Archive for October, 2016

Athletic Trainers Provide Psychological First Aid

Friday, October 28th, 2016

 

Posted October 28,2016

By Mackenzie Simmons, ATC

The theme for World Mental Health Day this year was Psychological First Aid. This theme ties directly to the care Athletic Trainers (ATs) provide on a daily basis to patients. Whether an athlete has suffered a season-ending or career-ending injury or has lost a loved one in their life, the AT will be there to assist with their mental and emotional well-being.

Mental health issues can affect athletes in a variety of ways. High school and collegiate athletes struggle with the stress of homework, practice and games. Professional and collegiate athletes spend a lot of time on the road, making it hard to see their families and loved ones on a daily basis.  At any level of sport, an athlete may suffer a serious injury and feel like they are losing a part of their identity. These factors can negatively impact the mental health of any athlete, causing serious and long-term issues if they are not handled in an appropriate manner.

The next time you are providing care to your patients, make an effort to look past the musculoskeletal injury of your athlete. Take a moment and look deep down to see how they are handling an injury or their overall participation in the sport emotionally. Many athletes are experts at masking their pain and appearing strong to continue with competition. However, deep down, they may be fighting some emotional battles that they are afraid to show.

By establishing a strong relationship with your athletes, they will likely begin to trust you more, thus allowing them to share their emotional and mental problems with you as well. We, as healthcare providers, need to bring mental health issues out of the shadows, and help our patients be physically well, as well as mentally and emotionally strong.

World Mental Health Day was celebrated worldwide on October 10 to help bring awareness to a variety of mental health topics while gaining support for these serious issues. Learn more about World Mental Health Day at http://www.who.int/mental_health/world-mental-health-day/en/.

 

Self-Care for Athletic Trainers: How to deal with stress, long days and an intense work environment

Tuesday, October 25th, 2016

Posted October 25, 2016

By Beth Druvenga, M.S. Ed, LAT, ATC

Beth Druvenga,
M.S. Ed, LAT, ATC

For years researchers have been interested in methods to help combat stress and burnout in healthcare fields. Studies have shown that an increase in fatigue, insomnia, depression, heart disease and other psychological and physiological ailments can be attributed to stress in the workplace. Other byproducts are decreased patient satisfaction and reduction of a clinician’s attention and concentration, which can reduce their decision-making skills and concentration.2 Obviously, to us in the healthcare field, reduced decision-making skills and decreased patient satisfaction are detrimental to our jobs. However, the physiological and psychological effects on the clinician are detrimental to our health and well-being.

So what are some ways to combat this stress in the workplace? The research is clear that exercise is one of the best ways to combat stress.1 Not only does exercise release hormones that are mood boosters, but it helps you expel aggression and focus your mind on something other than work. Other proven ways to combat stress include seeking outside help, broaching the subject at work to create a better work environment and meditation. Let’s take a deeper look into these less utilized options.

Outside help: There is a stigma in our society that, “only crazy people go to psychologists.” This stigma is false! In fact, a high percentage of those seeking advice from psychologists do not suffer from any diagnosed medical condition. Many employers offer the services of mental health and wellness to their employees. You should take advantage of this great opportunity! If you still feel uneasy about a mental health counselor, seek out a friend, family member, significant other, clergy or other trusted individual to speak to about stressors or struggles at work. Sometimes the best way to combat your stress is to talk it out. Another great resource could be a sport psychology consultant who specializes in sub-clinical issues. They would not only be beneficial to us as professionals but also a useful resource for athletes during the recovery process.

At work: ATs struggle at 2 major things in the athletic training profession, including saying no and asking for time off. We all know that our field is highly stressful. We don’t dictate our own schedule a majority of the day, and sometimes are left out of the loop. This can lead to burnout. So how do we address it? Speak to our supervisor. Companies want to retain their employees, but there is a direct link between burnout and its effect on retention.3 Odds are good you are not the only one suffering from stress, and maybe there is a way to incorporate a stress reduction program into your work day. Another option is to look into classes being held at a local fitness center, which may offer a short lunch time yoga class.

Meditation: Yoga is an ancient form of exercise; its goal is to connect mind and body. Studies show links between yoga and reduction in stress and anxiety levels.4 Apart from yoga, meditation can help reduce stress. In our profession, we need to take the time to sit in silence. A simple practice of setting aside 5 minutes of your day to quiet your mind free of counterproductive thoughts, to-do lists and stress will do wonders for not only releasing stress but increasing your positive outlook on the rest of the day.

As healthcare professionals, we put the focus on others and sometimes forget about ourselves. If you find yourself suffering from increased amounts of stress at work or in general, that could be a sign to make more time for yourself. We cannot be at our best for others, if we are not at our best for ourselves.

Resources

1. Gicaobbi, P. R. (2009). Low Burnout and High Engagement Levels in Athletic Trainers: Results of a Nationwide Random Sample. Journal of Athletic Training, 370-377.

2. Irving, J. A., & Park-Saltzman, J. (2009). Cultivating mindfulness in health care professionals: A review of empirical studies of mindfulness-based stress reduction (MBSR). Complementary therapies in clinical practice, 61-66.

3. Mazerolle, S., & Eason, C. (2016). A Longitudinal Examination of Work-Life Balance in the Collegiate Setting. Journal of Athletic Training, 223-232.

4. Smith, C., Hancock, H., Blank-Mortimer, J., & Eckert, K. (2007). A randomised comparative trial of yoga and relaxation to reduce stress and anxiety. Complementary Therapies in Medicine, 77-83.

About the Author

Beth Druvenga is an Athletic Trainer currently living in northern Virginia. She has experience working in both a collegiate and high school setting. Druvenga is originally from Iowa where she earned her Bachelor of Arts degree in Athletic Training from Central College in 2012. She graduated from Old Dominion University in 2014 with a Master of Science in Education. Her professional interests include patient-reported outcomes, psychology of injury and rehabilitation as well as using yoga to increase flexibility.

 

You’ve Earned It: Time to Ask for a Pay Raise

Thursday, October 20th, 2016

Posted October 20, 2016

Beth Wolfe
CAGS, ATC

By Beth Wolfe, CAGS, ATC

Asking for a pay raise can be a daunting, intimidating and lonely process. However, with the right tools, advice and support, the pay raise process can be easier than you might think. In her article, Carolyn O’Hara provides several tips to ponder before asking for a pay raise, and below are 3 adapted pieces of advice that can be useful in preparing to ask for a pay raise.

1. Do your homework. How much of a raise should you ask for? Are you making the same as your peers in the area? One thing you must also keep in mind is that sometimes pay raises aren’t possible for certain positions due to circumstances beyond your control. Ask your employer if they provide merit based pay raises or if your salary is predetermined by another source such as grant monies or contract agreement via outside provider. If your institution does not provide merit-based raises, you could still ask for a raise based on what others in your area are being paid. However, if your salary is predetermined by an external source it may be difficult to obtain a raise unless the funding source agrees to a higher salary. Utilize a national salary database such as Glassdoor, Indeed or US Department of Labor to see what other people with your same job title are making in your area and across the country.

2. Take a moment to reflect on your value.  Why should your boss give you a raise? What is your worth or value as a healthcare provider? Do you offer a special talent or skillset that warrants a pay raise? From these questions gather evidence and formulate a list of facts, contributions and patient care statistics. Statistics could include hours worked, overtime worked, patient feedback and outcomes, and number of patient encounters by day, week and month. Be confident in your list of evidence and be sure to provide examples for each item on your list.

3. Ask for advice from others in your industry. If you are the only employee at your organization, ask a mentor or peer in your area how they navigated asking for a raise. Each organization will handle pay raises differently, but at least you can gain some relevant and real-time advice instead of asking blindly. Additionally, ask this mentor or peer if you could practice your “ask for a raise speech” with them so that they can provide you with constructive feedback. A practice session can help alleviate nervousness, jitters and anxiety you may have going into the discussion.

What happens if you are denied or don’t get a raise? Don’t get discouraged; it is okay! Have a back-up plan in place so you could compromise with your employer. For example, could you have additional flex-time for extra hours worked? Or you could discuss how you could take on more responsibilities that could lead to a future pay raise. Make note of the reasons for why you weren’t offered a raise this time so you can continue to build your case for a raise in the future.

Reference

O’Hara, C. (2015). How to ask for a raise. Harvard Business Review. March 5. Retrieved from https://hbr.org/2015/03/how-to-ask-for-a-raise.

About the Author

Elizabeth “Beth” Wolfe is the Injury Prevention Coordinator and Research Assistant for the Tufts Medical Center Division of Trauma and Acute Care Surgery in Boston, Massachusetts. Wolfe received her undergraduate degree from the University of South Carolina (2010) and master’s in Health Education (2012) and CAGS in Sport Psychology (2013) at Boston University. Wolfe is currently pursuing a Doctorate of Health Science in Healthcare Administration and Leadership at the Massachusetts College of Pharmacy and Health Sciences. A few of her research interests include bike and pedestrian safety; fall prevention; concussion/head injury documentation and coding; and performance/quality improvement programming for the profession of athletic training. Wolfe is an active medical volunteer for the Boston Athletic Association and numerous other races/events throughout the greater New England area. In her free time, Beth loves to ride her bike around Boston and participates in local rugby and softball leagues.

 

 

Osteoarthritis Prevention and Wellness Protection Strategies

Tuesday, October 18th, 2016

Posted October 18, 2016

By Jeffrey B. Driban, PhD, ATC, CSCS

How many Athletic Trainers (ATs) can remember a patient who tore an anterior cruciate ligament (ACL), returned to visit a few years later and described chronic knee pain and limitations with their favorite activities?

The Bone and Joint Health National Awareness Week is a great time to focus on injury/illness prevention and wellness protection strategies that can help preserve long-term health. This is particularly relevant if we consider that 37 percent of ATs think osteoarthritis – a chronic painful and disabling condition – is not a major health concern.1 Furthermore, only approximately 70 percent of ATs discuss with a patient their risk for osteoarthritis and strategies to mitigate this risk.

In contrast, over 80 percent of adults after an ACL injury believe that knee osteoarthritis would be a major health concern and only 27 percent recalled having a conversation with their health professional about osteoarthritis risks associated with their knee injury.2 While many patients focus on short- and medium-term goals like return to play, it is vital that ATs provide patients with information about what they can expect after an injury. Let us consider some key questions.

What is osteoarthritis?

Osteoarthritis – the most common form of arthritis – is a progressive disease that affects all the tissues in a synovial joint. Osteoarthritis reflects a failed attempt to repair joint damage that is caused by stress on a joint. Osteoarthritis can be thought of as a disease, which is defined by the structural changes in a joint like bone spur formation or cartilage damage. It can also be thought of as an illness, which is defined by a patient’s reported experience like joint pain or other symptoms.3

Is osteoarthritis a major health concern?

Over 30.8 million million adults in the United States have osteoarthritis.4 Osteoarthritis is among the top 15 causes of disability.5 Osteoarthritis causes over $10 billion in annual absenteeism6 and more than $185 billion/year in healthcare expenditures.7 Unfortunately, a patient is at risk for early-onset osteoarthritis after a joint injury. This is troubling because adults 20 to 55 years of age with hip or knee osteoarthritis are 4 times more likely to be psychologically distressed compared with their peers. Furthermore, 67 percent of these patients report osteoarthritis-related work disability and approximately 40 percent report reduction in quality of life.8

Which physically active individuals are at risk for osteoarthritis?

Most adults who take part in physical activity and sports are safe and possibly even protected against osteoarthritis.9 However, men in soccer and certain elite-level sports may be at greater risk for hip or knee osteoarthritis.10,11 It remains unknown if these specific sports cause osteoarthritis or if other factors are the culprits (for example, the amount of training the athlete performs, the types of injuries that occur or how we manage an injury). Among our patients, one of the strongest risk factors for osteoarthritis is joint trauma. Individuals with a history of knee injury are 3 to 6 times more likely to develop osteoarthritis.12 Within the first decade after a knee injury, 1 in 3 patients develop osteoarthritis.13,14 Hence, a 20-year-old athlete who tears her ACL is at elevated risk for osteoarthritis by 30 years of age, which could lead to knee symptoms and then have a major impact on her work and quality of life for decades.

What can we do to prevent osteoarthritis?    

An injury prevention program can reduce the risk of injury by 35 to 68 percent.15,16 Furthermore, lower limb injury prevention programs can improve performance, keep athletes on the field and be easily implemented in a team warm-up. Recently, the Osteoarthritis Action Alliance, of which the NATA is a member organization, released a Consensus Opinion on the Best Practice Features of Lower Limb Injury Prevention Programs (Executive Summary). The task force identified 6 core components that should be included as part of a training program for prevention of major joint injury among youth athletes:

1. lower extremity and core muscle strength training

2. plyometric - jump training

3. balance training (as part of a program)

4. continual feedback on proper technique

5. sufficient dosing and compliance

6. minimal to no extra equipment

Unfortunately, we are unable to prevent every injury. Hence, we need to educate our patients about their risk for osteoarthritis and secondary prevention strategies that could help delay or prevent the onset of osteoarthritis. Secondary prevention strategies include regular exercise and weight management. These concepts will be expanded upon in the Athletic Trainers’ Osteoarthritis Consortium’s review and recommendations on the role of ATs in preventing and managing post-traumatic osteoarthritis in physically active individuals. The article will published by the Journal of Athletic Training in Spring 2017.

It is important to recognize that ATs are in a key position to help prevent this chronic disabling disorder and have a lasting effect on a patient’s long-term health and wellness. So next time you treat an injury, think long-term and talk with your patient about their future risk of osteoarthritis and how they can help reduce their chances of getting it.

References

1.  Pietrosimone BG, Blackburn JT, Golightly YM, et al. Certified Athletic Trainers' Knowledge and Perceptions of Posttraumatic Osteoarthritis After Knee Injury. Journal of athletic training. 2016.

2.  Bennell KL, van Ginckel A, Kean CO, et al. Patient Knowledge and Beliefs About Knee Osteoarthritis After Anterior Cruciate Ligament Injury and Reconstruction. Arthritis Care Res (Hoboken). 2016; 68(8):1180-1185.

3.  Lane NE, Brandt K, Hawker G, et al. OARSI-FDA initiative: defining the disease state of osteoarthritis. Osteoarthritis Cartilage. 2011; 19(5):478-482.

4. Cisternas MG, Murphy L, Sacks JJ, et al. Alternative Methods for Defining Osteoarthritis and the Impact on Estimating Prevalence in a US Population-Based Survey. Arthritis Care Res (Hoboken). 2016; 68(5):574-580.

5. Vos T, Flaxman AD, Naghavi M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2013; 380(9859):2163-2196.

6.  Kotlarz H, Gunnarsson CL, Fang H, Rizzo JA. Osteoarthritis and absenteeism costs: evidence from US National Survey Data. J Occup Environ Med. 2010; 52(3):263-268.

7.  Kotlarz H, Gunnarsson CL, Fang H, Rizzo JA. Insurer and out-of-pocket costs of osteoarthritis in the US: evidence from national survey data. Arthritis Rheum. 2009; 60(12):3546-3553.

8. Ackerman IN, Bucknill A, Page RS, et al. The substantial personal burden experienced by younger people with hip or knee osteoarthritis. Osteoarthritis Cartilage. 2015; 23(8):1276-1284.

9. Urquhart DM, Tobing JF, Hanna FS, et al. What is the effect of physical activity on the knee joint? A systematic review. Med Sci Sports Exerc. 2011; 43(3):432-442.

10. Driban JB, Hootman JM, Sitler MR, Harris K, Cattano NM. Participation in certain sports is associated with knee osteoarthritis: a systematic review. Journal of athletic training. In Press.

11. Michaelsson K, Byberg L, Ahlbom A, Melhus H, Farahmand BY. Risk of severe knee and hip osteoarthritis in relation to level of physical exercise: a prospective cohort study of long-distance skiers in Sweden. PLoS One. 2011; 6(3):e18339.

12. Muthuri SG, McWilliams DF, Doherty M, Zhang W. History of knee injuries and knee osteoarthritis: a meta-analysis of observational studies. Osteoarthritis Cartilage. 2011; 19(11):1286-1293.

13. Harris K, Driban JB, Sitler MR, Cattano NM, Balasubramanian E. Tibiofemoral Osteoarthritis After Surgical or Nonsurgical Treatment of Anterior Cruciate Ligament Rupture: A Systematic Review. Journal of athletic training. 2015; In Press.

14. Luc B, Gribble PA, Pietrosimone BG. Osteoarthritis Prevalence Following Anterior Cruciate Ligament Reconstruction: A Systematic Review and Numbers-Needed-to-Treat Analysis. Journal of athletic training. 2014; 49(6):806-819.

15. Sugimoto D, Myer GD, Barber Foss KD, Hewett TE. Specific exercise effects of preventive neuromuscular training intervention on anterior cruciate ligament injury risk reduction in young females: meta-analysis and subgroup analysis. Br J Sports Med. 2014.

16. Emery CA, Roy TO, Whittaker JL, Nettel-Aguirre A, van Mechelen W. Neuromuscular training injury prevention strategies in youth sport: a systematic review and meta-analysis. Br J Sports Med. 2015; 49(13):865-870.

About the Author

 Jeffrey B. Driban, PhD, ATC, CSCS is an Assistant Professor in the Division of Rheumatology at Tufts University School of Medicine and Tufts Medical Center. The goal of his research is to explore novel biochemical and imaging markers to gain a better understanding of osteoarthritis and potential disease phenotypes. Dr. Driban received his Bachelors of Science in Athletic Training from the University of Delaware. He received a Masters of Education and Doctor of Philosophy in Kinesiology with an Emphasis in Athletic Training from Temple University. He completed a post-doctoral research fellowship in the Division of Rheumatology at Tufts Medical Center where he continued his osteoarthritis focus. Dr. Driban also aims to raise awareness about osteoarthritis and promote primary and secondary prevention strategies for physically active individuals as the Chair of the Athletic Trainers’ Osteoarthritis Consortium and by serving as a National Athletic Trainers’ Association’s representative in the Osteoarthritis Action Alliance and Chair of the Alliance’s Osteoarthritis Prevention Work Group. Dr. Driban is also co-founder of Sports Medicine Research Company, which provides a blog and podcast focused bridging the gap between research and clinical practice related to sports medicine.

 

Save

Save

Save

Where did your state rank in votes for BOC Athletic Trainer Director?

Monday, October 17th, 2016

Posted October 17, 2016

During the election for BOC Athletic Trainer Director, we have been keeping track of the percentage of Athletic Trainers in each state who voted during the election. Online voting closed on Thursday, October 13, 2016 at 11:59pm ET.

Congratulations to Montana for taking first place! Texas was in second place, and Nebraska was close behind in third place. New Mexico, Wyoming, Pennsylvania, South Carolina, Indiana, Oklahoma and North Dakota all made the Top 10 list. Thank you to everyone who voted in this election!

The BOC is pleased to announce the election of 2 new Athletic Trainer Directors to the Board of Directors. Michael Carroll, MEd, LAT, ATC, and Neil Curtis, EdD, LAT, ATC, will take office in January 2018, following a year of mentorship and learning as AT Directors-elect. Learn more at http://www.bocatc.org/news-publication/media-room/11-boc-news/477-new-boc-board-members-named-for-upcoming-term.

Save

Is Cupping the New “Fad” Therapy?

Friday, October 14th, 2016

Posted October 14, 2016

By Mackenzie Simmons, ATC

If you watched the Olympics this summer, you likely saw many Olympic athletes covered in perfectly circular red spots. These red spots are left by a therapeutic tool, known as cupping. Cupping is an ancient therapy, most prominently used in Middle Eastern and Asian countries.  Cupping has recently started to become popular in the United States over the past few years.

The process of cupping involves heating glass suction cups and placing them on the treatment area. The suction cups are usually left on the skin for around 5 minutes before they are removed. As the suction cups cool down, a partial vacuum is formed with the skin. The number of cups that are used is dependent upon the size of the treatment area; the bigger the area, the more cups that are used.

Cupping is believed to relieve pain by stimulating the muscles while increasing blood flow. It has also been shown as a form of deep-tissue massage that helps with the relaxation of sore muscles. Unfortunately, there has not been much research conducted that shows the positive effects of cupping.

Cupping might be the new “fad” therapy for Olympic, professional and collegiate athletes. Over the past 10 years, Kinesiotape, cryotherapy chambers and power bands have all become well-known and are used by professional athletes. With the limited research on cupping, time will tell  if this therapy will be around in 4 years for the next Summer Olympics.

Reference

http://www.cnn.com/2016/08/08/health/cupping-olympics-red-circles/

 

 

Medical Therapeutic Yoga Series: A New Movement in Healthcare

Monday, October 10th, 2016

Posted October 10, 2016

Desi Rotenberg
MS, LAT, ATC

By Desi Rotenberg, MS, LAT, ATC

Medical therapeutic yoga is a new movement within the rehabilitative realm that is quickly becoming more widely accepted as a pragmatic route to improving physical, emotional and mental well-being. There has been a paradigm shift within the medical field, as yoga therapy becomes more and more integrated into healthcare. Furthermore, yoga therapy is becoming more popular in the treatment of musculoskeletal injuries.

The core premise and philosophy behind medical therapeutic yoga is to understand your own limitations to be able to deliver the safest and best care possible. This includes a comprehensive understanding of the human anatomy and the treatment of specific diseases, disabilities or disorders. Additionally, in order to become a yoga therapist, a medical professional must have knowledge of indications and contraindications for safe breathing practices, as well as a strong knowledge base in various yogic practices to ensure patient safety.1

In 2012, the International Association of Yoga Therapists (IAYT) advisory board approved the educational standards for the training of yoga. This approval opened the door for medical therapeutic yoga to be held to competency-based educational standards. Although, Yoga Therapy is not governed nor regulated by the IAYT. The focus is on entry-level requirements for the training of yoga therapists and includes a definition of yoga therapy and training requirements. The goal for any organization when developing competency-based standards “is to define the foundational knowledge and skills required for the safe and effective practice of yoga therapy.”2

The Scope of Practice for yoga therapy can be found here: http://www.iayt.org/news/308692/IAYT-Updates-Scope-of-Practice.htm.3

The Professional Yoga Therapy Certification can be a post-certification option for Athletic Trainers who are interested in furthering their knowledge base. The Professional Yoga Therapy Institute (PYTI) is one of several institutes who offer both continuing education courses and a full professional certification.

The PYTI defines medical therapeutic yoga as “the practice of yoga in medicine, rehabilitation, and wellness settings by a licensed health care professional who is completing or has graduated from the Professional Yoga Therapy Institute program and has been credentialed as a Professional Yoga Therapist-Candidate or Professional Yoga Therapist.”4

Becoming a medical yoga therapist is not for everyone. While knowledge is essential to a medical professional’s success as a practitioner, the journey of accruing wisdom holds an even greater weight. The uniqueness of this new field focuses on the well-being of the patient, while also ensuring the individual who practices medical therapeutic yoga is able to achieve a balance within every aspect of their life, both professionally and personally.

More information on medical yoga therapy and becoming a professional yoga therapist, can be found at the following websites:

International Association for Yoga Therapy- http://www.iayt.org/

Professional Yoga Therapy- http://proyogatherapy.org/

Medical Therapeutic Yoga- http://www.gingergarner.com/therapies/medical-yoga/

Resources

1. Garner, G. (2007). The Future of Yoga Therapy and the Role of Standardization. International Journal of Yoga Therapy, 17(1), 15-18.

2. Educational Standards for the Training of Yoga Therapists. (2016). http://www.iayt.org/?page=AccredStds. Accessed September 27, 2016.

3. Scope of Practice for Yoga Therapy, (2016). INTERNATIONAL ASSOCIATION OF YOGA THERAPISTS. http://c.ymcdn.com/sites/www.iayt.org/resource/resmgr/docs_certification/scopeofpractice/2016-09-01_IAYT_Scope_of_Pra.pdf. Revised: September 1, 2016.

4. Professional Yoga Therapy Institute, (2016). http://proyogatherapy.org/about-pyts/. Accessed September 27, 2016.

About the Author

Desi Rotenberg, originally from Denver, Colorado, graduated with his bachelor's degree in 2012 from the University of Northern Colorado. He has been a BOC Certified Athletic Trainer since 2012 and earned his master's degree in Exercise Physiology from the University of Central Florida in 2014. He currently is a high school teacher, teaching anatomy/physiology and leadership development. Along with being a teacher, he wears many hats, such as basketball coach, curriculum developer and mentor. He has been a contributor to the BOC Blog since the summer of 2015. 

Save

Save

Save

Save

Save

Save

Discussion and Research on Concussion Management

Thursday, October 6th, 2016

Posted October 6, 2016

Diane Sartanowicz,
MS, LAT, ATC

By Diane Sartanowicz, MS, LAT, ATC

With the start of the fall athletic season, much has been written about concussions. In the news and media, concussions are referred to as a public health crisis due to the increase in the number of diagnosed cases.  As Athletic Trainers (ATs), we are called upon as experts in the field of concussion management and are driving the research and discussion around this very hot topic. So why are there so many unanswered questions?

Some of it has to do with the definition of a concussion. The term concussion (or commotio cerebri) has been used for centuries to imply “a transient loss or alteration of consciousness without associated structural damage.”1 It is also known as a mild traumatic brain injury (mTBI) and can cause a variety of physical, cognitive and emotional symptoms. In recent years, concussion has been used most frequently in reference to sport-related head trauma.

Along with the struggle to come to a unified definition of concussion, another set of questions relates to the diagnosis of a concussion and the reporting rates. An estimated 1.7 million concussions occur each year in the United States as a result of sport and physical activity, and of those, 80 percent  are seen in an emergency room department. These numbers are staggering when almost half a million visits for mTBI are made annually by children aged 0 to 14 years.2  Many more concussed youth seek treatment through physicians’ offices or not at all.  So are these statistics accurate? We need to understand exactly what we are diagnosing in order to collect and track the data. Education on the signs and symptoms of a concussion is the key to successful outcomes for the athlete.

As a consequence of the multi-faceted issues facing youth sports concussions, programs like the Massachusetts Concussion Management Coalition (MCMC) are being established to address this issue.  MCMC is a group of individual stakeholders who are dedicated to the health and safety of our student-athletes. The broad range of groups like the Massachusetts Interscholastic Athletic Association (MIAA), Massachusetts School Nurse Organization, Athletic Trainers of Massachusetts (ATOM), Department of Public Health and the Brain Injury Center of Boston Children’s Hospital are represented and their top priority is to prevent and manage concussions.

MCMC is a pioneer in concussion research and education outreach bringing everyone together to collaborate on the best way to tackle the many issues surrounding concussions. Due to the generous funding by the NHL Alumni Foundation, MCMC has been able to provide free ImPACT™ neurocognitive testing to all MIAA member schools that enroll in the program. Along with the free testing, MCMC provides secondary schools with concussion education presentations to their communities. It is our goal to ensure tools are readily available for all secondary schools to be knowledgeable in the recognition, management and treatment of concussions. We hope to create a legacy of concussion education in the Commonwealth of Massachusetts which reflects these goals. For more information on our program or how to get involved, please visit our website at www.massconcussion.org.

As I write this blog, we have just completed a successful Concussion Awareness Week in Massachusetts. It is through the collaborative efforts of the Think Taylor Foundation and the MIAA that 86,000 student-athletes have become more engaged in the discussions surrounding concussions. Think Taylor was founded by Taylor Twellman, star forward for the New England Revolution soccer team. His career-ending concussion left him seeking answers and wanting to make an impact on the lives of student-athletes.

During Concussion Awareness Week, all student-athletes were encouraged to turn their school orange, the color of healing, and to take the TT Pledge. This pledge states, “I will become more educated on the signs and symptoms of concussions, I will be honest with my coaches, and Athletic Trainers, parents and teammates, and that I will be supportive of anyone with a concussion.” These 3 words – education, honesty, support – are what ATs embody every day. Our combined efforts lead the way to increased awareness and expanded concussion education across the state. I would encourage each of you to get involved in a movement like ours.

Resources

1 Charles H. Tator. Concussions and their consequences: current diagnosis, management and prevention, CMAJ. 2013 Aug 6; 185(11): 975–979

2 Faul M, Xu L, Wald MM, Coronado VG. Traumatic brain injury in the United States: emergency department visits, hospitalizations, and deaths. Atlanta (GA): Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2010.

About the Author 

Diane Sartanowicz, MS, LAT, ATC is the Director of the MCMC.  She was president of ATOM from 2006-2008, past-president of Eastern Athletic Trainers’ Association from 2011-2012 and is currently the NATA District One Treasurer.