Today, helmets for all (article)

Discussion about ways to make the sport safer and discussion of past injuries so we can learn how to avoid them in the future.
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Today, helmets for all (article)

New postby rainbowgirl28 » Sun Jul 23, 2006 4:27 pm

http://www.latimes.com/features/health/ ... ome-health

Today, helmets for all
The helmetization of America has reached even surfing and bull-riding. But are we safer?
By Hugo Martín, Times Staff Writer
July 24, 2006

COLLEGE track star Kevin Dare shook the track and field world four years ago when he attempted to pole-vault 15 feet, 7 inches during a Big 10 track meet in Minnesota.

The vault was no record attempt. It was not even Dare's personal best. The jump was sadly unforgettable because Dare missed and was killed when he landed head first in the steel takeoff box that vaulters use to catapult themselves into the air.

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After years of debate on ways to make the sport safer, a standards panel approved in May the first specifications for a pole vaulting helmet, spurring production of several models.

In the last few years, that same panel, the American Society for Testing and Materials, has approved headgear standards for martial arts, short-track speed skating, horseback riding, bull riding and soccer â€â€
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New postby rainbowgirl28 » Sun Jul 23, 2006 4:48 pm

After years of debate on ways to make the sport safer, a standards panel approved in May the first specifications for a pole vaulting helmet, spurring production of several models.


A standard has been approved, after several years of discussion. However, to the best of my knowledge, no one has begun making a helmet that meets this standard.

There are some helmets that probably meet this standard.

The KDMax helmet that is currently marketed and sold on www.polevaulthelmet.com does not meet the ASTM pole vault helmet standard that was recently passed.


Head injury experts worry that some new helmets have come on the market without empirical data to show the need for or the effectiveness of the headgear.

"There is limited data for some of these kinds of sports," said Dr. Frederick P. Rivara, a pediatrics professor at the University of Washington School of Medicine who has studied helmet use among youngsters. "Before we push these kinds of helmets we need to have an idea on the effectiveness."


This was an issue raised at the ASTM meetings. Do we need a pole vault helmet? A response given was that since several states require helmets, we ought to come up with a standard for what the kids are wearing because some of these helmets offer very little protection.

Dr. Tony Strickland, director of the Sports Concussion Institute at the Centinela Freeman Regional Medical Center in Marina del Rey, shares the same concerns, adding that poorly designed helmets could interfere with an athlete's hearing and vision.


One of the specifications in the ASTM pole vault helmet standard has to do preventing the helmet from limiting the athlete's field of vision in a negative way.


Because athletic associations and government agencies usually don't require helmets until a standard is set for thickness, shape, material and design, a campaign to mandate helmets for a sport often starts by persuading a testing agency to set a standard. Thus, the four panels are the target of heavy lobbying by helmet manufacturers and the parents of injured athletes.


This is a big reason the NFHS has not required helmets yet. Will they start requiring them now that the standard has been passed? That remains to be seen.

In the case of the pole vaulting helmet, Dare's father, Edward Dare, and his former Penn State coach, Tim Curley, launched a four-year campaign to improve pole-vaulting landing pads and require helmets.


Actually Tim Curley is the athletic director at Penn State.

Pole vaulting ranks far below most other sports in total head injuries. In 2001, the American Journal of Sports Medicine published a study that found 31 catastrophic head injuries associated with pole vaulting in the high school, college and amateur ranks between 1982 and 1998. Those accidents resulted in 16 deaths, according to the study.

The study did not compare pole vaulting injuries with other sports, but a Consumer Product Safety Commission study found that head injury incidents for pole-vaulters were relatively rare compared with other sports such as basketball (23,908), baseball (20,583) and football (20,128) in 1995 alone.

One of the authors of the 2001 pole vaulting study, 1972 Olympic pole vaulting bronze medalist, Jan Johnson, has been highly critical of the helmets. Johnson, who heads the pole vault safety committee for U.S. Track and Field, the governing body for high school track and field, said there has only been one catastrophic head injury since larger landing pads were adopted in 2002. "I think the problem was solved that way," he said.


I don't think Jan was actually an author of the study... more like the source used for the data on pole vault injuries.


Although the study did not investigate the pros and cons of a pole vault helmet, Johnson says he worries that they may cause spinal injuries by hyper-flexing a vaulter's neck on impact with the padding. "I am not a real strong advocate for helmets in pole vaulting," he said.


Jan is definitely not the only one worried about this. The medical personnel involved with USATF pole vault development are extremely concerned about this issue as well.

Even the ASTM, while considering a pole vaulting helmet, warned that such headgear would not eliminate the risk of head injuries altogether.


Nope. If you are 10+ feet in the air, it is impossible to completely eliminate all risks.

But Dare's father continues to press the NCAA and the National Federation of State High School Assns. to require helmets for all pole-vaulters.

Dare said there was no evidence that the helmets cause neck injuries. As for Johnson's suggestion that the larger padding has solved the problem, Dare said: "Tell that to the next parents whose son or daughter vaults and hits their head on the asphalt and dies."


This raises the next issue that the ASTM pole vault equipment subcommittee is working on: the padding of the hard and unyielding surfaces around the pit.

The rule that hard and unyielding surfaces around the pit must be covered has been on the books for quite awhile. The next step is being more specific about what a hard and unyielding surface is, and what types of padding should be used to cover it.
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Hock Box Protector solution

New postby ESSX » Mon Jul 24, 2006 8:51 am

Hock Box Protector will be available in 90 days a box collar with a panel that covers the box automatically after take-off with 4"s of urthane foam.
Can be reset and used over and over again.
Made for right handed and left handed vaulters.
Provides additional protection for falls in the box.
List price with box collar will be $450.00
Available from XLOGIC SPORTS and their distributors ONLY
(Patent filed & Pending)

www.xlogicsports.com will be introduced in 90 days as another means of protection for feet, legs, head, and body additional protection!
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I agree with Jan

New postby 2-15-46 » Mon Jul 24, 2006 10:34 am

After nearly 50 yrs of jumping and coaching.. the key to safe vaulting is proper technique and coaching..... the object is to land deep into the pit, not in the box.....helmet mfg's want to sell helmets.... coaches that know what they are doing will teach vaulters to be consistant on the runway, plant properly and grip the pole where they are capable of gripping. Usually accidents happen when a vaulter is unsupervised and grips higher that he is capable of handling. Helmets can hinder and possibly cause other injuries. Pole vaulting does have an element of danger...so do all other sports......what about gymnastics? Diving? Running? High Jumping? Hammer throwers? etc..... Accidents happen all the times with humans and all accidents can be avoided.

But then that's my opinion!
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New postby Russ » Mon Jul 24, 2006 10:47 am

Jim Bemiller and I are currently working on a legal analysis of the helmet issue. We have sent the NFHS a draft of our paper. We hope to have it completed by the end of the summer, at which time we'll be circulating it to scholarly journals in hopes of having it published soon.

In a nutshell, we take the same position that Jan Johnson, Dr. Wilson SooHoo, and Dr. Spencer Chang have expressed. We argue in our paper that it would be unwise - both in terms of legality and safety - for the NFHS or any rule making body (e.g., state associations, NCAA, USATF) to require helmets in pole vaulting.

Once the paper has been published, we'll do our best to make it available.
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New postby master » Mon Jul 24, 2006 1:22 pm

Russ wrote:We argue in our paper that it would be unwise - both in terms of legality and safety - for the NFHS or any rule making body (e.g., state associations, NCAA, USATF) to require helmets in pole vaulting.

Hi Russ,

The operative word in this statement would appear to be "require". I have read some of the concerns Doctors have about helmet use and can agree with them, primarily hyperextension of the neck. However I still choose to use a helmet because my vaulting seldom results in me landing in a position that the helmet would contribute to hyperextension of my neck. But at times the inconsistency of my plant (being late) does result in me being directed toward the right side of the pit, and sometimes near the standard. Recognizing this I have decided the protection I feel a helmet provides is worth the increase in risk of a hyperextension.

The legal issues, I'm assuming are primarily liability issues, and I'm not qualified to make a comment on those.

I am interested in your personal opinion about the logic of my decision. I feel it is an important component of a vaulter's voluntary decision to wear a helmet or not. Would you be willing to share it here or through a PM? Thanks.

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New postby Russ » Mon Jul 24, 2006 2:00 pm

You are right about the word "require." In response to you inquiry, I'll provide a very brief synopsis of some of our reasoning. Then I'll shut up. My intent is not to rehash this debate, and I certainly am not prepared to publish our paper in this forum at the present time (it's still a work in progress). I also must caution you that Jim and I both are lawyers and we both teach Sports Law, and Jim has considerable practical experience dealing with tort law and liability. So, our paper is full of legal analysis (and ultimately may make for sluggish, boring reading). That said, here's the gist of our take on this issue.

We take the position that the likelihood of hyperflexion injuries is sufficiently great (using medical research data provided by Drs. SooHoo and Chang) that a rule that requires helmets would likely result in an appreciable number of both direct hyperflexion injuries to the cervical vertebrae (e.g., sprained or broken necks) and, in addition, long-term, chronic neck injuries (arthritis-type symptoms with chronic neck pain) in the long term.

The medical costs associated with both types of injuries would be astronomical if all vaulters were required to wear helemts. We think that the pole vault community (e.g., vaulters, parents, coaches, adminsistrators, etc.) should be made aware of these risks. Of course they should be aware of the risks associated with the kind of trauma that can be caused by missing the pit and impacting a hard surface (such as a standard or asphalt) too.

We think that the newspaper headlines and publicity about the 2002 deaths has adequately informed people about the risks of blunt-impact trauma. But we think that the hyperflexion risks are far less well known, and that people need to be made fully aware of those enormous, severe, and dangerous risks.

Legally speaking, a rule that causes more injuries than it prevents (and ends up being more expensive than not having the rule) would be a bad rule. We think that a mandatory helmet rule would be just such a rule.

Thus, we advocate that, like yourself, it should be left up to each individual vaulter (and the parents & coach) to assess their unique risk factors, and make an individual decision about whether to wear a helmet or not. But they should make that decision for themselves only after they have weighed the pros and cons. And we think that a rule that requires vaulters to wear helmets would cause a significant number of injuries and, in addition, would subject the rule maker to liability.
Russ

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New postby master » Mon Jul 24, 2006 5:31 pm

Russ wrote:We take the position that the likelihood of hyperflexion injuries is sufficiently great (using medical research data provided by Drs. SooHoo and Chang) that ...

Are the "estimated likelihood" numbers available and can they be compared to the "estimated likelihood" of other injuries that a helmet might eliminate or at least mitigate? If so, will they be in the paper when it is published? Or, where can I find them.

Thanks for your time and knowledge in answering my questions.

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New postby Russ » Mon Jul 24, 2006 9:33 pm

The medical research is in an as-yet unpublished paper that the doctors shared with us. I'm not at liberty to divulge that info (since it's in their paper). But, yes, Jim, and I do cite that research in our paper.
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Hyperflexion injuries

New postby Spencer Chang, MD » Mon Jul 24, 2006 10:07 pm

Sorry,

I will post something longer later as I'm on vacation. The risk of hyperflexion injuries associated with landing in the pit are real. Just this past season, I witnessed and was the first person to assess a young collegiate athlete who sustained a hyperflexion back injury. She was attempting about 10', came out of her pole too soon (dropped her feet and attempted to go for the bar before the pole was completely straight), and got overrotated onto her back into the pit. Because she was rotating so quickly, her feet came over the top of her head as she landed, and she hyperflexed at her lumbar spine. She felt an immediate snap or crack in her low back, and severe pain.

The athlete sustained what is called a Chance fracture or Seatbelt fracture of the lumbar spine. This fracture gets its name because people would get this injury from severe hyperflexion of the lumbar spine after a motor vehicle crash with a waistbelt restraint. The car stops suddenly, and the body flexes over the waistbelt. Fortunately, she did not land on her head and neck, but more towards her lumbar spine. If she were attempting a higher height, this may have been a much more catastrophic injury (more time to rotate onto the head and neck). Fortunately, she did not overrotate too much. It sounds like she will have a full recovery with no neurologic deficits.

Don't underestimate the force that can be generated from overrotating on a landing. Moreover, don't underestimate the additional leverage that a helmet would cause upon impact. A helmet being used on a vaulter who has a tendency to overrotate his or her landings is a disaster waiting to happen.

On the other hand, a helmet in an individual who is more likely to hit the standards with their head might be a good idea. I disagree with Russ in that the helmet is unlikely to cause chronic injuries unless there is a pattern of subthreshold flexion injury to the neck on multiple landings.

It is that one landing, similar to what happened to this athlete I described (except with a higher landing on the head and neck), with the additional leverage that the helmet makes which could make a bad injury, catastrophic. Making the helmet mandatory will open up a can of worms, and we may see the first death from a landing in the pit.

Food for thought.

Remember, I am a sports medicine fellowship trained orthopaedic surgeon and Dr. Robert Cantu, whose credentials are listed below agrees with me on this issue.

Chairman, Dept of Surgery, and Chief, Neurosurgery Service at Emerson Hospital in Concord, Massachusetts.

Medical director of the National Center for Catastrophic Sports Injury Research in Chapel Hill, North Carolina.

Past President of the American College of Sports Medicine

Fellow of the American College of Surgeons (FACS)

Editorial Board Member of the The Physician and Sports Medicine

So even if I am a pole vault coach (and therefore perhaps biased in my opinion), experts at the highest level do not think that the helmet is the answer, and may even be more dangerous in certain scenarios. Rest assured that Dr. Cantu does not coach or participate in the pole vault.

Dr. Wilson SooHoo (USATF Pole Vault Development Medical Staff), a pathologist by training, also concurs with me on this subject.

Also, I have published on cervical spine injuries. Please listen to me regarding this topic because I do understand the mechanisms of these types of injuries.

If you would like to read that article it is located in the Journal of Trauma:

Risk factors for water sports-related cervical spine injuries. Journal of Trauma, 2006 May; 60(5): 1041-6.

I will post again later.

Aloha,
and Vault High!!!

Spencer Chang, MD
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USATF Pole Vault Development Medical Advisor
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New postby vaultmd » Tue Jul 25, 2006 2:31 pm

Hey Spence:

Where are you? I'm on vacation, too. Alaska cruise with the family. Turned 50 yesterday.

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Re: Hyperflexion injuries

New postby SKOT » Tue Jul 25, 2006 4:05 pm

Spencer Chang, MD wrote:Sorry,

I will post something longer later as I'm on vacation.


Where does someone from one from a vacation destination go on vacation?
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