If your son is gearing up for the football season, or if he plays baseball in the spring and summer, you probably spend a good amount of time making sure he’s got the right cleats, pads and gloves. But there’s a good chance you haven’t thought of a vitally important piece of gear: an athletic supporter.

A Geisinger study showed that 18 percent of athletes experienced a testicular injury, and 36.4 percent observed injuries in team members, yet only 12.9 percent of athletes reported wearing athletic cups.

“A hard hit to the groin can cause severe pain and even nausea or vomiting for boys and men,” said Joel Sumfest, M.D., a Geisinger urologist who co-authored the study. “And if the hit is hard enough, it can also lead to testicular fracture or testicular rupture.”

A testicular rupture occurs when blood leaks into the scrotum from the testicles and requires surgery.

Testicular torsion, in which at least one testicle gets twisted around inside the scrotum to the point where the blood is cut off, could also result from a blow to the testicular area.

In a worst-case scenario and if left untreated, the affected testicle might have to be removed.

These risks are heightened once boys hit puberty and their testicles grow in size and the scrotum drops.

“But even if your son plays sports and is under the typical puberty age, it’s a good idea to get him in the habit of wearing a cup,” said Dr. Sumfest.

Some athletes forgo use of a cup due to its restrictive nature. Also, if the waistband of the jockstrap shifts position during the course of an athletic event, the supporter could become uncomfortable to wear and even inhibit movement and athletic performance.

An alternative option could be a jockstrap without a cup that fits snuggly enough, while keeping the testicles comfortably pressed against the body, which could also mitigate the effects of a blow to the testicular area.

According to the study, the prevalence of testicular injuries was highest for lacrosse, followed by wrestling, baseball and football.

Football is fourth on the list of sports that cause the most testicular injuries, but it typically produces the most severe injuries. Dr. Sumfest said football coaches should make protective cup use mandatory.

Several NFL players have recently admitted they do not wear cups. Former NFL linebacker Chad Brown even claimed that no NFL players wear cups.

“Your son’s coaches, whether football, lacrosse or any other sport, should be concerned about their athletes’ safety out on the field,” said Dr. Sumfest. “Severe injuries from hard, violent hits can occur during practice or games.”