Chapter 6: Selecting and Using Protective Sports Equipment

1
Chapter 6 Selecting and Using Protective Sports
Equipment
2

• Selection, fitting and maintenance of protective
  equipment are critical in injury prevention
• Athletic trainers and coaches must have knowledge
  of protective equipment available for different
  sports and proper fitting procedures
• Protection is critical in contact and collision
  sports

3
Safety Standards for Equipment and Facilities

• Concerns relative to materials, durability,
  establishment of standards, manufacturing,
  testing methods, and requirements for use
• Must be in place relative to maintenance
• Concern should be protective ability not
  appearance of equipment
• A number of groups and agencies are involved in
  standardizing sports equipment and facilities

4
Equipment Reconditioning and Recertification

• NOCSAE has established test standards in order to
  reduce head injuries
• Set minimum safety requirements for helmets and
  masks for football, baseball/softball and
  lacrosse
• Accepted standards for various regulatory bodies
  in sports
• Type of helmet, amount of use/intensity will
  determine condition of help over a period of time

5

• NOCSAE label does not warranty helmets
• Indicates helmet met requirements when
  manufactured or reconditioned
• NOCSAE recommends reconditioning and
  recertification of equipment
• Consumer should use discretion based on use

6
Legal Concerns

• Increasing amount of litigation regarding
  equipment
• Must foresee all uses and misuses and warn user
  against potential risks inherent in equipment
  misuse
• If equipment results in injury due to defect or
  inadequacy for intended use manufacturer is
  liable
• If equipment is modified --modifier becomes liable

7
Off the Shelf vs. Custom Protective Equipment

• Off the shelf equipment
• Pre-made and packaged
• Can be used immediately
• Neoprene sleeves, inserts, ankle braces
• May pose problem relative to sizing
• Customized equipment
• Constructed according to the individual
• Specifically sized and designed for protective
  and supportive needs

8
Head Protection

• Direct collision sports require head protection
  due to impacts, forces, velocities and implements
• Football Helmets
• National Operating Committee on Standards for
  Athletic Equipment (NOCSAE) develop standards for
  football helmet certification
• Must protect against concussive force
• While helmets must be certified, they may not
  always be fail-safe
• Athletes and parents must be aware of inherent
  risks

9

• Each helmet must have visible exterior warning
  label
• Label indicates that helmet should not be used to
  strike an opponent due to risk of injury
• Also indicates risk of injury accidentally and
  that athlete plays at own risk while using helmet
• Athlete must be aware of risks and what label
  indicates
• Athlete reads and signs statement regarding
  warning label
• There are a number of helmet manufacturers, and
  even more have closed due to lawsuits and
  liability cases

10
(No Transcript)
11
Helmet Fitting

• When fitting head/hair should be wet to simulate
  sweat
• Follow manufacturers directions
• Must routinely check fit
• Snug fit (credit card test)
• With change in altitude, bladder helmets must be
  rechecked
• Chin straps (2, 4, or 6 strap systems)
• Jaw pads are essential (prevent lateral rocking)
• Certification is of no avail if helmet is not fit
  and maintained

12
(No Transcript)
13
Baseball/Softball Batting Helmets

• Must withstand high velocity impacts
• Research has indicated that helmet does little to
  dissipate energy of ball
• Possible solution would be to add additional
  external padding
• Helmet must still carry NOCSAE stamp (similar to
  football label)

14
Baseball/Softball Batting Helmets
15
Cycling Helmets

• Designed to protect the head during one single
  impact
• Football, baseball, and hockey helmets are more
  durable and can survive repeated blows
• Many states require use of cycling helmets,
  especially for adolescents

16
Face Protection

• Four categories
• Face Guard
• Has reduced the number of facial injuries
• Number of concussions has increased because head
  is most often used in initial contact
• There are a variety of protective options
  depending on sport and position
• Proper mounting of the mask must occur with no
  additional attachments that would invalidate the
  manufacturers warranty
• All mountings must be flush to the helmet

17

• In high school hockey, face masks are required
  (with white plastic coating) that meet Hockey
  Equipment Certifications Council and American
  Society for Testing Materials
• Opening can not allow passage of sticks or pucks
• Additional polycarbonate face shields are also
  available
• The use of throat protectors is also mandated at
  some levels
• Throat Protection
• Laryngotracheal injuries, while uncommon can be
  fatal
• Baseball catchers, lacrosse goalies and ice
  hockey goalies are most at risk
• Should be mandatory in these sports

18
(No Transcript)
19

• Mouth Guards
• Most dental injuries can be prevented with
  appropriate customized intraoral mouth guards
• Protect teeth, minimize lip lacerations, absorb
  shock of chin blows, and prevent concussions
• Should fit comfortably, not impede speech or
  breathing
• Should extend back as far as last molar
• Constructed of flexible resilient material formed
  to fit teeth and upper jaw
• Do not cut down mouth guard as it voids warranty
  for dental protection and could become dislodged
  and disrupt breathing
• Three types
• Stock
• Commercial (formed following submersion in water)
• Custom (fabricated from dental mold)
• Mandated use in high school and collegiate levels

20

• Ear Guards
• Most sports do not use
• Wrestling, water polo and boxing utilize to
  prevent ear irritation and ultimate deformity of
  ears

21

• Eye Protection
• Highest percentage of eye injuries are sports
  related
• Generally blunt trauma
• Glasses
• May slip on sweat, become bent, fog, detract from
  peripheral vision or be difficult to wear with
  headgear
• Properly fitting glasses can provide adequate
  protection
• Lens should be case hardened to cause crumbling
  and not splintering on contact (disadvantage
  increased weight)
• Polycarbonate lens is virtually unbreakable
• May have polarizing/tinting ability
• Plastic lenses while lightweight are easy to
  scratch

22

• Contact Lenses
• Become part of the eye and move with it
• Corneal and sclera lenses
• Peripheral vision, astigmatisms and corneal
  waviness is limited
• Will not fog and can be tinted
• Disadvantages include cost, corneal irritation,
  possibility of coming dislodged
• Soft hydrophilic lenses and disposable lenses are
  very popular

23

• Eye and Glasses Guards
• Necessary in sports with fast moving projectiles
• Athletes not wearing glasses should wear closed
  eye guards to protect orbital cavity
• While eye guards afford great protection, they
  can limit vision
• Polycarbonate eye shield have been developed for
  numerous pieces of head gear
• Neck Protection
• Serve primarily as a reminder to athlete to be
  cautious rather than providing definitive
  restrictions

24
Trunk and Thorax Protection

• Essential in many sports
• Must protect regions that are exposed to the
  impact of forces
• External genitalia, bony protuberances,
  shoulders, ribs, and spine

25
(No Transcript)
26

• Football Shoulder Pads
• Two types
• Cantilevered - bulkier and used by those engaged
  in blocking and tackling
• Non-cantilevered - do not restrict motion
  (quarterback and receivers)
• Rules of fitting
• Width of shoulders must be measured
• Inside of pad should cover tip of shoulder in
  line with lateral aspect of shoulder
• Epaulets and cups must cover deltoid and allow
  motion
• Neck opening must allow athlete to raise arms
  over head w/out pads sliding forward and back
• With split clavicle pads, channel for top of
  shoulder must be in proper position

27
Non-cantilevered
Cantilevered
28
(No Transcript)
29

• Straps underneath arms should hold pads firmly
  in-place, w/out soft tissue restriction
• Combinations of padding (football and hockey) may
  be used to supplement padding and protection
• Sports Bras
• Significant effort has been made to develop
  athletic support for women
• Most designed to minimize excessive vertical and
  horizontal movements that occur with running and
  jumping
• To be effective, should hold breasts to chest,
  preventing stretching of Coopers ligament

30

• Types available
• Compressive (bind breasts to chest wall -
  recommended for medium size breast)
• Support (heavy duty with additional upward
  support for larger breasts)
• Lightweight elastic (compression and support not
  as critical for smaller breasts)
• Thorax Protection
• Thorax protectors and rib belts
• Protect against external forces
• Air-inflated interconnected cylinders (jacket
  design)

31
Hips and Buttocks

• Required in collision and high-velocity sports
• Boxing, snow skiers, equestrians, jockeys and
  water skiers
• Girdle and belt types

32
Groin and Genitalia

• Sports involving high velocity projectiles
• Require cup protection for male participants
• Stock item that fits into jockstrap or athletic
  supporter

33
Lower Extremity Protective Equipment

• Socks
• Poorly fit socks can cause abnormal stress on the
  foot
• Should be clean, dry and w/out holes
• Different types for different activities
• Composition
• Cotton can be bulky
• Cotton/poly blend are lighter and dry faster

34

• Shoe selection
• Number of options for multiple activities
• Guidelines for selection
• Toe Box - space for toes (1/2 to 3/4 inch of
  space from toes to front of shoe)
• Sole - provide shock absorption and be durable
• Spongy layer to absorb force
• Midsole that cushions midfoot and toes
• Hard rubber which contacts the ground
• Heel Counter - prevents medial and lateral roll
  of foot
• Shoe Uppers - top of shoe made with combination
  of materials, designed for appropriate
  ventilation, drying and support
• Arch Support - durable but soft and supportive to
  foot
• Price- due to impact on performance and injury
  prevention, may be worth the extra investment

35
(No Transcript)
36

• Shoe fitting
• Measure both feet, as there will be slight
  differences
• Approximate conditions of use
• Fit at the end of day due to gradual increase in
  volume due to weight bearing
• Should be snug but allow ample movement of foot
  and toes
• Should break at widest part, coinciding with ball
  of foot
• Must also consider width of shank, non-yielding
  nature of sole and function of arch support

37

• Cleated and specialty shoes may present problems
  with fitting
• Playing surfaces and activities must be
  considered
• Heel Cups
• Used for a variety of conditions including
  plantar fascitis, heel spurs, Achilles tendonitis
  and heel bursitis
• Used to help compress fat pad, providing more
  cushion during weight bearing

38

• Foot Orthotics
• Device for correcting biomechanical problems that
  exist in foot that can cause injury
• Plastic, thermoplastic, rubber, sorbethane,
  leather support or ready-made products
• Can also be customized by physician, podiatrist,
  athletic trainer or physical therapist
• More expensive

39

• Ankle Supports
• Alone or with tape -- they are increasingly
  popular
• Significant debate over efficacy
• Little or no impact on performance
• Compared to tape, the device will not loosen
  significantly with use
• Shin and Lower Leg
• Often overlooked
• Commercially marketed, hard molded shin guards
  are used in field hockey and soccer

40
Ankle Braces
41
Shin Guards
Thigh Pads
42

• Thigh and Upper Leg
• Necessary in collision sports
• Pads slip into ready-made uniform pockets
• Customized pads may need to be held in place with
  tape and/or wraps
• Neoprene sleeves can also be used for support of
  injuries
• Knee Braces
• Used prophylactically to prevent injuries to MCL
• AOSSM has expressed concern about their efficacy
  in reducing injuries

43

• Types of Braces
• Rehabilitative
• widely used following surgery
• Allows controlled progressive immobilization
• Adjustable
• Functional
• Used during and following rehab to provide
  functional support
• Ready-made and customized
• Neoprene (w/medial and lateral support)
• Used by those that have sustained collateral
  ligament injuries
• Some are also used to provide support in those
  that have patellofemoral conditions

44
(No Transcript)
45
Elbow, Wrist, and Hand Protection

• While the elbow is less commonly injured, it is
  susceptible to instability, contusions, and
  muscle strain
• A variety of products are available to protect
  the elbow

46

• Wrist, hand, and finger injuries are often
  trivialized but can be functionally disabling
• Susceptible to fracture, dislocation, ligament
  sprains, and muscle strains
• Gloves and splints are available for protection
  and immobilization