Archive for January, 2014

Is Doing More Better?

Thursday, January 30th, 2014

I just read "How much is too much hockey for youth players?" from The Hockey News through a blog post by Mike Boyle, and it is shocking! Living in an area where hockey and soccer are very popular, it is incredible that schedules like this are the norm. Take a minute to read this.

Aside from the obvious concerns about injury risk through repetitive motion, what about the mental health of these kids? How are they able to think in school and focus on their studies when they spend hours a day playing or practicing with their team? It is even worse considering that most of them will never go on to play at the next level, even the ones who are not completely burned out.

Currently, we are in a mindset that if some is good, more is better. The problem is that more is worse. In an effort to improve and win, so many kids are being asked to sacrifice their physical, mental and emotional development. They are not getting a chance to physically recover day to day, they are not getting the mental rest needed to perform well and they are spending so much time practicing that they are missing out on the social aspects of being a kid.

Coaches and parents are pushing so hard that they are forgetting that it takes time to learn new skills and that practice does not make perfect. Perfect practice makes perfect. These kids need a complete approach to their training in order to allow them to fully mature as athletes and young adults, and playing the same sport all the time is not the way to do it. The best thing for some of these kids is rest, both mental and physical. The next best thing is free, unstructured play. I cannot remember the last time that I saw a group of children playing together in a backyard or a field. Encourage them to go meet up with some friends, play some games for the pure love of it, then go home, take a nap and eat dinner.

Since this pattern seems to be an international epidemic, how do you educate your coaches, athletes and parents on the benefits of rest, recovery and other sports? Do you think there is value to playing one sport all year long or should athletes vary their activities?

Written By:
Tim Koba, ATC, CSCS, PES, CES, CMT
tkoba@CAYUGAMED.org

Mentoring…A Few Ways to Think About It

Monday, January 27th, 2014

When one hears the word mentor, the instinctive response is to think of someone older helping to guide someone younger. This is not always the case. Mentoring does not have an age restriction on who can be a mentor and who can be a mentee. For example, someone who has worked in the educational setting for five years making a career change into a clinical setting should have someone to look to who has done the same thing, or to someone who has been in the clinic setting longer. This may not only help with the transition, but also help with a smoother immersion and understanding in the new setting. This does not mean the mentor has to be older - perhaps just more experienced in the current setting.

Mentors are sometimes chosen, or can reveal themselves over time. Either way, the relationship takes time to grow. You may have an "official" mentor-mentee relationship with meetings and checking in. Or, you may have a more casual mentor-mentee relationship that grows over time. Another way to look at a mentor is someone who is not directly related with your job, but perhaps someone who knows about your profession and can help guide you to succeed throughout career moves.

Here are five ways you can reflect upon your current mentor:
1) Did you choose your mentor or did your mentor choose you? Why?
2) Does your current mentor know you both professionally and personally?
3) Do you have to have just one?
4) Do you utilize your mentor for help, suggestions and guidance regularly?
5) Are you a mentor? To whom?

By reflecting upon your mentor-mentee relationship throughout the year, you can help ensure you are staying on track with your own goals, with the support that is needed.

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

Knee Injuries: How focus on the kinetic chain could reduce injury

Tuesday, January 21st, 2014

According to researchers at the Children’s Hospital of Philadelphia, sports-related knee injuries in children and adolescents are on the rise over the past decade. This research is documented in an article from the American Academy of Pediatrics. As clinicians, our goal is to prevent future injuries from occurring. With post-injury knee rehab, our initial focus is to restore quad function and knee ROM so the athlete can return to normal activities (squatting, walking, stair negotiation). But do we focus so much on fixing the current problem that we overlook the underlying cause?

Increased focus over the past few years has expanded to include the effects of hip internal rotation pathomechanics and gluteus medius weakness on knee injury trends. The effect hip mechanics have on knee valgus, and subsequently on knee injuries, has gained increased focus in the prevention and treatment of ACL injuries and patellofemoral injuries. But are we looking far enough up the kinetic chain? An article in LER (Lower Extremity Review) indicates we may need to look even further, critically evaluating what the trunk is doing with running, cutting and jumping maneuvers as well. It goes even further to suggest that training the muscle groups alone is not enough; we must retrain the athlete to perform the skills.

With so many contributing factors to knee injuries (especially in females), which one(s) should we focus on as clinicians? Everywhere you turn, different strength training programs (such as Bigger, Faster, Stronger) and so-called "ACL Injury Prevention Programs" are being promoted and implemented in our facilities. Where do you direct your athletes to help reduce their injury risk? What changes in athletics have you seen over the past decade that in your professional opinion is having the biggest impact on the rise in knee injuries? Is it increased sports participation, sports specialization, diet/hormone changes, something else entirely or all of the above?

Written By:
Claudia Percifield MS, LAT
Claudia.Percifield@phci.org

Approaches to Mentorship

Thursday, January 16th, 2014

Being a mentor can be a very rewarding experience. Being able to help colleagues navigate their careers and develop their skills is a noble undertaking. For those of you that have done it, you know what I mean. For some people, the thought of being a mentor can be a daunting task, but it does not have to be. Here are some steps to becoming a mentor and sharing your knowledge.

  1. Know you have something to share. Not everyone feels that they have enough experience or the kind of experience that others want to hear about. The truth is that everyone has something to offer. As long as you believe that you can add value to someone, then you can help.
  2. Establish a relationship. In order to mentor someone, you need to have a relationship with them. Start by asking questions and getting to know them and learning about what they enjoy, what their skills are and what they want to do. Once you show an interest in them you can start to build a rapport that will allow you to share experiences and help guide them.
  3. Add value. There are many different types of relationships that can be developed when you are a mentor. Find a relationship that works for you, and then work to add value and insights for your mentee. It is hard to understand what is happening around you, and having a trusted third party to talk to can be extremely beneficial.
  4. Take action. When you are mentoring someone your insights need to be short and actionable. You want your mentee to get more out of the relationship than a counseling session. You want them to be able to reflect on a situation, make adjustments and then take appropriate action.
  5. Make it reciprocal. Even when you are working with your mentee and trying to add value to their career, never forget that they can add value to yours. There is the obvious result of feeling needed and engaged at work, but there are other benefits such as new information, a fresh look at a situation you may be struggling with and access to a whole new network of professionals.

If you have been wondering how to mentor others or are unsure of what you have to offer, then I hope this list is a good starting point for you. Remember, everyone can be a mentor if they choose to be.

Do any of you have other thoughts on a mentorship relationship? What suggestions do you have? What has, or has not, worked for you?

Written By:
Tim Koba, ATC, CSCS, PES, CES, CMT
tkoba@CAYUGAMED.org

ETHICS IN ACTION: Personal and Professional Boundaries

Tuesday, January 14th, 2014

Athletic Trainers are often placed in situations where they are considered role models within their community.  Many Athletic Trainers struggle with the rigorous work schedule and hours spent at work.  When faced with the challenge of living and working in a small community, Athletic Trainers must make tough decision regarding social activities.

You are serving as an Athletic Trainer where there is much fraternization with the patients outside of the clinic hours.  Many of the clinical staff socialize with the patients at area establishments and, since it is a small town, there are few other venues.  Some of the administrators believe this is not conducive to the professional image the clinic wishes to portray. Is this behavior unethical?

Written By: Kimberly Peer, EdD, ATC, FNATA kpeer@kent.edu

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.

Become a Mentor

Friday, January 10th, 2014

January has been designated National Mentoring Month. Have you been a mentor or a mentee in the past year?

There are many benefits of mentoring not just for the mentee, but also for the mentor. It can be a great way for experienced clinicians to share their experiences, instruct new staff in office dynamics, guide their career development and be an open ear to bounce ideas off of.

Mentors can also learn from their mentees who can bring youth and a fresh look at situations, latest trends in the education curriculum, and an understanding of what the new fads and trends are.

Taking the time out of your busy schedule to reach out and talk with your younger colleagues and offer to help them can be very rewarding. Younger colleagues may feel intimidated or unsure how to approach discussing mentoring. But, if you take the time to talk with them and offer your expertise, you may be surprised how willing they are to talk with you.

Once you have broached the topic of mentoring with a colleague, lay out a framework for how you will approach your meetings. How often do you want to meet? Where would like to meet? For how long would like meet? What will be the topic of the day, and what are their goals for mentoring? Being clear with each other up front will make the conversations smoother and ensure that both of you get the most out of the experience.

Have you had the ability to mentor others, or been a mentor yourself? What did you think of the experience? Was it valuable? What recommendations on mentoring do you have?

There are many resources available for mentoring and how to approach it. Here are a couple that may help.

http://www.forbes.com/sites/lisaquast/2014/01/06/finding-a-mentor-is-easier-than-you-think/

http://www.asha.org/students/gatheringplace/MentBen/

Written By:
Tim Koba, ATC, CSCS, PES, CES, CMT
tkoba@CAYUGAMED.org

Mentorship in Athletic Training

Monday, January 6th, 2014

Carlen Mulholland, PhD, ATC, at Southeast Missouri State University.

January is National Mentoring Month. As a young professional (Certified in 2010) I have had the pleasure to work with many mentors. Some of them have been there when our paths met and others have stuck around for a long time! I’m grateful for every professional that has been there to help me so far whether they are a physical therapist, Athletic Trainer (AT) or physician. But today I want to highlight two ATs who have helped me numerous times over the last several years.

First, I want to recognize Carlen Mulholland, PhD, ATC, from Southeast Missouri State University (SEMO). Dr. Mulholland became the clinical coordinator at SEMO when I started the ATEP in 2008. She taught us a lot about athletic training, but also about life. She was a sounding board for us as students as we went through the difficulties of school. Life balance was very important to her and she worked hard for us to recognize its importance as students. It was something I struggled with as a student and something I continue to struggle with today. But she tried so hard to get me to "do something other than athletic training" when I didn’t have to be at clinicals. Another thing she opened me up to is the idea of "Every Athlete Deserves an Athletic Trainer," in that I had a majority of female sports as clinical assignments. As much as I resented that then, I’ve come to realize it has been a blessing for me. In my current position, I work with a variety of high school athletes but spend a lot of time working with female athletes. In fact, my focus in graduate school has been on female adolescent injuries. I would have never imagined! Today Dr. Mulholland continues to help me in many ways. One such way is that she is one of my mentors for my Capstone Project as I pursue my Master’s Degree in Medical Sciences.

Ashley Rockey, MS, ATC, at Southeast Missouri State University.

The second AT I want to recognize is Ashley Rockey, MS, ATC. Ashley was my clinical instructor working with the women’s gymnastics team at SEMO. She became much more than that as she immediately expressed an interest in my learning. She was so passionate not only about working with her athletes, but also teaching her athletic training students. I felt like I learned so much clinically from her, and possibly the most important thing was that she was always trying to learn as well. She expected her students to bring new ideas to the clinical practice every day and to come with questions. We would often play silly games, but those are things that you learned because they were fun. We remain in regular contact today through email and text message. She is also a mentor of mine for my Capstone Project. I received a Christmas card from Ashley earlier this week, and on the backside there was an anatomy question. Yes, she received an immediate answer from me.

As I said, I’ve had many mentors in my short career. But these two have been there time and time again. For others, I hope you realize that being a mentor does not take much effort. In fact, you may not even know how much you mean to those students or young professionals around you. And as the student or young professional, recognize those great mentors around you. Find one who matches your needs and help develop that relationship.

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

Hip Mobility

Thursday, January 2nd, 2014

Photo of Mike Boyle via Google Images.

If your athletes are anything like mine, a lot of them have movement deficiencies with squatting, stepping, lunging and changing direction. Then, when they get injured and you are assessing them you notice how tight their hips are. When you ask them to squat or demonstrate a dynamic movement, they have difficulty.

Sitting for most of the day and then participating in a sport that asks the body to perform a similar task (predominantly sagittal plane) is contributing to our athletes having tight hips that restrict their performance. They are not going to be able to generate full force on their lifts, change direction or land easily; nor can they pivot easily due to their restrictions. Helping them to open their hips and improve their mobility will improve their on-field performance and long-term health of their hips.

Some foam rolling and massage are good for breaking adhesions and fascial restrictions that are limiting their motion. Static stretching may be indicated for those areas that are extra tight and can involve Thomas stretching; kneeling lunge stretching, with or without elevating the rear foot; and quadriceps and hip flexor stretching.

Photo from T-nation via Google Images-Single leg Romanian deadlift or T-hold.

Activating their core musculature with static holds and low skill stability exercises teaches them how to maintain their posture while their hips move in different directions. This is necessary for higher technical lifts and movements they will encounter in their sport. Examples include bridges, side leg raises, leg swings, bird dogs, fire hydrants, single leg Romanian deadlifts, spidermans, and other exercises.

Progressively teaching and reinforcing more technical exercises that stress their body will help to develop long-term mobility in their hips. Training them to move in multiple planes will be effective in terms of gaining increased movement potential and will carry over to sport. Exercises that can accomplish this are lateral lunges and squats, reverse lunges with rotation or an overhead reach, drop step lunges and squats, and lateral step-ups.

Attacking the limitations in hip mobility can improve functional movement, improve quickness and deceleration, and decrease risk of injury.

What exercises have you found to be effective in terms of improving hip mobility? Do you have progressions you use with your athletes?

Resources:

http://www.strengthcoach.com/public/1298.cfm

http://movement-as-medicine.com/4-hip-mobility-drills-to-improve-your-squat/

Written By:
Tim Koba, ATC, CSCS, PES, CES, CMT
tkoba@CAYUGAMED.org