Northwest Health | SPRING 2009 By Rhonda Aronwald

As a pediatrician and a parent, Timothy Seppa, MD, knows firsthand how difficult it can be to get children and adolescents to wear protective gear. Because Dr. Seppa suffered a head injury in a childhood skating accident, he insisted that his daughter wear a helmet in the skating rink — something she'd only do if she was allowed to wear a wool hat on top. "She thought it looked more cool that way," says Dr. Seppa, who sees patients at Group Health Riverfront Medical Center in Spokane.

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But kids aren't the only ones who are image conscious and skimp on gear. Adults may also feel that protective apparel is unfashionable, uncomfortable, or unnecessary. "But the best athletes know that it's better to be safe than to waste a whole season over a serious injury," says Dr. Seppa.

Besides, these days gear is becoming increasingly hip. Stars of cycling, for example, have made colorful, aerodynamic helmets part of the look for recreational and professional riders alike.

Dr. Seppa would like to see athletes of all ages and skill levels discover the "cool factor" of protective apparel. "We see too many broken teeth, injured eyes, and sprained wrists when players go without gear," he says. "Many injuries could be prevented if people wore safety gear properly, with the right fit, and if they checked and maintained the equipment on a regular basis."

Protect Yourself From Head to Toe

Above the shoulders. In many athletic activities, your head is the most vulnerable part of your body — which is why helmets are the most important piece of gear you can wear.

"A lot of injuries can be treated and will respond to surgery, but severe brain injuries are often irreparable," says David Grossman, MD, Group Health medical director of Preventive Care and past director of the Harborview Injury Prevention and Research Center. "Research shows that helmets can prevent facial injuries, in addition to protecting the brain."Helmets are tailored to different activities and areas of likely impact for particular sports, so wearing the right one is important. Wearing it the right way is important too. Bicycle helmets, for example, don't provide protection if they're too loose, or are worn tipped back on the head.

Protective eyewear is advised for basketball, baseball, racquet sports, and cycling. Face shields are recommended or mandatory for baseball and hockey. "Baseball accidents account for 40 percent of all eye injuries in the 11- to 14-year-old age group," says Dr. Seppa.

Dental injuries are among the most common type of mouth and facial injury in athletics, and mouth guards add huge protective value — at a low cost. They act as a shock absorber for the teeth and jaw, protecting against flying balls, pucks, or elbows. They can also help prevent breaks to the facial bones and injuries to the neck and central nervous system.

Torso. Like the brain, the heart is a critical organ that's less forgiving in an accident. The heart and ribs are especially vulnerable in sports involving high-velocity balls or pucks — like baseball, hockey, and lacrosse — and high-impact sports like football. Fortunately, using protective apparel such as body padding and helmets is standard practice in many higher-risk athletic activities. For example, chest protectors are mandatory for catchers and umpires in baseball.

Shoulder pads protect athletes in tackling sports where clavicle fractures, shoulder dislocation, and joint separation are more common. Athletic supporters (cups) for boys and men protect the genitals.

Arms and legs. Wrists and elbows are particularly vulnerable in activities such as roller sports, skateboarding, and snowboarding, where the body can hit hard surfaces at high speed. Wrist and elbow guards can provide protection from impact when falling onto outstretched hands or elbows.

Knees, which "float" on the legs, held on by tendons and muscle, are vulnerable to injury in many sports. Knee pads are especially important for inline skating and skateboarding, and specialty pads are available for volleyball players and baseball catchers. Shin pads, for the area of the leg between the knee and the foot, are recommended for sports such as soccer, hockey, lacrosse, baseball, and softball.

Ankles and feet. Ankles can be vulnerable when an athlete lands awkwardly, and ankle sprains are the most common injury in the United States. Taping the ankle or wearing an ankle brace can help prevent injuries.

Stress fractures occur in the bones of the feet, and appropriate footwear plays a big role in prevention. Before heading to the basketball court, for example, choose a shoe with a stiff, thick sole for support while running and landing from jumps to the basket. Footwear needs vary depending on the sport.

Seek Guidance From Those Who Know

Athletic associations and athletic stores can provide further guidance on the use and selection of protective gear. The National Operating Committee on Standards for Athletic Equipment (NOCSAE) approves equipment for sports that include baseball, football, soccer, and lacrosse. Look for a NOCSAE stamp of approval when choosing athletic equipment.