The Sports Medicine Broadcast

Neuro 20 looks like a wet suit with electrodes for E-Stim built in. That is partially true, the materials a spandex or Dri-fit type material, and Wayne and Michael share a lot more on the Sports Medicine Broadcast. Give me the big picture. Background and origin of the idea. -Founder DJ Schmitt was injured during service and wanted to find a way to get healthy without taking so much medication.  He used his electrical engineering degree to develop the first Neuro20 suit. The suit is made up of a compression material(spandex). Establish firing rates for healthy individuals and be able to choose for the AT/PT to know which one to use. Where does the name Neuro20 come from? 20 large electrodes placed strategically to engage the maximum amount of motor neurons. Who is using it right now in sports? NHL  Olympic Athletes  NFL D1 Athletes What are the most common applications of neuro20? Prehab Rehab Active recovery Motor education Accessibility for the Athletic Trainer? At the moment it is not accessible to the high school population because of privacy issues. College-level or professional level Can you set them up and “walk away?” Patients can be set up and allowed to complete a workout session on their own. * One of our pro sports athletes uses it after games while on the plane for recovery. Can I use Neuro20 with my high school athletes? It is FDA-cleared for adult patients.  Some youth patients have used it with waivers and clearance from their doctors but that is not the target population. Contact Us: Wayne Smith - wsmith@neuro20.com

Sudden Cardiac arrest in sports with Travis Turner at the Memorial Hermann Sports Medicine Update. Randy and Sandy Harris from the ATCorner Podcast ask all the hard questions.

SUJI Blood Flow Restriction or BFR is changing the game with its AI-powered app. Dr. Michael MacPherson joins me and Lisette Guerrero to learn more about our new gear. What is your 10-second sales pitch for Suji BFR? A portable, affordable, and easy-to-use gold standard, AI-powered BFR technology The affordability of the device is one reason we chose to add Suji BFR.  Discuss current pricing. Suji has found the middle ground. We are data-driven for incredible accuracy at an affordable price, never before seen in the BFR space.  Let's get into the app, it is one of the big differences from the Delphi unit we have. Our AI-powered app automatically calculates LOP for the clinician and then saves that data to a patient/athlete profile, saving at least 3-5 minutes every BFR session. The AI-powered calibration process is also incredibly robust.  All patient/athlete data is stored in a HIPAA-compliant cloud that lives in your institution. A Suji institution is your team or clinic where all your Data lives. Only you have access to it as the administrator. With Suji, you only have to calibrate as often as you deem necessary.  Discuss the continuous monitoring vs the detachable hose. With Suji Pro and its real-time pressure adjustments, you won’t need to attach the hose to adjust the pressure within the cuff. With Suji Pro, you’ll be able to adjust the pressure on the pump in real time. Suji BFR Pro - what should we expect? Suji Pro is Lighter, Smaller, and Hoseless. Our users are passionate about our portability and our customizable in-app recovery sessions so we’ve made advancements in both areas. Our users also expressed the desire for real-time pressure control without attaching hoses and a pump, so you can expect greater control with Suji Pro without breaking the bank. Contact Us:

Backboarding the injured athlete is an ever-evolving skill. Dr. Matt Camarillo discusses it live at the Memorial Hermann Sports Medicine Update How common are spinal cord injuries? -9-10% of injuries are spinal. About 12,000 nationally. Looking at physicals I have a couple of athletes with previous spinal cord injuries. What are some of the things that I should be more aware of when taking care of these athletes?  -Usually due to trauma or born with cervical stenosis.  -Should have a spine surgeon associated with the athletic population We talk about spinal cord injuries, and the first thing we think about is football. We think that it is equipment-heavy and collision-based and talk about equipment removal for that. But what is the instance in other sports? -Happens in lacrosse, gymnastics, hockey, soccer, baseball, and basketball. -Helmet and shoulder pads keep them in alignment then leave it on.  -If only a helmet probably needs to come off.  These spinal cord injuries, I believe you mentioned there are about 12,000 injuries per year. Are these spinal injuries with awareness in education are we increasing these or decreasing these? -Since 1975 they have gone down.  -A lot of spinal injuries come from automobile accidents.  Is there a reason for that? -Awareness, and if it goes away the numbers will go up again.  Moving back into narrowing down into more of an athletic training setting when working with sport athletes for example what would be our initial assessment and what would be some red flags to actually move the person onto a spine board? -Big trauma like a head-on hit you want to be careful.  -Clinical judgment. -numbness bilaterally  The athlete just has a lot of pain.  -Trust your gut So once you decide to stabilize someone, I know you talked about two methods to stabilize, but what is your preferred method? -6 man lift -If you don’t have enough hands, nobody will fault you for doing a log roll.  When is it appropriate to move the neck into neutral? -It is always ok as long as you do the head or trap squeeze. -You want to make sure you have access to the airway.  Can you talk a little bit about the difference between a head or trap squeeze? - head squeeze is more about putting you hands around the athletes head or helmet -trap squeeze where you are putting your thumbs and finger around someone's traps and gives you more stability because you also have to add in the fatigue factor.  -Trap squeeze is more stable Be aware that clothing could cause you to slip while holding a helmet. I think it comes down to practice and figuring out how everything works. Because once you get it down, then when all that emotion going, if you practice over and over again it just becomes a routine. 

Protect3D joins medicine and technology to help Athletes return to the sport safer and maybe faster. Kevin Gehsmann joins me to share their story and how Athletic Trainers can get their athletes braced. Where did the idea come from? Engineering student Liked 3D printing Daniel Jones, the quarterback at Duke, went down with a clavicle fracture. They decided their engineering project would help Daniel and other elite athletes needing protection. Customized for his unique needs and ROM What has been the most difficult hurdle for Protect3d? In the early days, we were recognized by the NFL and won $50,000 and Superbowl tickets. The pandemic caused a lot of challenges. Every device we make has a positive impact on the athlete and their performance Share a success story you enjoy. Clavicle pads reduce the risk of re-injury and increase the confidence of the player and health care team. It is also the original pad or brace that birthed the idea. Outside of your own clinics where have you had doctors adapting this style of bracing? We started with elite athletes and have worked with orthopedic surgeons and athletic trainers. An ankle/foot orthotic is a new brace to help with foot drop. We had a D1 athlete participate in games with a Protect3D brace for foot drop.  What do you see as a hurdle for secondary setting adoption of Protect3d braces? The cost of the product is one hurdle. Setting up a system for billing on demand can be an obstacle as well. Are these braces something that could be printed on your everyday, at-home printer? Due to the material, printer, and the need to control different variables as a medical device, they are not currently printed at home devices. There may be options in the future as we grow and develop. Want to test out Protect3D? Have an athlete needing a brace? Willing to give me your honest feedback on the podcast? Send me an email and maybe follow it up with a social media post. Give me the story (protect patient privacy) If it works out then we will collaborate to get you a custom 3D-printed brace for your athlete. Contact Protect3D

How common are facial injuries occurring? -20-40% involve face It could just involve something as simple as a slap in the face. On-field assessment allows you to hone in on a specific injury.  Where does your mind go during the initial assessment for a facial injury? What are you looking for? -1st talking and airway  Ecchymosis is present, when should you refer? -Racoon eyes (both eyes) - vasal or skull fracture possibility -Battle sign - ecchymosis behind the ear. Basal or skull fracture possible. Skull fractures is surgery common or just monitor? -CT to check the brain and for fracture -not all require surgery Mandibular fractures. Are we looking at surgery? -Depends on the type of fracture. Not displaced can monitor and have on a soft food diet.  -High protein foods for high-level athletes so they can still get nutrients Healing time during a mandible fracture, what are they allowed to do? -As tolerated -Lift, light exercise -nothing stressful that they clench their jaw. Difference between RTP. What are you looking for, for an athlete returning to play in a contact sport? -Depends on sport and position.  -2-3 months, but it depends on how the athlete is healing and what their position entails.  Regulations in rugby. They aren’t allowed to wear certain masks? -Protective gear cannot be a hard shell.  -Lots of pads and tape. -Can have a mouth guard. TMJ dislocation. What is the relocation process? -Usually down and out. Put posterior pressure and push back in.  -Wear gloves and roll gauze on your thumbs since you have to push on the bottom teeth.  -Relocated the TMJ, but chose to not let him back in the game.  Follow up for TMJ dislocation? -Follow up with them.  -Ask about symptoms, can lead to who they need to be sent to.  -Typically if it is back in and they are good, you can watch them. Maxillary fracture. Seen one clinically? -Common from motor vehicle injuries -Never seen one from sport.  -Could maybe see one from a combat sport. Splint a lefort fracture. -Bartans split technique. Key signs of a zygomatic fracture? -Big swelling over cheek bone -Dent in the cheek bone Nasal fracture, when can you get them back to sport? -Depends on sport/position -usually 4-6 weeks -Need to be pain free and breathe ok.  Mask wearing can be just to be for the athlete to have comfort and prevent another injury.  Fix nasal bone once done with sports. Nasal bleeds. At what point should you call EMS if you cannot control a nosebleed? -Symptoms of lightheadedness or dizziness. Headache or nauseous

Discussion topics:  -Team paramedic and coordinates emergency care for on field.  What are the classifications from paramedic to ECA, EMS, and Paramedic -ECA - first responder. Couple weeks class -EMT basic - everyone starts off at. Full college semester -EMT advanced - Intubate and start IVs, and cardiac meds. Can’t RSI or DSI -Paramedic - nationally and state certification; Two-year program and learn advanced cardiology and pharmacology Difference: Licensed paramedics will have an AA in paramedics or a bachelor's in emergency medicine.  ATs are under the direction of a physician, how does that work with emergency medicine? -Work under a medical director. Medical directors must be licensed by the state. Emergency certified physician. Roll of team physician on the sideline? -EAP’s  -Get together with all emergency response teams to see what everyone can do or should do.  -Communication -EMS arrives, they take over control of the athlete and their protocols go into effect.  Equipment removal in in-service? -Discuss how far to go with equipment removal.  -CPR of football, don’t remove helmet/shoulder pads, just face mask. Open shoulder pads to do CPR and place AED pads. Organizing the annual practice, how should the AT approach it? -Week before training camp starts.  -Coordination through their contact. EMS Chief or president of the company.  How long does the training last? -Depends on how much you want to cover.  -At least CPR, backboarding, trauma injury. 30 minutes each -Debrief before and after.  How can we educate EMS on what ATs can do? -Invite EMS groups to your in-service to participate in the training process.  -Look at each other's protocols.  -Get everyone's education  How much are protocols changing year to year? -Generally, they don’t. Just based on technology and medical changes.  Differences between rigs? -BLS is a basic truck with 2 EMTs. Basic first aid/childbirth -ALS truck for higher emergencies.  What does it look like after EMS has taken over care and on the way to the hospital? -After a report from AT, they do their own patient assessment.  -After assessment, determine the care plan. Get vitals and stabilize life events.  What is the most important information coming out of the report from an AT? -Short and sweet -This is what happened, what I did, what I found.  Spine board or not to spine board? -Depends on the medical director's protocol.  -Depends on the situation and if it will make the injury worse.  -For the team, it might depend on the spine doctor/team physician.  -Annual meeting to discuss spine boarding and log roll vs. 6-man lift. Stories -Professional baseball game.

How do you go about starting a relationship to find a team dentist? -A lot of AT’s have nobody.  -Find someone who is available to come after hours and loves it. -Can cold call offices or Google search.  -looking for sports dentistry -Ask other ATs if they know a dentist since the community is small.  What resources are available to the AT with dental emergencies, especially after hours? -Cell phone number of the dentist -Tooth SOS app. How do you know who to refer to for dental injuries? -General dentist first, then general dentist can refer to the proper personnel.  Special consideration for athletes with braces? -If you have braces, ligaments are already loose and can put you at risk for trauma/injury. -Mouth guard. -Mouth guards specifically for braces. And because teeth move they might have to get mouth guards frequently.  -Custom has more compliance than boil and bite.  -Can get a custom mouthguard to go over Invisalign.  -See more soft tissue trauma How have patients felt with mouth guard around braces? -Tough sell because nobody wants to wear a mouthguard at that age.  What would you like the AT to do to help with the referral process? -Send pictures. -Backstory is nice to know -Timing -Don’t need past dental records Team dentist be utilized for PPE’s? -Have the athletes come in groups. -Visual exam  -Oral cancer screening -cavities/wisdom teeth -Get scans for mouthpieces.  -Able for the athletes to ask random questions -Establish a dental home, especially for college students who move away from home.  -Dentist can give a card Fun stories -Mowing lawn and trying to tie a string and it took the tooth.  The little girl had her silver cap come off and there was a Jolly Rancher glued to it.  -Kids are very resilient and heal a lot quicker than adults.  Action Item: What should an AT have in their bag? -gloves, gauze, light -Guidelines on what to do when it happens.  Cheat Sheet -Cell phone number of the dentist,  - Tooth SOS app - Save a tooth solution - Spit in a cup - Do not put the tooth in water

Work Right Northwest was the best fit for Jody during his current stage of life. He loves the industrial setting and the support the company offers for personal growth. Jody, Start with your AT story. From Waco Was not enjoying playing football and quit to become the student AT for softball. Chris Hargrove was the AT that me under his wing Graduated from Baylor as an AT working with some legendary ATs like Mike Simms Jody moved to Lincoln Nebraska to get a master’s degree and work with their Track & Field teams. 2007-2009 did a fellowship with US Olympic and Paralympic Track and Field. That led to internships with USA teams. He has worked with a lot of providers throughout the US and learned different perspectives as well as made a lot of connections. 13-year Outreach Coordinator at BSW 2012 I began the GA partnership with Baylor and grew the program to about 16 schools. How does WorkRight fit into that? Auto industry, shipping and delivery, food, manufacturing, and warehouses across the United States. We focus on being proactive with industrial athletes. These workers are at the same station doing the same repetitive motions for 8-10 hours per day. We are limited to OSHA first aid guidelines. There are plenty of at-home exercise options or opportunities. Better posture. Improved hydration. Early symptom intervention - 15-minute eval on site. Tell me a few stories Often times the job is the first time the workers have benefits that include healthcare. We provide a list of healthcare coverage professionals in the area and establish relationships with them to help facilitate care. One line worker was having continued upper trap and cervical issues.  After a few visits, he was able to work pain-free. One of our ladies had posture issues and we were basically the only medical option for her.  I have thought about how I could change into the industrial setting.  Walk me through the process. We work 4/10s with someone on duty 24/7  Mon-Friday. *dependent on site* We do a lot of 3-day weekends. Vacation time: can accrue up to 2 weeks of vacation time Holidays: get a lot of major holidays off…but this is site-dependent too. Manual therapy skills are important. Taping and first aid skills are important. Start learning the lingo. Visit LearnRightNW.com and take the entry-level course. How do you build connections with clients at Work Right NW? Listening Seeing them at their job What do I need to consider before making the move? Making that big of a change will come with some hiccups. Research the company Know the details Know their injury software Learn the lingo OSHA first aid principles

RankOne data makes it easy to tell your story as an Athletic Trainer. If you collect it then you can pull everything you need with a few clicks. If you need help just call and they can guide you through. What are some of the common things you RankOne sees from ATs? End-of-year audits Newspapers seeking info Easily filter through the data that has been entered We take data security seriously Data transfer is really important in security. We work with a lot of partners to make the transfer of data as seamless as possible We partner through our API to integrate those partners. Do you have a complete online solution for forms? We put the medical history form online We have included a physical upload form so parents can include a scan of the form. There are definitely pros and cons for both. Going Back to Data Collection Other than concussion reporting integration what are you seeing? Justifying the need for Athletic Trainers * Reports show how many treatments and using the CPT codes can demonstrate value The proof of your value is in the data. Until something bad happens the ATs value is usually glanced over. It gives you a great way to look back and reflect. Seen anything weird? We get calls requesting additions often. So we add fields when it helps them collect that data. We like to get a consensus before we make any big changes by checking with the Athletic Trainers. Ease of use features with RankOne Data: Print Paperwork Run Reports Messaging within RankOne We are creating a more robust messaging system that allows two-way communication. It will message the email that the account was created with. Any features you have cut? There have been quite a few changes that are in response to user feedback. What are we doing to prevent the dreaded August 1st breakdown? We have set up some API boundaries for our partners. Load-tested the servers. Thanks, Bethpage Consulting for helping make the trip to SWATA 2023 possible Check out the Instagram Live video

Kim Lowry and Nutrition Myths are so close, so easy, so trendy…Kim Lowry discusses some of the Sports Nutrition myths with Ryan Collins at the Memorial Hermann Sports Medicine Update. Protein 2-2.2 grams of protein if they are trying to bulk up Total calories are a common misconception You can not bulk up Muscle but not add any fat…almost universally Spread it out throughout the day Nutrient Timing Research is mixed - some say within an hour increases your muscle growth You can ap into muscle synthesis about every 3-4 hours High Protein snacks and meals Nuts Low-fat cheese sticks Greek yogurt Deli turkey P3 packets Protein bars and shakes Adding chicken to your pasta dish RAMEN -  You can add peanut butter Or peanuts I like to use the “Tasty App” and search for dorm room ramen for healthier options Eggs are another good option Creatine is BAD… Pretty much all of the nutrition myths have been disproven in all healthy usage of creatine.

Sean Hwang discusses his first SWATA experience with Dr. DJ Gilliland. Tell us your story, Sean Korean American Went to UT Austin. US Army field artillery officer for 3 years Went to chiropractor undergrad for a semester I had been doing something similar to AT with my amateur Korean soccer teams I shadowed John Houston at the University of Houston Women’s Basketball SWATA Student Track? I was not expecting to learn a lot because they made it out to be a fun hang-out. Dr. Knoblauch’s lecture about balance Being up to date on current trends Cannabis lecture from Dr. Konin Have you met anyone knew? I would love to…but I have not really. Dr. Harrison: we will take you around and let you shake hands with everyone Does UH pay for the students to go to SWATA? Nope they fundraise Last year's group did a great job fundraising. The stickers and bracelets were a pretty big hit How many students ended up coming from UH? There were about 20 students. Our preceptors and partners jump on the opportunity to get the students here. If you are passionate about learning new things then coming to SWATA is the place to be. What has been the most unique thing you have learned so far? Cannabis is not THC. CBD can be used without it causing an impact on your THC test levels. Suggestions from Sean I would like to see more nonathletic setting workshop courses here at SWATA. Tory Trevino asks: what are you learning as professionals? DG: CBD talks DG: Seeing people I have not seen in years LH: Bre’Layshia’s talk included a personality trait test and have mock conversations with different personality types. Contact Us @s.noogi__ on Instagram @drgililland on Twitter (X) @layciJ on Twitter (X)

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