Protective Equipment

1. Protective Equipment Chapter 3

2. 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

3. 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

4. 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

5. Construction: Custom Pads and Devices • Advantages • Cost, design, and availability • Caution • The athletic trainer assumes legal responsibility for use of any custom-made devices

6. 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!!

7. 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

8. 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) ASTM HECC CSA Athletic governing bodies Establish rules for the mandatory use of specific protective equipment Determine rules governing special protective equipment NFSHSA, NAIA, NCAA, USOC Liability and Equipment Standards (cont.)

9. Liability and Equipment Standards (cont.) • When an athlete provides their own protective equipment, the responsibilities of the athletic trainer do not change!

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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

20. 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

21. 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

22. Protective Equipment for Lower Body (cont.) • Knee braces

23. Protective Equipment for Lower Body (cont.) • Patella braces • Dissipate force • Maintain patellar alignment • Improve patellar tracking • Lower leg • Protect anterior tibia from extension forces

24. Protective Equipment for Lower Body (cont.) • Ankle braces • Lace-up • Semirigid orthosis • Air bladder

25. 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