Easy Shoulder Evals – 640

Dr. Ralph “Bud” Curtis goes live with Easy Shoulder Evals from Trinity University's Sports Medicine Symposium 2020.

About Dr. Curtis:

  • 15 Years as being recognized as a Texas Super Doctor. Dr. Curtis has been recognized every year since 2005.
  • Fellowship-trained shoulder surgeon
  • Board of Directors, THSCA Professional Development Curriculum
  • 30 years, UIW
  • UIW Sports Hall of Fame
  • Shoulder consultant: S.A. Spurs, UTSA, Trinity Univ., UIW
  • Hall of Honor THSCA
  • Hall of Honor Southwest Athletic Trainers Association
  • Author of multiple book chapters on shoulder injuries
  • Adjunct Professor, Department of Orthopaedics, UT Health
Easy Shoulder Evals

HAVE A SYSTEM

Needs to be quick and reproducible

Make sure it is age-based and know what is most likely for each age group

Understand traumatic vs non-traumatic

HS to the college level is most likely instability

Sitting fashion helps them relax

Try not to fight them

Find out the background before ever touching the patient

Then the provocative tests

Sulcus test

Load and shift – generalized laxity, not traumatic instability

Neer impingement test is a pretty lousy test

Hawkins impingement test

Anterior apprehension for anterior instability

Posterior instability including the jerk test

AC joint pathology is going to be painful so it confuses the test

Palm down O’brien’s test for SLAP

Anterior dislocation – check to see if there is good smooth motion internally and externally

Posterior instability the converse is true.

These often get missed because they look normal until follow up with ortho.

Once dislocation is reduced check for full internal and external rotation.

ANTERIOR INSTABILITY – 18 minutes

Look at ROM 

Click test is something that can be beneficial

RCT –

Empty can is often normal due to deltoid 

Arm inside external rotation

Stinger / Burner

C5/C6 

Deltoid weakness

External rotators weak

Possibly weak biceps

C7 cervical disk

Strong delts and biceps

Triceps are totally weak

C8 is ok (can keep fingers spread)

Watch the Easy Shoulder Evals Facebook live video

https://www.facebook.com/sportsmedicinebroadcast/videos/626240638142999/

Resources

Other shows from Trinity University's Sports Medicine Symposium 2020

Contact Us

Jeremy Jackson

Shawn Ready

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COVID19 RTP Recommendations – 639

Have you prepared your COVID19 RTP plans?

Bart Peterson and Jennifer Rheeling join the SMB to discuss the current recommendations and considerations created by the NATA Secondary Schools Athletic Trainer Committee to help you create your COVID19 RTP.

COVID19 RTP

We need to reconsider EAPs to include social distancing guidelines.

What about lightning…now, where will they go?

Know what phase of COVID19 RTP you are in from the local public health department.

Know the terminology and how its is defined:

Phase 2 is groups of 50.  Is that on the field or altogether outside at once?

Covid response team

Who is on yours?

They need to know what the plan of action is if you have a room full of kids and one test positive with temps or signs and symptoms.

ATs are a key component in risk mitigation

Being part of the decision-making process is important.

We also have to know how we are going to take care of the over 55 population…coaches, teachers, and officials.

Communication with the school nurse is crucial and this is a great way to build the bridge.

Cleaning Supplies

Districts may need to buy them out of another fund or fund next years purchases now even though budgets have not opened

Hydration

NO water sources until phase 3

Illness Reporting – start with the state, including local, report up the chain. 

Telemedicine –

Congress made this easier during COVID19

Need consent each time you do a telemedicine video

Can not cross state lines

Document as normal

Know your platform

Make sure that this is not occurring in a bedroom

Facebook Video of the COVID19 RTP talk

https://www.facebook.com/sportsmedicinebroadcast/videos/563648741015093/

Resources:

COVID19 RTP Document

Telemedicine

Contact US:

Jeremy Jackson

Jennifer Rheeling email – jennifer.rheeling@gmail.com

Jennifer on Twitter

Bart Peterson – email – arizatc@cox.net

Bart on Twitter

Help them keep supporting the podcast

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Candid Candidates – 638

NATA 2020 presidential Election has Candid Candidates

Chad and Kevan host Candid Athletic Training where they take a look at Athletic Training very candidly.

Kathy and Katie are used to answering questions about Athletic Training and fixing what is broken. We wanted to have some very Candid Candidate discussions to help you know your next NATA president.

Why would your undergraduate mascot make the best Athletic Trainer

KF: Beaver: adaptable, ferocious, make a phenomenal home from out of nothing, leaves everything better than it found it.

Being a team player, quietly getting things done under the radar

KD: Longhorn – Magnanimous animal

Quiet, slow-moving; large and graceful

If you get in the ways of the horns you will regret it.

Rehab specialty: Administration – quiet, contemplative

FMK

KD:

K – Cat D – I want it to be applicable and pertinent

M – EBP – a lifelong commitment to learning

F – Lecturing – it is a rush to share that knowledge

KF:

F – Cat B

M – EBP

K – the Cat D

What will you miss most about the COVID19 2020 convention cancellation?

People, socials, energy, relationships

Mount Rushmore 4 things you feel young ATs will face and need to be prepared for

KD:

  1. Give your self a break…there is a lot to learn
  2. Professional Communication
  3. Continue to learn
  4. Advocacy and showing your value is CRUCIAL 

KF:

  1. Follow your contract – Do not give your time away for free
  2. Policies – have those ready and follow them
  3. You Are Enough…
  4. Mentor over Data

How do you negotiate time for yourself?

KF: your first job is the only one where you might not negotiate…after that it is on you

KD: We are not training our students to negotiate.

How are you going to best get your objectives communicated to people?

KF: NATA News

Be responsive to the people

Be everywhere

KD: Diversity in mediums

Being willing to reach out on all of the different mediums.

Kathy prefers face to face or phone call, but currently have to respond and react.

Opinions on the dangers and benefits of Social Media

KF: uses it as a positive outlet 

FB, Twitter and IG

It is irresponsible to hide behind the account

It is a good source of what ATs are thinking and feeling

KD: Hardest thing is to keep up with all of the platforms

SM can really help reach people

It is really easy to anonymously complain…but is your message getting through if you are hiding.

“We learn the most from people who are unhappy”

Hats – Clinicians, educators, legislation

KD: We all have some of those roles with a focus

  • Feels it is more regarding settings vs roles

KF: I do all three of them

  • The researchers are valuable

Retention Rates in AT

KF: became members of American Advisors for allied health professionals

  • The continued growth of opportunity
  • It is a barge, so we can not turn on a dime

KD: 

  • Supply and demand
  • Negotiate contracts
  • Can we improve life balance in the traditional setting.
  • Non-traditional settings will likely bring the secondary setting up due to economics

Watch Candid Candidates

https://www.facebook.com/sportsmedicinebroadcast/videos/2841586455950336/

Contact Us:

Kathy Dieringer

Katie Flanagan

Candid AT

Previous podcast with your candidates:

Presidential Discussion

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PhysicalTherapy.com; 1freecourse; continued; Physical therapy

Upper Extremity Neuro Evals – 637

Dr. Jason Magonye and Dr. Shawn Scott put together an Upper Extremity Neuro Eval session at the Trinity University Sports Medicine workshop.

Upper Extremity Neuro Eval

Complete the CEU course FREE from Methodist San Antonio

Be familiar with the nuero anatomy of the upper extremity

Cranial nerves – remember they are contra lateral

Dermatomes – sensory innervation to the upper extremity

If it is intact distal, it is intact proximalStart distal and work proximal

Brachial Plexus – 11 min

Latisimus dorsi is the ladder climbing muscle

Subscapular – don’t let them pull their hands off their belly

Supraspinatus – starts abduction until the deltoid takes over.

Hornblower test – teres minor

Ulnar nerve (C7/C8-T1)

Median Nerve (C5-C8, T1) tip of fingers, the palm of the hand

Anterior Interosseous Nerve (AIN) 22 min

Radial nerve – extension nerve (C5-T1)

Posterior interosseous nerve – supinator

Most of the extensors

Nerve Entrapment -24 min

When nerves get entrapped they get irritated.

IF YOU CATCH THEM EARLY YOU CAN PREVENT THE NERVE DESTRUCTION PROGRESSION.

If they are having weakness then we need to really push to have that person looked at

Median nerve entrapment

Pronator syndrome is similar to carpal tunnel syndrome.

Carpal tunnel – positive tinels or phalens

Pronator teres syndrome.

Catch the rest in the podcast or on Facebook.

Do not be afraid to ask your athlete to provide copies of imaging and reports.

Case #1

16-year-old football player who presents with bilateral hand pain. Pushed from behind during a game and landed face down with his hands in front of his body. 

During further questioning of his hands symptoms he states that both of his middle fingers were tingling. 

Due to the fact that the patient is experiencing bilateral symptoms, you must go to the source in which would be the spine (C7 nerve)

Ulnar nerve splits the 4th digit. 

If you have someone who presents with tingling and numbness on the inner aspect of the hand you know that is C8. 

Radial nerve does not go to the tip of the fingers. 

Case #2 

Saddle bronc rider came off his horse and landed on his head. He walked out of the arena and did not complain of neck, head, or arm symptoms. After driving from Colorado to Texas he went to the sports medicine room stating that he had started to experience bilateral middle finger tingling sensations.

Worse thing to do when you have bilateral symptoms, trauma, and numbness and tingling would be to compress the neck. 

Range of motion, neurological testing, and gentle palpation are appropriate to perform in the exam. Orthopedic testing would not be appropriate for this exam. 

During exam in both case 1 and 2:

Flexion/extension movements caused finger sensations. 

Palpation produced “unusual neck pain” at this point your exam is done 

Both cases were referred for immediate cervical xrays. 

Case #1 Xray findings: Flexion tear drop fracture of the C5 vertebral body with grade 1-11 retrolisthesis of C5 and C6. 

Both of them had surgery the next day.

Catch the rest on the podcast or watching the Facebook videos.

https://www.facebook.com/980579115403772/videos/483133775723461/
https://www.facebook.com/980579115403772/videos/522437448480094/

Contact Us

Jeremy Jackson

Jeremy Jackson

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HOIST – No matter your reason for dehydration DRINK HOIST

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Upper extremity Neuro Evals

Dance Medicine with Jatin – 636

What do you know about Dance Medicine?

Jatin Ambegaonkar joins Sarah Gill live in the expo hall in Las Vegas during the 2019 NATA Convention.

Jatin; Dance Medicine; Sarah Gill

What are y'all doing at George Mason

Started in 2007 with a strong dance program, but no medical support.

Documentation!!!! This showed it needed a more a attention and resources for the performing arts facility

Clinical and research area fed off each other

Aesthetic Athletes

How does this impact the way you work with the athletes?

It changes a lot of things…nobody cares what an NBA player looks like jumping and landing.

These athletes need to know their maximum and work below that…what is the maximum you can perform and still maintain your game face

It needs to look effortless and easy

We as AT are tasked to knowing when to push through and when to back off.  Jatin, how do we know where the line is?

They need to recognize the 5 signs of inflammation

Heat

Swelling

Redness

Loss of function

Pain

Only 28% of dance athletes have specific healthcare access

We are focusing on empowering them to know when and how to reach out

How is your interaction with your instructors, choreographers?

Similar to a coach, but possibly a stronger bond to coach than the health care provider

Talk some more about your SMART lab

Collaborative endeavor: Sports Medicine Assessment Research and testing lab

15 years old now

Performance improvement across the life span of physically active people

Determine the quality of life the patient desires

Looking at dance to reduce the risk of obesity in middle schools

Focuses on benefiting the athletic community as a whole.

Recommendations for a small school or dance medicine clinic?

The buy-in is more important than the actual facility or equipment.

KEY – recognize who these people are and what the demands placed on their body

Pilates reformer

A full-length mirror is very important for this crowd.

Standard basic injury care gear

What does return to activity after concussion in the performing visual arts

No consensus yet

Focus on return to learn

Mimic the athletics model – warm-up at a symptom-free, gradual return to participation.

Most concussions for dance are in training rather than the performance which is the opposite of athletics.

Early Return to Activity – 

Issues with the cognitive portion

Take-Home Points

  • Recognize there is a need for the healthcare of this population.
  • How to speak their language and listen to them
  • Treat them as a whole person rather than an ankle injury or knee injury
  • Allowing them to work around the team decreases the social isolation and improves recovery more in this population

Does Jatin Dance?

At weddings he can get down and enjoys himself…even if others do not.  It is about having fun

Not everybody needs to be a good performer to dance.

Other Dance Medicine podcasts

Dance Medicine with Daria & Carina – 457

https://www.facebook.com/sportsmedicinebroadcast/videos/433302290586766/

Contact Us

Jeremy Jackson

Jatin – jambegao@gmu.edu
Facebook
Twitter

SmartLabs on Twitter

Sarah Gill – On IG @SarahGillATC

Jeremy JacksonHost of The Sports Medicine Broadcast

John Ciecko – jciecko@bloomfield.org

Alisha M Penningtonalisha@theatvantage.com

Mike McKenney – m.mckenney@northeastern.edu

Mike Hopper – Mike.Hopper@bishoplynch.org

Clint Sanders – clint@dragonflyathletics.com

These people LOVE Athletic Trainers and help support the podcast:

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Diagnostic Accuracy – 635

Do you personally have a Diagnostic Accuracy cutoff in terms of diagnostic factors to determine if you would use the test?

No, but if there are multiple tests available I look at the most accurate ones. I do not really like it when clinicians do every test available just because.

Diagnostic Accuracy

Are we image happy?

X-ray, MRI, Ultrasound – it is visual, so it gives us something to see

But blood tests do not really give us that.  It has to be done against controls.

Having every injury get an MRI would be great, but it is cost-prohibitive for a lot of people

“If we are sending every patient to get an ultrasound image, then why are we there?”

Talk about treating the patient vs treating the image or diagnostic test.

  • In Athletics, the nice thing is most injuries are life-threatening.
  • But for internal injuries MRIs are lifesavers.

It is hard to argue with an x-ray showing a fracture

What is the conversation you would have with parents before the season begins about your confidence in your evaluations and role at the school?

If I think we can treat them here we will if I think they need imaging I will refer them to our team doctor and he can order the images.

Mention this though: “a non-sports medicine doctor will likely default to out two weeks”  once they do that we are obligated to follow that before beginning rehab and return to play work.

Is there any uncertainty in using diagnostic accuracy values in Athletic Training?

YES!  There is untold value – the new ATs have learned this but it is a new development in AT education.

How do we make Diagnostic Accuracy Language more universal?

It is growing as we have more and more ATs learning about it as part of their education.

More talks at conventions with catchy names

When would you not focus on diagnostic accuracy measures?

In short, yes you can go with your gut and try a few other tests when things seem off.

How do you get students to buy-in?

This is how you win arguments.

If someone questions you and your evaluation you Have numbers and research to back it up…this usually will end the argument.

Make them understand it is not just statistics.

Some orthopedic tests have minimum research or no reported value, where does proof of the value come in?

Yes, you can still do the test if there is a value that is not reported.

Usually, this requires MRI proof.

Some conditions do not have a good test

https://www.facebook.com/sportsmedicinebroadcast/videos/626642927854955/

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Shawn Readyshawnreadyatc@gmail.com

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Dr. Layci Harrisonlharris5@Central.UH.EDU

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ATCornerPodcastATCornerds@gmail.com

Joseph Eberhardteberhardtj@pearlandisd.org

Christina Fry – fryc@pearlandisd.org

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HOIST – No matter your reason for dehydration DRINK HOIST

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Athletic Dry Needling – Save up to $100 when registering through our link.

These people LOVE Athletic Trainers and help support the podcast:

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HOIST – No matter your reason for dehydration DRINK HOIST

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Athletic Dry Needling – Save up to $100 when registering through our link.

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HOIST – No matter your reason for dehydration DRINK HOIST

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Athletic Dry Needling – Save up to $100 when registering through our link.

Presidential Discussion – 634

NATA Presidential candidates Kathy Dieringer and Katie Flanagan join Cari Wood in answering some member-driven questions.

Presidential Debate, presidential discussion, Katie Flanagan, Kathy Dieringer, Cari Wood, NATA, President, election, 2020, COVID19

Jill A. asks – Licensing in California – what’s the plan?

Katie Flanagan (KF): We need to pull back, circle the wagons and reconsider it

Kathy Dieringer (KD): It has gotten to the Governor’s desk multiple times…then vetoed but it does not pass due to politics. There is no lack of effort, but there are organizations working against us.

  • Continue to be persistent

Chris P – How will we work to expand Diversity in our field?

KF: Tripled our membership in 20 years but only increased diversity 3%

  • Diversity wins

KD: Diversity makes us stronger

  • NATA membership stat is about 80% caucasian
  • Other than the board our leadership does not reflect this number

Jeff K – What suggestions do you have for ATs to sustain viable employment due to the lack of sports?

KF: The secondary setting is hugely important and is a portion of what we do.

  • Use Go4Ellis
  • Be flexible and keep growing your skills
  • We need to think forward
  • Reach out to the NATA for additional resources

KD: We do not even know what is coming

  • We are great at responding and shifting
  • Advocate for yourself
  • Maximize your skillset
  • “Can I teach something else?”

Adam – What is the presidential plan for AT growth in rural areas?

KD: All about advocacy, collaboration with NFHS, principals…going to those meetings and getting facetime with those folks.

KF: Empower the local people and walk alongside them.

The NATA may be facing some financial difficulties due to canceling the annual convention.   How do you see that affecting the membership?

KD: Convention is a revenue producer, many ATs have been laid off.

  • What are the financial implications? this has to be considered.
  • Past treasurer of NATA
  • My business background will serve us well in this situation

KF: NATA has been very financially responsible and relies on several checks and balances.

  • NATA Offered ACES prep exam for the students getting ready for BOC exam
  • Creative thinking will be required

Secondary Schools – 

KD: It is where athletes are introduced to the AT for the most part

  • Collecting Data
  • Medical Autonomy
  • Pointing towards available resources
  • Monthly calls with chairs of committees and workgroups “What is working and not working?”

KF: they have rural and urban school settings and her students get to experience different settings.

  • The AT becomes the gatekeeper for the small schools and urban schools alike
  • Need to be flexible and know the situation to make them successful in that setting
  • Investigate equal representation for each type of secondary school

 Should we teach Sports Medicine in high schools:

KF: ATs are now has a seat at the table on the high school medical education

  • I could not do my job without my students…that creates a problem
  • Have them help collect data to show the need for help.

KD: HS ATs have a skill set of teaching

  • They are our preceptors…its what they do
  • The introduction to health professions is VERY important
  • Caution about teaching students skills that should only be practiced by and LAT BOC person
    • Student ATs were attending to the kid with a spleen injury…he almost died.
    • Perception is difficult when people think the students can do your job

Final Presidential Discussion remarks

KF: “I do not want to pretend to know everything.”

KD: “The most important thing is to be unified as a profession moving forward”

https://www.facebook.com/sportsmedicinebroadcast/videos/2859018704153260/

Contact Us

Jeremy Jackson

Jeremy Jackson

Cari Wood – cari.wood@redmondschools.org

Kathy Dieringer – kidier@ddsportsmed.com

Katie Flanagan – FLANAGANK@ecu.edu

These people LOVE Athletic Trainers and help support the podcast:

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HOIST – No matter your reason for dehydration DRINK HOIST

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Marc Pro – Use “THESMB” to recover better.

Athletic Dry Needling – Save up to $100 when registering through our link.

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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 money, be entered in a drawing for a second year free, and support the podcast.

Marc Pro – Use “THESMB” to recover better.

Athletic Dry Needling – Save up to $100 when registering through our link.

MioTech, Presidential Discussion, NATA President, 2020 Election, Kathy Dieringer, Katie Flanagan

Dislocation Management – 633

What is your plan for Dislocation Management?

Ray Olivo sits down with Dr. Mundluru after his Dislocation Management presentation at the Memorial Hermann Sports Medicine Update.

dislocation management; ray olivo; mudluru

Anterior Shoulder Disloaction

ALWAYS do a neurovascular assessment. Every single dislocation should experience this before reduction.

With the Shoulder there is a risk of axillary nerve entrapment

Typically if the nerves are intact distally then they are intact all the way up the nerve, therefore do your nerve tests at the distal end of the limb.

A dysvascular limb becomes a medical emergency so do a pulse check on both sides. double and triple check if there is no pulse as some are harder to palpate

Dr. Mundluru also recommends having the functional tests distal to check nerve and muscle function

  • OK sign
  • Thumbs up
  • Cross fingers
  • Scratch test

Repeat the scratch test at the deltoid and check bilaterally having the patient note any difference in sensation

A good motor assesment for dislocation management is having the patient press backwards at the elbow into the examiners hand. most other ROM tests will be limited or elicit pain.

They also discuss:

  • Brachial Plexus Crush
  • Transient symptoms after dislocation
  • Self-Reduction
  • Sports Specific RTP
  • When does it become surgical?
  • Elbow Dislocations
  • Hip Dislocations
  • Patella and Knee

Whenever possible treat young patients non-operatively.

Have stories of Dislocation Management gone well or poorly?

Send us your stories:

Dr. Mundluru

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.

Xothrm – Best heating pad available – Use “SMB” or email info@xothrm.com and mention the Sports Medicine Broadcast

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 money, be entered in a drawing for a second year free, and support the podcast.

Marc Pro – Use “THESMB” to recover better.

Athletic Dry Needling – Save up to $100 when registering through our link.

These people LOVE Athletic Trainers and help support the podcast:

Frio Hydration – Superior Hydration products.

Xothrm – Best heating pad available – Use “SMB” or email info@xothrm.com and mention the Sports Medicine Broadcast

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 money, be entered in a drawing for a second year free, and support the podcast.

Marc Pro – Use “THESMB” to recover better.

Athletic Dry Needling – Save up to $100 when registering through our link.

Frio Hydration – Superior Hydration products.

Xothrm – Best heating pad available – Use “SMB” or email info@xothrm.com and mention the Sports Medicine Broadcast

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 money, be entered in a drawing for a second year free, and support the podcast.

Marc Pro – Use “THESMB” to recover better.

Athletic Dry Needling – Save up to $100 when registering through our link.

McDonald; Dermoneuromodulation; Medbridge; CEUs Online CEUs; affiliate link
use “THESMB” to get your discount

Ramadan Tips for ATs – 632

Intermittent fasting and Ramadan tips are important considerations Athletic Trainers need to know about and be prepared to care for.

John Ciecko joins Registered Dietitians Kyla Cross and Melanie Battaglia to give some specifics and general considerations.

John has put together this letter for his coaches and athletes

Ramadan Tips for Diet

It has been widely recommended that athletes partake in multiple meals throughout the day in order to maintain the energy necessary to participate in athletic events. Most Muslims will automatically adjust their meal frequency to two meals in a 24 hour period, the Suhoor (early breakfast) which takes place at dawn and the Iftar which takes place just after sunset. The challenge is created as student-athletes find it more difficult to eat healthier meals as each Iftar is generally composed of meals that are high in fat, sugar, and salt. It should be noted that meals at both Iftar and Suhoor generally meet the daily caloric needs for student-athletes they may lack proper nutrients that are essential for optimal performance. 

Since the daily caloric value is generally met by student-athletes it is important to pay particular attention to the macronutrients (fats, carbohydrates, and protein) consumed. It has been recommended that foods high in both fat and protein are consumed during Iftar and that foods high in carbohydrates and low in glycemic index are consumed during Suhoor in order to provide adequate fuel for the day. 

Hydration

Lack of fluid intake throughout the day can create significant risks for those who participate in physical activity during Ramadan as most athletic events take place while Muslim student-athletes are fasting. A common occurrence for student-athletes is to ingest large quantities of fluids during hours of allowed fluid intake. This practice can prove ineffective as it will induce urine loss as well as disrupt sleep. It is recommended to drink water frequently in shorter intervals with solid foods during meals to aid in digestion and water retention. Another recommendation is to drink water with a marginal amount of salt and/or electrolytes prior to dawn to improve water retention and stores. Sugary and caffeinated drinks should also be avoided as they can cause further dehydration.

Sleep

Disruption in sleep will cause daytime fatigue and poor concentration. Coupled with a new fasting cycle, student-athletes may find it difficult to maintain a level of physical performance prior to Ramadan. Student-athletes are recommended to maintain a minimum of 8 to 9 hours of sleep a night. Since meals that break the fasts can often disrupt sleep cycles, student-athletes are encouraged to partake in naps in which they can obtain between 1.5 to 2 hours of sleep in the afternoon when able to in order to negate the effect of nocturnal sleep loss. 

Considerations for Coaches and Medical Emergencies 

Coaches and staff must always be aware of and sensitive to all student-athletes needs both religious and non-religious. It is important during this time that coaches routinely collect feedback from student-athletes but not to do so in a way that draws attention to a student who is practicing a religious observation. It is also important for the student-athlete to make the coaches aware of their practice, as fasting during Ramadan without knowledge can be misconstrued as a lack of effort or performance without the knowledge of these recommendations. 

One consideration to keep in mind is the early days and weeks of a new fasting cycle, is the disruption of a student-athletes ability to self regulate their body temperature during activity without the use of fluids. Student-Athletes will have access to cooling towels during athletic events as well as small cooling tubs in the Athletic Training Room. Student-Athletes are able to rinse their mouths with water in an attempt to stave off thirst but in the event that a medical emergency is believed due to dehydration and/or increase in body temperature, it is allowed to give fluids to the student-athlete and activate the Emergency Action Plan. In any instance, regardless of religious views or practices, all student-athletes should be treated equally as to not draw attention to their needs. 

Please inform booster families that student-athletes may attend, but will not be able to participate in pasta or pizza parties that take place during the season. In addition please inform banquet planning families to consider providing a take-home option during the postseason banquets. Even though there will be plenty of food for them at home, the notice and consideration will not go unnoticed by the student-athlete and their families.

Internet dropped so we have part one and part two on FB

https://www.facebook.com/sportsmedicinebroadcast/videos/233659441117897/?comment_id=233779897772518&notif_id=1586455659727364&notif_t=video_comment

Ramadan part two

https://www.facebook.com/sportsmedicinebroadcast/videos/218545922582875/?__so__=permalink&__rv__=related_videos

Contact us

John – jciecko@bloomfield.org

Kyla Cross – kycross@umich.edu

Melanie Battaglia – melanie.battaglia@memorialhermann.org

Previous Ramadan Podcast

Ramadan and Athletic Health Care – 546

MioTech

Check them out for good prices and great customer service – use THESMB

Paradigm Shift in ACLs – 631

Paradigm Shift in ACL Rehab is eligible for BOC Category A CEUsstart here

Rehabilitation for Anterior Cruciate Ligament Reconstruction (ACLR) has for years followed the time-based approach progressing athletes to the next step based solely on how far they are out from surgery.  Research has shown that criteria based protocols, where each athlete only progresses once they reach a specific goal improves outcomes in patients, specifically athletic populations. (cited research) In this course, participants will learn and discuss different methodologies for athletic trainers to use determining rehabilitation advancement for patients returning from ACLR.

Outline

Why do we say that at 6 weeks every ACL should be able to do a partial squat and be at 90 degrees flexion?

Adrian Peterson only needed 6 months…he rehabbed 25 hours per week

  • Navarro Bowman had Failure To Thrive and was 12 months +
  • Normal rehabilitation is about 9 months but often they athlete still lacks full function at this point and they are not totally comfortable with their knee
  • Let’s look at it similar to school…you pass the test you move on…you fail the test you get held back.
  • 150,000-200,000 ACL surgeries per year.
  • How are we doing a disservice to our patients using a time-based rehab program?
  • NFL bases their timeline on RTP for week ONE readiness

What are the parameters for RTP?

Each phase should have criteria before advancing:

  • Physician approval
  • Published research
  • Biological healing

Tissue healing – know the biological clock and tissue remodeling for each surgery

  • Graft type fixation
  • Other ligaments involved
  • Meniscal repair
  • Microfracture probability
  • Published literature
  • Validates rehabilitation protocol
  • Widespread use by the paraprofessional
  • Looking at specific criteria for return to play

Watch the video inside the course or on Facebook

Contact us:

Bubba Wilson

Jeremy Jacksoninfo@sportsmedicinebroadcast.com

Check out the sponsor of the SMB

Frio Hydration – Superior Hydration products.

Xothrm – Best heating pad available – Use “SMB” or email info@xothrm.com and mention the Sports Medicine Broadcast

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 money, be entered in a drawing for a second year free, and support the podcast.

Marc Pro – Use “THESMB” to recover better.

Athletic Dry Needling – Save up to $100 when registering through our link.