Definitions Pronators – people who have a flat arc or run on the inside of their foot Supinators – people with an abnormally high arch and for runners who run on the outside of their foot Safety Standards for Sports Equipment & Facilities Multiple disciplines are applied to solve the problems with the safety standardization of sports equipment and facilities

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Definitions

Pronators – people who have a flat arc or run on the inside of their foot

Supinators – people with an abnormally high arch and for runners who run on the outside of their foot

Safety Standards for Sports Equipment & Facilities

Multiple disciplines are applied to solve the problems with the safety standardization of sports equipment and facilities. It is important to not pass down old, worn out, poorly fitting equipment to younger inexperienced players as it increases their chances for injury.

Legal Concerns in Using Protective Equipment

The best way for an athletic trainer to avoid litigations is to follow exactly the manufacturer’s instructions for using and maintaining protective equipment. If an injury occurs because of defective or inadequate protective gear, the manufacturer is liable.

 

Equipment Reconditioning and Recertification

 

Using off the Shelf vs. Custom Protective Equipment

Off the Shelf – is premade equipment packaged by the manufacturer and may be used immediately out of the package without modification.

Custom Protective Equipment – is generally more expensive but is specifically sized and made to fit the protective and supportive needs of an individual.

 

Head Protection

Football helmets must be NOCSAE certified and the helmets must be able to withstand repeated blows of high mass and low velocity. Each player’s helmet must have this warning from NOCSAE visible, so they are clear of the danger and risks involved in football:

When fitting a football helmet, the manufacturer’s directions must be followed closely to ensure a proper fit, you can insert a credit card between the head and the liner to check for snugness, if the card is resisted firmly when moved back and forth, it is snug. There are three basic types of chin straps; a two-snap, a four-snap, and a six-snap, with the four-snap being the most preferred because it keeps the helmet from shifting forward and backward. The figure below details how to properly fit a football helmet:

 

Head Protection cont.

Ice Hockey helmets should carry the stamp of approval from either the Canadian Standards Association or the Hockey Equipment Certification Council.

Baseball/Softball helmets carry a similar warning as the football helmets carry from the NOCSAE stamp as previously mentioned, though the concern with these helmets is that they may not dissipate the energy of a high velocity ball during impact.

Cycling helmets are unlike any others previously discussed because they are designed to protect the head during one impact while the others mentioned can survive repeated impacts. Helmet use has been shown to protect against traumatic head and facial injury.

Lacrosse helmets are a requirement for all male players while women’s lacrosse only requires a protective eye guard. These helmets are made of hard plastic and have a face mask to protect the front of the face, the goalie’s helmets add a throat protector.

Soccer headgear is a headband of sorts with a piece of foam in the front that is about 1.5 to 2 inches wide. There is conflicting evidence about whether soccer headgear is effective or not when heading a soccer ball. It is most likely soccer players get injured hitting their head on another player than heading the ball.

Face Protection

Devices that provide full face protection are categorized as such:

1. Full Face Guards

a. Since the implementation of face guards (& mouth guards) there have been less incidents facial injuries

2. Throat Protection

a. Though uncommon, these types of injuries can be fatal. Throat protection should be mandatory for baseball catchers, lacrosse goalies, and ice hockey goalies because they are most at risk for laryngotracheal injuries.

3. Mouth Guards

a. Most dental traumas (i.e. Lacerations to lips and cheeks and mandible fractures) can be prevented if an athlete wears a correctly fitted, customized intraoral mouth guard.

4. Ear Guards &

a. Apart from three sports, most contact sports do not practice ear protection. Almost all contact sports can cause irritation of the ears to the point of deformity so to avoid these issues ear guards should be worn routinely.

5. Eye Protection

a. Polycarbonate lenses in glasses are highly recommended due to their durability and resistance to breakage, they are the newest and safest type of lenses. If an athlete can wear contact lenses it could eliminate most of the issues that come from wearing glasses. Eye protection must be worn by all athletes who play sports that use fast-moving projectiles. Polycarbonate eye shields can be attached to football face masks, hockey helmets, and baseball/softball helmets.

Neck Protection

Experts in cervical injuries consider the major value of commercial and customized cervical collars to be mostly a reminder to the athlete to be cautious rather than to provide a definitive restriction. IRL: most commonly, cowboy collars are not used in football unless an athlete is at high risk for neck injury or has had a previous neck injury. Please see image below:

 

 

Trunk & Thorax Protection

In football there are many two types of pads used, cantilevered and non cantilevered, the difference is that the cantilevered pads disperses pressure onto the pads rather than on the shoulder. Baseball, Lacrosse, and Hockey players also have shoulder pads and thorax protectors. For women, there are several types of sports bras available, lightweight bras for women with smaller breasts because they do not need the extra support, a compressive pullover bra (the most common), for women with medium sized breasts, and heavier support bras that lift up the breasts with underwire for women with larger breasts. To be effective, a bra should hold the breasts tightly to the chest.

Many thorax protectors and rib belts can be modified and many manufacturers provide equipment for thorax protection.

The most popular hip and buttock protection comes from girdles in which light weight hip and coccyx pads are inserted into pockets in the girdle. Sports involving high-velocity projectiles such as hockey, lacrosse, and baseball require cup protection for male participants. The cup comes as an off-the-shelf item that fits into place in a jockstrap, or athletic supporter

Lower-Extremity Protective Equipment

Proper shoes and socks are just as important as helmets and shoulder pads, poorly fitted socks can cause abnormal stresses on the foot. Socks should be clean and dry without any holes. Running shoes tend to break down between 350 and 550 miles. The following must be taken into account when selecting appropriate shoes:

· Toe Box - how much room the toes have in said shoe

· Sole - should provide shock absorption and durability

· Shank - should be sufficient to support the weight of the wearer

· Last - the form on which the shoe is built should be tailored to the foot type

· Heel Counter - the portion of the shoe that prevents the foot from rolling side to side

· Shoe Upper - should be lightweight, quick drying, and well ventilated

· Arch Support - should be made of durable yet soft supportive material

· Price - it is worth a little extra investment to buy a quality pair of shoes

A properly fitted shoe will bend where the foot bends. The ideal cleated shoe would find a balance between maximizing performance all while minimizing the chance of injury.

An orthotic device is a plastic, thermoplastic, rubber, sorbothane, or leather support that is placed in the shoe as a replacement for the existing insole.

Hard plastic or spongy rubber heel cups help to compress the fat pad under the heel, providing more heel cushioning during weight-bearing activities.

Off-the-shelf foot pads are intended for use by the general public and are not usually designed to withstand the rigors of sports activities. Indiscriminate use of commercial foot orthotics may give the athlete a false sense of security and can intensify a pathological condition or cause the athlete to delay seeking medical treatment.

Ankle bracing and taping has become more popular in recent years and studies have shown varied results pertaining to the subject.

Shin guards should be used to protect the anterior shin from direct blows. For maximum protection, the shin guards should extend from just below the tibial tubercle proximally to just above the malleoli distally.

Thigh protection is widely used in collision sports and pads slip into ready made pockets within the uniform.

Knee pads help dissipate direct blows to the knee in sports such as volleyball, a variety of knee braces has been made due to the high incidence of the knee joint. There are protective knee braces, rehabilitative knee braces, functional knee braces, and neoprene knee braces with medial and lateral supports.

Elbow, Wrist, & Hand Protection

A variety of off-the-shelf protective neoprene sleeves and pads and hinged adjustable rehabilitative braces can offer protection to the elbow. In both contact and noncontact sport activities, the wrist, hand, and particularly the fingers are susceptible to fracture, dislocation, ligament sprains, and muscle strains. Protective gloves are essential for sports like lacrosse and ice hockey.

Construction of Protective & Supportive Devices

Many of the materials used to protect or support an injury can be divided into two categories:

1. Soft materials

a. Gauze padding

b. Adhesive felts

c. Felts

d. Foams

2. Hard materials

a. Heat forming plastics

i. Heat-forming plastics of the low temperature (140 degrees fahrenheit to 180 degrees fahrenheit) variety are the most popular in athletic training.

b. Heat plastic foams

i. Heat-plastic foams are plastics that have differences in density as a result of the addition of liquids, gas, or crystals.

Fiberglass is used to make plaster casts, it uses resin and a catalytic converter, plus water, to produce hardening, the tools needed to work on said casts include adhesives (many cements and glues join plastic to plastic or join other combinations of materials), adhesive tape (linen and elastic tape can hold pads to a rigid backing or to adhesive felt (moleskin) and can be used to protect against sharp edges), heat sources (a heat source must be available), shaping tools( i.e. heavy-duty scissors, sharp-blade knives, and cast saws), and fastening material. Customized protective equipment often must be secured in place, it can be secured by either velcro, leather, or various types of laces.

A hard-shell pad is often required for an athlete who has an injury, such as a painful contusion, that must be completely protected from further injury.

A dynamic splint is used to provide long duration tension on a healing structure (usually a tendon) so that it can return to normal function. Dynamic splints use a combination of thermoplastic material, Velcro, and pieces of rubber band or elastic to provide dynamic assistance

Relation to Real Life

I am aware of how important it is to have protective equipment and use it correctly when playing contact sports such as football. For example, when I have watched certain NFL games, I have seen players who have had helmets malfunction or break and come off on impact. Of those instances 2-3 of them were dazed and exhibited signs of a concussion. I have also seen players injure themselves when they drop their shoulder and attempt a tackle because the force from impact was not fully dissipated through the pads. Though the pads were used correctly, some variables (like the force of impact) are just unpredictable.