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Injuries take the field

With the beginning of football season, hurt knees and ankles can't be far behind. Some precautions can help prevent injury.

I've always suspected that football is a game created by orthopedic surgeons. Short of a car accident, there are few activities that can cause so much damage in otherwise healthy young men.

The start of the school year means the start of football, and that also means someone is going to get hurt. The injury rate for high school football is as high as 50 percent in some studies. However, there are a number of steps that athletes, parents, coaches and school administrators can take to decrease injuries.

Most injuries occur during the preseason. Many football players do not report to camp in shape. They use the two-a-day workouts to get into shape. The chance of an injury in preseason is 5.4 times more likely than in in-season practices. Players need to start running six weeks before the start of football practice. This will improve their chance of making the team and decrease the chance of an injury.

Equipment must fit correctly to function properly. The helmet probably is the most important piece of equipment. When fitted properly, it can prevent a skull fracture or a severe concussion. The front of the helmet should be two finger widths above the eyebrows. The back of the helmet should cover the skull base but not dig into the neck. The ear holes should coincide with the canals. The jaw pads should fit snugly to prevent rocking.

Shoulder pads are fitted according to size. The inner pads should cover the tips of the shoulder. The neck area should not be constricting yet should minimize the areas exposed to injury. Straps and lacing should be as snug as possible without constricting breathing.

Rib and chest protection have been enhanced by the use of flak jackets. Quarterbacks, running backs and receivers are particularly vulnerable to rib injuries. When a player elevates his arms while throwing or catching the ball, the shoulder pads no longer cover the chest and ribs. It is always advisable to have extra protection for these areas in the form of a flak jacket.

The knee is most susceptible to a football injury. Unlike the helmet for the skull, there really is no protective device for the knee. Prophylactic braces have benefited linemen and linebackers. However, the injury rate in receivers, defensive backs and running backs actually increases with prophylactic knee braces, and many players in these positions say the brace hinders speed and agility. If a player is returning from an injury or surgery, however, a brace can prevent a recurrence.

Shoes and field conditions have increased injuries. Long cleats provide better traction but may cause more injuries because the foot remains in contact with the ground, letting the knee rotate and absorb the full impact of the tackle. Shorter cleats give way upon impact, preventing the knee rotation and resulting in fewer injuries.

Ankles are the second most frequently injured body part in football. Many players tape their ankles before practice and games. Taping is beneficial when done properly. Ankle braces and wraps also are effective in preventing injuries. If the team does not have a qualified coach or certified athletic trainer to tape ankles, ankle braces can be just as effective.

Dr. Koco Eaton is a St. Petersburg orthopedic surgeon. This article first appeared in the Times in 1996.

Fitting a helmet

The trainer checks how a helmet fits by having the athlete buckle the chin strap and hold his or her head straight ahead. The trainer grasps the sides of the helmet and tries to turn the helmet side to side and rock it front to back. A properly fitting helmet moves only slightly.

Jaw pads should fit snugly to prevent lateral rocking.

The front of the helmet should be about two finger-widths above the eyebrow.

The back of the helmet should cover the base of the skull, but not dig into the neck.

Source: Koco Eaton, M.D.