title: Mechanisms of head injury in bull riders with and without the Bull Tough helmet--a case series.
abstract: BACKGROUND
  Bull riding is one of the most dangerous sporting activities of the modern era. Head injuries are common in bull riders, yet helmets and faceguards are rarely mandated in competitive bull riding events and few participants use such protective headgear.
  
  
  OBJECTIVE
  The purpose of examining this case series was to characterize head and face injuries in bull riders, to gain a better understanding of the mechanisms associated with the various injury types and to assess the effect of wearing the Bull Tough Helmet (BTH).
  
  
  METHODS
  A survey was sent to 320 bull riders, asking them to provide details about the head and face injuries they had sustained while bull riding with and without the BTH. Eighty-one (31%) of the 265 surveys that reached their intended athlete were completed and returned. Riders were also asked to describe specific incidents where the BTH had saved them from head injury.
  
  
  RESULTS
  Respondents described 84 incidents of injury while not wearing the BTH; 110 injuries resulted. Respondents described 33 incidents of injury while wearing the BTH; 39 injuries resulted. Specific mechanisms and injury types were reported for both cohorts with concussions, lacerations and facial fractures being the most common injury types. In addition, respondents described 170 events in which an injury was prevented by the BTH.
  
  
  CONCLUSIONS
  Bull riders are at great risk of suffering severe head and facial injuries. Safe and effective helmets with protective face guards must be worn by bull riders if the incidence of these injuries is to be diminished. Organizations, promoters and schools that sponsor bull riding events, especially for minors, should mandate protective headgear in order to better protect these athletes.
authors.affiliation: Trauma Emergency Center, St. Francis Hospital, 6161 S. Yale, Tulsa, OK 74136, USA. mark-brandenburg@ouhsc.edu
authors.forename: Mark A
authors.initials: MA
authors.lastname: Brandenburg
authors.forename: Pam
authors.initials: P
authors.lastname: Archer
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D001265:Athletic Injuries / Q000209:etiology* / Q000517:prevention & control*; D002417:Cattle; D002648:Child; D006259:Craniocerebral Trauma / Q000209:etiology* / Q000517:prevention & control*; D006260:Head Protective Devices; D006306:Health Surveys; D006801:Humans; D008875:Middle Aged