Niki Terpstra says he’ll be back after being knocked unconscious in Tour of Flanders crash

The helmet prevents damage to the skull and prevents external bruising, which could then put pressure on the brain, which would be bad.

But no helmet will prevent the brain rattling inside the skull as a result of a crash, which is the cause of the concussion, you don't necessarily have to have a big lump on your head to have concussion.

Would absolutely agree with the compulsory aspect of removing a sportsperson from the field of play as a result of any suspected head injury.

1. It removes the element of peer or team management pressure to return to the fray when you really know that you should not.

2. People with head injuries and hyped on adrenaline are not best placed to self assess their medical needs.

3. In many sports an injured player or one not fully capable of making rational decisions can be a liability to other competitors, not just themselves.

As to - did the helmet mitigate further injury or not? That cannot be answered based on any single incident. There is a good argument that wearing protective equipment shifts the risk balance that the wearer is willing to accept, but this was racing and the incident doesn't look to have happened in an extreme moment. Actual reliable, peer reviewed evidence of the efficacy of wearing a helmet outside of the somewhat unrealistic, but repeatable world of the test lab is exceedingly hard to come by. However I'm not sure that given the choice, too many riders would wish to repeat the same incident without one.

Is the proposition that the injury would have been less severe had a helmet not been worn?

My only experience of head injury is crashing when not wearing a helmet and not remembering anything between leaving home and waking up in A&E.

Neither my accident or Terpstra's is repeatable with/without helmet so the 'debate' grinds on ad infinitum.

"Why compulsory?  No one is responsible for another person in this situation. If the rider choses to get back on then its his choice.  The very idea that it is desirable to protect someone from their own actions is ridiculous. Compulsory helmets even is immoral.  A doctor can suggest, a team can have a team policy which the rider signs up to, a race can be rquired to have a doctor etc on site,  but to suggest that anyone can over-ride an individuals rights to kill themselves is fundamentally wrong."

Helmets are compulsory in UCI races......

We cannot say the helmet didn't help him, he could easily be dead or seriously injured now without a helmet, likewise he could of been in the exact same sitution if he hadn't had a helmet on, to use this crash as an argument for or against helmet use is foolish at best as we cannot compare with or without.

Bit silly.

There's no evidence either way that the helmet either didn't protect him properly or that the helmet prevented a worse injury.

Support mandatory concussion protocols.

mattsccm wrote:

3. Why compulsory?

So that teams are compelled to look after their riders and not put them into races when they they should be recovering from concussion.

That's why.

Firstly this goes a small way to prove that helmets are not the universal answer to head injuries.

But more to the point the above poster is so wrong in several ways.

1. This happened in a nice safe situation. Likely a touch of wheels. What would the poster do? Have mandatory gaps around each rider. In this case "shit happens".

2. And just how would you improve helmets etc without adding to the weight, cost etc?

3. Why compulsory?  No one is responsible for another person in this situation. If the rider choses to get back on then its his choice.  The very idea that it is desirable to protect someone from their own actions is ridiculous. Compulsory helmets even is immoral.  A doctor can suggest, a team can have a team policy which the rider signs up to, a race can be rquired to have a doctor etc on site,  but to suggest that anyone can over-ride an individuals rights to kill themselves is fundamentally wrong.

look at how slow they were going, shocking how the helmet didn't stop this trauma from happening from a low speed fall!

 I hope he fully recovers with no lasting side effects but this yet again highlights how mickey poor helmets really are, the UCI should be looking further at how they can protect riders from such injuries BUT also importantly they should be looking at mandatory concussion protocols for ANY rider that has a concussion.

We have this in rugby league and rugby union, my team currently have a player who has had two concussions in the last 12 months, that means he's not allowed to play for two weeks minimum, the club have to put this (and any injury) onto his player passport and remove him from play immediately for assessment. This does not happen currently in cycling and is still way behind other sports.

You only need look at how there was no help for Toms Skujins in 2017 when he was clearly badly concussed, in fact the first person on the scene (neutral wheel person I think) was trying to aid him get back on the bike when they should have been getting him out of harms way and STOPPING him from remounting.

UCI needs to deal with these traumas better still despite the improvements in recent years but look yet again as to why crashes/injuries occur in the first instance, prevention is far better than a cure!!