The Sports Medicine Broadcast

Goal Setting can be awkward..."What do you mean what do I hope to get out of coming here today?" I am trying to have a more Patient-Centered Approach to Athletic Training Services, but I have not found a good way for me to ask the questions that the students understand. As a licensed AT and practicing PT Daria Oller knows the value of goal setting. She joins Ray Olivo and John Ciecko to try and make me less awkward...Good Luck. What is “patient goal setting in rehab”? Looking at objective measures * ROM* Strength parameters * Rep or weight count* Pain is an important measure - you can include subjective measures * Do not say “the patient will be better”* Use the SMART concept* Specific; Measurable; Attainable; Realistic; Time-Bound  Working on them together Recognizing them as a total person Continually listening How is it affecting the quality of life? What is not “patient goal setting in rehab”? If you take the patient out of the equation you are showing your ego… “I want the patient back playing in two weeks..” A big failure is removing the patient from the equation Having coaches dictate when an athlete or parent can return to play. Daria: LongCOVID - I want to get back to running, walking, dancing.  I am stubborn and would do them but then was just crashed out. How I have asked: “What is your goal for today?” “What are you hoping to get out of coming in today” “What are you wanting to hear after the evaluation?” Thoughts on asking these goal-setting questions? With kids, it may just be awkward because they are answering them for themselves the first time * There are therapy goals and then daily goals* They should still tie into what the overall goals are John: Relationship building * A majority of people will not know what their goals for the day are.* What is the real question?* Realistically you are talking about the history* “How are you doing today?”* “What have you learned today?”* You use those things as clinicians to help them define their goals. Remember the history and relationship with the kid and consider that as you are asking the “goal” question. * We do not use a lot of objective goals because we do not have to report it, but they can be useful in motivating. “How can I help you today?”Ray Olivo - on helping patients set goals for their healthcare Continue to ask questions to figure out who they are as a person rather than an injury “How can we work together to get you to your goal? Daria - the psychosocial is such a huge piece as well. Some goal-setting is defined by statements such as: “I want to get on the floor with my kids/ grandkids and play but the pain is preventing it.” Trying to document for insurance forces Daria to put all of the pieces together. * Are there stairs in your apartment* It sounds like you are saying this, this, and this.  How can we work together to get better? Example of “Goals” for athletes Ankle sprain

Rick Cox has used the Sports Medicine Broadcast on his path to leadership. Through John's Leadership series Rick has been able to strengthen and improve as a leader in Athletic Training and at home. An interesting fact: Rick was wearing his Sports Medicine Broadcast shirt when he dislocated his elbow rock climbing. “The world is always full of the sound of waves. The little fishes, abandoning themselves to the waves, dance and sing and play, but who knows the heart of the sea, a hundred feet down? Who knows the depth?” Why did you choose that line from Musashi? Well it illustrates a person's path to their given occupation or specialty. (Musashi)  We may see the outside but do we ever really know the true path that person took to get where they are now and more importantly, where they are going in the future?  Who is Rick?  * Year 3 at Suffolk Head AT* was satisfied for a while as an assistant* Realized that just being part of the staff was not going to be good enough, but he knew he needed to learn.* I am constantly questioning “what could I be doing better” What started Rick on his path to leadership?  * Had no experience * Did a lot of reflection and questioning himself* Makes small changes How did he do it? * A lot of reading, but not focusing on a single person* Simon Sinek* Ryan Holiday* Military tends to lend itself to leadership “Football (soccer) is life sped up” Life / Athletics and war are not the same thing but lessons can be learned You realize people have gone through some tough situations and you are not alone. What have been some of the leadership lessons you have realized?  There are examples everywhere The election is an example What are some of the universal truths you have learned? Not placing blame Honesty “Take the blame and give out credit” - Rick Cox In my path to leadership, building relationships has been one of my strengths and it has grown our influence with our athletes and coaches. Honesty with harshness When have you had to relearn the lessons? Year on we had a baseball player in the clinic and our Ortho wanted the athlete to go to the ER. We were busy and did not communicate with each other and the coach. The following day the baseball coach was pretty upset. Rick’s first instinct was to place blame, but before he spoke he remembered the lessons…”You are right, we messed this up” Have you seen improved relationships on your Path To Leadership? Not to the point of being “buds” but there have been improvements John busted his butt to build relationships, made progress but then for some reason it reset once the season was over It is like building a garden.  You have to replant each year What have been other benefits to your Path to Leadership? * I am still struggling with this at home and have not been able to transition this to home What has been the outcome?  * I have become a better clinician* I am better as a leader due to this.

Deanna, Kelsey and Jennifer, all Adopted ATs, share their stories to encourage others to compassion and action. Deanna, what is your Adopted AT story? Has a positive story Relationships with both of her biological parents Knew from birth that she was adopted but did not realize it until age 7 Searched for her Bio parents because of concerns with her health. Maternal Grandparents connected with her first Birth dad began connecting Since 2011 Deanna has been connected to all her bio and adopted family. Kelsey tell us about being adopted. “I am still related to my birth family” Born to a single mom and taken into foster care at the age of 4.  The CPS workers came to daycare and picked her up that day. Placed with aunts and uncles and began playing sports right away. Kelsey wanted to be a doctor and then got hurt as a freshman in high school and went to get treated by her Athletic Trainer. College would not have been an option if she had not been adopted. Jennifer share your Adopted AT story Adopted at birth in 1967 from a single mother Born Christmas day and was moved through foster homes to help hide the paper trail. Jennifer’s mom was a nurse and her dad was a teacher Mom took her to medical workshops once she showed an interest in the medical field. Her mom passed away in 2008 and her dad began searching for info on her bio mom. Has not connected with her bio parents. “Mamma Rheeling” has taken children into her home to unofficially foster and give them a safe place to stay. Her goddaughter lives with her now Adoption opens her up to compassion She has always known she was adopted. Speak to prospective adoptive parents. Jennifer - Being a parent is something that comes from your heart.  It is hard either biological or adoptive. If you want to make it work then you will find a way to. Deanna - I love God and in turn I love people. Kelsey - Fostering can be hard.  There will be trauma We would not be who we are today without someone stepping in. Watch Adopted ATs on Facebook https://www.facebook.com/980579115403772/videos/381220533183664 Contact us: Deanna - dmelancon@brortho.com Kelsey - grahamke@pryorschools.org Jennifer - jennifer.rheeling@gmail.com Jeremy - info@sportsmedicinebraodcast.com Sponsors

When I stepped into the "Head" Athletic Trainer role after 12 years here I thought I had earned leadership credibility. I had, it just did not go as smoothly as I assumed. Kevin Parker and John Ciecko discuss the book About Face by General Hackworth “Personal gifts like intellect or charisma help. But neither are required enough to be a leader. Physical appearance, poise, and outward self-confidence can be confused with leadership - for a time. I saw many new lieutenants arrive to battalions and fail to live up to the expectations their handsome, broad-shouldered look generated. Leaders walk a fine line between self-confidence and humility. People are born; leaders are made.”  - McChrystal “You can read all kinds of books you want and you can make all kinds of plans you want, but when you get out in the field, those books and those plans might not meet the eye of the situation you find there. So you just have to roll with it.” - Hackworth Kevin Parker joins again after last seasons Heroes as Leaders - https://sportsmedicinebroadcast.com/heroes-as-leaders/ 1. In discussing earned leadership, what is your favorite part of About Face? Kevin - when he took over the battalion in Vietnam and transformed them into a well-oiled fighting machine. Everyone wants to be the transformational leader that people write stories about...but this is where you miss the whole point of the book. Why a book about war to teach lessons in AT? * You take care of your people* ID problems and the people to handle those problems...then give them resources to deal with them. 2. Learning leadership - the wrong way “Grab at the coattails.” - p. 60 The Army was no more warriors than it was clerks trying to get the army out there. Rather than earned leadership people surrounded themselves with people that were going to agree and help support your decision. There was no one there to help prevent them from not making critical decisions. Hackworth’s willingness to accept clear honest feedback is ultimately the best for the organization. Be wary of an echo chamber “Figures don’t lie.” - p. 601 300% input of Ranger School...but that was because we went from 0 to 3… If you want to lie to get ahead you lose your leadership capital in the end. Hackworth was all about not sugarcoating things.  He wanted to clearly disseminate info up and down the chain in the same manner. You have to tailor your message to each person, but it’s the same message. To the athlete: the outside of your ankle hurts To the Doctor: his lateral malleolus is the affected area Rehab - do they know what they are doing and why...so you could walk away and they can continue. Don’t be that person “he is great at rehab but has terrible bedside manner...” DO YOUR ACTIONS MATCH WHAT YOU ARE SAYING? “Measuring up” p. 778 3. Learning leadership - Honesty and morality “Study of Vietnam” p. 614 The tactical know-how of senior officers has ended in a condition of not knowing how to fight but a bunch of corporate office managers. The soldiers are focused on advancing to the next lev...

Data collection is pretty easy now a days with all of the EMR options. We have plenty of data, but making it tell a story is different. Scott Mullett founder of AT Efficiency has crunched our numbers so we can show you what you can do with them. Daria Oller has researched epidemiology and wants to help turn those numbers into actionable items so that we can change the patterns of injury. How our Data Collection is answering Admin Questions. Dollar Value saved the district: * Ask your stakeholders what numbers they want to see.* The cost of injury for athletes that have gone to the hospital to receive some treatment is $709* Direct cost $168,000* Indirect cost $527,000* There is not a value or cost for them not participating as they are not getting paid to play* These costs are associated with parents' missed work and transporting kids to doctors.* Who are you saving money for?* In high school, it is parents, not the district.* Only 9.9% of injuries at the Penn state campers were sent to the hospital* Healthy Camp studies show 60% of injuries go to the doctor* ADD a “requires doctor visit” button* Document people who went to the ER and the outcomes.* This could be used to help establish a chain of care to get the kids the appropriate care they need.* They increased salary due to the research from the Penn State camps Treatments per week or day or month: * Average of 300 interactions per month Does your Data Collection show preventative practices? * Add an indicator saying “prevention” to improve data collection* This may take a few years of data to see if the numbers are going up and down.* You can also compare to national research* WE NEED an incoming freshman onboarding program to prevent injuries.* Educate the coaches* 7/12 football concussions were freshman* Maybe head impact monitoring could help How debilitating are the injuries The way our data collection was set up is hard to tell.- We do have a "Requires Surgery" button but do not always click it.- We do not have a graded severity scale- We will add the "Time Loss" button to our daily treatment logs A few questions we could not answer with our Data Collection * Costs of supplies per kid for strength and conditioning versus rehab* Other services provided* Athletic Training Facility hours/visits per week in healthy versus non-healthy athletes Tips and improvements from Scott and Daria Tips from Scott:  * Some of the gaps: narrow it down with preventative programs* Start small* Get little victories* Demonstrate the importance of staying healthy Tips from Daria: * Establish your goal(s).* Have clear operational definitions.* Have objective measures to quantify prevention strategies.* Look to the epidemiology literature.* Go beyond large numbers. * Consider if your documentation system is helping you capture the needed or desired variables. Watch instead on Facebook.com/SportsMedicineBroadcast https://www.facebook.com/sportsmedicinebroadcast/videos/407100297119732/ Contact Us Daria Oller

Conflict Resolution is a learned skill. John Ciecko was scared of conflict. By leading the leadership series here on the SMB we have walked through a lot and conflict resolution is a big part of leadership. Patrick Ohaver was a supervisor for an AT outreach program and had a fair share of conflict to resolve. This discussion is based off an article by Dr. Jordan B Peterson about becoming a peacemaker Facts are facts. Opinions about the facts differ. It is therefore the job of the peacemaker to bridge the gap between opinions, and in that manner, bring about reconciliation. The job of the peacemaker is to establish an accord that allows the facts themselves to become a matter of agreement. To do that, however, the peacemaker has to be able to see the facts that lead to peace. The peacemaker threatens, with the threat of peace, because peace means change.”- Jordan Peterson https://images.theconversation.com/files/138826/original/image-20160922-22533-1a7n230.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip How can the peacemaker bridge sides of an argument? How can the facts themselves differ? And if they do differ, how can the gap between men who have adopted antagonistic stances towards one another be bridged? They must want peace, more than security, more than charisma. That means that the peacemaker must be able to sell them something more valuable than victory, more valuable than success. That means the peacemaker must know what it is, that is more valuable than victory. It is for this reason that the peacemaker must be a man of the uncharted seas.” When we find ourselves in conflict how can we sift through the facts? John’s situation: Coach was asking questions and seemed to be questioning him and how the situation was handled. John allowed his opinion of the facts to be more important. “Relax” usually amplifies the conflict Amygdala hijacking - emotions get the thought process all jacked up Is it better to rush or be patient with an opinion or judgement? “Everyone must therefore have a voice.  The peacemaker, however, must even listen to the damned. He does not know what the facts are, and even the damned might therefore have something valuable to say.  When the facts themselves are in dispute, however, there is nothing left but patience. The invisible becomes visible of its own accord, in accordance with its own frame of time, and there is no pushing when the direction to push cannot be established.”  Everything in athletics has to be done right now...so we are in conflict with peacemaking situations as we have no patience to work with. We do not have to fix it now, we can wait for a day. The more you are able to pull the facts out the more you can heal. The facts give it a direction When it comes to resolution is speed over vision, or vision over speed more important?   “Peace must therefore be a journey – and a journey to an unspecified destination. The peacemaker is a guide, in a country whose topography remains uncertain. As a guide, he has to be going somewhere – but where? Speed is a virtue in the local environment. If the direction is uncertain, however, then speed may be a vice.” Most of the time it is vision over the speed Clifton’s strength finder -

Muriel, Wyatt, Marisha, Jasmine and Alyssa are Native American Athletic Trainers. They join John Ciecko and Jeremy Jackson to teach about their background, stories, and experiences. Muriel's Native American Background: I attended several undergraduate programs in my journey. I was a non-traditional student who returned to pursue my undergraduate in 2009 at the University of New Mexico-Gallup branch campus. After I completed my AA-Assoc. of Business Administration, I transferred to the main campus in Albuquerque, NM in 2013. There I completed my BS in Athletic Training in May of 2018 with a minor in Business Administration. During my undergraduate journey, I managed to work a full-time job, have my two boys who are now 9 and 15 years old, and take care of my family of four. It was certainly difficult trying to juggle being "Mom, Wife, Student AT" all at the same time and commuting weekly back and forth to home, but I knew ever since I was about six or seven years old Athletic Training was what I wanted to do, although at the time I had no idea the profession existed Alyssa's background and schooling My last two years of high school introduced me to my first Athletic Trainer (JD Burgess). A late tour senior year to Fort Lewis College introduced me to Athletic Training/Sports Medicine as a major so I immediately applied and began my education at Fort Lewis College in Durango, CO. I graduated in 2007 and was able to pursue my Masters at A.T. Still University in Mesa, AZ. I graduated in 2009 and went back to Durango to work at the Head AT at Durango High School as a part of Mercy Regional Medical Center. I stayed there until 2015 when my husband and I took a year off to travel and move back to Hopi. After that I set up an AT program at the local high school.  There have been a lot of road blocks Marisha's Life as a Native American Marisha Little, LAT, ATC currently works as the graduate assistant to the University of West Florida Athletic Training Program and as a PRN athletic trainer in the Sports Medicine Outreach department of Andrews Institute. She graduated with her Bachelor of Science in Athletic Training from the University of West Florida and is currently working on her Master of Science in Health Promotion. She is the recipient of the Bobby Gunn Award from the Southeast Athletic Training Association, the Legacy Scholarship of the Athletic Trainers Association of Florida, and the Memorial Scholarship of the Southeast Athletic Training Association. Marisha served on the National Athletic Trainers Association Student Leadership Committee from 2018-2019 and currently serves on the Public Relations and Marketing Committee of the Athletic Trainers Association of Florida. A little about Wyatt Wyatt's first exposure to AT was in undergrad as a potential PT student.  Changed paths when he was applying for PT school. Masters of public health from GWU He left the tribe to get the experience off the reservation to be able to get more perspective. Currently back on the reservation as a wellness program specialist for Native Americans. Jasmine's Story: Descendent of trail of tears I come from a long line of strong, resilient, compassionate, indigenous women, so it was only natural that I want to help others.  When I was in high school, at Culver City High School, we had a sports medicine program and I was introduced to the field. I went on to get my AA in Kinesiology at El Camino College and then graduated in 2016 from Azusa Pacific University with my BA in Athletic Training.

Shauna Ericksen is doing her Ph.D. work on the Psychological Risk factors that contribute to injury. Eli Kassab joins the Sports Medicine Broadcast again as we discus mental health. Shauna, you are quite active and adventurous, what are some of the ways you stay active? I was moving from Oregon to Montreal and decided to make a mountain biking trip out of the journey. Moab is legendary and so we decided to do it. Coming down off a boulder I got off balance and landed on a tree hanging over the cliff. Sprained my knee in the process. Did a self-evaluation and realized I needed to ride down the mountain.  I had to cut the trip short, luckily I was headed to work an AT event where my colleagues evaluate the injured knee. What got you into the Psychological Risk Factors of injury prevention? Shauna joined a free course online to grow her mindfulness and improve happiness. Shauna had been asked to deliver a mindfulness talk to her colleagues. It is all about the history of our stressors (upbringing, previous injuries, health, nutrition) Has the mindfulness translated to your practice? It helps in her coaching and one on one strength training. It allows her to pick up on emotion and open up the dialogue. Allows them to critically think about and process the stresses “How is work going at home” “Are your parents able to help?”  “I traveled around with a hypnotist for a summer” Halloween at the theme park -> went to a hypnotist show Shauna was the volunteer Mom ordered some hypnotist CDs Mom offered Shauna’s assistance Then traveled with her for a summer. She may have been one of the biggest influences in the career choice and style of treating athletes with a mental IQ. Making it commonplace to talk about emotions was huge for me as a practitioner “Why can you not just tell me something is wrong” - coaches treat them differently when they are injured or hurt physically or emotionally. I have seen athletes go from 0-100 in their head really quick...oh no, I’ll never play again… Let’s not skip straight to the end of the book and read chapters 1, 2, 3. We need to use our tools to help them focus on the here and now. We have to be cautious with our playful banter and acknowledge their perceptions. Encourage them to be open and honest with their emotions about the injury. How are you using that in your practice as an Athletic Trainer? It is extremely important for us as ATs to look at mindfulness. It is not everyone’s strong suit but we can learn to be emotionally mindful Teach them to express their factors without being judgemental. We need to practice mindfulness and good mental health practices. Discuss some of the more interesting/shocking finds  Last year I wrote a critically appraised paper and submitted it about the psychological risk factors. 4 constructs and how they correlate to injury outcomes.

If John Ciecko was not leading up the chain when COVID hit Bloomfield Hills High School would likely not be back to sports as safely or quickly as they were. Patrick Ohaver joins John in discussing how we can lead up the chain even when it is not easy. Image from: https://www.youtube.com/watch?v=51ZxYMZEKbw Due to COVID a lot of things have changed.  What is the current state of Sports where you are? Off-season conditioning in May / June Onsite training forced the Sports Med Staff to shift to screening protocols.  Some days were long but we screened over 3,000 athletes. John reached out to his contacts, Kurt Andrews at KC Sporting, and found what they were doing that worked really well. August 12 was the start date for football The state decided to start in phase 2 of the NFHS modified plan Pretty much everyone was practicing outside. They were able to block off parts of campus and then adjust as needed to create a more secure setting for them. The state continues to change the requirements. Lots of long days re-evaluating Math is confusing: 10% capacity up to a cap, then you divide that by 6 feet Swim team practiced outdoors. They decided to cancel football for the fall and allowed some spring sports...but Spring sports in March in Michigan are a nightmare HOW CAN WE PROVIDE AN EQUITABLE EXPERIENCE FOR ALL SPORTS? Governor issued another executive order. Patrick Ohaver: July they were in stage 4 of 5 Indiana never planned to postpone football His school decided to be more conservative and practiced outside. Soccer played two games then started playoffs. Individual school boards were left to plan. Discuss the conversations you were involved in once the talks started happening. Jamie Woodall’s document for the UIL set the standard for a lot of places Relationship building is key - John has been building them for years He has a group text with the principal, school board president and superintendent...that is a position of influence. The school shifted to two cohorts: Monday/Tuesday is group 1 Thursday/Friday was group 2 Cleaning was Wednesday Saturday Where have you been able to lead up the chain? Patrick - I will work by the hour and we can compact all of the practices into a 4-hour window each day. School covered his liability insurance Then he switched hospital systems to keep care flowing without interruption. Pre-planning and “medical timeout” helped prevent a catastrophe John - consider your team in the building… Your custodial staff needs to have a seat at the table too. Involve the leaders of every group that is affected. Get the team doctor involved in how care will change. What does an event venue change look like? My first internship in college taught me about making friends with secretaries and our cus...

The AT Wolfpack was born out of a need to communicate and commiserate. The founding members join the SMB to discuss the origin, what is has become, and where they think it might grow into. What’s the deal with these late-night Wolfpack zoom calls? With fewer people we get a little deeper in our feelings...or maybe just discussing the state of AT Someone joins today, what can they expect to cover tonight? In the word of Josh Dawsey - “Zooms are like a box of chocolates, you never know what you are gonna get” Paul - we may start talking about ankle sprains, jump to Bar-B-Que then to concussions on to whiskey, then back to ankle sprains.  And they are all related somehow. How did this start? Thomas and Ed were meeting with people on ATTalks and then COVID sent Tom home without the internet. They needed something to get them together and then... Ed sent out a tweet to see who would be interested and 40+ people responded. What have been the benefits? Connection - lots of people have connected as they have traveled with teams, for personal reasons or related to moves. We are building a network of ATs whose main connection is friendship. It is a safe space.  Some ATs have jumped in, taken the mic for a rant for 10 minutes, ended up in tears, received some connection and virtual hugs, and then been able to move on. Jumping into a group of 100+ ATs can be intimidating.  Speak to that person Sit back and watch, or just jump right in. Plenty of people sit and listen and watch until they have something to say or add. Nobody is looking for perfection or a professional presentation. Jeremy is an example: * Jumped on a call after a run and left the camera on...shirtless* Used thy massage gun on one of the kids with only the mic on and said “you can use this on my feet next” then you hear the massage gun.* Laying on the couch with the baby shirtless for the skin to skin contact. I set the bar pretty low...of course so that others will feel welcome..”At least I wasn’t shirtless like Jeremy…” What have you struggled with in growing or maintaining it? Getting back to work has made it slightly more difficult as Tuesday and Thursday nights tend to be game nights for ATs. There is not a structure or leader, just the more active members help to keep it regulated. Where is it headed? To Orlando for NATA 2021 then who knows. https://www.facebook.com/sportsmedicinebroadcast/videos/2704865483068065/ Contact Us AshTapesAnkles Paul Rupp - https://twitter.com/OaktonHSATP Thomas - https://twitter.com/thomasjbarkoski Ed - https://twitter.com/EdWozATC Jeremy - MrJeremyJackson on FB and Twitter SMB Supporters

For Dr. Natalie, Running Medicine came from a passion for running, experience as a Physical Therapist, and a furlough during COVID. Dr. Natalie Niemczyk is an accomplished runner: finishing race distances in running and triathlon events including 5ks, 10ks, Half Marathons, Marathons, Sprint Triathlons, Olympic-Distance Triathlons, and Half and Full Ironmans over the past 11 years! Additionally, she is a Certified Strength and Conditioning Specialist, Certified Running Technique Specialist, as well as a Certified Canine Rehab Practitioner and RRCA Run Coach. What made you decide to get into running medicine? * Passion of mine* Experience within the field as a runner* Wanted to channel my focus on one specialty* Value in finding specialists* Building knowledge in one topic vs. generalized practitioner How much does being a practitioner of running help your ability to treat patients? It lays the whole foundation “Running a marathon, I know that pain at mile 24” "I had a tonsillectomy at age 8, then a c-section...I have been healthy. It has taken over a year for me to get back to normal after that surgery. “It’s weird, but I kinda like getting hurt so I can relate to what they are feeling” - Todd Sabol Todd's coupon code for the WHOOP band What courses do you recommend to healthcare professionals looking to enhance their ability to treat runners? * The Science of Running Medicine: University of Michigan* Harvard Sports Medicine: Running Medicine* CSM: Physical Therapists Expo* POSE Method Course: RTS Certification* Medbridge Courses* Bryan Heiderscheit, Irene Davis, Richard Willy, Chris Powers* Mountain Land Running Summit* Strength and Conditioning Specialty Common misconceptions and technique mistakes in runners. * There’s one form out there that is universal and works for everyone! Everyone is different!!!* Forefoot vs. Heel Strikers * 180 cadence myth What are your goals for Revolution Running Physical Therapy in five years? So excited to have a one-stop-shop for runners where they can receive physical therapy, injury prevention education, gait analysis and movement assessments and coaching all for runners, all under one roof! I also want to welcome runners at any level, including recreational runners, beginners, pregnant runners and elite.  5 years: Have another therapist on board with the same passion, a rev running sponsored team, become better known and trusted within the community and be runners go to, get my hand into some running research! Embrace Race: elaborate on this event and who benefits from it EmbraceRace is an organization that was created by parents of all different backgrounds and nationalities, and they provide webinars, articles, and resources for parents to help raise children that are inclusive, understanding, and brave about race. My buddy Jen from

Dr. Zachary Winkleman is leading his students to provide Athletic Training services from a Patient-Centered Approach. Consider the Social Support system - Hey do you want me to talk to your family...or do you have someone you want me to call. By doing everything for the patients you are enabling them and preventing them from owning their own health care. Walk them through the process instead of doing it for them. Do your patients understand what you are saying...or handing them? The average reading level of America is 6th grade….So all of our forms need to be revised to that reading level An affluent suburb may not appear to have health literacy issues, but you need to look at the support system and handle this individually. Consent and assent are both important. Set and agree upon goals in your patient centered approach SMART goals - what do want to get out of the appointment today? Sometimes they only want to know they are OK...not how to get better. You can give them options. 1 - do exactly what I say 2 - part of what I say 3 - none of what I say Your choice but the outcomes will be...for each Coordination - our job is coordinating NOT EXECUTING Making sure patients feel powerful and not powerless. Fear and anxiety may not be more prevalent, but they are more willing to talk about it. PHq9 and screen patients is a good tool Communicate - What do you normally ask during your evaluation. 5 step interview - patient centered approach Step One * Welcome the patient* Use their name* Introduce yourself and ID your role* Ensure patient readiness* Remove barriers to communication (sit down) - removes the powerful struggle* Ensure comfort and put the patient at ease* A patient had been sexually assaulted in the prayer pose...therefore any sort of rehab in that pose triggered her. Step Two * Indicate time available* Forecast what you would like to happen during the visit* Obtain list of all issues the patient wants to discuss* Summarize and finalize Step 3 * Start with open-ended questions* Use non-focused skills (silence and non-verbal encouragement) Step 4 * Echo the patient’s words back* Request* Elicit emotional story (allow them to tell you their story Step 5 * Summarize* Check accuracy* Indicate the style* Ask permission to touch The Golden rule does not really work...you are not the patient, their experiences are not yours. Shift your mindset one piece at a time.  Choose one thing to implement in your practice. 8% of athletes believe the AT could not make a health status decision without the coach. Twitter question: Talk with parent and determine the goal and reasoning Educate about the bigger picture Discuss with patient Do not put yourself on opposite teams as the patient/parent. When we teach people  A common question we ask is “do you have any questi...

Orthopedic Trauma is one of the newer settings an AT can work while being employed in the physicians practice setting. Daniel Ruedeman joins Sandy Harris and me to discuss what Orthopedic Trauma is and how Daniel is setting the stage for AT growth in the field Daniel, where are you working right now? University of Colorado/ UC Health Orthopedic Trauma Limb restoration - Patients with non-union fractures Infections Prevent amputations Osseointegration - interactive way to help amputees with their artificial limbs Doing AT for about 20 years Daniel has worked in the PT, college and secondary setting “I do not want patients to come in and have just a doctor appointment. I want it to be a relationship and a positive experience.” He was the first one hired in the hospital setting at UC Health When they first hired him they did not know what his role was and he was able to build that from the ground up What was the transition like from the traditional setting? Started with him shadowing the physician That lead to a team focused approach so nursing, MA, AT, Doc all communicating the same thing to patients Being the pilot AT Daniel was able to set the stage for bringing on an AT and the office manager connected them. Departments like Oncology was asking how they could get an AT to work with them. He was also an office manager at a private practice between clinical sites and his current setting. What does a week look like in the Orthopedic Trauma center? Works 4/10s 40 patients between 7-2 Taking brief history Allows the med students to do the exams Preps the patient for what to expect Schedule next appointments Scheduling and setting up PT Home exercise programs Off Tuesday Wednesday is half office time / half clinic Thursday/Friday are full of clinic time Trauma doesn’t stop during COVID Tell us more about your Orthopedic Trauma job setting They use EPIC for the EMR. Daniel feels the open line of communication is important. The whole team is important. He touches base with each of his professionals almost daily What are you seeing in Orthopedic Trauma? Sees a lot of tibial plateau fractures Do not do spine or hand stuff “Any student that does a rotation or internship with me, I want them to Look at the x-ray and understand the injuries, but also think through the process of how the injury happened.” What do you not love about Orthopedic Trauma? Constantly building relationships Life balance has become a key focus

What does AT education look like now from a student's perspective? What changes both positive and negative have come from the pandemic? World Federation of Athletic Training and Therapy (WFATT) has put together a global group of students to share their take on on AT Education post COVID-19. Tell us about you Kate - should be doing her internship at the University of Pitt but is at home in Dublin Possible masters in physio or research in AT Madie - St. Louis University in her 5th and final year Dream Job - D1 Sports in US Nick Lichti - Manitoba Canada Hockey guy preferably with a pro hockey team Anat - Israel Entering her final year as part of the first class of Sports Medicine in Tel Aviv What has been challenging about the transitions associated with AT Education and COVID-19? Anat - nobody expected it Hard to pay attention at home Difficult to test on different bodies without risking exposure Taught her to be a self-learner Learned to be more sophisticated in the way she learns Maddie - Went home for Spring Break and was not prepared for learning home Wifi Issues Learned the back over zoom Had to get help from her family for her practical skills Studying at home with 5 other people in the house Kate - Gained independence learning Looking forward to getting back to face to face. Nick - U of W hands-on exams have been postponed without an official date for completion… It is basically a waiting game right now Masks at your placements make communication harder.  It hides expressions. Gloves for all assessments can make it harder to palpate an area. Lost a lot of jobs and volunteer opportunities due to COVID - very frustrating. What do the leaders in AT education need to know from YOU? Maddie - * Every expectation and experience...throw it ou the window.  * Seek feedback from students* Revisit a lot of topics* Be flexible* Take your time with students* Students need to extend grace as well Kate - * They know we need practical experience and are patient.* Keep in mind each student will adat differently Anat - * Do not be so hard on yourself* Academics in general should take advantage of this opportunity to improve teaching and learning skills both in-person and virtual. Nick - * Professors have been role models during this time.* Been available for questions and transparent “We are still very eager to learn, even virtually”- Nick Lichti * Try to replicate the structure of a typical AT class into the virtual format.* Do demos over zoom rather than just talking over lecture slides How have you seen a change in roles in AT in your area? Kate: AT is still unheard of and fighting for a...

Todd Sabol has been working to gain Mental Clarity since he suffered a weight lifting injury about 18 months ago. Fellow AT and host of The Eli Kassab Experience - Eli Kassab guest hosts this podcast and discusses some of his mental health struggles leading him to leave one position as an AT. What is Mental Clarity to You? Not feeling foggy, scattered, busy, angry, confused. Todd, what mentally got you? 4 am workout crew Lack of sleep (habitual) Beats and Barbells 315 front squat did one rep, then passed out mid rep on the second one Felt like a heart attack at softball practice one day. Felt like his heart was beating out of his chest Was driving a couple of hours each day Would drive to the gym, sit in his car and then drive home because he could not mentally gear himself up to walk in Cory Carpenter recommended Todd to do the “75 hard” with him * Follow a diet* Gallon of water* No cheat meals* 2 x 45-minute workouts* Take a progress picture daily Before the injury, I thought I was tough mentally Wake up early, train really hard, get back for grad school class, self-help podcasts and books… I was killing it But the one injury caused the whole deck of cards to fall. "YOU ARE BUILDING TRUST WITH YOURSELF"Todd Sabol on completing "75 hard" Constant building blocks...but that is how every building is built...from the bottom up with a solid foundation He had some hecklers along the way, but that did not phase him Running with Mindfulness Walking through the snow talking to himself audibly as he was following the book. Todd believes in the law of attraction - put kindness out and you will get that back eventually. How did the long drives impact Mental Clarity -  Fast food Was this how you were escaping? Burying himself in work and working out were his other two escapes. How does your mental clarity affect our relationships? Sharing your journey is healing For you and your listener I pour all of myself into my patient, my students, or clients. I used this as a way to take care of them instead of myself. FIND WHAT WORKS FOR YOU!!! Pick something and go with it, and if it does not work, give it another shot and then alter your path as needed, but do not look for the quick fix. Where are you at now compared to where you started? It is really hard to compare since I was at that low point for most of my life. “Hey Todd, you did X,Y,Z in spite of that thing” Before grad school, he went to a therapist who said he should not go to grad school because of his ADHD.