Profesional Cutman Jovan Means

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.

Jovan Means; Professional Cutman

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

Petroleum jelly

Horror Story

First time with a fighter and knew he had been whacked and would not have been allowed to play sports if at the high school

He went back in and got knocked out.

The fighter was out for a few minutes before coming to.

When have you been “star struck?”

Charlo brothers were at the ring hanging out were there.  There were also their trainers and cutman.

What courses, training, or certificates would be good for an AT interested in being a cutman.

Relationships

Work with the “losers”

Do your research

Reach out

Start putting in work

Jovan has been rejected more than once as they did not know what an AT is.

Favorite experience as a cutman?

Met two guys from Dallas the day before the fight.

His brother asked him to coach him as well.

This guy is 1-5 fighting a 6-0 guy

Jovan really got to coach this guy to a victory

Mike is part owner of WARTAPE

Shoutout to Dr. Donita Valentine

Watch Professional Cutman on Facebook

Contact Us

Jovan Means

Jeremy Jackson

These people LOVE ATs and help the SMB pay the bills:

Frio Hydration – Superior Hydration products.

MioTech – meeting all of your sports medicine supply needs

PhysicalTherapy.com – use promo code “1FREECOURSE” to start for free

Donate and get some swag (like patreon but for the school)

DragonflyMax – one-stop EMR

HOIST – no matter your reason for dehydration DRINK HOIST

MedBridge Education – Use “TheSMB” to save some, be entered in a drawing for a second-year free and support the podcast.

Marc Pro – Use “THESMB” to recover better.

Candid AT Live; HOIST; Professional Cutman
HOIST Hydration helps us get through days of podcasting

AT Dads 3 – The Wife

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.

The Wife; AT Dads; Kevin Briles; Kim Briles; Annie McCune; Dave McCune; Ryan Stevens; Sports Medicine Broadcast;

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 family?

  • Jackson Family: To raise Men (and maybe women) who honor God and positively impact the world around them.
  • Briles Family:
    • Driven
    • Compassionate
    • Kind
  • McCune Family:
    • Be relaxed in the situation
    • Trust
    • Always be kind to everyone you meet
  • Stevens Family:
    • You will be loved and you will love

“Keep Doing / Stop doing /Start Doing”

One key to successfully maintaining your family dynamic?

McCune – spend time together when we are off

Briles – just be quiet & Say yes more to friends and family

Jackson/ Stevens – prioritize family

What will you “STOP” doing which may lead to more stress upon the family?

McCune – stop trying to help when I get home

Briles – stop saying yes to everything

Jackson – The wife says I need to STOP being on my phone during the evenings

What do you hope to start doing/do more of moving forward to further build your family?

McCune – more fun things as a family

Briles – make the remaining moments count

Jackson – I apparently need to start listening more as I can not remember what the wife told me

Funny Stories?

Briles – Kim was pregnant with Liz, our first, we were warming up for the varsity football game.

I was in the old school locker and I got a message on my beeper…911

That was the code for it is time

I sprinted out and knocked over two band members trying to get the keys and get to the hospital.

Meanwhile the wife was headed to the hospital where she waited 8 hours for the baby to come.

Jackson: Sarah was having a rough day and my oldest decided to shoot at me with the nerf gun. So we had a battle that later turned into a shooting alley as we laid on the floor and shot nerf guns at the 2 youngest boys while they walked back and forth trying not to get hit.

Leave us with one action step:

Dave and Annie – focus on your relationship with your spouse

Kim – you get to going through the motions but these conversations remind us to focus

Kevin – put the phone down

Jeremy – Date Your Wife

Ryan – invest in yourself

Resources from AT Dads 3 – The Wife:

www.cATalyzingATs.com 

Date Your Wife Book

Watch AT Dads 3 on Facebook

Contact Us:

Dave – @RUTrainerMcCune @RUAthletics

Kevin – @kbriles @ATSNJ

Ryan – @CatalyzingATs

Jeremy – @MrJeremyJackson

These people LOVE ATs and help the SMB pay the bills:

Frio Hydration – Superior Hydration products.

MioTech – meeting all of your sports medicine supply needs

PhysicalTherapy.com – use promo code “1FREECOURSE” to start for free

Donate and get some swag (like patreon but for the school)

DragonflyMax – one-stop EMR

HOIST – no matter your reason for dehydration DRINK HOIST

MedBridge Education – Use “TheSMB” to save some, be entered in a drawing for a second-year free and support the podcast.

Marc Pro – Use “THESMB” to recover better.

PhysicalTherapy.com; 1freecourse; continued; Physical therapy; the wife

AT Dads 2 – Goals

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 then
We 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 retirement
All 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 on Facebook

Contact Us

Ryan

John

Jeremy

These people LOVE ATs and help the SMB pay the bills:

Frio Hydration – Superior Hydration products.

MioTech – meeting all of your sports medicine supply needs

PhysicalTherapy.com – use promo code “1FREECOURSE” to start for free

Donate and get some swag (like patreon but for the school)

DragonflyMax – one-stop EMR

HOIST – no matter your reason for dehydration DRINK HOIST

MedBridge Education – Use “TheSMB” to save some, be entered in a drawing for a second-year free and support the podcast.

Marc Pro – Use “THESMB” to recover better.

MioTech

AT Dads 1 – Relationships

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.

His wife stayed home with the kids.

Larry was able to take 2 weeks off and then proceeded to juggle and balance.

Pizza Friday – they would come up for dinner each Friday night and eat together.

His kids still carry on that tradition with their own.

Eat dinner together whenever possible

During summer Larry would plan camping trips and travel the country.  One trip was 7.5 weeks with a family camper.

“We are going to be in this area, what do you want to do?”

Watch the AT Dads 1 Facebook video

These people LOVE ATs and help the SMB pay the bills:

Frio Hydration – Superior Hydration products.

MioTech – meeting all of your sports medicine supply needs

PhysicalTherapy.com – use promo code “1FREECOURSE” to start for free

Donate and get some swag (like patreon but for the school)

DragonflyMax – one-stop EMR

HOIST – no matter your reason for dehydration DRINK HOIST

MedBridge Education – Use “TheSMB” to save some, be entered in a drawing for a second-year free and support the podcast.

Marc Pro – Use “THESMB” to recover better.

AT Dads; Hands Free
Water,
We freaking love these hands free units from FrioHydration

Emerging Setting with Max Mahaffey

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

    Frio Hydration – Superior Hydration products.

    MioTech – meeting all of your sports medicine supply needs

    PhysicalTherapy.com – use promo code “1FREECOURSE” to start for free

    Donate and get some swag (like patreon but for the school)

    DragonflyMax – one-stop EMR

    HOIST – no matter your reason for dehydration DRINK HOIST

    MedBridge Education – Use “TheSMB” to save some, be entered in a drawing for a second-year free and support the podcast.

    Marc Pro – Use “THESMB” to recover better.

    JOhn Harmon; Candice Teunis; Wrist and Thumb; Frio Hydration; NATA

    BFR in Adolescents

    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…

    BFR in Adolescents

    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.

    1. Measure LOC
      1. Prescribe pressure based on that number
      2. Some companies have not
    2. Document the number for full occlusion 
    3. Document the pressure for each session
    4. Document the length of time the cuff was on
    5. Document the load used
    6. interventions should be supervised with the AT

    Consider the timing of using the devices.

    We are basically lifting heavy so plan with the fatigue levels of the day.

    BFR in Adolescents

    What is the variability of using the device between clinicians?

    Experience can play a role in the use of BFR.

    • This is about equal parts perceived and real
    • Confidence and comfort are kinda contagious

    Have I done enough? – did they complete the 75 reps 2x in a row?  Then I need to increase

    How is the person moving?

    Are they really sore?

    What are they reporting about the interventions?

    Kyle takes girth measurements – within a month I should see some increase in girth size.  This allows me to check their attendance and level of exertion

    We also use this to discuss nutrition and protein intake.

    Watch BFR in Adolescents on Facebook

    https://www.facebook.com/980579115403772/videos/1597911170390829

    Contact Us

    Kyle – kyle@ors.io 

    IG: @kylekimbrell 

    Twitter: @kylekimbrell1

    Devin: Twitter: @kielur_devin

    Jeremy JacksonMrJeremyJackson on Twitter and Facebook

    Sponsors

    Frio Hydration – Superior Hydration products.

    MioTech – meeting all of your sports medicine supply needs

    PhysicalTherapy.com – use promo code “1FREECOURSE” to start for free

    Donate and get some swag (like patreon but for the school)

    DragonflyMax – one-stop EMR

    HOIST – no matter your reason for dehydration DRINK HOIST

    MedBridge Education – Use “TheSMB” to save some, be entered in a drawing for a second-year free and support the podcast.

    Marc Pro – Use “THESMB” to recover better.

    BFR in Adolescents

    Goal Setting for Patients

    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

    1. Walk pain-free
    2. Jog pain-free
    3. Run pain-free
    4. Practice pain-free
    5. Return to play

    Instead of “Here is what you are going to do today.” 

    Maybe try:

    “Here is what I feel like we need to work on how do think we can accomplish that?

    John – I like to look at it as a department view

    “What are our professional goals”

    • We write them out and put them on the wall and it leads everything we did

    You still need to have a goal as an AT to guide the patient’s recovery.

    Celebrate small goals

    In the secondary setting where we potentially see them every day, what should this look like?

    John – The target – “what is your bullseye?”
    Work backward from the outer rings to see how they get to the bullseye.
    We keep soap notes and rehab sheets out for all of our athletes. Rehab charts are on the back of the soap notes.

    WRITE THINGS DOWN

    Daria – know the target and work out from there
    8 weeks walking pain-free
    So what steps can we use to get you there at 2 weeks, 4 weeks, and 6 weeks?

    Ray– having them see their goal is important
    Let’s take a picture of your ankle daily and compare it
    Or lets video you walking and running
    Each athlete is by appointment currently and they have an agenda for the day.
    Ask them what their plan is

    Other tips for implementing the patient goal setting in rehab?

    Daria: Long-standing pain – the goal is not being pain-free, but finding distractions to keep his mind off his pain.

    Certain hobbies and activities and helping him build those into their life and improving the ability to perform those tasks.

    Ray: There are many ways to do goal setting.

    IT’S ALL ABOUT THE PATIENT

    John: Practice what we preach.

    How are your goals going to help your patient population?

    If you are good at setting your own goals it will show in your practice

    https://www.facebook.com/980579115403772/videos/411065410067494

    Got tips for us?

    Daria Oller – @OnTapPhysio

    Ray Olivo

    John Ciecko

    Jeremy Jackson

    Goal Setting Resources

    Setting Quality Goals – use the promo code “1FreeCourse” to earn some 2 CEUs related to the discussion.

    Financial Supporters

    Frio Hydration – Superior Hydration products.

    MioTech – meeting all of your sports medicine supply needs

    PhysicalTherapy.com – use promo code “1FREECOURSE” to start for free

    Donate and get some swag (like patreon but for the school)

    DragonflyMax – one-stop EMR

    HOIST – no matter your reason for dehydration DRINK HOIST

    MedBridge Education – Use “TheSMB” to save some, be entered in a drawing for a second-year free and support the podcast.

    Marc Pro – Use “THESMB” to recover better.

    PhysicalTherapy.com; 1freecourse; continued; Physical therapy

    Path to Leadership

    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.

    Path to Leadership; Rick Cox

    “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.

    What would you tell a Young Rick Cox?

    • Humility

    Books? 

    Anything by Jocko

    Simon Sinek’s Leaders Eat Last and Start with WHY

    Ryan Holiday’s The Obstacle Is The Way and Ego Is The Enemy

    Dare to Lead – Brene Brown

    https://www.facebook.com/sportsmedicinebroadcast/videos/340721383694562/

    Contact Us

    Rick Coxrcox2@suffolk.edu @Suffolk_AT

    John Ciecko – @John Ciecko

    Jeremy – @MrJeremyJackson

    Encourage them to buy more shirts for you…

    Frio Hydration – Superior Hydration products.

    MioTech – meeting all of your sports medicine supply needs

    PhysicalTherapy.com – use promo code “1FREECOURSE” to start for free

    Donate and get some swag (like patreon but for the school)

    DragonflyMax – one-stop EMR

    HOIST – no matter your reason for dehydration DRINK HOIST

    MedBridge Education – Use “TheSMB” to save some, be entered in a drawing for a second-year free and support the podcast.

    Marc Pro – Use “THESMB” to recover better.

    Armed Forces Athletic Trainer Michael Hooper; path to leadership; John Ciecko

    Adopted ATs

    Deanna, Kelsey and Jennifer, all Adopted ATs, share their stories to encourage others to compassion and action.

    Adopted ATs

    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

    Frio Hydration – Superior Hydration products.

    MioTech – meeting all of your sports medicine supply needs

    PhysicalTherapy.com – use promo code “1FREECOURSE” to start for free

    Donate and get some swag (like patreon but for the school)

    DragonflyMax – one-stop EMR

    HOIST – no matter your reason for dehydration DRINK HOIST

    MedBridge Education – Use “TheSMB” to save some, be entered in a drawing for a second-year free and support the podcast.

    Marc Pro – Use “THESMB” to recover better.

    Adopted ATs

    Earned Leadership

    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

    Earned Leadership; kevin parker; john ciecko

    “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 level rather than leading the people below them.

    “Never ask a subordinate to do a task you are not willing to do”

    Maybe you show up at 6 am to help with COVID screening a few times

    Does the AD need to be at every practice every day??? Nobody wants that.

    In every organization, there is someone who is promoted one level beyond their competence

    From Facebook: Richard Cox It reminds me of when Jocko would scramble guys' radios to make sure that they all knew how to fix them because he wanted everyone in the platoon to be able to do everyone else's job.

    “Westmorelands understanding from Napoleon.” p. 737

    “The interview – forest from the trees” p. 777

    “Issues and Answers” with Howard Tucker from ABC

    Did the upper echelon of the army ever become changed on the war…did they learn from their mistakes?

    “No” they became paper pusher and analytics and could not see the forest from the trees.

    We were measuring using the death ratio for success.

    You have to have strong moral courage to step up and say “maybe we are not winning”

    LOOK AT THE BIG PICTURE and see there is more going on outside of the immediate.

    One of the lasting lessons Kevin has learned: 

    Kids’ parents like to watch their kids play games…if we can change the game time so their parents can watch them we need to do that.

    “Learn from the past.” p. 831

    4. What have we seen during this time and how can this book (or ones like it) shape our learning curve of leadership?

    Anytime you can go back and have an understanding of how and why a decision was made you can see how changing just one step could have changed the course of action.

    It is easy to make decisions when there is an unlimited amount of time and resources…but that never happens.

    “Can you make a decision without having all the variables and info you need?”

    https://www.facebook.com/sportsmedicinebroadcast/videos/1513778832163017/

    Contact Us

    Kevin Parker – @kparker9200

    John Ciecko – @JohnCiecko

    Jeremy – @MrJeremyJackson

    Keep the “lights” on:

    Frio Hydration – Superior Hydration products.

    MioTech – meeting all of your sports medicine supply needs

    PhysicalTherapy.com – use promo code “1FREECOURSE” to start for free

    Donate and get some swag (like patreon but for the school)

    DragonflyMax – one-stop EMR

    HOIST – no matter your reason for dehydration DRINK HOIST

    MedBridge Education – Use “TheSMB” to save some, be entered in a drawing for a second-year free and support the podcast.

    Marc Pro – Use “THESMB” to recover better.