By Martha A. Simpson, D.O., M.B.A.
Assistant Professor of Family Medicine
Ohio University College of Osteopathic Medicine

COMMUNITY SKATE PARKS SHOULD REQUIRE THE USE OF HELMETS

Question: Our town recently opened a skateboard park for the kids. My 12-year-old son, however, will not wear a helmet as none are required at the skate park. Could you give me some information on helmet use and skateboarding? If the information comes from someone besides a parent, maybe he will understand how important helmets are.

Answer: Sports-related accidents lead to over 750,000 injuries annually. Of these, almost 400,000 necessitate a visit to a hospital emergency department, and more than 300,000 result in concussions, which are the most common kind of sports injury. In the year 2000, over 50,000 children, ages 5 to 14 were treated in emergency departments for skateboarding injuries. The vast majority of these were boys.

While skateboarding, inline skating, bicycling, and other such activities can cause a multitude of injuries and even death, most children -- and unfortunately, many of their parents -- are still not convinced that protective equipment is necessary.

The most crucial piece of protective gear, as you correctly infer, is the helmet. This is because the most frequent and serious non-fatal sports accidents involve a condition called traumatic brain injury (TBI).

Traumatic brain injury occurs anytime there is a blow to the head. Most commonly this involves what doctors call a “closed head injury,” meaning that there is no open wound, only direct trauma to the head. You may know this as a concussion.

The closed head type of TBI is graded as to severity -- mild, moderate or severe. Motor vehicle accidents are the most common cause of TBI. Symptoms can include headache, dizziness, nausea and lack of coordination. There can also be disorientation, amnesia and confusion. Once a person has had a concussion, they are at increased risk for a second. There is increasing evidence that repeated mild injuries over time can cause permanent neurological damage. In fact, repeated mild head injuries over a short period of time can even result in death. This is called Second Impact Syndrome. It occurs when there has been inadequate time for healing of the first concussion.

Children who receive a head injury can have permanent deficits in memory, learning, and physical abilities. Sometimes there can be personality changes as well as other behavioral changes. Even a mild TBI can cause lasting impairment.

We want our kids to be physically active and not become couch potatoes, but we must be sure that we provide as safe an environment as possible in which they can be active. The most important thing you can do to insure safety of your son at the skateboard park is to make sure he wears a helmet. Wearing the helmet properly is a must as well. Wrist, elbow and knee pads can also help prevent injuries. If every parent insisted on the use of these types of safety equipment, it would dramatically decrease the number of severe head injures. It’s also important that children -- and adults -- wear helmets when they engage in other activities like bike riding and inline skating.

A strong partnership between the parents and community leaders is vital to insure the safety of your children. You might want ask members of your city council to pass an ordinance requiring helmets and ticketing kids who are not wearing a proper helmet. Other communities have done this successfully.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.