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Only one in five competitive cyclists aware that helmets do not protect from concussion, according to new research

Researchers say that marketing of helmets should highlight their limitations

New research claims that many competitive cyclists who use helmets are unaware of their limitations when it comes to offering protection, including from concussion - with only one in five recognising that they are not designed to prevent it – which researchers say may lead them to ignore the potential consequences of what riders may view as a ‘minor’ crash.

Researchers at the University of Northampton and the University of Central Lancashire who carried out the study also say that “the marketing of cycling helmets also needs to clearly reflect how much protection they give.”

Published as an open access research paper in the Journal of Environmental Research and Public Health, the study was led by Dr Jack Hardwicke, a former racing cyclist who is lecturer in Health Studies at the University of Northampton.

Some 405 competitive cyclists from around the world were quizzed about their knowledge of helmets, when and where they use them, and also about issues related to sports-related concussion (SRC).

Only one in five respondents – 20.5 per cent – correctly agreed that helmets do not prevent concussion, although they can mean that traumatic head injury sustained in a crash may be less severe than when not wearing one.

Most respondents, 64.7 per cent, said that in the event of their helmet cracking following a crash, they would seek medical assistance.

But nearly half, 47.2 per cent, said they would not do so if their helmet was only left scuffed, and 44.7 per cent in the event of a crash in which their helmet had not made contact with the ground.

Dr Hardwicke commented: “Cycling – whether for recreation or competition – is an increasingly popular activity across the world. There are around 150,000 active members registered with British Cycling, and it’s great to see that number appears to be increasing.

“Sports-related concussion has been a concern within other sports – such as Rugby and American Football – for some time now, understandably so.  But as our research shows, cyclists may be lulled into a false sense of security about their safety from sports-related-concussion because of their perceptions of injury and by the very fact that many are wearing headgear marketed as giving them protection from concussion.

> UCI publishes new concussion protocol as other sports face lawsuits from retired athletes

“Coupled with a tendency within the sport to ‘brush off’ injuries and with many more of us ‘getting back on our bikes’, there is a need to make sure those who enjoy cycling do so as safely as possible.

“Our conclusions are not that cycling headgear doesn’t afford protection, but that more independent research underpinning new technologies marketed for reducing concussion is needed.”

“We hope that future research generated by our findings will also compel leading figures within the cycling sphere to ‘up gear’ about head safety and help promote to cyclists the need to adopt a more cautionary approach when a crash occurs,” he added.

> Swedish safety research recommends three helmets out of 23 tested

Co author Dr Howard Hurst, senior lecturer in sport, exercise and nutritional sciences at the University of Central Lancashire, said: “While there’s no doubting headgear can reduce the severity of head trauma, users should be educated on the limitations of such technologies.

“Headgear test standards currently only simulate impacts up to around 22 km/h. While this may meet the needs of most recreational riders and commuters, it is questionable whether they afford the same level of protection at the higher speeds typical of cycle racing.

“Additionally, while current research and test standards may demonstrate how effect headgear are in reducing impact forces, they cannot predict the psychological and cognitive trauma associated with concussion.”

Simon joined road.cc as news editor in 2009 and is now the site’s community editor, acting as a link between the team producing the content and our readers. A law and languages graduate, published translator and former retail analyst, he has reported on issues as diverse as cycling-related court cases, anti-doping investigations, the latest developments in the bike industry and the sport’s biggest races. Now back in London full-time after 15 years living in Oxford and Cambridge, he loves cycling along the Thames but misses having his former riding buddy, Elodie the miniature schnauzer, in the basket in front of him.

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30 comments

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HelmetInspectionCo | 1 year ago
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We're surprised the level of awareness is as high as 20%, but perhaps this points to competitors having a greater level of awareness than other demographics.

As with many of these articles, they don't address the Elephant in the room.

Despite cyclists wearing protective headgear, why are we still seeing high levels of concussion / brain trauma injury?

Destructive drop tests inform us how the helmet is likely to perform towards the prevention of skull fractures, and these tests generate valuable data.

However, brain trauma injury, concussion, shearing is the result of the shock pulse the brain receives during an impact.  It's one thing to mitigate against skull fractures, but more work needs to be done to slow down the shock pulse before it reaches the brain.

Expanded Polystyrene (EPS), typically used in helmet construction, does very little on its own to slow down the shock pulse.

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stulemanski | 1 year ago
3 likes

The current standard applicable in the UK (BS EN 1078) includes a perpendicular drop test onto a rigid anvil with an impact speed of 5.42 m/s (about 12mph). This is roughly equivalent to the perpendicular impact speed when a head falls from a height of 1.5m (which is roughly an average cyclist's head height whilst riding).

A large proportion of cycle accidents involve the cyclist falling (or being knocked) onto the ground. Under these circumstances, the speed of the cyclist is largely irrelevant. It is the perpendicular component of impact that is important - thats why GP motorcycle riders can come off at 100+mph and walk away - they've often only fallen from about the same height as a typical cyclist (and their leather overalls eliminate the gravel rash). 

In the BS1078 test, the maximum permitted peak linear acceleration (PLA) of 250g during impact is roughly equivalent to the PLA required to cause fracture of an unhelmetted head. 

This also happens to be around the level of PLA at which brain injuries transition from "moderate" severity (likely to make a full recovery with time) to "serious" severity (likely to have life-changing consequences).  

Helmets are likely to mitigate moderate and minor brain injuries: for example an impact that might have caused a "serious" injury might be mitigated to a "moderate" injury by a helmet. The outcome of a "moderate" injury does not indicate that a helmet has failed to provide protection, it highlights that there are limitations to the amount of protection a helmet can provide.  

Wearing a helmet does not mean that you are invulnerable. A mis-informed belief that a cycle helmet is some sort of "magic force field" that provides complete protection can potentially cause cyclists to take less care than they otherwise would. This confounding variable is (in my opinion) one reason why the epidemiological evidence for the benefits of cycle helmets is less strong than the lab test/medical evidence. If you ride less cautiously because you believe that you are "protected" by a helmet, then the increased risk of an accident might negate (or outweigh) the decreased risk offered by the helmet. 

However, testing, modelling and collision reconstructions all suggest that if you fall off your bike and hit your head, you will (in general) be better off with a helmet on your head.

In summary:  

Helmets are (generally) very good at preventing skull fractures. 

Helmets are also (generally) good at preventing serious brain injuries that are cause by linear accelerations during impacts. 

Helmets cannot prevent all injuries, do not make you invulnerable, and you should ride just as cautiously when wearing a helmet as if you were not wearing one. 

 

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AndyRed3d replied to stulemanski | 1 year ago
1 like

Now there is an excellent, well-informed, accurate and sensible reply. Thank you @stulemanski

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zideriup | 1 year ago
1 like

There have been civil cases where the lack of a helmet on a cyclist's head has been argued to be an 'aggrivating factor'/'contributory negligence' and resulted in a reduced payout. That's literally the only reason why I wear the things. 

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Sriracha replied to zideriup | 1 year ago
1 like

Maybe that should cut both ways then; where a motorist causes injury to a cyclist despite them wearing a helmet the aggravation is the motorist's with the damages awarded escalated in recognition.

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eburtthebike replied to zideriup | 1 year ago
3 likes

zideriup wrote:

There have been civil cases where the lack of a helmet on a cyclist's head has been argued to be an 'aggrivating factor'/'contributory negligence' and resulted in a reduced payout. That's literally the only reason why I wear the things. 

As far as I know, there has been a single case in the UK where failure to wear a helmet was accepted by the court as contributory negligence, but it was under such peculiar circumstances that it does not make case law.

There are plenty of money-grubbing motorists' insurance companies which will attempt to badger a cyclist to accept reduced damages because they weren't wearing a helmet, but if the cyclist sticks to their guns and gets proper legal advice, the insurers will withdraw the claim, even at the doors of the court, because they know it would fail.

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eburtthebike | 1 year ago
3 likes

Whilst I was slightly surprised and only mildly offended that this research didn't reference my own research*, it nevertheless repeats the same message; the protection offered by cycle helmets is grossly exaggerated.  The difference being that they looked at competitive cyclists while I covered utility cyclists, but the death rate of competitive cyclists doesn't seem to have dropped with the advent of helmet rules.

But it isn't the manufacturers who exaggerate the protection, it is the helmet zealots, who make utterly unfounded claims, both exaggerating the risks of cycling and the helmet's efficacy.  To make cycle helmets the answer to cycling safety, it is first necessary for the helmet zealots to greatly exaggerate the risks of cycling, when the death rate is the same for distance travelled as walking.

"But as our research shows, cyclists may be lulled into a false sense of security about their safety from sports-related-concussion because of their perceptions of injury and by the very fact that many are wearing headgear marketed as giving them protection from concussion."

I've never seen any marketing which made this claim, but I've seen hundreds of such claims by helmet zealots.

"Our conclusions are not that cycling headgear doesn’t afford protection, but that more independent research underpinning new technologies marketed for reducing concussion is needed.”

It's a pity that having done all that work, they leap to the wrong conclusion.  Any student of cycling safety would look at places which have the lowest rates of mortality of cyclists, and draw lessons from that.  If they had done so, they would have discovered that helmets don't make any difference to death rates, but proper cycling provision and proper laws controlling drivers does.

*Do cyclists have an exaggerated view of the risks of cycling and the efficacy of cycle helmets?  https://silo.tips/download/do-cyclists-have-an-exaggerated-view-of-the-r...

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cqexbesd replied to eburtthebike | 1 year ago
1 like

eburtthebike wrote:

"But as our research shows, cyclists may be lulled into a false sense of security about their safety from sports-related-concussion because of their perceptions of injury and by the very fact that many are wearing headgear marketed as giving them protection from concussion."

I've never seen any marketing which made this claim, but I've seen hundreds of such claims by helmet zealots.

I suspect they are reffering to things like:

Quote:

The MIPS system, based on over 20 years of research and testing at the The Royal Institute of Technology (Stockholm, Sweden), adds a special layer to abate rotational motion and potentially reduce the risk for injuries like concussions, DAI (Diffuse Axonal Injury) and subdural hematoma from rotational impacts

https://mipsprotection.com/the-lasting-effects-of-brain-injury/

Of course hte marketers are careful to not commit to anything but people get the impression that is intended.

(for the avoidance of any argumens I make no claim if MIPS can or can't help)

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eburtthebike replied to cqexbesd | 1 year ago
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Yep, pretty much advertorials like that, which can't be attributed to the manufacturers and has very few checkable facts, but lots of assumptions.

Like this from a solicitors group, which promotes helmets without providing factual data about them.  https://www.lexology.com/library/detail.aspx?g=98c80f7c-5b44-4ffa-91ed-d... I watched the seminar and it was frankly biased, cherry-picked facts and assumptions.

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OldRidgeback | 1 year ago
1 like

Whena rider at our BMX club has a high speed spill with the head hitting the ground, we always advise them to go to A&E and get checked out for concussion.

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wtjs replied to OldRidgeback | 1 year ago
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we always advise them to go to A&E and get checked out for concussion

That must present them with a problem, as concussion doesn't exist and nobody knows what it means. We have traumatic brain injury, which does exist, and there are some features detectable by observing and questioning the sufferer which makes that diagnosis more likely. The main benefit of sending them off to A&E is the long wait so that any arterial intracranial bleeding is more likely to become apparent. The choice between helmet of some sort, and no helmet at all remains and we can make our own choices on that.

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OldRidgeback replied to wtjs | 1 year ago
3 likes

wtjs wrote:

we always advise them to go to A&E and get checked out for concussion

That must present them with a problem, as concussion doesn't exist and nobody knows what it means. We have traumatic brain injury, which does exist, and there are some features detectable by observing and questioning the sufferer which makes that diagnosis more likely. The main benefit of sending them off to A&E is the long wait so that any arterial intracranial bleeding is more likely to become apparent. The choice between helmet of some sort, and no helmet at all remains and we can make our own choices on that.

Since we're following pedantic rules, it's worth noting that for BMX training/racing with a BC recognised club like mine, helmet use is a requirement and not a choice.

I did my first aid course last year as part of my coaching training and about a month after that, I was at my track for a ride. It's an open track so outside of our training hours, people can just rock up and ride. Two lads turned up and one started filming the other as he rode the track on his BMX, without a helmet. The lad mistimed a jump and landed smack on top of his head on the other side. I was riding round after him and saw him hit the deck and then start having a fit. I jumped off my bike and got him into the recovery position as he'd landed face down and was breathing in his own blood, totally unconscious while having a fit. His mate ran over and I got him to ring for an ambulance. The lad started to come out of unconsciousness but was very dazed and I stayed with him, keeping him from trying to get up and get back on his bike. He was very out of it. Then the ambulance crew arrived and I let the paramedic take over, while I helped guide the driver backwards down the track as close as possible to the injured lad (without grounding the ambulance on the last roller).

So yes, feel free to make glib comments about concussion/traumatic brain injuries. No, I don't use a helmet when cycling on the road. But it's a requirement if you're riding a BMX at a track by BC rules and as my experience shows, you're taking a big risk if you don't. If the lad had been riding on his own and I hadn't been there, it's possible he wouldn't have survived.

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mdavidford replied to OldRidgeback | 1 year ago
3 likes

OldRidgeback wrote:

Since we're following pedantic rules

Are you suggesting there might be times when we wouldn't?

sad

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brooksby replied to mdavidford | 1 year ago
1 like

mdavidford wrote:

OldRidgeback wrote:

Since we're following pedantic rules

Are you suggesting there might be times when we wouldn't?

sad

Anyway, isn't it "pedantically following rules"?

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mdavidford replied to brooksby | 1 year ago
1 like

brooksby wrote:

mdavidford wrote:

OldRidgeback wrote:

Since we're following pedantic rules

Are you suggesting there might be times when we wouldn't?

sad

Anyway, isn't it "pedantically following rules"?

I assumed it was like following Trumpington Variations.

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OldRidgeback replied to brooksby | 1 year ago
4 likes

brooksby wrote:

mdavidford wrote:

OldRidgeback wrote:

Since we're following pedantic rules

Are you suggesting there might be times when we wouldn't?

sad

Anyway, isn't it "pedantically following rules"?

Nah, being pedantic about it, that's a split infinitive. It should be- following rules pedantically. 

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Rendel Harris replied to OldRidgeback | 1 year ago
5 likes

OldRidgeback wrote:

Anyway, isn't it "pedantically following rules"?

[/quote]

Nah, being pedantic about it, that's a split infinitive. It should be- following rules pedantically. 

[/quote]

Being even more pedantic that's not a split infinitive, that would be "to pedantically follow rules" - "Pedantically following rules" is an adverb followed by a verb in the present tense followed by a noun, it's fine although adverbs of manner generally end a clause so "following rules pedantically" is preferable.

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mdavidford replied to Rendel Harris | 1 year ago
1 like

Rendel Harris wrote:

OldRidgeback wrote:

brooksby wrote:

Anyway, isn't it "pedantically following rules"?

Nah, being pedantic about it, that's a split infinitive. It should be- following rules pedantically. 

Being even more pedantic that's not a split infinitive, that would be "to pedantically follow rules" - "Pedantically following rules" is an adverb followed by a verb in the present tense followed by a noun, it's fine although adverbs of manner generally end a clause so "following rules pedantically" is preferable.

Being more pedantic about it again, there weren't any rules in the original post to be pedantic about - it was pedantry over definitions.

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OldRidgeback replied to Rendel Harris | 1 year ago
1 like

Rendel Harris wrote:

OldRidgeback wrote:

Anyway, isn't it "pedantically following rules"?

Nah, being pedantic about it, that's a split infinitive. It should be- following rules pedantically. 

[/quote]

Being even more pedantic that's not a split infinitive, that would be "to pedantically follow rules" - "Pedantically following rules" is an adverb followed by a verb in the present tense followed by a noun, it's fine although adverbs of manner generally end a clause so "following rules pedantically" is preferable.

[/quote]

Wow, I've been out-grammered pedantically! I doff my cap.

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Oldfatgit replied to OldRidgeback | 1 year ago
3 likes

A while ago, I posted on here an opinion that helmets are better than nothing ... Especially based on my own life-threatening and life changing experience.
The helmet in my case - while not preventing a TBI - did however stop my head and face from being cut to ribbons as it went through the windscreen of a poorly driven Mondeo. The chances are that the helmet reduced the scope and significance of the TBI, but didn't eradicate it entirely.
I was told that anecdotes are not evidence of a helmet's usefulness, and no doubt someone will be along soon to tell you that your experience doesn't count.

I'm all for choice; I choose to wear a helmet, because of I hadn't have been, my experience and recovery would have been even more traumatic than it was

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Adam Sutton replied to Oldfatgit | 1 year ago
0 likes

Have you been called a helmet zealot yet?

Never ceases to amaze me that it's the ones who bang on about it being a choice, who will act the most zealot like and lecture on how ineffective helmets are. I don't care if people wear a helmet or not, I just know I'm glad I was wearing one when my bike slipped out from me on a greasy road and I hit my head on the kerb. But that's just an "anecdote" innit.

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Griff500 replied to wtjs | 1 year ago
3 likes

wtjs wrote:

........ concussion doesn't exist and nobody knows what it means. We have traumatic brain injury, which does exist,...

Strange, because because the Mayo Clinic, who know a thing or two about medical matters, think it does exist, and they even have a definition:   "A concussion is a traumatic brain injury".   

https://www.mayoclinic.org/diseases-conditions/concussion/symptoms-cause...

Of course within the medical community, a more precise definition exists, to differentiate concussion from other forms of TBI, here from American Congress of Rehabilitation Medicine Brain Injury Interdisciplinary Special Interest Group Mild TBI Task Force:  ".....patients with “uncomplicated” mTBI (also known as “concussion” and characterized by an absence of trauma-related intracranial abnormalities on conventional structural neuroimaging)"

 

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Global Nomad | 1 year ago
0 likes

mmm...interesting...22km/h seems a low figure but i guess this is not riding speed, its impact speed, though how much you slow down before impact is not likely to be high. Does anyone test at 32km/h? wonder how much the protection reduces?

having twice ended up in hospital with broken helmets and knowing its about reducing effects not stopping them,  I suppose the article isnt a surprise.

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Sriracha replied to Global Nomad | 1 year ago
1 like

I'd have thought the speed that mattered was the perpendicular component of the speed between your head and whatever it hits. So in most cases that is the ground, and the speed perpendicular to the ground is a function of the height from which your head dropped rather than the horizontal speed of the cyclist. Of course if you crash into the back of a stationary bus, that would be different.

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janusz0 replied to Global Nomad | 1 year ago
3 likes

If you drop a head from 6 ft above, it will hit the ground at about 22 Km/h. That's the common impact that they're designed for

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Secret_squirrel replied to janusz0 | 1 year ago
4 likes

Bit of a flaw really.  By those standards we should be looking for PPE that stops the head becoming detached from the body in the first place.

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chrisonabike replied to janusz0 | 1 year ago
2 likes

The tragic thing is that the disconnected head is still invariably found to be dead.

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mdavidford replied to chrisonabike | 1 year ago
2 likes

Does Wurzel Gummidge wear a helmet?

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chrisonabike replied to mdavidford | 1 year ago
3 likes

No but the horseman of Sleepy Hollow must wish he had by that logic.

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brooksby | 1 year ago
10 likes

<opens popcorn and finds a comfy chair>  3

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