Honoring Athletic Trainer and U.S. Army 1st Lt. Ashley White Stumpf

By Mackenzie Simmons, ATC

As Memorial Day passes and Independence Day draws closer, it’s a great time to remember all those who have served in the military for our country. The countless sacrifices soldiers make to defend our nation are appreciated everyday.  In 2011, the athletic training community lost a soldier in battle, which impacted the lives of many people.  A true hero, 1st Lt. Ashley White Stumpf will always be remembered for her bravery.

Ashley was a graduate of the 2009 Kent State Athletic Training Degree Program.  While I never met her personally, the impression she left on the students and staff in the program is unforgettable.  I will always remember the stories I’ve heard about her hard work ethic and compassionate heart.  She was friendly to everyone and portrayed strong values of honesty, integrity, loyalty, consistency and trust.  In the athletic training program, Ashley was one of the students who was a positive role model to all around her.

Following her graduation from Kent State University, Ashley was commissioned in the U.S. Army as a medical service corps officer.  After a few years in the service, Ashley went on her first deployment to Afghanistan as a member of a Cultural Support Team attached to a Joint Special Operations Task Force.  While in combat operation on October 21, 2011, an improvised explosive device was triggered; this unfortunately took her life.

Ashley gave the ultimate sacrifice to our country.  Some of the awards she achieved were the Parachutists Badge, the Ohio Faithful Service Ribbon, the Armed Forces Reserve Medal, the Bronze Star, the Purple Heart and Meritorious Service Medal.  Several memorials dedicated to Ashley help her legacy live on.

As I think of Ashley today, I am thankful for the soldiers who have battled for my freedom.  Thank you to past, present and current veterans for what you have done for our country. You are all my heroes.

For more information about this topic, visit www.ashleywhitestumpf.com. You can also purchase the book, Ashley’s War, by Gayle Tzemach Lemmon.


In-Depth Look: AT who is the Founder and President of 2 Companies

Pictured are: Edward B. Kravitz, wife Michelle, daughter Adriana and dog Daphne.

 

 

 

Name and title:

Edward B. Kravitz, MS, ATC, LAT

Founder and President

Athletic Trainer Solutions, LLC

http://athletictrainersolutions.com/

Innovative CEUs, LLC

http://innovativeceus.com/

 

Describe your setting:

Athletic Trainer Solutions, LLC (ATS) is a per-diem Athletic Trainer assignment company in Connecticut. ATS assigns independent contractor athletic trainers to cover a wide variety of athletic contests from youth sports, tournaments, and middle school, high school and college events. We currently assign AT coverage for 3,000 to 4,000 games per year in Connecticut. Innovative CEUs, LLC (ICEU) is an on-line National Medical-Based Youth and Secondary Coaching Educational Company. We have also recently launched a new client’s area on our ICEU website to allow us to host any third party on line course. This now allows ICEU to license their website to any organization to host and make any of their courses as an on-line course utilizing the ICEU on-line platform. Innovative CEUs, LLC (ICEU) will be the hosting site where ATs can get a wide variety of very affordable, convenient, on-line BOC EBP CEUs to fit their busy schedules.

 

How long have you worked in this setting?

I have been a certified athletic trainer since 1994 when I graduated Central Connecticut State University (CCSU).  I founded Athletic Trainer Solutions, LLC on April 10, 2007 and Innovative CEUs, LLC on August 30, 2010.

 

Describe your typical day:

In the mornings and early afternoons I do office work for both companies, and some afternoons and evenings I cover athletic contests as an athletic trainer through Athletic Trainer Solutions, LLC. Evenings not in the field working on business work and spending time with my happy, healthy and beautiful family: my wife Michelle, our daughter Adriana and dog Daphne we adopted from Georgia.

 

What do you like about your position?

My creativity and passion let me found and create Athletic Trainer Solutions, LLC (ATS) and Innovative CEUs, LLC (ICEU). Athletic Trainer Solutions, LLC (ATS) allows me to be able to do amazing work. ATS provides AT coverage for athletic venues that would never be able to afford a full time AT, as well as covers maternity leave coverage for schools that would never be able to get an AT to provide this coverage. ATS also is able to provide ATs with a central location to get high quality independent contract AT assignments that fit their busy schedules. Innovative CEUs, LLC (ICEU) lets me run with my other passion, creating educational programs for a wide range of individuals and groups. ICEU has their own on-line medical-based coaching educational courses as well as we now license our site to any organization that wants to provide on-line education to their membership. ICEU is partnering with a lot of organizations and companies to license their on-line educational platform.   The first AT organization we have partnered with is the Great Lakes Athletic Trainers’ Association (GLATA) – District IV. GLATA is real excited about this collaboration so they can offer their EBP courses at an affordable price to their membership. http://innovativeceus.com/special_courses/Great_Lakes_Athletic_Trainers_Association.php

 

What do you dislike about your position? 

I do not have any dislikes running my own business.  I am really passionate about my roles and position in Athletic Trainer Solutions, LLC (ATS) and Innovative CEUs, LLC (ICEU). I embrace the hard work it is to run and grow both companies. Sometimes there are days you wake up and don’t want to work on a project that needs to get done.

 

What advice do you have about your practice setting for a young AT looking at this setting?

A young AT should get a lot of experience in a wide range of settings before starting their own AT Assignment Company. There is a lot to creating and running your own company.  My phone can ring from a current or future client etc. at any time of the day or evening. You always need to answer and return these phone calls in a very timely manner. The same applies to emails. I have found it much better to call and or meet my clients rather than communicating with them via text, email or social media. It makes for a much better relationship with this personal connection.

When things need to get done, if AT coverage is requested at the last minute, sometimes it is me who moves my schedule around and covers the game to make sure all games are covered. Often this affects our family time, so to be successful with a family your spouse and family need to buy in and be part of your team to make this work as a family. I am fortunate my wife Michelle has always supported all my work related to starting both my businesses. Another lesson I learned running my own businesses is the customer or client is always right even when they are not. One dissatisfied customer or client can ruin your reputation.

Never be satisfied with the growth of your business. Always strive to grow or diversity your own business. One foundation of my successes was to always have a 5 year plan with 3 month, 6 month, 9 month and 1 year incremental goals to accomplish. Without this 5 year plan, I would find myself being complacent and spinning my wheels instead of moving forward towards a goal. Perseverance I believe is 99% the formula for being successful with anything in life. For every no you hear you are halfway to the yes answer you are looking for. Find a good mentoring system with people you know to be able to support and answer all your business questions. Running my own business I learn at least one new thing a day. A lot of times, I need to bounce a business idea to one of my support team or advisors to get their perspective before I make a decision. A lot of what I learned running my own business on a day to day basis is not taught in the classroom.


The Differently-Abled Athlete: Are They Really That Different?

Jenna Street, MS, ATC
street.jenna@gmail.com
@JennaStreet

The proper term to use when referring to an athlete who has a disability changes frequently.  You may have heard the terms handicapped, differently-abled or athlete with a disability.  Each term is meant to label or identify a physical or mental challenge one may have.  Athletes whose anatomy may not be referred to as normal by some, may not only have skill, but extraordinary skill.

Working with an athlete with a disability should be approached the same as with any other athlete.  Their medical history may be a bit longer, or it may not be; it all depends on the person.  Each athlete needs to be treated as such: an athlete.  Below is a short list of conditions an athlete may present with.  As you read through the list, ask yourself what, if any, small changes you could make to accommodate the athlete’s condition.

Arthrogryposis
Above elbow amputation
Above knee amputation
Below elbow amputation
Below knee amputation
Hearing impairment
Oosteogenesis imperfect
Spina bifida
Spinal cord injury
Visual impairment

As Athletic Trainers (ATs), we have the knowledge and skill set to help all athletes achieve their full potential.  With our ability to think outside the box, adapt and adjust, we have the knowledge to do our job with every single athlete.  We cannot allow ourselves to be intimidated or surprised by a wheelchair, prosthetic or service dog.

We are not expected to know everything, so don’t be afraid to ask questions and research a condition new to you. Take it as an opportunity to expand your knowledge, which will help expand your skill set.

With an increase in military, collegiate and Paralympic programs throughout the United States, there will most likely be an increase in differently-abled athletes.  It is best we are prepared so we can assist and treat every physically active individual who walks into our athletic training room, clinic or office.


The King-Devick Test for Concussion Evaluation: What Questions Should We Be Asking?

Claudia Percifield, MS, ATC

The King-Devick Test is a vision-based concussion assessment tool, which has been previously used to identify a variety of other medical conditions and learning disabilities.

1.   Who is this test appropriate for?

The simplicity of the testing (reading numbers) means a much younger demographic could successfully follow the instructions for the King-Devick Test, making it a much more universal testing option.  However, this test is completely dependent on having an available baseline measurement for comparison.  This would mean all teams, in all sports, would need to perform this as a baseline and keep the results on them at all times.  Is this feasible?

2.   How frequently do baseline scores become obsolete?

The Centers for Disease Control and Prevention (CDC) recommends baseline testing for other concussion testing annually, with neuropsychological testing performed at least every 2 years.  With brains that are constantly developing, how quickly will athletes outperform their baseline of the King-Devick Test, even after suffering a concussion?

3.   What happens if the test gets interrupted due to the job demands of an Athletic Trainer?

While the King-Devick test only takes 1-2 minutes to administer, a selling point compared to the SCAT3 exam, what happens when another athlete is down on the field or even requiring wound care?  This test is completely dependent on your focus and timing as the administrator to provide accurate results of how the athlete performs.  In a setting where medical staff is abundant, there will be no issue with administration; but at the high school level, one Athletic Trainer may be the sole person responsible for multiple events and practices at multiple venues simultaneously.  Will you be able to rely on this test as heavily?  Should you rely on others to administer this exam?  And if you do, how seriously will the athletes take it?

4.   What about athletes who do not wear corrective lenses for sport but may need them for reading?

If worn for baseline testing, but not sport, this is easily a confounding variable with on the field assessment.

5.   What about confounding factors such as dehydration, facial trauma, dyslexia, other reading delays, etc.?

In a day and age where people are highly sensitive to their concussion number, false positives may be another concern.  One researcher noted in Neurology Now that the exertion level an athlete exhibits in sports can affect the outcomes of neurological exams regardless of injury or illness status.  For those athletes who are also exhausted or in a dehydrated state, wouldn’t impaired performance be noted as well?  Additionally, instructions for the King-Devick Test state that the athlete cannot use their finger to follow the pattern.  Some young readers or readers with learning impairments may struggle more with the exam under these instructions.  How does this affect how we interpret the results?

6.   What is the best way for this test to be implemented into our practice?

Some media outlets are calling for the King-Devick to be the test in concussion diagnosis.  The research indicates the support for that decision isn’t scientifically  there yet.  Should this be a supplemental initial screening tool, with those who demonstrate impairment, then follow up with a SCAT3?  Or do we wait until there’s more evidence-based research to support the appropriate implementation of the King-Devick Test?

7.   Are we trying to over-simplify concussions?

As clinicians, we all agree properly diagnosing and managing concussions is paramount to athletes’ safety.  We’re constantly searching for tools that work to make an injury filled with gray more black and white.  Are we too quick to jump on the band wagon because of the current concussion climate?

Resources:

King-Devick Test Website: http://www.kingdevicktest.com

Neurology Now, June/July 2014 Volume 10(3)p 12–1, Accessed online: http://patients.aan.com/resources/neurologynow/index.cfm?event=home.showArticle&id=ovid.com%3A%2Fbib%2Fovftdb%2F01222928-201410030-00011

Centers for Disease Control and Prevention: http://www.cdc.gov/headsup/basics/baseline_testing.html

New York Times: http://well.blogs.nytimes.com/2015/03/11/a-2-minute-test-to-detect-concussions/?_r=0

 


Athletic Trainer Retention: What Are We Doing About It?

By: Jenna Street, MS, ATC
street.jenna@gmail.com
@JennaStreet

One of the hottest topics in the athletic training profession right now is Athletic Trainer (AT) retention.  Whether you hear it discussed in social media, at conferences or over a casual cup of coffee, the topic is of interest among ATs throughout the industry.

As ATs, we sometimes feel undervalued within our profession. In some cases, people use the athletic training profession as a stepping stone to another profession.  The common reasons Athletic Trainers, specifically young professionals, leave the profession include odd hours, long days, salary, family conflicts and lack of professional and community respect.  Almost all of the topics mentioned have solutions.  The answers may not be fast or immediate, but they are worth exploring.

In order to find solutions, we must first change the conversation. Don’t ask why people are leaving the profession; ask why people are staying in the profession. In addition, we need to have the conversation of how to help others stay in the profession.  There are numerous Athletic Trainers who have been in the profession for over 25 years; they must know a thing or two!  We must remember there is a reason we all entered this profession and a reason why many of us stay.

As an Athletic Trainer, your reasons might include helping others or having a love of sports, the human body or the mechanism of injury.  You might enjoy the overall fun of the job, like never having 2 days the same.  Athletic Trainers also have the ability to work in a clinic, a hospital, outside on a field and travel both nationally and internationally.  There is also the flexibility of working full time, part time or contract.  You could work 9-5, or not.  Athletic training professionals also have the ability to teach within the profession.

I can personally speak to this topic with this being my 9th year as an AT.  As an AT and a young professional, there have been numerous sleepless nights, coaches who are practically impossible to work with, not to mention the parents, sponsors, insurance … and the list can go on.  However, for each moment that tries my patience or robs me of a night’s sleep, there are countless moments that keep me going to work with a smile on my face.  I love that no 2 days are the same. I love the challenge; the collaboration with other healthcare providers; the smile on an athlete’s face when they notice an improvement; the opportunity to travel and, most of all, the thank you from the athlete.  For me, this list of positives could continue to go on and on.

We should be surprised at ourselves for not changing the conversation sooner.  After all, one of our primary roles as an AT is prevention of injury and illness.  How can we not take this same approach of prevention and apply it to our profession and our career?

These solutions may not be fast, but if we first turn the conversation to be a positive conversation, it will catch on.


Athletic Training Supplies: 4 Steps to Get the Most Bang for Your Buck

By Brian Bradley, MS, ATC, LAT, CSCS

Whether you are a new Athletic Trainer (AT) or experienced professional, the school year is winding down and you’ll need to place an order to restock your inventory for next year. How do you go about ordering supplies and getting the best deal?  This article will give you 4 steps to follow to help get the most bang for your buck.

1. Take an Inventory

Start by taking an inventory of supplies at the beginning and end of the year. This will tell you how many supplies you used over the course of the year. After a couple of years, you’ll  see trends in your supply usage.

2. Make a List of Items Needed

Make a list of the items and quantities you want to order. I recommend ordering about 105 to 110 percent of what was used in the past year. This gives you a little cushion in case your usage goes up in the next year. If your usage goes down or stays the same, you’ll have some back-up stock and be able to order less the next year.

3. Make a List of Suppliers for Items and Request Pricing

Now you know what you want to order and how much to order, you will need to figure out where to get the supplies from. I suggest getting bids from different suppliers. Send the list of supplies you want to purchase with the quantity to the representative from the company. The supplier will then send back the list with the best price the company can offer you. I suggest sending this list of supplies to a few different companies. This way you can compare the prices and get the best possible deal.

4. Review Bid Pricing
Sometimes on the bid from the company, they may suggest a value brand they feel is comparable to the name brand. I recommend trying 1 or 2 of these items and seeing how the quality is compared to the name brand. This is a good practice because these items are usually less expensive, and it will keep you trying new items to see what is better.

A few things you will want to keep in mind:

  • Make sure you ask about the cost of shipping. That may increase the overall amount
  • If you are working at a school, see if the school is tax exempt and give that information to the supplier. It may save you some money on sales tax
  • Ask the company if there is any sponsorship available. This may require hanging up a banner or sign around campus to receive a larger discount or free items. Before taking this step, make sure you clear this with your boss
  • Don’t be afraid to call the company and talk to them about their bid process

Below is a list of companies that offer sports medicine supplies. There are many others out there, so be sure to do your research.

Collins Sports Medicine - https://www.collinssports.com/

Cramer Sports Medicine - https://www.cramersportsmed.com/products/training-room-supplies

Henry Schein - https://www.henryschein.com/us-en/Athletics-Schools/

Medco Sports Medicine - https://www.medco-athletics.com/

Sports Health - https://www.sportshealth.com/

Collins Sports Medicine - https://www.collinssports.com/

Cramer Sports Medicine - https://www.cramersportsmed.com/products/training-room-supplies

Henry Schein - https://www.henryschein.com/us-en/Athletics-Schools/


Understanding Overuse Injuries in High School and College

By Tim Koba, ATC

The American Journal of Sports Medicine published a recent article examining overuse injuries in high school and collegiate sports.  Overuse injuries account for 70 percent of injuries suffered in these groups. Of those injuries, running was the common cause.  The most commonly involved lower extremity joint was the knee; predictably, baseball, softball, swimming and diving had more shoulder involvement.

This study confirmed what practitioners have been observing when working with their athletes, and the comparison between groups is helpful in identifying trends.  College athletes have higher incidences that result in more time lost; women have more overuse injuries than men and lower extremity injuries are prevalent in sports that involve running.  While the conclusions are not surprising, I think the important point to remember is repetitive loading results in tissue breakdown that causes injury without adequate time for adaptation.

Coaches and those who work in coach education can use this information to better develop preseason and off season training plans that take overuse injuries into consideration.  Instituting programs that have athletes gradually start running or throwing in the off season can decrease the injuries once the season starts.  Too often, not enough is done in the off season and too much is done in the preseason and early season.  This jump in activity increases the tissue load beyond what it can absorb and leads to an injury.  Utilizing a periodized program can make sure loads are applied more thoughtfully to reduce the stress while still attaining the goal of greater skill and fitness development.

Understanding overuse injuries are prevalent can also help strength coaches and Athletic Trainers to come up with preventative programs.  For those athletes who do a lot of running, controlling the volume is helpful, but so is making sure there are no weaknesses in the kinetic chain.  Spending time on improving hip and core strengthening along with running drills can improve the ability to absorb force and decrease tissue overload.  Similarly, making sure the shoulders are strong and stable prior to swimming or throwing can decrease the overload they sustain once the season begins.  Continuing to monitor athletes and noticing deficits or changes can be an early warning sign the athlete is experiencing too much strain.

Once athletes start to have pain, early intervention and volume control may be undertaken to decrease the load applied and allow the athlete to continue with participation.  Knowing what the common injuries are in a sport can assist with ways of modifying the known risk factors.

http://ajs.sagepub.com/content/early/2015/04/30/0363546515580790.full.pdf+html


Athletic Training - A World of Adventure

By Paul LaDuke, ATC

I strongly believe there are 3 basic needs of man or woman - adventure, relationships and purpose. Athletic training provides avenues for all 3 of these basic needs, especially relationships and purpose. I often neglect to see the world of adventure within the profession. In February and March of 2015, I was blessed to have an adventurous month by being involved in 2 national championships, in 2 different sports, and in the Pennsylvania State Wrestling Championships.

For the past 14 years, I have been employed as an Athletic Trainer (AT) for a public school in Pennsylvania. In those 14 years, I have developed a love for the sport of Olympic weightlifting and started a weightlifting club at the school.

In February of 2015, one of the athletes I have been blessed to coach competed in the USA Weightlifting National Junior Championships at the Cox Convention Center in downtown Oklahoma City, Oklahoma. While I was there, I introduced myself to the sports medicine staff provided for the event. The staff consisted of an orthopedic surgeon, a chiropractor and an AT. They kept busy, tending to the needs of 330 weightlifters who were competing on the national stage.

Weightlifting is a relatively safe sport, and there were only a few minor incidents during this 3-day event. I witnessed 2 incidents where athletes passed out after a fight to stand up and after a heavy clean. The athletes needed a few seconds lying on the platform to allow the body to recover and the brain to receive oxygen again. One athlete suffered a minor hand injury from the fall with the weight on his shoulders. Most of the time, the sports medicine staff was busy stretching, massaging and giving advice on how to maintain optimal performance.

I had never been to Oklahoma City, so I took advantage of some free time to visit Tinker Air Force Base, the Oklahoma City National Memorial (site of the 1995 bombing of the Murrah Federal Building) and the Bricktown district for incredible food. My athlete and I even donned the earphones and mics to commentate for the USAW's live internet broadcast. The trip will be a lifetime memory for me.

Just 3 weeks after the trip to Oklahoma City, I was part of the sports medicine staff for the Pennsylvania Interscholastic Athletic Association (PIAA) Wrestling Championships in Hershey, Pennsylvania. This was my 6th year working at the 3-day event. PIAA Wrestling Championships has 2 classifications for wrestling based on school male enrollment. Each of the 12 weight classes had 20 wrestlers from around the state qualifying through various sectionals, districts and regionals. There were 560 athletes who competed with skin checks and weigh-ins to start each day.

The event provided 1 AT per mat (up to 6 at a time), 1 doctor per 2 mats and emergency medical services (EMS). The EMS were well versed in sports medicine, as the venue is home to the AHL's Hershey Bears Hockey Club. The most common injuries were bloody noses and lacerations requiring stiches on-site. Only a small number of wrestlers required a trip to the emergency room. One athlete suffered a dislocated elbow and a suspected ankle fracture.

Wrestling is an intense combat sport, and sitting mat-side provided a great place to experience these athletes’ dedication, excitement and disappointment. It was also a good time to network with other ATs and physicians from the region.

The following week, I was part of the sports medicine team for the NCAA Division 3 Wrestling National Championships in the same venue in Hershey, Pennsylvania. This event was hosted by Elizabethtown College. There were only 10 weight classes with 18 wrestlers qualifying through the Regional Championships. Both days of the event started with skin checks and weigh-ins. Wrestling was on 6 mats with 1 AT per mat and 3 doctors on site. The same EMS staff was also on hand. The injuries I observed were similar to those at the state wrestling event - bloody noses and lacerations. As with the state experience, the tournament gave me many opportunities to network with collegiate level ATs and meet many new people.

As the years pass, it is easy for me to become frustrated with traveling for work. Hours sitting on a bus or plane, weather delays, baggage claims, treatments in hotel rooms and less-than-desirable destinations can take a toll. I have found embracing the adventure and keeping a youthful attitude really helps. Athletic training is an incredible profession full of challenges, relationships and especially adventure.

Where has the profession taken you?  What memories do you have of special venues and events?


Graduated Return to Play Protocol: Getting Your Athlete Back in the Game Safely

By Amy-Lynn Corey

Unique challenges arise from sports-related concussions. Careful decisions need to be made about safe return to play after a period of recovery.  This infographic provides information on graduated return to play protocol and getting your athlete back in the game safely.

Download Graduated Return to Play Protocol Infographic

Amy-lynn Corey is the Online Content Specialist at AthleticTraining.com and HomeCEUConnection.com. AthleticTraining.com is a membership-based service that offers BOC approved online continuing education courses for Athletic Trainers, Physical Therapists and Physical Therapist Assistants.


Safety in Athletic Training Facilities – Look Before You Leap

We see stop signs, traffic lights and other warning signs in our world every day.  These warnings remind us of the importance of looking before we leap to keep us safe from injury and danger.

Much in the same way, the BOC Facility Principles document was designed as a risk management tool for administrators of athletic training facilities.  The ultimate goal of this document is to assist Athletic Trainers as well as athletic directors, principals, superintendents and other administrators in ensuring a safe, properly-equipped athletic training facility.

The BOC Facility Principles was originally created by the Facility Standards Work Group.  The work group consisted of experts from the Board of Certification (BOC), National Collegiate Athletic Association (NCAA), National Athletic Trainers’ Association (NATA), National Interscholastic Athletic Administrators Association (NIAAA), Henry Ford Health System (HFHS), NATA College/University Athletic Trainers’ Committee (CUATC) and NATA Secondary School Athletic Trainers’ Committee (SSATC).  Through their cooperative efforts, they were able to create an easy-to-use guidebook to help administrators gauge an athletic training facility’s compliance with applicable regulations and best practices.

You might be wondering: Why should my workplace or organization use the BOC Facility Principles document?

Most commonly, athletic healthcare occurs at an athletic training facility, not in a traditional healthcare setting.  Local, state and federal entities issue regulations and standards to help regulate these facilities.  Failure to observe safety policies not only increases risk, but also increases exposure to liability suits alleging negligence.

The BOC Facility Principles document includes checklists on employee safety, accessibility, privacy and confidentiality, emergency preparedness, safe handling of hazardous material and much more. The document can be used by secondary and post-secondary educational institutions and organizations to self-assess their policies, procedures and facility.

Ensuring your athletic training facility is safe is just one more way to provide your patients with important, life-saving healthcare.  Take the next step and download your copy today.

http://www.bocatc.org/resources/facility-principles