Chapter 6: Selecting and Using
Protective Sports Equipment
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• Selection, fitting and maintenance of
protective equipment are critical in injury
prevention
• Athletic trainers and coaches must have
knowledge of protective equipment
available for different sports and proper
fitting procedures
• Protection is critical in contact and collision
sports
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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 not
appearance of equipment
• A number of groups and agencies are
involved in standardizing sports equipment
and facilities
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Equipment Reconditioning and
Recertification
• NOCSAE has established test standards in
order to reduce head injuries
– Set minimum safety requirements for helmets and
masks for football, baseball/softball and lacrosse
– Accepted standards for various regulatory bodies
in sports
• Type of helmet, amount of use/intensity will
determine condition of help over a period of
time
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• NOCSAE label does not warranty helmets
– Indicates helmet met requirements when manufactured or
reconditioned
• NOCSAE recommends reconditioning and
recertification of equipment
– Consumer should use discretion based on use
• Helmets undergoing reconditioning can meet
performance for many seasons depending on model &
usage
– Will help equipment last longer
– If not kept clean various skin conditions and infections can
be unnecessarily transferred
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Legal Concerns
• 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
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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 pose problem relative to sizing
• Customized equipment
– Constructed according to the individual
– Specifically sized and designed for protective
and supportive needs
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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
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– 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 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
– There are a number of helmet manufacturers, and
even more have closed due to lawsuits and
liability cases
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– Football helmets generally have air or fluidfilled pockets to absorb force
• Riddell Revolution has made revolutionary
changes
– Computer designed helmet that extends further past
the jaw for additional protection and stability
– The distance between the helmet and head has been
increased
– Padding inflates to fit the player’s head shape
– The face guard system has isolated attachment
points from the shell, reducing jarring from low-level
impacts to the face guard
© 2010 McGraw-Hill Higher Education. All rights reserved.
© 2010 McGraw-Hill Higher Education. All rights reserved.
Helmet Fitting
• When fitting head/hair should be wet to simulate
sweat
• Follow manufacturer’s directions
• Must routinely check fit
– Snug fit (credit card test)
– With change in altitude bladder helmets must be
rechecked
– Chin straps (2, 4, or 6 strap systems)
– Jaw pads are essential (prevent lateral rocking)
• Certification is of no avail if helmet is not fit and
maintained
© 2010 McGraw-Hill Higher Education. All rights reserved.
© 2010 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)
© 2010 McGraw-Hill Higher Education. All rights reserved.
© 2010 McGraw-Hill Higher Education. All rights reserved.
Baseball/Softball Batting Helmets
• Must withstand high velocity impacts
• Research has indicated that helmet does
little to dissipate energy of ball
• Possible solution would be to add
additional external padding
• Helmet must still carry NOCSAE stamp
(similar to football label)
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Cycling Helmets
• Designed to protect the head during one
single impact
• Football, baseball and hockey helmets are
more durable and can survive repeated
blows
• Many states require use of cycling
helmets, especially in adolescents
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Lacrosse Helmets
• Required for male lacrosse players; females
must wear protective eye-guard
• Hard plastic with wire mess cage
• Must have center bar running from top to
bottom to absorb repeated, high velocity
blows
• Four point buckling system to keep helmet in
place and ensure better fit
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Face Protection
• Four categories
– Face Guard
• Has reduced the number of facial injuries
• Number of concussions has increased because
head is most often used in initial contact
• 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
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• In high school hockey, face masks are required (with
white plastic coating) that meet Hockey Equipment
Certifications Council and American Society for Testing
Materials
• Opening can not allow passage of sticks or pucks
• Additional polycarbonate face shields are also available
• The use of throat protectors is also mandated at some
levels
– Throat Protection
• 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
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© 2010 McGraw-Hill Higher Education. All rights reserved.
– Mouth Guards
• Most dental injuries can be prevented with
appropriate customized intraoral mouth guards
• Protect teeth, minimize lip lacerations, absorb
shock of chin blows, and 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
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• Do not cut down mouth guard as it voids
warranty for dental protection and could
become dislodged and disrupt breathing
• Three types
– Stock
– Commercial (formed following submersion in water)
– Custom (fabricated from dental mold)
• Mandated use in high school and collegiate
levels
• Mouth guards wear down over the course of a
season
– Coaches should routinely inspect mouth guards to determine
if replacement is necessary
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– Ear Guards
• Most sports do not use
• Wrestling, water polo and boxing utilize to prevent ear
irritation and ultimate deformity of ears
– Eye Protection Devices
• Highest percentage of eye injuries are sports related
• Generally blunt trauma
• Glasses
– May slip on sweat, become bent, fog, detract from peripheral
vision or be difficult to wear with headgear
– Properly fitting glasses can provide adequate protection
– 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
– Plastic lenses while lightweight are easy to scratch
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– Contact Lenses
• Become part of the eye and move with it
• Corneal and sclera lenses
• Peripheral vision, astigmatisms and corneal
waviness is limited
• Will not fog and can be tinted
• Disadvantages include cost, corneal irritation,
possibility of coming dislodged
• Soft hydrophilic lenses and disposable lenses
are very popular
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– Eye and Glasses Guards
• Necessary in sports with fast moving projectiles
• Athletes not wearing glasses should wear closed
eye guards to protect orbital cavity
• While eye guards afford great protection, they can
limit vision
• Polycarbonate eye shield have been developed for
numerous pieces of head gear
– Neck Protection
• Serve primarily as a reminder to athlete to be
cautious rather than providing definitive restrictions
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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
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© 2010 McGraw-Hill Higher Education. All rights reserved.
• 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
• Width of shoulders must be measured
• Inside of pad should cover tip of shoulder in line with
lateral aspect of shoulder
• Epaulets and cups must cover deltoid and allow motion
• Neck opening must allow athlete to raise arms over head
w/out pads sliding forward and back
• With split clavicle pads, channel for top of shoulder must
be in proper position
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© 2010 McGraw-Hill Higher Education. All rights reserved.
• Straps underneath arms should hold pads firmly inplace, w/out soft tissue restriction
– Combinations of padding (football and hockey)
may be used to supplement padding and
protection
• 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 Cooper’s ligament
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– Types available
• Compressive (bind breasts to chest wall - recommended
for medium size breast)
• Support (heavy duty with additional upward support for
larger breasts)
• Lightweight elastic (compression and support not as
critical for smaller breasts)
• Rib Protection
– Thorax protectors and rib belts
– Protect against external forces
– Air-inflated interconnected cylinders (jacket
design)
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Hips and Buttocks
• Required in collision and high-velocity
sports
• Boxing, snow skiers, equestrians, jockeys
and water skiers
• Girdle and belt types
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Groin and Genitalia
• Sports involving high velocity projectiles
• Require cup protection for male
participants
• Stock item that fits into jockstrap or athletic
supporter
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Lower Extremity Protective
Equipment
• Socks
– Poorly fit socks can cause abnormal stress on
the foot
– Should be clean, dry and w/out holes
– Different types for different activities
– Composition
• Cotton can be bulky
• Cotton/poly blend are lighter and dry faster
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• 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
– Spongy layer to absorb force
– Midsole that cushions midfoot and toes
– Hard rubber which contacts the ground
• Last – 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)
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© 2010 McGraw-Hill Higher Education. All rights reserved.
• Heel Counter - prevents medial and lateral roll
of foot
• Shoe Uppers - top of shoe made with
combination of materials, designed for
appropriate ventilation, drying and support
• Arch Support - durable but soft and supportive
to foot
• Price- due to impact on performance and injury
prevention, may be worth the extra investment
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• Shoe fitting
– Measure both feet, as there will be slight
differences
– Approximate conditions of use
– Fit at the end of day due to gradual increase in
volume due to weight bearing
– Should be snug but allow ample movement of foot
and toes
– Should break at widest part, coinciding with ball of
foot
– Must also consider width of shank, non-yielding
nature of sole and function of arch support
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– Cleated and specialty shoes may present
problems with fitting
– Playing surfaces and activities must be
considered
• Heel Cups
– Used for a variety of conditions including
plantar fasciitis, heel spurs, Achilles tendonitis
and heel bursitis
– Used to help compress fat pad, providing
more cushion during weight bearing
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• Foot Orthotics
– Device for correcting
biomechanical problems
that exist in foot that can
cause injury
– Plastic, thermoplastic,
rubber, sorbothane,
leather support or readymade products
– Can also be customized
by physician, podiatrist,
athletic trainer or physical
therapist
• More expensive
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• Ankle Supports
–
–
–
–
Alone or with tape -- they are increasingly popular
Significant debate over efficacy
Little or no impact on performance
Compared to tape, the device will not loosen
significantly with use
• Shin and Lower Leg
– Often overlooked
– Commercially marketed, hard molded shin guards
are used in field hockey and soccer
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Ankle Braces
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Shin Guards
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• 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
– AOSSM has expressed concern about their efficacy
in reducing injuries
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• 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 sustained collateral
ligament injuries
• Some are also used to provide support in those
that have patellofemoral conditions
© 2010 McGraw-Hill Higher Education. All rights reserved.
© 2010 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
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• 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
© 2010 McGraw-Hill Higher Education. All rights reserved.
© 2010 McGraw-Hill Higher Education. All rights reserved.