Chapter4

advertisement
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)
• Athletic governing bodies
– Establish rules for the
mandatory use of
specific protective
equipment
– Determine rules
governing special
protective equipment
– NFSHSA, NAIA, NCAA,
USOC
• ASTM
• HECC
• CSA
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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Download