Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Protective Equipment Chapter 3

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Principles of Protective Equipment Protection from forces –High velocity–low mass: focal injury –low velocity–high mass: diffuse injury Design factors that can reduce potential injury –Increase impact area –Disperse impact area to another body part –Limit the relative motion –Add mass to the body part –Reduce friction –Absorb energy –Resist the absorption of bacteria, fungus, and viruses

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Materials Used Low-density material –Light and comfortable to wear –Only effective at low levels of impact intensity High-density material –Less comfortable –Less cushioning –Can absorb more energy by deformation Resilience –High Regain their shape after impact Used over areas subject to repeated impact –Nonresilient or slow-recovery resilient Best protection Used over areas subject to one-time or occasional impact

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Materials Used (cont.) Soft materials –Light due to incorporation of air into material –Examples: gauze padding, neoprene, Sorbothane™, felt, moleskin, and foam –Open-cell vs. closed-cell foam Hard materials –Thermomoldable plastics—able to be heated and shaped before rehardening –Examples: orthoplast, thermoplast, casting materials

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Construction: Custom Pads and Devices Advantages –Cost, design, and availability Caution –The athletic trainer assumes legal responsibility for use of any custom-made devices

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Rules Regarding Protective Pads NFSHSA and the NCAA –Specific rules established –Written authorization from physician can be required ATC must be aware of specific rules!!

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Liability and Equipment Standards The proper use of protective equipment is usually a shared responsibility among the athletic staff ATC duty –Select appropriate equipment –Properly fit equipment –Instruct individual in proper care of equipment –Warn individual of any danger in using the equipment inappropriately –Supervise and monitor proper use of equipment

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Liability and Equipment Standards (cont.) Standards of quality agencies –NOCSAE Football, baseball, softball, and lacrosse helmets and facemasks –Other equipment (i.e., protective eye wear, ice hockey helmets, and facemasks) ASTM HECC CSA Athletic governing bodies –Establish rules for the mandatory use of specific protective equipment –Determine rules governing special protective equipment –NFSHSA, NAIA, NCAA, USOC

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Liability and Equipment Standards (cont.) When an athlete provides their own protective equipment, the responsibilities of the athletic trainer do not change!

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Protective Equipment for Head and Neck Football helmets –Can reduce head injuries, but do not prevent neck injuries due to axial loading –Construction Single or double air bladder, closed-cell padded, or combination Shell – plastic or polycarbonate alloy –Effect of heat –NOCSAE warning –Fitting – follow manufacturer’s guidelines –Paperwork

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Protective Equipment for Head and Neck (cont.) Ice hockey helmets –Can reduce head injuries, but do not prevent neck injuries due to axial loading –Must absorb and disperse high-velocity, low-mass forces –CSA approved Batting helmets –NOCSAE approved –Double ear flap design Other helmets –Lacrosse –Bicycle

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Protective Equipment for Head and Neck (cont.) Face guards –Protect and shield facial region –Football Effectiveness depends on the strength of the guard, the helmet attachments, and the four-point chin strap on the helmet Proper fit –Ice hockey Made of clear plastic, steel wire, or combination HECC and ASTM standards Proper fit

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Protective Equipment for Head and Neck (cont.) Eye wear –Goggles Eyecup design (e.g., swimming) Over spectacles (e.g., skiing) Sport goggle with a mask design –Face shields Attached to helmets –Spectacles Lenses Should be 3 mm thick Made from CR-39 plastic or polycarbonate Frame – resilient plastic

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Protective Equipment for Head and Neck (cont.) Ear wear –Protective cup to reduce friction and trauma –Should be worn regularly in boxing, wrestling, and water polo

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Protective Equipment for Head and Neck (cont.) Mouthguards –Reduce dental and oral soft tissue injuries and, to a lesser extent, jaw fractures, cerebral concussions, and TMJ injuries –Proper fit –Types Thermal set, mouth-formed Custom-fabricated – pressure-formed type Custom-fabricated – vacuum-formed type

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Protective Equipment for Head and Neck (cont.) Throat and neck protectors –Attachable throat guard Required for catchers in baseball and softball –Cervical rolls and collars Designed to limit motion of cervical spine Effective in preventing burner, but properly fitted shoulder pads are critical Do not decrease axial loading on the cervical spine when the neck is flexed

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Protective Equipment for Upper Body Shoulder pads –Should protect the soft and bony tissue structures in the shoulder, upper back, and chest –Construction –Types Cantilever: protect AC joint and distribute forces throughout entire shoulder girdle Flat: provide less protection to shoulder region but permit more glenohumeral motion –Select on player position, body type, and medical history

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Protective Equipment for Upper Body (cont.) Elbow, forearm, wrist, and hand –Protection from external forces Thorax, ribs, and abdomen –Protection from external forces Sports bras –Prevent excessive vertical and horizontal breast motion during exercise

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Protective Equipment for Upper Body (cont.) Lumbar/sacral protection –Weight training belts; abdominal binders –Should support the abdominal contents, stabilize the trunk, and prevent spinal deformity or injury during heavy lifting

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Protective Equipment for Lower Body Hip and buttock region –Protect the iliac crest, sacrum, coccyx, and genital region –Pads typically composed of hard polyethylene covered with layers of Ensolite™ –Girdle with special pockets can hold pads in place Thigh –Pad: protect quadriceps –Neoprene sleeves: provide compression, therapeutic warmth, and support for quadriceps or hamstring strain

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Protective Equipment for Lower Body (cont.) Knee braces –Prophylactic Protect the MCL Redirect lateral valgus force to points distal to the joint –Functional Provide proprioceptive feedback Protect ACL –Rehabilitative Provide immobilization at a selected angle Permit controlled ROM through predetermined arcs Prevent accidental loading in non-weight bearing activity

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Protective Equipment for Lower Body (cont.) Knee braces

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Protective Equipment for Lower Body (cont.) Patella braces –Dissipate force –Maintain patellar alignment –Improve patellar tracking Lower leg –Protect anterior tibia from extension forces

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Protective Equipment for Lower Body (cont.) Ankle braces –Lace-up –Semirigid orthosis –Air bladder

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Protective Equipment for Lower Body (cont.) Footwear –Selection and fit may affect injury Foot orthotics –Devices used in the treatment and prevention of foot and gait abnormalities –Rigid, soft, semi-rigid