National Winter Sports Traumatic Brain Injury Awareness Month

Many winter sports are fast, practiced on uneven and slick surfaces, and require a great deal of skill and balance: these factors make accidents commonplace, and fast-moving impacts can lead to traumatic brain injuries (TBIs). January is National Winter Sports Traumatic Brain Injury Awareness Month to call attention to winter sports safety. Read on to understand not only the risks of winter sports, but how you can protect yourself and prevent these injuries.

What are Traumatic Brain Injuries?

Simply put, a Traumatic Brain Injury is when an external force changes brain activity or function. Anything that occurs outside your body but damages or changes your brain is a TBI: falls, car accidents, and sport injuries are good examples. Non-Traumatic Brain Injuries, by contrast, are caused by internal forces: diseases, strokes, even drug overdoses. TBIs are traumatic impact injuries, and they can be closed (non-penetrating: a blow or jolt to the head) or open (penetrating: an object entering the head).

Concussions

The TBI you're probably most familiar with is a concussion, when a blow to the head or body causes the head or brain to rapidly move back and forth. This movement can cause the brain to bounce or twist inside the skull, damaging or stretching brain cells and possibly causing chemical changes to the brain. There may be no visible damage when a concussion occurs - you may not even have been hit in the head! A jolt to the body, especially during a contact sport, can cause a concussion.

Brain Injury Symptoms

No two brain injuries are the same. The brain is the most complex organ in the human body, and the signs of a brain injury are wide-reaching. In many cases they won't appear or become noticeable for days or even weeks after an impact. Knowing what to look for can be crucial to getting someone the help they need. These may include:

• Body numbness or tingling.
• Coma or semi-comatose state: not alert, unable to respond to others.
• Confusion.
• Difficulty speaking or swallowing.
• Difficulty thinking: memory problems, slow thought processing, poor judgment, poor attention span, difficulty "thinking straight."
• Dizziness.
• Headache.
• Inappropriate emotional responses: irritability, frustrated easily, inappropriate crying or laughing.
• Lethargy.
• Loss of bowel control.
• Loss of consciousness.
• Paralysis or difficulty moving.
• Poor coordination or difficulty with balance.
• Respiratory problems.
• Slow breathing rate combined with an increase in blood pressure.
• Slow pulse.
• Spinal fluid leakage: a thin, clear fluid coming out the ears or nose
• Tinnitus (ringing in the ears) or difficulty hearing.
• Weakness.
• Vision problems: blindness, blurred or double vision, sensitivity to light, loss of eye movement.
• Vomiting.

Winter Sports and TBI Potential

The sport most associated with TBIs has been football, of course. You've likely seen discussions of the impact of TBIs on pro football players. But while many winter sports are solo pursuits and not contact sports, the potential for injury can be high. Multiple studies have found that the rates of injuries and potential for TBI during skiing and snowboarding are significant:

• Around 10 million Americans ski or snowboard each year.
• Over 600,000 injuries from skiing or snowboarding are reported annually.
• Over 16,000 winter sports related head injuries occur yearly.
• Severe head trauma occurs in 20% of skiing and snowboarding injuries, with loss of consciousness or concussion reported in 22% of those injuries.
• Head injuries are the most frequent cause of death and severe disability among skiiers and snowboarders.
• Snowboarding and skiing have the second- and third-highest incidence of head and neck injuries (HNIs) of all extreme sports, behind only skateboarding.
• Snowboarding has the highest percentage of concussions in extreme sports at 30%, with snow skiing close behind at 25%.

Hockey also accounts for some head injuries during the winter:

• Concussions make up 2-14% of all hockey injuries, and 15-30% of all hockey head injuries.
• The highest incidence rates for concussions in youth hockey is at 12-14 years old.
• 88% of concussions in professional hockey occur during player-to-player contact, with a full 43% occurring as a result of illegal activity.
• Youth leagues that allow body checking have higher concussion rates than those that do not, and rules banning body checking have been shown to drop concussion rates within two years.

Other winter sports or activities, such as sledding, ice skating, and operating powered recreational vehicles, also carry dangers with them. Some more statistics:

• 20,000 sledding injuries occur every year in the U.S.
• 30% of children hospitalized following a sledding injury suffer significant head injuries, with 10% of these children acquiring a permanent disability.

Avoiding TBIs

These statistics may seem frightening, but there's good news: rates of TBIs drop when preventative measures are taken. Most sports involve some level of risk, but all of these winter sports have options available to increase player safety.

Helmets

Helmets are a great way to prevent TBIs or reduce their severity, but many people haven't considered them for most winter sports. Although required by hockey leagues, few states have laws requiring minors to wear a helmet during other winter sports. Helmet use has gone up remarkably, however, with an astonishing 180% increase among snowboarders and skiers in a 10-year period. It's also shown that helmet usage increases with experience level, indicating that athletes most keenly aware of a sport's dangers opt for them.

Some helmet tips:

• Purchase a helmet that fits properly, and don't forget to try it while you're wearing a winter hat or cap.
• Replace your helmet after any serious fall or head impact; they can only withstand a single impact of this nature.

Rules and Environment

Winter sports are all different, but having firm guidelines for any sport has been shown to reduce rates of injury, including TBI. In addition, proper maintenance and attention to surroundings can further reduce these risks.

• Hockey: As mentioned above, body checking in youth leagues increases risks of TBI, as does illegal play. Properly enforcing the rules of the game, and embracing limited contact rules in youth leagues promotes safety. Many leagues begin incorporating body checking at 13, but 15 has become the recommended age. Like all contact sports organizations, hockey leagues should have firm, written guidelines on how to spot and treat players who have possibly suffered concussions or other TBIs.
• Skiing, Snowboarding, and Skating: Proper training is crucial. Many injuries are caused to people new at a sport not understanding their own skill limitations. Taking lessons from a licensed instructor or experienced coach and gradually increasing your experience level is the best way to get the most out of a sport, improve balance and technique, and learn how to fall safely.
• Recreational Motor Vehicles: Children under 6 shouldn't ride on snowmobiles or ATVs, and children under 15 shouldn't drive them.
• Sledding: Sled in areas that are clear of trees, rocks, fences, or buildings. Crashing into trees accounts for 63% of sledding accidents.
• Outdoor Sports: Winter is a harsh season, and snowy or icy surroundings can be tough to navigate. No matter what outdoor activity you're enjoying, take some time to familiarize yourself with your surroundings and look for potential hazards or changes in the landscape. Stay on established trails and within marked boundaries. Avoid crowding, as accidents in the middle of a group of people can cause injuries to others.

Most importantly, never go alone. Make sure children are properly supervised, and make sure when participating in a winter sport you have others with you. Whenever possible, stay active in an area with nearby medical attention, or at least instructors, coaches, or other professionals with winter sports experience.

PLEASE CONSULT WITH YOUR DOCTOR, OR OTHER QUALIFIED HELATH CARE PROFESSIONAL BEFORE TAKING ANY MEDICATION, SUPPLEMENTS, OR BEGINNING ANY HEALTH RELATED REGIMEN.