another from the Big Ten Conference(Albright et al,
1994) showed a consistent trend toward a reduction of
medial collateral ligamentMCL injuries with use of
prophylactic braces. Owing to these inconsistent find-
ings and the lack of demonstrated proof of efficacy,
both the American Academy of Pediatrics and the
American Academy of Orthopedic Surgeons have rec-
ommended against the routine use of prophylactic
knee bracing in football.
•ACL functional braces are available for players with
ACL-deficient knees. Custom-fit braces have not been
shown to perform better or offer more protection than
off-the-shelf braces (Wojtys and Huston, 2001).
BASEBALL/SOFTBALL
- The NCAA mandates the use of a double ear-flap
helmet for all batters and base-runners as well as a
mask and throat guard for catchers. - Little League Baseball requires protective helmets for
batters, catchers, baserunners, first and third base
coaches, and on-deck hitters. - All helmets should be NOCSAE certified to ensure
strength and safety, and bear a “Meets NOCSAE
Standard” seal on the outside. - It is recommended that baseball batters age 4 to 14
wear helmets with face protectors to reduce the risk of
eye and facial bone injury. This recommendation was
originally made in 1984 by the Sports Eye Safety Com-
mittee of the National Society to Prevent Blindness. - Breakaway bases are available which can decrease
sliding-associated injuries by approximately 98%
(Naftulin and McKeag, 1999).
ICE HOCKEY
- The NCAA mandates the use of helmets with fastened
chin straps, face masks, and an internal mouthpiece. - Shoulder pads, elbow pads, protective gloves, padded
pants, and shin guards are also standard equipment. - Athletic supporter and neck or throat guard are also
recommended for goalies. - The use of full face shields results in a significantly
decreased risk of facial or dental injury (Benson et al,
1999). - Unfortunately, the use of helmets and face shields in
hockey and the style of play allowed a player with
head protection have contributed to an increase in cer-
vical spine injuries (Reynen and Clancy, Jr, 1994). - It has been shown that prophylactic knee braces do
not significantly reduce the incidence of knee injury
among hockey players (Tegner and Lorentzon,
1991).
LACROSSE- The NCAA requires the use of a NOCSAE certified
helmet with face mask, chin strap, and chin pad, as
well as protective gloves and a mouthguard for all
male lacrosse players. Goalies are additionally
required to wear chest and throat protectors. - Shoulder and rib pads are also standard, but not
mandatory, equipment. Many players also wear rib
protector vests.
RACQUET SPORTS- Some clubs require eye protection for badminton,
squash, and racquetball players. - Lenses should be composed of at least a 3-mm thick
CR 39 plastic or polycarbonate plastic. - Glass lenses are discouraged owing to risk of breakage.
- Lenses should be mounted in a nylon sports frame
with a steep posterior lip and temples that rotate about
180 °. When a lens in a sports frame is struck, it proj-
ects forward rather than back and towards the eye.
(Kulund, 1988)
BASKETBALL- Mouth guards are recommended, but not mandatory,
to reduce risk of dental trauma.
•High top basketball shoes have been shown not to
reduce the incidence of ankle sprains during play
(Barret et al, 1993). - The use of a semi-rigid ankle stabilizing brace does
seem to reduce the incidence of ankle injury, but not
the severity of such injuries (Sitler et al, 1994).
WRESTLING- The NCAA requires use of ear protectors, which pro-
tect against the formation of auricular hematomas and
the cosmetic deformity, cauliflower ear.
SOCCER•Shin guards should be worn to reduce incidence of tibia
and fibula fractures, as well as compartment syndrome
from anterior leg contusions. Shin guards should pro-
tect the entire length of the tibia (Howe, 1999).- Use of a semirigid ankle orthosis has been shown to
decrease the incidence of recurrent ankle sprains in
soccer players with previous history of sprains (Surve
et al, 1994).
104 SECTION 1 • GENERAL CONSIDERATIONS IN SPORTS MEDICINE