Data Collection and Epidemiology

Data collection is pretty easy now a days with all of the EMR options. We have plenty of data, but making it tell a story is different.

Scott Mullett founder of AT Efficiency has crunched our numbers so we can show you what you can do with them.

Daria Oller has researched epidemiology and wants to help turn those numbers into actionable items so that we can change the patterns of injury.

How our Data Collection is answering Admin Questions.

Dollar Value saved the district:

  1. Ask your stakeholders what numbers they want to see.
    1. The cost of injury for athletes that have gone to the hospital to receive some treatment is $709
    2. Direct cost $168,000
    3. Indirect cost $527,000
      1. There is not a value or cost for them not participating as they are not getting paid to play
      2. These costs are associated with parents' missed work and transporting kids to doctors.
      3. Who are you saving money for?
        1. In high school, it is parents, not the district.
    4. Only 9.9% of injuries at the Penn state campers were sent to the hospital
    5. Healthy Camp studies show 60% of injuries go to the doctor
    6. ADD a “requires doctor visit” button
    7. Document people who went to the ER and the outcomes.
      1. This could be used to help establish a chain of care to get the kids the appropriate care they need.
    8. They increased salary due to the research from the Penn State camps

Treatments per week or day or month:

  1. Average of 300 interactions per month

Does your Data Collection show preventative practices?

  1. Add an indicator saying “prevention” to improve data collection
  2. This may take a few years of data to see if the numbers are going up and down.
  3. You can also compare to national research
  4. WE NEED an incoming freshman onboarding program to prevent injuries.
    1. Educate the coaches
    2. 7/12 football concussions were freshman
      1. Maybe head impact monitoring could help

How debilitating are the injuries

The way our data collection was set up is hard to tell.
– We do have a “Requires Surgery” button but do not always click it.
– We do not have a graded severity scale
– We will add the “Time Loss” button to our daily treatment logs

A few questions we could not answer with our Data Collection

  • Costs of supplies per kid for strength and conditioning versus rehab
  • Other services provided
  • Athletic Training Facility hours/visits per week in healthy versus non-healthy athletes

Tips and improvements from Scott and Daria

Tips from Scott: 

  • Some of the gaps: narrow it down with preventative programs
  • Start small
  • Get little victories
  • Demonstrate the importance of staying healthy

Tips from Daria:

  • Establish your goal(s).
  • Have clear operational definitions.
  • Have objective measures to quantify prevention strategies.
  • Look to the epidemiology literature.
  • Go beyond large numbers. 
  • Consider if your documentation system is helping you capture the needed or desired variables.

Watch instead on

Contact Us

Daria Oller

Scott Mullett

Jeremy Jackson


“The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School. . .” J Ath Train. 2018 53(8) – 53(12), 2019 54(1) – 54(2). 

Non-Time-Loss and Time-Loss Softball Injuries in Secondary School Athletes: A Report From the National Athletic Treatment, Injury and Outcomes Network (NATION). J Athl Train. 2020;55(2)

Injury Incidence in Youth, High School, and NCAA Men's Lacrosse. Pediatrics. 2019;143(6).

Trends in Emergency Department Visits for Contact Sports-Related Traumatic Brain Injuries Among Children – United States, 2001-2018. MMWR Morb Mortal Wkly Rep. 2020 Jul 10;69(27)

Work-Related Injury and Management Strategies Among Certified Athletic Trainers. J Athl Train. 2018;53(6)
Catastrophic High School and Collegiate Cheerleading Injuries in the United States: An Examination of the 2006-2007 Basket Toss Rule Change. Sports Health. 2019;11(1)

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Conflict Resolution

Conflict Resolution is a learned skill. John Ciecko was scared of conflict. By leading the leadership series here on the SMB we have walked through a lot and conflict resolution is a big part of leadership.

Patrick Ohaver was a supervisor for an AT outreach program and had a fair share of conflict to resolve.

This discussion is based off an article by Dr. Jordan B Peterson about becoming a peacemaker

Facts are facts. Opinions about the facts differ. It is therefore the job of the peacemaker to bridge the gap between opinions, and in that manner, bring about reconciliation. The job of the peacemaker is to establish an accord that allows the facts themselves to become a matter of agreement. To do that, however, the peacemaker has to be able to see the facts that lead to peace. The peacemaker threatens, with the threat of peace, because peace means change.”

– Jordan Peterson
Conflict Resolution; peacemaker; primates; Jordan Peterson; Leadership

How can the peacemaker bridge sides of an argument?

How can the facts themselves differ? And if they do differ, how can the gap between men who have adopted antagonistic stances towards one another be bridged? They must want peace, more than security, more than charisma. That means that the peacemaker must be able to sell them something more valuable than victory, more valuable than success. That means the peacemaker must know what it is, that is more valuable than victory. It is for this reason that the peacemaker must be a man of the uncharted seas.”

When we find ourselves in conflict how can we sift through the facts?

John’s situation: Coach was asking questions and seemed to be questioning him and how the situation was handled.

John allowed his opinion of the facts to be more important.

“Relax” usually amplifies the conflict

Amygdala hijacking – emotions get the thought process all jacked up

Is it better to rush or be patient with an opinion or judgement?

“Everyone must therefore have a voice.  The peacemaker, however, must even listen to the damned. He does not know what the facts are, and even the damned might therefore have something valuable to say.  When the facts themselves are in dispute, however, there is nothing left but patience. The invisible becomes visible of its own accord, in accordance with its own frame of time, and there is no pushing when the direction to push cannot be established.” 

Everything in athletics has to be done right now…so we are in conflict with peacemaking situations as we have no patience to work with.

We do not have to fix it now, we can wait for a day.

The more you are able to pull the facts out the more you can heal.

The facts give it a direction

When it comes to resolution is speed over vision, or vision over speed more important?  

“Peace must therefore be a journey – and a journey to an unspecified destination. The peacemaker is a guide, in a country whose topography remains uncertain. As a guide, he has to be going somewhere – but where? Speed is a virtue in the local environment. If the direction is uncertain, however, then speed may be a vice.”

Most of the time it is vision over the speed

Clifton’s strength finder –

If you are pretty certain route “A” is better than route “B” than use facts and allow hem to make the decision

If you continue to go back and use the vision over speed you build capital with the people you work with.

This allows you to use the get this done now statements.

What does it take to become a true person of conflict resolution?

“The man with a disharmonious household cannot serve as a peacemaker… The man who is afraid of war cannot serve as a peacemaker. Peacemaking must be a vocation, and not an occupation.” 

Peacemaking can not be your job title, but it needs to be part of your life.

Vocation – a strong feeling of suitability for a particular career or occupation

Occupation – a job or profession

What is the importance of both empathy and sympathy? 

Empathy – the ability to understand and share the feelings of another

Sympathy – feelings of pity and sorrow for someone else's misfortune or understanding between people; common feeling

Closing Thought:

“‘I fear not the man who has practiced ten thousand kicks once, but I fear the man who has practiced one kick, ten thousand times.’ Conflict resolution must be a skill that is practiced over and over knowing that it will never be perfected.” 

Facts lead to peace

Contact Us:

John Ciecko – @JohnCiecko

Patrick Ohaver – @patc1996

Jeremy Jackson – @MrJeremyJackson

2020 Leadership Series Lineup

Leading Up the Chain

Conflict Resolution

Earned Ledership

The Path of Leadership

Support those who love ATs

Frio Hydration – Superior Hydration products.

MioTech – meeting all of your sports medicine supply needs – 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.


Native American ATs

Muriel, Wyatt, Marisha, Jasmine and Alyssa are Native American Athletic Trainers. They join John Ciecko and Jeremy Jackson to teach about their background, stories, and experiences.

Muriel's Native American Background:

I attended several undergraduate programs in my journey. I was a non-traditional student who returned to pursue my undergraduate in 2009 at the University of New Mexico-Gallup branch campus. After I completed my AA-Assoc. of Business Administration, I transferred to the main campus in Albuquerque, NM in 2013. There I completed my BS in Athletic Training in May of 2018 with a minor in Business Administration.

During my undergraduate journey, I managed to work a full-time job, have my two boys who are now 9 and 15 years old, and take care of my family of four. It was certainly difficult trying to juggle being “Mom, Wife, Student AT” all at the same time and commuting weekly back and forth to home, but I knew ever since I was about six or seven years old Athletic Training was what I wanted to do, although at the time I had no idea the profession existed

Alyssa's background and schooling

My last two years of high school introduced me to my first Athletic Trainer (JD Burgess). A late tour senior year to Fort Lewis College introduced me to Athletic Training/Sports Medicine as a major so I immediately applied and began my education at Fort Lewis College in Durango, CO. I graduated in 2007 and was able to pursue my Masters at A.T. Still University in Mesa, AZ. I graduated in 2009 and went back to Durango to work at the Head AT at Durango High School as a part of Mercy Regional Medical Center. I stayed there until 2015 when my husband and I took a year off to travel and move back to Hopi. After that I set up an AT program at the local high school.  There have been a lot of road blocks

Marisha's Life as a Native American

Marisha Little, LAT, ATC currently works as the graduate assistant to the University of West Florida Athletic Training Program and as a PRN athletic trainer in the Sports Medicine Outreach department of Andrews Institute. She graduated with her Bachelor of Science in Athletic Training from the University of West Florida and is currently working on her Master of Science in Health Promotion. She is the recipient of the Bobby Gunn Award from the Southeast Athletic Training Association, the Legacy Scholarship of the Athletic Trainers Association of Florida, and the Memorial Scholarship of the Southeast Athletic Training Association. Marisha served on the National Athletic Trainers Association Student Leadership Committee from 2018-2019 and currently serves on the Public Relations and Marketing Committee of the Athletic Trainers Association of Florida.

A little about Wyatt

Wyatt's first exposure to AT was in undergrad as a potential PT student.  Changed paths when he was applying for PT school.

Masters of public health from GWU

He left the tribe to get the experience off the reservation to be able to get more perspective.

Currently back on the reservation as a wellness program specialist for Native Americans.

Jasmine's Story:

Descendent of trail of tears

I come from a long line of strong, resilient, compassionate, indigenous women, so it was only natural that I want to help others.  When I was in high school, at Culver City High School, we had a sports medicine program and I was introduced to the field. I went on to get my AA in Kinesiology at El Camino College and then graduated in 2016 from Azusa Pacific University with my BA in Athletic Training. My career started with working for West Coast Sports Medicine and Team to Win, which is a non-profit sports medicine clinic for the local high schools, that are typically in under-served and systematically oppressed communities. I then started my life at Lawndale High School as the ATC.

After my first year there, with the help of my Principal Dr. Rodas, Athletic Director Demetre Howard, and Football Coach Travis Clark, established a sports medicine pathway and program and offer a sports medicine curriculum for the biomedical careers academy and have over 250 students enrolled. We currently have one of the best Sports Medicine programs in the South Bay.

Being the ATC at Lawndale changed my life, it made me want to be a better person for my athletes and students because they deserve greatness from the people around them, they became my motivation. Our football program won a CIF state championship in 2018, I was awarded CIF Athletic Trainer; Champion of Character for 2018/19, and I received the Far West Athletic Trainers’ Association Excellences in Athletic Training award in 2020. I am now the coordinator and program director for the sports medicine education pathway and sports medicine apprenticeship/team we have

Cultural experiences with medicine

  • Other Cultural Experiences
    • Navajo
      • Largest landmass reservation
        • About the size of West Virginia
      • Honor and value kinship
      • Always at the forefront of what we do
      • Known for basketball
      • 40% have no running water, less with electricity and internet
      • We live by a concept of balance 
        • When this gets out of balance we see much more illness
        • Restore balance by getting up early, running to the east, ceremonies, running to the east
      • Over half of the Navajo tribe does not speak the native language because of assimilation.
      • Living in two different worlds is difficult as some of the older people do not feel she is “Navajo enough”
      • Ingenious framework
      • Maternal lineage society
        • Clan type society that essentially makes your extended family your family and builds a close-knit group
    • Hopi
    • Muscogee
  • My experience with medicine and culture started before I started my education in AT and my career. My family has influenced a lot of my “whys”, I have two examples. 
    • Respect to Quality of Life
    • Assuring Pt comprehension and understanding
  • Traditional Ceremonies/Beliefs
    • Kinnalda, Solar Eclipse 
  • (Alyssa) As Hopi, we have our traditional medicine men/women that help with a variety of mental, spiritual, and physical maladies. It is not customary to pay them money, but rather with food (nova) and cornmeal (homa).
  • (Alyssa) Personally, I didn’t have much experience until my freshman year of high school when I broke my ankle. Along with a visit to IHS which wasn’t a great experience, my mother arranged for me to see a medicine man to “reset” my ankle. Very painful and then I received a cast and had no other medical help with rehab/return to sport. 
  • (Alyssa) Our families continue to use Medicine Men/Women for treatment, I don’t know much about Navajo but rely on the athlete/family to keep me updated about what they can/can’t do. The same goes for Hopi, but the very good ones know when to send them to me or IHS for more orthopedic. 
  • (Jasmine) works with many Polynesians at work as well. Tongan doctors and medicine is important for her population
    • Her tribal understanding has made the inclusion and relatability much easier
    • “For your body and practice, what do you need to do?”
    • Prays for her students and asks her ancestors to guide her to best care for her students
  • (Wyatt) – uses a holistic approach and connects the mind and body.
  • (Muriel) – with head injuries, the Navajo will pour water on the ground to shift the energy and try to reset the balance.
    • Teams will go together before a season and have ceremonies together
  • (Marisha) – you may speak to an older person in the third person…instead of “you have this injury…” one might say “if a person has this injury…”
    • In Navajo culture, if you say Grandma when addressing a patient you are showing respect
    • In western medicine that is possibly offensive

College experiences with western medicine

  • Anatomy Lab
    • (Alyssa) College/Grad School was my first experience with cadaver lab anatomy and physiology. We have some taboos about dead bodies so I went to my grandma (So’oh) to ask about what I should do. She explained that since I was doing this as learning to help others, it was ok to do, but try not to touch. Luckily, both my teachers were very understanding and allowed me to observe and let my classmates do movements for me. I had to cleanse myself, spouse, and the apartment every time I got home with cedar smoke (momahpi) and cedar wash (boiled cedar water). 
  • (Alyssa) When I was in Durango, I experienced what it was like for families that had good insurance. We were spoiled as we had two Orthopedic Surgeons that did visits to our school and when they needed to get seen quickly, all I had to do was call. We also had access to a school health center with an NP on-site as well as several Family Physicians. This was something I never saw at home on the reservation.
  • (Jasmine) We learn the routine basics, core classes, AT classes, etc. I think one in order for us to be good at our jobs we need to be understanding of western medicine. But we also have to be willing to learn about other cultural medicine. When it comes to my practice we focus on a lot of mind and body experience; refocus before treatment, we do breathing exercises and have a conversation focus on what the patient's body is telling them and then reinforce the idea that whatever we are doing will improve their well being. My AT education incorporated a lot of other styles of medicine; eastern medicine for example. I had a professor Bill Ido tell us all the time; “treat locally, but look globally” What is really wrong with the patient. We incorporated a lot of cupping, essential oils, incorporating anti-inflammatory foods into the athletes' diet. We have to embrace our cultures and other cultures and accept the fact that sometimes western medicine isn't always the correct method, it's subjective (Jasmine)

Current job and AT experience

  • Alyssa
    • Part-time AT at Hopi Jr/Sr High School (2016-current) l and created a Sports Medicine Club (2019) at my hometown high school on the Hopi reservation.  I have another full-time job as a Parent Educator.
    • Arizona Athletic Trainers Association Secondary Schools Committee Member (2019-current)
    • Native ATs Discussion Group (2020)
    • Head AT Durango High School (2009-2015)- responsible for over 23 sports and three different venue sites. Proctor for Fort Lewis College student ATs. 
    • AT Still University (2007-2009)- Various GA Assistantships at a city public high school, private high school, and sports performance clinics. Was able to cover the NABI basketball tournament and be a speaker for youth (2008).
    • Fort Lewis College (2003-2007)- Women’s basketball student Athletic Trainer senior year
  • Jasmine: Athletic trainer for TTW and Children's Hospital of Los Angeles; CTE Sports Medicine Program Director

Things I should know when working with a Native American

  • Family Oriented- Strong family ties
  • Athletes sometimes work with Traditional Medicine People, or Shalman’s and so we have to be mindful that they can’t do certain things or ask about treatments they may have received? For example: 
    • Navajo way – they remain revenant sometimes for four days, so this may mean they can’t be at practice, or they can attend but not allowed to participate. Just varies from each athlete. 
  • When working with anyone from a different culture or race we first need to check our own implicit biases we may have about that culture or identity, and then be culturally sensitive, ask lots of questions beforehand and understand that you may need to incorporate traditional medicine people or medicines into your practice. Be open to learning about other medical practices
  • (Alyssa) Many students are shy and need to take some time to talk to you
  • (Alyssa) Hopi still practice our cultural traditions and our ceremonial calendar runs from Jan-Nov as a part of the solstices. It is very common for athletes, coaches, and staff to miss school/practices when we have many of our dances/ceremonies. In February, we have our Purification time (Powamuwa) where all the villages are busy so the schools offer Cultural Days every Friday to accommodate all the students/staff not being at the school.
  • (Alyssa) Working with Navajo and other tribes students are affiliated with is asking what they are comfortable with and making efforts to be respectful of different beliefs.

How has COVID affected your nations and how have you been able to help?

  • Alyssa – there are alot of considerations
    • It takes us an hour to fill our tanks and 3 tanks to fill our cistern…we have to haul water in and 20 seconds of handwashing might not be feasible
    • Maybe have kids shower at school to improve water usage
    • They do not have any full functioning grocery stores without driving to a city
  • Jasmine – took it as a call to action to bring awareness to the situation with her people.
    • She was told “if it does not meet a social media agenda then it wont pick up steam”
    • She decided to teach her students about it and that has brought about change inside her school
  • Marisha – You can still make a difference wherever you are
    • Stand in solidarity with her tribe.
    • Multi-generational housing
  • Muriel – experienced a lot through COVID
    • Became a pharmacist delivery agent
    • Used her AT connections to help guide her community in education and contact tracing
    • “57 – hour lockdown” have prevented some people from being able to get the supplies they need

How can we help advocate for Native Americans?

  • Wyatt – educate yourself and advocate for equal rights
  • Muriel – reach out to someone in a similar situation
    • I want to be a mentor to our upcoming youth
  • Marisha – being aware and education; collaboration
    • Navajo water project
    • National missing and murdered women and children 
    • Bi-culturalism is a real gift
    • We are looking for people to connect with
    • Education is not solely our responsibility, it has to come from the top and the bottom
  • Jasmine – Educate and advocate
    • I do not want our culture to be unheard
  • Alyssa
    • We have learned how to balance living in both worlds.
    • I had to learn how to look people in the eye
    • There is an assumption that all native tribes are the same…

Call to action:

  • (Alyssa) All Native American ATs need to come together to show our youth, especially on the reservations, the wide world of Sports Medicine. There are so many professions to pursue that our tribes need and we have to not be scared to be the “first” or “only” in those professions. I am unfortunately used to being the only Native in a lot of AT and Sports Medicine circles. I want that to change, I want to see more faces like mine, not only in the AT profession but in leadership roles as well.
  • Join the Native American Athletic Trainers Instagram group
  • Or the Native American ATs Facebook Group
  • Or the Native American Athletic Trainers video chats

Contact the Native American ATs

Muriel –, FB:Muriel Tapaha-Tsosie, IG: @runsmallsrun

Alyssa –

Wyatt –

Jasmine – @jasvelasquezatc 

Marisha –

John Ciecko – @JohnCiecko on Twitter


Frio Hydration – Superior Hydration products.

MioTech – meeting all of your sports medicine supply needs – 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.

Psychological Risk Factors for Injury

Shauna Ericksen is doing her Ph.D. work on the Psychological Risk factors that contribute to injury.

Eli Kassab joins the Sports Medicine Broadcast again as we discus mental health.

Psychological Risk Factors for Injury; Shauna Ericksen; Joshua Tree

Shauna, you are quite active and adventurous, what are some of the ways you stay active?

I was moving from Oregon to Montreal and decided to make a mountain biking trip out of the journey.

Moab is legendary and so we decided to do it. Coming down off a boulder I got off balance and landed on a tree hanging over the cliff. Sprained my knee in the process.

Did a self-evaluation and realized I needed to ride down the mountain.  I had to cut the trip short, luckily I was headed to work an AT event where my colleagues evaluate the injured knee.

What got you into the Psychological Risk Factors of injury prevention?

Shauna joined a free course online to grow her mindfulness and improve happiness.

Shauna had been asked to deliver a mindfulness talk to her colleagues.

It is all about the history of our stressors (upbringing, previous injuries, health, nutrition)

Has the mindfulness translated to your practice?

It helps in her coaching and one on one strength training.

It allows her to pick up on emotion and open up the dialogue.

Allows them to critically think about and process the stresses

“How is work going at home”

“Are your parents able to help?” 

“I traveled around with a hypnotist for a summer”

Halloween at the theme park -> went to a hypnotist show

Shauna was the volunteer

Mom ordered some hypnotist CDs

Mom offered Shauna’s assistance

Then traveled with her for a summer.

She may have been one of the biggest influences in the career choice and style of treating athletes with a mental IQ.

Making it commonplace to talk about emotions was huge for me as a practitioner

“Why can you not just tell me something is wrong” – coaches treat them differently when they are injured or hurt physically or emotionally.

I have seen athletes go from 0-100 in their head really quick…oh no, I’ll never play again…

Let’s not skip straight to the end of the book and read chapters 1, 2, 3.

We need to use our tools to help them focus on the here and now.

We have to be cautious with our playful banter and acknowledge their perceptions.

Encourage them to be open and honest with their emotions about the injury.

How are you using that in your practice as an Athletic Trainer?

It is extremely important for us as ATs to look at mindfulness.

It is not everyone’s strong suit but we can learn to be emotionally mindful

Teach them to express their factors without being judgemental.

We need to practice mindfulness and good mental health practices.

Discuss some of the more interesting/shocking finds 

Last year I wrote a critically appraised paper and submitted it about the psychological risk factors.

4 constructs and how they correlate to injury outcomes.

Some research has ID’ed at-risk athletes but are geared towards all athletes not just the ones at risk.

The realm of intervening to reduce injury risk is all new.

video, cognitive awareness, imagery are tools used to help reduce injury.

Overuse injuries are the most common associated with Psychological Risk Factors.

How long was the research for that paper?

Started in January and submitted in July

Have you seen anything with COVID and Psychological risk factors?

It has changed a lot, data is not as accurate since people are not playing sports, not exposed to the AT staff, practicing on their own

The initial thought would be reduced injury risk due to lower volume.

Instead, we shifted to treat this as an official offseason to train them to use mindfulness, sleep, eat, and hydrate properly.

There is a catastrophe mindset and we do need to implement the mindfulness.

My biggest goal is going to be how can I help other AT to incorporate these into their injury practices.

Data shows this works if you do the work, in the beginning, the athlete will be healthier longer.

Contact Us

Shauna – IG: mvmt.matters

Eli Kassab –  IG: elikassab 

Jeremy – IG: Sports Medicine Broadcast

Financial Partners

Frio Hydration – Superior Hydration products.

MioTech – meeting all of your sports medicine supply needs – 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.; 1freecourse; continued; Physical therapy

Leading Up The Chain

If John Ciecko was not leading up the chain when COVID hit Bloomfield Hills High School would likely not be back to sports as safely or quickly as they were.

Patrick Ohaver joins John in discussing how we can lead up the chain even when it is not easy.

Image from:

Due to COVID a lot of things have changed.  What is the current state of Sports where you are?

Off-season conditioning in May / June

Onsite training forced the Sports Med Staff to shift to screening protocols.  Some days were long but we screened over 3,000 athletes.

John reached out to his contacts, Kurt Andrews at KC Sporting, and found what they were doing that worked really well.

August 12 was the start date for football

The state decided to start in phase 2 of the NFHS modified plan

Pretty much everyone was practicing outside.

They were able to block off parts of campus and then adjust as needed to create a more secure setting for them.

The state continues to change the requirements.

Lots of long days re-evaluating

Math is confusing: 10% capacity up to a cap, then you divide that by 6 feet

Swim team practiced outdoors.

They decided to cancel football for the fall and allowed some spring sports…but Spring sports in March in Michigan are a nightmare


Governor issued another executive order.

Patrick Ohaver:

July they were in stage 4 of 5

Indiana never planned to postpone football

His school decided to be more conservative and practiced outside.

Soccer played two games then started playoffs.

Individual school boards were left to plan.

Discuss the conversations you were involved in once the talks started happening.

Jamie Woodall’s document for the UIL set the standard for a lot of places

Relationship building is key – John has been building them for years

He has a group text with the principal, school board president and superintendent…that is a position of influence.

The school shifted to two cohorts:

Monday/Tuesday is group 1

Thursday/Friday was group 2

Cleaning was Wednesday Saturday

Where have you been able to lead up the chain?

Patrick – I will work by the hour and we can compact all of the practices into a 4-hour window each day.

School covered his liability insurance

Then he switched hospital systems to keep care flowing without interruption.

Pre-planning and “medical timeout” helped prevent a catastrophe

John – consider your team in the building…

Your custodial staff needs to have a seat at the table too. Involve the leaders of every group that is affected.

Get the team doctor involved in how care will change.

What does an event venue change look like?

My first internship in college taught me about making friends with secretaries and our custodial staff.

How do you see this impacting sports long term?

We are seeing a philosophical change in ideas…how important is this game when it comes to community health???

We are looking more at a big picture now rather than minute details.

We need to look and consider how this affects the mental health of students and athletes.

High school sports are important to emotional health, but is this game this week worth the risk???

Athletic Trainers are Health Care Providers

COVID highlighted the superstars on social media

What do I do if I do not have that seat at the table?

Start from here and build community

You can force your way into the door or build relationships.

There is a time and place to be abrasive and a time and a place to cultivate.

John had to learn how to ask to be at the table.

The more trust you earn the more respect you will get and the closer to the head of the table you will sit.

“How dare they not have me, John Ciecko, the medical expert here at the board meeting!!!”

– John Ciecko

What are we looking forward to in the 2020 Leadership series?

Conflict Resolution with Patrick Ohaver

Earned Leadership with Kevin Parker

Path to Leadership with Rick Cox

Documents created at BHS:

Modified step 2 protocol:

COVID Guidance for return to sports

Contact Us

John Ciecko

Patrick Ohaver

Jeremy Jackson

Keep the podcast alive…because it is not free

Frio Hydration – Superior Hydration products.

MioTech – meeting all of your sports medicine supply needs – 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; Conflict Resolution

AT Wolfpack – Time to Join

The AT Wolfpack was born out of a need to communicate and commiserate.

The founding members join the SMB to discuss the origin, what is has become, and where they think it might grow into.

What’s the deal with these late-night Wolfpack zoom calls?

With fewer people we get a little deeper in our feelings…or maybe just discussing the state of AT

Someone joins today, what can they expect to cover tonight?

In the word of Josh Dawsey – “Zooms are like a box of chocolates, you never know what you are gonna get”

Paul – we may start talking about ankle sprains, jump to Bar-B-Que then to concussions on to whiskey, then back to ankle sprains.  And they are all related somehow.

How did this start?

Thomas and Ed were meeting with people on ATTalks and then COVID sent Tom home without the internet.

They needed something to get them together and then… Ed sent out a tweet to see who would be interested and 40+ people responded.

What have been the benefits?

Connection – lots of people have connected as they have traveled with teams, for personal reasons or related to moves.

We are building a network of ATs whose main connection is friendship.

It is a safe space.  Some ATs have jumped in, taken the mic for a rant for 10 minutes, ended up in tears, received some connection and virtual hugs, and then been able to move on.

Jumping into a group of 100+ ATs can be intimidating.  Speak to that person

Sit back and watch, or just jump right in.

Plenty of people sit and listen and watch until they have something to say or add.

Nobody is looking for perfection or a professional presentation.

Jeremy is an example:

  • Jumped on a call after a run and left the camera on…shirtless
  • Used thy massage gun on one of the kids with only the mic on and said “you can use this on my feet next” then you hear the massage gun.
  • Laying on the couch with the baby shirtless for the skin to skin contact.

I set the bar pretty low…of course so that others will feel welcome..”At least I wasn’t shirtless like Jeremy…”

What have you struggled with in growing or maintaining it?

Getting back to work has made it slightly more difficult as Tuesday and Thursday nights tend to be game nights for ATs.

There is not a structure or leader, just the more active members help to keep it regulated.

Where is it headed?

To Orlando for NATA 2021 then who knows.

Contact Us


Paul Rupp –

Thomas –

Ed –

Jeremy – MrJeremyJackson on FB and Twitter

SMB Supporters

Frio Hydration – Superior Hydration products.

MioTech – meeting all of your sports medicine supply needs – 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 Wolfpack

Running Medicine with Dr. Natalie

For Dr. Natalie, Running Medicine came from a passion for running, experience as a Physical Therapist, and a furlough during COVID.

Dr. Natalie Niemczyk is an accomplished runner: finishing race distances in running and triathlon events including 5ks, 10ks, Half Marathons, Marathons, Sprint Triathlons, Olympic-Distance Triathlons, and Half and Full Ironmans over the past 11 years!

Additionally, she is a Certified Strength and Conditioning Specialist, Certified Running Technique Specialist, as well as a Certified Canine Rehab Practitioner and RRCA Run Coach.

What made you decide to get into running medicine?

  • Passion of mine
  • Experience within the field as a runner
  • Wanted to channel my focus on one specialty
  • Value in finding specialists
  • Building knowledge in one topic vs. generalized practitioner

How much does being a practitioner of running help your ability to treat patients?

It lays the whole foundation

“Running a marathon, I know that pain at mile 24”

“I had a tonsillectomy at age 8, then a c-section…I have been healthy.

It has taken over a year for me to get back to normal after that surgery.

“It’s weird, but I kinda like getting hurt so I can relate to what they are feeling”

– Todd Sabol

Todd's coupon code for the WHOOP band

What courses do you recommend to healthcare professionals looking to enhance their ability to treat runners?

Common misconceptions and technique mistakes in runners.

  • There’s one form out there that is universal and works for everyone! Everyone is different!!!
  • Forefoot vs. Heel Strikers 
  • 180 cadence myth

What are your goals for Revolution Running Physical Therapy in five years?

So excited to have a one-stop-shop for runners where they can receive physical therapy, injury prevention education, gait analysis and movement assessments and coaching all for runners, all under one roof! I also want to welcome runners at any level, including recreational runners, beginners, pregnant runners and elite. 

5 years: Have another therapist on board with the same passion, a rev running sponsored team, become better known and trusted within the community and be runners go to, get my hand into some running research!

Embrace Race: elaborate on this event and who benefits from it

EmbraceRace is an organization that was created by parents of all different backgrounds and nationalities, and they provide webinars, articles, and resources for parents to help raise children that are inclusive, understanding, and brave about race. My buddy Jen from EliteFeats and I created this Virtual 5k & 10k to raise money for EmbraceRace– you can complete the race between October 24th-November 1st!

Sign up at!

Contact Us

Instagram: @natalie.dpt & @revrunningpt

Todd Sabol@ToddSportsMed


Let's continue to grow together

Frio Hydration – Superior Hydration products.

MioTech – meeting all of your sports medicine supply needs – 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.

Patient-Centered Approach to AT Services

Dr. Zachary Winkleman is leading his students to provide Athletic Training services from a Patient-Centered Approach.

Complete the course work to earn Category A CEUs sponsored by Methodist Healthcare Sports Medicine of San Antonio

Patient centered approach, patient based care.

Consider the Social Support system –

Hey do you want me to talk to your family…or do you have someone you want me to call.

By doing everything for the patients you are enabling them and preventing them from owning their own health care.

Walk them through the process instead of doing it for them.

Do your patients understand what you are saying…or handing them?

The average reading level of America is 6th grade….So all of our forms need to be revised to that reading level

An affluent suburb may not appear to have health literacy issues, but you need to look at the support system and handle this individually.

Consent and assent are both important.

Set and agree upon goals in your patient centered approach

SMART goals – what do want to get out of the appointment today?

Sometimes they only want to know they are OK…not how to get better.

You can give them options.

1 – do exactly what I say

2 – part of what I say

3 – none of what I say

Your choice but the outcomes will be…for each

Coordination – our job is coordinating NOT EXECUTING

Making sure patients feel powerful and not powerless.

Fear and anxiety may not be more prevalent, but they are more willing to talk about it.

PHq9 and screen patients is a good tool

Communicate – What do you normally ask during your evaluation.

5 step interview – patient centered approach

Step One

  1. Welcome the patient
  2. Use their name
  3. Introduce yourself and ID your role
  4. Ensure patient readiness
  5. Remove barriers to communication (sit down) – removes the powerful struggle
  6. Ensure comfort and put the patient at ease
    • A patient had been sexually assaulted in the prayer pose…therefore any sort of rehab in that pose triggered her.

Step Two

  1. Indicate time available
  2. Forecast what you would like to happen during the visit
  3. Obtain list of all issues the patient wants to discuss
  4. Summarize and finalize

Step 3

  1. Start with open-ended questions
  2. Use non-focused skills (silence and non-verbal encouragement)

Step 4

  1. Echo the patient’s words back
  2. Request
  3. Elicit emotional story (allow them to tell you their story

Step 5

  1. Summarize
  2. Check accuracy
  3. Indicate the style
  4. Ask permission to touch

The Golden rule does not really work…you are not the patient, their experiences are not yours.

Shift your mindset one piece at a time.  Choose one thing to implement in your practice.

8% of athletes believe the AT could not make a health status decision without the coach.

Twitter question:

Talk with parent and determine the goal and reasoning

Educate about the bigger picture

Discuss with patient

Do not put yourself on opposite teams as the patient/parent.

When we teach people 

A common question we ask is “do you have any questions?” Try instead a teach-back method – repeat these steps back to me as you understand them.

patient centered approach

Watch Patient Centered Care on Facebook

Contact us:

Dr. Zacahary Winkleman –

Jeremy JacksonMrJeremyJackson on Twitter and Facebook

Ray Olivo –

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 – 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.

patinet centered approach

Complete the course work to earn Category A CEUs sponsored by Methodist Healthcare Sports Medicine of San Antonio

Orthopedic Trauma – Daniel Ruedeman

Orthopedic Trauma is one of the newer settings an AT can work while being employed in the physicians practice setting.

Daniel Ruedeman joins Sandy Harris and me to discuss what Orthopedic Trauma is and how Daniel is setting the stage for AT growth in the field

Daniel, where are you working right now?

University of Colorado/ UC Health

Orthopedic Trauma

Limb restoration – Patients with non-union fractures


Prevent amputations

Osseointegration – interactive way to help amputees with their artificial limbs

Doing AT for about 20 years

Daniel has worked in the PT, college and secondary setting

“I do not want patients to come in and have just a doctor appointment. I want it to be a relationship and a positive experience.”

He was the first one hired in the hospital setting at UC Health

When they first hired him they did not know what his role was and he was able to build that from the ground up

What was the transition like from the traditional setting?

Started with him shadowing the physician

That lead to a team focused approach so nursing, MA, AT, Doc all communicating the same thing to patients

Being the pilot AT Daniel was able to set the stage for bringing on an AT and the office manager connected them.

Departments like Oncology was asking how they could get an AT to work with them.

He was also an office manager at a private practice between clinical sites and his current setting.

What does a week look like in the Orthopedic Trauma center?

Works 4/10s

40 patients between 7-2

Taking brief history

Allows the med students to do the exams

Preps the patient for what to expect

Schedule next appointments

Scheduling and setting up PT

Home exercise programs

Off Tuesday

Wednesday is half office time / half clinic

Thursday/Friday are full of clinic time

Trauma doesn’t stop during COVID

Tell us more about your Orthopedic Trauma job setting

They use EPIC for the EMR.

Daniel feels the open line of communication is important.

The whole team is important.

He touches base with each of his professionals almost daily

What are you seeing in Orthopedic Trauma?

Sees a lot of tibial plateau fractures

Do not do spine or hand stuff

“Any student that does a rotation or internship with me, I want them to Look at the x-ray and understand the injuries, but also think through the process of how the injury happened.”

What do you not love about Orthopedic Trauma?

Constantly building relationships

Life balance has become a key focus

Daniel leaves work at work

How does Sandy create life balance?

It is tough since they are both ATs and host an AT podcast

They do have a dog

Do you have a hard close time?

There are no rain delays or extra innings in the OT center

They schedule their last patient at 3:30 so they have time to get out by 5:30

He has flexibility to leave at 4:30 or earlier if needed

He was furloughed during COVID and then switched to hourly.  Now he has to watch his hours.

What are some of the cool tools you see?

Worked on a leg ring like Alex Smith used.

Got to see a rod running through a pelvis

Discuss the talks you do across the country and where someone should search to learn more?



Email Daniel for more

Contact Us:

Financial Partners for the podcast:

Frio Hydration – Superior Hydration products.

MioTech – meeting all of your sports medicine supply needs – 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 Education Post COVID – 653

What does AT education look like now from a student's perspective? What changes both positive and negative have come from the pandemic?

World Federation of Athletic Training and Therapy (WFATT) has put together a global group of students to share their take on on AT Education post COVID-19.

AT Education

Tell us about you

Kate – should be doing her internship at the University of Pitt but is at home in Dublin

Possible masters in physio or research in AT

Madie – St. Louis University in her 5th and final year

Dream Job – D1 Sports in US

AT Education, Madeleine Bozych, WFATT, COVID

Nick Lichti – Manitoba Canada

Hockey guy preferably with a pro hockey team

AT Education, Nick Lichti, WFATT, COVID

Anat – Israel

Entering her final year as part of the first class of Sports Medicine in Tel Aviv

AT Education, Anat Buhnik, WFATT, COVID

What has been challenging about the transitions associated with AT Education and COVID-19?

Anat – nobody expected it

Hard to pay attention at home

Difficult to test on different bodies without risking exposure

Taught her to be a self-learner

Learned to be more sophisticated in the way she learns

Maddie – Went home for Spring Break and was not prepared for learning home

Wifi Issues

Learned the back over zoom

Had to get help from her family for her practical skills

Studying at home with 5 other people in the house

Kate – Gained independence learning

Looking forward to getting back to face to face.

Nick – U of W hands-on exams have been postponed without an official date for completion…

It is basically a waiting game right now

Masks at your placements make communication harder.  It hides expressions.

Gloves for all assessments can make it harder to palpate an area.

Lost a lot of jobs and volunteer opportunities due to COVID – very frustrating.

What do the leaders in AT education need to know from YOU?

Maddie –

  • Every expectation and experience…throw it ou the window. 
  • Seek feedback from students
  • Revisit a lot of topics
  • Be flexible
  • Take your time with students
  • Students need to extend grace as well


  • They know we need practical experience and are patient.
  • Keep in mind each student will adat differently


  • Do not be so hard on yourself
  • Academics in general should take advantage of this opportunity to improve teaching and learning skills both in-person and virtual.


  • Professors have been role models during this time.
  • Been available for questions and transparent

“We are still very eager to learn, even virtually”

– Nick Lichti
  • Try to replicate the structure of a typical AT class into the virtual format.
    • Do demos over zoom rather than just talking over lecture slides

How have you seen a change in roles in AT in your area?

Kate: AT is still unheard of and fighting for a place at the table in Ireland

Athletic Therapists are still treated as personal trainers

Anxiety drove Kate to contact her local club teams where she was able to learn a lot more during the pandemic by putting herself out there than she did in college.

“It is kinda a blessing in disguise”

Maddie – a new appreciation for AT, I learned more of the administrative side.  In college, we focus so much on the clinical skills

Worked with the preceptor being in the meetings and advocating for the students

Worked as a screener for COVID

Loved seeing how her preceptor advocated for the overall health.

Grew in understanding

Jonathan Burch at SLU

Morgan Jasperton

Nick – “I watched some ATs step-up and volunteer on the front lines.”

Continued working with the hockey team as part of the screening team.

More spare time – allowed Nick to look into other areas of improving himself and his AT education. He is currently studying for the CSCS exam.

You also begin to appreciate in person classes and exams.

Anat – Sports Therapy is not acknowledged by the Minister of Health so we are still limited.

Worked with some COVID related patients as well

Contact Us

John Ciecko – @JohnCiecko

Jeremy – MrJeremyJackson on Twitter, and Facebook

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 – 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 Education