WBGT – Wet Bulb with Tom Woods

Wet Bulb Globe Temperature is the standard for protecting from heat illness which is 100% preventable in athletics. Tom Woods discusses where we are as a state in adopting it.

What is the ATLAS ambassador?

What changes would you make to protocols in Texas?

WBGT takes in several more important factors than Heat Index

Don’t forget about band, dance, cheer in your WBGT needs

What is the next major tech advancement you would like to see?

Switching to WBGT and becoming a mandate rather than a recommendation.

NFHS covers 48 states..but not TEXAS

Will heat illness training become a required training?

Contact Us:

Jeremy Jackson

Shawn Readyshawnreadyatc@gmail.com

Dr. Mark Knoblauchmaknobla@Central.UH.EDU

Dr. Layci Harrisonlharris5@Central.UH.EDU

Bob MarleyBob.Marley@uth.tmc.edu

ATCornerPodcastATCornerds@gmail.com

Joseph Eberhardteberhardtj@pearlandisd.org

Christina Fry – fryc@pearlandisd.org

These people LOVE Athletic Trainers and help support the podcast:

Frio Hydration – Superior Hydration products.

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

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.

Hoist logo; rapid hydration

Turf Injuries in Competitive Athletes

Turf Toe is ever-changing. Dr. Paul Shupe and Joseph Eberhardt discuss some of the facts and history of turf toe at the Memorial Hermann sports medicine update.

What can I do to benefit my athlete since turf is here to stay?

Making sure the field is well maintained, and proper personal protective equipment is significantly important. A lot of football players like to wear narrow cleats which can contribute to lower extremity injuries based on the cleat pattern, length, and width of the shoe. The time of day we practice is important as well. 

Is there any data or research done about laces and appropriately tying the shoe with appropriate arch support?

Great question, I’d have to look into that. I’m sure there are studies – I didn’t delve into that. These are very important questions, I think that core strengthening is a very pertinent point as well. 

You spoke about an increase in PCL injuries. From my education, the mechanism of injury for PCL is that dashboard injury, coming from direct force on the anterior tibia. Is there any research, or from your background and knowledge, why is it that we’re seeing more prominence from that mechanism on that turf?

When it’s not a dashboard injury, the common mechanism is that you onto your knee bent at 90 degrees, your toe has interacted and your cleat is stuck in the turf so it's not giving away.

Your foot is in this dorsiflexed position and you land on that knee with all of the force going back through, as opposed to if the shoe gives out allowing you to land on less of a 90-degree angle. 

Is there any correlation to gastrocnemius weakness regarding those Turf Toe injuries?

I think that's a valid argument, I don't have enough science or background to say but I do think that would be an interesting thing to study. 

We talked about the history of turf in your presentation, would you say we’ve moved in a safer direction? Are we moving to a safer surface?

I think we are, I think we’re moving to a safer surface for our lower-level athletes. I think our higher-level athletes have different muscle builds and different muscle types that may lead to some of those injury at a higher level.

I do think the technology that's going into it is moving towards a safer playing surface, I don't think there's much we can do about the heat and some of the other things, and they are looking into that. I think we are moving there, the important thing here is that turf isn't going away, I don't think that we’ll ever go back to grass.

With technology moving forward, I do think it's becoming safer. I don't think it'll ever be 100% safe but with education, and proper maintenance, I think we can make it as safe as we can. 

You mentioned the coconut or the cork, those things are natural materials that would rot, and putting turf in is a lengthy and expensive process. How does it make sense for a high school field to put something that might rot underneath there?

So part of it is just the turnover of it, so it's got to be properly maintained. So when we use the proper equipment and the proper rakes just to shift it around that's a valid question, especially in a wet and humid environment like it is here. It’s not being used a ton yet, and I think that's yet to come. We may determine years from now that it's a bad idea.

Rice uses wood instead of rubber on their field, I found that interesting when we played there last year. 

Did you notice any difference?

Thinking back, I think your point about feet being sore on these fields; is a major problem. Your feet hurt at the end of the day on the rubber. There’s less of that impact.

We did have in our Rice game, but I don't think it makes a difference in injury, we had an ankle fracture that game, we had a significant hamstring rupture, and a couple of other things so I don't think it makes a difference as far as the interaction of the cleat but it may make it as far as the softness. 

You mentioned your time in the military where you would sweep and make sure there was no foreign debris as part of the turfing. Can you speak briefly about your time serving our country?

I served in the Navy for 12 years and loved it. I trained as an intern, and then I was 3 years as a flight surgeon with the Marines, serving in an F-18 squadron. I had the opportunity to go all over the world with that, then finished my ortho training in San Diego.

Then I spent 4 years as an orthopedic surgeon in Japan and Florida, and loved it.

They were not allowing me to do sports medicine, which is what I came to Houston to do a fellowship for. So, there are nothing but good things to say about the Navy and those who serve. 

People who go to the military to become physical therapists or surgeons, can you talk about what they should and shouldn't think about before?

So for me, it was an avenue for me to pay for medical school. They paid for me to go to George Washington University, and so one thing is well paid and very well educated no matter where I go in the world or in the country.

The training that we got is respected. Same thing for physical therapy. Other than the Naval Academy, and probably West Point Force Academy, there are not a lot of athletic trainers in the military.

But you certainly get that experience working with different types of teams, and I think the opportunities that you get serving far outweigh the downsides of deployment or other unfriendly things like being told where you have to be, when you have to be there, where to have to move to, overall very positive.

I think the Navy and all of the armed forces provide great education both in-person and online learning. A lot of the coremen would enlist, and have their education paid for while working on campus, and several of the individuals I worked with would graduate with a year's degree while they were on active duty service with no cost to them. 

Got Questions about Turf Toe?

Dr. Paul Shupe – Reach out to his office and tell them the Sports Medicine Broadcast sent you

Contact Us:

Jeremy Jackson

Shawn Readyshawnreadyatc@gmail.com

Dr. Mark Knoblauchmaknobla@Central.UH.EDU

Dr. Layci Harrisonlharris5@Central.UH.EDU

Bob MarleyBob.Marley@uth.tmc.edu

ATCornerPodcastATCornerds@gmail.com

Joseph Eberhardteberhardtj@pearlandisd.org

Christina Fry – fryc@pearlandisd.org

These people LOVE Athletic Trainers and help support the podcast:

Frio Hydration – Superior Hydration products.

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

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.

turf toe; medbridge

EMRs with Will Ryan

EMRs are like most things, it is not one size fits all. When looking for a solution for records management Will Ryan wanted to share his search results with all ATs.

EMR

Discussion topics: 

  • Searching for EMR
  • How to obtain EMR
  • How to Familiarize yourself with EMR
  • Communications with EMR Companies

What has been your process for searching for an EMR?

Identifying limiting factors like cost. Sportsware and AT Genius are cheaper options.

Barriers to documentation – time, limited resources, uncertainty of what to document. NATA has created guidelines regarding methods of documentation. Consider the legal aspect of documentation.

How do you approach your school about obtaining an EMR?

Build value in the documentation. Explain how EMR protects patients, coaches, and healthcare providers; and keeps everything secure. Convenient place to store all UIL-required documentation.

What is the best way to familiarize yourself with EMR’s?

CAATE standards have now included EMR’s. 

Pearland ISD uses Rank One – signs in upon entry and documents almost everything. We introduce our MAT program students to Rank One and have them document all patient interactions. 

Did companies offer demos of their EMR systems during your search?

Rank One, Healthy Roster, Healthy Monitoring, Sportsware, AT Genius.

All provided demos, and were very open and helpful.

The creator of AT Genius took the time to meet with me. 

Collecting some data is better than none, do what you can. 

Use documentation to show the dollar value of your care and how much money you save parents by providing care. 

Christina Instagram:

Cmfry16

Sydney Instagram:

sydneyhayes95

Contact Us:

Jeremy Jackson

Shawn Readyshawnreadyatc@gmail.com

Dr. Mark Knoblauchmaknobla@Central.UH.EDU

Dr. Layci Harrisonlharris5@Central.UH.EDU

Bob MarleyBob.Marley@uth.tmc.edu

ATCornerPodcastATCornerds@gmail.com

Joseph Eberhardteberhardtj@pearlandisd.org

Christina Fry – fryc@pearlandisd.org

These people LOVE Athletic Trainers and help support the podcast:

Frio Hydration – Superior Hydration products.

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

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.

EMR, RankOne

Combat Sports Medicine

Combat Sports Medicine seems like an extreme environment to practice Athletic Training. Dr. Ethan Kreiswirth created Blackbelt Sports Medicine to provide Athletic Trainer care for combat sports athletes.

You are always posting gnarly pictures and videos on IG. What gives you pause or catches you off guard?

As an Athletic Trainer, I started covering tournaments around 1997.

Personal experience in the sport helps me understand the types of injuries that occur.

Tournaments now are 40 mats over 6 days

Dislocations, unconscious used to give me pause.

Now it is just running a company.

Or working youth tournaments, those are always difficult for me.

Does Blackbelt Sports Medicine have tournaments across the United States?

Yes, we work with the BJJ organizations to help provide medical care for combat sports.

A new AT is going to work in combat sports medicine.  How do you prep them?

Gloves, gauze, skin lube, and nose plugs.

An Athletic Trainer working with Black Belt Sports Medicine could almost get away with just bringing their fanny pack, like the Nexus Deadbug

There is almost no taping done, maybe some finger taping.

You do a good bit of suturing…discuss that as an AT. 

Many of these BJJ athletes are from out of state or another country.

Suturing on the sidelines helps them out tremendously.

I have done about 10 sutures so far.

There is a lot of practice involved with the practice kits.

Not being licensed gives me more freedom to practice the emerging skills.

We take a table behind the scenes and do the standard prep work.  We also instruct them to follow up with their HCP.

The larger tournaments have an overseeing physician onsite as well.

Sign up for a tournament and see if Combat Sports Medicine is for you.

Contact:

Dr. Kreiswirthhttps://www.facebook.com/Blackbeltsportsmedicine/

IG: https://www.instagram.com/dr.kreiswirth/

Jeremyhttps://www.instagram.com/sportsmedicinebroadcast/

Resources:

Pub med research

These people LOVE Athletic Trainers and help support the podcast:

Frio Hydration – Superior Hydration products.

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

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.

Amy Metiva, snocross, HOIST

Crisis Etiquette

Bubba Wilson discusses Crisis Behavior or Crisis Etiquette live from the Memorial Hermann Sports Medicine Update. He has been leading D6 in ATsCare since its inception and has learned a lot over the years.

Crisis Behavior, Bubba Wilson

Discussion topics: 

Did crisis management help you be prepared for being inducted into the SWATA Hall of Fame?

AT Cares drove me there.

CCISM credential:

Certified Critical Incident Stress Management – Level 1 deals with individuals in crisis, the majority of AT Cares population. Level 2 deals with groups in crisis. 

Began Crisis Management training in 2019. 

AT’s managing grief:

Grief comes in at a later time, ATs have to finish the game/event after a critical injury/event.

AT Cares reaches out once notified to ensure assistance is provided where needed

NATA Gather Program Integration:

Young professionals can use NATA’s gather program to find mentors. 

Crisis on campus – what is the best method to find that definite grief to counsel them?

Don’t counsel them. Listen. Refer out. 

Soapbox Warning – What is step 1 in managing the secondary loss of loved ones?

Have affairs in order. Have a will, have life insurance. Have your burial wishes written down. Have the conversation. Have a list of your account usernames and passwords. Know how many death certificates you may need. Legal Zoom is a good resource. Make sure you constantly update your affairs. The primary loss will be exacerbated if we don’t handle our affairs. 

Currently working on a presentation with AT Cares members regarding their experiences with loss and what they’ve learned along the way.

Thanks, Sydney Hayes for creating the Crisis Behavior show notes

Contact Us:

Jeremy Jackson

Shawn Readyshawnreadyatc@gmail.com

Dr. Mark Knoblauchmaknobla@Central.UH.EDU

Dr. Layci Harrisonlharris5@Central.UH.EDU

Bob MarleyBob.Marley@uth.tmc.edu

ATCornerPodcastATCornerds@gmail.com

Joseph Eberhardteberhardtj@pearlandisd.org

Christina Fry – fryc@pearlandisd.org

These people LOVE Athletic Trainers and help support the podcast:

Frio Hydration – Superior Hydration products.

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

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.

Crisis Behavior, HOIST

Practical Preceptor Tips – Christina Fry

Practical Preceptor Tips from Christina Fry at Dawson High School in Pearland, Texas. They do an amazing job with the Sports Medicine staff, their student aides, and as preceptors for the University of Houston MAT program.

Discussion topics: 

  • Advancing students in the profession
  • Preparing students 
  • Outfitting students
  • Providing learning opportunities 
  • Scheduling
  • What to avoid
  • Practical Preceptor Tips

How long have you been a preceptor?

7 years. 

Can you share some of the things you have done to help master's students be involved and advance in the profession?

We treat the masters' students as an extension of our staff, we want them to be respected in our ATR just like us.

We have our high school students refer to them as Mr/Ms/Mrs. We interview them to make them feel that they are in a professional setting.

My assistant, Thomas, likes to ask them “What did you learn today?”. We outfit them, invite them to our pregame meals, we make sure that they feel respected. We make sure that every day they learn something new.

You interview them for the position, but they’re already assigned there?

Correct. We ask them to submit a resume, and for a lot of them this is their first job “interview” and ask them interview-like questions and ask them to submit a cover letter.

We then give them critiques so they can start working and build that resume so that when they are done with their program they can apply and be successful for their interviews for their actual job. 

Do you do that just once, or every week, every 3 weeks, etc?

So our level 2’s are with us all year long, we make sure we give them monthly updates. Our level 2 this past year wanted an update every day, every week, so we always were helping her and growing her, anytime there was a hiccup or something she was unsure of, we gave her that reassurance and feedback.

For the level 1’s, it takes a while to get into that comfort zone, but we always try to give them feedback when we notice something, good or bad. 

You talked about outfitting them to make them feel welcome, do we give them the ones that say athletic trainer, or the ones that the students wear, do they keep them; what does that look like for you?

So it varies, level 2 vs level 1. Level 2’s we’ll give them the game day polo for the year, and require them to look professional when they come into the ATR.

Our students will wear Nike shorts and a T-shirt. We ask that our UH students either wear something UH to differentiate them or they wear a polo with either nicer shorts or nicer slacks, with their UH ID badge. And that way it identifies them as an adult and not a student.

More Practical Preceptor Tips: Include them in almost everything! So for GHATS, we made a fun t-shirt for the t-shirt contest, and we had a team-building activity of tie-dying the shirts.

We invited our UH students to join in since they went with us to GHATS, and they were allowed to wear that shirt as a fun GHATS representation. For our level 1’s, if there’s an event going on during the time that they are with us we’ll give them one of the students' shirts, but for the most part, we’ll give them our practice shirt for the year that they can wear to Saturday treatments, etc.

One of the things I’m trying to still work out is scheduling, how do you balance that out and hold them accountable while keeping in mind that they’re college students?

You and I have the luxury of working in a high school setting, so we automatically have Sundays off, that is the one day a week they have off because they are required to have at least one day off within a 7-day span. So we keep that in mind.

We use something called “Homebase” which is a scheduling app, where our students, ourselves, and our UH kids can submit their days off requests, so we honor that.

We always remember that they are students first, so they can communicate with us if they have a big test coming up and they'd like the evening off before to study, they just have to have that communication with us, and then we treat it like how if one of us had a doctor’s appointment that morning and we’d say hey, I need this off for that; so encourage them to communicate with their staff, which is the other UH students, to ensure that things get covered.

When it comes to accountability, they've got a set amount of time with us to get the hours they need, so they know that if they’re not going to be there they have to make up the hours they need. 

For games that they weren’t scheduled for but show up for, how do you handle that?

A great Practical Preceptor Tip is to have them ask them to ask us in advance. Especially for indoor games or baseball/softball because the space is limited, so we tell them if they do want to come and work extra to give us that heads up that way we can say yes or no.

Ensuring that you're providing an educational opportunity, how do you hand off responsibility to those students?

So when the first years come in, they haven't gone over any anatomy for their assessment class so once they reach the test or the ankle, knee, hip, etc; if they're going over the ankle at the time, we say that every ankle sprain that comes in here, we want you on it, evaluating it to where you're at in your studies.

Once you complete ankle, every ankle eval we say that's yours. That way they are getting that clinical experience.

Our level 2’s, get a little more autonomy when it comes to that. If they’re struggling to remember shoulder special tests, every shoulder that comes in, go get on that eval and come back and ask us questions. We’re right there with them making sure they’re completing it correctly but we want to make sure they get as much hands-on experience with different patients. 

Do you have the course syllabus of when they go over certain things?

We ask to see that, we just ask them hey what did you go over today in assessment, hey what are you learning in this class and they tell us and we say okay we’ll make sure to touch on that.

We’re using a more practical time in a hands-on setting. We also meet each week to go over GHATS quiz bowl material with our kiddos and we always invite our grad students to sit in on those lectures as well. 

Do you have any release of responsibility schedule or do you just have an internal feel for it?

We’re not going to give them something they’re not comfortable with, we kind of feel them out in the beginning and try to build up what they're not as confident in within their realm of comfortability, because at the end of the day, they’re students too and we want them to learn and grow, within their limits.

Our UH girl this past year wanted to learn more about admin, so we said okay, you’re going to look at our student manual and we want you to go through and make these changes. So it varies based on each individual, and we always ask “What are you not comfortable with?”, and then we try to make them comfortable. 

Are any other cool things that stand out?

Something I learned when I was in undergrad, we called it twisted Tuesday. Every Tuesday the upperclassmen, whoever was in charge of that sport, became in charge for the day. The preceptors dressed down into what the students would wear, and those students in charge dressed up as the preceptors.

For every new injury that walked in, they corralled how to treat it, or tasked a student with rehabbing them, they set up practice, talked to coaches, delivered injury reports, etc. So that’s something I’ve taken over at Dawson, and every Thursday night during football season, our UH students are “in charge”, so they’re the first ones to go onto the field, they set up games for the day, and that is their time to get their autonomy and to feel confident in those high-pressure situations. 

How do you prepare your students and staff for those Thursday nights?

So we go over the way games are set up in the beginning, they usually get a game or two under their belt as a UH student and then we say alright it's your turn, so they get to see what a setup looks like, they get to understand how we run things and our expectations. We tell the coaches, hey by the way you are going to be hearing from so and so tonight they are in charge.

Of course, we are always right there behind them making sure that if there is something a little bit more extreme or if they’re out of their comfort zone and need us to step in we’re right there. We let them communicate with coaches and parents, that way they get that experience in a high-pressure situation. And they know that it's coming, we give them a heads up. 

When you say you're right there with them, are you still on the sideline when they go onto the field, are you kind of halfway in between, or are you standing right beside them and just not saying anything?

I am behind them, always looking over them. I’m always watching. We might stand off a little to the side especially if they don’t like someone hovering over them, but we’re always watching to make sure there's no malfeasance going on and ensuring that they’re doing everything correctly. And we do make sure that before they go do it in a game-time situation, they’ve performed the skill correctly in clinic. 

What else as far as practical preceptor tips?

I just always remember my time as a student, and things that helped me, things that didn't help me. We try to give them the recipe for success.

I always want to make sure that our students feel comfortable and can come to us with any issue, we always have open communication with any question they have and we always want them to learn, so by providing that safety realm of education and comradery, we want to make sure that they know that were an asset for them, we talk to them about how we came to be who we are and we want them to feel proud in their journey too. 

Anything that you've seen or heard from your students over the last few years as something you should try to avoid?

 A lot of the times whenever we do kind of expose them in the first few weeks they feel kind of overwhelmed, but we explain to them that every situation you are in won't be a comfortable one, you are not always going to feel like it's easy.

A lot of times we get “At first I was nervous because you just kind of like put me in there.”, but we explained it, and we went through it, and it is scary but that's what our job is. Sometimes we have them drive our gator, and a lot of times they say they don't feel comfortable doing that so we say okay. We listen to what their comforts are and respect them.

Previous Practical Preceptor Tips Conversations:

Preceptor Tips with Dr. DJ Gilliland

Don't be That Preceptor

Contact Us

Jeremy JacksonMrJeremyJackson on Twitter, SportsMedicineBroadcast on IG, FB

ATCorner Podcast

Ryan Collins

Joseph Eberhardt

Christina Fry

Bob Marley

These people LOVE Athletic Trainers and help support the podcast:

Frio Hydration – Superior Hydration products.

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

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.

Practical Preceptor Tips

Neuro20 – Wayne Smith

Neuro 20 looks like a wet suit with electrodes for E-Stim built in. That is partially true, the materials a spandex or Dri-fit type material, and Wayne and Michael share a lot more on the Sports Medicine Broadcast.

Give me the big picture. Background and origin of the idea.

Founder DJ Schmitt was injured during service and wanted to find a way to get healthy without taking so much medication. 

He used his electrical engineering degree to develop the first Neuro20 suit.

The suit is made up of a compression material(spandex).

Establish firing rates for healthy individuals and be able to choose for the AT/PT to know which one to use.

Where does the name Neuro20 come from?

20 large electrodes placed strategically to engage the maximum amount of motor neurons.

Who is using it right now in sports?

NHL 

Olympic Athletes 

NFL

D1 Athletes

What are the most common applications of neuro20?

Prehab

Rehab

Active recovery

Motor education

Accessibility for the Athletic Trainer?

At the moment it is not accessible to the high school population because of privacy issues.

College-level or professional level

Can you set them up and “walk away?”

Patients can be set up and allowed to complete a workout session on their own.

  • One of our pro sports athletes uses it after games while on the plane for recovery.

Can I use Neuro20 with my high school athletes?

It is FDA-cleared for adult patients.  Some youth patients have used it with waivers and clearance from their doctors but that is not the target population.

Contact Us:

Jeremy Jackson

Wayne Smith – wsmith@neuro20.com

These people LOVE Athletic Trainers and help support the podcast:

Frio Hydration – Superior Hydration products.

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

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.

Marc Pro

Sudden Cardiac Arrest in Sports

Sudden Cardiac arrest in sports with Travis Turner at the Memorial Hermann Sports Medicine Update. Randy and Sandy Harris from the ATCorner Podcast ask all the hard questions.

Contact Us

Jeremy JacksonMrJeremyJackson on Twitter, SportsMedicineBroadcast on IG, FB

ATCorner Podcast

Ryan Collins

Joseph Eberhardt

Christina Fry

Bob Marley

These people LOVE Athletic Trainers and help support the podcast:

Frio Hydration – Superior Hydration products.

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

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.

Hoist logo; rapid hydration