ATTENTION: USPA

I AM NOT SURE WE ARE GETTING THE REAL INFO FROM USPA. READ THIS EMAIL–FROM PEOPLE IN THE KNOW.

FW: Following up on our helmet discussion. I think this matter needs to be brought to the attention of our USPA circuit governors as well as the trustees of this club.

Inbox

Leigh Brecheen	Sun, Jun 5, 10:42 PM (20 hours ago)
to me

From: Leigh Brecheen
Sent: Sunday, June 5, 2022 10:42 PM
To: gpalmer@ghpalmer.com (gpalmer@ghpalmer.com) <gpalmer@ghpalmer.com>; Chuck Lande <clande@chadmar.com>
Cc: Anant Pandadiya, Asst. to Leigh Brecheen <leigh.asst@bfbst.com>
Subject: Following up on our helmet discussion. I think this matter needs to be brought to the attention of our USPA circuit governors as well as the trustees of this club.

In the interest of time, I have just pasted some of my Facebook posts to illustrate what my limited research has turned up about the safety of the NOCSAE helmets, in particular the Casablanca, as well that the steps take to choose the standard and the inaction of the USPA to all the bad news, up to and including denial of knowledge of concussions sustained in the NOCSAE helmets. BTW, in the 4PM 12 Goal game today, Adam Ransom got into an accident and his Casablanca went flying off. As far as I know he didn’t hit his head but he did break his wrist.

My view is that the USPA needs to immediately commission a study from the Swedish group that did the studies for the Folksam insurance company to compare the NOCSAE helmets against other helmets in general and the ARAMIS with MIPS in particular. I also think they would be well advised to immediately notify all players that the Casablanca is not safe to play in due to the buckle. My bigger issue is that the standard they mandated does not include any of the concussion mitigation technology. They will be very lucky if they escape only having to replace all the USPA member’s helmets rather than a huge lawsuit..

First Facebook Post: Polo friends, I have been in regular touch with the USPA since my groom/pilot Antonio Juarez sustained a nasty concussion wearing his NOCSEA Casablanca helmet. I had anecdotally heard that a lot of people were getting bad concussion in the NOCSEA helmets and I also wanted to know if the USPA was studying the problem and also what it is doing about the “flying” ( as in off) Casablanca buckles.
Lindsay Dolan from the USPA has stated that they ” are also unaware of any cases other than Mr Juarez´s “….and yet, just today I have been contacted by or seen posts of Facebook by 3 people who sustained very significant concussions in their USPA mandated NOCSEA helmets. See below from Elizabeth Hart Humphreys<https://www.facebook.com/elizabeth.h.humphreys?__cft__%5b0%5d=AZXs7orJeE7NdAQJhaWh62sG6w7da5hsZ-eCAwn5QTJpfyjg17EQ0JqPBZIHRRIqgq-r9ePdTHG4Ond1qr1yGfiDl9DmPpLve9XGC_03d-Dpue54HOFQfTyCcOW7X4mbU_R4_Tz83zb6gkd4cRer5ZcfruTNV2oFUGfPSwioX8qagpSBfc_7OlrJXvUeyt98ojFTVr4J-ml6uaR1lQF5HCXW&__tn__=-%5dK-R>.

Athena Malin also reached out and said “…I had the worst head injury in the new Casablanca helmet and had a terrible concussion, and it wasn’t the worst fall I’ve had….I was knocked out and then then went to the hospital. I’ve heard of many other people having bad head injuries too….The USPA was well aware of this…I asked them to help me and make a note of it…”

In the comments to Elizabeth’s comment, Elizabeth Cunningham noted that she had sustained a concussion in one of these helmets..

James Glew reports that he also sustained one and that “When I rang the USPA to report my injury/complain about the quality of the Casablanca helmets they basically told me it was not something they were interested in and any complaints / concerns should be directed to the helmet manufacturer”.

Players, PLEASE, if you have an accident report it to the USPA (Lindsay Dolan) ldolan@uspolo.org<mailto:ldolan@uspolo.org> and fill out this USPA accident survey. https://www.surveymonkey.com/r/699H7J7<https://l.facebook.com/l.php?u=https%3A%2F%2Fwww.surveymonkey.com%2Fr%2F699H7J7%3Ffbclid%3DIwAR28vR9wywBCtBgS9I4UmEbWPAKoR4MCjeMAubGGcjLC3hnxOgMcZzsSIak&h=AT04sGsisvVnNNVKeqPGxH-9R-keNBPerz__cEfrDgPJDovM7Igey1OJAsrP5I9LOLPYaEfloWK7TwY1r1ZV7QukDw1-A53-GmuYHAim5Urpqrk_f84IOU8WsZeoX62FiQ&__tn__=-UK-R&c%5b0%5d=AT15c_sBhhLF2vrCkncV9LfqDyhoCg0aShkNCL7l0stmw7FiK3U5fy_UijGUkiphk_KV0Dk5P16dW92AyEx0RnHqlIsYnpcvTuOOPon-tBAmjrUgSwAQEbDjGqOM83Tfi3pgBp3hDYX2LYTLmuEa-IwuBeA-X53YQgn5uVp0y0ldD-XTvRyzwJeAohRvZOw0pVfcGK5k2DtMvrc6QDigS58Wj08WwmLb1dBIQaOIQ5HS>
You should copy ssanders@seinet.org<mailto:ssanders@seinet.org> which is the testing facility. Also copy Carlucho Arellano Carlucho@uspolo.org<mailto:Carlucho@uspolo.org>; Chris Green chris@uspolo.org<mailto:chris@uspolo.org>.

The USPA should make filling out this survey mandatory for the management of USPA clubs.
Everyone should be clear that the Virginia Tech Study that the USPA used as a basis for choosing the NOCSEA standard specifically says that it does NOT address concussion protection and encourages Phase 2 and 3 studies to examine what kind of helmet standard would best protect the brain. While they recommend the NOCSEA standard, they also explicitly state that the new helmets should also meet other equestrian helmet standards.

Why was the prevention of concussions not a consideration before the adoption of the new standard? Most of the top equestrian helmet manufacturers these days have incorporated technology that is designed to prevent concussions such as MIPS.

At the bottom I have pasted some info about other technology that various helmet manufacturers have incorporated in their helmets. This is from the Charles Owen website. Although I have always worn and taken some hits in the prior Charles Owen polo helmets with no ill effects, despite being knocked out, I didn’t choose its NOCSEA helmet because it is very uncomfortable and DOES NOT meet all the other standards that all the other Charles Owen Equestrian helmets are manufactured to and does not include MIPS.
“Charles Owen harnesses MIPS technology.
MIPS is a Brain Protection System that aims to combat rotational motion that can cause brain injuries.
A low friction layer allows a sliding movement of 10-15mm, in all directions, reducing rotational motion to the brain during impact.
“As part of the European-funded Horizon 2020 research project, we have been studying jockey falls onto grass and sand surfaces. It was evident that standard helmet technology is not reducing brain injury in falls at speed. MIPS is part of a new generation of protection and we can now see how it will benefit many riders who are looking to reduce the less catastrophic brain injuries. We are excited to be able to bring this technology in an affordable helmet for every rider.” – Roy Burek”

Second Post[Friends]
Polo Friends- More on helmets and the USPA choice of the NOCSAE standard and the failure to include ( or even study) anti concussion technology and measures. All the latest data shows that rotational forces are the primary cause of concussions and the type of force most likely to be experience in a fall from a horse.

In 2021 The Swedish insurance company Folksam independently tested 15 riding helmets for children and adults available on the Swedish market and the test shows that only three out of fifteen helmets obtained the Folksam best in test or good choice label. “One out of nine who sustained a concussion must deal with permanent medical impairments . Given these numbers it is very regrettable that so few helmets actually protect the riders against concussions. The manufacturers of equestrian helmets should take a larger responsibility in improving the protection.”, says Helena Stigson PhD and Associate Professor at the Folksam research team…..The test shows that there is significant differences between the helmets and the risk of sustaining a concussion is two to five times higher if one of the lowest scoring helmets are used compared to the best one.- “We can tell by the test that there is great potential for improvement to make the helmets safer. The two top scoring helmets were equipped with rotational motion protection system (MIPS), but all equestrian helmets needs to be better at reducing rotational forces to avoid concussions or even more serious brain damage”, says Stigson..The major difference between a good and a poor helmet is how well it protects the head during oblique impact. Today there are no legal requirements on the equestrian helmet manufacturers to prevent rotational forces. Only vertical impacts are tested to show how well the helmets can prevent skull fractures. This is in spite of a lot of research showing that rotational forces create brain damages. In the Folksam test the helmets are subjected to impacts at an angle, which closer simulate the actual forces during an accident compared to the vertical tests performed required by current legislation…The two top scoring helmets were equipped with rotational motion protection system (MIPS), but all equestrian helmets needs to be better at reducing rotational forces to avoid concussions or even more serious brain damage”, says Stigson.

Possibly Third Post
[Friends]More on concussions and helmets in equestrian accidents.
This is from an interview with the head of innovation at Charles Owen and the head of Product Development at MIPS on the US Equestrian website.
“What makes Mips technology so important to equestrian safety?
In scenarios where the rider is injured in a fall from a horse, the most frequent are oblique angle falls (falling at an angle). It is known that angular acceleration is the dominating cause of brain injuries. The Mips safety system and other technologies are engineered to act in a way to reduce the angular forces and therefore help reduce the risk of brain injury.
MARCUS SEYFFARTH – HEAD OF PRODUCT DEVELOPMENT, MIPS
What is Mips technology? How does it work?
The Mips system is designed to provide added safety for helmets. For certain impacts, the Mips system can reduce harmful rotational forces that might otherwise be transferred to the head.
Rotational motion is the most common cause for concussions and more severe brain injury in oblique hits to the head. The Mips system consists of a low-friction layer that is mounted in the helmet. In a crash, the low-friction layer is designed to move slightly inside the helmet in order to help redirect rotational forces away from the head.
Why should an equestrian want Mips technology in their helmet?
When falling and hitting your head, you will most likely have an oblique impact, which can create rotational motion to the head. The Mips system is designed to help reduce rotational motion in certain impacts. In your view, how does the Folksam study illustrate the value that Mips technology brings to an equestrian helmet?
Thanks to tests like the one Folksam is doing, even more people can learn about the crucial importance of adding protection against rotational motion in your helmet. As we can see, rotational motion is a common cause for concussions and more severe brain injury in oblique hits to the head.
…………………………

Fourth Post ( or possibly as a comment to someone else’s. (Reuters Health) – Youth ice hockey players who wear mouthguards to protect their teeth and jaws may also have significantly lower odds of concussion, a Canadian study suggests.

Concussions are the most common injury in youth ice hockey, and while Hockey Canada has a policy requiring mouthguard use, it’s not universally enforced, said senior study author Brent Hagel. The new evidence that mouthguards may reduce concussion risk adds to the case for making them mandatory, Hagel and his colleagues write in the British Journal of Sports Medicine.

“When we looked at both off-the-shelf and custom-fit mouthguards together in the analysis, we found their use lowered the odds of concussion by 64%,” said Hagel, a child injury researcher with the Cumming School of Medicine and Sport Injury Prevention Research Center at the University of Calgary.

Previous research has suggested that mouthguard use was associated with fewer concussions, but the findings have been inconsistent, the study team writes.

To explore this question, the researchers analyzed data from two injury surveillance studies in 2011-20212 and 2013-2016 that included child and youth players in Pee Wee (11-12 year-olds), Bantam (13-14 year-olds) and Midget (15-17 year-olds) divisions.

The researchers compared a total of 315 cases of concussion to 270 cases of non-concussion injuries, such as injuries to the trunk or a limb, to see if mouthguard use was tied to concussion risk

Overall, 236 of the concussion cases (75%) were wearing a mouthguard when they were injured, as were 224 of the comparison group (83%). For youth wearing a mouthguard, the risk of concussion was almost two-thirds lower, the study found.

When researchers looked to see if the type of mouthguard made any difference, they found that off-the-shelf versions were tied to a 69% reduction in concussion risk compared with no mouthguard. Custom-fit mouthguards made by a dentist were linked to a 49% risk reduction – although that result was not statistically significant, meaning it could have been due to chance.

Fifth Post ( courtesy of Diana Palmer who attended the USPA Safety committee with me 7-9 years back and who offered to assist in researching concussions since she was a key part of a concussion study of all high school athletes in the Santa Barbara School system and also to introduce them to the top researcher in the field. They never even called her! https://www.hopkinsmedicine.org/health/conditions-and-diseases/traumatic-brain-injury?fbclid=IwAR2ZFJwei9YBAKxZeHzNQ-KxCDT5gVB-t8LxzxO_ertOa5XBMtRIVMMY3ao

Sixth Post

Three studies that make it clear that rotational impact is an essential part of helmet safety analysis. We need to demand that the USPA conduct further testing of the NOCSAE helmets it is requiring USPA members to buy and wear, particularly given the number of serious concussions that seem to be occurring in them.
1) Impact Performance Comparison of Advanced Snow Sport Helmets with Dedicated Rotation-Damping Systems
Gina DiGiacomo, Stanley Tsai & Michael Bottlang
2) New Assessment of Bicycle Helmets: The Brain Injury Mitigation Effects of New Technologies in Oblique Impacts
Annals of Biomedical Engineering volume 49, pages2805-2813 (2021)
Ann Biomed Eng. 2021; 49(10): 2716-2733.
Published online 2021 May 10. doi: 10.1007/s10439-021-02785-0
PMCID: PMC8109224
PMID: 33973128
Fady Abayazid,corresponding author1 Ke Ding,1 Karl Zimmerman,1,2 Helena Stigson,3,4,5 and Mazdak Ghajari1 “The results of this study show that in comparison with the conventional helmets, the helmets fitted with MIPS, WaveCel, SPIN and Hövding can reduce peak rotational acceleration and velocity, BrIC, overall brain strain and strain in corpus callosum and sulci.”
3) Impact Performance Comparison of Advanced Bicycle Helmets with Dedicated Rotation-Damping Systems
Michael Bottlang,corresponding author Alexandra Rouhier, Stanley Tsai, Jordan Gregoire, and Steven M. Madey. Ann Biomed Eng. 2020; 48(1): 68-78. Published online 2019 Jul 24. doi: 10.1007/s10439-019-02328-8
PMCID: PMC6928098. “The MIPS and SPIN helmets provided considerable improvements in absorption of rotational kinematics and associated concussion risk compared to control helmets. These highly encouraging results emphasize the need to advance traditional helmet designs towards effective rotation-damping systems that hold a considerable potential for brain injury prevention.”
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