One Year Ago… The Damar Effect

It’s been one year since America watched as Damar Hamlin suffered a sudden cardiac arrest as a result of commotio cordis on Monday Night Football. Commotio cordis is quite rare, but sudden cardiac arrest is not. But SCA has never received the amount of attention before January 2, 2023 as it has since that time. As Matthew Mangine Jr’s father has said, their organization and other organizations like them would not have been able to garner the amount of attention. But the whole cause and so many things surrounding Sports Safety became a hot topic in 2023. The question for 2024 is where do we go from here? We’ve identified a major problem, but in 2024 we must attack the problem.

On my drive home for Christmas this year, I listened to “The Tipping Point: How Little Things Can Make A Big Difference.” This was definitely not what I was expecting it to be, but a very good book to listen to while I drove for ~10 hours. As I listened to the book, I wondered what the Tipping Point would be in youth sports and were we witnessing it happening right now? Ironically enough, I think we are seeing it and it’s not because of youth sports at all! One of the concepts in the book is the “actions of few” who make a difference. Athletic Trainers have called for improvements in sports safety for a long time and have often fallen on deaf ears. ATs have saved lives for a long time, but none have been as influential as the sports medicine staffs from the Buffalo Bills and the Cincinnati Bengals as they saved Damar Hamlin’s life on the field that night. Or what about the actions of Rachel Leahy who was instrumental in saving the life of an Army hockey player and was featured on ESPN last winter? These “actions of a few” have made a lot more people aware of the needs for sports safety. It’s unfortunate that it took an event on national television to wake a lot of people up, but the “action of the few” concept is fully in play and now it’s time that we capitalize on it.

The Matthew Mangine Jr “One Shot” Foundation definitely did that in 2023, as they announced a few days ago that they had trained 10,000 people in hands-only CPR in 2023! That is an amazing feat! And I look forward to so much more of this type of training, from them and from other groups, in 2024. It’s time that we have an epidemic of sports safety. And it’s started… in 2024 we must push to make it even better! Through the work of organizations like the Matthew Mangine Jr “One Shot” Foundation, the Zach Martin Memorial Foundation, and the Jordan McNair Foundation, the work of #SaferSidelines by Stephanie Kuzydym, and the everyday work of athletic trainers with their feet on the ground—We will improve sports safety for more kids!

Be Prepared

Be Prepared– A motto that the Boy Scouts introduced. And a concept that Athletic Trainers practice.

Be Prepared. For what? ANYTHING. Athletic Trainers are prepared for just about anything. We take the time to prepare prior to a game or practice so that you can perform fully. We prepare for emergencies. We prepare for weather.

Athletic Trainers Aren’t Just First Responders

So many times over the last few weeks I’ve posted emergency and urgent reasons why high schools and youth teams needed Certified Athletic Trainers. But what must be understood is that Athletic Trainers do much more than just game coverage. Athletic Trainers are responsible for the evaluation of injuries, but also prevention of injuries. I’ve said it before and I truly mean it: I would rather spend 10 hours doing preventative work to prevent injury than 1 hour of rehabilitation after an injury. Prevention of injury does not simply mean taping ankles and wrists. But evaluating movement and making changes to movement patterns. Creating strength and conditioning programs which could very well prevent an ACL rupture. Evaluating the field surface, ensuring water and Gatorade are available during practices and working with the coaches in extreme heat to prevent heat illness. There are so many things that Athletic Trainers do to PREVENT injuries instead of having to deal with the aftermath later… #AT4ALL #NATM2014

Heart Issues Major Concern

DYK more athletes died last year due to heart issues than brain injuries? The amount of research, media, and conferences related to concussions would make you think otherwise. We must recognize the BIG PICTURE of youth sports injuries.

Youth Sports Being Neglected?

We know severe injuries happen on the battle field so we put combat medics in the field to treat those injuries. We know horrific crashes occur in NASCAR so we put EMTs and firefighters inside of the track. We know injuries happen in youth sports… so we say “go see your doctor in 2-3 days.” Yep… It all makes sense to me! #AT4ALL

Time For a Real Answer to Youth Sports Injuries

So many people believe we need this reporting system or this helmet in youth football. Or we need to wear this soccer headgear. So many believe that if we educate parents and coaches we could advance. But the most important thing we can do for youth sports and high school sports is just considered “too expensive.” Or we find so many other excuses. The one I especially love is “there aren’t enough ATs available.” No, what really is the answer here is there aren’t enough ATs willing to work for next to nothing or volunteer their time. If parents, coaches, and league/school administrators want to get to the bottom of youth sports, they will find a way to afford a Certified Athletic Trainer.#AT4ALL

What is “Appropriate Attire” in Athletic Training?

A common debate among athletic trainers is that of dress code. There are those who are very casual and believe that jeans or athletic apparel is acceptable for work and then there are others who believe that athletic trainers should dress in dress slacks and button-up shirts on a regular basis. I believe most would agree that some form of “professional attire” is important. But the million-dollar question is What is “professional attire” in athletic training?

Preventing Concussions from Turning Catastrophic

The most common discussion right now in sports is surrounding concussions. Last month, the National Football League settled with former players relating to a lawsuit filed regarding concussions. Not a day goes by that Twitter is not filled with headlines from concussions at the youth, high school, college and professional levels. Many states have taken some sort of step, they believe, through legislation but critics say that legislation does not go far enough. In many states, that is true as some of the most vulnerable athletes are left with no legal protection. In many states, the concussion legislation only covers high school athletes. Illinois is one such state that while legislation is in place, it goes nowhere near far enough. In Illinois, the only ones truly protected are those who compete for IHSA schools as the law mandates such schools to have policies in place in accordance with IHSA rules. But what about those schools who are not members of the IHSA? What about middle schools, junior highs, and elementary schools? What about club sports?

Let’s look a little closer and we’ll often find that legislation only mandates education. But what education is sufficient? What is overkill? And does the education work?

Here today I want to consider a multi-level approach to concussions. We cannot forget any of these levels because each piece is an important piece.

I’ve said it before and I’ll say it again. Concussions themselves do not worry me so much. They happen and they will happen regardless of what we do. The biggest concern to me is the lack of recognition and the lack of awareness after the fact. We must improve this aspect.

Education

Education is at the forefront of everything we do in the concussion world. Parents, athletes, coaches, school administrators, and healthcare providers must be educated in concussion recognition and concussion management. But does the current education go far enough? I don’t believe it does. Too often do I continue to hear things such as “I don’t have a headache” or “I didn’t lose consciousness” as reasons for why people believe they cannot have suffered a concussion. There are about 25 concussion symptoms; headache is not the only one. So when you report several symptoms, but no headache, you are likely concussed! And a small percentage of concussions result in loss of consciousness. It’s important to note if LOC did occur, but the severity of the injury is not linked to that potential event.

Student-athletes and parents must be educated on the signs and symptoms of a concussion. It’s important that the parents be able to recognize these problems with their son or daughter and equally important for the athlete to report problems to their parents, coaches, and or healthcare provider. Additionally, it is crucial that the athletes report problems that their teammates are experiencing. When you see your teammate “not acting right” then you need to say something!

Coaches also must be educated in the recognition of concussions. At the high school and youth level, there is not always a healthcare provider available. The coaches must take on these responsibilities and if there is any question, hold the athlete out until they are seen by a healthcare provider. Additionally, coaches must be educated in proper techniques whether that be tackling in football, heading a soccer ball, or stunting in cheerleading. Coaches should regularly undergo education in safety topics.

School administrators also must be educated so that cognitive impairments are identified and can be corrected. Concussions don’t only affect the physical activities such as sports, but can have significant problems in an academic setting. Concussion management must be included at the schools too.

Healthcare Providers

The National Athletic Trainers’ Association now says that approximately 60% of high schools nationwide have access to an athletic trainer. Athletic trainers are healthcare providers specifically trained in athletic injuries and one such injury is concussion. Athletic trainers have long been on the forefront of concussion recognition and concussion management.60% of high schools may have access to an athletic trainer, but what does that really mean? If it’s like at my current school, it means there is a healthcare provider there occasionally. But what about all the other occasions? If it’s the case of many schools, the athletic trainer is often there for football games only or maybe varsity events. But what about that freshmen soccer game? What about that cheerleading practice? There are many incidences where athletic trainers are not present, but the school “has access.”

On this blog, I have long said “Every Athlete Deserves an Athletic Trainer.” The time has come that schools MUST have athletic trainers. These individuals must be certified by the Board of Certification and licensed by their respective state. An inability to hire a full-time athletic trainer is an inability to provide adequate athletic opportunities to a school’s students.

In addition to a certified athletic trainer, schools must have a team physician who is also trained in concussion management. The athletic trainer and physician must work together for all injuries for the safety of the student-athlete.

Protocols and Procedures

The last piece of the puzzle is having proper protocols in place. We cannot allow a student-athlete to simply return because they “feel better.” There is a lot of controversy with regards to things like neurocognitive testing, baseline testing, and return to play protocols. But utilizing the available resources the healthcare providers should be able to develop protocols that are sound. In our company, we do utilize ImPACT but that’s just one tool in the big picture. You must also have progressive return to play protocols so that you gradually increase activity before allowing one to return fully to sports.

As you can see, there are multiple avenues that must be undertaken in order to properly manage concussions. It is this management that can be life or death so it is vital that we get it right. Do the right thing, and take the steps necessary. Educate, hire proper healthcare professionals, and have protocols in place.

Sports Medicine Team: Athletic Trainers

I consider sports medicine to be very much a team activity and to provide superior sports medicine, there must be a team of professionals in place to make it happen. In this post, I will address those professionals that I consider crucial for a high school sports medicine team. I will post both the “ideal roles” as well as more realistic roles.

I’m biased, but this is the most important professional in the sports medicine team. The athletic trainer is the central figure with responsibilities in every facet of sports medicine. Every high school should have at least one athletic trainer if not a team of athletic trainers. The athletic trainers are responsible for six domains of athletic training.

March is…

March is National Athletic Training Month and this year the National Athletic Trainers’ Association is celebrating it with the theme “Athletic Trainers Save Lives.” I believe this is a great theme because athletic trainers are healthcare providers often responsible for potential life threatening injuries on the athletic fields and off! But athletic trainers are so much more than just emergency personnel.

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