Protective Sports Equipment

1. Protective Sports Equipment Mrs. Dobbins Sports Medicine I

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

4. 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

5. 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

6. 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

8. 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

9. Legal Concerns • To avoid litigation, athletic trainer should follow specific use instructions of equipment exactly • If the athletic trainer’s modification results in injury the ATC and the institution are subject to a suit (tort)

10. 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

11. 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 be protective against concussive force • While helmets must be certified, they may not always be fail-safe • Athletes and parents must be aware of inherent risks

12. Head Protection • 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

14. Helmet Fitting • When fitting head/hair should be wet to simulate sweat • Follow manufacturer’s 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

16. Ice Hockey Helmets • Undergone extensive testing in an effort to upgrade and standardize • Must withstand high velocity impacts (stick or puck) and high mass low velocity impacts • Helmet will disperse force over large area and decelerate forces that would act on head (energy absorption liner) • Helmets must be approved by Canadian Standards Association

18. Baseball 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)

19. 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

20. 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 manufacturer’s warranty • All mountings must be flush to the helmet

21. Face Protection • 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

23. Face Protection • 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

25. Mouth Guards • 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

27. Mouth Guard • Do not cut down mouth guard as it void 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

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

29. Eye • 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) • May have polarizing/tinting ability • Plastic lenses while lightweight are easy to scratch

30. Eye • 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

31. Eye • 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

32. Neck • Neck Protection • Serve primarily as a reminder to athlete to be cautious rather than providing definitive restrictions

33. 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 • While equipment may provide armor it may also be used as an implement • Question must be asked concerning necessity of equipment and its role in producing trauma

36. Football Pads • 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)

37. Football Pads • 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 • 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

38. Non-cantilevered Cantilevered

41. Thorax • Thorax Protection • Thorax protectors and rib belts • Protect against external forces • Air-inflated interconnected cylinders (jacket design)

42. Sports Bras • 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 Cooper’s ligament

44. Sports Bras • Non-supportive bras, can cause rubbing and abrading of skin and nipples due to construction • 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)

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

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

49. 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

50. Shoes • 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 durable • Spongy layer to absorb force • Midsole that cushions midfoot and toes • Hard rubber which contacts the ground