Sports Medicine Broadcast

Foster Care is not easy. Neither is Athletic Training. Travis Turner is trying to grow his family through foster care/adoption.

Storytime with buzz is just that, fun stories from an old school Athletic Trainer still practicing. Thanks, Bethpage Consulting for helping to get the SMB out to SWATA 2023 in Arlington. I have been attending SWATA for about 38 years I broke my collarbone playing football and then became the team manager. Sam Aguilara came to teach the coaches about Athletic Training products. I knew I could do the stuff he was showing the coaches. The next thing I knew they were sending me to AT clinics at colleges. I have met a lot of great people during my career as an Athletic Trainer Joel Kregerberg was the assistant AT for the Oilers while I was an intern. I got to tape Earl Cambell. He greatly deflated my ego when he told me it was the worst tape job he ever had. Give me some more storytime Houston Rodeo got me started with Justin Sports Medicine and Truman Spoon Sports Medicine Did you get autographs? Not really, I was always around the people and did not consider it. Where was your first job as an AT? Seminole High School is about an hour from Lubbock. I moved to Macaney with the head coach Then the Houston Oilers called and I moved to Houston Take us back to Seminole HS I taught driver's ed in the morning. It is a small school with a small AT Facility We were really good at basketball and gymnastics I taught a job at the Air Force base with firemen and nurses Who are some of the mentees that have impacted you? Valerie Tinklepaugh-Hairston - with her impact on college sports and SWATA David Traylor - SWATA Hall of Honor Southlake Carroll High School is being run by two of my former ATs TSATA Hall of Honor This award brings a smile to my face every time I think about it. What did you dream about being as a kid? My dad was a pharmacist My brother was a pharmacist and MD I thought about following them Storytime - What sticks out the most? A Houston Oiler went down and was basically numb from the neck down We backboarded him That was his last game to ever play. He was a good friend of mine. My wallet and everything I needed were in my bag that the equipment managers packed up since I went to the hospital with him. We almost got stranded in Kansas City. [email protected] Contact us:

Preparedness to throw is a whole new process of injury prevention. Chris Gallina joins Ryan Collins live at the Sports Medicine Update 2023 What are we looking for as parents Volume Radar guns BAD in Youth Athletes Rest for throwing Athletes We usually suggest no athlete should be pitching for more than 7 months Maybe pitch for 2 seasons then focus on fielding and hitting Pitchers should not play pitcher and catcher as well Breaking balls James Andrews - you should not throw a curve ball until you can shave Mechanics is key during the pitch Fastball and changeup are very effective for youth athletes What are the signs and symptoms to look for Medial elbow pain is number one The posterior cuff is sore on the Youth Athlete after almost every pitching outing When do we shut them down? Flex Rotation Cross body abduction External Rotation Gain Is it GIRD or adaptation? Mr. Burns Posture (The Simpsons) Soft tissue Pec Minor Deep Neck Flexors

Career Advancement brought Bre'Layshia Alexander from working intermediate athletics to her current role with Baylor Scott and White. She discussed this all with Joseph Eberhardt live at SWATA 2023. Sponsored by San Antonio Sports Medicine What are the goals of the Career Advancement Committee? Chaired by Bre’Layshia Split from the young professional committee 7-12 years in the profession Everyone on our committee presented at SWATA 23 The Career Advancement Committee also hosts a scavenger hunt for prizes to increase engagement. Student workshop highlights: Resume workshop Career Advancement talks Tools on how to advance your pay or benefits Life Balance options How do we contact the Career Advancement group? @D6_YP_CAC @Swata-YPC Email: [email protected] Facebook Bre’Layshia @atc_mojo2015 Facebook Where did you get into AT? I was a cheerleader in high school and band in high school. After not making the team I searched for a way to be on the sidelines. I became a student aide for 1.5 years in high school Graduated from Texas State and got a job in Temple. After 3 years as a middle school AT I knew I had to move on SportsCareAT Now a physician liaison with BSW What is your role with TSATA? Recently passed legislation that opens up jobs and expands the scope of an ATs practice. Bre'Layshia Alexander Joseph Eberhardt

Concussion technology has come a long way in helping us understand and manage concussions. Dr. Summer Ott discusses some of the options available and who they best fit. What is a digital assessment? Started in the ’90s, Professional teams Not meant to replace traditional assessments A combination of tests is still being used Pros: Efficient Easy access and use of mobile devices Allow tracking Remote testing Cons: What/which app is reliable Who is using/trained to use Environment Considerations when deciding on a digital tool Budget Feasibility Is it comprehensive Age range Considerations Comparison / Contrast different tests available Example: Impact, Axon, ANAM 20 min to complete Test Cognitive Skills and symptom Ex. C3 Logic, Sway, King Devick Used with Handheld devices Quicker to complete 10-15 min Offer Alternative stimuli Important to look at “What is the cost?” Does the cost correlate to the effectiveness What tools and how many are practitioners using in assessing Concussions How do you pick a digital tool? / What is the right choice? What is VOMS? Looking at: eye movements, eye tracking, convergence, and rating symptoms while performing assessments Symptom Checklist- Can be broken down into clusters: Physical, Emotional, Sleep, Cognitive, Case Management example: Natasha Law The Law and UIL sports vs Club sports on concussion Considerations for Special populations (504, at-risk) The Law and Academic Accommodations/Recommendations Reach out to @ATC_mojo for PDF of Academic Recommendations

Hot Springs Arkansas is the place to be in July 2024. Keith Shireman and the Arkansas Athletic Trainers Association will host SWATA outside of Texas for the first time in years. SWATA is the largest attended district meeting. Next year Keith and the team in Arkansas hope to make SWATA 2024 the newest record holder for SWATA attendance. Why come to Hot Springs? It is a family-friendly place. Three lakes Hot Springs Lots of hiking and biking trails I love coming to SWATA because: Interacting with Texas folks. Friendships Great topics Fun entertainment What else about SWATA in 2024: There will be plenty of places to eat Bath Houses National Park Contact Heidi for the local scoop Contact Keith Shireman on Twitter - @KeithMxATC

Eddie Smith shares how the state powerhouse Katy Tigers are reducing the fear of hamstring injuries during rehab for their athletes. There have been 6000 papers published about hamstring injuries The research is all over the place. The only real consensus is Nordic hamstring curls We start with NSAIDs The next day we start with movement COMPEX Ankle movement Heel slides As soon as they can walk pain-free we get them back on the field We use short lever arm exercises We use Catapult for GPS data and can help know when our players are working within a safe range. If it is a larger injury, how do you talk them through the mental aspect? Know your athlete Communicate with all of the stakeholders Athlete Coach Mom and dad 0-80% is easy, but 80-100% is the really hard part. Educate them on some of the options: PRP, Cryo, …anything that will help them feel better. Mentally they are prepared, physically they are not. How do we reduce the recurrence of injury? The first two weeks are most commonly the time frame for reinjury Repeat the exposure incident over and over again. I like to have them sprint over and over again. How do we recreate sprinting for the kids that can not? We want to train on the speed-strength continuum as much as possible Gymaware is the bar speed program we use. Nordic Hamstring curl Highest-rated prevention exercise Activates the highest quantity of muscle fibers How can we implement "reducing the fear" into off-season or pre-season programming? Implement the eccentric Are there any hamstring quad deficits

QCollar seems like just another gimmick...but this could really be a life-changing tool. Dr. David Smith, inventor of the Q-Collar joins me to discuss the story, how it works, and his book When Heads Come Together. Where did the idea for the Q-Collar start? Dr. Dave was presenting at the Army Research Lab in 2008 where they threw down the gauntlet complaining that clever people should "figure out Traumatic Brain Injury." I was working on wound care. When presented with the woodpecker I immersed myself in the anatomy and physiology of cavity animals. During a yawn, you are occluding your jugular. When getting FDA clearance, what were some of the harder questions you had to answer? 42 patents We are the only FDA-approved TBI prevention device. Is there any concern with extended use, like several hours at a time? FDA recommends 4 hours. We lay down to sleep for 8 hours at a time and occlude our jugulars. When Heads Come Together - this is a more detailed story about your journey to “solve” TBI…discuss the book. Julian Bailes listened to me and encouraged me Discuss the rebreather and how you can reverse TBI. We looked at how a giraffe breathes In the first 10 minutes after a concussive event, there is a critical issue We partnered with Dr. Jedd Hardings at Cinncinatti Spreading depolarization I told him CO2 was the trigger for the depolarization They raised the CO2 levels of a legally brain-dead patient in a coma. The family agreed to try this and 4 hours later he awoke from his coma.

Youth Sports Safety is Jim Mackies passion project. With over 50 years working as an AT, he can sit back and turn the profession over to the younger crowd, but instead, he continues to give time and effort to help improve healthcare for all athletes Mr. Mackie have you ever had to perform CPR? Had a coach drop dead on the goal line after a game. As I am headed that way I see the firetruck pulling out, and this was before we AEDs readily available. Jim, What is happening in Youth Sports Safety? Florida is # 1 in sport safety but much to be done. Laws re Concussion, CWI, AED, EAP, etc. but much education and compliance are needed. There are a lot of causes or task forces, why did you choose Youth Sports Safety? Obviously, there was a big void legislatively & in the knowledge base. Allows me to put many years of experience back into the community to advocate and educate. Where is it headed? Progress is being made but we have to see more implementation of best practices done consistently. With many schools without an AT there requires more district education, especially in our rural communities. What roadblocks are we seeing? Resistance and slow to change the culture, especially in youth leagues. Many are volunteer-driven and they rely on what their personal experience was and not best practices as well as the effort it takes to implement. We have discussed social media a lot recently, what role does it play in Youth Sports Safety? Podcasts can help to educate and influence the public. They see a lot of situations that happen and yet are dismissed or diminished in a 24-hour news cycle. Youth Sports Safety Podcast - tell me about that. Started in 2021 We have been opportunistic and gotten some really high-profile doctors and Athletic Trainers. Call to action: Take the time to educate kids, parents, and coaches on the best practices. Raise the expectations of those you entrust your child to at their sports venue. Take the steps to create a venue-specific EAP, learn CPR, have AEDs accessible everywhere, and connect with an AT. Jim Mackie - [email protected] JAXSMP.com ATSJAX.com

Tyler Knight shares some Soccer Specific Return To Play or RTP tips and tricks. With nearly a decade of soccer experience, he has seen a lot of growth in sport-specific rehab plans. What is the least soccer specific rehab exercise you have seen? Almost everything we do…discuss the importance of understanding the ‘why’ of what we do, as well as never forgetting components of movement. Isometrics because the patient can’t perform much more Eccentrics once able Stretch-shortening cycle Unloaded → supported → unsupported “Train movement not muscles” What do we need to consider in on-field RTP? In order to get to the field, you have to get out of the Athletic Training room first. Treat the person, not the athlete or the injury (reference all that people have going on in their lives). Ron Corson-ism Good communication, setting expectations, and appropriate planning are MUSTs. Individualization (based on person, position, and injury) Consider our two biggest protective capacities and build upon those early: strength and endurance Programming based upon working zones (importance of ESD) Quantifying internal vs. external load To do that, we have a few basic rules at Charlotte FC: 1. Create a safe environment. 2. Don’t hurt the person. 3. Be aggressive without breaking rules 1 and 2. KPIs to provide direction and accountability to the process Additional principles of rehab to accelerate and enhance what we do on the field: Move early, move often. Highlight BFR and isometrics. Don’t mess it up. Consider tissue healing times. Periodize manual therapies, incorporate things the person believes in Break down the phases of healing (acute, subacute, remodeling), as well as the places of healing: table, Athletic Training room, gym, field, and everything in between. Create time for mental or psychological recovery KPIs Mobility Stability Function Power On-Field Consider position, individual needs, team tactics, and demands of the sport…and MAKE IT FUN Players have the ball only 3% of the time, a good reason to emphasize the incorporation of the ball and fitness/drill exercises that place focus on getting into the right spaces In 2019/2020 EPL season, the highest average number of passes per game was 688 (Man City; approx 62. per player) and the least was Burnley at 333 (approx. 30 per player). Paul Bradley research Consider control - chaos continuum Reverse engineer and use the prospective loading document When we have elevated AC ratios, did the majority of that come from a more controlled environment or chaotic environment By using fatigue, you can increase chaos (for those athletes limited in what they can perform) How are you going to account for one of the most unique facts of the game: limited substitutions and, potentially like many other sports, the pace of the game is only increasing Actual loading Link load with the context of how it happens in a session/match TD, HSR, sprint, ACC/DEC, HMLD or explosive efforts Intensive vs. extensive days (can you match what the player is doing with you to what the team is doing; team schedule, RPExduration) Density of high intensity actions (repeated sprint ability and repeated high intensity efforts in 1, 3, and 5 min blocks) In the secondary setting, we may not be out on the field for practice. How can we help coordinate RTPs? “It takes a village.” Educate, incorporate, and empower those around you. If we all understand the why, we will know how to do it, and what we need to use to get there. Trust is a major factor here. Create a PowerPoint document, have illustrations, don’t be afraid to do the math ahead of time, use a stopwatch. Let's talk through a RTP plan you use and why: The war is won and lost in the mind Briefly recap where we are and where we’re going What can we do to prepare, potentiate, desensitize,