Protective Gear and Sports Equipment Britni Racus MS, ATC, LAT, CSCS, PES

Why protective equipment? Selection, fitting and maintenance of protective equipment are critical in injury prevention. ATC must have knowledge of protective equipment available for different sports and proper fitting procedures Protection is critical in contact collision sports ATC must also have knowledge of how and when protective equipment should be used to facilitate rehabilitation.

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 no appearance of equipment A number of groups and agencies are involved in standardizing sports equipment and facilities

Legal Concern 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 To avoid litigation, individuals should follow specific use instructions of equipment exactly.

Equipment Reconditioning and Recertification National Operating Committee on Standards for Athletic Equipment (NOCSAE) established voluntary testing standards in an effort to reduce head injuries Established for football helmets, baseball/softball helmets, lacrosse helmets/facemasks Takes into consideration type of helmet and amount of and intensity of usage

NOCSAE Standard NOCSAE Helmet Standard Not a warranty Indicates that helmet met requirements of performance tests when manufactured/reconditioned Helmets should undergo regular recertification and reconditioning Will allow equipment to meet necessary standards for multiple seasons.

Off the Shelf vs. Custom Protective Equipment Off the shelf Pre-made and packaged Can be used immediately May pose problems relative to sizing Customized Constructed according to the individual Specifically sized and designed for protective and supportive needs Can be costly

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 Athlete must be aware of risks and what label indicates 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 athletes plays at own risk while using helmet 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 Measure the circumference of the athlete’s head to find the right size helmet. Ear holes match up Two fingers down on the forehead Three fingers from nose to face mask Occiput is covered Chin strap is centered Cheek pads are snug against cheeks No side-to-side movement No up and down movement Air bladder is filled with air Recoil when axially loaded

Baseball/Softball Batting Helmets Must withstand high velocity impacts 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 Neck and Throat Mouth Ear and Eye

Face Guards Has reduced the number of facial injuries in athletics 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

Neck and Throat Guards Throat protections 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 Neck Protection Serve primarily as a reminder to athlete to be cautious rather than providing definitive restrictions.

Mouth Guards Most dental injuries can be prevented with appropriate fitted mouth guards Protect teen, minimize lip lacerations, absorb shock of chin blows and can 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 guards as it voids warranty for dental protection and could become dislodged and disrupt breathing Mandated use in high school and collegiate levels

Ear and Eye Guards Ear guards Most sports do not use Wrestling, water polo and boing utilize to prevent ear irritation and ultimately deformity of ears Eye protection Highest percentage of eye injuries are sports related Generally blunt trauma Eye and glasses guards Necessary in sports with fast moving projectiles athletes not wearing glasses should wear closed eye guards to protect orbital cavity

Rest of Body Protective Equipment

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 Measure shoulders AC to AC Joint Inside shoulder pads should cover both AC joints Epaulets and cups must cover deltoid muscle and allow motion Neck opening must allow athlete to raise arms over head w/o pads sliding forward and back Nipples should be covered Scapulae must be covered Clavicle should be covered When strapped in, shoulder pads should have minimal movement

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 Copper’s ligament

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 Football, boxing, snow skiers, equestrians, jockeys and water skiers Girdle and belt types

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

Foot, Ankle and Lower Leg Protective Equipment Socks Poorly fit socks can cause abnormal stress on the foot Should be clean, dry and w/o holes Shoes Number of options for multiple activities Shoe will breakdown and degrade over time Running shoes will last between miles Shoes many need to be constantly replaced if very active Shin Guards Anterior aspect of leg is exposed to direct blows Commercially marketed, hard molded shin guards are used in field hockey and soccer Ankle braces Alone or with tape – they are increasingly popular Little or no impact on performance Compared to tape, the device will not loosen significantly with use

Knee Braces Used prophylactically to prevent injuries to MCL May positively influence joint position sense Rehabilitative: Widely used following surgery Allows controlled progressive immobilization adjustable Functional Used during and following rehab to provide function 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.

Thigh and Upper Leg Protective Equipment 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

Elbow, Wrist and Hand Protective Equipment While the elbow is less commonly injured, it is susceptible to instability, contusions and muscle strains. 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

Construction of Protective and Supportive Devices An ATC should be able to design and construct protective devices Must have knowledge of theoretical basis of padding construction Art form based on science A variety of materials are available. Soft Materials Gauze Cotton Adhesive and Non-Adhesive Felt Adhesive and Non-Adhesive Foam Open and Closed Celled Foam Hard Materials Thermomoldable plastics Casting materials