Use Protective Gear

OVERVIEW

1 Yet, these high numbers have led to increases in injuries. Each year, teens in high school have an estimated 2 million injuries, with 500,000 doctor visits and 30,000 hospitalizations. Meanwhile, each year, more than 3.5 million kids under the age of 14 years receive some type of medical treatment for a sports injury. 2

Though the prevention of as many injuries as possible is always the goal, the prevention of concussions, which occur when the brain knocks against the skull’s bony surface, is of prime importance. Most of the time, especially when the concussion is relatively mild, healing is fairly rapid. But, according to the Nemours Foundation, every year “more than 400,000 kids are sent to the emergency department for serious brain injuries.” 3 Though these may well occur in car crashes, they may also be the result of playing a variety of different sports. Concussions vary in the degree of severity. It is not unusual for a concussion to result in a loss of consciousness for seconds, minutes, or longer. Common concussion symptoms include feeling groggy, dazed, and very confused. A medical provider should check anyone with a head injury.

One of the ways to lower these high rates of injury is to use protective gear, such as helmets, mouthguards, and pads. Probably the most important piece of protective gear is the helmet. Of course, there are different types of helmets. So, a helmet used for riding a bike is unlike a helmet used for playing football. It is important to use the correct helmet for the sport you are playing. A helmet for a different sport may not provide the protection you need. Purchase a helmet at a sporting goods store where the sales representatives are well trained. A helmet should be snug and not tilt backward or forward.

Many sports require eye protection. Look for eye protection made from polycarbonate. All types of eye protection should fit securely. Teens who wear prescription eyeglasses probably need prescription polycarbonate glasses or goggles. If you play a contact sport, such as hockey, football, basketball, it is important to protect your teeth, mouth, and tongue. For this, you need mouthguards. Although these may be obtained from your dentist, quality mouthguards may be purchased at better sporting goods stores. If you are wearing a retainer, as part of your orthodontic treatment, remove it before exercising.

People who are at increased risk for wrist, knee, and elbow injuries, such as those who ride scooters and skateboards, need to use wrist, knee, and elbow guards. These guards help prevent fractures and other injuries. Pads are recommended for many different types of contact sports. There are pads for the elbows, wrists, knees, and other parts of the body. Guys who play contact sports may require a protective cup, and guys who run may wish to use an athletic supporter. 4

WHAT THE EXPERTS SAY

Protective Gear May Prevent Severe and Debilitating Water Sports Injuries

In a study published in 2013 in the Journal of Pediatric Surgery, researchers from Alabama, Washington, New York City, and Canada noted that children may suffer severe and debilitating injury from watercraft-associated trauma. The cohort consisted of 15 children, between the ages of 7 and 15 years, involved in 14 accidents who were admitted to the trauma service of Children’s of Alabama (hospital) between September 1999 and August 2009. Most often, the injuries occurred while the children were riding inflatable tubes pulled by the boat. In these instances, the children lost control over their speed or direction of the pull. But, there were also other types of accidents. Though all the patients in this cohort lived, two required partial lower extremity amputations. None of the patients was reported to be wearing any protective gear. As a result of their investigation, the researchers recommended the mandatory use of protective gear, such as helmets, special clothing, life vests, and easily visible flotation devices, for children participating in water sports activities. And, they stressed a need for more awareness about safety measures to prevent these serious injuries. 5

Using Hip Pads Prevents Injury in Recreational Snowboarders

In a study published in 2012 in the British Journal of Sports Medicine, researchers from Japan wanted to learn if hip pads reduced some of the injuries that happened to recreational snowboarders. The cohort consisted of 5,561 injured snowboarders who were admitted to a Japanese hospital during four snowboarding seasons. Distal radial fracture (broken wrist) and head injury were the two most common injuries. Other frequent injuries included clavicle fracture, humerus fracture, glenohumeral dislocation (shoulder dislocation), spinal burst, compression fractures, and elbow dislocation. The researchers found that the use of hip pads reduced the overall risk of these injuries. The researchers commented that the “reduction in the overall risk of common snowboarding injuries is necessary to make snowboarding safer.” And, hip pads were the only “effective protective gear to reduce the overall risk of common injuries.” 6

Protective Gear Reduces Flag Football Injuries 7

Protective Gear Prevents Boxing Injuries

In a study published in 2010 in Deutsches Ärzteblatt International, researchers from Germany noted that boxing has been associated with a number of medical problems, including concussions and dementia. As a result, they conducted a comprehensive review of several studies on the acute, subacute, and chronic neuropsychiatric consequences of boxing to determine if the use of protective gear, such as a head guard and heavily cushioned gloves, could prevent some of these serious medical problems. The researchers found that protective gear has dramatically reduced the risk associated with amateur boxing. However, there appears to be a lack of interest in protective gear for professional boxing. Apparently, such gear has the potential to decrease the “thrill, which does appeal to many supporters.” 8

Using Helmets Prevents Injuries in Children Participating in Nonmotorized Wheeled Activities 9

In Many Instances, Protective Gear Is Cost-Effective

In a study published in 2008 in the Southern Medical Journal, researchers from Cincinnati, Ohio, examined the cost-effectiveness of requiring all recreational ice hockey players to wear facial protection. The researchers surveyed 190 players, with a mean age of 34 years, at two indoor hockey rinks in Evendale, Ohio, from October 2005 to March 2006. On average, they had been playing hockey for 17 years. Forty-six percent of the hockey players reported experiencing a serious injury during the previous five years. Yet, 25 percent of those surveyed did not wear face protection, which only cost $48 per person. “Individuals with face protection reported significantly more sprains and strains that resulted in significantly more physician office visits and specialty physician visits.” According to the researchers, over a five-year period, face protection would prevent seven facial lacerations and three facial bone fractures. That would be a savings of about $15,000 (in 2008 dollars). The researchers concluded that “wearing face protection is cost-effective due to the prevention of facial injuries.” 10

BARRIERS AND PROBLEMS

People Using Protective Gear May Take More Risks

In a study published in 2007 in Accident Analysis & Prevention, researchers from Canada examined the notion that school-age children who wore protective gear engaged in more risk-taking practices. The cohort consisted of 100 children in four groups. One group had 25 boys between the ages of seven and nine years; a second group had 25 girls of the same age. The third and fourth groups had 25 boys between the ages of 10 and 12 years and 25 girls of the same age. Each child navigated an obstacle course twice, once with protective gear and a second time without. To minimize the potential for practice effects, the second navigation was completed in the reverse direction. Children and parents independently completed questionnaires. The researchers found that when the children were wearing protective gear, they had more “reckless and risky behaviors.” When they were wearing their protective gear, “children went faster through the obstacle course and behaved more recklessly, as indicated by tripping and falling and banging into things more frequently.” Those children who were high in “sensation seeking” were more likely than the other children to take risks. 11

12

All-Terrain Vehicle Safety Education Program Failed to Improve the Use of Protective Gear

In a study published in 2013 in the Journal of Primary Care & Community Health, researchers from Los Angeles and Peoria, Illinois, wanted to learn if a program to improve all-terrain vehicle safety was improving safety knowledge and practice among youth in rural central Illinois. The cohort consisted of 260 rural central Illinois middle and high school students. During the 2009 to 2010 school year, they received didactic and interactive training in all-terrain vehicle safety. Before and after this training, the students completed surveys, which included questions about all-terrain vehicle safety knowledge and actual riding practices.

Before the intervention, more than 200 surveys were collected; 12 to 24 weeks after the intervention, 165 surveys were collected. The researchers learned that after the educational program, there were significant increases in knowledge about safety issues. However, there was no significant increase in the use of protective gear. According to the researchers, even though the students knew what they should be doing, the “nonsignificant changes in riding practices and crash rates demonstrated that youth behavior is more difficult to impact than knowledge.” The researchers suggested that a future program may be more successful if it also targets the parents. 13

Football Helmets Do Not Always Protect Players from Concussions

In a study presented to the 66th Annual Meeting of the American Academy of Neurology, held from April 26 to May 3, 2014, in Philadelphia, researchers from Florida noted that the football helmets that are currently used provide little protection to the side of the head. The researchers conducted 330 tests on dummies to measure the ability of 10 popular football helmets to protect against traumatic brain injury. When compared to wearing no helmet, the researchers found that the football helmets reduced the risk of traumatic brain injury by only 20 percent. According to the lead researcher, Frank Conidi, MD, DO, MS, “Alarmingly, those that offered the least protection are among the most popular in the field.” 14

Some Football Helmets Appear to Be Better Than Others in Preventing Concussions

In a retrospective analysis published in 2014 in the Journal of Neurosurgery, researchers from multiple locations in the United States wanted to learn if some football helmet designs are better than others in preventing concussions. The cohort consisted of head impact data collected from 1,833 collegiate football players. Out of a total of 1,281,444 head impacts that were recorded, there were 64 diagnosed concussions. Different helmets appeared to place players at increased or decreased risk for sustaining a concussion. According to the researchers, “not all helmets are designed equally in their ability to rescue the head accelerations resulting from impact.” As a result, “helmet designs should be optimized to reduce head acceleration over the continuum of impacts experienced by football players.” 15

NOTES

1. U.S. Centers for Disease Control, www.cdc.gov.

2. Stop Sports Injuries, www.stopsportsinjuries.org.

3. The Nemours Foundation, http://kidshealth.org.

4. Ibid.

5. Richard Keijzer, Geni F. Smith, Keith E. Georgeson, and Oliver J. Muensterer, “Watercraft and Watersport Injuries in Children: Trauma Mechanisms and Proposed Prevention Strategies,” Journal of Pediatric Surgery 48 (2013): 1757-61.

6. Daichi Ishimaru, Hiroyasu Ogawa, Kazuhiko Wakahara et al., “Hip Pads Reduce the Overall Risk of Injuries in Recreational Snowboarders,” British Journal of Sports Medicine 46, no. 15 (2012): 1055-58.

7. Y. Kaplan, G. Myklebust, M. Nyska et al., “The Prevention of Injuries in Contact Flag Football,” Knee Surgery, Sports Traumatology, and Arthroscopy 22, no. 1 (2014): 26-52.

8. H. Försti, C. Haass, B. Hemmer et al., “Boxing—Acute Complications and Late Sequelae: From Concussion to Dementia,” Deutsches Ärzteblatt International 107, no. 47 (2010): 835-39.

9. H. Lindsay and M. Brussoni, “Injuries and Hemet Use Related to Non-Motorized Wheeled Activities Among Pediatric Patients,” Chronic Diseases and Injuries in Canada 34, no. 2-3 (2014): 74-81.

10. Scott E. Woods, John Diehl, Eric Zabat et al., “Is It Cost-Effective to Require Recreational Ice Hockey Players to Wear Face Protection?” Southern Medical Journal 101, no. 10 (2008): 991-95.

11. Barbara A. Morrongiello, Beverly Walpole, and Jennifer Lasenby, “Understanding Children’s Injury-Risk Behavior: Wearing Safety Gear Can Lead to Increased Risk Taking,” Accident Analysis & Prevention 39 (2007): 618-23.

12. Cynthia J. Thomson and Scott R. Carlson, “Increased Patterns of Risky Behaviours Among Helmet Wearers in Skiing and Snowboarding,” Accident Analysis and Prevention 75 (2015): 179-83.

13. Joshua A. Novak, John W. Hafner, Jean C. Aldag, and Marjorie A. Getz, “Evaluation of a Standardized All-Terrain Vehicle Safety Education Intervention for Youth in Rural Central Illinois,” Journal of Primary Care & Community Health 4, no. 1 (2013): 8-13.

14. Science Daily, www.sciencedaily.com/releases/2014/02/140217200751.htm.

15. Steven Rowson, Stefan M. Duma, Richard M. Greenwald et al., “Can Helmet Design Reduce the Risk of Concussion in Football?” Journal of Neurosurgery 120 (2014): 919-22.

REFERENCES AND RESOURCES

Magazines, Journals, and Newspapers

de Rome, L., R. Ivers, M. Fitzharris et al. “Effectiveness of Motorcycle Protective Clothing: Riders’ Health Outcomes in the Six Months Following a Crash.” Injury 43 (2012): 2035-45.

Försti, H., C. Haass, B. Hemmer et al. “Boxing—Acute Complications and Late Sequelae: From Concussion to Dementia.” Deutsches Ärzteblatt International 107, no. 47 (2010): 835-39.

Ishimaru, Daichi, Hiroyasu Ogawa, Kazuhiko Wakahara et al. “Hip Pads Reduce the Overall Risk of Injuries in Recreational Snowboarders.” British Journal of Sports Medicine 46, no. 15 (2012): 1055-58.

Kaplan, Y., G. Myklebust, M. Nyska et al. “The Prevention of Injuries in Contact Flag Football.” Knee Surgery, Sports Traumatology, Arthroscopy 22, no. 1 (2014): 26-32.

Keijer, Richard, Geni F. Smith, Keith E. Georgeson, and Oliver J. Muensterer. “Watercraft and Watersport Injuries in Children: Trauma Mechanisms and Proposed Prevention Strategies.” Journal of Pediatric Surgery 48 (2013): 1757-61.

Lindsay, H., and M. Brussoni. “Injuries and Helmet Use Related to Non-Motorized Wheeled Activities Among Pediatric Patients.” Chronic Diseases and Injuries in Canada 34, no. 2-3 (2014): 74-81.

Morrongiello, Barbara A., Beverly Walpole, and Jennifer Lasenby. “Understanding Children’s Injury-Risk Behavior: Wearing Safety Gear Can Lead to Increased Risk Taking.” Accident Analysis & Prevention 39 (2007): 618-23.

Novak, Joshua A., John W. Hafner, Jean C. Aldag, and Marjorie A. Getz. “Evaluation of a Standardized All-Terrain Vehicle Safety Education Intervention for Youth in Rural Central Illinois.” Journal of Primary Care & Community Health 4, no. 1 (2013): 8-13.

Rowson, Steven, Stefan M. Duma, Richard M. Greenwald et al. “Can Helmet Design Reduce the Risk of Concussion in Football?” Journal of Neurosurgery 120 (2014): 919-22.

Thomson, Cynthia J., and Scott R. Carlson. “Increased Patterns of Risky Behaviours Among Helmet Wearers in Skiing and Snowboarding.” Accident Analysis and Prevention 75 (2015): 179-83.

Woods, Scott E., John Diehl, Eric Zabat et al. “Is It Cost-Effective to Require Recreational Ice Hockey Players to Wear Face Protection?” Southern Medical Journal 101, no. 10 (2008): 991-95.

Web Sites

Stop Sports Injuries. www.stopsportsinjuries.org .

The Nemours Foundation. http://kidshealth.org .

U.S. Centers for Disease Control. www.cdc.gov .

  This information is not a tool for self-diagnosis or a substitute for professional care.