The Man Behind the Mask

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Many people watched on national television as the Detroit Pistons triumphed over the Los Angeles Lakers in the 2004 National Basketball Association (NBA) championship finals. Especially notable for his performance in the series was Detroit Piston power forward Richard "Rip" Hamilton. While his above-the-rim performance in the series certainly drew the attention of the media, much of the hype landed on the clear plastic protective mask that Hamilton wore because of recent fractures to his nose.

"Rip" makes a break for the bucket. Photo courtesy of the Detroit Pistons, Allen Einstein photographer.

Having suffered a fractured nose early in the season, Hamilton suffered yet another in late February, which led to nasal reconstructive surgery. If he had any hope of remaining on the active roster for the NBA playoffs, with protection from further injury, he had to wear a protective mask. Mike Abdenour, team trainer for the Pistons, knew just who to call. "Jerry McHale is an expert in his field. We were first introduced to him in 1989 when Isiah Thomas and Joe Dumars suffered injuries to their hands. Jerry's expertise in orthotics and the padded splints he fabricated for them allowed them to continue regular season play just three to four weeks after surgery in that championship year for the Pistons."

Jerry McHale, CO, of the Michigan Hand & Sports Rehab Centers, headquartered in Warren, Michigan, has a long history of providing high-profile athletes with quality orthotic devices. In fact, McHale was the orthotist to introduce the first clear plastic facemask into sports medicine for protective purposes. McHale made the original protective mask for Bill Laimbeer, another notable "bad boy" of the Detroit Pistons, in 1990 after Laimbeer suffered an orbital fracture that extended into his cheek. Abdenour recalls his experience in working with McHale at that time, "We wanted something a little different than the usual white plastic facemasks that resembled those used in hockey. Jerry was the first to design a clear plastic facemask and this served as the forerunner for everything we see used today in sports rehab. Jerry's creativity speaks volumes about the progressive-thinking taking place in O&P. He is a genius at what he does." Abdenour says he receives at least two inquiries each month from people around the world asking where they can get the same sort of masks made for athletes. "Our organization is considering adding a link from our website to share Jerry's contact information with individuals seeking these specialized orthotic services," says Abdenour.

Career Path Leads to High-Profile Cases

Richard "Rip" Hamilton pictured with Jerry McHale, CO. Photo courtesy of the Detroit Pistons, Allen Einstein photographer.

Jerry McHale, who had been a certified orthotist for nearly 20 years, just recently rejoined the orthotic field following a four-year absence. In fact, he just recently received word that he passed his board tests to be certified by the American Board for Certification in Orthotics & Prosthetics (ABC), which had lapsed in his absence from the field. McHale started his own business, Orthotic Specialists, in 1987. After running the practice for about ten years, he sold his facility to NovaCare in 1997. He then left the practice and the O&P field altogether in 2000 to pursue other interests.

An automotive safety restraints company employed him to study lower-limb injuries caused by front-end collisions. He worked in this position for three years before a downturn in the automotive industry forced his layoff. McHale returned to orthotics in December of 2003, when the Michigan Hand & Sports Rehab Centers hired him to establish an orthotics department. He is also pursuing a masters degree in biomedical engineering at Wayne State University in Detroit. Having established himself in the orthotics and rehabilitative field many years ago, McHale was happily welcomed back by staff members at the Detroit Pistons organization. He had worked with the Piston organization's injured athletes many times over a 15-year period.

The Tedious Process of Fitting

McHale turns on vacuum as Durr-Plex sets up.
McHale turns on vacuum as Durr-Plex sets up.

McHale explained that clear plastic facemasks have been used for many years by occupational therapists for burn injuries to control scarring. McHale says, "Some people would think that having the clear plastic directly against the skin without a lining would irritate the burns; however, it actually provides a closer and more intimate fit to aid in healing with minimal scarring."

McHale describes the clinical process of making a clear plastic protective facemask, "You first have to take a negative impression of the facial area using plaster. It is very important to be extremely accurate. I first place stockinette material over the patient's hair, coat the face in Vaseline®, make marks on the face with an ink pencil, for trim lines and landmarks, then begin making the impression using plaster splints. I have tried using other materials, but I find that plaster is sufficient for required accuracy and is simple and easy to control. It usually takes around 20 minutes for the entire procedure."

The mask is set and ready for trim and detail.
The mask is set and ready for trim and detail.

From that negative plaster impression, which looks much like a mask of the patient's face at this point, a positive model is made. This means that the practitioner pours a plaster mixture into the negative model, allowing the plaster to set up. Once the plaster sets up, and the negative model is peeled away, the product is a detailed plaster impression of the patient's face. McHale then takes an 18-inch square of 3/16" Durr-Plex plastic material, which has been heated in an oven, and drapes or pulls it over the positive model of the patient's face. This process forms a clear mask over the entire face model that can be trimmed down to the appropriate size for the patient's specific needs. The mask usually extends from the tip of the nose to the front edge of each ear and from the hairline to just under the nose above the upper lip.

These masks can be used for nose fractures, orbital fractures, or cheek fractures. The effectiveness of the mask is determined by the fit. A total contact fit is typical except where relief is needed for lesions or breaks in the skin. The key component is to keep it simple, McHale notes. He further explains that many people ask, "why no padding?" The mask is very effective without it. The strapping system uses Velcro® and elastic which keeps the system simple, so athletes can then change and adjust the straps themselves when needed. According to McHale, this fabrication procedure can be used to make custom eye goggles or protective eyewear as well.

History of the Face Mask

McHale removes mask from positive model.
McHale removes mask from positive model.

McHale estimates that he has made several hundred facemasks for other facilities around the world on a central fabrication basis in his earlier days of practicing orthotics. He recalls having made Hamilton's most recent nemesis, Kobe Bryant, LA Lakers guard, a facemask in his high school years, via a central fabrication order from an industry colleague who was treating Bryant at the time.

McHale says that with the style of play in the NBA, Hamilton may not have been able to continue his season without further injury to his nose without the mask. According to McHale's account of the NBA playoffs, "There were players on the opposing team that may have purposely targeted Hamilton's nose in defensive play, just knowing that he had been injured several times." In 1990, when Bill Laimbeer suffered his fracture, which also required reconstructive surgery, opposing teams' players went after his face with malicious intent simply because of Laimbeer's "bad boy" role in the NBA. When asked in a recent interview about the usefulness of the mask at that time, Laimbeer offered this comment, "Following my reconstructive surgery, the mask distributed the weight of any hit and actually gave me confidence that I could stick my face into any intense rebounding scrum and not get hurt."

McHale shows a finished Hamilton mask.
McHale shows a finished Hamilton mask.

Because of cosmetic concerns, Hamilton initially was resistant to wearing the mask. Once he was convinced to follow through, he did a complete turnaround, realizing the value of the mask and the sense of protection it offered him while he had other important tasks on which to focus.

According to McHale and Abdenour, the Piston's medical staff has become a proponent for the protective facemask. Piston's medical staffers hope that the NBA will accept and offer it to players prone to facial injuries as a preventative measure.

Although Rip Hamilton was not available during the off-season to offer comment on the usefulness of the mask, McHale believes Hamilton expressed his feelings during the final minutes of the championship game. "As he walked off the court, replaced by a substitute with one minute to go in the final game, he removed his mask, held it up to the crowd, and pointed to it with his index finger. This gesture filled me with an overwhelming sense of pride, knowing that I had something to do with his success in some small measure," said McHale.