BOC protective gear and sports equipment

Soccer headgear

-Designed to reduce incidence of concussions due to heading ball -Consists of headband with foam padding -No research to support effectiveness in reducing incidence of concussions

Supplemental shoulder pads can be places under football pads

-deltoid cap of hockey pads connected to main body by adjustable lacing (distal end held by velcro) -football shoulder pads placed over hockey pads (larger football pads may be needed)

Soft materials

-gauze -cotton -adhesive felt -felt -foam

Off-the-shelf foot pads

-generally not designed to withstand the rigors or sports activities -indiscriminate use of commercial foot orthotics may intensify the pathological condition or cause athlete to delay seeing the team physician or podiatrist for evaluation

Football shoulder pad fitting

1. width of shoulders is measured to determine proper size of pad 2. inside shoulder pad should cover the tip of shoulder in a direct line with the lateral aspect of shoulder 3. epaulets and cups should cover the deltoid muscle and allow movements required by specific position 4. neck opening must allow athlete to raise arm overhead, but not allow pad to slide back and forth 5. split-clavicle shoulder pad- channel for top of shoulder must be in proper position 6. straps underneath arm must hold pads firmly in place but not so they constrict soft tissue

Chin strap types

2 snap 4 snap 6 snap 4 snap preferred because it keeps helmet from tipping forward and backward chin strap should be locked so it cannot be released by hard external force to helmet

Shoes last ___ miles

350-550

Throat (laryngotracheal) Protection

Baseball catchers, lacrosse goalies, and ice hockey goalies are at most risk (should be mandatory for these sports)

NOCSAE

National Operating Committee on Standards for Athletic Equipment established voluntary test standards to reduce head injuries by establishing minimum safety requirements for helmets and face masks standards adopted by NCAA and national federation of state high school associations (NFSHSA)

Thigh and upper leg protection

Necessary in collision sports such as hockey, football, and soccer 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

nonyielding materials

Plastics, casting

Arch support

Should be made durable yet soft supportive material and should smoothly join with the insole. Rough seams or ridges inside shoe may cause blisters

Rehabilitative braces

Widely used following surgery or recontruction to joints Allows controlled progressive immobilization Adjustable

Ear guards

Wrestling, water polo, boxing (irritation of ears to point of permanent deformity)

NOCSA certification

athlete must read warning out loud by the equipment manager and sign a form

Adhesive felt (moleskin)

contains an adhesive mass on one side, thus combining a cushioning effect with the ability to be held in a specific spot; versatile and can be used on all body parts

Contact lenses

corneal type- covers just the iris scleral type- covers the entire front of the eye, including the white yellow against ice glare, blue against snow glare disadvantage- expensive, can cause corneal irritation due to dust getting under lens, not everyone finds them comfortable

Custom foam

cut a donut type hole in softer foam material the same size as injury cut foam the same shape as hard shell use tape of an adhesive to affix the foam to the shell

Semicruved last shoe

designed for average wearer or normal foot. small curve on the medial side of foot to fit a normal arch

Cycling helmets

designed to protect head during one single impact

Non-cantilevered shoulder pads

do not restrict motion (quarterback and receivers)

Jaw pads

essential to keep helmet from racing laterally (fitting singly against cheeks)

Neck protection

experts in cervical injury 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 definite restrictions.

Price of shoes

extra investment is worth the better performance and prevention of injury

Too narrow shank

fails to adequately support inner long arches (causes extra strain)

Straight last shoe

filled on inside/medial side of the shoe to increase stability for people who have flat arch or who run pronated

The best way for AT to avoid litigation is to

follow exactly the manufacturers instructions for using and maintaining protective equipment

The cleated shoe

football/soccer cleats should not have cleats longer than ½ inch; specific shoes should be worn on synthetic turf; cleats must be properly positioned under the two major weight-bearing joints and must not be felt through the soles of the shoes can be made of polyurethane, rubber, or metal

Photochromic lenses

lenses will become color tinted when exposed to UV rays

Elbow protection

less commonly injured but still vulnerable to instability, contusion and muscle strain (protective neoprene sleeves, pads, and adjustable rehabilitative braces can offer protection)

Guaze padding

less versatile than other pad materials, has varied thicknesses and can be used as an absorbent or a protective pad

Xenith helmet

lined with 18 thermoplastic airflow shock absorbers which are embedded in a flexible cap the design is said to adapt to the force of an impact and dissipate the energy to decrease the acceleration of the head and precent the jarring that causes concussions

Shoe uppers

made of some combo of nylon and leather; should be lightweight, quick drying and well ventilated. Should have some extra support in saddle area and area of achilles tendon just above heel counter

Adhesive tape

major tool in holding various materials in place; linen and elastic tape can hold pads to a rigid backing or to adhesive felt (moleskin) and can be used t protect against sharp edges

Trunk and thorax protection

of particular concern are the external genitalia and exposed bony protuberances (shoulders, ribs, spine) problem in wearing protective equipment- it serves as body armor to injury and weapon against opponents

Heat forming plastics

of the low temperature variety, most popular, when heated to 140-180 F plastic can be accurately molded to body part aquaplast and orthoplast

Shank of shoe

part of the sole between the heel and metatarsal heads usually reinforced with material or sufficient density to support weight of wearer

NOCSA recommends

periodically reconditioning and recertifying helmets (every 2 years if no warranty) usually a reconditioned/recertified helmet can last many seasons

Too stiff soles

place extra strain on foot tendons

Heat plastic foams

plastics that have differences in density as a result of the addition of liquid, gas, or crystals. commonly used as shoe inserts or other body padding used in shoe orthotic inserts, and other body padding ex- aloplast, plastazote

Glasses

should be polycarbonate lenses which are virtually unbreakable if athlete has glass lenses they must be case-hardened to prevent them from splintering on impact when case hardened lens breaks, it crumbles, eliminating sharp edges that may penetrate the eye- cost is low, but makes glasses heavier than normal and more scratchable

Athletes eye guard

should wear close eye guards to protect orbital cavity

Cantilevered shoulder pads

strap that extends from the front to the back of the shoulder pads that causes the shoulder pads to arch above the tip of shoulder, dispersing the pressure onto the pads rather than on the shoulder- restrict motion more bulkier (blocking and tackling)

Shaping tools

tools required to shape devices are heavy-duty scissors, sharp blade knives, and cast saws

Protective knee brace

used prophylactically to prevent injuries to MCL in contact sports (little data to support)

Dynamic splints

used to provide long duration tension on healing structure (usually a tendon) so that it can return to normal function. use a combo of themoplastic material, velcro, and pieces of rubber band or elastic to provide dynamis assistance

Functional knee brace

worn during and following rehab period to provide support during functional activities purchased ready made or can be custom made

Baseball/softball batting helmets

• Each batter and on-deck batter must have a helmet that carries the NOCSAE stamp not much data has been collected on effectiveness, it is suggested that batting hlemets do little to dissipate force (possibly solution- add external padding or improve helmets suspension) ear flap can add additional protection

Heel cups

• May be used for plantar fasciitis, heel spurs, Achilles tendonitis, and heel bursitis; hard plastic or spongy rubber • Help to compress fat pad under heel, providing more heel cushioning during weight-bearing activities

Mouth guards

• Protects teeth and the intraoral mouth guard absorbs the shock of chin blows and helps prevent possible cerebral concussion; minimize lacerations to lips & cheeks and mandible fractures. • Proper and tight fit, comfortable, unrestricted breathing, and unimpeded speech • Best when mouthguard is retained on the upper jaw and projects backward to last molar (permits speech) • Mouthguards should NOT be cut down to cover only front teeth (invalidates manufacturer's warranty, can potentially become dislodged and lead to an obstructed airway) • 3 types: 1) stock variety; 2) commercial mouth guard (boil & bites); 3) custom fabricated type • NCAA requires mouth guards for certain sports (made in highly visible colors to assist enforcement)

Face guards

• Used to protect against flying or carried objects during a collision with another player adoption in football- decreased facial injuries, increase concussion and neck injuries (head is more often used to make initial contact)

Knee pads

• Valuable in sports in which athlete falls or receives direct blow to anterior knee • Elastic sleeve with a pad may help dissipate anterior force but fails to protect against lateral, medial, or twisting forces

Socks

• Well-fitted: too short (crowd toes, especially 4th & 5th), too long (wrinkle & cause skin irritation) • Should be clean, dry, and without holes • Cotton socks may be too bulky (combo of cotton/polyester is less bulky & dries faster)

Shin and lower leg

- Often overlooked - Commercially marketed, hard molded shin guards are used in field hockey and soccer - should extend from just below tibial tubercle proximally to just above malleoli distally

Hip and buttocks protection

-often needed in collision, high velocity sports ( hockey, football) -also boxers, snow skiers, equestrains, hockey, water skiers -most common pads: girdle and belt types

Customized Hard-Shell Pads

-often required for injury such as a painful contusion that must be completely protected from future injury -select proper material and tools (thermomoldable plastic sheet, scissors, felt material) -palpate and mark margins of tender area that need protection -cut a felt piece to fit the area of tenderness -heat plastic until malleable -place heated plastic over felt and wrap in place with elastic wrap -when cooled, remove elastic wrap and felt pad -trim shell to desired shape; a protective shell has now been made to provide a bubble relief -if needed, add softer inner layer of foam to distribute and lessen force further

Groin and genitalia protection

-sports involving high velocity projectiles (hockey, lacrosse, baseball) -cup protection fits into jockstrap or athletic supporter

Properly fitting a cycling helmet (8)

1. level on the head 2. if not level, adjust the fit using the extra foam fitting pads on the inside to provide contact with the head all the way around 3. with "one size fits all" model, adjust the fit by tightening the ring if needed 4. adjust the rear straps then the front straps to position the Y fitting where the straps come together just under the ear 5. adjust chin strap so it is comfortably snug 6. adjust rear stabilizer if the helmet has one 7. shake head violently 8. push under the front edge and push up and back. if helmet moves more than an inch or so from level tighten the straps so that helmet is level and feels solid but comfortable on the head

Properly fitting an ice hockey helmet (6)

1. should be comfortably snug at the forehead, top, back, and sides of head 2. helmet should not shift or wobble on head- this will reduce protection and comfort 3. chin strap should be adjusted so that it gently contacts the chin when the mouth is closed 4. helmet should be fit flat and snug on the head above the eyebrows without tilting forward or back 5. if helmet is loose or not properly fastened, it loses protective qualities 6. bottom of the full cage face mask should rest gently on chin when properly fitted

Fitting a football helmet (8)

1. wet players hair to simulate playing condition Fitting Standard: 1. helmet should fit sung: no gaps between pads and head/ face. 2. cover base of skull; pads placed at back of neck should be snug, not uncomfortable. 3. helmet should not come down over eyes front of eyes ( front edge 3/4 inch/ 2 inch finger width above eyebrows) 4. ear holes should match 5. should not shift when annual pressure is applied; should not recoil on impact 6. the chin strap should be an equal distance from the center of the helmet; straps must keep helmet form moving up and down side to side. 7. cheek pads should fit snugly against face 8. face mask should. be attached securely to helmet; positioned 3 finger- width from nose.

Lightweight revolution helmet

Riddell protective shell is computer designed and extends to jaw area to provide protection to the side of head and jaw as well as improve front to back fit and stability padding inflates to adjust to players head shape face guard system is designed to isolate attachment points from the shell (reducing jarring injury)

Toe box

The part of the shoe that surrounds the toes -1/2 to 3/4 inch distance between longest toe and front of shoe

Football face masks

at least 2 bars, bar attachments should be flush with helmet, 3 inch space between top of faceguard and lower edge of helmet, no more than one drilling on each side (drilling by a factory- authorized reconditioner)

neoprene braces with medial/ lateral supports:

athletes who have injured collateral ligaments and want support

Curved last shoe

built with larger medial side of shoe and has a wider outside portion of the shoe to provide more forefoot stability. abnormally high arches and are supinators

Football shoulder pads

cantilevered noncantilevered

Cotton

cheapest and most widely used, ability to absorb, hold emollients, and offers a mild padding effect

Open versus closed cell foam

closed preferred because it rebounds and returns to original shape quickly

Foams

come in many different thicknesses and densities (1/8-1/2 inch) usually resilient, nonabsorbent, and able to protect body against compressive forces some foams are thermomoldable and become high pliant and easy to shape, when cooled they maintain shape most often used for injury protection can be easily worked through cutting, shaping, and faceting used in inner soles in shoes, foam helps prevent blisters and effectively absorbs anterior/posterior and medial/lateral ground reaction forces

Ice hockey face masks

commercial plastic-coated wire mask guards (must meet standards of HECC and american society for testing materials/ASTM) openings must not allow entry of stick, goalkeeps must wear commercial throat protectors plastic guards such as polycaronate face shields have been approved by HECC required for all player in HS/college

Felt

composed of matted wool fibers pressed into varying thicknesses (1/4-1 inch) its comfrotable, semiresilient surface gives a firmer pressure than most sponge rubbers; absorbs sweat and clings to skin (less tendency to move than sponge rubber) felt should be replaced daily most often used for support and foot conditions

Last of shoe

form on which the shoe is built may be straight, semicurved, or curved

All football helmets must

have NOCSAE certification (not necessarily fail-saef but exterior warning label helps)

Tort

injured athlete must show that the athletic trainer was negligent in his/her decision to alter piece of equipment and that the negligence resulted in injury

Wrist/hand/finger protection

injuries are often trivialized and considered insignificant o Protective gloves are essential in preventing injuries in sports like lacrosse & ice hockey; also off-the-shelf and custom-molded splints for support and/or immobilization after injury

Check helmet for snugness

insert credit card between head and liner (proper when card is resisted firmly when moving back and forth)

Injury occurs as a result of defective or inadequate equipment

manufacturer is liable if equipment is modified any way- liability of manufacturer is void, modifier becomes liable

Adhesives

many cements and glues join plastic to plastic or join other combination of materials

Casting materials

material of choice if fiberglass which uses resin and a catalytic converter plus water to produce hardening this material also makes effective shells for splints and protective pads

Lacrosse face mask

must have a center bar running from the top to the bottom

Sole

must provide shock absorption and must be durable (also traction, tough material resistant to wear) -most have 3 layers: 1. thick, spongy layer (absorbs force of footstrike under heel), 2. midsole (cushions midfoot and toes), and 3. a hard rubber layer (comes into contact with ground) -average runner strike ground 1500-1700 times per mile, so its essential that the force of the heel strike be absorbed by the spongy layer to prevent overuse injury -heel wedges may help with correcting for structural deformities -flared heel may be appropriate for running shoes, but not recommended in aerobic or court shoes -provide good traction and must be made of tough material that is resistant to wear

Eye protection devices

national society to prevent blindness; highest percentage or eye injuries are sports related (blunt trauma)

Heat sources

necessary or thermomoldable plastics. three common sources include hydrocollator, hot air gun, or hair dryer and a convection oven with temperature control desired temp is > or equal to 160

Heel counters

prevents foot from rolling side-to-side at heel strike A firm but well fitted heel counter may prevent ankle sprains and painful blisters

Neoprene sleeves

provide some support for patellofemoral conditions

Surgery to correct vision

radial keratectomy (RK) laser insitu keratomileusis (LASIK)

heat-setting plastics

require a relatively higher temperatures for shaping; rigid and difficult to form, usually requiring a mold rather than being formed directly to body part ex- high impact vinyl, kydex, nyloplex

Lacrosse helmets

required for men, not for women hard plastic with wire mesh cage or face mask to protect the front of the face designed to absorb repeated impact from a hard, high velocity projectile 4 point buckling system

Fastening materials

velcro (when device must be continually put on and removed); leather cut and riveted to form hinge straps with buckles attached; laces; tools for construction include drill, hole punch, and ice pick

New class of foam

viscoelastic polymers (ex-sorbathane)- high energy absorbing quality, but also has high density, making it heavy

thermomoldable plastics

widely used brace, splint, and shield a body area provide casting for fracture, support for foot defect, or a firm nonyielding surface to protect a severe contusion

Ice hockey helmets

• Blows to the head in hockey are usually singular rather than multiple • Ice hockey helmet must withstand high-velocity impacts (hits by stick or pucks) but also high-mass-low-velocity forces (produced by running into boards or falling on ice) • Needs to have a firm exterior shell to disperse impact over a large surface area and an energy-absorbing liner to deccelerate forces that act on the head • Must carry stamp of approval from the Canadian Standards Association (CSA) or HECC (hockey equipment certifcation council)

Shoe fitting

• Measure both feet, approximate sport condition (i.e. socks, activities), should fit at end of day (volume increase) • Shoe should be snug but not too tight; allow full extension and movement of toes • Shoe should bend/"break" at its widest point; break of shoe and ball of foot should coincide • Measurements (select shoe size for the longer of the two measurements)- distance from heel to metatarsophalangeal joint or distance from heel to end of longest toe

Thorax and rib protection

• Most can be modified by replacing stock pads with customized thermomoldable plastic protective devices • Jacket for protection of ribs incorporates a pad composed of air-inflated, interconnected cylinders

Sports bras

• Most sports bras designed to minimize excessive vertical and horizontal movement of breasts • Bra should hold breasts to chest and prevent stretching of Cooper's ligament -metal parts rub and abrade skin -nonsupport bras lack sufficient padding and seams over nipples compound rubbing (irritation) -common pullover bra is most common (medium breasts) -support bras can provide support with elastic material and underwrise (larger breasts)

Ankle supports

• Most studies indicate that bracing is effective in reducing ankle injury, while other studies show no/neg. effects • When compared with ankle taping, braces do not loosen significantly during exercise

Foot orthotics

• Plastic, thermoplastic, rubber, sorbethane, or leather support placed in the shoe to replace existing insole • Custom made orthotics may be worth the expense