Sports Safety

Introduction
General prevention guidelines
Warm-up and stretching
Treating and Preventing Facial Injury
Mouth Guards

General prevention guidelines
Before beginning an exercise program or training for an athletic event, follow a few simple guidelines to help prevent injuries.

Prevent injuries with a complete examination

• Have your doctor review your medical history.
• Make sure you receive a heart and lung examination.
• Schedule an orthopaedic screening.

Prevent injuries with proper attire and equipment

• Make sure your equipment fits properly (ie, helmet, tennis racquet grip, etc).
• Make sure you wear quality shoes designed for your sport or foot type (ie, good arch support, durable heel, proper sole contour, and flexibility).
• Obtain necessary mouth guards or face masks for collision sports.

Prevent injuries by training and playing "smart"

• Avoid overuse injuries like tendinitis and stress fractures by beginning slowly and gradually increasing the time and intensity of your workouts.
• Acclimate yourself to the environment. Avoid heat or cold-related stresses.
• Limit your workout session to two hours. Allow adequate time to recover from a training session.
• Maintain hydration or fluid levels. Drink plenty of water before, during, and after practice or competition.

Prevent injuries by training correctly

• Address all aspects of fitness, muscle strength, endurance, cardiovascular fitness, and flexibility.
• The minimum training requirement is two times per week to see improvement in aerobic or anaerobic activity.
• Noticeable improvements in strength and endurance take three to four weeks.
• Your pre-season conditioning program should begin six weeks prior to the start of your sports season.

• Warm-up prepares the body for performance, decreases the potential for soft tissue injury, and helps reduce delayed onset muscle soreness that can follow exercise.
• Warm-up should consist of 15 minutes of sub-maximal sports-specific exercise. This activity increases the bodies heart rate, body and muscle temperature, and muscle elasticity.

Prevent injuries by stretching

• Stretching prepares your muscles for activity and prevents injuries from tight soft tissue structures such as muscles and tendons.
• Static stretches should be slow and sustained; no bouncing or jerking. You should not feel pain while stretching. Stretch the entire body. No sport requires just part of the body's involvement. Stretch each body part two to three times for 20 to 30 seconds.

First aid treatment for injuries (RICE)

• Rest - Relative rest to reduce the stress to the injured area.
• I-ce - Apply ice to the injured area for 20 minutes at a time four times per day.
• C-ompression - Apply an elastic bandage to the injured area. Do not sleep with elastic bandage on.
• E-levation - Raise the injured body part above the level of the heart to decrease blood flow.

Prevention of re-injury

• Rehabilitate your injury completely before returning to competition or activity.
• Protect the injured area with special equipment or brace.
• Gradually return to practice or competition.

Maxillofacial injuries, also referred to as facial trauma, encompass any injury to the mouth, face and jaw. Almost everyone has experienced such an injury, or knows someone who has. Most maxillofacial injuries are caused by a sports mishap, motor vehicle accident, on-the-job accident, act of violence or an accident in the home.

If a person is unconscious, disoriented, nauseated, dizzy or otherwise incapacitated. Do not attempt to move the individual yourself. If these symptoms are not present but the injury is severe or you are uncertain about its severity, take the person to the nearest hospital emergency room as quickly as possible.

One of the most common types of serious injury to the face occurs when bones are broken. Fractures can involve the lower jaw, upper jaw, palate, cheekbones, eye sockets and combinations of these bones. These injuries can affect sight and the ability to breathe, speak and swallow. Treatment often requires hospitalization.

The principles for treating facial fractures are the same as for a broken arm or leg. The parts of the bone must be lined up (reduced) and held in position long enough to permit them time to heal. This may require six or more weeks depending on the patient's age and the fracture's complexity.

While not all facial injuries are extensive, they are all complex since they affect an area of the body that is critical to breathing, eating, speaking and seeing. Even in the case of a moderately cut lip, the expertise of the oral and maxillofacial surgeon is indispensable. If sutures are needed, placement must be precise to bring about the desired cosmetic result. So a good rule of thumb is not to take any facial injury lightly.

Because avoiding injury is always best, oral and maxillofacial surgeons advocate the use of automobile seat belts, protective mouth guards, and appropriate masks and helmets for everyone who participates in athletic pursuits at any level. You don't have to play at the professional level to sustain a serious head injury. New innovations in helmet and mouth and face guard technology have made these devices comfortable to wear and very effective in protecting the vulnerable maxillofacial area. Make sure your family is well-protected. If you play the sport, make the following safety gear part of your standard athletic equipment.

Football: Helmets with face guards and mouth guards should be worn. Many of the helmets manufactured for younger players have plastic face guards that can be bent back into the face and cause injury. These should be replaced by carbon steel wire guards.

Baseball: A catcher should always wear a mask. Batting helmets with a clear molded plastic face guard are now available; these can also be worn while fielding.

Ice Hockey: Many ice hockey players are beginning to wear cage-like face guards attached to their helmets. These are superior to the hard plastic face masks worn by some goalies, as the face guard and the helmet take the pressure of a blow instead of the face. For extra protection, both face and mouth guards — including external mouth guards made of hard plastic and secured with straps — can be worn.

Wrestling: More and more high school athletic associations require wrestlers to wear head gear. A strap with a chin cup holds the gear in place and helps steady the jaw. Recently, face masks have been developed for wrestlers, who should also wear mouth guards.

Boxing: Mouth guards are mandatory in this sport. A new pacifier-like mouth guard for boxers has been designed with a thicker front, including air holes to aid breathing.

Lacrosse: Hard plastic helmets resembling baseball batting helmets, with wire cage face masks, are manufactured for this sport.

Field Hockey: Oral and maxillofacial surgeons recommend that athletes participating in this sport wear mouth guards. Goalies can receive extra protection by wearing Lacrosse helmets.

Soccer: Soccer players should wear mouth guards for protection. Oral and maxillofacial surgeons advise goalies to also wear helmets.

Biking: All riders should wear lightweight bike helmets to protect their heads. Scooters and Skateboarders: Bike helmets are also recommended for those who ride two-wheeled scooters and skateboards.

Skiing and Snowboarding: The recent surge in accidents among skiers and snowboarders has encouraged many safety conscious participants to wear lightweight helmets that will protect the maxillofacial area in the event of a fall or crash.

Horseback Riding: A helmet and mouth guard are recommended for horseback riding, particularly if the rider is traveling cross-country or plans to jump the horse.

Basketball, Water Polo, Handball, Rugby, Karate, Judo, and Gymnastics: Participants in these sports should be fitted with mouth guards.

New synthetic materials and advances in engineering and design have produced mouth guards that are sturdier yet lightweight enough to allow the wearer to breathe easily. Mouth guards can vary from the inexpensive "boil and bite" models to custom-fabricated guards made by dentists, which can be adapted to the sport and are generally more comfortable.

A mouth protector should be evaluated from the standpoint of retention, comfort, ability to speak and breathe, tear resistance and protection provided to the teeth, gums and lips.

There are five criteria to consider when being fitted for a mouth protector. The device should be:

1. fitted so that it does not misalign the jaw and throw off the bite;
2. lightweight;
3. strong;
4. easy to clean; and
5. should cover the upper and/or lower teeth and gums.