Document 7168127
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Transcript Document 7168127
Chapter 6: Selecting and
Using Protective Sports
Equipment
► Selection,
fitting and maintenance of
protective equipment are critical in
injury prevention
► Athletic trainers and coaches must have
knowledge of protective equipment
available for different sports and proper
fitting procedures
► Protection is critical in contact and
collision sports
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
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
► NOCSAE
helmets
label does not warranty
Indicates helmet met requirements when
manufactured or reconditioned
► NOCSAE
recommends reconditioning
and recertification of equipment
Consumer should use discretion based on
use
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
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
► Direct
Head Protection
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 protect 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
Baseball/Softball 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)
Baseball/Softball Batting Helmets
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
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
►Most
sports do not use
►Wrestling, water polo and boxing utilize to
prevent ear irritation and ultimate deformity of
ears
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)
Polycarbonate lens is virtually unbreakable
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
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
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
► 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
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
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
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
► 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 be durable
Spongy layer to absorb force
Midsole that cushions midfoot and toes
Hard rubber which contacts the ground
►Heel
Counter - prevents medial and lateral roll of
foot
►Shoe Uppers - top of shoe made with combination
of materials, designed for appropriate ventilation,
drying and support
►Arch Support - durable but soft and supportive to
foot
►Price- due to impact on performance and injury
prevention, may be worth the extra investment
► Shoe
fitting
Measure both feet, as there will be slight
differences
Approximate conditions of use
Fit at the end of day due to gradual
increase in volume due to weight bearing
Should be snug but allow ample movement
of foot and toes
Should break at widest part, coinciding
with ball of foot
Must also consider width of shank, nonyielding nature of sole and function of arch
support
Cleated and specialty shoes may present
problems with fitting
Playing surfaces and activities must be
considered
► Heel
Cups
Used for a variety of conditions including
plantar fascitis, heel spurs, Achilles
tendonitis and heel bursitis
Used to help compress fat pad, providing
more cushion during weight bearing
► Foot
Orthotics
Device for correcting
biomechanical problems
that exist in foot that
can cause injury
Plastic, thermoplastic,
rubber, sorbethane,
leather support or
ready-made products
Can also be customized
by physician, podiatrist,
athletic trainer or
physical therapist
► More
expensive
► Ankle
Supports
Alone or with tape -- they are increasingly
popular
Significant debate over efficacy
Little or no impact on performance
Compared to tape, the device will not
loosen significantly with use
► Shin
and Lower Leg
Often overlooked
Commercially marketed, hard molded shin
guards are used in field hockey and soccer
Ankle Braces
Shin Guards
Thigh Pads
► Thigh
and Upper Leg
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
► Knee
Braces
Used prophylactically to prevent injuries to
MCL
AOSSM has expressed concern about their
efficacy in reducing injuries
► Types
of Braces
Rehabilitative:
►widely
used following surgery
►Allows controlled progressive immobilization
►Adjustable
Functional:
►Used
during and following rehab to provide
functional 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
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
► 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