Concussions in Cycling

Brain injury is a really scary thing

I bet many of us know someone with brain injury - of varying degrees - but the fact is that if you immerse yourself in the world of cycling, you will know someone who has had injury to their brain. It has to be one of the scariest things for a cyclist and yet it is often not in the spotlight.

This year team Garmin-Sharp made a noticeable change in helmets to the POC Road AVIP; this year I followed the progress of Dale Stetina after his terrible road crash and brain injury; this year I need three hands to count the number of people I know with outward signs of brain injury.

Accidents happen, but if we understand the type of unseen damage that is happening, we understand the treatment and know where to find help - outcomes may improve. A broken bone can mend, but a broken brain can change a life forever.

This video is really really excellent at explaining exactly what happens to a cyclist in a fall. About why the intensity of the fall does not equate to the severity of injury or to the longevity of symptoms. And why we need to seriously rest both physically and mentally (for about 2 weeks) after a fall and should not be rushing to get back on the bike, just as a ball player should not be rushing to get back in the game.
 

Concussions and Sports

Diagnosing and treating concussions in athletes.

Premiere Date: 9/2/2013
Eric Freitag is a licensed psychologist and a board certified clinical neuropsychologist. He started the Sport Concussion Program in 2006 and has provided baseline and post injury care to hundreds of athletes. He explains the risk factors for athletes as well as the medical implications of concussions. Learn how to spot a concussion, when to see a doctor, and how treatment should progress.

Video (30 mins): link
Please watch this video, and thank you to my cycling friend Suze for sharing the link.
 

Education and rest

If more athletes, coaches and officials had a clear understanding of signs and symptoms and what to do for an athlete post crash, perhaps someone could stand up and say no to a cyclist wanting to race in a later category or the next day. Watch this video and you will understand exactly what is happening to our brains. This is an area where education would help immensely.

Help with head injury

A friend, Scott, highly recommends this organization for individuals with brain injury.  Brain Injury Alliance of Colorado - serving individuals affected by all forms of brain injury such as stroke, TBI, tumor and infection.

Helmets

Improvements in engineering of helmets continues, but the nature of falls in cycling are best treated by experts, and rest.

Johan Vansummeren in the team's 2013 Giro helmet.  Photo by Karen Rakestraw of Pedal Dancer

Thomas Dekker in the team's new look for 2014 - POC.  Photo from Garmin-Sharp team website.

You probably noticed the new look on the heads of Garmin-Sharp riders, whether you like the style or not, the purpose is safety. Although the purpose of those POC sunglasses seem to be pure style. Garmin-Sharp riders will wear the Octal helmet, the Octal Aero and the Tempor TT helmet for the next three years.

The new Garmin-Sharp helmet styles: Octal, Octal Aero, and Tempor

Related post by Pedal Dancer: Protect your noggin.

Man with a helmet - one of my favorites of a relaxed Philippe Gilbert. Photo by Karen Rakestraw of PedalDancer

Updates: A Climb, Credit Cards, Helmets, and TDF

It is Sunday afternoon and time for some updates

Today we talk about two updates on previously written posts and another nice Colorado bike ride.

First - I did a short climb today up Chicago Creek Rd (Colorado State Hwy 103) to Echo Lake Lodge and took exactly zero photos to share. I realized this while descending at rapid speeds, but since that was going pretty well I saw no point in stopping. At the top I had met a number of interesting cyclists who apparently were a distraction from photography, including one guy who was planning on doing La Marmotte in France (108m, 16.990 ft) in two weeks and was spending his day climbing up and down and up and down the same roads near Mt Evans.

Basically I climbed the road to Mt Evans (the highest paved road in the United States) from the Idaho Springs side.  In this neck of the woods (literally inside the Arapaho National Forest) all roads lead to Echo Lake Lodge where water refills await and an endless stream of cyclists flow in and out. Those who have good timing, or good weather, continue another 15 miles (24km) to a parking lot just short of the 14,265 ft (4,348 m) summit of Mt Evans.

As I climbed I kept thinking, I cannot believe my nephew won Cat 4 at age 21 in the Mt Evans hillclimb a few years ago - it is a tough road to race. Weather was looming today when I reached Echo Lake Lodge. From the sight of the shaking cyclists who had just descended from the peak of Mt Evans, I made the correct decision to turn around and glide back downhill 13.75 miles to the town of Idaho Springs. I returned home, showered, and went to yoga class in Denver under the sound of thunder and raindrops.

The Bob Cook Memorial/Mt Evans Hill Climb (Event Race Flyer) is July 20, 2013

I rode the entire ride today and never took a photo, not one, oops, but I do have a post I wrote in 2010 to share with you, same road, with photos!: Colorado High. This one image below may best describe my climb today. Ride: Idaho Springs to Echo Lake, 13.75miles one-way, 3028.22 ft elevation gain, max elevation 10,663ft. 

Oooh pinks and reds and oranges look much nicer than they feel

Mt Evans is west of Denver, and the closest to Denver of Colorado's 54 fourteeners.

Second - an update to Protect your noggin, the post I wrote about the scary state of safety when it comes to bicycle helmets and the long wait for a MIPS helmet for road cyclists. The news is that Scott has a MIPS helmet for sale in bike shops, but not all shops, so you may have to special order one. Although the helmet is available now, it is pricey at $220. As demand rises perhaps protecting our brains from concussions will not be such an expensive deal. The prevalence of head injury and its association with cycling is a scary reality to me since I can quickly name off 5 people I know who have affects of brain trauma. From Bruce Barcott, read and use the Store Locator: http://www.brucebarcott.com/2013/05/here-are-the-mips-helmets.html.

Third - an update to Chip and PIN Credit Cards, another post about traveling and the annoyance of old fashioned American credit cards that restrict our flow of currency while being tourists in Europe. More American Banks have come out with Chip and Signature Cards. Two now offer true Chip and Pin cards, a higher security method of using plastic. Good news is that you can at least get a Chip and Signature card for zero annual fees and zero transaction fees. From The Points Guy, read: http://thepointsguy.com/2013/05/us-credit-cards-with-smart-chips/. If you must have one, the only two Chip and Pin cards are from Commerce Bank Visa Signature Card, and Andrews Federal Credit Union GlobeTrek Visa.

Fourth - the 100th Tour de France (not to be mistaken with the 100th year of the Tour de France, which was in 2003) begins NEXT weekend. Are you ready?  I can't wait to watch and write about the Tour as it travels through some wonderful cities and countryside, many of which we have visited over the years. The Tour de France to me means travel memories combined with the unknown of bike racing. Especially a bike race which extends over three weeks. Ignore the pre-race predictions, no one truly knows who will win the 2013 Tour de France.

I dug out my old La Randonnee du Centenaire jersey from 2003 when I participated in the citizen ride through the streets of Paris before the final stage of the 100th year of the Tour de France.

La Randonnee du Centenaire jersey

My brother Mike brought me back from France this programme officiel Tour de France 100 guide in French! It will be my challenge to read the pages during the not as exciting stages labeled en ligne (flat stages).

Too bad Bradley Wiggins, featured on the cover above, will not be back, nor will Bernie Eisel, Thor Hushovd, Chris Horner, Tyler Farrar, Dave Zabriski and a shocking number of the recently crowned National Champions from today's races around the globe. But Ted King made the cut, so did Jens Voigt. And we'll get to see Mark Cavendish sprint against Peter Sagan, Greipel, and Matt Goss.

Next Saturday - the Tour de France begins on the Island of Corsica.

Protect your noggin

Bicycle Helmets

There is a time when weight, color, price, aerodynamics and good looks probably should not matter. Yes, I know these are too often the 5 golden rules of buying any new cycling gear, but when it comes to a bike helmet we really should buy responsibly. When it comes to protecting our precious brains, many of us would pay top dollar to ensure our ability to take care of our family, rather than our family taking care of us. But what if even our big bucks could not buy what we need to protect our most valuable asset.

That's right, money can't buy happiness and money can't always buy safety. Turns out that bike helmet we strap to our skull before our jolly bike ride is not good enough.

Bruce Barcott wrote a lengthy well-researched article for Bicycling.com recently in which he reported on a number of unnerving facts about the current lack of protection of bicycle helmets. Mainly concussions are a real problem and helmets are not helping the problem. Excerpts from his in-depth article:

• The basic setup (a thin plastic shell over a thick foam liner) hasn't changed much since the first [bike helmet] was sold in 1975. 
• By 1999 half of all riders were wearing [bike helmets]—up from just 18 percent eight years earlier.
• Between 1997 and 2011 the number of bike-related concussions suffered annually by American riders­ increased by 67 percent,
• Recent studies of football and hockey players­ have raised alarming questions about the disabling short- and long-term effects of concussions.  
• Bicycle-helmet standards were first developed in the 1950s by the Snell Memorial Foundation in Sacramento, California. 
• Though the standards were voluntary [in the 1980s], most major helmet ­companies adhered to at least one set (ASTM, ANSI, and Snell).
• The certifying authority. That would be the Consumer Product Safety Commission. The federal agency sets out minimum standards to protect consumers against shoddy helmets. 
• Standards set by the CPSC demand that helmets perform—that is, hold up through the 6-foot drop test (straight 90-degree impact)—at room temperature and in a variety of extreme conditions.
• Helmet experts call it "slowing the blow,"  By crushing and cracking, the inner EPS liner attenuates impact energy—that is, it extends the hit over a longer period of time. Six milliseconds, say, instead of two. 
• "A lot of the innovation in helmets has been focused on making them lighter, more ventilated, and fit better," said John Thompson, bike helmet product manager for Scott Sports. 
• Patients who arrived at ERs in seven Seattle-area hospitals after bicycle-related­ accidents. In that second study, 63 percent of all head-injured cyclists over the age of 39 wore helmets at the time of the crash.
• In 1994 when Congress mandated that all bike helmets­ sold in the United States meet minimum safety standards set by the CPSC ... ultimately­ enacted a rule that was essentially a hybrid of the existing ANSI, Snell, and ASTM standards.
• If you crash and hit your head, there are two types of impacts. One is known as linear acceleration. The second type is known as rotational acceleration —the technical term is inertial spin—which creates shear strain.
• There are other factors involved, but research has consistently pointed to rotational acceleration as the biggest single factor in a concussion's severity. The CPSC helmet benchmark is based solely on linear acceleration. 
• (We knew this a long time ago) In 1962, a team of Michigan State University researchers presented a study at the American ­College of Sports Medicine's annual convention. "It is fairly well established that the extent of skull fracture and severity of concussion are not closely related," they said. Further research, they added, should focus on "developing headgear which would ­provide greater protection from brain concussion."  
• ...the data led the UCLA researchers to implore the medical community to "discard the magical notion that wearing a helmet on the head is sufficient to protect against impact brain damage." 
• "Little has changed in helmet-safety design during the past 30 years."  
• "If a bicyclist is getting more than one or two concussions a year," he added, "he really needs to take up another activity." 
• "A lot of people think that because people sometimes suffer concussions while wearing helmets, that the ­helmet didn't do its job,"
• The problem lies in the way the head is attached to the body. When a rider falls, he said, "the head rotates like the end of a flyswatter, and the shear strain is high enough to break axons in the brain."

Then in the late 1990s a Swedish team stepped in, and a second group of engineers from Portland joined in the innovation wave:

• By 2008, after years of sketching, testing, and prototyping, they (the Swedish team) had a working ­model. Their MIPS (Multi-directional Impact ­Protection System) helmet contained a ­low-friction slip plate between the head and EPS liner. On impact, the helmet rotates independent of the MIPS liner, absorbing some rotational acceleration. 
• As the MIPS engineers fine-tuned their system, a group of inventors in Portland, Oregon, also attacked the problem. Bottlang and Madey hit upon a potential solution: They built an aluminum honeycomb liner with ultrathin cell walls that replaces the EPS liner, the prototype AIM (Angular Impact Mitigation) helmet.
• Few manufacturers were interested.  
• "We'd created a situation where good protection was available but no one gave a damn about it because you didn't need it to pass certification." 
• But their customers—from top pros to weekenders—haven't been clamoring­ for safer helmets, and the unchanging CPSC standards helped to ensure they were never offered one. 
• He has to convince customers that a MIPS-equipped helmet is safer, despite the fact that all helmets pass the same safety test.
• In late 2012, a third team jumped in. 6D, "It's suspension for your brain," "We're making a helmet to protect riders long-term."
• The new rotation-­dampening systems may not be perfect, but they are the biggest step forward in decades. The choices cyclists make with their money matter. 

Read the full article: SENSELESS, By Bruce Barcott for Bicycling Magazine

In the future look for products coming from POC, Scott, Abus, Easton-Bell, and Giro.  Every so often do a Google search for a MIPS or AIM bike helmet, and the day you get a result - BUY BUY BUY. Snowboarders already have a MIPS helmet. Motorcyclists do too. Mountain bikers, Road bikers, and equestrian athletes all gain to benefit in the future from better helmets for their specific sport.

Almost there but not quite yet. This helmet is for single track and enduro riders - POC Trabec Race MIPS

Meanwhile, all us cyclists are out here waiting, sporting anything that first and foremost fits us, and secondly matches with our bike or our favorite jersey, and of course is lightweight, a nice color, aerodynamic and good looking. Not so perfect consumer sense.

The pro peloton is right there with us, they are told which helmet to wear by their team helmet sponsor. Last year when the Giro Air Attack helmet showed up on the heads of the Garmin-Sharp and Rabobank teams at the Tour de France, and then this year when Mark Cavendish donned his Specialized Prevail helmet, the helmets caught on so fast consumer cyclists scooped them up. If only Mark Cavendish would sprint in a new MIPS helmet, we would all be better for it.

What kits (apparel) and helmets are the pro teams wearing in 2013? I bet most of our own helmets are represented among this list:

TEAM	CLOTHING	HELMET
AG2R LA MONDIALE (FRA)	ODLO	Ekoi
ASTANA PRO TEAM (KAZ)	Moa	Specialized
BLANCO PRO CYCLING TEAM	Pro	Bell
BMC RACING TEAM (USA)	Pearl Izumi	Giro
CANNONDALE PRO (ITA)	Sugoi	Cannondale
EUSKALTEL-EUSKADI (ESP)	Moa	Catlike
FDJ (FRA)	Pro	Uvex
GARMIN-SHARP (USA)	Castelli	Grio
LAMPRE – MERIDA (ITA)	Champion Systems	Kabuto
LOTTO-BELISOL (BEL)	Vermarc	Lazer
MOVISTAR TEAM (ESP)	Nalini	Catlike
OMEGA PHARMA-QUICKSTEP	Vermarc	Specialized
ORICA-GREENEDGE  (AUS)	SMS Santini	Scott
RADIOSHACK LEOPARD (LUX)	Craft	Bontrager
SKY PROCYCLING GBR)	Rapha	kask
TEAM ARGOS-SHIMANO (NED	Pro/Pearl Izumi	Uvex
TEAM SAXO-BANK TINKOFF	Sportful	Specialized
VACANSOLEIL-DCM  (NED)	SMS Santini	BBB

What kit and helmet am I wearing in 2013?

TEAM	CLOTHING              HELMET
PEDAL DANCER (USA)	Castelli                     Cannondale

What would I like to be wearing in 2014 - Castelli clothing and a MIPS equipped helmet please!
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What are we seeing in the Tour de France

Men, land, jerseys, numbers and bikes

Upon watching the first stage of this year's Tour de France, I found myself glued to the screen, again becoming familiar with all there is to see in any one stage. To me the race is never one that whizzes by - not when there is so much to look at. Special jerseys, helmets, numbers, bikes, motos, and oh the marvelous scenery. As wonderful as the atmosphere appears on TV, it is incredible to be there at the Tour in person. The sounds, the people, the towns, and the rush of excitement as the caravan, riders and team cars pass by - the Tour de France is simply fabulous.

What is new in 2012?

Helmets

What is up with the yellow helmets? This year the Tour organizers have asked the teams to bring extra yellow helmets just in case the team is in the lead for the team classification. That is correct, the order went out to all teams to pack an extra 9 yellow helmets. Team Sky got to wear their inventory of yellow helmets on day one, designating the team as leading in the team classification. People either like or hate the visual that the new yellow helmets create in the peloton. I like the concept since the other classifications have special jerseys and I tend to overlook which team is in the lead, but I'm not sure about over-using the color yellow. Sure new helmets are a low-cost easy solution to highlight the team, and give more exposure to team helmet sponsors, but they diminish the tradition of the maillot jaune helmet.

All the riders on Team Sky have new yellow Kask helmets
 

Update: If you are wondering what that helmet cover on Mark Cavendish's helmet during Stage 2 (not stage 1) was all about - Cavendish believes the cover to be more aero. He wore a helmet cover when he won his world championship title last year. I am impressed that Team Sky thought to bring the yellow cover with them, but maybe they had big hopes of someone being in the yellow jersey. Probably more likely than wishing the entire team would be in yellow helmets. Which reminds me, how long will this new yellow helmet rule be in place. Is this a trial rule, or a rule that is here to stay?

Yes even road helmets are turning aero; read about the development of the new Air Attack helmet by Giro and Tour de France teams go aero for Monday's expected bunch sprint, by CyclingWeekly. CyclingWeekly reported that Team Sky, Rabobank, Lott-Belisol, and Garmin-Sharp were a few of the teams using differing forms of aero covers, ventless helmets or the new Air Attack aero helmets. The new Giro helmets are said to be available to consumers next spring, for around $200.

Robobank's Bram Tankink in his new Giro Air Attack helmet - he looks like a skateboarder

Another unique helmet is worn by Sammy Sanchez, who wears a gold helmet (not yellow, but glistening gold, with Olympic rings) marking him as the current Olympic gold medalist in road cycling. Sanchez also wears gold shoes.

Jerseys

In addition to the classification jerseys (yellow, green, polka-dot, white) and the team jerseys, you will notice a few other unique jerseys. When racing a road stage the current World and National Champions will wear their country jerseys. When racing the time trial, the current time trial champions will wear their national skinsuits. Who are the world and national champions in the 2012 Tour de France?

World Champion

• Road: Mark Cavendish (Sky) - Great Britain
• Time Trial: Tony Martin - Germany

Road National Champions (see full list of champions, by Inrng)

• Peter Sagan (Liquigas) - Slovakia
• Edvald Bossan-Hagen (Sky) - Norway
• Simon Gerrans (Orics-GreenEDGE) - Australia
• Yauheni Hutarovich (FDJ-BigMat)  - Belarus
• Borut Božič (Astana) - Slovania
• Eduard Vorganov (Katusha) - Russia
• Andriy Grivko (Astana) - Ukraine
• Robbie Hunter (Garmin-Sharp) - South Africa

Time Trial National Champions

• Fabian Cancellara (RSNT) - Switzerland
• David Zabriskie (Garmin-Sharp) - United States
• Luis Leon Sanchez (Rabobank) - Spain

There are plenty of colored armbands in the peloton, these mark the former national and world champions. What an honor it must be to wear ones country colors on a jersey sleeve or collar for the remainder of a career. You will notice the RadioShack Nissan Trek team wearing the yellow Livestrong cancer awareness armband on their left sleeve. Yellow in color, the band has nothing to do with the Tour de France. Note that all apparel and logo advertisement on jerseys must be pre-approved by race organizers - that was the reason for the delay and subsequent fine to the RadioShack team on the last stage in 2010 when the team changed jerseys to honor cancer patients. Noble, but not allowed.

The classification jerseys for 2012 Tour de France are no longer made by Nike, the yellow, green, polka-dot and white jerseys are now manufactured by Le Coq Sportif (read more Tour de France Jerseys by velopeloton).

Tejay van Garederen (BMC) in his new Le Coq Sportif best young rider's white jersey

A few teams presented with new jerseys for the Tour de France. Garmin-Sharp and SaxoBank-Tinkoff both have new sponsors and thus new jerseys. Team Orica-GreenEDGE updated their jerseys to better reflect sponsor colors. Other team jerseys can be seen here: 2012 ProTour Team Jerseys by Pedal Dancer.

New Garmin-Sharp team jersey

New Saxo Bank-Tinkoff team jersey

New Orica-GreenEDGE team jersey

Dossards (bib numbers) 

Fans can also garner more information by reviewing a rider's number. Yellow background denotes the current team classification leaders (the entire team wears numbers on a yellow background). Red background is worn by the rider awarded the most aggressive title from the previous day's stage. Dossard #13 is often worn upside down to ward off superstition. Number one, of course, is worn by last year's winner Cadel Evans. The composition of the dossard number describes both the team number and the rider number - please read more about dossards at this very popular Pedal Dancer post Word of the Day: Dossard (you might learn something new).

Bikes

Isn't it amazing how quickly the equipment suppliers show up with a yellow helmet, yellow glasses, and yellow bike whenever there is a change in the general classification leader? Fabian Cancellara was fully yellow-out by the beginning of Stage 1.  That special yellow bike always miraculously appears for the yellow jersey wearer. Usually a few frames will be produced by bike manufacturers in limited numbers. See images of Fabian Cancellara's new Trek bike build on facebook, or on Fabian Cancellara's Trek Domane 6-Series Maillot Jaune by BikeRadar.com

Fabian Cancellara's new yellow Trek bike for the Tour de France

George Hincapie was given a specially designed bike to honor his record setting participation in his 17th Tour de France. The details on the bike are personal and fantastic - gold and gray are the colors of the bike. See images of George Hincapie's new Trek bike build on facebook, or on George Hincapie's 'Gentleman's Round' BMC TeamMachine SLR01, by BikeRadar.com

George Hincapie's new bike for the 2012 Tour de France has special graphics.

Cadel Evans also rides his yellow and black BMC bike. Consumers can buy 1 of only 141 of these special SLR01 frames made by BMC. Again, there is almost too much yellow in the peloton this year.

BMC SLR01 Yellow Cadel Evans limited edition bike

Peter Sagan has a new Cannondale EVO Supersix bike for the Tour de France called the "Tourminator"

Peter Sagan's new Cannondale EVO Supersix Tourminator bike

Philippe Gilbert's Belgium flag highlighted BMC bike

Giro winner Ryder Hesjedal's Cervelo Canadian flag graphics bike

Scenery

Today we were in Belgium, riding through the Ardennes, a green hilly region well known for it's historic battles. The helicopter views looked like a movie set, although I am aware that most towns would probably not want their town thought of as a war movie-set. I became a big fan of Belgium after my last visit in April for the Tour of Flanders and Paris-Roubaix. Although I am returning this year to the Alps, Provence, and Pyrenees of France, next time I go back, I want to see much more of north-western France and Belgium. I was very interested in the mix of history and land.

Where are we going this year in the Tour de France? As we all know, many, dare we say most, fans tune in to watch the scenery. In the course of 3-weeks we will see large cities, small towns, mountains, cobbles, castles, sea and vineyards. 

This first week we will spend a chunk of time in the north.

map of week one Tour de France  (map from LeParisien)

Next week we will do a quick fly over in the Alps, a day in Switzerland, followed by more time in the Rhone River Valley (yeah vineyards!).

map of week two Tour de France  (map from LeParisien)

The final week we spend time in the south of France in the mighty Pyrenees, with a final time trial just outside the city of Paris before the final ceremonial procession into the grand city on July 22nd.

map of week three Tour de France  (map from LeParisien)

map of final two stages Tour de France  (map from LeParisien)

Between the current Olympic trials, Tour de France, and the Olympics in London - this summer we have a lot of fun to look forward to. 

I leave Colorado on July 9th ... in route to Lyon. France here I come!

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