Imagine that it’s a beautiful day and you are out taking a bicycle ride. You are coasting along a quiet neighborhood street, loving the feeling of zipping along on wheels and WHAM! You didn’t see that car backing out of a driveway. The impact sends you soaring, head first, over the trunk of the car.
Are you wearing a helmet? Do you wish you were? Do you think it matters?
A British neurosurgeon, Henry Thomas Marsh, famous for operating on the brain while patients are conscious and under local anesthesia, was recently quoted as saying that it doesn’t matter—and the quotes went viral online. Suddenly millions of people were questioning their belief that bicycle helmets protect them, and others—those who don’t wear helmets for whatever reason—were saying “I told you so.” Could this be right? Are bike helmets actually useless, and if so, how can cyclists protect themselves from head injuries?
The news reports quoting Dr. Marsh, senior consultant neurosurgeon at St. George’s Hospital in London, on the value of bicycle helmets use words such as “useless” and “a waste of time” again and again. I thought that sounded over the top coming from a well-trained, respected medical man. So I went beyond the quotes and listened to the 57-minute recording of the interview that sparked the news reports. At the 52-minute mark, this is what Dr. Marsh actually says…
“I see lots of bicyclists with severe head injuries at work, and, with high-impact injuries, these flimsy little helmets don’t help. Maybe they reduce some morbidity.”
That’s it! In all, Dr. Marsh talks about bicycle helmets for about two minutes and never uses the words “useless,” or “waste of time.” Although, in his opinion, helmets are generally too flimsy to protect against injuries from high-impact (sudden and intense) collisions, they can at least reduce the degree of injury that would occur if no helmet were worn at all. Now that sounds a bit more reasonable coming from a top brain surgeon. But how valuable are bike helmets really?
Although John Abrahams, MD, a neurosurgeon at Brain & Spine Surgeons of New York and chief of neurosurgery at the Northern Westchester Hospital in White Plains, New York, somewhat agrees with Dr. Marsh, he spoke with me about helmets for a lot longer than two minutes, which gave time to put the issue into perspective. He began with the story of a patient who suffered a severe head injury after hitting a stopped car while riding a bicycle at about 30 miles per hour. “She was wearing a helmet, and although her head injury did require surgery, she might have died if she hadn’t been wearing a helmet,” he said. He explained, however, that although helmets can protect against injury, they increasingly lose effectiveness as the speed at which an accident occurs increases. Still, this is a far cry from being “useless.”
Although not a guarantee, a helmet is the single most effective way to prevent head injury resulting from a bicycle accident, according to the US Department of Transportation’s National Highway Traffic Safety Administration (NHTSA). It recommends that all bicyclists wear properly fitted bicycle helmets every time they ride. Helmets have been shown to lower the risk of head or brain injury by up to 88%, according to NHTSA, which reported that 49,000 bicyclists were injured and 726 were killed in accidents involving motor vehicles in the US in 2012. National—and worldwide—statistics on bicycle safety also report that about 90% of bicyclists who are killed in accidents involving motor vehicles aren’t wearing helmets.
“Cycling without a helmet is just not worth the risk,” said Dr. Abrahams, who noted that helmet use is par for the course for professional bike racing as well as sports such as skiing, lacrosse and football. “Over and over again, data have supported the finding that the rate of brain injury is lessened with helmet use. I think that if you ask 100 neurosurgeons, 99 would say a helmet lessens the severity of the injury,” he said.
Is the British neurosurgeon Dr. Marsh the one in 100 who disagrees? He may not be a big fan of bicycle helmets, but it’s clear that he was grossly misquoted. Bottom line: Don’t worry about mussing your hair or not looking cool or especially thinking it just doesn’t matter. As the Brits say, “mind your head.” Always wear a helmet when you bike ride.
