The Sports Medicine Broadcast

AT Moms have a lot to deal with. Being mom at home and "mom" at work, breastfeeding in a football locker room at halftime...I mean come on. Cari Wood, Valerie Moody, and Kelly Salter join share some of their stories to encourage and lift you up as an AT Mom. Val, what is your family makeup? University of Montana Director of our program AT Journey Colorado, Nebraska, Colorado, Florida back to Nebraska Met husband in high school but actually met when she was back in Nebraska Cari? 22 year old and 19 year old Married 23 years Kelly? Born and raised in Michigan Husband was a coach at her first job 23 years this summer 21 and 20 year old sons Tell some stories of raising kids as an AT mom? Kelly - we now sleep with a phone on for our kids...but it can not be me as I get messages from former kids at all hours. I was able to provide AT care to my kids in little league. As the only AT at my school, I have to care for my kids.  It takes practice and objectivity. Cari - former athlete called her after a varsity football game and they had been having fun. I love they feel safe to call me A friend fell off the golf cart and broke her 5th metatarsal but Cari made her play through it. It is hard to evaluate your own kid. My son was a wrestler but my contract did not cover the road trips.  So I had to sit in the stands and sit and watch, but I can never really turn that off. Val - when my kids are playing I have the other AT doing the evaluation.  It gives me a layer of separation. “Will there ever be a game where I am just mom, not the AT?” What are some of the best moments? Cari - raising the kids in the high school and having them be included with the teams.  Allowing the high school kids to guide and instruct them. Realizing I had to lay down the law with the boys trying to date my daughter. Kelly - getting to see role models and how the teams can be like family. Now my boys are returning the mentor favors. Keeping my kids involved in what I do and allowing them to be pediatric patients and part of my regular routine How do you handle the dating scene? It was great for me but tough for the kids.  I always knew everything. It is a double-edged sword.  There was much more benefit than difficulty. Being relationship-driven has always been important to me so it caused some issues as I wanted to be friends with others. Am I an imposter? Val - It is easy for us to fall into that trap with social media. I try to surround myself with good role models that I can reach out to. I intentionally connected with another faculty member who is in a similar situation. Cari - I missed a lot of competitions because I had to work, my husband did a lot of the nighttime routines. Kelly - It is hard to be vulnerable,

As a single mom AT you have to make a lot of sacrifices. Dr. Erin Hassler has gathered a few friends to share their stories. Dr. Hassler, start us off with your story of getting into AT. Went to school in Atlanta and always playing some sort of sport. When I got to college I put the two together. The 1996 Atlanta Olympics Currently a teacher Own SportzFactory Own a non-profit Work with Olympic Track and field Teach adjunct online Paula - 20 years out of college and 28 years in AT world I started as an aide at 13 years old I hated PE and tried to find my way out of it. As a cheerleader, I jumped down the stairs and had to visit  First 5 years I was at a private school and then after school stuff After that I became the sports performance coordinator. I loved being part of the team and celebrating and getting better. It was neat as a high school student to understand the psychological pressures Chakaia - Athlete with a lot injuries My high school AT taught me a lot  Tennessee state for undergrad Fell in love, got engaged, had a baby, we split and went our separate ways I knew it was time for me to complete my schooling. Te Shondra - Born and raised in Florida and I was into sports. A close family friend was the AT and she became my ride to and from school. I was active but always found a way to help in with AT. Went to school in South Carolina Was married for about 7 years and moved back to Florida. About year 7 or 8 we were pregnant and about that time he bailed I did not make the adjustment until my daughter was at an age where she needed more hands-on for competitive practices. When did the kid(s) come into the picture? Tell me about your Tribe: Co-workers that all started at the same time and were in similar situations. These are the emergency contacts for my daughter Now I have my “mommy squad” that I have met through my daughter. Being willing to pick up and drop off your friend’s kids and it is reciprocal. You need someone to celebrate and sorrow with. Dr. Hassler - I do not call myself a single mom I do not label myself as a single mom so that it does not look like I am missing a piece. “You do not need to try to make up for someone else” K - I am a thinker and a planner.  I will manage my emotions, but sometimes that is at the end or the process. I have to let someone else help me Advice for K Let your story show your passion and desire Build your network now Reach out to everyone you know. Know the presence the ATs have in the area.

Founder of the Brookbush Institute, Dr. Brent Brookbush joins Tanya Watson to discuss some tips for maximizing online learning. AS we are hot on the heels of NATA going virtual again, we hope to help make lemonade. Dr. Brent Brookbush, you were recently on the movement underground with Mike Stella.  What was your big takeaway from that podcast? We make statements that I feel are for social media.  We do not live that out in our lives, but we do it for the clicks. Manual Therapy is supported in research.  Period All of our courses are Evidence-Based courses Joints mobs and manipulations have the most research of any treatment in our profession. How do I find a research-based course? If it does not have a bibliography then it is not worth studying. Is there evidence other than this guru’s opinion? Is there original research? Look for original sources as the citation Accreditation is important but an end all be all Brookbush Institute has lots of courses, almost all online now.  How can we as ATs maximize our online learning?  There is no current research saying in-person education is better than online. Would you benefit more if you could review the material and practice on a colleague and then go to the course or course first? Take it on your own Repeat it as much as you want Practice until you are comfortable Practice on related injuries but not the exact (i.e. shoulder injuries get a spinal manipulation) Add in an in-person workshop for mastery. What is Brookbush Institute including in their courses to help retain learning? The online workshops were incredibly successful because now people had access. We were only getting into 20-30 cities “I hate the education system as it is” - Brent Brookbush What will make this possible for my working colleagues? We have to make courses short and give credit as they go. Needs to be on mobile and desktop. Multimedia - we are adding audio voice over so you can listen while driving or running We want you to have more access during random downtime. We do not want to penalize people for taking a long time to finish a course. Educators tend to kick customer service out the window. Make it possible to take education easily. I want to take an IASTM course. What can I do to help me master the manual skills while learning online? Find a mentor or find/form a local group and “therapize” each other Watch the podcast on Facebook Contact Us: Brent - www.brookbushinstitute.com Tanya @tewatc on

Women in Athletic Training acknowledges women and men are not the same; however, that does not mean one is less than the other. Come celebrate with this awesome group as they are growing healthy relationships to grow our profession. What’s new with WAT?  * Since the last time we were on the SMB a ton has happened - specifically in the area of intentionality and forward direction. * We launched our re-brand of WAT 2.0 on 1/1/2020 and that for us signified a HUGE shift both in who we were and where we were going. We started the process in September of 2019 and used the last 4 months of 2019 really collaborating and digging deep into who we (the revitalized WAT board) wanted to be and where we wanted to take WAT. * That leads us to the creation of a formal mission, vision, and our credo that WAT is more than AVERAGE (insert visuals here) standing for authenticity, virtue, empowerment, respect, advocacy, growth, and elevATion. * We moved what was a place for all women AT to just come and ‘be’ to a true resource. A safe space for the women in this profession to empower one another. * It was through this re-launch that we saw a huge shift in the way our membership interacted with the group - in a hugely positive way. We also were sure to come into the process using the evidence-based models and surveys out then 7800 members. This year when we started 2021 we did the same thing to evaluate our model. * We are super proud that we just hit 9000 members, have 9 board members, we were the 1st group to offer a virtual interview of the then-candidates for NATA presidency, have hosted multiple call-in sessions for professional development around covid, interviews with NATA LGBTQ, EDAC, and more.   What are y’all working on now? * At the end of each year, we put out a survey for our members to complete for the Women in AT board to review and re-assess the needs of what our members are wanting from us. We all completed passion roadmaps which is a resource that we utilize from Passion Planner (Megan loves Passion Planner) that allows us to each individually brainstorm the goals that we foresee for WAT over a time period of 3 months, 1 year, 3 years, and a lifetime. * We work together to review the survey answers to plan and create a quarterly outline for Women in AT to help us take small steps to reaching our larger goals for WAT while also catering to the needs that our members requested of us. * This past year the survey revealed that the top two needs that the members would like for us to provide are networking opportunities and educational content. This is something we are working hard to provide for our members. * This month as NATM’s theme is AT’s are Healthcare, we want to shed more light on the emerging settings of athletic training. This month will include some roundtable discussions from multiple settings, some social opportunities, and an interview with a professor who teaches negotiation tactics. We are all very passionate about athletic training and the future for WAT, and are excited to see how it all evolves.  What are two key issues y’all are working to improve for women in athletic training? Showing up for each other in an authentic, empowering way. For too long women in this profession (and in general) are forced into competitive environments that pit one against another. We aim to change that. We should be building each other up, and working together as athletic training professionals. Empowering each other forward. Not holding each other back.   What is the vision for the next 5-10 years? To infinity and beyond :-) no but in all seriousness, we have big dreams and no intention of slowing down.

What are you doing to provide quality COVID Care and Prevention? Paul Calloway of MiotechGroup joins us to discuss some of the options available to prevent the spread of COVID and other communicable diseases. What is new in COVID care? NanoBio - the average person touches their face BZK kills 99.9% + the negatively charged bacteria Nasal Swab basically creates a line of defense Microsure surface protectant Let’s talk about washing hands 8HD  Up to 200 applications Spray rub and let your hands dry BZK has antiseptic properties Surface disinfectant Microsure surface protectant Protective barriers MS Sports & Healthcare - basically a bag that goes between the. PPE The materials used for masks is the same used for underwrap There are no alot of places the produce vinyl gloves. Some of the hospital systems are using 2 years’ worth of gloves in 90 days. Purell has a food service-rated disinfectant.  Look for the foodservice disinfectant products for things that are dealing with food. What do you think? What are you doing for COVID care and prevention? Tweet Us: @MrJeremyJackson @JohnCiecko @Paul_Calloway @MioTechGroup Watch COVID Care with MioTech on Facebook Contact Us: Paul Calloway John Ciecko Jeremy Jackson Sports Medicine Broadcast and COVID Care partners

Allan Parsells is an Amazon AT or as they call him IPS. Injury Prevention Specialists are positions at Amazon that are only held by Athletic Trainers. What is it like working for Amazon? There are about 150 ATs across Amazon BOC certified is a job requirement Been with Amazon for 4 months The industrial setting is a complete 180 from the traditional setting. I had to step out of my comfort zone. I had to learn OSHA stuff and learn what I was able to do and what they wanted me to do. From day one the IPS network at amazon has been extremely helpful.  From onboarding to answering questions. There is a six-month learning curve. How did you get the job? Amazon is the most customer centered company in the world. Allan’s customers are the associates that fulfill orders. Our “athletes” are our associates and getting them back into work. You are dealing with professionals that can not afford to go home or “sit out” They need to earn income. What is good about being an Amazon AT? Favorite thing: interactions with associates that make a difference. * Collaborating with co-workers * Great Benefits Package* Stability* Opportunity for advancement* Life Balance Calling in sick - there is no sub, you just do not go to work. Switching to the morning shift - may require moving to a different building. Leadership roles - there are managerial roles in IPS, safety manager role, ergonomics role. What is not so good? There are a lot of people that have to approve things before changes can be made Everything that happens in safety affects operations. Amazon is hell-bent on safety. In the Facebook Insights, it says women 2-10 years into the profession are the target audience.  What specific advice would you give them? What am I going to do now and what am I going to do when I have a family. Amazon provides a great opportunity for you if you are starting a family.  Maternity/paternity leave. It is not a “boy's club”. Everyone has equal opportunity here. If you love to help people you can help people here at Amazon too. Amazon is thriving during the pandemic, does that impact you as an AT? There are salary employees and hourly employees. At this point, I do not know what that looks like. PhysicalTherapy.com is a great way to earn CEUs as an AT and be a better clinician.  What are the skills you are improving on as an AT right now? If you stop learning you are getting behind. OSHA requirements are the biggest learning right now Contact Us Allan - aparsells@premiersportsmedicine.net

When you are ready to change there are several employment considerations you should consider. Dr. Danny Barringer did his dissertation project on the key areas Athletic Trainers should condsider before making the move. The Problem: The Athletic Trainer applying for a job did not know what to ask and what to look for. COVID really underscores the need to know and clarify the expectations of your job Three main employment consideration models:  School District Outreach PRN Source of Funding School District - city/state/federal level Are you going to be teaching anything? Does the school only need to cover the stipend? Outreach Typically from a hospital Are you an at-will employee? Will you be furloughed? PRN Usually, funding comes from the school district to the third party. Job Expectation School District -  The AT knows the hours are long but usually has summers off. May have to supervise student aides Outreach Hours are usually better regulated But typically working year-round (finding more business) Mileage? When are you on the clock, when you leave the house or arrive on site? Supervision of PRN ATs PRN Much more freedom of schedule Consider who will keep the documents and records Varying policies and procedures between sites Human Resources School District -  Teaching with stipend A clinician with or without teaching responsibilities Summer camps # of days on contract Stipends Benefits Outreach HR may not know what you do and who you are.  Make sure you have liability and physician oversight Stark Law/referrals PRN * No benefits / HR Access* Liability and physician orders are on your own Immediate Supervisor School District * Typically and Athletic Director (hopefully we are moving away from this)* Principal* Superintendent Outreach * You could be reporting to a clinician* Maybe a CEO or CFO* Contracted Schools ADs PRN * Physician* Tournament Director* School AD Location Specific Nuances School District * Rural vs. Urban* Physician/clinical staff Outreach * Clinical space access* Multiple offices PRN * Could but constantly changing Contact Us: Dr. Danny Barringer

Amy Metiva did not ride snocross, or even really know about the sport. She is a really good AT and busted it to be the best wherever she was working. Check out some of her story below. Start us with a crazy/awesome story Fargo, North Dakota and it’s negative 39 degrees. The propane tanks froze so the trailer stayed around 42 degrees the whole weekend. Most race weekends we work 15 hour days. We had to backboard in the snow...in the negative 40-degree snow.  There were 2 sleds stuck together and a rider underneath the sled. Knowing he needed advanced care quickly we carried him right to the ambulance. Hunter was in an accident in a tight corner. “We are basically waiting for a car accident to happen and then being ready to pounce.” We had a racer get hit by a spindle and had an arterial bleed from the nose and he was not breathing when we got to him. By divine intervention, he came back. He was buried under the snow and we had to dig him out of the snow.  Ended up breaking every bone in his face and had 97 stitches in his face. He got to race about 3 weeks later. Hunter, discuss your previous interactions with ATs Hunter grew up playing football and had the high school AT. He did not have much interaction with her. Got hit with a spindle and tried to shake it off. Once he could not move his arm he needed to go see medical. Amy always seems to know when you are going to be hurting and ready to take action. Racers are tougher than nails, so how have you softened them up? Do not go up to the racers when they are focused and in the zone. I communicate beforehand and set up some signals to know they are all good. Build trust before they are injured They come to know if I can get them back into the race safely I will. If I can help them hit their goal and dream...that is the most amazing thing Discuss your journey to becoming an AT. Middle School athlete and was told she had swelling and could not play anymore.  She went to an Athletic Trainer and he helped her rehab. In 7th grade she went to a camp and found a book by Arnheim and started reading it on her own. By high school, she was the self-proclaimed medical person. Went through the internship program at Lake Superior State and was assigned tennis. Her parents told her to be the best tennis AT there was even though she did not like tennis. She then moved onto wrestling and loved being the only female AT.  That led her to volunteer in lots of places. She stopped the Harlem Globetrotters bus to speak with the AT. This conversation changed Amy’s direction for her career. A year later he called her and brought her to the court to meet the first female Harlem Globetrotter. I have had a lot of jobs between now and then including a ten-year sabbatical to raise my two boys. How did you get into snocross?

Dr. Julia Hines has connected her passions and works with Auto Racing Medicine because her dad took her to races growing up. She joins us to discuss her story of becoming and AT and PT as well as how she is helping make racing safer. Julia, What is your favorite race event and why? Going to Monaco would be a bucket list item What is your experience in driving racecars? I have done some courses Dr. Hines’s husband is a racer I get in the racing go-karts now and then. How did you get into Athletic Training and Physical Therapy? Dad is an amateur racer and started going to the track at 3 or 4 years old. He got a concussion in her senior year of high school. They basically did not treat him at all He drove the pacecar the next day He had symptoms for about a year including BBPV I grew up close to Limerock park and love all those events Went for PT school but ended up doing the combined AT PT program. I got injured a lot as a dancer growing up There are ATs with racing, but they are few and far between. Showed up at races and talked to everyone I could My doctoral thesis was on returning the motorsports PT. Talk about the evolution of concussions in Auto Racing Medicine. This is not a team sport.  If the drivers are not driving, they are not earning their money and they are potentially out of the industry. The big teams, NASCAR, INDY, F1 they have traveling medical teams The “arrive and drive” guys do not have any sort of consistent medical care. Julia is currently working with more of the endurance events where they are driving for 24 hours. NASCAR has been focusing on improving the health of the pit crews and a lot of ATs Back in the 90s they would grab the guy from the local oil shop to be part of your pit crew. Do you have experience treating Pit Crews with random injuries? They have medical personnel in the pit..and everywhere. If there was an emergency we would work as a team, allowing the emergency medical crew to lead and then being the primary on the follow-up or continuation of care. Talk about the marathon races...how do you prepare them? Anytime a driver exits the car after 2 hours...something is going to be sore.  Low back, foot, hand. Rule out red flags. What can I do in this instant to help them get back in the car in a few hours? As a PT I avoid passive therapies As a MotorsportsPT we utilize a lot of the passive therapies because they are not really done with their event. If it is the night time you are trying to allow them to get treatment and get rest. Letting them know you have a plan in case treatment one does not work Do you ever have to “talk” them back into the car?  I had a driver with a torn ACL who was concerned about driver changes.  We had to work through the process of what causes pain and what does not.

Jovan Means is an Athletic Trainer and a professional cutman. It would seem that these jobs conflict each other but Jovan shares how these professions work together for him. Where does your Cutman story start? 16 years as an AT DC native Currently working in the same school system, he graduated from (not at the same school though) Jovan has always been a fan of boxing and MMA and thinking “I always wanted to expand my skill set.” One day he was watching a fight with his son and he said “Dad, that is similar to what you do.”  Light bulb moment. Started reaching out to cutmen in the area and Mike Rodriguez reached out to him and serves as his mentor. Being a cutman is an inside job. You have to know someone to get your foot in the door. Mike Rodriguez invited him to a cutman workshop and they sparked a friendship. What about taping? It takes Jovan takes 12 minutes to wrap one hand Different classes and commisions have requirements for the amount of tape per hand. Make gauze pads for knuckles. Tape must be 1 inch from the knuckles. Monitored by an official and the opponent’s team. There are a lot of rules to follow. Back to cutman business You got 60 seconds to get in the ring, handle swelling, overheating, and out of the ring. He has learned how to anticipate what injuries will be coming and how he will handle it. 2019 Jovan was in Las Vegas for NATA and there were a few fights in Las Vegas that he was able to shadow him. Mike is really big in boxing; it was really a blessing for him to be connected with such a big name. Chris Colbert allowed Jovan to walk out with him Mike reminded him you gotta start in the trenches.  The Las Vegas week was pretty "big-time" but definitely solidified Jovan’s desire to grow in this field. Jovan does a lot of volunteer work at a local boxing club. Some cutmen do not tape hands...so for Jovan's fighters it is a bonus. Ringside you get a 10-second heads up to jump into action. Keep the “Enswell” tool on ice. Jovan also uses an ice cream scooper to help with swelling. Wound care is something we obviously know how to do as ATs. What is your priority as a cutman? Over the eye first - blood Swelling before under the eye-bleeding Nose plug How do you stop the bleeding? Dog ear cleaner q-tips You are allowed some medicines, but you gotta know the rules. Adrenaline chloride 1:1000 and other coagulants

The wife is the greatest source of growth. I trust my wife and if she tells me I need to be kinder, slower, more active with my kids then I usually listen. Ryan Stevens asked a few of his colleagues and their wives to join us and see what makes a good AT Dad...and what does not. How did you meet?  Dave and Annie McCune - Annie was a PA and took a sports medicine course at Rutgers where she met Dave.  They waited until she finished her rotation to start dating of course Kevin & Kim Briles - Kim was coaching at the same school and came in to ask why her kids did not have water setup.  Kevin Blew up on her, set her straight about the role of the Athletic Trainer, and then the rest was history. Sarah and Jeremy - We were at a college dance with other people and kept checking each other out. We started hanging out after that and now almost 16 years and 3+ kids later we are here. Ryan and Jamie met in an AOL chat room, stayed in touch and 15 years and 4 kids later  What does your life look like now?  Annie - Craziness -  We just moved back for Dave’s job at Rutgers. I was doing door dash Staying home with their son Dave has to be at school early for testing One 6 year old together Dave was living in a dorm for a little while when he was transitioning jobs. Was able to come back to Virginia during COVID * Kim Ships passing in the night We kind of have opposite schedules 15/17/20-year-old kids We have a son that hasn’t left his pajamas in 10 months It is a good crazy, we are used to it. * Jeremy, what about your wife Sarah? Sarah is a stay at home mom and works part-time at the church.  She is the primary caregiver to our kids both biological and foster. 3 boys under the age of 10 and a foster daughter under 1 * Ryan and Jaime Wife stays home with the 4 young kids Ryan says “I could not make it without her.” Paint a picture of the relationship you have with your children now.  Briles: the wife gets up at 4:30 to get the kids to daycare on time. Kids ride the bus home We had to orchestrate the entire fall season of who was picking the kids up from school.  We had grandparents and family that we trusted. We use to take them to school and the teams would automatically babysit for us There was a  time I needed a break. It was Christmas time, we were supposed to go to this event - I told Kevin “Get everyone out of this house and do not come back until I tell you” Kevin called the wife a few times to see if he had permission to come home. McCune: I used to take them to school with me all the time pre-COVID Annie says she needs that time alone. As the mom and the wife everyone needs something and she just needs some time alone. If it was written on the wall, what would be your mission statement for your fami...

John Ciecko is a goal setter, so in AT Dads 2 we discuss the end goals and how we can work backward from that to make all 940 weekends count. Ryan, give us an intro to your family. 3 boys and a girl 10 and under What does the end of your career look like as related to your family? John - For a goal setter the end of my career has always been saved for… the end of my career. Now I’m focusing on financials more, planning and goal setting for 4 rather than just 1. Is there a career change, job change. I’m now more aggressive in my job responsibilities and worth at my current job.  Ryan - I am not a goal setter, I set priorities and work towards making those good.I want them to be functioning and contributing members of society.All my kids will be adults by thenWe want them to always feel welcome to come back and spend time in our house Let’s work backward from there to make a plan. 20 years Jeremy - approaching retirementAll Bio kids out of college; Possibly grandkids.I want to know my grandkids the way my mom and Sarah’s parents do.  I want to be an actively involved part of their life.  This doesn’t happen if I am absent from my kid’s life now. John: As Jenny says, in 20 years, I’ll be close to 100! - I’ll be approaching retirement or onto my “second” career in retirement. I will be focusing on Davids’s post-college and Cece's college years. These are very important years for them, where advice and communication are important to their adulthood. I’m building capital and “collecting coins” now so that my words then will have more of an impact on them when they need it.  10 years Jeremy - I will have 2 out of high school and at least one to go. Dating my Wife Intentional conversations and interactions with my kids. Ryan: I’ll have 4 teenagers… I want them to be safe Foster a relationship that allows them to tell you the bad stuff too. John: in 10 years David will be getting ready to try out for the basketball team at my high school...if that is what he chooses.I look forward to dealing with “father/son/patient/medical provider scenarios”I want them to fail so they can learn, but not fall. Next year Jeremy - adopting MJ, attending school events, taking them to school and events with me. It is not about the big events, but the daily interaction. “Dating my kids” - giving them individual time to invest in our relationship DATING MY WIFE  John: Focusing on my relationship with Jenny so that our relationship with our children is meaningful. We are intentional with our words and actions throughout our relationship.  How are we as AT Dads going to get there? John - Pulling on inspiration and examples from my ATDads/Men mentors like Jeremy, Tom Ford, Larry Cooper etc.  Call to action: “Dad can you look at this or are you too busy (with your phone)”...if you are hearing this look at why and respond appropriately. Make a plan for how you will hit your target. Watch AT Dads 2 ...

AT Dads are similar to dads in every other profession: great, average, or awful. Dads are one of the biggest influences in the life of a child for both good and bad. Meet our AT Dads Ed, what is the one question you want answered by the end of the episode? What were some of the biggest challenges you faced balancing being a father and an athletic trainer?  * Prioritize and set non-negotiables  Were you able to increase the amount of quality time throughout their childhood and adolescence? And if yes, how? * Friday Pizza Nights * Driving to school with altered schedules Joel? How understanding does your significant other need to be in order to find the balance? Larry’s wife was non-athletic so she does not fully understand the lifestyle. Larry used to hold a team meeting to discuss the week and expectations and schedule. Has the balance ever brought you to consider changing settings/roles in the profession? Jeremy: As an AT Dad, How do I foster a lifetime relationship with my children? Larry, let’s start back in the beginning. When did you meet your wife and marry? Wrestled in high school and in community college Left and went to Pitt Wanted to be an architect, then an accountant.  Realized he could not stay inside all day every day Larry’s uncle introduced him to athletic training Was a student teaching and doing field experience at Baldwin high school. One of the team members introduced him to his wife. Went to Sugarbowl with Pittsburgh and spent a lot of money on alcohol and she possibly saved his liver and his life. First Job in Arlington VA as a certified AT Got married over Thanksgiving in his first year as a teacher. His wife attended a lot of the games and they became friends with one of the coaches and his spouse. Moving 6 hours away from his parents brought him closer to his wife. Waited 5 years to have kids and spent a lot of time investing in each other. Larry’s wife got a job at Larry’s school so they got to work together. The first kid Sarah born in April 1990 The most rewarding job I have ever had was being a dad. They moved back to Pennsylvania and worked at a clinic.  He used this time to spend with family. Larry would take his daughter to pre-school daily and work on the counting skills while in the car. The Second Kid Molly was born in 1993 Another AT joined Larry on staff that allowed him some more time off Third time is the charm... Delaney was born in 1997 and they had 3 full-time ATs on staff at that time Larry was involved in the state association and coaching soccer..life was busy, but life was good. All 3 played Volleyball, cross country, soccer. The administration was supportive and family-oriented when his daughter was born.

An emerging setting is the non traditional roles, athletics, an Athletic Trainer is employed in. The Physician Practice Setting only makes up around 2% of Athletic Trainers currently. About Max: * He played football and graduated from Louisiana College* Worked in Alexandria, Louisianna for 2 years with an independent minor league team and as a physician extender* Went back to Lousianna college to work as an AT * Went back to school and got his masters at the University of Houston* Worked as the Baseball AT after graduating* Got hired by Memorial Hermann to work with the Sugarland Skeeters What do you need to work in the PPS?  DME - Durable Medical Equipment - need to be able to communicate how and why to use these devices Casting and splinting - both removal and application. Communicating the goals and expected outcomes. Physician Practice Value Model * Manual for what ATs do in this role What does max do in this emerging practice setting? * HPI* Exam* Initial assessment / DDx* Answer questions* Confer with Doctor* Plan* Imaging* HEP vs PT* RTP protocol* Orthos referrals* In-office procedures Pros and Cons of Physicians Practice Setting Pros * Work closely with doctors* Set schedule vs athletics* Had freedom to pick “regular AT” per diem* Wide variety of patients* Pediatric* Youth* Geriatric* A lot of concussions  Cons * Public’s lack of knowledge of an AT* Difficult/ rude patients* They are not there to see Max* A lot of concussions* A lot of the same stuff* neck/back CPT Codes * ICD vs CPT* 97110 Therapeutic Exercise for 15 minutes* Codes are not profession-specific Financial Impact * Worth and Value* Worth - the monetary cost of the service* Value - is the perceived worth* ATs can increase efficiency by performing the non-billable tasks and freeing up the Doc for the billable tasks.* Pecha et al study* Increase of $200-$1200 per day increase* In Max’s clinic study over 6 months, this value would have been about $16,000* Patient satisfaction survey Sugarland Skeeters experience: * He has been there since the inaugural season* Mostly veteran players trying to get back to affiliated ball Facebook video Contact Us Max Jeremy Financial Supporters

It is the ultimate biohack, but is BFR in adolescents a good idea? Devin Kielur DAT, LAT, ATC joins Kyle Kimbrell PT, MPT to discuss procedures, protocols, outcome measures...not just hey this is cool... Blood Flow Restriction: What contraindications are there? It is like a hybrid car - there are two ways two produce energy for movement With BFR you are limiting the ability to produce aerobic energy. Too much load can be problematic post-surgery Open wounds - no BFR * With any clotting issues, there should be a doctors clearance* Post-op is the target time* The first teaching was: wait until the wound was closed* With use, there has been less concern with waiting until the wound was closed. Hypertension Who is administering it? What methodology? - you need to have the means to measure the pressure Do you need it at all? * Encourage the behavior of “Is this going to outweigh the risk?” Athletes that do not like having their BP taken. Sickle cell and diabetes could cause problems. Clotting disorders ORS has trained over 8,000 people in the US alone. What is the main goal or purpose in using it? Devin likes to focus on good sleep, nutrition, hydration, and body awareness. How do you decide what load is used? We use an RPE scale Then use our rep scheme and by the end of the exercise, we need you to be exhausted. We found the analgesic side very beneficial - the cuffs seem to settle the pain down * Tissue flossing produces a similar effect on the ischemic area and reduces pain...but it should not be counted as occlusion training Do these goals change in adolescents? Reduce pain Limit muscle atrophy Repeated inflation and deflations of the cuffs change the hydration of the cell and trick the body into “feeling normal” * This would need to occur frequently Cuffs allow for movement and walking. This allows PTs to space out the sessions RPE -  Omnires scale “I do not want to make your pain worse, but do not tell me your pain.” I do not tell them what number I am looking for. They give me the number they feel fits 30/15/15/15 rep scheme with 30-second intervals ***use the patient as the guide*** Initial BFR goal: I want them to be mesmerized by it. This means I have set the load up and it seems really low at first. We need a continual push for growth to occur What procedures or policies would you recommend before beginning to use it. * Measure LOC* Prescribe pressure based on that number* Some companies have not* Document the number for full occlusion * Document the pressure for each session* Document the length of time the cuff was on* Document the load used* ...