Bicycle Helmet Safety Institute

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When Can I Ride Again
After a Head Injury?

Summary: How long must you wait to ride again after a head injury? The first and last advice is "listen to your doctor."

Doctors are sometimes not too sympathetic with the question every rider asks from the hospital bed: When can I ride my bike again?

Sympathetic or not, your doctor is the best source of good information to answer that question! Keep that in mind as you read this page. This is a background discussion. It will be interesting, but will not help you make the decision about when to start riding again. Only your doctor should make that decision. You are warned!

There is no single answer to the question for a number of reasons. The severity of head injury varies widely. The damage done to your brain is not readily apparent. The long-term consequences can be considerable and are not known at the time of your first recovery. The potential for another hit is always difficult to assess. The helmet you buy to replace the one you smashed may have harder foam if the vents are bigger, and not be the "softest landing" helmet you need now. Your age may be a factor, since some experts believe that older people are more prone to brain injury to begin with. Your brain has taken a hit, and nerves and blood vessels have probably been stretched. They are much more easily damaged now, and will be for some long time to come. Only your doctor can assess all of that and tell you what your risks are.

In sports the question is known as the "return to play" issue. You can find a lot of info designed for football and hockey coaches that gives them guidelines to judge when a player can resume a violent sport. In general, the guidelines are not as thoroughly applied as they should be, and some suspect the guidelines may not be conservative enough. It is not unusual for a player who has suffered a concussion in one of those sports to return to play in the same game! If you want to check out the guidelines, here is a Google search that should bring up some relevant documents that are current. The Colorado Medical Society guidelines adopted in 1991 have been a reference point for most others.

Although hockey may seem a long way from a nice bike ride, the fall you can take on your next ride can deliver a blow right through your helmet that can give you another concussion. Today's bike helmets designed to the CPSC standard in the US or a similar but weaker European standard are not designed for preventing concussions and mild head trauma. They are designed to prevent major and permanent head injuries. Deaths.

The helmet you really need if you have already been injured would be much softer than a normal bike helmet, but would probably have to be four inches thick to work equally well in a hard hit. There is nothing like that on the market today. That is one reason why you do not see any bicycle helmets advertised as preventing concussions. (In fact, they don't even say directly that they prevent injuries--a catchy slogan using words like "courage" or saying Lance Armstrong wears this helmet and it is cool and light is all the corporate lawyers will approve.) One bike helmet brand has used the word concussion in an ad, but they were careful to be very vague about it, and did not promise to protect you against one. In football, the situation has changed as Riddell has now released a new football helmet they bill as an anti-concussion helmet. That's a major step forward, and we did a newsletter on it. But it won't be useful for bike riding.

So what is a rider to do? First, check out the best helmets in the Virginia Tech testing program for their Stars ratings. They test at lower velocities to make sure a helmet performs well. And we have a page up on top helmets that also score high on the Consumer Reports impact testing. Make sure you pick out a replacement helmet that is thick and does not have jillions of huge vents. That eliminates all of the helmets you see in the Tour de France that cost over $100 at the local bike store. You want a lot of foam in your helmet, not voids. Try to make sure it is round and smooth on the outside. Test the hardness of the foam with your thumb--you will be amazed at the difference between one of the expensive hypervented helmets and a cheaper, thicker, less vented model. Then ask why nobody does that test for you. We would, but we can't afford the necessary lab testing. When we sent a small selection of expensive and cheap helmets to the lab, the results were strikingly similar. You can check out our page on the ideal helmet for more details. You can also check out the latest Consumer Reports article, but they test for the helmet that can take the hardest hit, rather than the helmet that gives you the softest landing. Interestingly, in their 2002 article they found that the less expensive models got the their highest ratings.

Then it's decision time. Take that helmet to your doctor on one of your followup visits and find out when you can ride again. There is no other smart way, so if you are not thinking about asking your doctor you may not be recovered enough to think clearly.