While the lack of snow at some of the larger ski resorts in the United States has been disappointing, it seems to be picking up. And with the snow come the skiers and snowboarders ready to hit the slopes. But it is important to keep some tips in mind to try to avoid some of the head injuries that can unfortunately occur. And it is not just the experienced snowboarders performing the dangerous tricks that should worry about head injuries.

SnowboardingA study published in the December 2011 issue of The American Journal of Sports Medicine, Shinya Koyama, MD et al. look at the differences between head injuries in beginner snowboarders and those of intermediates and experts. Some of the findings were expected, in that beginners were more likely to suffer these injuries after falls on gentle slopes and intermediate runs, while the advanced snowboarders were more often injured during jumps.

There were some surprising results, however. More beginner snowboarders needed surgery for head injuries, usually acute subdural hematomas, than the expert groups, but the intermediate and expert snowboarders were more likely to suffer amnesia and loss of consciousness.

Of the 959 beginner snowboarders who suffered head injuries, 10 (1.04%) required surgery. 4 of the 10 were first-time snowboarders, and 7 fell on flat or beginner slopes. 2 of the 10 died, and in both cases, they had become separated from their friends, so more than 30-60 minutes elapsed before they were found. Of the 1408 intermediate and expert snowboarders with head injuries, only 5 (0.36%) required surgery. Of note, two of the five collided with trees and one fell outside of a run.

In both the beginner groups and the expert snowboarders, knit caps were the most common head protection. Beginners were also more likely to wear no cap at all, while experts were more likely to wear helmets. Interestingly, a higher percentage of intracranial injuries in the expert group were suffered by those who wore helmets than ones who didn’t. One could argue, though, that snowboarders who wear helmets are more likely to try more dangerous stunts. No patient who worse a helmet required surgery in this study.

So what can we learn from this data? Unfortunately at least to some extent, head injuries are part of snowboarding. But there are some measures that we can take to minimize our chances of suffering one or hopefully decrease its severity and increase our chances of complete recovery.

Take head injuries seriously. We all need to understand that any level of snowboarder can suffer fatal head injuries, not just those performing dangerous stunts. In this study, there were more surgical cases, moderate disabilities, comatose patients, and deaths in beginners than in the intermediate/expert snowboarders.

Take lessons when learning to snowboard. Beginners especially should take lessons not only to learn proper techniques for traveling down the slops but should learn proper falling techniques to minimize the chances of hitting their heads.

Skier carried down mountainStay close to family and/or friends. As the two deaths in the group of beginners with head injuries demonstrates, the time between the injury itself and treatment can be critical. A delay in diagnosis and treatment can be fatal. Stay with family and friends to help recognize if and when someone in the group has fallen and gotten injured and notify ski resort personnel for transport immediately.

Stay within the marked boundaries. Three of the five intermediate and expert snowboarders who suffered intracranial injuries and required surgery were hurt snowboarding in dangerous areas – either colliding with trees or falling out of the boundaries of the run. Not only are these areas more dangerous, but also it will likely take much longer for ski patrols to find and rescue snowboarders in these areas quickly.

Try to avoid collisions with skiers and other snowboarders. Maintain enough distance on the slopes and in the halfpipes to avoid contact with others.

Pay attention to the weather conditions. If there is any question about the visibility on the slopes, stay off the mountain.

Wear a helmet. They won’t prevent every head injury. But Sulheim et al. showed in an article published in the Journal of the American Medical Association in 2006 that wearing a helmet reduced the risk of head injury by 60% in skiers and snowboarders.

Seek medical evaluation for any blow to the head. Even if it is seemingly mild, any symptoms should be evaluated by medical personnel, including headaches, blurry vision, dizziness, disorientation, nausea, and others. Some findings, such as loss of consciousness and amnesia, likely warrant emergent transport to an emergency department.

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Do you have any suggestions for ways that snowboarders can avoid head injuries and stay safe on the slopes? Share them here! Or offer your feedback for my suggestions!

Note: This is a post I wrote for the blog of the STOP Sports Injuries campaign.