Despite widespread adoption of ski helmets, rates of serious brain injuries on the slopes aren’t falling, prompting a reassessment of current safety measures.A veteran neurosurgeon in Switzerland has observed a troubling shift – while skull fractures are down, devastating diffuse axonal injuries are persisting, even among helmeted skiers [[2]]. This trend coincides with advances in ski technology and grooming practices that allow for greater speeds, raising questions about the limitations of existing helmet design and the need for innovation in protective gear [[1]].
Despite near-universal helmet use, serious brain injuries related to skiing aren’t declining, raising concerns about the increasing speeds and conditions on modern ski slopes. The trend is prompting medical experts to re-evaluate the effectiveness of current protective gear and consider new safety measures.
Dr. Jean-Yves Fournier, head of neurosurgery at Valais Hospital, first observed this troubling pattern decades ago. While a medical student in Sion in the 1980s, he participated in a study tracking roughly 100 ski-related head traumas over eleven years.
“Back then, we primarily saw skull fractures and epidural hematomas that were operable. Patients typically returned home after a week or ten days,” Fournier said. Of those 100 cases, only seven involved diffuse axonal injuries – severe and irreversible brain damage – and those occurred in skiers not wearing helmets.
Nearly 40 years later, Fournier has found the situation dramatically changed. Despite widespread helmet adoption, the number of diffuse axonal injuries hasn’t decreased. In fact, in a single ski season in 2018, after returning to Valais following time spent abroad, he observed seven such cases.
“Combination of Factors”
Fournier attributes the increase to a “combination of factors” stemming from changes in how people ski. Modern carving skis allow skiers to quickly progress to challenging, high-speed runs. This is compounded by harder, often artificially snow-covered, slopes that facilitate significantly higher average speeds than in the past.
The helmet doesn’t protect beyond 35 or 40 km/h
And contrary to popular belief, helmets aren’t foolproof. “People need to understand that the helmets available protect the skull or scalp, but they don’t protect the brain beyond certain speeds,” Fournier explained.
Current helmet designs, typically consisting of a rigid plastic shell with a polystyrene foam liner, primarily absorb linear impacts. They are less effective against rotational forces, which can be particularly destructive to brain tissue. Even with improvements, “the helmet doesn’t protect beyond 35 or 40 km/h.”
“Revolution to Make”
In light of these findings, simply mandating helmet use, as has been done in Italy, or adding visual or auditory alerts for exceeding certain speeds may not be enough. Fournier believes skiers need to be aware of these limitations.
>> Read also: Is Switzerland next to make ski helmets mandatory?
Looking ahead, Fournier envisions a “revolution” or a “change in concept”: entirely new protective systems, such as airbags encompassing the head, neck, and torso. These are still experimental, but may be the only way to effectively reduce irreversible brain injuries in the future. The findings underscore the need for continued research into ski safety and the limitations of current protective equipment.
Reported by Coralie Claude
Web text: Fabien Grenon
