Heads Up On the Slopes This Winter

Winter enthusiasts in the North Country live for days outside, but the inherent risks shouldn’t be overlooked. 

Traumatic brain injury (TBI) is a significant concern for skiers and snowboarders, accounting for up to 47% of injuries, with concussions comprising 70 to 90% of these TBIs. 

Understanding Concussion 

A concussion, a form of TBI, results from a jolt or blow to the head or body, causing the brain to move within the skull. Diagnosing concussions can be challenging, as they do not appear on MRI or CT scans.

“A concussion is not going to show up on imaging,” explains Alina VanRuff, an occupational therapist at University of Vermont Medical Center. “With a concussion, there’s no bleeding in the brain. It's more of a grouping of symptoms.”  

Still, if you suspect someone has a concussion, see a doctor immediately.  

Beyond the Slopes 

Concussions are surprisingly common; nearly 20% of youth hockey players experience a concussion annually, and non-athletes are also at risk. Falls, whether down stairs or on ice, are the most common cause. While headaches, concentration issues, and nausea are well-known symptoms, others, such as slurred speech, blurred vision, and ringing in the ears, may be less familiar. Symptoms can persist for days, weeks, or longer, affecting balance, mood, and sleep.

“No brain injury is created equal,” notes Meredith Bushey, a speech language pathologist at UVM Medical Center. “Symptoms vary from person to person.”  

Repeated concussions can lead to serious mental health challenges and brain disorders including Alzheimer’s disease and chronic traumatic encephalopathy (CTE). 

Staying Safe This Winter 

To protect yourself and loved ones, consider the following safety measures: 

• Wearing a well-fitting helmet on the slopes or while playing ice hockey. 

• Ski or snowboard in control and adhere to mountain rules. 

• Use ice grips or spikes for traction when walking on ice. 

• Recognize the signs and symptoms of concussion. 

• Seek medical attention if you fall and are over 60, especially if taking blood thinners, which increase the risk of brain bleeding. 

Helmets and Concussion Prevention   

The good news is that helmet use among skiers and snowboarders has risen from 25% in the 2002-2003 season to 90% in 2023-2024, according to the National Ski Areas Association (NSAA). While helmets help prevent skull fractures and severe brain injuries, they are less effective at preventing concussions. Nevertheless, they are always recommended. "We urge all participants to wear a helmet but to ski or ride as if they are not wearing one," advise NSAA experts. 

Recovering from Concussion   

Recovery from a concussion involves balancing rest with gradual exposure to activities and stimuli, such as jogging, screen time, light and noise. VanRuff explains that computer screens, which emit blue light, can be particularly challenging for those with light sensitivity.

"Resting in a quiet room with your eyes closed will help you feel better but won't necessarily speed recovery," she says. "If you continue to isolate from the things that trigger symptoms, you create a greater intolerance to those things." 

Most concussion symptoms resolve within 10 to 14 days, but they can linger for weeks. Post-concussive syndrome occurs when symptoms persist beyond three months. Recovery may be slower for older adults and those with previous brain injuries, as having one concussion increases the likelihood of another. 

"Think of a concussion as an injury that requires rest and rebuilding strength," VanRuff advises. "It's about gradual exposure and returning to prior activities based on how you're feeling. It's a matter of finding that balance of doing things a little bit at a time."