Archive for March, 2017

A Look into Concussion Protocols

Wednesday, March 15th, 2017

Posted March 15, 2017

Nicole T. Wasylyk

By Nicole T. Wasylyk, MSEd, LAT, ATC

Preventing, identifying and managing sport-related concussions (SRC) continues to be a challenge for both healthcare professionals and for patients. The complexity in management of SRC may be mitigated by adopting solid policies and procedures to follow for those involved with concussion care. Best practice for concussion management encourages all high schools, colleges, club and professional sports to have policies in place regarding SRCs.

Both the National Hockey League (NHL) and National Football League (NFL) have accepted policies1,2 with the NHL adopting a new mandatory protocol this season. The purpose of the protocols is to educate players and provide guidelines for identifying and managing sports-related concussions. It has been well publicized that both the NHL and NFL face litigation from former players accusing the leagues of failing to protect them from concussions and head injuries. They also allege the withholding of information about long-term effects of concussions.3,4 These new protocols may achieve improved player education, prevention and recognition of concussion.

At their core the protocols are very similar; the NHL and NFL reference the Zurich II Consensus Statement from 2012 to define concussion as a “brain injury and is defined as a complex pathophysiological process affecting the brain, induced by biomechanical forces.”5 The NHL’s protocol specifically states that all players must watch an educational video and received a brochure of the information prior to the first day of training camp. All players are also required to complete baseline concussion testing, a well-adopted best practice for all contact sport athletes. Players complete both the SCAT3 and ImPACT® Test, core components of baseline testing.

The protocols both take into account thoughtful details regarding baseline and follow-up concussion testing. For example, they recognize the importance of an appropriate baseline testing setting.  Baseline testing environment and timing of the test (not immediately after physical exertion) should be considered carefully.  It is crucial for these tests to be completed in an environment where a player has minimal distractions to ensure validity of these tests.

As both protocols describe baseline testing, they also describe recognition of sports-related concussion during game play and on-field management. Signs and symptoms of concussion are mentioned in detail along with the way each league monitors for concussions. During gameplay, the NHL utilizes 2 types of spotters or individuals who monitor game play for potential athletes who may have sustained a head injury.

The first type is a Central League Spotter described as an Athletic Trainer (AT) or athletic therapist who observes the games via multiple live game feeds in the NHL offices. The second is an In-Arena League Spotter described as an Off-Ice Official who observes the game live in the arena. If either spotter suspects a player has sustained a concussion the player is then taken off ice and assessed by the club’s medical personal as described in the protocol. In contrast, the NFL only describes a Booth Athletic Trainer; this individual serves as the spotter similar to the Central League Spotter for the NHL.

If an NFL player is suspected of having a concussion during a game, they are removed from play and assessed as described by the “Madden Rule.” This rule states that the player must be removed from the field and evaluated in the locker room area by medical personal. If medical staff concludes a concussion was sustained that player is not permitted to return to play the same day. If no concussion is suspected, then video of the game play must be reviewed to remove any doubt of head injury prior to allowing the player to return to participation. The NHL describes assessment similar to the NFL’s “Madden Rule.” Return to play progression is also outlined in both protocols and both leagues encourage a multidisciplinary team approach to treatment. The medical teams are comprised of either a neurotrauma consultant or neuropsychologist along with the team medical doctors and ATs.

These concussion protocols serve as a comprehensive approach to education, diagnosis and management of sports related concussions. It is important that a transparent policy is adopted as a part of best practice so players, coaches, medical staff and officials understand not only the actions to take to protect athletes but expectations surrounding concussion recognition, management and return to sport.









About the Author

Nicole Wasylyk works as an Athletic Trainer in a physician practice at Dartmouth-Hitchcock Medical Center (DHMC) in Lebanon, New Hampshire. Prior to DHMC she resided in Madison, Wisconsin and was an Athletic Trainer in a physician practice at Meriter-Unity Point Health. Wasylyk obtained her Bachelor of Science in Athletic Training from Boston University and Masters of Science in Education from Old Dominion University. She has completed a residency program for healthcare providers who extend the services of a physician at UW Health. Wasylyk also obtained her orthopedic technician certification. Her professional interests include injury surveillance and prevention, standardization of best practices and patient reported outcomes collection. 




Sports Dentistry: Why is it Critical to have Dentists Part of the Pre-participation Examination?

Monday, March 13th, 2017

Posted March 13, 2017

Kurt Andrews

By Kurt Andrews M.S., ATC, PES, CES

It’s not even day 1 of the new season yet. It’s the first time the lights have been turned on in the athletic training facility since an early exit in playoffs gave rise to a dramatic ending and unexpected offseason. Memories of the holidays remain fresh but need to be stored in the long-term memory bank as it is now time to get things prepared for the upcoming season.

The offseason has brought many changes within the organization as old faces have gone on to new challenges where new and old faces have assumed new positions. In preparation for the upcoming physicals, it’s encouraging to know that the medical staff has remained the same, thus ensuring continuity and efficiency at the doctor’s office.

All stations are set, the orthopedic doctors are set to do their exams, the podiatrist is confirmed to come down and scan everyone and the primary care providers are all set for electrocardiogram (EKG) testing. The doctor’s office has hired nurses to run all the tests for general health, the ophthalmologist is ready to do the annual eye exam and the chiropractors are coming by to do spinal evaluations. The dietician is ready to sit down and do one on one evaluations with all the athletes, the neuropsychologist is ready to impact test everyone and the performance staff is ready to put the team through physical test to get an understanding of the performance perspective. Amongst the organized chaos in the doctor’s office is a familiar face, one that doesn’t get much sideline attention during games.  But, one who is a crucial component of the sports medicine staff, the team dentist.

Sports dentistry is a new area of sports medicine specialization, not so much in terms of utilization amongst the athletes and athletic departments, but more so in its utilization in prevention principles of potential oral and facial injuries involved in the related sports. Sports dentistry also focuses on the prevention of any oral diseases and manifestations that may occur along with the maintenance and treatment of oral and facial injuries.

Dental trauma in sports is the major link between sports and dentistry, thus making dentists a necessity at pre-participation examination (PPE). During the team physicals the team dentist conducts oral health screenings and is involved with the fabrication of custom made mouth guards for certain sports such as  football, hockey, lacrosse, basketball or wrestling. They also make themselves available for any sort of emergency care or dental procedures that need to take place before the season starts preventing athletes from missing time during the season. Dentists should also be playing an active role in educating the public and athletes on the use of protective equipment for sporting activities not only to prevent injuries but also to reduce healthcare costs (Ramagoni et al., 2014).

Many sports related traumatic dental injuries are preventable with the use of appropriate, properly fitted and protective athletic equipment. These include but are not limited to helmets, facemasks and custom mouth guards. The National Youth Sports Foundation for the Prevention of Athletic Injuries, Inc. estimates that during the season of play athletes have a 10 percent chance of sustaining an injury to the face or mouth (Ramagoni et al., 2014). The most common orofacial sports related injuries include soft tissue injury and hard tissue injury including those to the teeth and facial bones such as tooth intrusions, luxations, crown/root fractures, complete avulsions and dental facial fractures (Saini, 2011).

The front teeth are the most affected by dental trauma with the maxillary central and lateral incisors being the most commonly injured teeth. The most common tooth injury is an uncomplicated crown fracture (Soares et al., 2014). Most of the time these injuries occur from a direct hit by a ball or from player to player contact. On the rare occurrence, while on the road for a game, it can be critical for an Athletic Trainer to have the team dentist available via phone or text to assist in the trouble shooting of a problem and come up with a short-term solution until the team comes back home.

By having a team or university dentist involved during the entrance physical, this professional can help facilitate the custom fabrication of mouth guards for the athletes involved in contact sports. These custom made mouth guards are superior to the stock or “boil and bite” mouth guards because of their adaptability and retention but are also believed to interfere the least with breathing and speech. Mouth guards should be worn when there is a possibility of any sort of physical contact with an opponent because they can help to prevent injuries to the teeth, lips, gingiva, tongue and mucosa. They cushion the blows that could cause jaw fractures, dislocations and trauma to the temporomandibular joint (Saini, 2011). According to the American Dental Association, the use of faceguards and mouth protectors prevent more than 200,000 orofacial injuries in football annually (Saini, 2011).

During the Athens Olympics in 2004, dental services were the second most utilized service in the Olympic village behind physiotherapy. The most common procedures were dental fillings (313 permanent and 31 temporary), root canals, pericoronitis treatment and mouthguard fabrications. The entrance physical is a perfect place for the dentist to be involved so every athlete can have a dental assessment. This will ensure that their oral health status is verified and cleared and any issues that may come up can be handled in the preseason.

In a study from 2003 to 2006, professional soccer players from the Spanish team Barcelona were compared with students of Dentistry and Medicine from the University of Barcelona. The researchers found that the average active dental cavity was significantly higher among professional soccer players compared to the dental student (Soares et al., 2014). What this shows is that the students practiced what they preached and were more willing to participate in dental hygiene practices, but that’s because they are familiar with them. The take home message from a study like this is that these dental issues are more widely spread amongst  athletes and the team dentist needs to establish a program encouraging oral health to the athletes of a university, college, professional or amateur teams.

A different study looking at 400 medical records of 353 amateur and 47 professional soccer players, found the results of poor oral health far worse for amateurs than the pros. In the amateur athletes, they found 283 cavity lesions (71 percent), 109 root canals (27 percent), 33 abscesses (9 percent) and 78 tooth extractions (22 percent). When compared to the professional athletes, they found 32 cavity lesions (68 percent), 11 root canals (23 percent), no cases of abscesses (0 percent) and 24 tooth extractions (51 percent) (Soares et al., 2014).

Swimmers have also been found to have a higher than normal tooth enamel decay. Researchers have found that swimming athletes are affected with biocorrosion of enamel because of the chlorine used to keep the pools clean; the acidic water in contact with the teeth causes irreversible tooth structure wear especially to the anterior teeth (Soares et al., 2014).

It is easy to understand now how important it is to have a dentist involved within the sports medicine team, and why they could and should be involved during the PPE or entrance physical exam. The duty of the sports dentist is to work alongside the athletic training staff to ensure the oral healthcare of the athletes, identify any individual risks, and develop prevention plans so that the athletes can avoid any major dental issues. The inclusion of a dentist to your sports medicine program can be a major component of your injury prevention model.

Dr. Padilla’s (Team Dentist for LA Galaxy) Top Tips for Dental Health

1. Regular scheduled dental exams and professional cleanings.

2. Be proactive rather than reactive. Complete any necessary treatment in a timely manner. Don’t put off treatment because it doesn’t hurt yet. This will insure minimal treatment performed.

3. Have good home dental hygiene care. Brush and floss at least twice a day.

4. Diet can contribute to dental problems. Limit excessive acidic drinks like sodas, fruit juices and sports drinks. These acidic drinks may dissolve tooth enamel which may contribute to tooth erosion and cavities. Rinse and hydrate with water after taking these acidic drinks.

5. Avoid smokeless tobacco, which can cause periodontal and oral cancer complications.

6. Wear custom made athletic mouth guards in competing in trauma related sports.


Ramagoni, N. K., Singamaneni, V. K., Rao, S. R., & Karthikeyan, J. (2014). Sports dentistry: A review. Journal of International Society of Preventive & Community Dentistry4(Suppl 3), S139.

Saini, R. (2011). Sports dentistry. National journal of maxillofacial surgery2(2), 129.

Soares, P. V., Tolentino, A. B., Machado, A. C., Dias, R. B., & Coto, N. P. (2014). Sports dentistry: a perspective for the future. Revista Brasileira de Educação Física e Esporte28(2), 351-358.

About the Author

Kurt Andrews, originally from the metro Detroit area, graduated with his bachelor’s degree in Exercise Science in 2008 from Oakland University. He has been a BOC Certified Athletic Trainer since 2011 where he earned his master’s in Athletic Training from the entry level master’s program at the University of Arkansas. He currently is in his fifth year as an assistant Athletic Trainer for the Major League Soccer (MLS) club LA Galaxy. He currently holds memberships with NATA, CATA and PSATS where he serves on the sponsorship, continuing education and research committees and was presently serving as the Western Conference senator.


In-Depth Look: Head Athletic Therapist for the Kingston Frontenacs Hockey Club

Tuesday, March 7th, 2017

Posted March 7, 2017

Ryan Bennett, BHED, Dip SIM, CAT(C), ATC, CSCS is Head Athletic Therapist for Kingston Frontenacs Hockey Club, a major junior hockey team in the Ontario Hockey League. He has worked for 12 seasons in this league.

Describe your work setting:

I work for a major junior hockey team in the Ontario Hockey League. Currently, there are more players who go to the National Hockey League from our league than any other junior league in the world. It is a field setting, but I have a clinic and office I use for rehab and treatments.

How long have you worked in this setting?

I am in my 12th season in this league. Before that, I worked 4 years in professional hockey, mainly in the American Hockey League.

Describe your typical day:

There isn’t really a typical day for me as we play or practice at different times depending whether it's a weekday or weekend. Typically, we play 2-3 days a week, have 1 day off where only injured players report and practice each day the rest of the week. Our season starts with training camp in early September. The end of season is late March with a possibility of 9 weeks of playoffs. We play 34 home games and 34 road regular season games.

A typical practice day has me arriving around 8:45am to prepare for our older, non-high school players' arrival at 9:30am. They workout or receive necessary treatment until 11:00am. Once they have left for lunch, the equipment manager and I work on laundry, tidying the dressing room and gym and getting the bench ready for afternoon practice. Players arrive back around 1:00pm, and I work on any pre-practice stretching, taping, wrapping and treatment. Practice starts around 2:15pm, and I watch for issues and injuries from the bench.

When practice ends at 4:00pm, I supervise the high school players' workout and perform any other stretching or necessary treatments. The players leave around 5:00pm. At this time, the equipment manager and I work on laundry, and clean and prepare the dressing room and gym for the next day. I typically leave the rink at 6:00pm.

Game days have a similar morning with a few hours break in the middle of the day. I arrive back at 3:00pm to prepare. The players arrive between 4:00pm-5:00pm. Games usually start at 7:00pm, and I get home after the game and cleanup, between 11:00pm and 12:00am.

What do you like about your position?

I grew up playing hockey so I've always loved the team atmosphere, it's like a second family. The feeling of winning, especially big games and championships, is second to none. Treating elite and motivated athletes twice a day allows me to see quick improvements. It's very rewarding to get them playing ahead of doctors' estimates. Hockey has also allowed me to travel all over the province, country and world with my junior teams and international programs.

What do you dislike about your position?

I've missed many events including weddings, funerals, birthdays and celebrations of friends and family which is unfortunate. My schedule isn't very flexible and doesn't allow for any missed or sick days. I've missed only 2 games over 12 years, for my daughter's birth. It's also tough being away from my family during long days and long road trips. However, things like FaceTime help and having summers off goes a long way to make up for it.

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

For those looking to work as an athletic therapist or Athletic Trainer (AT) with an elite sports team, I would suggest volunteering as an assistant to make sure you understand the huge level of commitment required to do a good job. Also, work with as many different ATs and other healthcare providers as possible. The skills and connections gained from other healthcare professionals will prove invaluable. Finally, nobody gets into this field for the hours or money so make sure you're learning and enjoying your job every single day. This is what I do and I haven't worked a day in my life!


Exercise Associated Muscle Cramps

Monday, March 6th, 2017

Posted March 6, 2017

By Michelle Snow, MA, AT, CSCS

Muscle cramps are often associated with heat and dehydration. A 2003 study looked at the number of heat related illnesses during a football season. Seventy-three percent of these illnesses were related to muscle cramping.1  Dehydration has long been blamed as the cause of exercise associated muscle cramps (EAMC). The most common theory places blame on salty sweat removing electrolytes from the body.

However, if EAMCs are heat and dehydration related, why do people experience cramping during cold weather events or while swimming in cold water? And, why does stretching almost immediately relieve the EAMC?

Unfortunately, to date, very little evidence and research has found a cause for EAMC. Two theories have been developed to help explain what may contribute to cramping, the dehydration and electrolyte imbalance theory and the altered neuromuscular control theory.

Initially, it was believed fluid and electrolyte disturbances may cause EAMC. This theory hypothesized that sweating caused a loss of fluid and electrolytes. This would lead to contraction of the interstitial space and a loss of interstitial volume. The increase in surrounding ionic concentrations and mechanical deformation of the nerve endings leads to a hyper-excitable motor nerve and a spontaneous contraction.

The theory was based on observation that athletes who experienced EAMC would often have significant fluid and electrolyte losses at the time of the cramp.4 However, it has been shown that losses in fluids and electrolytes, plasma, blood volume and body weight are similar in individuals who experience EAMC and those who do not experience cramping. Even when given a sports drink that reflected individual fluid losses, approximately seventy percent of participants still experienced EAMC.2

Due to these discrepancies, the second theory regarding a neuromuscular etiology has the strongest support from current research. This theory hypothesizes that neuromuscular fatigue alters the reflex control mechanisms of both the muscle spindle and golgi tendon organ, eliciting muscle cramping.4

The muscle spindle responds to length changes in the muscle. As length increases, the muscle spindle increases impulses to the agonist muscle to contract and decreases impulses to the antagonist muscle so it relaxes. The golgi tendon responds to length changes in the tendon and causes the agonist muscle to relax. Both work together to protect the muscle from over stretching. However, with fatigue, it has been noted that the muscle spindle activity increases while the golgi tendon activity decreases.2 This may explain why muscle cramps occur later in activity once the muscle has fatigued.

In most studies, fatigue has been the most common contributing factor to muscle cramping. This may be caused by an increase in exercise intensity and/or duration. It has also been found that those who have a history of EAMC are more likely to cramp again during other bouts of exercise. Current injury or previous history of injury may also play a role in EAMC. And, it has been found that male athletes are more likely to cramp than female athletes due to the greater proportion of fast-twitch fibers4.

The most effective treatment for acute fatigue-induced muscle cramps is static stretching of the affected muscle. It is thought that static stretching activates the golgi tendon organ by increasing tension in the tendon, causing increased afferent reflex inhibition.4  While the old method of using pickle juice may not change the blood plasma concentrations of electrolytes, it has been found that the acetic acid in pickle juice may trigger a reflex that increases neurotransmitter inhibition to cramping muscles.3 This has been found to effectively shorten the duration of EAMC.

However, it may not be an effective treatment for athletes who develop stomach duress or acid reflux after consumption. Even though there is little evidence to support the dehydration-electrolyte theory, it is still recommended that athletes remain hydrated to prevent heat illness. It is important to continue to recommend athletes to consume enough fluid so that not more than two percent of body weight loss occurs due to perspiration.

Other treatments have been recommended, however, little research has been completed to determine how effective they may be. Plyometric exercises and eccentric exercise may be incorporated for athletes who chronically experience muscle cramps. One study looked at strengthening the gluteus medius to help an athlete who struggled with hamstring muscle cramping. With the agonistic relationship of the hamstring and the gluteus medius, it was proposed that the weak glut might increase the amount of work the hamstring needed to do,  fatiguing the hamstring more quickly. The athlete targeted in this study was able to complete 3 triathlons without EAMC following 3 weeks of the targeted strengthening.4

Further research is needed to explain what causes exercise associated muscle cramps. Fatigue plays a significant role in muscle cramping. However, it does not explain how some athletes experience cramps, while others do not. The most effective treatment is static stretching of the affected muscle.


1. Cooper, E. R., Ferrara, M. S., Broglio, S. P. (2006). Exertional Heat Illness and Environmental Conditions during a Single Football Season in the Southeast. Journal of Athletic Training, vol. 41, 332-336.

2. Miller, Kevin. The Neurological Evidence for Muscle Cramping. NATA Symposium, June 2011, New Orleans Convention Center, New Orleans, LA. Conference Presentation.

3. Miller, K. C., Mack, G. W., Knight, K. L., Hopkins, J. T., Draper, D. O., Fields, P. J., Hunter, I. (2010). Reflex Inhibition of Electrically Induced Muscle Cramps in Hypohydrated Humans. Medicine and Science in Sports and Exercise, vol. 42, no. 5, 953-961.

4. Nelson, N. L., Churilla, J. R. (2016). A Narrative Review of Exercise-Associated Muscle Cramps: Factors that Contribute to Neuromuscular Fatigue and Management Implications. Muscle and Nerve, vol. 54, no. 2, 177-185.





Cardiac Screening in High School and College Aged Athletes

Friday, March 3rd, 2017

Beth Druvenga

Posted March 3, 2017

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

The inherent risk of injury when participating in some form of competitive athletics is widely accepted. Athletes suffer sprains, strains, concussions, fractures, contusions and lacerations to name a few injuries. A risk not so widely accepted is the risk of sudden cardiac arrest (SCA) or sudden cardiac death (SCD).

We have all seen the stories on the news or read the articles: A young athlete gone too soon. Athletes are in shape and generally in good health; they are not supposed to be participating one minute and unresponsive the next. As an empathetic, reasoning and rational culture, we cannot accept young lives being taken unexpectedly during athletic participation. But, it does happen. As an Athletic Trainer (AT) there is a list of potentially fatal events which may occur every day. I have to take a time out before games to internally review my emergency action plan (EAP), to prepare myself for the worst.

According to a 2011 study by Harmon et al., “SCD is the leading medical cause of death in NCAA athletes, is the leading cause of death during sport and exercise, and occurs at a much higher rate than previously accepted.”1 Hypertrophic cardiomyopathy and coronary artery anomalies account for 53 percent of all sudden cardiac deaths.2 Universally, professionals in the cardiac and sports medicine world alike have a common goal of preventing sudden cardiac death in athletes.4

To help prevent SCD, scientists and researchers have encouraged cardiac screening as a tool to detect underlying cardiac disorders and take the necessary steps for prevention. In fact, the Fédération Internationale de Football Association or International Federation of Association Football (FIFA) and the Union of European Football Associations (UEFA) have made cardiac screening mandatory before competition, and the International Olympic Committee encourages it as best practice.3 However, in the United States, only the National Basketball Association (NBA) mandates electrocardiograms (ECGs) or echocardiography annually.2

In Italy and Israel, it is required as part of a pre-participation examination (PPE) to have a cardiac screening.4 While in the United States a PPE involves a medical questionnaire and physical examination by a healthcare professional.2 And although the American Heart Association (AHA) supports pre-participation cardiovascular screening, it also acknowledges that it is not practical in mass context or nationwide mandate, due to the cost being an estimated 2 billion dollars per annum. Thus, the question remains. How do we move forward?

Until a nationwide, homogenous standard for cardiovascular screening is established for all high school and college aged athletes, take a look at some ways to combat SCA and SCD.

- Review your PPE questionnaire to confirm it includes questions the AHA supports for detection of potential cardiovascular disorders. Verify that these exams are being performed by a physician, nurse practitioner or physician assistant; someone who is trained and comfortable with detection of cardiovascular problems. According to the AHA, there is an increasing trend of states allowing chiropractors and naturopaths to perform PPE screenings, though they lack the cardiovascular screening training.2

- Review your facility’s EAP with not only your sports medicine staff but with people in the building who will be present when the EAP is put in to action. I am certain there are coaches and administrators who receive their EAPs but fail to read them and are not familiar enough to confidently put them into action.

- Get an automated external defibrillator (AED). I repeat, get an AED! Early defibrillation is essential during SDA to increase the chances of survival. If your school doesn’t have an AED, there are many grants and resources available to assist you in acquiring one.

- Consider providing cardiac screening for your school. There are many companies that perform cardiac screening, so reach out to your community and see what is out there. The most basic cardiac screening consists of a 12-electrode ECG which analyzes resting heart rhythm. This can help detect cardiac anomalies which may require further testing.

You, as an AT, are the best resource. Advocate for your athletes. I know ATs who have lost a student athlete to SCD. My hometown lost a student athlete to SCD during a wrestling tournament a little over a year ago. It all begins with YOU. Do your research to help prevent SCD and protect your athletes. Below are resources for cardiac screening and resources for AED grants, and I urge you to utilize them.

Cardiac Screening Resources

Parent Heart Watch:

AED Resources

Sudden Cardiac Arrest Foundation:


1. Harmon, K., Asif, I., Klossner, D., & Drezner, J. (2011). Incidence of Sudden Cardiac Death in National Collegiate Athletic Association Athletes. Circulation, 1594-1600.

2. Maron, B., Thompson, P., Ackerman, M., Balady, G., Berger, S., Cohen, D., et al. (2007). Recommendations and Considerations Related to Preparticipation Screening for Cardiovascular Abnormalities in Competitive Athletes: 2007 Update. Circulation, 1643-1655.

3. Schmied, C., & Borjesson, M. (2013). Sudden cardiac death in athletes. Journal of Internal Medicine, 93-103.

4. Steinvil, A., Chundadze, T., Zeltser, D., Rogowski, O., Halkin, A., Galily, Y., et al. (2011). Mandatory Electrocardiographic Screening of Athletes to Reduce Their Risk for Sudden Death: Proven Fact or Wishful Thinking? Journal of the American College of Cardiology, 1291-1296.

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.