Ski Helmets and Brain Injuries: Why More Helmets Didn't Mean Fewer Injuries

Ski helmets went from rare to standard in barely a decade. In the 2002/03 season about a quarter of American skiers and snowboarders wore one; by 2013, two in three did. Yet when the New York Times looked at the numbers on New Year's Day 2014, it found something that surprised many people: the rate of serious brain injuries on the slopes had not dropped. Here is what that finding really tells us, and why doctors still say: wear the helmet.

The 2014 helmet paradox

The New York Times story, "On Slopes, Rise in Helmet Use but No Decline in Brain Injuries," appeared just days after Formula One champion Michael Schumacher suffered a life-threatening head injury while skiing off-piste at Méribel in the French Alps, on 29 December 2013. He was wearing a helmet.

At the time the National Ski Areas Association (NSAA) estimated that about 67 percent of skiers and snowboarders in the United States wore helmets. Only New Jersey required them, and only for children. Even so, the share of serious brain injuries and deaths on the hill had stayed roughly flat for years. Snow-safety researcher Jasper Shealy summed it up: helmet use had climbed to around 40 percent at one point with no change in fatalities over a ten-year period.

What ski helmets are designed to stop

The explanation lies in physics. Ski helmets are certified under the European standard EN 1077, first issued in 1996, and the American ASTM F2040. Both test the helmet with impacts at roughly 20 to 23 km/h (about 14 mph), the speed of a simple fall from standing height or a slow collision.

Recreational skiers often cruise at twice that speed, and many go much faster. At 50 or 60 km/h, a collision with a tree, a lift pylon or another skier carries far more energy than a few centimetres of foam can absorb. A helmet turns a cracked skull into a bruise in a low-speed fall; it cannot make a high-speed crash into a fixed object survivable.

That is why the injury statistics behave the way they do. Helmets sharply cut the minor and moderate head injuries: scalp wounds, skull fractures and many concussions. The rare, catastrophic accidents that drive the brain-injury and fatality figures happen at speeds beyond any helmet's design.

What the research shows about helmet effectiveness

The best summary of the evidence is a 2010 meta-analysis in the Canadian Medical Association Journal by Kelly Russell, Josh Christie and Brent Hagel. Pooling 12 studies, they found that skiers and snowboarders wearing helmets had about 35 percent lower odds of a head injury. Helmets did not raise the risk of neck injuries, an old worry about the extra weight on the head.

Researchers also offer several reasons why overall numbers stayed stubborn while helmet use rose:

• Speed and tricks. Modern carving skis, groomed pistes and terrain parks let people go faster and jump higher than skiers of the 1990s.
• A false sense of security. Doctors interviewed at the time described some helmeted skiers feeling invincible, a pattern known as risk compensation.
• Poor fit. A loose rental helmet that slides back on the head leaves the forehead and temples exposed.
• Who gets hurt. Studies of fatal ski accidents point mostly to experienced, fast-skiing men hitting trees or other fixed objects, and a helmet does nothing to slow them down.

Helmet use today and how to ski safer

The habit has only grown since 2014. According to the NSAA, 90 percent of skiers and riders in the United States wore helmets in the 2023/24 season, and around 96 percent of children aged 17 and under. The association's long-running "Lids on Kids" campaign helped make that happen without state mandates.

A few simple habits get the most out of a helmet:

• Buy one that meets EN 1077 or ASTM F2040 and fits snugly, with the front edge just above the eyebrows and no gap with your goggles.
• Replace it after any hard impact, even if the shell looks fine, because the foam liner crushes to absorb a blow only once.
• Ski at a speed that lets you stop or swerve, and stay well clear of trees and lift towers.

After any blow to the head, watch for headache, dizziness, confusion or nausea, and get checked by a doctor; the CDC's HEADS UP programme explains the warning signs of concussion. The helmet is your last line of defence. Speed control is the first.

More from the slopes: interpreting a study of music and snowboard injuries; a prepared first step in ski jumping; Seven Ski Destinations: Mountains, Ski Culture and Different Kinds of Trips; Switch Telemarking: The Rhythm behind the Moonwalk Effect; IMAGINE: Wingsuit Flight and Skiing Share the Mountain Frame; Let Me Take You to the Mountain: GoPro’s Andes Adventure; Mount Baker Road Gap: A Backflip Attempt and Its Landing.

Related reading: Michael Schumacher’s 2013 Ski Accident.

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