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Dr. Charles TatorJENNIFER ROBERTS/The Globe and Mail

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With winter in full swing, it's time to get outside and enjoy the activities that make this season special, like tobogganing – but it's important to stay safe while doing so.

People may think it's enough to grab a toboggan and head off to the nearest hill, but you may be surprised to know that tobogganing has significant risks of injury. In fact, when I first entered medical practice as a brain surgeon, I operated on a young mother of two who broke her neck when she fell off a toboggan, leaving her a quadriplegic. This tragic incident was one of my motivations to make sports, including tobogganing, safer through research and education – a practice I continue to this day.

However, the risk of injury should never deter anyone from participating in this fun and timeless winter activity. This article is your prescription to being able to return to the tobogganing hills year after year.

Wear a helmet

All tobogganers should wear helmets to reduce the risk of brain injury. Brain injuries can occur in many ways in tobogganing: head hits the ground, head hits the toboggan, head hits another tobogganer, head hits a tree etc. In fact, while doing my own research on catastrophic injuries in sports and recreation for a book, I found that tobogganing ranked fourth on the list of sports and recreational activities in terms of personal risk –after diving, snowmobiling and parachuting. Even in my line of work, it was startling to me to find that tobogganing was that risky! Head injuries were frequent among tobogganers, and most could have been prevented by helmets.

Helmets provide great protection from almost all types of brain injuries (except concussions).

But remember, not all helmets are created equal

When choosing a helmet for tobogganing, a snow sport helmet is best, such as a skiing or snowboarding helmet. A hockey helmet is also good. Bike helmets are better than nothing, but must be discarded after one significant impact. Most bike helmets are single-impact helmets, while the other helmets mentioned are designed to withstand multiple impacts.

The helmet must also be worn properly. It must be a good fit so that it doesn't slide around on the top of the head, and the strap must be tight following the one-finger rule: only one finger should fit between the chin and the strap.

Select a safe tobogganing hill

Some municipalities like the City of Vaughan just north of Toronto have been terrific at designing and designating safe tobogganing hills. What is a safe tobogganing hill? It's a hill with no obstacles that could be struck on the way down, including trees, benches, water fountains, etc., and a hill that doesn't run-out onto a street.

A good toboggan hill is checked daily and closed if the conditions are too risky such as the build up of ice. It includes designated areas for tobogganers to slide down the hill and safe areas to walk back up the hill. It also has posted signs with safety messages including recommendations for the use of helmets.

..and a safe toboggan

Steerable toboggans are best, especially those that are close to the ground, but this doesn't include crazy carpets and snow racers. Don't use a toboggan with broken or projecting parts.

Position the toboggan properly

The sitting position, face forward, is the only safe position on a toboggan. Never go down the hill head first. Face down on your stomach with your head forward, is the most dangerous position.

And supervise

Adult supervision for kids under about 10 is essential. Kids should be instructed about where it is safe to go up the hill, and where it is safe to go down the hill as well as be told to move out of the way as quickly as possible once they reach the bottom of the hill.

Follow these steps and you're sure to have a good time this year and next.

Dr. Charles Tator is a neurosurgeon at the Krembil Neuroscience Centre of Toronto Western Hospital. He is also the founder of ThinkFirst, now part of Parachute Canada, a national non-profit organization dedicated to the prevention of brain and spinal cord injuries, and the research lead for the Canadian Sports Concussion Project which is studying the long-term effects of repetitive concussions.