© 2007 McGraw-Hill Higher Education. All rights reserved. Chapter 6: Selecting and Using Protective Sports Equipment

© 2007 McGraw-Hill Higher Education. All rights reserved. Selection, fitting, and maintenance of equipment is critical in injury prevention Must have knowledge of how to fit equipment for different sports Protection is critical in contact and collision sports Why does this matter?

© 2007 McGraw-Hill Higher Education. All rights reserved. Collision Football Hockey Lacrosse Rugby Contact Soccer Basketball Wrestling Non-Contact Baseball Softball Swimming Tennis Track/Field Sport Categories

© 2007 McGraw-Hill Higher Education. All rights reserved. Effectiveness more important than looks NOCSAE: o National Operating Committee for Standards in Athletic Equipment o Set safety standards for equipment NOCSAE has established test standards to reduce head injuries o Set minimum safety requirements for helmets and masks for football, baseball/softball and lacrosse o Colleges and high schools require the NOCSAE certification NOCSAE label is not a warranty The label indicates the helmet met requirements when manufactured or reconditioned Helmets must be reconditioned Safety Standards for Equipment

© 2007 McGraw-Hill Higher Education. All rights reserved. Legal Concerns Number of lawsuits are increasing If equipment results in injury due to defect or inadequacy for intended use manufacturer is liable If equipment is modified --modifier becomes liable

© 2007 McGraw-Hill Higher Education. All rights reserved. Who is liable? 1.A player is injured when his helmet cracks during a football game. The manufacturer’s guidelines state the helmet should be reconditioned every 2 years, but it the helmet has been used for over 3 years since it was last checked. 2.A player is injured when the padding inside the helmet moved and the side of the helmet injured the players neck beside his ear. The helmet was NOCSAE approved and still under warranty. 3.A player is wearing a knee brace, but complains it is too bulky and hot. The AT agrees to remove some padding. The athlete’s skin gets irritated and is infected with MRSA.

© 2007 McGraw-Hill Higher Education. All rights reserved. Off-the-Shelf vs. Custom Protective Equipment Off-the-shelf equipment o Pre-made and packaged o Can be used immediately Neoprene sleeves, inserts, ankle braces o May be hard to size o Less expensive Customized equipment o Made for a specific individual o Specifically sized and designed for protective and supportive needs o More expensive/takes time

© 2007 McGraw-Hill Higher Education. All rights reserved. Which organization oversees equipment standards? 1.HIPPA 2.NATA 3.NOCSAE 4.OSHA

© 2007 McGraw-Hill Higher Education. All rights reserved. Which is a collision sport? 1.Basketball 2.Football 3.Soccer 4.Tennis

© 2007 McGraw-Hill Higher Education. All rights reserved. This type of equipment can be purchased at retail stores and is more of a one size fits all. 1.Custom 2.Off-the-shelf

© 2007 McGraw-Hill Higher Education. All rights reserved. Head Protection: Football Helmets o National Operating Committee on Standards for Athletic Equipment (NOCSAE) develop standards for football helmet certification o Must be protective against concussive force o While helmets must be certified, they may not always be fail-safe When helmets fail… o Athletes and parents must be aware of inherent risks o Arkansas Coaches Talk About Importance of Protection Arkansas Coaches Talk About Importance of Protection

© 2007 McGraw-Hill Higher Education. All rights reserved. o Each FB 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 o Athlete must be aware of risks and what label indicates Athlete reads and signs statement regarding warning label Assumption of risk form Head Protection: Football Helmets

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Helmet Fitting When fitting a helmet the hair should be wet to simulate sweat Follow manufacturers directions Must routinely check fit o Players check daily o Coaches/equipment manager check weekly o Snug fit, full air bladders, chin strap, tight face mask, jaw/cheek pads If not fitted correctly a helmet will not protect

© 2007 McGraw-Hill Higher Education. All rights reserved. Football Helmet Fitting Guidelines Check fit under all pads; should be snug Should cover base of skull Should be 2 finger widths above eyebrow Ear holes should align with center of ear Face mask should sit 3 finger widths from mouth Helmet should not shift when manual pressure is applied in all directions o Hold facemask rock helmet forward and back o Hold facemask twist helmet right to left o Hold sides of helmet and rock sideways o Push down on top of helmet o USA Footbal and Riddell Football Helmet Fitting USA Footbal and Riddell Football Helmet Fitting

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Lacrosse Helmets Must meet NOCSAE standards- must have sticker Recommended to be reconditioned every year or replaced after 3 years Lacrosse Helmet Fitting Guidelines o Sit squarely on head o 1 finger width above eyebrow o Padding should give firm and uniform pressure o Skin of forehead should move as helmet is moved left to right and front to back o Four-point chin strap tightened with no slack Replace screws and t-nuts at beginning of each season Lacrosse Helmet Fitting

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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 (CSA)

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Baseball/Softball Batting Helmets Must withstand high velocity impacts Research indicates the helmet does little to dissipate energy of ball Possible solution – add additional external padding Helmet must still carry NOCSAE stamp (similar to football label)

© 2007 McGraw-Hill Higher Education. All rights reserved.

Cycling Helmets Designed to protect the head during a single impact – 1 time use only Football, baseball and hockey helmets are more durable and can survive repeated blows Many states require use of cycling helmets

© 2007 McGraw-Hill Higher Education. All rights reserved. Football helmets must be NOCSAE certified and have a warning label. 1.True 2.False

© 2007 McGraw-Hill Higher Education. All rights reserved. This helmet is designed for a single impact and must be replaced. 1.Baseball 2.Cycling 3.Lacrosse

© 2007 McGraw-Hill Higher Education. All rights reserved. Face Protection Five categories o Full face guards o Throat Protectors o Mouth guards o Ear guards o Eye protection Facial injuries have decreased by over 50% since facemasks and mouth guards have been required The number of concussions has increased since helmets have been required? o Why?

© 2007 McGraw-Hill Higher Education. All rights reserved. Face Guards Have reduced the number of facial injuries The design depends on sport and position Proper mounting of the mask must occur with no additional attachments that would invalidate the manufacturer’s warranty FB must have at least 2 bars on face mask High schools require all hockey players to wear a mask

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o Throat injuries are uncommon but can be fatal o Baseball/softball catchers, lacrosse goalies, hockey goalies o May be mandatory for these positions Throat Protection

© 2007 McGraw-Hill Higher Education. All rights reserved. o Boxing and wrestling require special ear protection o Most contact sports do not o Irritation can cause permanent damage Cauliflower Ear Auricular Hematoma Ear Guards

© 2007 McGraw-Hill Higher Education. All rights reserved. Most dental injuries can be prevented with mouth guards Protect teeth, lips, and absorbs shock of chin blows Should fit comfortably, not impede speech or breathing Should extend to last molar Do not cut down mouth guard – it voids warranty for dental protection and could become dislodged and block breathing Three types o Stock o Commercial (formed following submersion in water) o Custom (fabricated from dental mold) Mandated use in high school and collegiate levels Mouth Guards

© 2007 McGraw-Hill Higher Education. All rights reserved. Cauliflower ear is most common in what sport? 1.Boxing 2.Football 3.Hockey 4.Lacrosse

© 2007 McGraw-Hill Higher Education. All rights reserved. The number of concussions has ___ since helmets are required in more sports. 1.increased 2.decreased

© 2007 McGraw-Hill Higher Education. All rights reserved. Highest % of eye injuries are sports related Generally blunt trauma Glasses o Slip on sweat, bend, fog up, detract from peripheral vision or hard to wear with headgear o Lens should be case hardened to cause crumbling and not splintering on contact (disadvantage = increased weight) o Polycarbonate lens is virtually unbreakable o May have polarizing/tinting ability o Photochromatic lenses change color when exposed to sun o Plastic lenses while lightweight are easy to scratch Eye Protection

© 2007 McGraw-Hill Higher Education. All rights reserved. o Contact Lenses Become part of the eye and move with it Corneal (hard) and sclera (soft) lenses Does not affect peripheral vision Will not fog and can be tinted Disadvantage – corneal irritation and it falling out Keep extra contacts

© 2007 McGraw-Hill Higher Education. All rights reserved. o Eye Protection Necessary in sports with fast moving projectiles o Hockey, lacrosse, racquetball, paintball Athletes not wearing glasses should wear closed eye guards to protect orbital cavity While eye guards protect, they can limit vision Polycarbonate eye shields have been developed for numerous pieces of head gear Eye Protection

© 2007 McGraw-Hill Higher Education. All rights reserved. Trunk and Thorax (chest) Protection Abdominal, chest, back Essential in many sports Must protect regions that are exposed to the impact of forces o External genitalia, bony protuberances, shoulders, ribs, and spine

© 2007 McGraw-Hill Higher Education. All rights reserved. Shoulder Pads: Football Two types o Cantilevered - bulkier and used by those engaged in blocking and tackling o Non-cantilevered - do not restrict motion (quarterback and receivers)

© 2007 McGraw-Hill Higher Education. All rights reserved. Extra padding can be worn to increase protection Shoulder Pads: Football

© 2007 McGraw-Hill Higher Education. All rights reserved. o Football Shoulder Pad Fitting Guidelines Width of shoulders must be measured Inside pad should cover tip of shoulder Top pad must cover deltoid and allow motion Neck opening must allow athlete to raise arms over head without the pads moving on neck Straps under arms should hold pads firmly in-place Riddell Shoulder Pad Fitting Shoulder Pads: Football

© 2007 McGraw-Hill Higher Education. All rights reserved. Lacrosse Shoulder Pad Fitting Guidelines o Shoulder caps rest on top of shoulders: should hang about 1-2 inches off shoulder o Collar of pad should lay flat on collar bone o Tighten bicep pad and secure high on arm o Sternum plate should properly cover sternum o Lacrosse Shoulder Pad Fitting Lacrosse Shoulder Pad Fitting Shoulder Pads: Lacrosse

© 2007 McGraw-Hill Higher Education. All rights reserved. o Thorax protectors and rib belts o Protect against external forces o Air-inflated interconnected cylinders (jacket design) Rib Protection

© 2007 McGraw-Hill Higher Education. All rights reserved. The larger more bulky shoulder pads worn by blockers are called __. 1.Cantilevered 2.Non-cantilevered

© 2007 McGraw-Hill Higher Education. All rights reserved. Hips and Buttocks Required in collision and high-velocity sports Boxing, snow skiers, equestrians, jockeys and water skiers Girdle and belt types

© 2007 McGraw-Hill Higher Education. All rights reserved. Lower Extremity Protective Equipment Socks o Poorly fit socks can cause stress, irritation, and blisters o Should be clean, dry and w/out holes o Different types for different activities o Composition Cotton/poly blend are lighter and dry faster - best All cotton can be bulky and do not dry quickly - bad

© 2007 McGraw-Hill Higher Education. All rights reserved. o Number of options for multiple activities o 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 Last – the form on which shoe is built o May be straight, semi-curved, curved o Straight = flat arch or run on inside of foot (pronator) o Semi-curved = foot to fit normal arch o Curved = more forefoot stability, high arch (supinator) Shoe Selection

© 2007 McGraw-Hill Higher Education. All rights reserved. Heel Counter (back of the shoe)- prevents medial and lateral roll of foot Shoe Uppers – material on top of shoe Arch Support - durable but soft and supportive to foot Price- due to impact on performance and injury prevention, may be worth the extra investment

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o Measure both feet, as there will be slight differences o What will they be used for? o Fit at the end of day – feet swell after wt. bearing o Should be snug but allow movement of foot and toes o Should break/bend at widest part, coinciding with ball of foot o Playing surfaces and activities must be considered Shoe Fitting

© 2007 McGraw-Hill Higher Education. All rights reserved. Heel Cups o Used for a variety of conditions including plantar fascitis, heel spurs, Achilles tendonitis and heel bursitis o Used to help compress fat pad, providing more cushion during weight bearing Shoe Accessories

© 2007 McGraw-Hill Higher Education. All rights reserved. Foot Orthotics o Insert that corrects biomechanical problems that exist in foot o Plastic, thermoplastic, rubber, leather support or ready- made products o Can also be customized by MD, AT, PT, or podiatrist More expensive Shoe Accessories

© 2007 McGraw-Hill Higher Education. All rights reserved. Ankle Braces o Alone or with tape o Significant debate over efficacy o Little or no impact on performance o Compared to tape, the device will not loosen significantly with use Shoe Accessories

© 2007 McGraw-Hill Higher Education. All rights reserved. Shin and Lower Leg o Often overlooked o Commercially marketed, hard molded shin guards are used in field hockey and soccer Leg Protection

© 2007 McGraw-Hill Higher Education. All rights reserved. Thigh and Upper Leg o Necessary in collision sports o Pads slip into ready made uniform pockets o Customized pads may need to be held in place with tape and/or wraps o Neoprene sleeves can also be used for support of injuries Knee Braces o Used prophylactically to prevent injuries to MCL o Prophylatctic – preventative Leg Protection

© 2007 McGraw-Hill Higher Education. All rights reserved. Types of Knee Braces o Rehabilitative: widely used following surgery Allows controlled progressive immobilization Adjustable o Functional: Used during and following rehab to provide functional support Ready-made and customized o Neoprene (w/ medial and lateral support) Used by those that have collateral ligament injuries Some are also used to provide support in those that have patellofemoral conditions

© 2007 McGraw-Hill Higher Education. All rights reserved. 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

© 2007 McGraw-Hill Higher Education. All rights reserved. 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