Chapter 7 Protective Equipment

Chapter 7

Extended Lecture Outline

  • Safety Standards for Sports Equipment and Facilities
  • Standards are necessary for regulating material durability, protective equipment maintenance, repair and replacement
  • Too often worn out equipment is passed down from varsity to junior varsity and is putting athlete’s at risk
  • There are equipment regulatory agencies that standardize sports equipment and facilities (See Focus box 7-1)
  • Legal Concerns in Using Protective Equipment
  • Increasing litigation related to the use of protective equipment
  • Both manufacturers and those who purchase equipment must foresee all possible uses and misuses of the equipment and must warn the user of all potential risks inherent in using or misusing that equipment
  • The manufacturer is liable if an athlete is injured as the result of using a piece of equipment that is determined to be defective or inadequate for its intended purpose
  • If a piece of equipment is modified in any way the manufacturer is no longer liable and the person that modified the equipment becomes liable
  • To avoid litigation one must follow the manufacturer’s guidelines and instructions for using and maintaining protective equipment
  • Equipment Reconditioning and Recertification
  • NOCSAE (National Operating Committee on Standards for Athletic Equipment), established voluntary test standards to reduce head injuries through establishment of minimum safety requirements for football helmets/face masks, baseball/softball batting helmets, baseballs and softballs, lacrosse helmets/face masks
  • The Helmet standard is not a warranty, but rather a statement that the helmet has met the requirements of performance tests when it was manufactured or reconditioned
  • Helmets should be regularly reconditioned and recertified, based on usage
  • Using Off-The-Shelf vs. Custom Protective Equipment
  • Off-the-shelf equipment: premade and packaged by the manufacturer and can be used immediately without modifications right out of the package (neoprene sleeves, shoe inserts, ankle braces)
  • Customized equipment: constructed according to the individual characteristics of the athlete
  • Head Protection
  • Football Helmets
  • NOCSAE has developed standards for certification, and each helmet must have a warning sticker present on it making players aware of the risks involved in playing the game
  • The athlete must sign a statement agreeing with the warning label
  • Riddell lightweight revolution helmet – protective shell has been computer designed and extends to the jaw area to provide protection to the side of the head and the jaw as well as improved front-to-back fit and stability
  • Fitting a Football Helmet (Focus box 7-4)
  • Always wet the players hair to simulate playing conditions
  • Follow manufacturers recommendations for a proper fit
  • Check helmets routinely for proper fit
  • Ice Hockey Helmets
  • Must withstand low-mass-high-velocity impacts (being hit with a puck or stick) and high-mass-low velocity forces (running into the boards or falling on the ice)
  • All helmets should carry the stamp of approval from the Canadian Standards Association (CSA) or the Hockey Equipment Certification Council (HECC)
  • Proper fit see Focus Box 7-5
  • Baseball/Softball Batting Helmets
  • Need to withstand high-velocity impacts
  • Each runner and on-deck batter is required to wear a helmet that carries the NOCSAE stamp
  • Cycling Helmets
  • Designed to protect the head during one single impact
  • Not required in all states
  • Proper fit see Focus Box 7-6
  • Lacrosse Helmets
  • Required equipment for all male lacrosse players, women’s lacrosse requires only a protective eye guard
  • The helmet is designed to absorb repeated impact from a hard, high-velocity projectile
  • Soccer Headgear
  • Many companies marketing headgear for purpose of reducing concussions from heading the ball
  • No studies to date that demonstrate that the headgear is effective in reducing the incidence of concussions or other head injuries from heading a ball – more likely to get a concussion from hitting another player, the goalpost or the ground
  • Face Protection
  • Face Guards
  • Incidence of facial injuries decreased since adoption of face guards and mouth guards in football
  • Face masks vary depending upon sport and position played
  • No face mask should have less than 2 bars in football
  • Face mask should sit flush with the helmet and a 3 inch space should exist between the top of the face mask and the lower edge of the helmet
  • Ice hockey helmets and face masks are required in high school for all players and the helmets with the plastic-coated wire mask guards must meet the standards of the Hockey Equipment Certification Council (HECC) and the American Society of Testing Materials (ASTM)
  • Carbonate face shields have also been approved
  • Goalkeepers must also wear commercial throat protectors in addition to the face protectors
  • Throat (Laryngotracheal) Protection
  • Baseball catchers, lacrosse goalies, and ice hockey goalies are most at risk and throat protection should be mandatory
  • Mouth Guards
  • Intraoral mouth guards: protect the teeth, absorb shock of chin blows, helps prevent possible cerebral concussion, minimize lacerations to the lips, cheeks and fractures to the mandible
  • The mouth piece should be retained on the upper jaw and project backwards only as far as the last molar, thus permitting speech
  • Three types of mouth guards: stock variety, commercial mouth guard formed after submersion in boiling water, and the custom fabricated type
  • NCAA football rules mandate that all players wear a mouth guard. To assist with enforcement, mouth guards are now required to be in a highly visible color
  • Eye Protection Devices
  • Glasses
  • Athletes should wear polycarbonate lenses, which are virtually unbreakable
  • If Athlete’s wear glass lenses they must be case-hardened to prevent them from splintering on impact
  • Photochromic lenses become color tinted when exposed to ultraviolet rays from the sun and then return to a clear state when removed
  • Contact Lenses
  • Corneal type which covers just the iris and the scleral type which covers the entire front of the eye including the white
  • Normally do not cloud during temperature changes and can be tinted to reduce glare
  • Disadvantage: possibility of corneal irritation by dust getting under the lens and the possibility of the lens becoming dislodged during body contact
  • Neck Protection
  • Trunk and Thorax Protection
  • Football Shoulder Pads
  • Two types cantilevered and non-cantilevered
  • Non-cantilevered pads do not restrict shoulder motion as much as the cantilevered pads which are bulkier
  • Fitting Shoulder Pads (Focus Box 7-16)
  • Measure width of shoulders to determine the correct size
  • Inside shoulder pad should cover the tip of the shoulder
  • Epaulets and cups should cover the deltoid and allow enough motion for athlete to play their position
  • Sports Bras
  • Designed to minimize excessive vertical and horizontal movement – prevents stretching of Cooper’s ligament which causes premature sagging
  • Compressive pullover bra – recommended for women with medium-size breasts, bind the breasts to chest wall
  • Support bras are heavy duty and provide good upward support – Designed for women with larger breasts
  • Women with smaller breasts a lightweight bras is sufficient
  • Thorax and Rib Protection
  • Thorax protectors and rib belts are used for protection from external forces
  • Hips and Buttocks
  • Pads in region of hips and buttocks are needed in collision and high velocity sports such as hockey and football
  • Groin and Genitalia
  • Males need cup protection in sports that involve projectiles (hockey, lacrosse, and baseball) moving at a high velocity
  • Lower-Extremity Protective Equipment
  • Footwear
  • Socks
  • Shoe Selection
  • Toe Box: Should be ½ to ¾ inch distance between longest toe and the front of the shoe
  • Sole: Must provide a shock absorptive function and also be durable
  • Shank: part of sole between the heel and the metatarsal heads
  • Last: The form on which the shoe is built (straight, semicurved or curved)
  • Heel counters: Prevents the foot from rolling from side to side at heel strike
  • Shoe Uppers: Made of combination of nylon and leather
  • Arch Support
  • Price
  • Shoe Fitting (See Focus Box 7-8)
  • Frequently the athlete’s left foot varies in size and shape from the right foot
  • Fit shoes at the end of the day to accommodate the gradual increase in foot volume that occurs during weight-bearing
  • Measure the distance from the heel to the metatarsophalangeal joint and the distance from the heel to the end of the longest toe – shoes should be selected for the longer of the two measurements
  • Lacing techniques can be used to adjust the width of the shoe (see Focus Box 7-9)
  • The Cleated Shoe
  • The Cleats should be positioned under the two major weight-bearing joints and must not be felt through the soles of the shoes
  • Orthotics
  • A device for correcting biomechanical problems that exist in the foot
  • Plastic, thermoplastic, rubber, Sorbothane, or leather support
  • Are either off-the-shelf or custom made
  • Heel Cups
  • Used for variety of conditions including plantar fasciitis, a heel spur, Achilles tendinitis and heel bursitis
  • Made be hard, plastic or spongy rubber
  • Helps to compress the fat pad under the heel, giving more cushioning during weight-bearing activities
  • Off-the-Shelf Foot Pads
  • Manufactured for almost every type of structural foot condition, ranging from corns and bunions to fallen arches and pronated feet
  • Made of a variety of materials (foam, felt, plaster, aluminum, and spring steel)
  • Ankle Braces
  • Most studies indicate that bracing is effective in reducing ankle injuries, while others show no effect or even negative effects
  • Compared to taping, ankle braces do not loosen significantly during exercise
  • May have proprioceptive effects influencing balance, postural sway, and joint position sense
  • Shin and Lower Leg
  • Shin guards should extend from just below the tibial tubercle proximally to just above the malleoli distally
  • Knee Supports and Protective Devices
  • Knee Pads
  • Knee Braces
  • Protective Knee Braces: Used prophylactically to prevent injuries to the medial collateral ligament
  • Rehabilitative Braces: Used following surgical repair or reconstruction of the knee joint for controlled progressive immobilization
  • Functional Braces: Worn both during and following the rehabilitative period to provide support for functional activities
  • Neoprene Braces with Medial and Lateral Supports: Used by individuals who have sustained injury to the collateral ligaments
  • Neoprene Sleeves: Used to provide some support for patellofemoral conditions
  • Elbow, Wrist, and Hand Protection
  • Construction of Protective and Supportive Devices
  • Custom Pad and Orthotic Materials
  • Soft Materials
  • Gauze padding: Varying thicknesses and can be used as an absorbent or protective pad
  • Cotton: Has ability to absorb, to hold emollients and to offer mild padding
  • Adhesive felt (moleskin) or sponge rubber: Combines cushioning effect with the ability to be held in a specific spot by the adhesive side
  • Felt: Composed of matted wool fibers pressed into varying thickness (¼ to 1 inch)
  • Foams: Provide injury protection and come in a variety of thickness and densities – Comes in Closed cell and open cell form: Closed Cell: rebounds and returns to its original shape quickly
  • Nonyielding Materials
  • Thermomoldable plastics: Used for customized orthotics, can brace, splint and shield a body area (provide casting for a fracture, support for a foot defect, or a firm nonyielding surface to protect a severe contusion)
  • Heat forming plastics: low temperature variety (when heated to 140-180º F, can be molded to a body part) – Orthoplast, Aquaplast
  • Heat setting plastics: require higher temperatures for shaping – rigid and difficult to form, usually require a mold rather than being formed directly to the body part (High-impact vinyl, KYDEX and nyloplex)
  • Heat-plastic foams are plastics that have differences in density as a result of the addition of liquids, gas or crystals – commonly used as shoe inserts and other body padding (aloplast and plastazote)
  • Casting Materials
  • Material of choice is fiberglass
  • Besides casts – fiberglass makes effective shells for splints and protective pads
  • Tools Used for Customizing
  • Adhesives: Cements and glues join plastic to plastic or joint other combinations of materials
  • Adhesive Tape
  • Heat Sources
  • Shaping Tools
  • Fastening Material: (Velcro, leather)
  • Customized Hard-Shell Pads
  • Often required for an athlete who has acquired an injury such as a contusion, which needs to be protected from further injury
  • See Focus Box 7-10, for fabrication instructions
  • Dynamic Splints
  • Used to provide long-duration tension on a healing structure (usually a tendon) so that it can return to normal function
  • Combination of thermoplastic material, Velcro and pieces of rubber band or elastic to provide dynamic resistance

Prentice, Principles of Athletic Training , 15e LO-7 | 1