CHAPTER 17 • PLAYING SURFACE AND PROTECTIVE EQUIPMENT 103“green dust,” which can result in secondary infections
(Gieck and Saliba, 1988).- Increased incidence of turf toe, a sprain of the plantar
capsule ligament complex of the metatarsophalangeal
(MTP) joint of the great toe, is also associated with
this increased traction. Hyperextension of the MTP is
the most common mechanism.
•Leg fatigue and shin splints are common on artificial
turf. Blisters are more common owing to increased
traction. - Because of the tremendous build-up of heat near the
surface of artificial turf, heat exhaustion is a danger to
players, particularly in the summer.
TENNIS
•Tennis is another sport with playing surface options,
including hard court, clay, composition, grass, and
carpet.
- Hard courts are associated with greater stress on the
lower extremities as a result of the reduced shock
absorbing ability and increased traction between shoe
and court.
•With its energy absorbing properties, clay is more for-
giving to the upper extremities owing to reduced ball
speed (Nicola, 1997). - During rehabilitation from injury, carpet, composi-
tion, and clay offer more cushion and are more for-
giving to the lower extremities.
PROTECTIVE EQUIPMENT
- The purpose of protective equipment is to prevent
injury and to protect injured areas from further injury.
Sanctioning bodies, e.g., the National Collegiate
Athletic Association (NCAA), of various sports have
rendered certain protective equipment mandatory.
FOOTBALL
- The NCAA mandates the use of a helmet; face mask;
four-point chin strap; mouth guard; shoulder pads;
and hip, coccyx, thigh, and knee pads during football
competition. - There are two types of helmets currently in use: (1)
padded, and (2) air and fluid filled, with combinations
of both types. - All football helmets in use at the high school or col-
lege level must be certified by the National Operating
Committee on Standards for Athletic Equipment
(NOCSAE). This ensures that each helmet has been
tested to withstand repeated blows of high mass and
low velocity. A study by Cantu et al attributed in large
part a dramatic reduction in brain injury-related fatal-
ities from football to the adoption of NOCSAE helmet
standards (Cantu and Mueller, 2003). These standards
went into effect in 1978 for colleges and in 1980 for
high schools.- Proper fitting of a helmet is ensured by the following
criteria: the frontal crown of the helmet should sit
approximately one to two finger breadths above the
eyebrows; the back edge of the helmet should not
impinge on the neck as it extends; when the head is
held straight forward, an attempt to turn the helmet on
the head should result in only a slight movement; jaw
pads should fit the jaw area snugly to prevent lateral
rocking of the helmet; the chin strap should fit snugly
with equal tension on both sides; the hair should be
cut to normal length prior to fitting. - Mouth guards include ready-to-wear, mouth-formed,
and custom-fitted types. Ready-made guards are the
least comfortable and least protective type. Mouth
guards have been required equipment for high school
football players since 1962 and for their collegiate
counterparts since 1973. Mouth injuries, which at one
time comprised 50% of all football injuries, have been
reduced by more than half since the adoption of face
masks and mouth guards for use in the sport.
•Two types of shoulder pads are in use: flat and can-
tilevered. Flat pads allow greater glenohumeral
motion and are appropriate for limited contact posi-
tions, such as quarterback and receiver. Cantilevered
pads are named for the cantilever bridge that extends
over the shoulder, dispersing impact force over a
wider area. These pads offer greater protection to the
shoulder area and are appropriate for the majority of
players.
•A proper shoulder pad fit is achieved when the tip of
the inner pad extends just to the lateral edge of the
shoulder. The sternum and clavicles should be cov-
ered, and the flaps or epaulets should cover the
deltoid area. - Hip and coccyx pads are mandatory equipment and
should cover the greater trochanters, the iliac crests,
and the coccyx. Snap-in, girdle, and wrap-around
pads are available. Girdle pads are the most
common type but also the most difficult to keep in
place. Care should be taken to ensure coverage of
the iliac crest. - Controversy exists regarding the use of prophylactic
knee braces in football. A study by Rovere in 1987
actually showed an increased rate of anterior cruciate
ligament (ACL) injuries with brace use (Rovere,
Haupt, and Yates, 1987). Since then, however, a study
carried out at West Point (Sitler et al, 1990) and