The Sports Medicine Broadcast

Susan Taah knows negotiating benefits is the only way to work one job and maintain a quality of life. So she did. Now she joins Jared Plummer to share her story on the Sports Medicine Broadcast Where did Susan start? Working at a beer and wine distributor - so in industrial AT. Susan knew she wanted to make her living solely off of her job, not having to do side jobs. She knew starting off that she was making at least 40k so she skipped out on several sub 30k jobs. What triggered you to go into the industrial setting? * Start with Why* President of the student AT program for 2 years* Worked with Volvo truck plant in Dublin Virginia and doing a health fair type event*  My why was always preventing injuries Even though healthcare is part of the job benefits the distribution plant workers were oddly cut off from healthcare That first salary met my needs and I did not have facts. Sometimes it is not the right time to advocate. Sometimes you just have to gather facts and dataSusan Taah What is next in negotiating benefits? Have a list of things you are accomplishing and want to accomplish at work. Projects were a big part of what she did. * Heat illness was a huge issue* They did not have coaching* She started a heat acclimatization program* Weight charts like in football training camp She presented the results an findings at her company conference The company already has a dollar value for loss of man hours, hospitalization, workers compensation. Use them. What are the factors you feel like you need to put together to illustrate your point? * Documentation - Susan can calculate costs based on the cost of hospitalization, loss of productivity. * Expertise - tell them about an area you are an expert in.   ie. hydration or injury prevention What does this look like in COVID times? For her current job she had one phone call and two video interviews. Advocate for why you are the one worth picking and why you are the one. Have a timeline for when you are going to get certain certifications they will need. What about times like right now where so many ATs are unemployed? * Show your value, your worth, know the important metrics to your employers* Be flexible and willing to help* Going the extra mile now shows the need for others in the future* Long term health* Insurance* Risk management Did you drop a bomb or hint at your compensation package? She was advocating through the process of her previous job Money talk was saved towards the end so they are bought in and invested. Give the reasons first, then you are less likely to need to defend the request. These are the things I have implemented, these are projects I am working on, this is the value I am bringing. *  great* Write an elevator pitch - maybe 4 sentences - practice it.* I have looked over the offer, but it will not be adequate to cover the cost of living and change in responsibility* After they hung up Susan thought “I am done”* Have your number ready in salary format and hourly.* Moving Bonus - she did not negotiate this as it was a one-time pay...

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Understanding why youth burnout of sports is a question Dr. Jennifer Etnier says comes back to coaching. https://smile.amazon.com/Coaching-Love-Game-Practical-Athletes-ebook/dp/B07XH9FPK2/ref=sr_1_1?dchild=1&keywords=jennifer+etnier&qid=1598497524&sr=8-1 Who is Dr. Jennifer Etnier? * A Fellow of the American College of Sports Medicine and the National Academy of Kinesiology. * Former the President of the North American Society for the Psychology of Sport and Physical Activity and Editor of the Journal of Aging and Physical Activity. * The principal investigator of the Physical Activity and Alzheimer’s Disease 2 study at UNCG. You talk about sports, but do you even play them? She plays pretty much all sports Soccer is the family favorite, but in the days before the interview, she was out water-skiing and playing tennis...so yes she plays How can we avoid contributing to athlete burnout? ATs can really help in preventing this, here are a few ways. * Educating athletes about being in tune with their own body* Educating about overtraining - leads to higher stress hormones* Knowing the ability to get over a plateau and encouraging them through* Being a confidant/peer/friend Talk more about the confidant role: * If you have a sports psych they should be the main contact.* You can really point them in the right direction* Sometimes the battle is with the parents* We are already knowledgeable of the needs and burnout, but outside of sports can really play a role...acknowledge, normalize, what does bring you joy… let’s bring those things back into sport.* EDUCATE, use every tool* Know that if I push too hard they may burn out of ALL physical activity.* Avoid sports specialization After the interview, Sofia, my co-worker, said the coach was the reason she quit playing sports in college. She did not feel she could talk to the coach without retribution. Half of the team left because of the abusive style of the coach. In your NYT article, published earlier this year, you detailed the lack of “quality” coaches at the youth level. What do you think youth organizations could do now, and in the future, to promote higher quality coaching? Organizations like SportsMedDiscussion that help educate FUN - people play sports because it is fun...if it is no longer fun it is because of the people in it Focus on process, not the outcome when a kid says: “Oh my coach only cares about winning” They figure it out quickly, if you focus only on winning then they learn there is no point of playing unless you are winning. Even at the professional level this is true, focus on the process. FUN and the Process With respect to the effects that COVID has had on the mental health of student-athletes (young and old), what do you feel are the most important principles that should govern the way we approach coaching? Dr. Etnier reminds us: Do not cross the line - if you are not a mental health professional do not take on that role Find joy and fun in our lives

Have you tried installing Patient-Reported Outcome Measures into your practice as an Athletic Trainer? “PROMs just tell a story” - Dr. Lam Brian Columbe from Texas Luthern University and Dr. Kenny Lam join the Sports Medicine Broadcast today to help discuss what they are and how we can add them to our practice to add value to our services. This podcast was at the request of Ryan Pena, long time listener and Athletic Trainer in Dallas ISD What are PROMs or Patient-Reported Outcome Measures? Are there different types of PROMs? Short form 36 Common body region measure - uses FAM Single item measure - one item questions - numeric pain rating score. May not be sensitive enough for our patients but the numeric pain scale relates to their understanding. What is the current state of PROM use in AT?  Fairly low about 26% of regular usage in AT PT / OT is 30 - 40% so we are close to similar disciplines. Usually higher with higher support staff groups General lack of familiarity with PROM What are the major barriers related to their routine use? The main barrier is changing routines, habits, and culture. Incorporating it into notes What is your goal?  Use that and the single-item measures to set clearer exercises. SCAT5 is a PROMs How do we demonstrate the need for this to admin? Increases difficulty when bringing in the AD or admin as they may not know or care. As far as improving the situation, it is truly a case by case basis. How do you reflect on these PROMs? Allows you to formalize the impact ATs are good at asking about the whole person. We have not systematically assess those components across patient care Formal single item measures every time a patient comes in. Share some examples and stories of this being used? Single item measure is a great place to start START SIMPLE, build momentum, and expand from there. Maybe - this year we are only going to focus on ankles and give the FAM for every ankle. Resources: https://natajournals.org/doi/pdf/10.4085/1062-6050-171-19 - article by Dr. Lam Related Podcasts: https://sportsmedicinebroadcast.com/patientrelatedoutcome/ https://sportsmedicinebroadcast.com/briancoulombespats16/ Watch the episode on YouTube https://www.facebook.com/sportsmedicinebroadcast/videos/245191343508872/ Contact us Dr. Lam @kennyLam_ Ray Olivo - @RayOlivo20 Brian Columbe -

Ever wondered what it is like to have a Chinese Olympic Experience...and then get interrupted by a global pandemic/ Adam Stoyanoff joins John Ciecko to share his odd path to working with the Olympic kayaking team of China. Where did Adam get his start? I have been fortunate to observe and be part of many different things...some may seem wrong, but that is a closed-off perspective. Assistant coaching at Boling Green University for 3 years - spent time with all sports Worked with local high schools as a contract S&C coach Then went out on his own as an independent contractor with 2 high schools and college. This increased his diversity and ability to adapt his skills. Then went to Boston to lead an afterschool program for 2-5th graders - larget challenge as you have to keep changing to keep them interested. Learned it was important to keep contact and build relationships with parents so the kids and parents are doing and talking about the same thing. Next job was to Dallas, Texas Opened his eyes to see “there is always a reason why” Did not spend his life thinking “How can I build my resume?” He got a phone call from the Chinese canoe association that was training in Waco, about 1-2 hours from Dallas. That lead to him becoming a coach more than a coordinator. Juataga Portugal was their training site and also made the canoes they were using. Lived on the training compound with the athletes More about his Chinese Olympic Experience Coaching vs coordinating Coordinating is more like the AD role - dealing with all of the wants and needs It will stress your relationship building skills As the coordinator, you are in a service position and making sure everyone has everything they need and want. “Rocky 4 was a documentary right?” - John Ciecko But really that is what life is like, someone is always watching you and videotaping You should always act as if there is a camera on you.  Even in your moments of weakness. “What are you doing when nobody is looking - definition of Integrity” You have to stop, observe and listen to understand why a person may be acting a certain way Chinese athletes are taken out of school at 12-13 years old to be an athlete. Lessons Learned The coaches who are and were doing well put their ego aside and were there to serve and help. Calm and stillness with a few deep breathe Do not take it personally when a Serbian coach yells at you for setting a plate down to loud and disturbing their athlete. He was working with professional athletes...professional kayakers who wee making millions I can get you that info, I need to find the best way to get that to you safely. https://www.facebook.com/sportsmedicinebroadcast/videos/1126643737710753/ Contact Us Adam - Instagram John - Twitter

Krampade claims to stop cramps through science. John Ciecko, Sofia Mata, and I provide some anecdotal evidence. Our experience with Krampade Jeremy - Tasted it. it tastes and feels like cloudy or salty water should. I have never had an athletic related cramp so I can not vouch for the effectiveness My wife tried it to validate the Menstrual cramp claim. She honestly hated it but she is not an active athlete or intense workout person. My boys will drink it but it does not go down smooth. With a little getting used to it i think players could get past the salty taste. Jeremy's Athlete Senior Male soccer player with a serious history of cramping during games. he felt the product helped prevent him from cramping but drinking the whole bottle of water + Krampade left him feeling heavy. With some fine tuning in intake and nutrition I think the athlete could really benefit from the product. Sofia's experience Personal - had a hard time drink it due to the salty nature. Did not feel the menstrual cramps were affected by drinking it either. Sofia's Athlete using Krampade Varsity female soccer player goes down with cramps. Sofia administers the Krampade and within minutes the athlete is back up and running like nothing happened. John Ciecko's thoughts - One swig in and one swig out...if you are not ready for the saltiness then you will spit it back out like he did. Contraindications -  Heart or kidney issues check with your doctor Dietary contraindications - nope...but two 4ks back to back will create osmotic diarrhea Watch our Krampade talk on Facebook: https://www.facebook.com/sportsmedicinebroadcast/videos/2312673835502763/ Contact Us: Sean Murphy John Ciecko Jeremy Jackson

We are ordering Smart Cuffs by Smart Tools to provide Blood Flow Restriction training to our patients. Sofia has taken the course and we are excited to add this tool to the high school. First, we have some questions for Nick and Ed. "BFR is the ultimate biohack and tricks your body into “thinking it is doing a heavy load without the heavy load”Ed LeCera Talk about the Gen 3 BFR cuffs that are fully automatic. Gen 1 cuff in 2017 was kinda a POS But they quickly learned that was not best practice Multi-chamber system does not allow for limb occlusion. The new systems are single chamber which are much more effective. 5 sizes of the cuffs that are over 4 inches External doppler was chosen because it is close to the computer monitored systems SmartToolsPlus is focused on taking what the expensive units do and making it affordable and compact. Currently Two models of Smart Cuffs: commercial and consumer It auto measures the LOP 3 steps, inflates in 45 seconds The manual model is available, but the system auto senses occlusion and auto shuts off. Keep it connected for autoregulation of pressure. What is in Level 1 Smart Tools Training? Level 1 is a rehab or clinical-based training that is from scratch. It focused on getting the cuffs on and doing a hands-on workshop. Discuss the recommended frequency and duration of treatment.  It depends on the goal. You can train multiple times per day as there is not any damage being done One study showed D1 basketball players - 11% increase by using the cuffs on walking programs. 2-3x per week is as effective over the long run I always have to ask about my elderly parents and grandparents.  How can Smart Tools be used with them safely? Ischemic preconditioning - getting ready for surgery and being under a tourniquet Cellular swelling protocol is great for reducing swelling.  As the limb starts to swell from the cuff, then the cells start to reabsorb the fluid which leads to muscle protein synthesis without the muscle damage Lots of growth factors start moving Bottom Line: We want to drive growth hormone https://www.facebook.com/sportsmedicinebroadcast/videos/516565245698745/ Smart Tools Resources We currently have a Spring Sale going on. 25% off and free shipping SmartCuffs Basic and Personal sets (code: smart25): https://www.smarttoolsplus.com/detail.cfm/id/76/name/smart-cuffs Our Level 1 live courses booked for this year: https://www.smarttoolsplus.com/courses/index.cfm/level/1-day-bfrOnline course for $59 How to Train Clients Online: A...

Mandy Tyler is a RD working with pro, collegiate and high school athletes in the San Antonio Area. She joins us for some key points to remember when fueling for performance Fueling for performance for games and practice Eating frequently throughout the day and establish an eating routine for each day Improving variety in your diet Timing and wholesomeness of the foods for snacks Eat every 3-4 hours everyday and plan your meals out Follow the rule of 3s (3 meals, 3 snacks) Mandy Tyler presents 3 keys to fueling performance Key #1 - Do Not Workout on EMPTY  You can train your stomach like you train your lungs and muscles...work up to a regular breakfast DON'T eat high fat or fried foods low fiber Game Day meals closer to the event- hi-carb low protein  Meal day before high protein (steak, spaghetti with lean meat sauce) Key #2 - Recover after a workout Ideal goal recover time within 30-60 min after Fuel up as you cool down Need carbs and protein Freebird or Chipotle might be a great recovery meal Key #3 Stay hydrated Decrease performance can happen when 2-3% dehydrated Post pee color posters in the bathrooms. Water throughout the day and save sports drinks for competitions An ounce is about the equivalent of a big gulp. Need 4-6 ounces of water per 20 mins Cool not ice cold Drink do not pour it on your head Supplements are NOT well regulated If a supplement works then it might have a banned substance You are responsible for anything you put in your body. If it says “boost testosterone” it is likely got a steroid in it Careful taking pre-workout because they throw everything in them Look for third party testing for supplements Do not model drinking energy drinks… it’s just bad practice Food is energy Alcohol - interferes with recovery 5 drinks delays up to 72 hours Other points presented today: Athletes plates versus my plate model Olympic committee has an example of this Consuming adequate calories and protein especially recovery Immune Health - stay hydrated Use herbs and spices Omega-3 fatty acids Increase variety of fruit and vegetables (more color the better) Vitamin D Tart Cherry Juice  Probiotics  Eating out - make the best of the worst choices Get it on a bun Get it on wheat when you can Milk or juice instead of soda Avoid supersizing BUILDING muscle mass Rule of 3 is important Eating machine - schedule Prepare meals and snacks

Dr. David Schmidt and Marc Powell discuss Why Athletic Trainers are so important. What was your first interaction with an Athletic Trainer? He did not have an AT in high school Dr. Schmidt's first experience was as a resident He learned why Athletic Trainers are crucial...on field evaluations. How did you and Marc Powell meet? Marc called Dr. Schmidt pretty much everyday...then it became a habit. Now he looks forward to the regular interaction. Why are ATs important from the physicians standpoint? * unique skill set* on field evaluation Share some stories * Dr. Schmidt always took the phone calls... every day* He was a mentor and allowed me to grow as an Athletic Trainer* Dr, Schmidt endorsed Marc and really pushed him forward* Marc can not shoot a deer Did you intentionally mentor Marc Powell? well, I did not have a choice... I really try to treat all ATs the same Dr. Schmidt wants each AT to know that are not an island. You are not practicing all alone. What is an important to growth as an AT? We need to continue to push the envelope for ATs insurance recognition is critical Push it forward with each setting - Tactical, Industrial, Collegiate, Secondary How can a young AT build a similar relationship? * Listen* Pay attention* Ask Questions What makes a good team physician? Accessibility Ability to get athletes in quickly What are you currently doing to advance sports Medicine * Prevention* Load Management* Understanding the importance of recovery Thoughts on Why Athletic Trainers are important? Always seek to get better and tools to your tool box. Explain who we are...just keep talking. Contact Us: Marc Powell - mpowell@trinity.edu Dr. David Schmidt - Contact Marc Jeremy Jackson - www.SpoprtsMedicineBroadcast.com/about Email the companies that help keep this going and say thanks

Dr. Podell says concussions are treatable. I have traditionally heard you do not treat a concussion, instead you manage it. Join Dr. Podell for a discussion live from the Trinity University Sports medicine Workshop 2020. Cervical Strain is Treatable - 3 min Neck issues can play a big role in prolonged headaches. Location of headaches may correlate to the c-spine that has been affected. Role of Myodural connection - 5 minutes “Effect of the Suboccipital Musculature on Symptom Severity and Recovery after Mild Traumatic Brain Injury”: http://www.ajnr.org/content/37/8/1556 Study done in 2016 on myodural bridge and its connection to post-concussive symptoms, may suggest that treating suboccipital musculature early on may reduce post-concussive headaches and/or other symptoms. Neck strengthening and conditioning - 6-9 min Neck girth and strength = reduced impact to the head and neck Strength exercises must be done in all planes! “The effects of rest and treatment following sport-related concussion: a systematic review of the literature”   https://bjsm.bmj.com/content/47/5/304.long Studies revealed that those who reported pre-season baseline symptoms had an increased risk for concussions during the season. “Sex Differences in Head Acceleration During Heading While Wearing Soccer Headgear” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2582549/ The study revealed that soccer females wearing headgear had greater head acceleration compared to males who had a slight decrease in head acceleration. This suggests that headgear may not be appropriate for all athletes. Measuring Neck Strength - 10 min “Neck Strength: A Protective Factor Reducing Risk for Concussion in High School Sports” https://link.springer.com/article/10.1007/s10935-014-0355-2 This study showed that “smaller mean neck circumference, smaller mean neck to head circumference ratio, and weaker mean overall neck strength were significantly associated with concussion.” Vestibular balance is also treatable - 15 min BESS/ Sway app / Force plate Balance work = decreased risk of lower body injuries relating to prior concussions Vestibular-ocular - 17 minutes “Does it feel unstable to you?” “Rocky boat”  Are they experiencing vertigo? Increased s/s if they were previously experiencing motion sickness Vestibular-ocular issues are a “major source of fatigue, headaches, and cognitive problems Vestibular Ocular Motor Screen (VOMS);  smooth pursuits, horizontal and vertical saccades, horizontal vestibulo-ocular reflex, near point convergence, visual motion sensitivity Home exercises; Eply/Brandt-Daroff exercises and gaze stabilization Beginning vestibular therapy at two weeks will greatly impact and help during post concussion recovery Training for professionals in vestibular rehab techniques is available CAUTION! 

Matt Holland joins us on the podcast today from Trinity University to talk about the Thrower’s Elbow. Why do we see so many elbow injuries in throwers? “A great deal of stress is placed on the elbow with throwing, particularly in the late cocking and acceleration phase.  The forearm musculature has a limited ability to help with the stress load so the bone and ligaments of the elbow absorb a significant amount.” Also contributing to the rise of injuries is the early commitment of young athletes to year-round baseball, especially in the south.  As well as great rehab that doesn’t address mechanics or the importance of core and lower extremity strength as well as balance. Are there factors that can be indicative that an athlete may suffer an elbow injury? Rotator cuff weakness, altered scap position, altered throwing mechanics, GIRD and not using the core or lower extremity during throwing contribute to the elbow being injured.  Dr. James Anderson states, “the #1 cause of elbow injuries is bad mechanics, and the #2 cause is overuse.  Combine those two factors and you are doomed.” UCL tears aren’t the only injuries we see in the elbow.  What other ones might we come across? Triceps tendonitis is common among throwers.  Most often this is an overuse issue and athletes recover quickly with rest. Flexor tendon tears can occur but are incredible frequent especially in younger throwers. Valgus extension overload can cause repetitive abutment of the olecranon.  It is important to look at mechanics here and ensure that there isn’t a UCL injury causing this. Little League elbow is very similar to a UCL tear.  However the weakest link in a skeletally immature body is the growth plate so this becomes injured instead of the UCL.  The key to healing this is rest, rest and more rest coupled with parent education. How important is rest with elbow injuries? In a recent study published in 2019 the thickening of the UCL and the increased joint space of the elbow found in thrower’s experiencing elbow pain returned to normal on imaging after rest.  However, if these athletes had GIRD that wasn’t addressed, that correlated with a continued increased joint space in the elbow. What questions should we ask an athlete who comes to us with elbow pain? What position do you play or combination of positions? What is your volume of play? Do you take time off? Where is your motion does it hurt?  This question is of particular importance because if the pain is happening during the maximum external rotation found in late cocking it is usually a UCL issue. What are the rehab guidelines post-TommyJohn surgery? Protect the graft for 6 weeks and return normal strength to not only the elbow but to the shoulder, core and lower extremity.  Focus on balance and at the 4-5 month mark throwing can begin.  It is a long process because once throwing is started that is how we strengthen the ligament with little stressors.  Throwing should include working on mechanics but stressing the ligament a little bit followed by rest.  It’s also important to note the type of revision done because some revisions like the modified Jobe move the nerve and this becomes important to know while doing soft tissue work. Does the UCL reconstruction have favorable Return-to-play? Yes!

Dr. Ralph "Bud" Curtis goes live with Easy Shoulder Evals from Trinity University's Sports Medicine Symposium 2020. About Dr. Curtis: * 15 Years as being recognized as a Texas Super Doctor. Dr. Curtis has been recognized every year since 2005.* Fellowship-trained shoulder surgeon* Board of Directors, THSCA Professional Development Curriculum* 30 years, UIW* UIW Sports Hall of Fame* Shoulder consultant: S.A. Spurs, UTSA, Trinity Univ., UIW* Hall of Honor THSCA* Hall of Honor Southwest Athletic Trainers Association* Author of multiple book chapters on shoulder injuries* Adjunct Professor, Department of Orthopaedics, UT Health HAVE A SYSTEM Needs to be quick and reproducible Make sure it is age-based and know what is most likely for each age group Understand traumatic vs non-traumatic HS to the college level is most likely instability Sitting fashion helps them relax Try not to fight them Find out the background before ever touching the patient Then the provocative tests Sulcus test Load and shift - generalized laxity, not traumatic instability Neer impingement test is a pretty lousy test Hawkins impingement test Anterior apprehension for anterior instability Posterior instability including the jerk test AC joint pathology is going to be painful so it confuses the test Palm down O’brien’s test for SLAP Anterior dislocation - check to see if there is good smooth motion internally and externally Posterior instability the converse is true. These often get missed because they look normal until follow up with ortho. Once dislocation is reduced check for full internal and external rotation. ANTERIOR INSTABILITY - 18 minutes Look at ROM  Click test is something that can be beneficial RCT - Empty can is often normal due to deltoid  Arm inside external rotation Stinger / Burner C5/C6  Deltoid weakness External rotators weak Possibly weak biceps C7 cervical disk Strong delts and biceps Triceps are totally weak C8 is ok (can keep fingers spread) Watch the Easy Shoulder Evals Facebook live video https://www.facebook.com/sportsmedicinebroadcast/videos/626240638142999/ Resources Other shows from Trinity University's Sports Medicine Symposium 2020 Contact Us Jeremy Jackson Shawn Ready

Have you prepared your COVID19 RTP plans? Bart Peterson and Jennifer Rheeling join the SMB to discuss the current recommendations and considerations created by the NATA Secondary Schools Athletic Trainer Committee to help you create your COVID19 RTP. We need to reconsider EAPs to include social distancing guidelines. What about lightning...now, where will they go? Know what phase of COVID19 RTP you are in from the local public health department. Know the terminology and how its is defined: Phase 2 is groups of 50.  Is that on the field or altogether outside at once? Covid response team Who is on yours? They need to know what the plan of action is if you have a room full of kids and one test positive with temps or signs and symptoms. ATs are a key component in risk mitigation Being part of the decision-making process is important. We also have to know how we are going to take care of the over 55 population...coaches, teachers, and officials. Communication with the school nurse is crucial and this is a great way to build the bridge. Cleaning Supplies Districts may need to buy them out of another fund or fund next years purchases now even though budgets have not opened Hydration NO water sources until phase 3 Illness Reporting - start with the state, including local, report up the chain.  Telemedicine - Congress made this easier during COVID19 Need consent each time you do a telemedicine video Can not cross state lines Document as normal Know your platform Make sure that this is not occurring in a bedroom Facebook Video of the COVID19 RTP talk https://www.facebook.com/sportsmedicinebroadcast/videos/563648741015093/ Resources: COVID19 RTP Document Telemedicine Contact US: Jennifer Rheeling email - jennifer.rheeling@gmail.com Jennifer on Twitter Bart Peterson - email - arizatc@cox.net Bart on Twitter Help them keep supporting the podcast

NATA 2020 presidential Election has Candid Candidates Chad and Kevan host Candid Athletic Training where they take a look at Athletic Training very candidly. Kathy and Katie are used to answering questions about Athletic Training and fixing what is broken. We wanted to have some very Candid Candidate discussions to help you know your next NATA president. Why would your undergraduate mascot make the best Athletic Trainer KF: Beaver: adaptable, ferocious, make a phenomenal home from out of nothing, leaves everything better than it found it. Being a team player, quietly getting things done under the radar KD: Longhorn - Magnanimous animal Quiet, slow-moving; large and graceful If you get in the ways of the horns you will regret it. Rehab specialty: Administration - quiet, contemplative FMK KD: K - Cat D - I want it to be applicable and pertinent M - EBP - a lifelong commitment to learning F - Lecturing - it is a rush to share that knowledge KF: F - Cat B M - EBP K - the Cat D What will you miss most about the COVID19 2020 convention cancellation? People, socials, energy, relationships Mount Rushmore 4 things you feel young ATs will face and need to be prepared for KD: * Give your self a break...there is a lot to learn* Professional Communication* Continue to learn* Advocacy and showing your value is CRUCIAL  KF: * Follow your contract - Do not give your time away for free* Policies - have those ready and follow them* You Are Enough…* Mentor over Data How do you negotiate time for yourself? KF: your first job is the only one where you might not negotiate...after that it is on you KD: We are not training our students to negotiate. How are you going to best get your objectives communicated to people? KF: NATA News Be responsive to the people Be everywhere KD: Diversity in mediums Being willing to reach out on all of the different mediums. Kathy prefers face to face or phone call, but currently have to respond and react. Opinions on the dangers and benefits of Social Media KF: uses it as a positive outlet  FB, Twitter and IG It is irresponsible to hide behind the account It is a good source of what ATs are thinking and feeling KD: Hardest thing is to keep up with all of the platforms SM can really help reach people It is really easy to anonymously complain...but is your message getting through if you are hiding. “We learn the most from people who are unhappy” Hats - Clinicians, educators, legislation KD: We all have some of those roles with a focus * Feels it is more regarding settings vs roles KF: I do all three of them * The researchers are valuable

Dr. Jason Magonye and Dr. Shawn Scott put together an Upper Extremity Neuro Eval session at the Trinity University Sports Medicine workshop. Complete the CEU course FREE from Methodist San Antonio Be familiar with the nuero anatomy of the upper extremity Cranial nerves - remember they are contra lateral Dermatomes - sensory innervation to the upper extremity If it is intact distal, it is intact proximal.  Start distal and work proximal Brachial Plexus - 11 min Latisimus dorsi is the ladder climbing muscle Subscapular - don’t let them pull their hands off their belly Supraspinatus - starts abduction until the deltoid takes over. Hornblower test - teres minor Ulnar nerve (C7/C8-T1) Median Nerve (C5-C8, T1) tip of fingers, the palm of the hand Anterior Interosseous Nerve (AIN) 22 min Radial nerve - extension nerve (C5-T1) Posterior interosseous nerve - supinator Most of the extensors Nerve Entrapment -24 min When nerves get entrapped they get irritated. IF YOU CATCH THEM EARLY YOU CAN PREVENT THE NERVE DESTRUCTION PROGRESSION. If they are having weakness then we need to really push to have that person looked at Median nerve entrapment Pronator syndrome is similar to carpal tunnel syndrome. Carpal tunnel - positive tinels or phalens Pronator teres syndrome. Catch the rest in the podcast or on Facebook. Do not be afraid to ask your athlete to provide copies of imaging and reports. Case #1 16-year-old football player who presents with bilateral hand pain. Pushed from behind during a game and landed face down with his hands in front of his body.  During further questioning of his hands symptoms he states that both of his middle fingers were tingling.  Due to the fact that the patient is experiencing bilateral symptoms, you must go to the source in which would be the spine (C7 nerve) Ulnar nerve splits the 4th digit.  If you have someone who presents with tingling and numbness on the inner aspect of the hand you know that is C8.  Radial nerve does not go to the tip of the fingers.  Case #2  Saddle bronc rider came off his horse and landed on his head. He walked out of the arena and did not complain of neck, head, or arm symptoms. After driving from Colorado to Texas he went to the sports medicine room stating that he had started to experience bilateral middle finger tingling sensations. Worse thing to do when you have bilateral symptoms, trauma, and numbness and tingling would be to compress the neck.  Range of motion, neurological testing, and gentle palpation are appropriate to perform in the exam. Orthopedic testing would not be appropriate for this exam.  During exam in both case 1 and 2: Flexion/extension movements caused finger sensations.  Palpation produced “unusual neck pain” at this point your exam is done