Tuesday, September 10, 2013

Do you like your brain? (then wear a helmet)

You have such a nice brain! Why not protect it?

I know, I know, I promised that my next blog would be about myofascial release, BUT, this past Sunday was the first Westchester Bicycle Sunday since June, and as I was out enjoying the PERFECT autumn weather and sunshine, I couldn’t help but notice how many people weren’t wearing helmets while riding their bicycles. Those of you who know me know that this is one of my one-woman campaigns—to make all the kids in the Bronx where bicycle helmets.
Don't worry. This was in New Zealand. That's why
I'm on the other side of the road. The cars do it too.
As a resident pediatrician, I have taken care of more kids than I would like to admit who were riding their bicycles in the Bronx without helmets and got hit by motor vehicles. Traumatic Brain Injury is a very serious thing. Some kids are luckier than others after being struck by a car (what normally happens in cities) or riding down a dangerous hill a little too fast (Let’s face it, we all love doing it) and taking a nasty fall. But what it boils down to is that if you like riding a bike, if you like running, if you like walking, if you like talking to your friends and eating food by mouth—all things this amazing thing called your brain helps you do—then wear a helmet.

The nitty gritty:
The Centers for Disease Control notes that only 48% of kids age 5-14 years wear bicycle helmets while riding. Older children were even less likely to wear helmets.
Data from 2010 shows that 800 bicyclists were killed, with an estimated 515,000 who sustained injuries requiring emergency department care.
Lastly, each year, 26,000 of the children and adolescents who experienced bicycle related injuries actually developed TBI, traumatic brain injury.

From the AAP, helpful tips to get your child to wear a bicycle helmet:

I know now more each day that I was very lucky to have the parents that I had growing up. One of the many things they did for me besides encouraging sports and staying active was that they encouraged safety, health, and nutrition. I never considered riding a bicycle without a helmet. Why? There was a law in the state of Georgia that all children under the age of 16 had to wear one in order to ride a bicycle. But, more importantly, my parents not only bought me a helmet when I got my first bike from Santa, but they also always wore helmets themselves. When you’re a little kid, you don’t make fun of your parents yet, so when they wear a helmet, you might actually model them and think that it’s the cool thing to do. Isn’t that a great opportunity that parents have? Model good behavior. Model safe bicycle riding. Explain rules. Kids want to learn this stuff; we just have to teach them J

Maybe we don’t need to argue about why kids should be wearing their helmets. I mostly see adults not wearing them when I am out running or riding myself. So, to adults, I say, don’t you like your brain? Doesn’t it do awesome things for you? Do you like being able to contribute to society, work at your job, play with your kids? Then wear a helmet. I know, I know, you just got the NYC Citi Bike to go downtown a bit. I love the idea of Citi Bikes and what this could do for healthy transit in NYC. I think they should also have helmets at each little station. But that’s just me. And yes, those fun hipster cycling hats look cooler than helmets, but they don’t do much to protect your brain! You’re going to have hat hair either way, so just wear a helmet.

The right fit for your helmet:
¤ Helmet should sit slightly above the eyebrows and not slide around the head.
¤ Should be worn level on the head with straps forming a Y shape immediately under the wearer’s ear.
¤ Strap should be securely fastened to the point where the helmet stays still on the ehad but without being painfully tight around the chin. When you open your mouth, your helmet should pull down tightly on your head.

Other safety concerns while riding:
Since more and more folks are using bikes to commute (YAY! Fight obesity, America!), I thought some riding rules would be helpful for novice and even seasoned riders:
  1. No headphones! Being able to hear what is going on around you is half of the fun of being outdoors but more importantly it is for your safety! You need all your senses to alert you if a vehicle, runner, or other cyclist is approaching.
  2. Obey traffic signs and signals just as if you were in a car.
  3. Use hand signals to let drivers and even other cyclists know what you’re doing.
  4. Ride on the right with traffic, not against traffic. (Unless you’re in Australia, New Zealand, Japan, or anywhere else where they like doing things a big opposite.)
  5. Stop and look both ways before entering a street.
  6. If on a path, make sure you ride to the right to allow others to pass. If on a road closed to traffic, the right lane is typically the slower lane. Be courteous of others.
  7. Don’t ride side-by-side or multiple riders across. (Be courteous to others.)
  8. Wear a helmet. (Sorry. I just didn’t think we had said it enough here.)
    The closest I could find to Gatorade out
    on the road in Chiang Mai.
  9. Bring adequate nutrition/hydration. Always err on the side of over-estimation because we tend to underestimate what we need and sometimes go farther than we think we will. If you are riding with kids, bring a snack and beverage for each of them. You know they’ll need/want it; they want it if they go to run errands with you.
  10. Wear sunscreen (trust me).
  11. Wear protective eyewear. Eyes, like a brain, are pretty nice to have around.
  12. Teach your kids! Make sure they know the rules before they go out of the parking lot or the backyard where they have been learning how to ride their bicycles.

On an even more personal note, I have ridden some crazy climbs in the mountains of Montana with sheer cliffs to the side of me, and I have ridden in the busy streets of Bangkok and Chiang Mai in Thailand. 

I have to say, I would not have done any of it without a helmet. During Ironman Texas, about mile 106 of the bike, I was so tired and dehydrated that I took my eyes off the road for a moment (Don’t do that, guys.), and I crashed. I was not going very fast at all because it was just after a nutrition station and I was adjusting water bottles, but I hit the ground and slid several feet, my head hitting a telephone pole. Guess what I was really glad I had on? My helmet. Thank you, Giro helmet, for cracking and withstanding the force that could have smashed my brain and kept me from going on to begin my residency in pediatrics. Here’s a photo of my cracked helmet.
Wouldn’t you rather have a cracked helmet than a cracked brain? I would.

This was a just a little glimpse of a huge topic in sports: sports related head trauma. Football season just started, so we will most surely be talking more about this! In the meantime, get out and enjoy this awesome weather, but if you’re on a bike (or skating or whatever you’re doing), wear a helmet. ;)

Megan Long, M.D.

More info:
Brain Injury Association of America http://www.biausa.org/brain-injury-children.htm