Chapter 6: Selecting and
Using Protective Sports
Equipment
► 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
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
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
► NOCSAE
helmets
label does not warranty
 Indicates helmet met requirements when
manufactured or reconditioned
► NOCSAE
recommends reconditioning
and recertification of equipment
 Consumer should use discretion based on
use
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
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
► Direct
Head Protection
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 protect against concussive force
 While helmets must be certified, they may
not always be fail-safe
 Athletes and parents must be aware of
inherent risks
 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
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
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)
Baseball/Softball Batting Helmets
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 for adolescents
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
►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
 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
►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
 Ear Guards
►Most
sports do not use
►Wrestling, water polo and boxing utilize to
prevent ear irritation and ultimate deformity of
ears
 Eye Protection
►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
 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
 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
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
► 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
Non-cantilevered
Cantilevered
►Straps
underneath arms should hold pads
firmly in-place, 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
 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)
► Thorax
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
► Boxing, snow skiers, equestrians, jockeys
and water skiers
► Girdle and belt types
Groin and Genitalia
► Sports
involving high velocity projectiles
► Require cup protection for male participants
► Stock item that fits into jockstrap or athletic
supporter
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
► 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 be durable
 Spongy layer to absorb force
 Midsole that cushions midfoot and toes
 Hard rubber which contacts the ground
►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
► 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, nonyielding nature of sole and function of arch
support
 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 fascitis, heel spurs, Achilles
tendonitis and heel bursitis
 Used to help compress fat pad, providing
more cushion during weight bearing
► Foot
Orthotics
 Device for correcting
biomechanical problems
that exist in foot that
can cause injury
 Plastic, thermoplastic,
rubber, sorbethane,
leather support or
ready-made products
 Can also be customized
by physician, podiatrist,
athletic trainer or
physical therapist
► More
expensive
► 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
Ankle Braces
Shin Guards
Thigh Pads
► 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
► 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
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
► 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