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RAyers - they aren’t MY surgeons. They are the surgeons who treated my friend and extremely well credentialed men. LOOK inside the helmets and feel the liner that is in them. It’s not that forgiving. And it isn’t just a coincidence that the skull fracture line in my friend’s situation follows the rather hard liner around the opening for the ear.
Virginia Tech has done a study on the cumulative affect on the brain from impact in contact sports. They have come up with a liner that has a light indicator on a tab at the back that registers impact on incident and also cumulative impact. As we all know people with even a severe concussion can very often continue to actively play in a sport and not even remember the event. This work at VT would give feedback to be able to prevent injured players from continuing to play.
What indicators do we have in equestrian sport??
Your quote " The liners used in CO and many other helmets is possibly the BEST out there given the design requirements". A rather sweeping statement… don’t you think? Just my personal observation but the helmets are NOT providing adequate protection specifically for accidents where the rider had impact on the side of the helmet.[/QUOTE]
This is a complex issue that can not easily be distilled down to a few points but I will try.
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All available ASTM certified helmets have deformable liners. The trauma surgeons you refer to clearly did not know how to evaluate this. This is no surprise! As a neurosurgeon with a special interest in traumatic brain injury, I never learned about helmet manufacturing in medical school or residency! I learned about it via several hired consulting positions where I was given access to technical materials about the design of different helmets, the testing criteria for approval, and the results. Having investigated this to great length and talked to numerous safety engineers from both the helmet manufactures and independent testing agencies I can assure you that our helmets have deformable liners, and I can also add that I ultimately came up with no specific ASTM certified helmet that I felt was safer than the others. My family and I ride in the helmets that meet the standard, fit our heads, and are cheap. There are lots of experimental tests, materials, and devices out there and as a neurotrauma consultant to the NFL I hear about many of them. There is not one that I would advice is ready for prime time in recreational or competitive equestrian sport.
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If your friend suffered a temporal bone fracture (ie skull fracture along the line of the helmet at the ear) that is not because helmets aren’t designed with side impact in mind. It is in part because the temporal bone is the thinnest part of the skull and most prone to fracture. This is particularly true at the temple itself, which is fairly well protected by our helmets. Helmets with more of a motorcycle style, covering all the way to the skull base, might offer more protection of the petrous temporal bone. MIGHT. I have not seen any evidence to support this one way or the other in equestrian use. Equally possible: the increased weight could make injuries more severe. No way to know without doing the appropriate testing (cue the engineers, not the surgeons!)
Bottom line, I have to agree with Reed and not the “best trauma surgeon in NJ” on this one (would love to know how that designation is made though!)
