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