Stay safe this winter: Tips for avoiding outdoor injuries |

Stay safe this winter: Tips for avoiding outdoor injuries

Family playing with snow on ski
Getty Images/iStockphoto | iStockphoto

General signs of concussion from the Brain Injury of America website:



Blurred vision



Slurred speech

Appearing dazed

Ringing in the ears

Delayed response to questions

Person may or may not lose consciousness

Seek immediate medical attention if a person exhibits any of the following after a head injury:

Worsening or persistent headache

Weakness, numbness or decreased coordination

Vomiting or nausea

Slurred speech

Very drowsy or unable to be woken 

One pupil is larger than the other

Convulsions or seizures

Doesn’t recognize familiar people or places

Increasingly confused, restless or agitated

Unusual behavior

Loss of consciousness

Winter sports fans across our region are dusting off their skis and snowboards this month, hopeful that recent storms will lead to the first real snow accumulation in the Sierra Nevada mountains in several years.

Before hitting the slopes, sledding hills or skating rinks, however, it is important that you and your loved ones take precautions to ensure that you enjoy these activities safely, says Cindy Shaw, Speech Pathologist with Dignity Health Sierra Nevada Memorial Hospital (SNMH) Rehabilitation Services. Shaw leads the Traumatic Brain Injury (TBI) Support Group at the hospital.

Sports and recreational activities contribute to about 21 percent of all traumatic brain injuries among American children and adolescents. Researchers at Johns Hopkins found that among skiers and snowboarders of all ages, severe head trauma accounts for about 20 percent of the 600,000 skiing- and snowboarding-related injuries every year. Head injury is also the most frequent cause of death and severe disability among skiers and snowboarders.

“The most important way to help avoid brain injury is, of course, to wear a helmet,” Shaw says. “We don’t have helmet laws for skiing. We don’t have helmet laws for sledding. So it is up to parents and to each individual to follow these safety precautions.”

She also shared the importance of making sure that protective equipment fits properly and staying within the limits of your abilities while on the slopes. Those who have never skied or boarded before should consider taking lessons and those with experience should proceed cautiously if they choose to try something more challenging.

Helmets are suggested during sledding activities as well — especially for children. Though snow may seem soft, it often isn’t.

In any outdoor winter activity you choose, always familiarize yourself with your surroundings, looking for possible blind spots, sudden drops or turns. Avoid areas with trees or other obstacles that could become a hazard. Resist the urge to wear earbuds or headphones so that you will be alert and able to hear what’s going on around you at all times.

Twenty-two percent of all skiing- and snowboarding-related head injuries are serious enough to lead to concussion or loss of consciousness, according to the Johns Hopkins study.

The Centers for Disease Control (CDC) defines concussion as a traumatic brain injury caused by a bump, blow or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth.

Shaw, who specializes in cognition and neurologic problems, said the effects of concussion can be long-lasting.

“Concussions can result in memory loss, depression and other emotional changes that can impact performance in school, work or their personal relationships,” Shaw said.

Knowing the symptoms of concussion (see sidebar) is key to preventing more long-term damage to the brain. An injured person may or may not lose consciousness with a head injury. You should seek medical attention if you have any symptoms present after a fall, even if there is no visible sign of injury to the head. Symptoms can take days to appear, so the individual and those close to them need to remain vigilant.

According to Shaw, the protocol for anyone who is believed to have suffered a concussion is to take them to the emergency room where a CAT scan may be recommended to rule out bleeding in the brain. If it turns out to be a “mild” concussion, the symptoms will likely resolve on their own.  

“Most concussions will heal with appropriate physical and mental rest. However, if symptoms don’t resolve in a timely fashion, then we start getting concerned and looking into additional treatment,” Shaw said.

When symptoms don’t go away, or get worse, a person may be referred to a physiatrist — which is a specialist in sports medicine and rehabilitation — for further medical evaluation and treatment. Those who could benefit from additional assistance can also join the TBI Support Group at SNMH.

For information about this group or other services offered, contact SNMH Neurological Rehabilitation Services at 530-274-6170.

While it’s important to be armed with information, the key is always prevention. Get outside and enjoy winter fun, but do so safely.

All physicians providing care for patients at SNMH are members of the medical staff and are independent practitioners, not employees of the hospital.

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