When the International Motorsports Industry Show announced Dr. Terry Trammell would be hosting a seminar on youth safety in motorsports, I knew it was an event NKN had to attend. For those of you who don’t know Dr. Trammell, simply put over the past twenty years he’s the surgeon who “rebuilt” almost every Indycar driver after they attempted to turn their bones into dust. He is also a consultant with the FIA and CIK regarding karting safety.

Along with Dr. Trammell, there were a number of experts in motorsports/sports psychology, concussion, and safety speaking. Bob Hills from IRL Ministries is a sports psychologist. Dawn Flinn is a licensed audiologist who makes molded earpieces for most professional drivers and a number of bands, and Jeff Horton the Director of Engineering for the IRL. Two other speakers included Doctors Dan Thomas of the Snell Foundation and Michael Turner of the Goodman Campbell Brain and Spine Institute.

The topics were simple, yet so important to the future, prosperity and growth of racing. Hills was the first speaker and would give an insight to how the young competitive mind works and how young drivers weigh the risk versus reward factors while driving.

Bob Hills, Indy Racing League Chaplain and Sports Psychologist

Hills started his speech with some sobering statistics about motorsports death to racers under the age of seventeen. From www.motorsportsmemorial.org, Hills had obtained some statistics from 1995-2008 there has been 595 motorsports related deaths including drivers, spectators, mechanics, and other race personnel. Of those, forty-four were karters, sixteen were from the United States and four were age seventeen or under (two were 9, one was 12, and 1 was seventeen).

As one of the Chaplains for the Indianapolis Motor Speedway, Hills continued talking about a story that hit him a little closer to home. Peter Lenz, the 13-year-old rider who was killed at the US Moto GP at Indianapolis earlier in 2010. Lenz, was a protégée and expected to be a major star in Grand Prix motorcycle racing in the next decade. However, in 2009 Lenz had a serious accident in which he broke several bones.

Following this story, Hills stated a theory and raised the question if it was “true or false.” The theory is: “the greater a racer’s performance is, the less likely they are to be involved in an accident.”

Hills believes this theory to be true, and part of the reason is the result of some studies done by a sports psychologist, Dr. Michael Henderson, that concur as a young competitor’s skills increase their fear (subliminal or not) decreases.

“I believe and statistics show that through experience, coaching, etc. any racer, especially young racers, are less likely to be involved in a major accident,” stated Hills. “And these coaches have to be involved in more than just on-track coaching.”

Hills continued to explain the role coaches should play off the track in greater detail (and this will be a feature story in a future NKN issue). It involves developing a strong relationship and understanding of the driver’s skills, thought process, and other aspects of their mental development and psyche.

“One of the questions I’m often asked is, ‘what is the right age for my child to begin racing?” continued Hills. “That answer is always ‘depends on the child’ as every child is different, and the parent should know their child better than anyone.”

Hills went on to talk about the importance of education, and how good grades should be a reflection of the young racer’s desire and maturity level. He recommends, “Don’t home school your young racer, the development of social skills outside of racing are very important.”

There are other important questions Hills (and other experts) would like to see a parent and young racer answer before hitting the track:

• Does the child really want to do it and how do you know?

• Are they (the child) having fun?

• Look for stressors caused by racing: other siblings, financial, social, parents/marriage. “Parents are one of the biggest problems for a young racer,” stated Hills.

• What are the parents expectations? 99.999% of young racers will not drive professionally in motorsports. “The dream needs to be the racer’s dream, not dad or mom’s,” stated Hills.

Finally, Hills concluded his portion of the seminar with a statement all too well known in the karting world, but rarely acted upon. “We need some level of licensing for young racers.”

Dawn Flinn, Audiologist & Owner of Ear Everything

Following Hills was the leading lady of soundproofing ears for motorsports and a number of today’s hottest bands. Dawn Flinn is a licensed audiologist and through her company, EAR Everything, she tests hearing and produces custom ear molds (for noise reduction and in-ear earphones).

Flinn talked how quickly a racer’s ears, especially young ones, can be damaged from the intense or continuous noise. “Guys who have been around the track without ear protection for say ten years, typically have noticeable hearing damage,” says Flinn. “Sometimes it’s the difference between hearing: “car on fire” versus “car lost tire.” That’s just one of the reasons to always wear ear protection while at the track.”

As a long time customer of Flinn’s, I can vouch for the advantages of custom-made earplugs. They work, fit comfortably, and in the kart actually help reduce my engine’s noise allowing me to hear other nearby karts better.

Jeff Horton, Indy Racing League Director of Engineering

Jeff Horton has been with the IRL for a number of years and is currently the director of engineering. Horton was part of the team that instituted all Indycar drivers having accelerometers built into their earplugs. In a crash, these accelerometers provide crucial data to medical personnel, helmet designers, and car builders. He is also in charge of crash investigation for the IRL, and stated that “crash boxes” in Indycars consistently record 60-70G hits with spikes between 100-200G!

Being a father of a Junior High aged football player, motorcross rider, and “future karter in 2011,” Horton also has a personal interest in understanding and preventing head injuries to young racers and athletes. Two years ago, he purchased a special football helmet from Riddell that has accelerometers built into it to measure the force of “hits.” The helmet and accompanying software measures total hits, highest G’s, and cumulative G-forces over the course of a season. The numbers were staggering with the highest G-force recorded over 80 G’s and the total cumulative G’s being over 1,000 in a season.

“Don’t underestimate a hit,” stated Horton. “The highest hit we saw was over 80 G’s; now, that was measured on the helmet (whereas the in-ear accelerometers used in Indycar measure ‘inside’ the head).”

On November 1, 2010, Sports Illustrated released a comprehensive article and study on concussion, specifically in football. Part of the data included test results from a Purdue University study that concluded the quantity of hits was as much of a factor as the severity of the hit. But much of the information can be applied to karting.

“One of the things all our drivers do is a baseline ImPACT test,” continued Horton. The ImPACT test is an online neurocognitive exam that is the most recognized and validated computerized evaluation system. After a baseline is established, athletes who sustain a concussion can retake the test and determine key “return-to-play” factors.

“One of the most important factors in football or racing is: make sure the equipment fits properly,” stated Horton. As Horton wrapped up his speech, Dr. Trammell added a few points about concussion.

“You don’t have to have a ‘big hit’ to have a concussion,” stated Dr. Trammell. “Also, don’t ignore the warning signs. One of the first things we ask a driver is a ‘recent memory question’ like what happened or what event are we at?”

“Concussion is possible without being knocked unconscious,” stated Dr. Trammell. “A lot of it has to do with the head’s rotation not just the G load.”

Dr. Dan Thomas, Snell Foundation

Smoothly transitioning from Horton’s data on concussion and G loads of an impact, Dr. Trammell introduced the next speaker: Dr. Dan Thomas from the Snell Foundation. Every racer has heard and is influenced by Snell Foundation, and 2011 was an important year to be familiar with Snell because most major sanctioning bodies updated their requirements to “Snell 2005” helmets.

The Snell Foundation is known for its ongoing work in setting, maintaining, and continually upgrading the most authoritative helmet standards in the U.S. and throughout the world. “Snell develops standards for a ‘one shot’ use,” stated Dr. Thomas. “Our efforts are to prevent fatality and prevent permanent brain injury.”

The latest Snell 2010 standard helmets were released mid-2010. There are other standards around the world including CM standard (which is the Snell/FIA standard), DOT (SFI), and the ECE 22-05 standard. Check with your local sanctioning body to assure your helmet meets or exceeds the standard they call for.

Dr. Thomas presented some additional statistics on fatalities and injury in motorsports. Since 1990, there have been ninety deaths of racers under age fifteen, 113 total were karters, and there were 12,000 injury treatments as a result of motorsports in that time period (Editor’s note: we were not able to ascertain the source for these statistics).

Helmets prevent injury by decreasing and distributing the force of the sudden stop (if even for a fraction of a second, the head does stop in an impact) both linear and rotation, although there are no equipment standards yet developed for rotational forces. A helmet, namely the shell, helps distribute the energy of the impact across its surface.

Dr. Thomas then talked about the variances in the different ages of drivers pertaining onto how their brains are affected by a major impact. Younger drivers have a much greater tolerance than racers who have fully developed skulls and brains. Racers over the age of 45 seem to have a significantly higher potential to suffer greater and more permanent brain injury –citing the example of Colorado’s Rich Vito, age 61, who passed early in 2010 from injuries suffered in 2009.

Dr. Thomas explained how helmets work: “Helmets work with space and time. The ‘space’ being defined as the thickness of the helmet: the space between the point of impact and the skull. And time being the time it takes to dissipate the impact’s energy. The hard shell spreads the load of the impact, while the thick/dense foam increases the time it takes for the energy to reach the driver’s head.”

All the pieces of the helmet must work together: the shell, the foam, and the liner each serve a unique purpose, but rely on the other to prevent injury. At this point, Dr. Thomas displayed a rough graph to explain how the shell, foam, and liner of a helmet work together in an accident against force and time.

On the vertical plane, the force of the accident is represented, and on the horizontal plane time (the time from the start of the accident until the car stops). The initial hit, and a majority of the force, is first absorbed and distributed by the shell. The foam and liner distribute the energy from the accident over as much time as possible to bring the head and neck to as slow (peaceful) stop as possible.

Over the past decade, Snell has worked to develop helmets specifically designed for youth (under 12 racers). There are two key differences between the design of an adult racing helmet and one for a child.

The first difference is weight. When Snell started their study and development of youth racing helmets, the average adult racing helmet weighed in at 2000g (today, the lightest weight helmets are down to 1300g). A child’s neck strength simply isn’t strong enough to hold up a helmet of that weight, especially over the course of a ten-lap plus race. Therefore, Snell mandated a recommended maximum weight of 1100g for a child’s size helmet (driver with head under 49cm in circumference).

Secondly, youth helmets needed to be made to fit their facial structure. While a child and adult may have the same size crown (or at least 7/8 the size), the facial features of a child are much smaller; therefore, the helmet design must be modified from the temple area down through the jaw-line to accommodate.

Dr. Thomas offered “no recommendation” for helmets for drivers under age six, as most of the helmets are still to large for their heads. “Get the smallest helmet possible,” stated Dr. Thomas, “but not too tight.”

Dr. Thomas wrapped up his portion of the program discussing the new materials being used in motorsports helmets. The ‘latest/greatest’ helmets are being made out of carbon fiber and do a much better job than fiberglass or Kevlar in the distribution of energy due to it’s high rigidity.

Dr. Michel Turner, Neurosurgeon and Leading Expert on Concussion in Sports

Dr. Turner began his speech by saying much of the information he was going to discuss was available at www.cdc.gov/concussion/index.html. In much of his speech, he reiterated a number of the points already made.

One of the new terms Dr. Turner introduced was the “second impact syndrome.” A mild, possibly unknown, concussion can lead to amplified damage should a second impact occur before the first is properly healed. This is especially a problem with the “immature brain” (a subject under the age of 25).

Dr. Turner stressed the importance of creating a “concussion policy.” He cited the example of the Indiana High School Athletic Association’s “3 and out” (for the season). While this might be extremely rare in karting, a possible concussion should not be ignored.

“The policy of ‘shake it off’ is wrong,” stated Dr. Turner. “Racers and athletes lie, letting them back in the car or game could have consequences should another hard impact occur.”

In addition to some of the symptoms described earlier in this article, Dr. Turner said a caregiver, coach, official, etc. should look for fatigue and sensitive to light in a concussed athlete/racer. He does not believe they should return to driving until they “100% return to normal physical and mental functions.”

“My advice to any race promoter would be to have a concussed driver get written clearance from a Doctor before allowing them back on track,” concluded Dr. Turner. Dr. Trammell concurred and added that most sanctioning bodies, especially those in ‘miniature motorsports’ (like karting) do not have a medical officer on staff that has the final decision on whether or not a driver is physically fit to return to the track. A medical officer doesn’t necessarily have to be a Doctor; any medically train person (RN, EMT, etc.) should be able to recognize the signs of a concussion and have the authority to send the driver for further medical evaluation before allowing them to return to the track.

Dr. Terry Trammell, Orthopedic Surgeon and Indycar “Medical Legend”

With the bulk of the discussion already having been on helmets and concussions, Dr. Trammell shifted gears a bit and discussed neck and spinal cord injury. “The flexibility of the neck of children is great,” stated Dr. Trammell. “But the spinal cord is not.”

SFI 38.1 standard (8858 FIA) is essentially the HANS device standard. The HANS device became popular around 2001 as an effective piece of safety equipment to prevent basal skull fracture.

For forms of motorsports that “no belts are required” (like most of karting), there are pieces of safety equipment, like the Leatt Brace, that Dr. Trammell acknowledges will help prevent basal skull fracture and could earn the SFI 38.1 rating. However, he stressed that he has no additional data at this time to support that any of these types of head and neck restraints prevent other injuries saying pieces like the Leatt Brace are hard to test in simulations or a laboratory. Dr. Trammell did stress that it has to fit well or he believes it could cause other injuries. For example, should it get shoved up under the helmet the larynx could be crushed (Author’s note: this could probably be prevented by wearing the included straps that goes around the driver’s chest and holds the Leatt in place. Most karters seem to disregard them).

“We just don’t have the data yet,” declared Dr. Trammell. “But what we do know is the head and body have mass, and the neck does not. Stopping the neck safely is just as important as stopping the head and body in an accident.”

A question from the audience arose, do the foam neck collars required by karting sanctioning bodies and insurance providers do anything to prevent neck injuries? Dr. Trammell stated, “We have no evidence that foam neck collars help with anything. They are so soft it doesn’t do anything. They don’t do any harm either, but they don’t do anything for the neck.”

As Dr. Trammell began to wrap up his speech, he stated his opinion on Nomex suits and where they (or at least Nomex underwear) should be made mandatory in motorsports. “Do you need a fire suit? Yes, if your car has fuel.”

Dr. Trammell then sited some economic facts that should persuade anyone who thinks of skimping on safety think twice. “If you are transported to a hospital for any auto racing accident is automatically a ‘Trauma 1’ with a minimum cost of around $13,000.”

“If you would be required to have a Pan Scan (a head to hips scan), you can only have two of those in a lifetime,” stated Dr. Trammell. “Anymore than that and the cancer risk rises to eight in 1,000. The amount of radiation exposure after the Hiroshima bomb was half that of a Pan Scan.”

Dr. Trammell stressed that safety should be a way of life for a racer, something they are always looking to improve without complaint. He said when they ‘suggested’ the use of the HANS device in Champ Car, they met with a lot of resistance from drivers (regarding comfort and lack-of head movement). However, when they made the HANS device mandatory in the Skip Barber series with the younger drivers, there were no complaints. “Start the safety mindset young, and it will become the norm.”