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Sports Medicine Articles

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Steve Kleeman, L.A.T.C.

Northeast Rehabilitation Health Network

Head Athletic Trainer Billerica High School

discussing sports injury prevention, frequently, one of the first suggestions is
the introduction or modification of safety equipment. Unfortunately, often
equipment is introduced without thoughtful and careful consideration of the pros
and cons of a particular piece of equipment. Some possible negatives to consider
when introducing safety equipment include increasing the aggressiveness of play,
creating a sense of invulnerability amongst players and changes in the
techniques employed by the players and coaches.

football is a very different game than when it was first introduced. The most
significant change in the game with regards to equipment is the modem football
helmet. The modem football helmet was first introduced in the early 1960’s. by
the late 60’s deaths due to head injury had dropped to 5 per year nationwide.
However, at the same time a steady increase in cervical spine injury developed.
Cervical spine injuries were determined to occur when a player strikes an
opponent with the helmet. Football players had begun to use the helmet, designed
as protective device, as a weapon against opponents. So while the helmet brought
about its desired end it also brought about changes in the way the game was
played which led to a devastating new injury .A similar situation developed in
ice hockey with the advent of the full-face mask and helmet. Researchers found
that there was an increase in the number of spine injuries and fatalities that
occurred when players hit the boards headfirst. Many observers of hockey have
noted that the players became more reckless and aggressive after the full-face
mask and helmet were introduced. In both instances rule changes and changes in
coaching technique have led to a drop in cervical spine injuries.

it was proposed that youth baseball programs begin using facemasks on the
batting helmets, chest protectors for the batters and softer baseballs. All of
these proposals are due to the fact that the majority of injuries in youth
baseball are caused by the impact of a ball. A worthwhile and appropriate goal
but what are the possible negatives? Will this increase in protection lead to an
increase in player to player contact due to a feeling of invulnerability? Will
there be a change in the nature of the game itself because the batters and the
base runners would likely need this protection? These are the types of questions
that need to be answered before implementing equipment changes.

debate currently underway is whether girls’ lacrosse/field hockey should wear
head and face protection. One side saying that if head and face injuries might
be prevented then the equipment should be issued. The other opinion being that
injury data does not show head and face injuries to be a large enough percentage
of the injuries in this sport. Therefore, the potential decreased in injuries is
not worth the risk of changing the nature of the game.

issues raised in these examples are only a few of the many ongoing dilemmas of
this type. These examples do, however, help to illustrate that the introduction
of protective equipment without careful consideration can work against the goal
of injury prevention.