Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

Featured on Channel NewsAsia

Neck Protection

Serious injuries to the neck can be prevented by neck protection.

Shoulder padding

Shoulder padding is used by ice hockey, American football and lacrosse players, and in motor racing. Similar padding could probably also be used in other sports such as riding, cycling, alpine skiing, and ski-jumping, in which injuries to the shoulder area often occur.
Shoulder padding chiefly protects the front and outside aspect of the shoulder from impact. The padding should cushion the ball and socket joint and distribute the energy of the impact over the more robust surrounding tissues. The most common causes of shoulder injuries are falls on the outside of the shoulder, shoulder-to-shoulder tackles, or collision with the board in ice hockey. Such injuries can be prevented by shoulder padding. In American football, the tackle often hits the shoulders from above. These areas are especially protected with shoulder pads.

Elbow guards

Elbow guards are used in sports such as basketball, team handball, volleyball, ice hockey, American football and lacrosse. The most common cause of elbow injuries is falling and landing on the tip of the elbow. The guard should completely cushion this area and prevent it from hitting the surface.

Wrist guards

Wrist guards should be used in sports such as inline skating, skate-boarding, or snowboarding.

Genital protectors

Boxes (cups) are used by ice hockey and soccer players, cricketers, and boxers, and sometimes by American footballers, team handball players and others. A box should enclose the penis as well as the testicles and protect them against direct impact.

Hip or thigh guards

Hip or thigh guards are used by cricketers, ice hockey and American football players, and by goalkeepers in team handball and field hockey; they should be used more extensively. There are only a few hip guards on the market and they are generally badly designed. A hip or thigh guard should cushion the upper end of the femur and thus unload the hip joint itself.

Knee Pads

Knee pads protect the knee joints only during falls, and not when they are subjected to blows from the side or to twisting, which may cause meniscus or ligament injuries.Combined knee and shin pads are used by ice and field hockey players, while separate knee pads are used by basketball, team handball and volleyball players, and by American footballers, cricketers, and soccer goalkeepers.

The pads should cushion the force of the impact from falls as well as from blows to the knees and shins. The patella is especially sensitive and should be completely cushioned from impact, so that a blow to the knee is redistributed over the surrounding tissues.

Shin pads

Shin pads are used to protect the shin from kicks and painful contact with the surroundings.
Further development and research are needed to improve the shock absorption provided by shin pads and ultimately to reduce the risk of injury to bone and soft tissue.

Ankle and foot protection

For many athletes, shoes or boots are of prime importance since they protect against overuse injuries and sprains. The development of the protective properties of shoes, however, has been neglected, and we have, for example, only a limited knowledge of the relationship between the playing surface, the shoe and the foot, and of the importance of the design of the sole with regard to studs, profile, resilience, and so on.
The skating boot offers ice hockey players a built-in protection against injuries to the ankle and foot; alpine skiers have a similar protection in the ski boot. Skating and ski boots protect the ligaments and bones in the foot and ankle.

Ski safety bindings

Ski injuries continue to be common in spite of improved equipment and better facilities. The safeguard of importance in preventing injuries in skiing is the safety-release binding of the ski, providing it has been correctly designed and set. The type of ski binding has a direct effect on the overall injury rate in skiers. Some injuries occur because the release bindings are poorly designed and adjusted, and the binding fails to release properly, or releases at the wrong time. During the past few years there has been a significant reduction in binding-related injuries. There is evidence that a better-functioning ski binding is the single most important factor contributing to this trend, but approximately 30% of all injuries st ll remain related to improper binding performance.

The binding can be a multidirectional release, which releases in any direction the skier might fall. Bindings today still most commonly have a limited release function such as a side-to-side or twist release capability at the toe, and a forward lean mechanism on the heel. Few bindings incorporate several of these modes. The choice of ski binding for a beginner, who tends to fall frequently, should be a multimode release system.

Binding function should be checked regularly and well maintained. Mechanical checks should be carried out at least once before each season. The boots, bindings, and skis should be kept clean. The bindings should be tested each time someone uses the skis. The bindings should be tested in each and every direction before going on the slopes.

Ski poles and gloves

Injury to the ulnar collateral ligament at the base of the thumb is the most common upper extremity injury to the skier, and is to some extent related to the design of the poles. A ski pole should be designed so that it can readily be discarded. Another technique is to avoid placing the hand through the strap, so that the ski pole can be dropped during the fall. Gloves protect against fractures of the bones of the hand and painful bruising. They are used mainly by ice hockey and American football players, cricketers, and boxers. Injuries to the ligaments of the thumb and wrist may also be prevented.

General advice

Athletes should form their own opinions about the risks of injury in their particular sport, and should then test the protective clothing available. If this advice were followed more widely it would be possible to reduce the injury rate in many sports, especially in sports such as rugby in which traditionally little or no protection is employed.

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