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Health Information Keep a Lid On It: Wear a Helmet

It's uncomfortable and hot. It messes up my hair. It isn't cool. I'm not going to fall, so I don’t need one. These are just a few of the reasons people give for not wearing a helmet while roller skating, inline skating, riding a bicycle, scooter or motorcycle, or engaging in other potentially risky outdoor activities.

But according to James Young, MD, physical medicine and rehabilitation specialist at Rush University Medical Center and a nationally recognized expert on traumatic brain injury, there are no valid excuses for not strapping on this vital piece of protective gear. "Your brain is the single most important organ system in your body, and it cannot be replaced," he says. "So it should be your top priority to keep it safe."

Brain Matters

Trauma to the brain can occur as a result of an impact, which can cause a concussion or open skull fracture. A jarring motion, such as a quick turn or sudden stop, can also injure the brain.

And you don't have to be going fast, fall far or hit your head hard to suffer lasting damage. Young says that even seemingly mild head injuries, where you don't lose consciousness, can cause permanent behavioral and cognitive problems, such as memory loss, inability to concentrate and sleep disorders. In some cases, traumatic brain injuries can lead to permanent disability or death, as in the case of actress Natasha Richardson.

Studies have shown that wearing a helmet can reduce your risk of a serious brain injury and death because during a fall or collision, most of the impact energy is absorbed by the helmet, rather than your head and brain. Statistics offer further proof: Head injuries account for more than 60 percent of bicycle-related deaths each year. And, according to the Bicycle Helmet Safety Institute, up to 88 percent of the brain injuries suffered by cyclists could be prevented by helmets.

How to Choose a Helmet
Just as important as wearing a helmet, however, is wearing the right helmet. A helmet that doesn't fit properly or offer sufficient cushioning can give you a false sense of security while not actually providing the level of protection you need, Young says. The following tips will help you select the best helmet to safeguard your gray matter:

  • All helmets are not created equal. There are, in fact, different helmets for different activities, and each type of helmet is designed to protect your head from the impacts common to a particular activity or sport. You should always wear a helmet that is appropriate for the activity you’re involved in because other types of helmets may not protect you adequately. Some helmets can be worn for multiple activities, but don't assume. Check the manufacturer's instructions for guidelines.
  • If the helmet fits. To ensure optimal protection, your helmet should meet the following criteria:
    • Feel comfortable but snug.
    • Sit evenly on your head (not be tilted back on the top of the head or pulled too low over your forehead).
    • Not move in any direction, back to front or side to side.
    • Have a secure buckle to keep it from moving or falling off on either a first or second impact. So if you are riding your bike and collide with something (first impact), the helmet will still be in firmly place if you then fall onto the pavement (second impact).
    • If it's for children or toddlers, have a buckle that holds firm in a crash but releases after five seconds of steady pull to avoid potential strangulation.
    • Be easy to adjust and fit properly without a lot of adjustments. And once adjustments have been made, they should stay put.
  • To replace or not to replace? Some helmets are manufactured to withstand one impact, while others are made to withstand multiple impacts. Bicycle helmets are designed to protect against a single severe impact, such as a fall onto the pavement. The foam material in the helmet will crush to absorb the impact energy during a fall and can't protect you again from a subsequent impact. So even if there are no visible signs of damage, you must replace it. Other helmets are designed to protect against multiple moderate impacts, including football and hockey helmets. However, you may still have to replace these helmets after one severe impact, particularly if the helmet has visible signs of damage, such as a cracked shell or a permanent dent.

Finally, it's important to remember that while helmets are protective, they aren't perfect: You can sustain a head injury even if you always wear one. That's why it's important to further reduce your risk by exercising caution during recreational activities. Watch your speed; always obey posted traffic signs and signals; and be mindful of cars, pedestrians, animals, uneven pavement and other impediments that may cause a collision or fall.


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Please note: All physicians featured in Discover Rush Online are on the medical faculty of Rush University Medical Center. Some of the physicians featured are in private practice and, as independent practitioners, are not agents or employees of Rush University Medical Center.

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