The Sports Medicine Broadcast

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

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

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

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

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

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

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

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

Tyler Knight shares some Soccer Specific Return To Play or RTP tips and tricks. With nearly a decade of soccer experience, he has seen a lot of growth in sport-specific rehab plans. What is the least soccer specific rehab exercise you have seen? * Almost everything we do…discuss the importance of understanding the ‘why’ of what we do, as well as never forgetting components of movement. * Isometrics because the patient can’t perform much more  * Eccentrics once able * Stretch-shortening cycle * Unloaded → supported → unsupported “Train movement not muscles” What do we need to consider in on-field RTP? * In order to get to the field, you have to get out of the Athletic Training room first.  * Treat the person, not the athlete or the injury (reference all that people have going on in their lives). Ron Corson-ism * Good communication, setting expectations, and appropriate planning are MUSTs. * Individualization (based on person, position, and injury) * Consider our two biggest protective capacities and build upon those early: strength and endurance * Programming based upon working zones (importance of ESD) * Quantifying internal vs. external load * To do that, we have a few basic rules at Charlotte FC: 1. Create a safe environment. 2. Don’t hurt the person. 3. Be aggressive without breaking rules 1 and 2. * KPIs to provide direction and accountability to the process * Additional principles of rehab to accelerate and enhance what we do on the field: * Move early, move often. * Highlight BFR and isometrics. * Don’t mess it up. * Consider tissue healing times. * Periodize manual therapies, incorporate things the person believes in * Break down the phases of healing (acute, subacute, remodeling), as well as the places of healing: table, Athletic Training room, gym, field, and everything in between. * Create time for mental or psychological recovery * KPIs * Mobility * Stability * Function * Power * On-Field * Consider position, individual needs, team tactics, and demands of the sport…and MAKE IT FUN * Players have the ball only 3% of the time, a good reason to emphasize the incorporation of the ball and fitness/drill exercises that place focus on getting into the right spaces * In 2019/2020 EPL season, the highest average number of passes per game was 688 (Man City; approx 62. per player) and the least was Burnley at 333 (approx. 30 per player). * Paul Bradley research * Consider control - chaos continuum * Reverse engineer and use the prospective loading document * When we have elevated AC ratios, did the majority of that come from a more controlled environment or chaotic environment * By using fatigue,

MOBO is a single myofascial release tool designed and created by Dr. Christie Powell. Her inventor story is different than the ones we have heard previously. MOBO is only offered in blue…why blue? I have scaled back the company and product offering We got a huge verbal order before COVID that wanted blue. Happy accident since we had to order 10,000 units How did you get started? As a smaller person performing myofascial release on large D1 athletes. I kept having to McGyver things together to teach the patients how to do the work at home. At a huge CrossFit event, the contestants all had 10+ devices and that was a huge inspiration. I wanted one device that could replace most of those. I reached out to an engineering friend and we worked together. You mentioned getting funding for MOBO…can you share? It is so complicated, I am a PT and I just want something for my patients. We had to create CAD drawings Film videos Pay someone to listen to your idea The very first prototype was $1000 to produce. We connected with a producer that worked out in our gym and he was our first funder. $10,000 seemed like so much but that went through really quickly He hooked us up with the filming studio. We launched a Kickstarter to produce about 1000 units. All my friends were product models and my gym was always the setting for photo shoots. We did a “Meet and Greet” and the people donated about $20,000 which allowed us to make our first order. We had trouble sourcing the materials in the US so we had a big process of finding the materials that were responsible. We got another couple hundred thousand dollars from customers.  This was a personal loan-type investment. I had to bring on some business partners and there was much more stress. So much time lapsed between a problem and a solution because they were being made overseas. The last round of funding happened right at COVID.  We had put in all the work and fine-tuned the process. We took away all of the moving parts to limit the possible breakages. We simplified the tool, but of course, that costs money and time. We got 1.5 million dollars from one investor and that was in January 2020…right before COVID. We now have to spend all this time filming and creating a website and an online shop. Discuss the MOBO licensing deal I felt like I was letting my baby leave the house. Our deal was with DICK’S Sporting Goods. We actually shared their manufacturing facility and they felt our tool would help them reach the adventure sports crowd. We had to negotiate so many things to produce the product cheaper. We knew there were certain areas we could not compromise on certain components. What would you do differently if you were starting over? Everything got me to where I am now with the product and c...

Alex Bray is a young professional that grew up with social media and smartphones. She uses it to make an impact in her sports medicine practice. Why do you use social media for sports medicine? Started in grad school as a way to network, turned into a way to advocate for our profession & athletes, share things I struggle with as an AT to help others, and learn from other ATs in areas that I’m weaker in.  What have you taken from Social Media? It can be helpful or hurtful. I’ve created some friendships because of it, but I also see toxic, negative things in the AT Social Media world every day. I tend to scroll past those & ignore them as best I can.  How has it helped? I’ve learned things to help my athletes (@ Zach’s incredible shin splint program, patellar tendon treatments, etc), learned about jobs, and gotten involved more in my state association because of it. Has it been harmful or negative for you at all? The most “harmful” thing for me is more of my personal anxiety struggles. I feel like I’m a part of the first generation that ever grew up with social media and playing competitive sports we always hear “Everyone is watching what you post,” so I tend to overthink if my content is portraying what I want to, or if someone will take it out of context. When I start to overthink things and feel like my mental health is struggling, I usually delete the apps for a while. How do you manage Twitter? I try to go by the rule I grew up with using social media: Don’t post anything you wouldn’t want your grandma to see! There are certain hot takes that I avoid sharing opinions on. I also tend to ignore any of the toxic, negative comments/accounts. Which platforms do you use and why? Twitter - a huge opportunity to network with other ATs, learn from other ATs, and also share things with parents/athletes that they may not learn otherwise.  Facebook - From an AT perspective, mainly to connect with my athletes’ parents/encourage other parents to understand what ATs do for their kids. For example, I had the opportunity to go to the state capitol this year, so of course I’m going to share that and make sure parents see ATs do so much more than stand on the sidelines! TikTok- I use TikTok in waves. I’ll download it, post some content, and then get anxious with it (afraid something is taken out of context for example) and delete it for a while. I try to take “social media breaks” anytime I start to feel like they’re affecting my mental health. What has your HR or legal department given you for guidelines? Probably more than I can remember. Honestly, living by the “don’t post anything you don’t want your grandma to see” is my general guideline for social media use. I definitely have certain opinions that are different than Select Physical Therapy, but I try to disclose that my opinions are my own, not the company I work for.  What connections have you made through social media? Friendships/relationships more than anything! Call to action: Use social media to share positive things about the profession / where it’s going / what we do. Feeding into the toxic negativity spiral doesn’t help anyone! Use that same energy to reach out to people who can make a difference at the state and national levels!

Andrea Kovalsky uses Twitter a lot as an Athletic Trainer. Why do you use social media for sports medicine? * I was professionally socialized by Boomer ATs, so I’m a bit old school. But working on a relatively nontraditional DAT, I’ve learned that we have to embrace change and make it work for us before we get left behind. If social media is how future generations consume information and interact with the world, then it has to be a part of how we advocate and move the profession forward. Otherwise, we’re losing out on engaging with a huge audience.   * There is just so much information out there, it’s impossible to read & digest everything coming out of sports medicine today. I like the short snippets that social media provides so that I can decide whether I want to read the whole article/study later * Journal subscriptions are expensive! I’m completing a DAT at FIU right now, but I joke that I’m only there for access to the university’s library databases (PS: If we want preceptors to encourage clinical students to practice EBP, we must give preceptors access to the university library databases as a form of payment for the work they do!) What have you taken from Social Media? * Like the disclosure slide that no one pays attention to in CEU presentations: my opinions may not be those of my employer, and use this information with caution!  * Take everything with a grain of salt: Who is the speaker? What’s their background? What’s their motivation for posting this? Are they blowing off steam, subtweeting someone, or looking for genuine engagement? If they are looking to engage, are they open to learning, or will any discourse make them dig in further? Know when to disengage. * We have such a diverse community on #ATtwitter. There are a lot of positives as well as some challenges. It’s also helpful to bring those connections to the real world, though. The life we present online is often much rosier than real life, but real life is where things get done. Advocating on social media and living it are two different things. I try to be the same person online as off. How has it helped? * Probably wouldn’t have survived lockdown without finding AT friends online * Learning new clinical techniques, hearing about research before it’s published * Another avenue to get questions answered & reach people in power * Got our new practice act language passed! * Helps me survive as a solo AT: venting, troubleshooting, connecting with others who get my jokes Has it been harmful or negative for you at all? * There will always be trolls and misinterpretation of context, which is how messages get blown out of proportion * Probably mildly addicted, but who isn’t? (It’s also kinda my job to be on socials, so I use that excuse) How do you manage Twitter? * Tweetdeck is a lifesaver, but there are dozens of paid and free social media managing apps out there * Add relevant images as much as possible, it boosts your visibility * Use a link-shortener like bit.ly when you reach a character limit * Don’t just post a link to other content, post a quote or short explanation * Ask a question,

TikTok always ended up showing me stuff I did not want to see, so I deleted the app. Meanwhile, KP, AKA Kyle Parkison, is amassing quite a following and positively impacting the world using TikTok. Why do you use social media for sports medicine? Started it for fun and advocacy A lot of students and people did not know All of the things we do as Athletic Trainers. TikTok has a lot more random followers TikTok would be the only one if I had to choose. Those videos are about ten seconds to a minute long. A lot of people know and follow me… It is kinda weird I am outgoing but people outside of my circle following and recognizing me was just weird. What have you taken from Social Media I have been using it for about 6 years. I have taken a  lot of ideas from others How has it helped? Free stuff for the kids Advocacy Has it been harmful or negative for you at all? My wife and I have had a few conversations about it, but she actually is pretty helpful in making videos. How do you manage a video per day? Some are 1.5 hours  Some are 30 seconds Some are 6 seconds I keep the app open while recording the long videos and just lock the phone until it is time to record again. Which platforms do you use and why? I use: Twitter IG TikTok Facebook YouTube shorts TikTok is easily my favorite What has your HR or legal department given you for guidelines? Our admin team was 100% supportive None of them really knew what is going to happen Make sure you ask and keep open communication. I ask parents before posting ones with student-athletes What connections have you made through social media? Several brands have sent me things or given me discounts for making videos. Lots of student-athletes in the surrounding area have connected with me. KP - Kyle Parkison Twitter: https://twitter.com/MonroeCentralAT IG: https://www.instagram.com/monroecentralat/ TikTok: @MonroeCentralAT

Growth Plate Injuries are hard to identify unless you know what to look for. Dr. Lindsay Crawford specializes in Pediatric Orthopedics and shares some of her wisdom with the Sports Medicine Broadcast. The location of the pain is an indicator Is it at the joint itself or on the bone adjacent? Dr. Crawford likes to have xrays before doing a lot of special tests on athletes with swelling How can they verbalize? Take your time Look all around Break it down and say words they understand Use your normal system for evaluating Give them a distraction - maybe close their eyes I try to not clue them into what I am looking at. Little league elbow - what tips do you have? Year-round baseball is huge in the southern states where you can play all year long. You need to have a feel for the parents and kid and know if you can say rest or not throw anything at all other than in a life-threatening situation. Return to throwing instructions are complex and have a lot of steps. After they begin their program require them to come back into the clinic to re-evaluate Speak to the Mental Health of the kids that get shut down. Know what the patient's goal is, and form a plan that works and they can follow. Do we have an end point or goal The curveball and growth plate injuries? If there was no pain, and then they started throwing the curve ball and pain started, we need to cut out the curve. If you have mysterious knee pain then check the hip. Growing pains are real Some kids have growing pains 3-6-year-olds, typically have pain in their calf or knee They can not relate it to any activity @UTPedsOrtho on TikTok and Instagram Contact Us:

Mental Health Coordination is preparation for when a mental health crisis occurs. Amanda Groller and Bubba Wilson discuss things available to Athletic Trainers when they need help. ATsCare - Professionals responding to professionals 2016 is when it became official How did it start -  A perfect storm of events. Jim Thornton had been trained in CISM as an EMT and reached out to him after a wrestler died. This sparked some conversations and got the train moving. Many people separate mental health and physical health, but really it is just health. This statement could help destigmatize mental health It only makes sense for ATs to have their own CISM tools Military people want to hear from people in the military, someone who knows their situation. Having conversations about CISM teams is really important.  It gets the ball rolling and allows us to call in support to continue to do the job that we do. Self-care is emptying your bucket and escaping for a minute. Compassion fatigue is a problem. You need to debrief the debriefer Dr. Jessica Yellen went through a Trauma Informed Yoga Course.  This course was meant for the caregivers to release their burdens.   What techniques can you share? We use this approach: "What has happened to you?" rather than "What is wrong with you?" Psychological first aid Suicide prevention training - get them to the next step alive Stay within your scope, but know the resources available. Help simplify the process for the ones struggling.  REMOVE THE RED TAPE QPR training is a good option Know when to refer “When you do not know what you do not know you become dangerous” - Dr. Josh Yellen We are mandatory reporters, but we also have a duty to report people who are struggling. You are not going to get in trouble for calling 911, you are going to get in trouble for NOT calling. Build relationships before so that the resources are available. How do we help people start to process? My crisis is not your crisis I can not force you to take the help Education is one of the best things we can do. If you did not need help then there would not be available.