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The relentless winter poses risk for head injuries

A participant in the 374th Force Support Squadron Outdoor Recreation trip to Myoko-Suginohara ski resort looks over forested terrain Feb. 11, 2017, in the Niigata prefecture, Japan. Skiing and snowboarding trips from Outdoor Recreation range from one to multiple days and may include lessons from qualified skiers and snowboarders. (U.S. Air Force photo by Airman 1st Class Donald Hudson)

A participant in the 374th Force Support Squadron Outdoor Recreation trip to Myoko-Suginohara ski resort looks over forested terrain Feb. 11, 2017, in the Niigata prefecture, Japan. Skiing and snowboarding trips from Outdoor Recreation range from one to multiple days and may include lessons from qualified skiers and snowboarders. (U.S. Air Force photo by Airman 1st Class Donald Hudson)

FALLS CHURCH, Va. -- Whether skiing down slopes or walking on an icy sidewalk, winter sports and weather conditions can pose a higher risk for a traumatic brain injury. Especially with the late-winter (now early-spring) onslaught, Military Health System experts are encouraging people to be cautious of surroundings and take steps to protect themselves from these injuries that are often preventable.

"TBI is a major cause of death and disability in the United States and, unfortunately, these injuries can happen at any time,” said Dr. Treven Pickett, who is the department chief of research at the National Intrepid Center of Excellence, a directorate of Walter Reed National Military Medical Center in Bethesda, Maryland. “The risk for TBI is increased in a number of contexts. It’s important to consider how weather conditions, including winter weather, may increase the risk for these injuries.”

Aside from risks in winter sports and outdoor hobbies, opportunities for head injuries can also be present in daily activities because of environmental conditions, such as driving on frozen roads underneath soft snow, or black ice.

According to the Centers for Disease Control and Prevention, falls are a leading cause of TBI and account for a large proportion of emergency department visits, hospitalizations, and deaths in the United States. In winter, falls may occur suddenly in slippery or icy conditions, without sufficient opportunity to protect the head from impact with the ground or other hard objects, said Pickett. While a mild TBI, also known as a concussion, is more common, he added that sustaining more serious head injuries is also possible depending on the nature and force of impact.

Winter sports, such as ice hockey, skiing, and snowboarding pose a risk for serious injury, including concussions. According to the Defense and Veterans Brain Injury Center, also known as DVBIC, almost four million Americans are affected by sport or recreational traumatic brain injuries every year. But unlike contact sports like football, head injuries specific to winter sports have not been studied nearly as much.

Dr. Scott Livingston, education director at DVBIC, said tracking winter sports and weather-related head injuries is difficult as they often go unreported. The majority of data he has seen tracks snowboarding, followed by freestyle and alpine skiing. However, that information doesn’t include ice hockey, which has a higher percentage of head injuries, he said.

“In winter sports, like skiing, snowboarding, and ice hockey, head injuries do tend to be more serious than in other sports and recreational activities,” said Livingston. “The number of serious head injuries in those sports has been increasing in the past several decades because of the number of people participating in those sports.”

These events can include a moderate or severe head injury, skull fracture, or even death, Livingston said. He warned that thinking a properly fitted helmet makes a person immune to getting a concussion is a common misconception.

“It’s the movement of the brain inside the skull, not the force hitting the helmet or striking the head directly, that causes the concussion,” Livingston said. Wearing a helmet appropriate for the sport or activity is recommended, but taking additional precautionary steps is important, too. This includes being mindful of less-visible conditions, like black ice, and seeking medical attention if symptoms are present, he said.

Following a mild traumatic brain injury (concussion), an individual may experience headache, dizziness, nausea, visual problems, and a range of other, mostly transient, post-concussive symptoms. In most cases, these symptoms improve in a matter of days or weeks.

Traumatic brain injuries can happen to anyone even with the best prevention techniques. Young children, however, may be less likely or able to talk about or fully describe symptoms after an injury. Dr. Pickett recommends seeking medical evaluation if there is any doubt of the severity of a TBI. A suspected concussion or other traumatic brain injury, whether from recreational activities or an accident, is something to take seriously and address immediately.

“Prevention is the top priority,” said Pickett, adding that everyone should have increased caution due the unpredictability of surrounding conditions at this time of year.

Whether walking or driving, allowing more time to get to a destination is recommended in winter weather. The CDC recommends working slowly during outdoor chores, such as shoveling snow, and keeping walkways free of ice by using a de-icing compound, such as rock salt. Wearing shoes with rubber soles that have treads or raised patterns on the bottom can help maintain grip and balance on slippery surfaces.

“Overall, environmental and self-awareness is the number one way to reduce risk of winter weather injury. This doesn’t mean not having fun; it just means taking the proper measures to prioritize your health and safety.”

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