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Facial Injuries in HEMA, Mask Fitting, and More
Back in Fall 2024 when the Beyond the Blade newsletter was not being indexed we did an issue focused on orofacial trauma in HEMA. As these injuries continue to happen in competition and freeplay, this week we’re revisiting that topic in request from one of our readers. Although fencing masks do a great job at protecting us from penetrating injury, their ability to “waffle” inwards do little to protect us from blunt trauma to the mouth, forehead, or nose. Others wear their mask fitted or worn incorrectly, putting the mask at risk of rocking back and impacting the face during incidental contact. Let’s take a look at some of the data and recommendations for oral trauma in sport.
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Research Corner
In Fall 2024 we discussed an editorial from the British Journal of Sports Medicine (BJSM) on mouthguards. The article describes the current position statement from leaders in the sports medicine and dental fields, and underscores the importance of mouthguards in preventing orofacial trauma (OFT) in sport. Here’s what the data says:
Real Injury Reduction: Non-mouthguard users are over 7 times more likely to sustain dental trauma in contact sports compared to those who wear them (59.5% vs. 7.5%). Relative Risk Reduction: Mouthguard use decreases the risk of OFT by over 200% compared to athletes who don’t use them (all sports). Custom vs. Stock: Custom-made mouthguards, fitted by dental professionals, provide the best protection and comfort. Meanwhile, off-the-shelf options like boil-and-bite mouthguards offer varying levels of fit and safety but remain a cost-effective alternative - IF you actually wear them. Comfort and Performance: Contrary to popular belief, well-fitting mouthguards don’t impede performance or communication once athletes get used to them. Most athletes can acclimate to wearing a mouthguard within a few weeks. tl;dr: consistent use of mouthguards, regardless of sport, significantly reduces both the frequency and severity of dental injuries. |
HEMA Hot Take: Mandatory Mouthguards?
Let’s shift the focus specifically to HEMA. What do we compare it with? Unlike MMA or jiu jitsu, olympic fencing isn’t typically associated with intended or incidental direct facial impacts and serious orofacial injury is very rare (BUT still not unheard of). On the other hand, HEMA is diverse - some weapons and rulesets involve grappling, wrestling, as well as less flexible weapons than olympic fencing, at which point the risk likely starts to approach that of traditional combat sports. Newer HEMA masks like the increasingly popular Wukuski design resist "waffling" or buckling in fairly well, but the mask can still shift on the fencer's face with a direct impact enough to create injury. Where do we draw that line, then, and should mouth guards be a required part of the HEMA equipment check? Here’s my take, provided sparring intensity is appropriate for the weapon.
Smallsword: Likely not needed, lowest (but not 0) risk of facial injury
Sword & Buckler, Rapier, Saber, Longsword: Not required but recommended for high intensity sparring & competition.
Armored Combat - depends heavily on the design of the helmet and how it fits (i.e. a Houndskull and a close fitting Armet are difficult to compare), but still not a bad idea for high intensity sparring or where throws may occur
Ringen/Abrazare/Wrestling: Here there is no question that a mouthguard is essential both in practice and in competition. Face-limb and face-head collisions are common, making mouthguards a must to prevent dental trauma. From what I've seen in dagger competitions, I would also put dagger in this category.
Coach’s Corner
What to do if a Fencer Knocks Out a Tooth
Accidents happen, but dental injuries can feel alarming for everyone involved. Here’s a quick-and-dirty guide to dealing with a knocked-out or displaced tooth:
Act Quickly: Time is critical. Ideally, you want to find and place the tooth back in the mouth as quickly as possible.
Handle with Care: Pick up the tooth by the crown (the white chewing surface), not the root. Avoid touching the root to prevent damage.
Rinse Gently: If the tooth is dirty, rinse it gently with milk or saline. Avoid using water or scrubbing the tooth if possible.
Replant if Possible: If the fencer is conscious and the tooth is intact, try to gently place it back into the socket. Have the fencer bite down on a clean cloth or gauze to hold it in place until they can get help.
Store Safely: If replanting isn’t possible, store the tooth in milk, saline solution, or a tooth preservation kit. In a pinch, old advice is to have the fencer hold it in their cheek (if they’re conscious and not at risk of swallowing it), but use your discretion here.
Seek Immediate Dental Care: Head to the nearest emergency dentist (call first) or the emergency room as soon as possible.
Broken Bits: For chipped or fractured teeth, rinse the mouth with warm water and apply a cold compress to reduce swelling. Save any fragments and bring them to the dentist.
Health & Fitness Tips - Fit your Fencing Mask
Fitting a fencing mask well requires more than just choosing between small, medium, and large and tossing it on your head. If you want to have the best chance of your mask protecting you from injury, make sure it’s fit appropriately:
Size Wisely: It sounds silly to need to say this, but make sure you actually measure your head and compare it to the listed sizes from the vendor when purchasing. Trying on your friend’s size M and calling it a day if you can cram your head in it is likely to result in ordering the wrong size.
Set it Up: It’s not ready out of the box. Depending on the make and model of the mask it will have the metal tongue that needs to be shaped to your head as well as an adjustable velcro strap (or two). For directions on how to safely shape the tongue without compromising the mask design, check out this page from Imex Sport.
Check the Fit: Once you think you’re good to go, check the fit with these quick actions:
Make sure you can talk and move your jaw comfortably.
Shake your head "yes", and "no". Your mask should follow your head movement and not feel like it’s sliding.
Now hold your mask in place, and try to shake your head yes and no again. You should feel like your mask slides a bit and your head can move a little inside.
Look down at your toes and then up at the ceiling. Your chin should still be resting in the same spot after all of these maneuvers.
Breaking it In: Just like gloves, masks require a break in period to start to feel comfortable. At the beginning you may feel pressure on your neck from the stiff bib or have a hard time getting it on and off easily. This is fine. Expect to re-adjust the mask as it breaks in over the course of a few weeks. If needed, wear it around the house for awhile each day until its broken in enough you can begin fencing in it.
Conditioning Move of the Week
Depth Drop to Lateral hop
This plyometric move combines the power generation of a depth drop with an explosive but controlled lateral hop. This exercise builds strength, stability, and power in the lower body, focusing on the ability to absorb force in a controlled way and then redirect it effectively - exactly what you need for quick direction changes in your fencing.
Upcoming Events
⛰️ Highland TwotenannyJoin Sprezzatura April 11-12 in the Appalachian Highlands of TN for a weekend of HEMA shenanigans! Coach Liz will be leading a workshop on all things conditioning for HEMA at this weekend-long event. We’ll be warming up, cooling down, and exploring games that make group conditioning fun. Registration closes soon - hope to see you there! | 💥 Summer is Coming!I am looking for EIGHT HEMA fencers who are ready to start a conditioning journey together to get ready for summer events. If you do not currently go to the gym (or feel lost when you do), and are ready to jumpstart your conditioning at beginner-friendly pricepoint, we’ve cooked up an exciting new program just for you. Stay tuned for more info! SUMMER CONDITIONING ACCELERATOR: Enrolling soon! |
What are your thoughts on mouthguards for HEMA? What would it take for YOU to wear a mouthguard? Send me an email or reach out on social media, I’d love to hear your opinions.
Coach Liz
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