Archive for December, 2013

New Year’s Resolutions for the AT Profession

Monday, December 30th, 2013

2013 is coming to a close, and the New Year is soon approaching. It’s time to start thinking about New Year’s resolutions. This year, put extra effort into something that betters you as a person as well as a professional and helps others along the way.

    1. SPREAD THE GOOD WORD about your profession. It’s called Public Relations. The thought of "being in the spotlight" may be intimidating to some, but PR is really very simple and many of you are doing it already. If you have summarized your job to friends, family or parents of student-athletes, that is PR. Speaking to students at a career fair or allowing them to job shadow you is PR. Communicating with the media on the sideline or promoting your profession through social media is PR. Interacting with the BOC’s social media on Facebook, Twitter and the BOC blog? That too is PR.For Athletic Trainers (ATs), March is coming quickly and March equals National Athletic Training Month (NATM). The 2014 theme is "We’ve Got Your Back." It is important for ATs to promote the profession and our knowledge and skill on a daily and weekly basis, but the month of March provides the opportunity to reach out to communities both in society and in the medical professions around us.
    2. EXERCISE YOUR BRAIN. Get a jump start on your CEUs. Even though the next recertification requirement deadline isn’t until December 31, 2015, waiting until the last minute to start your CEUs can be stressful. Start the year off right by identifying events you are interested in attending and try to organize the courses so that you are not overloaded in 2015. Learning is much more fun when you can choose what you want to learn about rather than be forced to complete a course because of the number of contact hours assigned. Learn more about maintaining your certification and the 2014-2015 changes.
    3. GET ENGAGED! Do you know about the latest happenings in your state? Many states have passed concussion legislation within the past year. Other states have passed licensure. Learn more about State Regulatory News.

The BOC is looking forward to an exciting year ahead, supporting you in the profession while providing new, value-added services for ATs and BOC Approved Providers.

Written By:
Brittney Ryba

Review 2013 and Prepare for 2014

Friday, December 20th, 2013

The end of the year brings many things: family, holidays, playoffs, travel. The one item that may fall off our radar in the midst of all of this is our professional development: finishing the year strong and preparing for a stronger year ahead. Below is a list of the top 5 items that should be, at minimum, on your radar as 2014 draws closer and closer.

5. BOC Website. In January 2013, the BOC launched a redesigned website, which earned the Public Relations Society of America, Nebraska Chapter Paper Anvil Award of Merit. Visit it for resources and information regarding continuing education and how to market your certification.

4. National Athletic Trainers’ Association Clinical Symposia & AT Expo. The BOC participated in the 64th Annual NATA Symposia and plans on having an exhibit at the 65th annual event. The meeting will be held in Indianapolis, Indiana, from Wednesday, June 25, to Saturday, June 28, 2014. Housing is officially open and can be reserved at

3. National Provider Number (NPI): The BOC, along with the NATA, strongly encourages all Athletic Trainers to register for their National Provider Identifier number (NPI). Read the BOC blog about the NPI number and how to register.

2. BOC Reporting Requirements for 2014: Effective January 1, 2014, the following are guidelines for all ATs:

  • Reporting period is every two years at 50 CEUs
  • The definition of Continuing Education (CE) now eliminates the phrase "beyond the levels required for entry-level practice"
  • The new Evidence Based Practice Category calls for the completion of 10 EBP CEUs per certification maintenance period

Detailed information can be found here:

1.) Certification Maintenance Period: Everyone who was certified prior to 2013 has CE and the 2012 and 2013 recertification fees due by December 31, 2013. In order to maintain your credential, you must report your required amount of CEUs this year. To check your status, enter CEUs and submit CEUs, please log onto BOC Central

This is, by no means, an all-inclusive list – just a few important topics that will help you close out 2013 strong, help you maintain your certification and prepare you to start 2014 understanding the changes that have been made.

Written By:
Jenna Street, MS, ATC


Youth Strength Training

Tuesday, December 17th, 2013

When should young athletes start to strength train? Is it safe? These questions are asked of us all the time and it can be a challenge to convince parents of the safety of strength training since they have grown up believing that it can inhibit growth or affect the growth plates.

It is safe for young athletes to start a resistance/strength training program prior to puberty without risk of inhibiting growth or sustaining an injury. The American Academy of Pediatrics has published a policy statement outlining their position. The greatest risk of injury in young participants is poor coaching, and, I would add, unrealistic expectations.

While a lot of us do not work directly with young athletes, we do see injuries and the subsequent compensations they’ve made that originated from when they were younger. The goal of resistance training with young athletes should focus on the development of neuromuscular control, coordination, balance and movement. With this population, it is vital to lay a foundation that they can build off of as they grow and develop over the years. Programs should start with body weight exercises to develop movement and kinesthetic awareness. Programs should then progress over time to include the introduction of typical strength training exercises, once the athletes have demonstrated movement proficiency.

Instruction should focus on teaching basic movements such as squats, lunges, lateral lunges, planks, pushups, pull-ups or rows, landing mechanics, and deceleration and change of direction drills. These key movements form the base of athletes’ sporting movements, as well as their future strength and conditioning protocols.

Every athlete is different and has different needs, so they will progress at a different rate. Working with them to maximize their movement quality and efficiency will pay dividends for them later on.

What do you do when you work with young athletes? What do you start doing with them? What recommendations do you give to parents of young athletes? Read more articles by Tim about youth athlete safety in Training & Conditioning and the Cayuga Medical Center healthcare library.


American Academy of Pediatrics. Strength Training by Children and Adolescents. Policy Statement.

IYCA. Kids Fitness Programs, should they really lift weights?

Written By:


Return to learn following a concussion: Is this within our scope of practice as Athletic Trainers (ATs)?

Friday, December 13th, 2013

As a follow-up to a conversation with a physician that return-to-learn (RTL) is outside the scope of Athletic Trainers’ practice, I began to research what the literature says about the role we should play in RTL. In a recent BOC blog post, Return to School Post-Concussion, Tim Koba, ATC, CSCS, PES, CES, CMT, cites the position statement by the American Academy of Pediatrics, found here. While the AT is not listed as part of the “school academic team,” the position statement advocates for use of the AT in regard to both return to school and sports. Additionally it calls for pediatricians to utilize the AT to assist in patient management. Recently, The Concussion Blog reviewed the AAP’s position statement, found here. The review posted makes valid points, and the overwhelming undertones are that a comprehensive approach is necessary . . . and doesn’t exist currently.

Based on the document “Athletic Training Services,” published by the NATA, one could infer from the definition of the profession’s practice in the introduction that assisting with RTL is within the scope of our practice as we aim “to minimize subsequent impairments, functional limitations, disability, and societal limitations.” Functional and societal limitations to a high school or collegiate athlete encompass their education. My perception of this physician’s statement was that RTL is out of our scope of practice because it doesn’t relate to physical activity, but the previous statement indicates that our organization recognizes that our role extends beyond sport.

What do you feel the AT’s role in RTL should be? How supportive is your school in utilizing you as part of the “school academic team”? Do you feel there is appropriate research out there to justify AT involvement in RTL?


Written By:

Claudia Percifield MS, LAT

ETHICS IN ACTION: In Matters of Principle, Stand Like a Rock. In Matters of Preference, Go with the Flow.

Tuesday, December 10th, 2013

Ethics education is designed to deepen our reflection on the ultimate questions in life; to help us think more clearly about morality and the choices we make; to sharpen our general thinking and our ability to reason; and, more importantly, to defend our stance.  We know that much of ethical decision-making is situational and subjective at times.  We know that being able to stand behind our decisions within the scope of our practice is critical in healthcare. One of my favorite guiding principles is referenced in the title – when in a situation where it is a matter of principle, I am not easily swayed.  I consider the options yet stand firm in my principles regarding the case.  In matters of preference however, it is easy to rationalize multiple approaches to solving the dilemma while often considering situational factors in the resolution.

After reflecting on the following case, respond to the posted questions and create others if you have them.

You work for a private outpatient clinic.   A worker who was recently injured is nearing time to return to his job. His progress has been fair, but it certainly falls within the marginal range. He has shared with you that during his time off he has been able to help his elderly father care for his mother, who has Alzheimer’s disease. He is always on time to the clinic and works hard during his rehabilitation. He states that his father cannot afford to institutionalize his mother and his help creates some relief from the situation. You are writing the report for his follow-up visit for the physician, which will determine whether he returns to work the next week or has his therapy extended another three weeks. You know the physician will ask what you think about his readiness to return to work. What is the RIGHT THING to do?

1. Is holding him out another three weeks ethical?

2. Would it matter if the patient was non-compliant and missed several rehabilitation sessions with you?

3. Would it matter if the patient was not caring for parents and was just off work and reported playing video games all day?

4. Is it important to consider all of the factors that influence the patient’s life in the return to play decisions?

Written By:
Kimberly Peer, EdD, ATC, FNATA

Dr. Peer is an Associate Professor at Kent State University. She holds a Doctorate in Higher Education Administration with a Cognate in Health Care Management. Kimberly was recently appointed as the editor-in-chief for the Athletic Training Education Journal and serves on the Commission on Accreditation of Athletic Training Education Ethics Committee as well as the NATA Committee on Professional Ethics. Her national contributions include service to the BOC, NATA, JAT and REF in multiple capacities. Her statewide service includes the Governor’s appointment to the Ohio licensure board and over 12 years of service to the OATA.

Peer received the NATA Fellow Award and OATA Hall of Fame Award in 2012 and has been lauded with other national, regional and state level awards for her contributions to the profession and athletic training education. Dr. Peer has published and presented extensively on the international and national levels about ethics education and pedagogy and has co-authored with Dr. Gretchen Schlabach the first textbook on ethics in athletic training.


GIRD or Total Range of Motion Deficit?

Friday, December 6th, 2013

What do you do with a baseball player who presents with Glenohumeral Internal Rotation Deficit (GIRD)?  How much loss of internal rotation, and gain in external rotation, is a ‘normal’ adaptation to throwing, and how much is related to dysfunction?

There is some thought that the loss of internal rotation is not really an issue with overhead athletes, unless there is a loss of total rotational range of motion in the dominant shoulder. This means that just treating someone with a loss of internal rotation is not addressing the problem, especially if they are asymptomatic.

It also means that one of the things that we need to be careful of is the increase in external rotation. Constantly overworking these muscles places increased stress on the labrum, bicep and anterior joint capsule that can lead to changes and pain over time. Working with our athletes to increase their eccentric strength, stabilization, serratus anterior and lower trapezius strength may be more effective in limiting their shoulder pain than restoring motion and stretching the posterior tissues.

Screening our overhead athletes for total range of motion and scapular motion allows us to observe their structures at work and develop specific plans to meet their needs. Our athletes may display pain free, aberrant motions, but as long as they are not progressing to pain we may not want to change too much, or we may risk causing them pain due to the motion change.

How do you treat shoulder pain in overhead athletes? Do you have them stretch or strengthen for their treatments? Or, both? Do you screen all your overhead athletes prior to the season and follow them throughout?


Written By:


Cheerleading Injuries and Athletic Trainers

Wednesday, December 4th, 2013

Cheerleading is an activity that continues to grow. Shields and Smith reported that participation grew from 3 million participants in 1990 to over 3.5 million in 2003. At the same time, injuries increased by 110%!

Cheerleading has grown from an activity that at one time was all about spirit and supporting other athletic teams to where it stands now in a competitive environment. Tumbling, stunting and cheering have all been wrapped into intense routines. This can be attributed to an increase in injuries as these females and males attempt techniques that require a lot of strength, flexibility and coordination.

It has also been reported that cheerleading accounts for approximately 65% of catastrophic injuries in female high school athletics. While the actual injury rate itself may be low in cheerleading, the amount of catastrophic injury is cause for concern. Additionally, the injury rate is increasing so it is important to take steps to prevent injuries as best as we can. Cheerleaders experience injuries of all types from minor scrapes and bruises to serious head and neck injuries. Sprains and strains are also very common in the activity.

It is a surprise to me that only 29 state associations consider cheerleading a sport. The NCAA also currently does not recognize it as a sport. There are many who believe that designating cheerleading as a sport will improve its safety. To me, I don’t believe the designation itself matters. But recognition that cheerleaders are athletes is where I insist we must improve.

The American Academy of Pediatrics released some recommendations in November 2012. Here is a brief run-down of those recommendations:

1. Cheerleading should be designated as a sport.

2. Cheerleaders should undergo a pre-participation exam.

3. Cheerleaders should be supervised by certified coaches.

4. Cheerleaders should be trained in the proper technique in stunts and in spotting.

5. Technical skills should not be performed on hard, wet or uneven surfaces.

6. Pyramid and partner stunts should be done on soft surfaces only.

7. Pyramids should be no more than two people high.

8. Coaches should follow rules for execution of technical skills.

9. Coaches, parents and athletes should have access to venue-specific emergency action plans (EAPs), and a Certified Athletic Trainer or physician should be present for all practices and competitions.

10. Cheer competitions should be held in venues compliant with the National Cheer Safety Foundation.

11. Any cheerleader displaying signs and symptoms of a concussion should be removed from activity until cleared by a physician.

12. Surveillance of cheerleading injuries must continue.

To read more about this statement, please go to the following link:

The research into cheerleading injuries remains rather limited, and I hope that will continue to improve. As Athletic Trainers, we must be advocates for all athletes.

Every Athlete Deserves an Athletic Trainer #AT4ALL

Shields BJ, Smith GA. Cheerleading-related injuries to children 5 to 18 years of age: United States, 1990-2002. Pediatrics. 2006; 117(1):122-129.

Jacobson BH, Redus B, Palmer T. An assessment of injuries in college cheerleading: Distribution, frequency, and associated factors. Br J Sports Med. 2005; 39:237-240.

Written By:
Michael Hopper, ATC