Head Protection Direct collision sports require head protection due to impacts, forces, velocities and implements Football Helmets 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

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

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

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

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)

Cycling Helmets Designed to protect head during one single impact Many states require the use of cycling helmets Especially in adolescents

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

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

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

Ear Guards Eye Protection Most sports do not use Wrestling, water polo and boxing utilize to prevent ear irritation and ultimately deformity of ears Eye Protection Highest percentage of eye injuries are sports related Generally blunt trauma Glasses – must be protective 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

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 Introduction of surgical techniques Radial kerotectomy Laser in-situ kertomileusis (LASIK) Safe and effective in improving faulty vision

Eye and Glasses Guards Neck Protection 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

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

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

Non-cantilevered Cantilevered

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 Cooper’s ligament

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

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

Groin and Genitalia Sports involving high velocity projectiles Require cup protection for male participants Stock item that fits into jockstrap or athletic supporter Female protection is also available