Nina Hoffmann Chose Not to Race in Leogang Following Concussion Symptoms

 Look at Sam Gaze before and after his head injury at the Cape Epic.

 Cameron Mcadoo in supercross this year at Atlanta comes to mind as a counterpoint to this...and how the concussion was handled.. Multiple choices made throughout the process then he lined up and had that second crash. Now he's out for the season after another crash in mx...

 You can't be too careful, even the first hit can ruin your life. I have a mate who smacked his head while skiing last year, and it made him basically unable to function. Weeks barely able to get out of bed, headaches, weakness, fatigue and a host of mental problems triggered by it including anxiety attacks and severe depression. He didn't manage a full day back at work for 8 months and he's still a complete mess. If you fall and hit your head, just walk or cruise out and take some time off. It's not risking that trip through hell.

 I'm sure we'd all agree on the "should", but what about the "could"?
Could it actually work in DH and what would it look like?
How would riders be compelled to report head-related injuries?
Who would administer?
Maybe there's a feature idea in this Pinkbike?

 @chakaping: whats so hard about it? There are eyes all over the course. The sad thing is when you can see a guy get his sack ripped off filmed from 3 different angles and get no immediate medical attention OR first aid by anyone else. It really isn't complicated as long as athletes are more important than a result.

 @RonSauce: You've just explained what's so hard about it. If medical provision for acute conditions such as Payet's (and not to mention Brook's back) is so patchy already, how will less-obvious conditions like concussion be effectively monitored and rules enforced?
I'm not saying it's not possible, just asking what it'd look like. I'm not sure expecting bystanders to report potential concussions is either realistic or adequate.

 We have it at our club here in South Australia. It's a very simple if in doubt, sit it out rule. This was implemented after constant debates with riders and parents on whether they are fit to ride. Now they don't get a say unless the medics say so, or they provide a letter from their doctor. So any big hits that get reported the rider has to head to our medics and if there is any slight hint of cuncusion the rider is not allowed back on track. It really isn't that hard to implement and riders are pretty easy to chat to about it. They often start off annoyed but once we explain that it's not their decision, it's club rules, plus adding that they are putting huge risk on our club, their family and others they always agree that it makes total sense to sit it out. And although it can be hard to implement, with constant reminders to riders to look out for each other, having proper medics on track, photographers carrying radios and proper course marshaling the risk can be reduced significantly.

 @chakaping: i agree that it is hard to evaluate and at first sight not very objective. This is why concussion is so dangerous, but i think it could be safer. If a rider get a hit on the head than she/he should visit the doctor on site, plus you can use a cheap G sensor and set a threshold and there are a lot of cameras and event organizers on site so the riders hands are tied. Then there are multiple neurological exams in cuncussion diagnostics which can be implemented in DH racing too.

 Maybe you missed the part where she was evaluated and cleared to race by an on site physio?

 @Dudeclimbsrocks: no, i did not. But its not a big conussion protocol if a physio takes a look at her.

 @Dudeclimbsrocks: I think the physio mentioned is employed for the races by Santa Cruz though. Who arguably have an interest in Nina racing.
While I'm sure the physio acted totally appropriately, I'm still not sure that equals a robust system of clinical governance.
Would be good to hear what the race medics & physios think, as I suggested above - it would make a worthwhile feature.

 @galuska: A mulit axis g sensor would help. I'm no expert, but from a book I read it's very complicated: the g force for concussion in one direction is different than others, i.e. hitting the back of the head vs the side. And rotation plays a huge role. Plus everyone is different and g limit for a concussion would be averages at best. Having the type of multi axis g sensor[s] that measure x, y ,z and yaw, pitch, roll would generate a lot of useful data tho. Not sure if the sensors are cheap and more importantly, small/light enough yet to be integrated into helmets without making them too impractical or less safe. Anyone more up to date on accelerometer tech?

 Uuhh, the article clearly stated she had to pass a concussion protocol. She then decided her head space wasn't right to charge a WC track. Comment makes no sense.

 Yet another reason they need a rider's union. One reason it works like that in NFL and NBA is that they have some collective bargaining power as well as some guarantees on contract for professional athletes. In the cutthroat world of professional MTB, you're only as good as your last race. So, even if you're on a "supportive" team, you always feel that your contract is in jeopardy and you may get discarded and lose your livelihood if you don't go out and perform.

The culture of MTB and its relationship with its athletes needs to change. I think that article series that PB did on athlete pay and attitude toward injury/health care costs was a great step in the right direction.

 @galuska: A physio should stick to his stuff- concussion symptoms and other brain related injuries are not his profession.

If she gets a pass from a neurologist- fair enough.

 @NotNamed: exactly, i was meant to write this.

I googled wheter the UCI has a protocol on concussion and it does have (sort of). From 2021 the non medical staff is prepared to evaluate a concussion and if they notice symptoms then they report it and the racers need further examination and rest time. Its not the safest, nor the most sophisticated protocol but they started to take it more serious.

 @NotNamed: Physios are not ER doctors so maybe should not be the ones making emergency treatment decisions, but physiotherapists definitely do work with neurological and brain injuries.

 None of this makes any sense. How can you even be able to organise a world cup race without an on site standby race physician just for legal liability's sake?

I can already imagine the press release. "Yeah, they thought they could do the race, so who are we to say no, right haha?"

 I agree 100% there needs to be an independent neuro there to make the determination....but Case Keenum is a great example of the NFL's system totally failing a player a few years ago.

 @acrowe: True but the Problem with a lot of brain damages is that you wont see sidd effects on the outsidd- and when you see them the person is in life treathening danger.

A physio doesnt scan your head etc - I dont get it why a physio gives her a go- that surely not work done "lege artis"

 Would like to have some input from a company like @KaliProtectives on this. Would a sensor like this provide a decent first indication or is it still all over the place. From what I understand, it are the oblique impacts that do most harm. But how would a sensor distinguish that from a straight impact? Plus, if it is about the acceleration of the head (not the helmet shell), would it be something the helmet could even measure? Not meant to be sceptical, more to pick up an idea from the comment section and trying to invite some expert views on (which I trust Kali for, but sure there must be others). Tests only work if people trust them, after all. How reliable is such a system compared to the rider's perception (which isn't too great) or to the basic tests performed by a trained course marshall (which should be better). If it is promising then yeah by all means develop it and make it public (possibly a crowd funding campaign could work?) instead of make it one more proprietary system. Gravity mountainbiking may not even be such a huge market, but there are more helmet sports where more money is made and lost. I recently read in the news that this self proclaimed greatest country in the world scrapped the notion that a black athlete's brains would be worth less than a white athlete's brains so they've some catching up to do repaying some athletes with football induced brain trauma. Which inherently implies it is actually worth more money up front to prevent brain trauma in the first place.

www.cbsnews.com/news/nfl-race-norming-settlements

 I work for TLD and I've gone to a few events with these types of meters in hand to test on our athletes. One type was a bonnet/beanie sort of thing and another was a module I attached to helmets, thankfully the meters were not needed at those events I tested! I did leave them with athletes to take home and they did get 'used'.

Problem was, they did not measure rotational forces, they measured linear g-forces (and poorly at that) and as we have learned (and we are still learning) rotational forces are assumed to cause the bulk of concussion symptoms in the brain. We are still testing these devices, but to the best of my knowledge, none really do what we need them to do-yet.

I agree with many commenters on here in that we commend Nina and the people around her to help her make the wise decision not to race.

I also agree racing needs better protocol in the future-but hey, watch supercross, they have 'protocols' and they have 'medical staff on track' and too often someone that should NOT be racing gets cleared.

I have been embedded in MTB racing since the late 80's, and I will say, if anything we have come a long way in acceptance of riders/teams/staff that choose to be wise and NOT compete after concussion-or any injury. For so long, I watched (myself included) people tell an athlete "shake it off, get back out there" and that attitude is slowly disappearing and that is great.

My wife (MTB legend Leigh Donovan) I recall, mt snow vermont, she was leading the norba DH points and slalom overalls, she crashed in practice (99 or 2000 I think) and hit her head hard, couldnt see out of one eye for a moment, head ache, etc classic concussion symptoms. She 'recovered' before the finals but crashed again and that memory haunts me because all of us (and the athletes) just were trained to shake it off, get back out there and it was a mistake.

We have made a lot of progress in mentality, technology, but still lots of room for improvement. Get well Nina-the sport needs people like you and thank you for telling the fans that it's ok to step away from a race for the sake of good mental health.

 Locating the sensor in the helmet: the helmet is doing everything it can not to transfer the forces it experiences interfacing with the ground to the wearer. So a helmet-mounted sensor hypothetically could accurately report the forces imparted to the helmet, but what we want to know is the forces imparted to the wearer. I know they never caught on as a very popular piece of protective gear in MTB, but I think something like a mouth guard which is stationary and closer to the center of the head might be a better non-invasive site for sensors for DH, slalom, BMX, slopestyle

 Wow healing vibes mate

 Back in the day, when no helmet was the only cool option, I went snowboarding and got a decent hit to my head ... to make it worse, young and dumb I went drinking with the mates in the evening. I only had minor symptoms (headache, etc. that I attributed to the booze). A week later, the first time i had to write a longer text, I noticed that something with my handwriting was off. I could not write certain words in one try, and it took more than 2 years for that to disappear. That was scary as f*ck. Take good care of your head, this ain´t a game!

 Oh, and wishing you all the best dude!

 I was thinking the same thing. Require all racers to complete and submit their baseline testing score prior to the season. Then you have data to help inform the decision on if they should return to play or not.

 The problem is we now know what these racers make. They are still being paid like they are disposable, its obvious companies aren't investing money in their athletes like bigger sports. Imagine suffering a life changing injury for a job that pays less than McDonald's.

 I hit my head last winter skiing and did a bit of googling to see what the recommended guidelines. What I read seemed to indicate that if there was any loss of consciousness the recommendation is minimum 2 weeks off from any activity where you could hit your head, and not returning to those activities until you've had at least 1 week of no symptoms. We've all seen articles recently of the dangers of having a second concussion before the first one heals.

 So glad that riders like K Courtney and Nina are taking it upon themselves to change the culture around concussions.

 @Clavdivs: yup!

 lmao you speak like a physio diagnostic is acceptable. it's a fucking joke that they rely on a physio for such things

 Making assumptions about the physio's capability like this is not helpful. I've just spent 18 months recovering from concussion. I saw probably 10 different professionals, including 2 neurologist's, 3 physio's, osteopath, concussion therapist... It was the last physio I saw that understood and helped me recover from my injury.