Posts Tagged ‘injury prevention’

Nutrition, Recovery and Injury Prevention for Basketball Players

Tuesday, January 3rd, 2017

Posted January 3, 2017

Desi Rotenberg
MS, LAT, ATC

By Desi Rotenberg, MS, LAT, ATC

Basketball is a sport that requires several complex movement patterns, both within the individual and the team. Before an exercise specialist can create a training and nutrition program for any sport, it is important to first fully understand the game as a whole. This includes, but is not limited to, the specific movement patterns required to optimize performance as well as how to decrease overall time to fatigue in-game and during off-court training. Coupling movement patterns with a deliberate hydration plan and nutrition plan can optimize performance, while ensuring the athlete’s body can handle the strenuous mental and physical demands of the sport itself.

Nutrition

Basketball requires a combination of movements that include strength, endurance, power, agility, quickness and proprioception. While a single game lasts between 32 and 48 minutes, depending on the level, the actual exercise time may only be a fraction of that time. A single player will undergo 1 high intensity run every 21 seconds and spends nearly 60 percent of their playing time undergoing low intensity activity .2

In order for each player to maximize their performance on the court, they must ensure they have properly fueled the energy systems needed. The training needs of the sport will also need to be taken into consideration: the average basketball player trains between 2-3 hours per day, 4-6 days per week.2 Additionally, it is estimated that the average basketball player runs between 1 and 3 miles per game. These values have only been confirmed at the professional level with state-of-the-art tracking technology. Currently, the record belongs to Jimmy Butler, who ran an average of 2.74 miles per game during the 2015-2016 NBA season.

Nonetheless, a basketball player’s diet must reflect that of the short-term, high intensity movements coupled with long-term low intensity energy demands. The table below illustrates the nutritional requirements for basketball players at the high school and post-secondary levels:

  Men Women
Calories

2,500-3,000 (High school)

3,000-3,500 (Post-Secondary)

2,200-2,700 (High School)

3,500-4,000 (Post-Secondary)

Protein

1.4-1.7 g/kg

1.4-1.7 g/kg

Carbohydrate

2.7-4.5 g/kg

2.7-4.5 g/kg

It is recommended athletes eat a high carbohydrate, low fat meal roughly 3-4 hours prior to the start of a practice or competition. A small snack should be consumed 1-2 hours prior to the start. This snack should be relatively high in carbohydrate (juice, cereal bar or bagel) and have some protein (peanut butter, milk, cheese or yogurt) in order to prepare the athlete’s body for the energy need required. The protein will help initiate the athlete’s muscle recovery following completion of the practice or competition. Less than 1 hour prior to the start of the practice or competition, the athlete should consume a sports drink. This will help prime the athlete’s short-term energy system and contribute to hydration, which will help prevent fatigue.

During the practice or competition, it is recommended the athlete drink water or colored sports drinks that are kept at a cool temperature. This will prevent dehydration and exercise-induced hypoglycemia. Basketball players should be taking breaks and consuming either water or a sports drink roughly every 15-20 minutes during play.1

Injury Prevention

According to a 2016 study by Bird and Markwick published in the International Journal of Sports Physical Therapy, injury prevention within the basketball population is a combination of the ability to recognize poor movement patterns and the theoretical likelihood to predict future injury incidents.3  A meta-analysis of basketball injury prevalence showed amongst high school basketball players, an injury will occur 2.08 times per every 1,000 exposures in boys  and 1.83 per times per 1,000 exposures in girls.3 An exposure being an opportunity for an injury to occur within practice or in-game. Concurrently at the collegiate level, the injury rate substantially rises: 9.9 times per 1,000 exposures in men and 7.68 times per 1,000 exposures in women.3

Furthermore, as expected, the lower extremity was the most common region of the body to have sustained injury amongst basketball players. Ankle sprains during landing accounted for nearly 45 percent of all lower extremity injuries. In females, knee injuries that occur during a cutting or rotational movement account for nearly 30 percent of all injuries amongst high school and collegiate basketball players.3

As mentioned above, given the knowledge we have about the specific injuries that occur within the sport, we can begin to predict future injury occurrences. Bird and Marwick explain it as “injury prevention through prediction; an approach that is used to assess fundamental movement qualities in order to identify and predict overall injury risk.”3

Recent research suggests that movement screens are moving away from the traditional isolated muscle strength assessment tests. They are moving towards an integrated approach that evaluates fundamental movements related to the assessment of “an athlete’s movement competency, or the fundamental mechanics required over a period of time within a specific sport.”3 In simple terms, the assessment should focus on the fundamentals, which can then be continuously trained to ensure a safe, yet effective improvement in overall sport performance.

Below are a few of the functional assessment tools utilized by this study and their practical applications. Each test is scored on a scale of 1-3 (1 being can not complete without major flaws; 2 being can complete but with some flaws and 3 can execute with technical proficiency).3

1. Hop and Jump Variation Assessment

a. A good way to assess neuromuscular control using single leg hopping, hopping for distance and timed hop.

b. Practical Application: These assessments will allow the practitioner to visualize any neuromuscular control deficits, muscular strength deficits or imbalances, knee position and trunk position/compensation.3

2. Landing Error Scoring System

a. Known as the “Drop Box Vertical Jump test;” evaluates 17 jump-landing characteristics

b. Practical Application: Considered a reliable screening tool in the identification and prediction of non-contact ACL injuries through the evaluation of landing mechanics.3

3. Tuck Jump Assessment

a. Allows for evaluation of the ability of the hip, knee and ankle to absorb force during take-off and landing, specifically targeting the stretch-shortening cycle.

b. Practical Application: The ability to identify and predict lower extremity dysfunction such as high risk landing patterns, knee loading patterns and neuromuscular control within the hip, ankle and knee in conjunction with the trunk.

4. Weight Bearing Lunge Test

a. Correct landing technique can be visualized through ankle dorsiflexion range of motion

b. Practical application: can be a predictor of ankle injuries caused by poor force absorption within the ankle due to a lack of ROM.3

5. Star Excursion Test

a. Used to assess static and dynamic balance and neuromuscular control that involves single leg balance in 8 different directions. This will allow for the assessment of “ankle dorsiflexion, knee flexion, overall knee and hip range of motion, and proprioception.”3 Considered a reliable and predictive measure of lower extremity injuries within high school basketball players.4

b. Practical application: The ability to identify and/or predict chronic ankle instability, ACL deficiencies and patellofemoral pain.

Sleep and Recovery

Furthermore, a 2011 study by Mah, et al. out of the Stanford Sleep Disorder Clinic, investigated the effects of sleep extension on specific measures of athletic performance as well as the effect of sleep on reaction time, mood and daytime sleepiness in collegiate basketball players. It was noted an athlete who receives 79.7 additional minutes of sleep (~1.2 hours) per night, can see substantial improvements in performance in strenuous physical requirements, cardiorespiratory functioning and psychomotor tasks that include memory, learning ability and reaction time.5

Sleep extension will be predominantly critical within the collegiate and professional athletic population. This is due to the frequent travel across several time zones and into several different locations within the United States in a relatively short period of time. It was noted in this same study that collegiate basketball players travel on average of 2-3 times per month, with trip duration lasting anywhere from 3-5 days.5  This study reinforces the notion that at any level and within any sport, athletes require additional sleep in order to ensure optimal performance.

Through the use of a predictive model, the practical application of nutritional requirements, injury prevention and sleep extension can ensure optimal performance within the sport of basketball at any age level. Often times these aspects of athletic competition go unnoticed and only come to the forefront following an injury, burnout, nutrient deficiencies or an incident that is secondary to 1 of these occurrences. While there are specialists geared towards nutrition, sleep and injury prevention at the professional and collegiate levels, it will be important for high school athletic coaches and staff to understand the correlation between proper nutrition, proper sleep, injury prevention and overall performance and success within the sport in general.

Resources

1. Academy of Nutrition and Dietetics, (2016). “Fueling Basketball Players.” https://www.nutritioncaremanual.org/vault/2440/web/files/SNCM/Client%20Education%202014/Basketball%20Players-4-2014.pdf. Accessed: December 5, 2016.

2. McInnes, S. E., Carlson, J. S., Jones, C. J., & McKenna, M. J. (1995). The physiological load imposed on basketball players during competition. Journal of sports sciences, 13(5), 387-397.

3. Bird, S. P., & Markwick, W. J. (2016). Musculoskeletal Screening and Functional Testing: Considerations for Basketball Athletes. International Journal of Sports Physical Therapy, 11(5), 784.

4. Plisky, P. J., Rauh, M. J., Kaminski, T. W., & Underwood, F. B. (2006). Star Excursion Balance Test as a predictor of lower extremity injury in high school basketball players. Journal of Orthopaedic & Sports Physical Therapy, 36(12), 911-919.

5. Mah, C. D., Mah, K. E., Kezirian, E. J., & Dement, W. C. (2011). The effects of sleep extension on the athletic performance of collegiate basketball players. Sleep, 34(7), 943-950.

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. 

 

Adopting Injury Prevention Programs in High School

Wednesday, November 16th, 2016

Posted November 16, 2016

Tim Koba, MS, ATC
Twitter: @timkoba
Blog: www.timkoba.blogspot.com

By Tim Koba, MS, ATC

Participation in high school athletics carries an intrinsic risk of injury, but that doesn’t mean certain types of injuries can’t be decreased. There has been a proliferation of injury prevention programs. These programs have the ability to improve performance and decrease risk of sustaining certain injuries, especially ACL injuries and ankle sprains. While this information is readily available, there has been some hesitancy to adopt these and similar programs.

In an Oregon survey of high school soccer and basketball coaches, many of the coaches were aware that injury prevention programs existed, but they were not adopting those programs for their own teams.1 Some of their reasons included the belief that what they currently did was similar to the program; their program was superior to the researched program; or they were not aware of how much actual sport performance gains occurred as a result of these programs. Those concerns have validity and merit further discussion.

Many injury programs have similar features that are easy to adopt and implement such as squatting, jumping, cutting and using a balance apparatus. The key with any of these exercises is to focus on form and ensure the athletes are appropriately performing the required task and not going through the motions. Some of the programs are definitely more involved and time consuming and may cut into the limited time available for training. However, before changing or eliminating exercises, it is important to understand the mechanics and rationale behind those exercises and why they were included in the first place. Arbitrarily eliminating exercises can invalidate the program resulting in a failure to achieve the intended prevention outcomes.

A relatively new option for reducing injury risk, improving fitness and performance is to adopt a training program in physical education (PE) classes.2 This exercise vehicle may be a great way to teach fundamental movement skills to adolescents who carry on to their chosen sport. In a study out of Canada, researchers compared a typical PE class with a specific training PE class. The specific training PE class was geared toward the improvement in movement, reduction in injury and had significantly fewer injuries than the control group. The exercises regimen they chose was similar to the FIFA 11+ and included squats, jumps, lunges, planks and running drills. The inclusion of this, or a similar program, in middle and high school may help to decrease on field injury rates during athletic participation.

The potential for injury will always be a part of athletics, but accepting that there is nothing to help prevent injury is not accurate. At this point there are many options to keep players healthy and participating safely. Knowing the common injuries in your chosen sport and available resources are essential for successful participation in athletic endeavors.

Conclusion

- Injury prevention programs can decrease risk for certain injuries and improve performance

- There is hesitancy to adopt these programs despite their proven effectiveness for a variety of reasons

- Implementing a school wide program can help to bridge the gap between player safety in athletics, exercise, fitness and movement

References

1. Norcross, M.F., et. al. (2016). Factors influencing high school coaches’ adoption of injury prevention programs. Journal of Science and Medicine in Sport, 19: 299-304.

2. Richmond, S.A., et. al. (2016). A school based injury prevention program to reduce sport injury risk and improve healthy outcomes in youth: A pilot cluster randomized controlled trial. Clinical Journal of Sports Medicine, 26(4): 291-298.

About the Author

Tim Koba is an Athletic Trainer, strength coach and sport business professional based in Ithaca, New York. He is passionate about helping others reach their personal and professional potential by researching topics of interest and sharing it with others. He contributes articles on injury prevention, management, rehabilitation, athletic development and leadership.

 

 

Save

Injuries in Gymnastics

Monday, August 22nd, 2016

Tim Koba, MS, ATC
Twitter: @timkoba
Blog; www.timkoba.blogspot.com

Posted August 22, 2016

By Tim Koba, MS, ATC

If you’ve been watching the Olympics, you may have been mesmerized by the physical abilities of the gymnasts competing. Their ability to run, jump, leap, twist, twirl and flip is awe-inspiring. It may also leave you wondering how prone to injury they are given the skills they need to perform and the training required to reach this elite level.

Different studies cite different overall injury rates, but gymnastics generally has a greater risk of injury than many other sports.  Injury rates differ between male and female gymnasts, the events and the various apparatus.

Female gymnasts are more likely to suffer lower extremity injuries while their male counterparts have higher levels of upper extremity injury. Due to the upper body dominant skills of the male events, they are much more likely to suffer wrist and hand injuries. Women are more likely to have ankle and foot injuries. For female gymnasts, the most commonly suffered injury is an ankle sprain on 3 out of 4 apparatus, except for uneven bars which is upper body injury of the shoulder or wrist.

As young gymnasts progress in skill and hours training, their risk of injury goes up since they spend more time under load practicing higher level skills. As they produce more force with their maneuvers, the risk of having an injury increases. Younger athletes are also prone to wrist injuries at the growth plate. As their wrists extend under a load, the forces are transmitted to the growth plate and can result in pain and injury. This is most pronounced in athletes aged 10 to 14. Care should be taken to assess total volume and pain at this level to avoid wrist injury or manage it early.

Injuries in competition are more common as a result of performing the high level skills at higher speeds and greater heights without the benefit of crash pads and landing pits utilized in practice. Unfortunately, traumatic knee injuries, including ACL tears, are the most common cause of long term time away from the sport, surgery and medical disqualification from participation. Injuries as a result of floor routines are the most common mechanism for ACL injury in gymnastics.

Because of the nature of the sport, and the extreme flexibility needed to perform, gymnasts also sustain other injuries. Rates of back pain differ, but low back pain is one of the top 5 most common injuries. The main concern with gymnastics is developing a stress related fracture from constant extension. With the extreme range of motion in the hip, there have been case reports of hip instability and impingement syndromes of that joint. The hours required to learn and master a maneuver can lead to gradual overload and overuse injuries.

Conclusion

• Rates of injury in gymnastics differ, but the most commonly injured areas are the ankle and foot for females; wrist and hand for males

• Knee sprains are the most common cause of time lost from sport and injuries requiring surgery

• Injuries are more likely to occur in competition than in practice and when progressing from one level to another

• There are some unique injuries as a result of participation including wrist growth plates, low backs and hips

Understanding common injuries associated with participation and specific apparatus can help to develop prevention and rehab programs geared toward helping gymnasts successfully participate at their desired level.

References

Kerr, Z. et. al. (2015). Epidemiology of National Collegiate Athletic Association women’s gymnastics injuries, 2009-2010 through 2013-2014. Journal of Athletic Training: 50(8).

Kox, L. et. al. (2015). Prevalence, incidence and risk factors for overuse injuries of the wrist in young athletes; a systematic review. British Journal of Sports Medicine: 49.

Saluan, P. et. al. (2015). Injury types and incidence rates in precollegiate female gymnasts. Orthopaedic Journal of Sports Medicine: 3(4).

Tirabassi, J. et. al. (2016). Epidemiology of high school sports related injuries resulting in medical disqualifaction: 2005-2006 through 2013-2014 academic years. American Journal of Sports Medicine: 20(10).

Weber, A. et. al. (2014). The hyperflexible hip: managing hip pain in the dancer and gymnast. SportsHealth: 7(4).

Westermann, R. et. al. (2014). Evaluation of men’s and women’s gymnastics injuries: a 10 year observational study. SportsHealth: 7 (2).

About the Author

Tim Koba is an Athletic Trainer, strength coach and sport business professional based in Ithaca, New York. He is passionate about helping others reach their personal and professional potential by researching topics of interest and sharing it with others. He contributes articles on injury prevention, management, rehabilitation, athletic development and leadership.

Save

Save

Consensus Statement on Injury Prevention

Thursday, August 11th, 2016

Posted August 11, 2016

Tim Koba, MS, ATC
Twitter: @timkoba
Blog: www.timkoba.blogspot.com.

By Tim Koba, MS, ATC

The American College of Sports Medicine (ACSM) recently released a consensus statement on injury prevention geared to the team physician. Their conclusions, however, are beneficial for coaches, athletes, parents, Athletic Trainers (ATs) and other healthcare professionals.

In the statement, the authors focus on ankle, patella femoral syndrome, ACL, shoulder, elbow, head and neck injuries in high school and college athletes. They also touch upon sudden cardiac death, heat illness and skin infections. The article systematically addresses the mechanisms of injury and injury reduction strategies of each injury. I will include a brief summary with action items of the statement and refer those interested to the complete article.

Ankle: Ankle sprains have a high risk of repeat injury and are the most commonly suffered injury in athletics. Key prevention strategies include balance training; neuromuscular training to include jumping, landing and cutting exercises; and technical training. Once an ankle is injured, bracing is an effective way to provide support while the athlete is performing rehabilitation.

ACL: Although not a very common injury, it does account for significant time lost from activity and long term joint health. In high school, the sport with greatest risk of injury is football. In college, it is women’s soccer, with female athletes being at increased risk of injury in general over their male counterparts. Adopting an injury prevention program that addresses strength, core strength, neuromuscular control, cutting, jumping and landing can effectively reduce the risk of injury. Bracing is not an effective means of reducing injury risk.

Patellofemoral pain: Patellofemoral pain is characterized as pain around the front of the knee. Contributing factors include muscle weakness, previous injury, training error and improper movement patterns. Injury prevention techniques include assessing and training for proper jumping and landing form and implementing a structured training program to minimize muscle imbalances with an emphasis on quadriceps, hamstring and hip abductor strengthening.

Shoulder pain: The disabled throwing shoulder is a term to describe pain and dysfunction with overhead sports. Risk factors are muscle imbalances, previous injury and training error. Prevention is focused on following recommended pitch counts, optimizing form for throwing and serving, balancing activity with rest and strengthening the upper body to correct any imbalances in the shoulder, arm and scapula.

Elbow injury: There are no injury prevention programs developed for reducing elbow injury in throwing athletes. The main focus currently is on monitoring fatigue, incorporating adequate rest periods, monitoring total throwing volume to reduce overload, not throwing too many months out of the year and undertaking a general strength program to improve strength and reduce any imbalances.

Sudden cardiac death: Luckily, sudden cardiac death is a rare phenomenon and occurs for several reasons, including genetics. From a prevention standpoint it is important that all athletes have a physical to determine their risk factors and follow-up testing as indicated by their doctors. All athletic sites and sports should have a written and communicated emergency action plan in the event of a catastrophic injury. Access to an AED is essential, and one should be close by to provide care to a fallen individual within 3 minutes of collapse. Chest protectors do not prevent death from sudden impact, also known as commotio cordis, but using a softer ball in youth sports might. It is also not recommended that athletes step in front of a shot due to risk of having a commotio cordis event.

Exertional heat illness: The main risk factors for exertional heat illness are environment, previous injury and some heritable traits such as sickle cell. The main prevention strategy is acclimatization. Ideally, athletes prepare for the environmental conditions that they will be playing in. Coaches can monitor and modify practice and equipment needs depending on the weather. In preparation for weather, athletes can pre-hydrate, stay hydrated during activity and monitor weight loss between practice sessions. Having an emergency action plan in place in case of emergency is essential to management of heat illness.

Skin infections: College wrestling has the greatest incidence of skin infections. Other risk factors include previous skin infection, reduced immune function, body shaving, facility cleanliness and sharing personal care items. Some general rules are important for reducing risk of skin infections and include good hygiene, immediately laundering of uniforms and practice garments, facility cleaning, not sharing equipment or care items and promptly reporting any wounds or lesion to the team AT or your physician.

Conclusion:

While this statement is geared for the team physician, the information is very valuable for those working in athletics to understand and implement.

- Pre-participation physical exams to identify risk factors and assess health history prior to participation.

- Instituting a school wide or at least team wide training program to improve strength, neuromuscular control, balance and technique is an effective means to reduce risk of injury.

- Monitoring athletes to provide adequate recovery and early intervention can delay time lost from competition for musculoskeletal injuries and heat illness.

- Crafting an emergency action plan that is easy to understand and implement, in conjunction with quick access to an AED, can provide the best chances for survival in the event of a catastrophic injury.

Resources

Special Communications. (2016). Selected issues in injury and illness prevention and the team physician: a consensus statement. Medicine and Science in Sports and Exercise, 48 (1). http://journals.lww.com/acsm-msse/Fulltext/2016/01000/Selected_Issues_in_Injury_and_Illness_Prevention.21.aspx

About the Author

Tim Koba is an Athletic Trainer, strength coach and sport business professional based in Ithaca, New York. He is passionate about helping others reach their personal and professional potential by researching topics of interest and sharing it with others. He contributes articles on injury prevention, management, rehabilitation, athletic development and leadership.

Save

Decreasing Injury Risk

Wednesday, June 1st, 2016

Tim Koba, MS, ATC
Twitter: @timkoba
Blog: www.timkoba.blogspot.com

Posted June 1, 2016

By Tim Koba, MS, ATC

If you are involved with youth sports and have seen injuries suffered by the participants, you should know it doesn't have to be that way. There have been several studies examining the effectiveness of implementing an alternative warm up specifically geared to decrease injuries. So far, the findings have been successful. Now, a study out of Canada also points out decreasing injury risk in sport saves money for the healthcare system, too.

Depending on the injury an athlete suffers, the financial, physical and mental cost can add up quickly. In the event an injury requires a surgical repair, the costs can skyrocket and the athlete may not return to participation. This lack of participation can have profound health effects if they suffer early joint pain, arthritis and inactivity leading to chronic illness or obesity. Obviously, this is a worst case scenario and the majority of injuries are relatively minor and easily treatable. Still, the possibility does exist for long term impairment. This is especially true for ACL injuries, medial elbow injuries in baseball players and shoulder labral tears.

So, if there is a chance some of these injuries can be decreased, we should take it. The good news is that while preventing all injuries is not possible, there are steps that can be taken to decrease certain ones. We know some of the global and more specific risk factors for suffering an injury. When athletes increase the intensity of their activity too quickly, they are more likely to get injured. Having already sustained an injury makes you more likely to suffer a recurrent injury.

Prior to puberty, boys and girls demonstrate similar movement patterns that change after puberty. Part of this divergence may be contributing to the increase in injuries suffered by female athletes after this time. We also know females are more likely to suffer ACL injuries and following a specific exercise program can decrease that risk.

Many studies have been conducted with soccer teams to determine the effectiveness of these programs. But, there is nothing specific about the exercises that make it special for soccer. The exercises are more global neuromuscular movements that if performed properly can improve movement quality, strength and performance metrics while decreasing the risk of injury.

Many programs are readily available for implementation, or there are community resources that are able to help. Finding and working with a qualified Athletic Trainer, physical therapist, strength coach, personal trainer or coach who understands the sport, common injuries and conditioning is a great place to start. They are able to find the research studies and programs available, demonstrate and instruct teams in how to perform the drills and be available to assess ongoing progress.

Taking the time to learn a few specific movement based exercises and drills can improve movement quality and strength. It can also lead to better, more conditioned athletes who are able to stay healthy throughout the year. With the ever increasing cost of healthcare and percentage of people with obesity, we need to do everything we can to keep people healthy and active from an early age. Incorporating injury prevention programs into a practice is a simple way to have a large impact.

Resource

http://bjsm.bmj.com/content/early/2016/04/10/bjsports-2015-095666.short

About the Author

Tim Koba is an Athletic Trainer, strength coach and sport business professional based in Ithaca, New York. He is passionate about helping others reach their personal and professional potential by researching topics of interest and sharing it with others. He contributes articles on injury prevention, management, rehabilitation, athletic development and leadership.

You can connect with him on twitter @timkoba or check out his blog, www.timkoba.blogspot.com

 

Save

Save

In-Depth Look: Meet an Athletic Trainer for Disneyland Park

Thursday, February 11th, 2016

Posted February 11, 2016

Jena Hansen-Honeycutt, MS, ATC, PES is an Athletic Trainer at Disneyland Park in California.  Her role includes working with the entertainment staff to improve performance and prevent injuries.

Describe your setting:

I work with the entertainment staff at Disneyland by providing injury prevention services for a diverse work force, including but not limited to, character performers, equity stunt performers, actors, gymnasts, puppeteers, dancers, musicians, photographers, show support technicians, and cosmetology technicians.

How long have you worked in this setting?

I have been working in this setting for 2 years.

Describe your typical day:

A typical day depends largely on the shift that you are working and staff that you will encounter. I mostly work in a location that works with Parades and entertainment support staff. On a typical day I would initially check my email and schedule to see if there are any scheduled appointments for the location I am at. About 2 hours prior to the parade step-off time we see the performers as needed and provide services to aid them in preparing for their day (i.e., warm-up, exercise progression, first aid, taping, etc.), improving performance, and preventing injuries. At the time of Parade step-off there is a drop in patient load and we take a lunch break.

Upon returning from lunch the performers are taking a break and checking in with AT staff as needed, preparing for the next performance, and creating a plan for progression. Following this second wave of parade preparation we complete any documentation that could not be completed earlier and clean our facilities. In other shifts, I would work with smaller shows and spends the day going to the areas of performances/ where performers are taking breaks and check-in with them to provide them with injury prevention services and education regarding health and wellness.

What do you like about your position?

I enjoy working with the performers and all other support staff, the patients are uniquely aware of their body and work diligently to improve performance and prevent injuries through participating in movement and performance screens. This patient population enjoys learning how to make their body function more efficiently.

What do you dislike about your position?

In this location there is a large patient population making it difficult to have continuity between athletic trainers providing services to the individuals.

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

I would encourage other ATs to seek opportunities in their area where they can contribute to providing AT services to groups of performing artists as this population is in need of quality health care services.

Pre-Participation Examinations are an Important Opportunity

Wednesday, September 16th, 2015

By Mike McKenney, MS, ATC, NASM-CES

Pre-participation examinations (PPEs) are often considered a nucleus of densely packed chaotic activity with numerous orbiting particles and a singular goal in mind: to determine if an individual can safely participate in athletic activity.  PPEs come in all shapes and sizes ranging from full movement screens with performance testing, to simply collecting paperwork.  While this process is often fraught with mountains of paperwork and stress, we must not lose sight of what it really is: an opportunity.

During the PPE process, we have the opportunity to see into an athlete’s medical history, and analyze the information for red flags or other points of emphasis that may negatively impact their ability to participate safely.  A prime example can be found in the newly published NATA position statement on exertional heat illness.1 Table 2 in this document contains questions to include in PPE questionnaires or verbal screenings to help identify athletes who may be at risk for heat illness.  Additionally, the NATA position statement2 on pre-participation physical examinations contains numerous other recommendations to discover potentially harmful conditions.  But once these potentially serious conditions are ruled out, what other opportunities exist in a PPE?

Arguably, one of the most unique domains of athletic training is injury prevention, and the PPE process can be a source of information to prevent orthopedic injury.  In addition to an in-depth history2, there are many types of movement screens and technologies available that can be employed to establish a baseline movement profile.  This information can be used to guide rehabilitation and strength training strategies focusing on targeting areas of opportunity for each athlete.  However, in order for this process to be effective, the Athletic Trainer must act on the information they obtain.  Similar to pre-participation questionnaires, the results of movement screens are meaningless if they do not influence the decision-making of the sports medicine team.  It is crucial to implement an early intervention for an abnormal movement pattern that could potentially have an adverse effect on an athlete’s participation.

Similar to an annual review of your athletes’ health records, taking time to review your current PPE process to evaluate weaknesses and strengths is always a useful exercise.  It is also never too late to review available literature and add to your PPE for an upcoming season or for next year.  Further information can be found in the 2 sources included in this post, which provide an evidence-based guide to planning your next PPE, including instructions for a basic movement screen.2

Resources

1. Casa DJ, DeMartini JK, Bergeron MF, et al. National Athletic Trainers’ Association position statement: exertional heat Illnesses. J Athl Train. 2015;50(9):000-000

2. Conley KM, Bolin DJ, Carek PJ, et al. National Athletic Trainers’ Association position statement: Preparticipation physical examinations and disqualifying conditions. J Athl Train. 2014;49(1):102-120.

An In Depth Look with… Tim Koba, ATC, CSCS, PES, CES, CMT

Friday, November 22nd, 2013

An In Depth Look with… Tim Koba, ATC, CSCS, PES, CES, CMT

Describe your setting:

I am an Athletic Trainer and strength coach working in a sports medicine clinic, seeing patients with physicians in my role as a physician extender. I also work with local high schools holding outreach injury clinics and consulting with teams on injury prevention, speed, agility and strength development for their sport. I also provide staffing for football games in the fall and other events throughout the year.                                                                                                                  

How long have you worked in this setting?

I have worked there for about 6 years.

Describe your typical day:

I come to work at 8:00am and prep for the day. Then I see patients alongside the physicians until 5:00pm. On days that I travel to a school I will leave after the morning patients are completed.

What do you like about your position?

Seeing a lot of patients coming in over the years has improved my ability to take a pointed history, see trends in injury patterns and recognize the injury .

What do you dislike about your position?

I would like to be more hands-on with evaluation and treatment of patients. While it is nice being able to identify what is wrong, I would like to be able to work with them on rehab and returning them to their desired level of activity.

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

Working in a clinic is a great way to gain exposure to injuries, seeing commonalities in how injuries present and working on taking a pointed history in order to streamline the diagnostic process.