Learn from the Olympians – A Helmet Can Prevent Concussions and Save Lives

What do the Olympic snowboarders, skiers, sledders, and hockey players all have in common? Win, lose, or draw – they all wear helmets.

If you have been watching the 2014 Winter Olympics as I have, you have seen some nasty skiing, sledding, and snowboarding “wipe outs.” I personally saw one of the athletes crack her helmet as she hit the ground. I bet it saved her life – even if she still got a concussion out of the deal.

With that being said, we’ve heard a lot about concussions lately. If you watched the Super Bowl and other NFL games this past season, you heard the word concussion plenty of times. In years past, we would often “blow off” minor head injuries that may have been true concussions, but these days, we take concussions much more seriously. And we do this for an important reason – the research has clearly shown that concussions need to be taken very seriously, diagnosed accurately, and treated appropriately.

At the “end of the day” we need to be doing everything in our power to prevent concussions in ourselves and our kids – and hence the column about helmets…

The Olympics – and most importantly the Olympic crashes and wipeouts – highlight the need for children – and parents – to wear their helmets when engaging in activities that could result in head injuries. We simply need to take the appropriate precautions when we engage in sports and endeavors that could place us in harm’s way. Your mother was right – it’s simply better to be safe than sorry.

Take it from a guy whose bonked his head a few times – and gotten very lucky – helmet use is very important. No matter what your age or level of experience, whenever you bike, inline skate, skateboard, ski, snowboard, sled, or engage in other activity where your head is vulnerable to injury, you should wear a helmet.

Why wear a helmet?

Cuts, bruises, sprains, and even broken bones will heal, but damage to your brain can last a lifetime. In an instant your head can smack the street, sidewalk, curb, a car, tree or anything else around you. Some of the most tragic cases that I have seen are closed head injuries and concussions. Sadly, many would have been prevented if a helmet was worn.

How do helmets protect you?

When you fall or crash the helmet absorbs much of the impact that would otherwise cause a bruise, concussion, skull fracture, or serious brain injury. Thick plastic foam inside the hard outer shell of your helmet cushions the blow. The helmet essentially “takes the hit” instead of your head.

Here are some keys to choosing an appropriate helmet:

  • Choose the right helmet for the right sport.
  • The helmet should be snug: It does not slide from side-to-side or front-to-back.
  • The helmet should be level: It is square on top of your head, covering the top of the forehead. It does not tilt in any direction.
  • The helmet should be stable: The chinstrap keeps the helmet from rocking in any direction.
    Choose a bright, colorful one that everyone will see and respect!

Children and helmets

Young children are particularly vulnerable to head injuries. They have proportionally larger heads and higher centers of gravity, and their coordination is not fully developed. It is more difficult for children to avoid obstacles when biking, sledding, in-line skating, skiing, or doing other activities.

Tips to help children understand the importance of wearing helmets:

  • Teach by example: Always use your helmet when playing sports with potential for collision.
  • Buy a helmet that fits your child now – don’t try to skimp by buying one to “grow into.”
  • Be aware that your child is more likely to wear a helmet if he or she likes the way it looks.

Oh, and parents – remember that it’s not just the kids who need to wear their helmet. Let’s all take a lesson from the Olympians and wear our helmets!

Enjoy the rest of the Olympics – and just like an Olympian – be a winner, first and foremost, by being smart and be safe.

Sledding Safety

You can feel the excitement building as the Winter Olympic Games approach. While the Olympic Alpine events are thrilling to watch, speeding down a hill on a ski, a snowboard, a sled – or some other contraption – has its risks. As you may recall, I recently wrote an article on “skiing safety,” and low-and behold – right about the same time – our iconic Olympic skier, Lindsey Vonn, blew out her knee. And many of us remember the Olympic sledder who tragically crashed and died during the last Winter Olympic Games.

On a brighter note, sledding is a great activity. It’s fun, it’s family-oriented, and it’s good exercise! With this being said, Olympic injuries and tragedies remind us that safety comes first when it comes to ourselves and our kids. Even though your sledding speeds won’t approach 90 miles per hour like in the Olympics, some precautions are still in order.

Although we have been bombarded by the weather this winter , it seems that some of our best sledding days may be upon us and our children. Rather than complaining about the snow, I truly believe that we should all have some fun with it! Perhaps we can learn from our kids who seem to find plenty of ways to have fun with the snow. Many of us adults simply drive through it, shovel it, and blow it. It’s no wonder that so many people in Michigan despise the snow and suffer from conditions like seasonal depression. Have we all forgotten about snow ball fights, snow men, snow angels, snow forts, and last but not least – sledding? I guarantee that if you spend some time with your kids out in the yard or on the sled hill, it will lift your spirits, give you a little exercise, and perhaps even give you a more positive view of one of Michigan’s seasonal gifts.

Of course, sledding is supposed to be fun, but it also needs to be safe. Every year, thousands of youths and adults are injured while sledding down hills in city parks, streets and resort areas. Most of these injuries are very preventable. Your kids probably won’t hurt themselves building a snowman or making a snow angel, but it’s worth taking a moment to discuss sledding safety.

Incidence of Injury

According to the U.S. Consumer Product Safety Commission, there are approximately 75,000 sledding, snow tubing, and tobogganing-related injuries treated at hospital emergency rooms and doctors’ offices each year. Believe it or not, the total medical, legal, and work loss-related costs exceed $2.3 billion! Luckily most sledding injuries are “bumps and bruises,” but some of the injuries, even on our hills in Michigan, can be serious enough to cause lifelong disability or death.

When a sled hits a fixed object such as a tree, rock or fence, the rider may suffer serious head and neck injuries. The majority of injuries happen to youths age 14 and younger, especially in the run outs at the end of the sledding path. Young children are especially vulnerable, as they have proportionally larger heads and higher centers of gravity than older children and teens. In addition, the coordination of youngsters has not fully developed and they can have difficulty avoiding falls and obstacles.

Essential Precautions

Sledding should be done only in designated and approved areas where there are no trees, posts, fences or other obstacles in the sledding path. The sledding run must not end in a street, drop off, parking lot, pond or other hazard. Do not sled on public streets – the first big snowfall of the winter season often tempts youths to sled down sloping streets where they may be hit by cars and trucks or slam into parked vehicles, curbs, and fences.

Parents or adults must supervise children in sledding areas to make sure the sledding path is safe and there are not too many sledders on the hill or at the end of the run at the same time. A little “sledding organization” can go a long way when it comes to avoiding collisions.

No one should sled headfirst! All participants should sit in a forward-facing position, steering with their feet or a rope tied to the steering handles of the sled. Some youths like to run with their sleds and leap forward in a “belly flop.’ This does not give them control of where they are sliding and can expose them to possible head and neck injuries.

Preferred Precautions

  • Young children should wear a fitted helmet while sledding.
  • The sled should have runners and a steering mechanism – this is safer than toboggans or snow disks.
  • Sledding in the evening should only be done in well-lit areas.
  • Plastic sheets or other materials that can be pierced by objects on the ground should not be used for sledding. In addition, they are difficult to steer.
  • Sledders should wear layers of clothing for protection from injuries and cold.

Bottom line – Let’s take a few simple precautions and have both a fun and safe time sledding this winter! It’s truly one of the great seasonal activities that we Michiganders have the opportunity to enjoy.

Have a Blast Skiing this Winter – Not a Blow Out

It’s that time of year – many of us migrate to the snowy ski slopes of the west, or the icy ski slopes of Michigan, to enjoy the invigorating thrill of downhill skiing and snowboarding. When planning out our weekends, we choose Boyne Mountain over Somerset Mall, and when choosing our winter break, we forgo the relaxing “beach somewhere warm” and opt to tackle the mountains of Colorado, the hills of Northern Michigan, or the slope on the side of a landfill right up I-75. With this choice of activities, however, comes risk. We’ve all heard of someone “blowing out” their knee. Generally speaking, this refers to the tearing of one or more ligaments inside the knee. But before we go any further, let’s learn a little more about the ligaments of the knee:

The cruciate ligaments are two ligaments that are located deep inside the knee joint and connect the thighbone (femur) to the shinbone (tibia). They are called “cruciate” ligaments because they “cross” in the middle of the knee. They are instrumental in providing the stability that is needed for proper knee joint movement and stability when you torque on your knees and put them to the test. The cruciate ligament located toward the front of the knee is the anterior cruciate ligament (ACL), and the one located toward the rear of the knee is called the posterior cruciate ligament (PCL).

ACL Injuries

The ACL prevents the shinbone from sliding forwards beneath the thighbone. The ACL can be injured in several ways. Most often this involves a sudden change in direction during which the knee is twisted or during direct contact, such as during a football tackle. ACL injuries are quite common in skiers, particularly if you “wipe out” or “catch an edge” with your ski. Because your ankle is rigidly immobilized in the ski boot, it’s your knee that gets torqued, and if enough force is involved, ligament or cartilage injury can result.

If you injure your ACL, you may feel or hear a pop. The knee will swell and get stiff, and you will often feel pain when you try to stand. Over time, without a functional ACL, the knee may give out, especially when you attempt to change directions. When the knee gives way, this can lead to additional cartilage.

The diagnosis of ACL injury is based on the history, a good physical exam, and often, an MRI. A partial tear of the ACL may or may not require surgical treatment. A complete tear is more serious, and unfortunately, ACL tears do not heal. Complete tears, especially in younger patients, athletes, and active individuals, may require surgery to restore stability to the knee. Operative treatment is most often done arthroscopically and uses a piece of tendon, usually taken from the patient’s knee (patellar tendon), hamstring muscle, or from a cadaver. This “graft” is then passed through the inside of the joint and secured to the thighbone and shinbone. Surgery is followed by a rehabilitation program. Occasionally, complete tears may be treated conservatively in less active individuals or in individuals whose knees remain stable despite the injury.

PCL injuries

The posterior cruciate ligament, or PCL, is not injured as commonly as the ACL. PCL sprains usually occur when the knee is twisted or from a direct blow to the front of the knee. Without a PCL, your knee sags, and there can be increased wear and tear on the cartilage inside the knee. Like the ACL, PCL tears do not generally heal. Fortunately, some patients with PCL tears often do not have as much knee instability as patients with ACL tears, and even high level athletes can return to their sport after completing a good rehabilitation program. For patients who continue to have pain, swelling, or instability of their knee, surgery may be necessary to reconstruct the PCL.

Collateral ligament injuries

The collateral ligaments are located at the inner side and outer side of the knee joint. The medial collateral ligament (MCL) connects the thighbone to the shinbone and provides stability to the inner side of the knee. The lateral collateral ligament (LCL) connects the thighbone to the other bone in the lower portion of your leg (fibula) and stabilizes the outer side. Injuries to the MCL are very common and are usually caused by contact on the outside of the knee and are accompanied by sharp pain on the inside of the knee. The LCL is rarely injured. If the MCL is torn, is does have the ability to heal. Remember the acronym RICE: Rest, Ice, Compression or bracing, and Elevation. Most MCL tears do fine with an initial period of RICE followed by a good rehab program.

Finally, when it comes to the treatment of ligament injuries, it’s a really exciting time in the world of research. We are using more and more growth and healing factors to get ligaments and tendons to heal better and faster. As a matter of fact, we use substances like Platelet Rich Plasma (PRP) to help tendons and ligaments heal faster almost every day over at Beaumont. Additionally, we recently carried out a study where we were able to stimulate ACL tears to heal on their own – in the lab – by adding a “cocktail” of growth and healing factors to the torn ligament. Wouldn’t it be cool if we could get ACL tears to heal without surgery someday? Stay tuned…We’re on it.

There you have it – the “inside scoop” on the ligaments inside your knee. So have fun this ski season, but know your limits. Hopefully, a little knowledge and a little common sense will give you “the edge” when it comes to avoiding knee injuries this ski season.

Female Athlete Injury Prevention Program-Injury Screening at Local high schools The staff at Performance Orthopedics and members of Oakland University’s Recreation Department have initiated a program to screen female athletes in order to assess their risk for injury. They provide free injury prevention screenings for High School female athletes.

Our team of doctors, physical therapists, and athletic trainers evaluate the young athletes for any imbalances that may predispose them to injury. Based on the findings, a score is derived which places the athletes in various categories of relative risk. For those with a significant risk for injury, referrals are made to seek help to correct imbalances and thus reduce risk of injury. We can also suggest programs or products that might help the female athlete in decreasing their risk of injury. One program through Oakland University Recreational Department focuses on core strengthening and sport specific drills to reduce injury.