Archive for August, 2012

Back to School as a Secondary School Athletic Trainer (SSAT)

Wednesday, August 29th, 2012

I have heard it said that the two best things about being a SSAT is June and July!  If you are like me, that statement brings a smile and a knowing nod.  The problem with June and July is that nervous knowledge that August follows these great months.  The month of August is like no other month in the SSAT calendar year.  Collecting physicals, freshmen, fitting equipment, new athletes, new coaches… freshmen, preparing for the brutal summer pre-season practice schedule…freshman, etc. are individually stressful that collectively take a toll on the SSAT.  Did I mention freshman?  Many of my Facebook AT friends are posting status updates about these stresses with 70-90 hour work weeks, huge piles of physicals to catalog, freshmen, frustrating injuries to out of shape freshmen athletes, etc.

I constantly read news articles in sports magazines, health magazines, websites, newspapers, etc. focused on the athlete surviving the grueling two-a-day practice regimen.  I have never read an article for the athletic trainer surviving pre-season. 

This current pre-season is my twelfth time through a pre-season at this high school.  Yes, this is my twelfth class of freshmen, and I still don’t understand how they make it.  I have seven more years of experiences as an SSAT during grad school and my early professional career making this year my nineteenth year at the high school level.  I also coached football and played high school and college football adding another 10 years of experiences on the flip side from an AT.  (Before you think I am old, I am only 45!)  It is safe to say I have learned a lot during those collective 29 years of experience with high school sports and freshmen.

Be organized

The first 2 weeks of high school sports can be a mad house.  My assistant and I care for over 400 individual athletes (7-12th) participating in 8 different sports on 20 distinct teams (7th, 8th, 9th, JV, Varsity).  These teams have their own schedules throughout the day set up by their coaches.  My office also gathers all the physicals and determines eligibility to play.  Processing all those physical forms forces us to be organized.  Keeping the schedules straight and providing appropriate medical supervision takes organization.  A few hours of work organizing schedules and establishing a system to process the physicals in the weeks before the pre-season starts, decreases the stress. 

Communicate

Right along with the organization is the need for communication.  Set up a good communication system to effectively keep the coaches, AD and the AT staff on the same page.  It is very important to know who to talk to, when to talk to them, how to talk to them and vice versa.  Know who all your coaches are.  Know how to contact them (email, cell phone, home phone, etc.).  As you get to know each other, learn what they want to know and when they want to know it.  Let them know what you want to know and when you need to know it.

In my situation, I send a daily email in the 10 days before the season starts to update the coaches on physical eligibility of the athletes.  The coaches take the responsibility to communicating with the athletes who don't have paperwork in to my office.  They also communicate with me what their schedules will be.  A good communication system decreases the stress of the pre-season.

Eat right

As an AT, we must practice what we preach.  I know I am always talking to athletes about eating right.  We know that “you are what you eat.”  If you eat poorly, you will feel poorly.  The preseason schedule of a 60-90 hour work week forces you to plan ahead.  Take time the week before to plan ahead.  Write out an eating plan for the week, make a healthy list, go to the grocery store and buy what is on the list.  Don't forget healthy snacks.  If you eat right, you will feel better.

Exercise

Again, we must practice what we preach.  I feel part of my role as a SSAT is to model a healthy lifestyle.  My exercise modes of choice are Olympic weightlifting, kettlebells, bodyweight exercise, swimming and bicycling.  My 70+ hour work week prevents me from spending as much time on fitness as I did over the summer, but I also don't want to avoid all exercise.  I work my fitness into my day.  I ride my bike to work.  I workout with the kettlebells for a few minutes here and there when I get some down time.  I do bodyweight work (pushups, squats, lunges) throughout the day also.  There seems to be a growing body of evidence that small workout sessions (i.e. - 10 minutes) several times a day has the same health benefits as 1 long session.  Get up and move.  Movement is always good.  Take time to move.  Your body and mind will thank you and your stress levels will decrease.

Sleep

This may be the hardest part of the pre-season, getting adequate and quality sleep.  It is physically difficult to go from working a few hours a week to a stressful 60-90 hour work week.  The SSAT will be physically exhausted but because your body is in stress mode, it won't shut down.  Mentally, the pre-season is exhausting and also further exacerbating sleep quality.  I often dream about work during the pre-season ensuring that I feel stress even while I sleep.  There are several things you can do to improve your sleep.  Obviously, nutrition and exercise can contribute.  Avoid caffeine late in the day.  Avoid “screen time” 30 minutes before bed.  Turn off the TV, iPod, computer, radio, etc.  Let your mind relax.  Take 30 minutes to relax and read a book right before bed.  These are simple guidelines that I have learned through the years that aid in sleep.

 I hope these ideas get you thinking about minimizing stress and surviving the start of the athletic season with your health. 

 What are your experiences?  What ways you been successful in minimizing stress?  What stresses you about the preseason?  Leave comments for discussion.

Written by: Paul LaDuke, MSS, ATC, CSCS
pladuke@ldsd.org

 

An In Depth Look with an Athletic Trainer in the AHL

Friday, August 24th, 2012

An In Depth Look with… Kevin Morley, MS, ATC, LAT

Describe your setting:
I am the Athletic Trainer (AT) for the Albany Devils of the American Hockey League, the affiliate of the NJ Devils of the NHL. 

How long have you worked in this setting?
I worked in college hockey for six years, and came to the Devils in 2007, so I just finished my fifth year in pro hockey.

Describe your typical day:
Practice days and game days are very different.  On a normal practice day I am at the rink by about 6:45am working on chart notes, workman’s comp claims, medical billing, inventory, and preparing for the day’s treatments and Ther-Ex sessions.   We practice in the morning, for about an hour, so once that’s done, and the players finish treatments, Ther-Ex, and workouts, I am done by about 2:000pm. 

Game days are much longer.  We have a Pre-Game Skate in the morning, which is an abridged version of the schedule I described for a practice day.  Then, we’re back mid-afternoon to prep for the game.  After the game we clean up, do whatever treatments & assessments are needed, talk with the Coaches and Management, and try to be out by about 10:30pm.

What do you like about your position?
I love hockey and working with hockey players.  They are the best group of pro athletes I have ever come in contact with.  I like this setting better than the collegiate environment because I have just one team to take care of, so I can devote more time to each player.  I utilize some time-consuming treatment techniques, so it’s nice not to be pulled in many different directions.

What do you dislike about your position?
I would say the thing that I like the least is the time away from my family.  My wife and I have two small children, so I am gone for many dinners and bedtimes.  It is a trade-off though, as during the off-season, I am completely off and have tons of time for family events.   Since the NJ Devils played in the Stanley Cup Finals, this summer is about six weeks shorter than usual, but I think it’s a good problem to have!

What advice do you have about your practice setting for a young athletic trainer looking at this setting?
I would recommend getting your foot in the door as early as possible.  There are, relatively speaking, a small number of college hockey teams to rotate with during your ATEP education, so many students will not get that opportunity.  If hockey is interesting to you, seek out a local pro team or junior hockey team’s AT.  See if you can help out, observe, or shadow that person for practices or games.  They may be able to help connect you with other professionals in the hockey sports medicine community.

Hydration and Proper Fluid Balance Vital for Athletes

Tuesday, August 21st, 2012

It’s that time of year again, with official practices starting for many fall sports programs and discussions regarding safe participation in the heat are at the forefront of athletic training. In addition to the important and very serious discussions surrounding the prevention and treatment of heat stroke and related illnesses, hydration and maintaining proper fluid balance are also vital for athletes participating in the heat during pre-season training. 

Sodium is the main electrolyte lost in sweat in addition to body water. During conditions that facilitate high sweat rates, Athletic Trainers know that large losses can lead to decreases in plasma volume and cardiac output, as well as the potential to develop hyponatremia. This is why the National Athletic Trainers Association (NATA) position statement on fluid replacement stresses constant ingestion of fluids during exercise in the heat in order to minimize body weight losses to around 2%. The NATA also recommends the addition of 0.3 to 0.7 g/L of salt to hydration beverages in order to offset sodium losses due to sweating (NATA Position Statement on Fluid Replacement). 

In addition to hydration during participation, it is of equal importance to educate participants about rehydration and sodium replacement strategies that should continue after the day’s activities have concluded following the NATA’s guidelines. These strategies include achieving full rehydration within 4-6 hours post-activity, which can be accomplished by ingesting fluids up to 150% of total sweat losses. Post-activity replacement strategies must also include sodium in both fluids and as a part of meals. However, the NATA advises that the exact amounts must be individualized to each athlete with special care taken to avoid overdrinking. The full NATA position statement on fluid replacement can be found here: http://www.nata.org/sites/default/files/FluidReplacementsForAthletes.pdf 

Athletic Trainers play a critical role in educating athletes about proper hydration strategies - prevention is one of the five major domains of the AT scope of practice. Failure for athletes to fully rehydrate and replace sodium over the course of pre-season training camps can put athletes in the difficult position of constantly trying to get their bodies caught up, which can be prevented with proper guidance on hydration and nutrition. Also, don’t forget about your coaches. They are in the same conditions as the athletes and can also benefit greatly from proper hydration strategies.

Additional information on conditions affecting athletes that participate in the heat can also be found in other position statements from the National Athletic Trainers Association:

-          National Athletic Trainers’ Association Position Statement: Preventing Sudden Death in Sports - http://www.nata.org/sites/default/files/Preventing-Sudden-Death-Position-Statement_2.pdf

-          National Athletic Trainers’ Association Position Statement: Exertional Heat Illnesses – http://www.nata.org/sites/default/files/ExternalHeatIllnesses.pdf

Written By: Mike McKenney, LAT, ATC, NASM-CES
michael.mckenney@outlook.com

Time Out for Emergencies

Wednesday, August 15th, 2012

The National Athletic Trainers’ Association (NATA) is calling for a “time out” for emergencies as the fall sports seasons prepare to kick off.  The NATA is recommending a meeting be held prior to athletic participation by healthcare providers to ensure proper safety procedures are in place and so the providers are coordinated for any emergencies that may occur.

The BOC Certified Athletic Trainer (AT) is recognized by the American Medical Association as an “allied healthcare provider” and it is my belief that it is essential an AT be present for the health and wellbeing of all athletes. In addition, members of the Sports Medicine team can often include physicians and emergency medical technicians.

The purpose of the “time out” is to coordinate among the medical professionals so that things are clear before an emergency.

Things that should be discussed could include:

  • Location of medical personnel
  • Role of each medical provider
  • Location of emergency equipment such as an automated external defibrillator, vacuum splints and a backboard. Sport-specific equipment could include things such as facemask removers for football.
  • Location of an ambulance for high-risk events. Is it onsite? Who is responsible for calling if not?
  • Route for the ambulance and EMTs to take if called upon
  • Is there a designated hospital?
  • Communication methods—hand signals, cell phone, two-way radios?

Many of these items should already be prepared in the emergency action plans for each specific sport and site. This “time out” gives the healthcare providers (and coaches!) an opportunity to refresh their memory and prepare.

To read the full statement, go here!

Every Athlete Deserves an Athletic Trainer

Written By: Mike Hopper, ATC
michael.n.hopper@gmail.com

An In Depth Look: Working in a Student Health Center

Friday, August 10th, 2012

An In Depth Look with… Michelle Haselhorst, MS Ed, ATC

Describe your setting:

I am employed at McKinley Health Center at the University of Illinois (U of I), located in Champaign. The Health Center serves the students at U of I - a total population of about 42,000. I thoroughly enjoy working on such a beautiful campus with an extremely diverse student population. I work directly under a Physical Therapist and I am the only Athletic Trainer (AT) in this setting. We work closely with a nutritionist and a fitness educator, and the four of us comprise the SportWell Center within McKinley. I do therapy with patients and treat athletic and/or exercise-related injuries sustained by students (undergraduate, graduate and doctoral), with the exception of intercollegiate athletes. I typically work with injuries sustained through club sports, intramurals, exercise classes, weight-lifting/working out, and running. Oftentimes, I will collaborate with other SportWell providers for the health and well-being of our patients.

How long have you worked in this setting?

I am just starting my 5th year in the clinic. Prior to this, I had never worked in a clinical setting, and the Health Center had never employed a full-time AT. Though it was a completely new experience for all of us, it was an easy transition for me and the camaraderie was instantaneous with the other SportWell providers. 

Describe your typical day:

Starting at 8:00am, I generally see between 8-12 patients/day, by appointment only. Appointments generally last between 30-60 minutes each. I do an initial injury evaluation for first-time patients, where I will assess their gait, posture, footwear or other biomechanical factors that may be influential. During follow-up appointments, I generally focus on taking them through therapeutic exercises or provide hands-on treatment. I catch up on injury documentation over lunch, and at the end of each day. Occasionally I work at health resource fairs around campus and collaborate with other health professionals to organize running clinics each semester, which focus on injury prevention, proper running technique, nutrition and training. About 40% of my patients are runners, so I do a fair amount of running gait analyses and instruct numerous patients on proper running form.

What do you like about your position?

All patient interaction is by appointment-only, no walk-in hours. I work 40 hours/week and make my own schedule each semester. The appointments in this setting are provided for the students with one flat health service fee each semester, so I don’t work with insurance fees.  The benefits in this clinical setting are great, and I enjoy working with a small staff that specializes in several different healthcare domains. Over the past three years I have seen a drastic increase in the number of running-related injuries on campus, since U of I has been the site of the Illinois Marathon, and I am currently working toward a certification in Good Form Running. This is a great setting for me to specialize in running-related injuries and prevention.

What do you dislike about your position?

I am the only AT at the University Health Center, so oftentimes during the fall and spring semesters my schedule is booked out for 2-3 weeks, and each year the number of student visits increases. Because of this, students are limited with the number of treatments they can receive each semester. I am limited with the types of modalities I am able to use for treatment in this setting as well.

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

First, and foremost, I would advise young professionals to try to work in a variety of athletic training venues/settings as students, in order to decide where they are best-suited. Even if you think you know where you want to end up in your career, certain experiences or opportunities may steer you in another direction. My particular clinical setting is unique for an AT because of the types of injuries I have worked with, and the limitations in treatment options, but it has certainly broadened my knowledge and creativity with regards to therapy and hands-on treatment. It is imperative to think outside the box when developing home therapy routines in order to keep patients interested. Unless the student is willing to go to the rec center for daily therapy, he/she may not be diligent with recommendations, which can be frustrating for both the AT and the patient.

Convenience is the key to patient-compliance in this setting, which leads to positive outcomes. Also, I have found that broadening my knowledge in hands-on types of treatments has been extremely beneficial in this setting. I have attended several courses about myoskeletal techniques and positional release therapy, which have resulted in good outcomes. I see the same types of injuries in my office day in and day out, so learning a variety of different treatment techniques through continuing education opportunities helps to keep myself and my patients entertained, all the while working to get the best injury outcomes.

Lifelong Learner

Wednesday, August 1st, 2012

One of my favorite questions to ask candidates I’m interviewing is, “Name the top three resources you use to stay current in your field.”  Frankly, I could care less what their answer is as I care more about the fact that they make an effort to continuously improve themselves.  Some people will pause and it is easy to tell the question confuses them, which, by the way, doesn’t bode well for them in the interview.  Others will answer immediately with a book they just read, a blog they subscribe to or authors they seek out in research.  If they can answer the question immediately, it is a definite plus for them as I weed through candidate after candidate.

I am an “information gatherer” by nature.  Just in the past few months I’ve read Outliers, Drive, One Minute Manager, Necessary Endings, New Rules for Lifting Abs and several other titles.  This doesn’t include the blogs I read, podcasts I listen to, or the research I scan.  Because I love learning and have this thirst for new knowledge, I often make the assumption that self-improvement and lifelong learning is a given for people.  Unfortunately that just is not true.

However, if you look at people who are “successful” they often have similar characteristics.  It seems that one of those traits is the constant search for new knowledge.  I haven’t had a chance to philosophize about whether this can be a learned habit versus something a person innately desires to do, but I would imagine one of the best things a new graduate  might be able to do would be to get in the habit of seeking out new information on a regular basis.  Even if you aren’t a new graduate, it is never too late to start a quest for self improvement.  Everyone has room to grow.  Need a place to start?  Pick up a copy of 212° or visit www.212movie.com and put some of the items into practice right away!

Written By: Danielle Kleber, ATC
dkleber@athletestrainingcenter.com