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 350-

550 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