1. © 2007 McGraw-Hill Higher Education. All rights reserved. Chapter 7: Selecting and Using Protective Equipment Objectives: –Students will be able to identify why it is important to properly select and fit protective equipment. –Students will be able to describe the necessary steps to properly fit protective equipment. –Students will be able to classify sports by the level of contact.

2. © 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

3. © 2007 McGraw-Hill Higher Education. All rights reserved. Collision Football Hockey Lacrosse Wrestling Contact/Limited Contact Soccer Basketball Baseball Softball Volleyball Cheerleading Gymnastics Non-Contact Swimming Tennis Track/Field Golf List Sports for Each Category

4. © 2007 McGraw-Hill Higher Education. All rights reserved. Safety Standards for Equipment and Facilities Materials, durability, safety standards, manufacturing, testing methods, and requirements for use Effectiveness more important that looks NOCSAE: –National Operating Committee for Standards in Athletic Equipment –Set safety standards for equipment

5. © 2007 McGraw-Hill Higher Education. All rights reserved. NOCSAE has established test standards to reduce head injuries –Set minimum safety requirements for helmets and masks for football, baseball/softball and lacrosse –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 –Consumer should use discretion based on use

6. © 2007 McGraw-Hill Higher Education. All rights reserved. Legal Considerations Lawsuits related to equipment have increased Who could be responsible if an injury occurs while protective equipment is being worn? –Manufacturer, equipment manager, coach, AT, player

7. © 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.

8. © 2007 McGraw-Hill Higher Education. All rights reserved. Legal Concerns Number of lawsuits are increasing –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

9. © 2007 McGraw-Hill Higher Education. All rights reserved. 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 be hard to size –Less expensive Customized equipment –Made for a specific individual –Specifically sized and designed for protective and supportive needs –More expensive/takes time

10. © 2007 McGraw-Hill Higher Education. All rights reserved. Head Protection Direct 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 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

11. © 2007 McGraw-Hill Higher Education. All rights reserved. –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 –Athlete must be aware of risks and what label indicates Athlete reads and signs statement regarding warning label Assumption of risk form

12. © 2007 McGraw-Hill Higher Education. All rights reserved.

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

14. © 2007 McGraw-Hill Higher Education. All rights reserved. Helmet Fitting Wet hair 1 inch above eyebrow Tight chin strap Snug fit/should not move Covers Base of Skull Ear Holes Match 3 Fingers from Nose to Facemask

15. © 2007 McGraw-Hill Higher Education. All rights reserved.

17. 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) Extra padding can be worn to increase protection

18. © 2007 McGraw-Hill Higher Education. All rights reserved. –Rules of fitting Shoulder Pads 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

19. © 2007 McGraw-Hill Higher Education. All rights reserved. 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)

20. © 2007 McGraw-Hill Higher Education. All rights reserved.

21. 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)

22. © 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

23. © 2007 McGraw-Hill Higher Education. All rights reserved. Face Protection Four categories –Full face guards –Mouth guards –Ear guards –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? –Why?

24. © 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

25. © 2007 McGraw-Hill Higher Education. All rights reserved.

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

27. © 2007 McGraw-Hill Higher Education. All rights reserved. Ear guards –Boxing and wrestling require special ear protection –Most contact sports do not –Irritation can cause permanent damage Cauliflower Ear

28. © 2007 McGraw-Hill Higher Education. All rights reserved. –Mouth Guards 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 –Stock –Commercial (formed following submersion in water) –Custom (fabricated from dental mold) Mandated use in high school and collegiate levels –High schools require strap on mouth piece

29. © 2007 McGraw-Hill Higher Education. All rights reserved. –Eye Protection Devices Highest % of eye injuries are sports related Generally blunt trauma Glasses –Slip on sweat, bend, fog up, detract from peripheral vision or hard to wear with headgear –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 –Photochromatic lenses change color when exposed to sun –Plastic lenses while lightweight are easy to scratch

30. © 2007 McGraw-Hill Higher Education. All rights reserved. –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

31. © 2007 McGraw-Hill Higher Education. All rights reserved. –Eye and Glasses Guards Necessary in sports with fast moving projectiles –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 shield have been developed for numerous pieces of head gear

32. © 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 –External genitalia, bony protuberances, shoulders, ribs, and spine

33. © 2007 McGraw-Hill Higher Education. All rights reserved. Sports Bras –Research/development for good sports bras –Decreases vertical and horizontal movements –To be effective, should hold breasts to chest, preventing stretching of Cooper’s ligament –Types available Lightweight elastic (for smaller breasts – support not as critical) Compressive (bind breasts to chest wall - recommended for medium size breast) Supportive (stronger and provide upward support for larger breasts – provides the best supportive)

34. © 2007 McGraw-Hill Higher Education. All rights reserved. Rib Protection –Thorax protectors and rib belts –Protect against external forces –Air-inflated interconnected cylinders (jacket design)

35. © 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

36. © 2007 McGraw-Hill Higher Education. All rights reserved. Groin and Genitalia Sports involving high velocity projectiles Require cup protection for male participants Stock item that fits into jockstrap or athletic supporter

37. © 2007 McGraw-Hill Higher Education. All rights reserved. Lower Extremity Protective Equipment Socks –Poorly fit socks can cause stress, irritation, and blisters –Should be clean, dry and w/out holes –Different types for different activities –Composition Cotton/poly blend are lighter and dry faster - best All cotton can be bulky and does not dry quickly - bad

38. © 2007 McGraw-Hill Higher Education. All rights reserved. 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 durable Last – the form on which shoe is built –May be straight, semi-curved, curved –Straight = flat arch or run on inside of foot (pronator) –Semi-curved = foot to fit normal arch –Curved = more forefoot stability, high arch (supinator)

39. © 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

40. © 2007 McGraw-Hill Higher Education. All rights reserved. Shoe fitting –Measure both feet, as there will be slight differences –What will they be used for? –Fit at the end of day – feet swell after wt. bearing –Should be snug but allow movement of foot and toes –Should break/bend at widest part, coinciding with ball of foot –Playing surfaces and activities must be considered

41. © 2007 McGraw-Hill Higher Education. All rights reserved. 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

42. © 2007 McGraw-Hill Higher Education. All rights reserved. Foot Orthotics –Insert that corrects biomechanical problems that exist in foot –Plastic, thermoplastic, rubber, leather support or ready-made products –Can also be customized by MD, AT, PT, or podiatrist More expensive

43. © 2007 McGraw-Hill Higher Education. All rights reserved. Ankle Supports –Alone or with tape –Significant debate over efficacy –Little or no impact on performance –Compared to tape, the device will not loosen significantly with use

44. © 2007 McGraw-Hill Higher Education. All rights reserved. Shin and Lower Leg –Often overlooked –Commercially marketed, hard molded shin guards are used in field hockey and soccer

45. © 2007 McGraw-Hill Higher Education. All rights reserved. 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 –Prophylatctic – preventative

46. © 2007 McGraw-Hill Higher Education. All rights reserved. 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 collateral ligament injuries Some are also used to provide support in those that have patellofemoral conditions

47. © 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

48. © 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