened to me, so I don't know if I'd do the right thing or not. It's also hard to say without the benefit of hindsight what exactly is a crash severe enough to stay where you fall and wait for help, or to attempt to reach medical staff.


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## bbeltramo (Aug 7, 2012)

I was lurking on this thread last week and coincidentally, had an interesting helmet test this weekend. On Saturday, a friend of mine and I went riding. He went over the bars, seemed okay at first, but about 45 minutes later started showing some pretty serious concussion signs. Severely confused, didnt remember anything, kept repeating questions, etc. Checked in at the local hospital, diagnosed with concussion. It was bad enough I had to show him where his room was back in his building. His helmet was barely scratched from where he hit.

Fast forward 24 hours, and I was riding by myself. Went over the bars at a slightly slower speed, and took a direct impact to my helmet from a rock in the same spot as my friend just the opposite side (front right as opposed to front left). Hit hard enough to create a 3/4in deep, half dollar sized dent in my helmet. I got up, brushed it off, kept riding. Had a slight headache later, but that could have been from dehydration as much as hitting my head.

We were wearing very similar priced helmets, and impacted in almost the same spot, at almost the same speed, within 24 hours of each other. 2 completely different results. It really does come down to the individual. Me personally, I am not completely sold on the MIPS idea yet (although I respect the data, I just want to wait and see some more real world results). I do believe in the extended protection that the new "All Mountain" helmets are providing, so I ordered a Bell Super yesterday.


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## OldManBike (Apr 16, 2011)

ColinL said:


> It's also hard to say without the benefit of hindsight what exactly is a crash severe enough to stay where you fall and wait for help, or to attempt to reach medical staff.


I found this very true. I had never had a concussion and was very, very aware of the issue. (As an aside, if you haven't read & watched this from NYT on hockey enforcer Derek Boogard, I recommend it.) When my crash happened, I was immediately asking myself whether I'd had a concussion. I decided I probably hadn't: no blackout, no disorientation, no ringing ears, remembered the impact, no visible helmet damage. So I went ahead and raced a techy super-D right after, and I did fine and remember everything.

Didn't decide I'd had a concussion until I woke up the next day feeling fuzzy. And, fast forward to today, I've been off my bike again for several weeks due to strong recurrence of symptoms after a couple minor head impacts long after I thought I was home free. Now, concussion specialist visits, PT a couple times a week, supplements. A discouraging pain in the ass.

My point being that it can be very difficult to recognize right away if you've had a 'minor' concussion, and the consequences still can be far from trivial.


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## TwoTone (Jul 5, 2011)

OldManBike said:


> I found this very true. I had never had a concussion and was very, very aware of the issue. (As an aside, if you haven't read & watched this from NYT on hockey enforcer Derek Boogard, I recommend it.) When my crash happened, I was immediately asking myself whether I'd had a concussion. I decided I probably hadn't: no blackout, no disorientation, no ringing ears, remembered the impact, no visible helmet damage. So I went ahead and raced a techy super-D right after, and I did fine and remember everything.
> 
> Didn't decide I'd had a concussion until I woke up the next day feeling fuzzy. And, fast forward to today, I've been off my bike again for several weeks due to strong recurrence of symptoms after a couple minor head impacts long after I thought I was home free. Now, concussion specialist visits, PT a couple times a week, supplements. A discouraging pain in the ass.
> 
> My point being that it can be very difficult to recognize right away if you've had a 'minor' concussion, and the consequences still can be far from trivial.


I had the same experience with my recent crash. The ER Dr actually gave me a note for no work for 4 days and I thought to myself why?
I work from home and I found out why that Monday (crash was Sunday) I had a hard time concentrating, even working at a desk, I felt like I had to go lay down for a bit every few hours, just tired. My family noticed I was off for about a week.


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## thorkild (Jul 22, 2008)

I'm curious whether anyone on these forums has dealt with long term post concussion syndrome before. I'm now at 8 months post injury and while I am way way better than 4 months ago, I am still far from out of the woods. I still get some pressure feelings in my head along with foggy feelings (the closest thing I can analogize to is a hangover) on a somewhat regular basis to go along with extended periods of feeling much closer to normal. I am told that things should continue to improve and most people do improve within a year, but some people continue to have issues over a much longer time frame. In other words, no real idea but you just have to keep working at it on a daily basis. I can ride my MTB now, but I can't go as near as fast or sustained as I did pre-injury. Just curious if anyone has had longer term concussion symptoms that did resolve.


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## albertf15 (Jan 13, 2007)

thorkild said:


> I'm curious whether anyone on these forums has dealt with long term post concussion syndrome before. I'm now at 8 months post injury and while I am way way better than 4 months ago, I am still far from out of the woods. I still get some pressure feelings in my head along with foggy feelings (the closest thing I can analogize to is a hangover) on a somewhat regular basis to go along with extended periods of feeling much closer to normal. I am told that things should continue to improve and most people do improve within a year, but some people continue to have issues over a much longer time frame. In other words, no real idea but you just have to keep working at it on a daily basis. I can ride my MTB now, but I can't go as near as fast or sustained as I did pre-injury. Just curious if anyone has had longer term concussion symptoms that did resolve.


I am not 100% sure but I think I might have post concussion syndrome and next time I go to see a Doctor I will bring it up. For the last 5 years I have had weird headache, and once in a while, I feel a my head a little fuzzy and or get the hangover feeling.

I had really bad crash back in 2008 during a road race when I crashed into guard rail when I took a turn too wide. The last thing I remember is just taking a right turn too wide and after crashing into the guard rail the feeling of my body flying forward, The after math was my head took a big hit that destroyed my helmet, lost 2 tooth and cut my bottom lip and fractured my right wrist.

People used to ask me if I passed out, and I used to tell them I did not since by the time I opened my eyes it felt like a split second, but I realized I had to be unconscious since it didnt make sense that the ambulance got there almost right after I opened my eyes..


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## BoiseBoy (Mar 1, 2006)

thorkild, it is typical for around 90% of all concussions to clear by the four week mark. With that lingering 10%, we most often Dx them with Post Concussion Syndrome (PCS). In regards to your situation, it is not rare to see pt's weeks and even months post concussion. Rather than putting a "one year time frame" on your healing, what I would ask is if you are continuing to heal / make improvements? If the answer is yes, then I would continue to take the time to heal. However, if you have hit a plateau and are not seeing resolution of your sx's (HA, nausea, dizziness, neck pain, memory, concentration, processing etc...) then I would seek medical attention with a concussion specialist or with a local mild traumatic brain injury team. 

For most of our PCS pt's, we typically take a team approach to include an MD, PT for manual / spine, a PT for balance/vestibular, a speech therapist, and sometimes, even OT and neuropsych. It really depends on what your continued deficits are as to what specialties you may benefit from. 

Since you mentioned riding, one thing to pay close attention to, is your response to stress (cognitive or physical). For both, but more specific to MTBing, you want to pay attention to your sx's as you ride and afterward. It is quite helpful to the brain's healing process to perform regular cardiovascular exercises, however, it is important that you not worsen you sx's from the ride, either. Try to keep you riding below eliciting / worsening your concussion sx's.


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