Negotiating Benefits – 651

Susan Taah knows negotiating benefits is the only way to work one job and maintain a quality of life. So she did.

Now she joins Jared Plummer to share her story on the Sports Medicine Broadcast

Negotiating Benefits; Susan Taah

Where did Susan start?

Working at a beer and wine distributor – so in industrial AT.

Susan knew she wanted to make her living solely off of her job, not having to do side jobs.

She knew starting off that she was making at least 40k so she skipped out on several sub 30k jobs.

What triggered you to go into the industrial setting?

  • Start with Why
  • President of the student AT program for 2 years
  • Worked with Volvo truck plant in Dublin Virginia and doing a health fair type event
  •  My why was always preventing injuries

Even though healthcare is part of the job benefits the distribution plant workers were oddly cut off from healthcare

That first salary met my needs and I did not have facts.

Sometimes it is not the right time to advocate. Sometimes you just have to gather facts and data

Susan Taah

What is next in negotiating benefits?

Have a list of things you are accomplishing and want to accomplish at work.

Projects were a big part of what she did.

  • Heat illness was a huge issue
  • They did not have coaching
  • She started a heat acclimatization program
  • Weight charts like in football training camp

She presented the results an findings at her company conference

The company already has a dollar value for loss of man hours, hospitalization, workers compensation. Use them.

What are the factors you feel like you need to put together to illustrate your point?

  • Documentation – Susan can calculate costs based on the cost of hospitalization, loss of productivity. 
  • Expertise – tell them about an area you are an expert in.   ie. hydration or injury prevention

What does this look like in COVID times?

For her current job she had one phone call and two video interviews.

Advocate for why you are the one worth picking and why you are the one.

Have a timeline for when you are going to get certain certifications they will need.

What about times like right now where so many ATs are unemployed?

  • Show your value, your worth, know the important metrics to your employers
  • Be flexible and willing to help
  • Going the extra mile now shows the need for others in the future
  • Long term health
  • Insurance
  • Risk management

Did you drop a bomb or hint at your compensation package?

She was advocating through the process of her previous job

Money talk was saved towards the end so they are bought in and invested.

Give the reasons first, then you are less likely to need to defend the request.

These are the things I have implemented, these are projects I am working on, this is the value I am bringing.

  •  great
  • Write an elevator pitch – maybe 4 sentences – practice it.
  • I have looked over the offer, but it will not be adequate to cover the cost of living and change in responsibility
  • After they hung up Susan thought “I am done”
  • Have your number ready in salary format and hourly.
  • Moving Bonus – she did not negotiate this as it was a one-time payment.


Population you see (only this facility, only one school, no weekends)


What are Industrial setting negotiating benefits items?

  • Salary
  • Moving
  • CEUs
  • Schedule
  • License / certification
  • Lunch break
  • 40 hour weeks
  • Per diem or help

Special thanks to my guest intro by Jonah

Facebook version of Negotiating Benefits

Negotiating Your Benefits

Susan Taah just got what she asked for in her new job.Jared Plummer has always negotiated benefitsAs you are looking for your new job, remember there is always room to negotiate.

Posted by Sports Medicine Broadcast on Tuesday, August 25, 2020

Contact us:

Susan Taah

Jared Plummer

Jeremy Jackson


Frio Hydration – Superior Hydration products.

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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.

Hoist logo; rapid hydration

Energy Drink Education – 650

Energy Drink Education; Brett Singer; Shawn Ready; Ray Olivo
Energy Drinks and Pre-Workout Supplements – What Can We Tell Our Athletes? – Brett Singer, MS, RD, CSSD, LD

Energy Drinks and Pre-Workout Supplements – What Can We Tell Our Athletes? – Brett Singer, MS, RD, CSSD, LD

Posted by Sports Medicine Broadcast on Tuesday, June 11, 2019

Contact us:

Jeremy Jackson



Dr. Mark Knoblauchmaknobla@Central.UH.EDU

Dr. Layci Harrisonlharris5@Central.UH.EDU


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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.

Burnout in Athletics with Dr. Etnier – 649

Understanding why youth burnout of sports is a question Dr. Jennifer Etnier says comes back to coaching.

Who is Dr. Jennifer Etnier?

  • A Fellow of the American College of Sports Medicine and the National Academy of Kinesiology. 
  • Former the President of the North American Society for the Psychology of Sport and Physical Activity and Editor of the Journal of Aging and Physical Activity. 
  • The principal investigator of the Physical Activity and Alzheimer’s Disease 2 study at UNCG.

You talk about sports, but do you even play them?

She plays pretty much all sports

Soccer is the family favorite, but in the days before the interview, she was out water-skiing and playing tennis…so yes she plays

How can we avoid contributing to athlete burnout?

ATs can really help in preventing this, here are a few ways.

  • Educating athletes about being in tune with their own body
  • Educating about overtraining – leads to higher stress hormones
  • Knowing the ability to get over a plateau and encouraging them through
  • Being a confidant/peer/friend

Talk more about the confidant role:

  • If you have a sports psych they should be the main contact.
  • You can really point them in the right direction
  • Sometimes the battle is with the parents
  • We are already knowledgeable of the needs and burnout, but outside of sports can really play a role…acknowledge, normalize, what does bring you joy… let’s bring those things back into sport.
  • EDUCATE, use every tool
  • Know that if I push too hard they may burn out of ALL physical activity.
  • Avoid sports specialization

After the interview, Sofia, my co-worker, said the coach was the reason she quit playing sports in college. She did not feel she could talk to the coach without retribution. Half of the team left because of the abusive style of the coach.

In your NYT article, published earlier this year, you detailed the lack of “quality” coaches at the youth level. What do you think youth organizations could do now, and in the future, to promote higher quality coaching?

Organizations like SportsMedDiscussion that help educate

FUN – people play sports because it is fun…if it is no longer fun it is because of the people in it

Focus on process, not the outcome when a kid says:

“Oh my coach only cares about winning”

They figure it out quickly, if you focus only on winning then they learn there is no point of playing unless you are winning.

Even at the professional level this is true, focus on the process.

FUN and the Process

With respect to the effects that COVID has had on the mental health of student-athletes (young and old), what do you feel are the most important principles that should govern the way we approach coaching?

Dr. Etnier reminds us: Do not cross the line – if you are not a mental health professional do not take on that role

Find joy and fun in our lives

I have never dealt with depression, but in May of 2020 I was dealing with some

Calling friends on the phone.

“Isn’t it great that we are back together” – maybe you need to help amplify

How do we teach “process”

Mental imagery is a great tool if you can teach it

Goal Setting is important

Setting up short term goals that move you to long term goals can help prevent burnout…small victories

Have coaches provide positive feedback not just negative.

From a coaching standpoint: How do you suggest dealing with the kid who isn’t necessarily the “most talented” or “least attentive”? How do you get them to buy-in?

Only as strong as your weakest link the top athletes are going to get the attention, but the bottom half of the order can strike out and kill the rally.

If we all get better than we as a team will have more success than we did last year.

Equitable vs equal is an important shift

What are some suggestions you have for compliance to exercise/practice that coaches can use/we can use ourselves?

Revisit goals

Routine and Rut can get old

  • Is it always the same old thing?  Let’s mix it up

Make it so they want to come.

Always have something new as part of your routine

Play music

Picture wall

Change the location some – outside, hallway, gym

***it comes back to relationships***

Watch Dr. Etnier on Facebook

Burnout in Athletics

Dr. Jennifer Etnier joins Ray Olivo on the Sports Medicine Broadcast to discuss why some kids quit athletics at an early age.Dr. Etnier is a professor at UNCG and life long sport enthusist. She has played, coached, and watched sports most of her life. Through the process she has learned what makes some kids quit: coaching Usually poor coaching leads to kids quitting.We discuss how this correlates to life as an Athletic Trainer.

Posted by Sports Medicine Broadcast on Thursday, 20 August 2020

Contact Us:

Dr. Jennifer Etnier –

Ray Olivo –

Jeremy –

Links and Resources

Article in NY Times

Sponsor for today’s podcast

Podchaser sponsored today’s podcast with Dr. Etnier.

Get connected with potential guests or find some new podcasts on

Patient-Reported Outcome Measures – 648

Have you tried installing Patient-Reported Outcome Measures into your practice as an Athletic Trainer?

PROMs just tell a story” – Dr. Lam

Patient Reported Outcome, Kenny Lam

Brian Columbe from Texas Luthern University and Dr. Kenny Lam join the Sports Medicine Broadcast today to help discuss what they are and how we can add them to our practice to add value to our services. This podcast was at the request of Ryan Pena, long time listener and Athletic Trainer in Dallas ISD

What are PROMs or Patient-Reported Outcome Measures?

Are there different types of PROMs?

Short form 36

Common body region measure – uses FAM

Single item measure – one item questions – numeric pain rating score.

May not be sensitive enough for our patients but the numeric pain scale relates to their understanding.

What is the current state of PROM use in AT? 

Fairly low about 26% of regular usage in AT

PT / OT is 30 – 40% so we are close to similar disciplines.

Usually higher with higher support staff groups

General lack of familiarity with PROM

What are the major barriers related to their routine use?

The main barrier is changing routines, habits, and culture.

Incorporating it into notes

What is your goal?  Use that and the single-item measures to set clearer exercises.

SCAT5 is a PROMs

How do we demonstrate the need for this to admin?

Increases difficulty when bringing in the AD or admin as they may not know or care.

As far as improving the situation, it is truly a case by case basis.

How do you reflect on these PROMs?

Allows you to formalize the impact

ATs are good at asking about the whole person.

We have not systematically assess those components across patient care

Formal single item measures every time a patient comes in.

Share some examples and stories of this being used?

Single item measure is a great place to start

START SIMPLE, build momentum, and expand from there.

Maybe – this year we are only going to focus on ankles and give the FAM for every ankle.

Resources: – article by Dr. Lam

Related Podcasts:

Watch the episode on YouTube

Patient Reported Outcomes with Dr. Kenneth Lam

Ryan Pena of Dallas ISD asked to do a podcast with Dr. lam about PROs.This topic helps to continue our recent interview of Dr, Zachary Winkleman about Patient-Centered-Approach to AT Service.Post your questions here and join us for the live show Thursday, May 7th, at 9 am CT.

Posted by Sports Medicine Broadcast on Thursday, May 7, 2020

Contact us

Dr. Lam @kennyLam_

Ray Olivo@RayOlivo20

Brian Columbe

Jeremy Jackson

Ryan Pena – @RyanPena75 or @DallasSportsMed


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MioTech – meeting all of your sports medicine supply needs – use promo code “1FREECOURSE” to start for free

DragonflyMax – one-stop EMR

HOIST – no matter your reason for dehydration DRINK HOIST

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FrioHydration; frio hydration; Get Frio; Best in class; Waterboy; wisstech; hydration station; sports medicine broadcast; Jeremy Jackson; Rob McFarlin

Chinese Olympic Experience – 647

Ever wondered what it is like to have a Chinese Olympic Experience…and then get interrupted by a global pandemic/

Adam Stoyanoff joins John Ciecko to share his odd path to working with the Olympic kayaking team of China.

Chinese Olympic Experience

Where did Adam get his start?

I have been fortunate to observe and be part of many different things…some may seem wrong, but that is a closed-off perspective.

Assistant coaching at Boling Green University for 3 years – spent time with all sports

Worked with local high schools as a contract S&C coach

Then went out on his own as an independent contractor with 2 high schools and college.

This increased his diversity and ability to adapt his skills.

Then went to Boston to lead an afterschool program for 2-5th graders – larget challenge as you have to keep changing to keep them interested.

Learned it was important to keep contact and build relationships with parents so the kids and parents are doing and talking about the same thing.

Next job was to Dallas, Texas

Opened his eyes to see “there is always a reason why”

Did not spend his life thinking “How can I build my resume?”

He got a phone call from the Chinese canoe association that was training in Waco, about 1-2 hours from Dallas. That lead to him becoming a coach more than a coordinator.

Juataga Portugal was their training site and also made the canoes they were using.

Lived on the training compound with the athletes

More about his Chinese Olympic Experience

Coaching vs coordinating

Coordinating is more like the AD role – dealing with all of the wants and needs

It will stress your relationship building skills

As the coordinator, you are in a service position and making sure everyone has everything they need and want.

“Rocky 4 was a documentary right?” – John Ciecko

But really that is what life is like, someone is always watching you and videotaping

You should always act as if there is a camera on you.  Even in your moments of weakness.

“What are you doing when nobody is looking – definition of Integrity”

You have to stop, observe and listen to understand why a person may be acting a certain way

Chinese athletes are taken out of school at 12-13 years old to be an athlete.

Lessons Learned

The coaches who are and were doing well put their ego aside and were there to serve and help.

Calm and stillness with a few deep breathe

Do not take it personally when a Serbian coach yells at you for setting a plate down to loud and disturbing their athlete.

He was working with professional athletes…professional kayakers who wee making millions

I can get you that info, I need to find the best way to get that to you safely.

Chinese Olympic Experience

Some people just have a good story to tell.Adam Stoyanoff worked with the Chinese Olympic Teams and was in a foreign country when the coronavirus started raging.Join John Ciecko as we hear some of his stories.

Posted by Sports Medicine Broadcast on Thursday, May 14, 2020

Contact Us

Adam – Instagram

John – Twitter

Jeremy – Twitter

Want to be able to make moves like Adam?

School loans and other debt prevent a lot of people from taking the job they long for.

Check out Financial Peace University from Dave Ramsey and change your family tree. If you do the work and stick to the plan it works every time.

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

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.

Krampade – An Intro – 646

Krampade claims to stop cramps through science. John Ciecko, Sofia Mata, and I provide some anecdotal evidence.


Our experience with Krampade


Tasted it. it tastes and feels like cloudy or salty water should.

I have never had an athletic related cramp so I can not vouch for the effectiveness

My wife tried it to validate the Menstrual cramp claim. She honestly hated it but she is not an active athlete or intense workout person.

My boys will drink it but it does not go down smooth.

With a little getting used to it i think players could get past the salty taste.

Jeremy’s Athlete

Senior Male soccer player with a serious history of cramping during games.

he felt the product helped prevent him from cramping but drinking the whole bottle of water + Krampade left him feeling heavy.

With some fine tuning in intake and nutrition I think the athlete could really benefit from the product.

Sofia’s experience

Personal – had a hard time drink it due to the salty nature. Did not feel the menstrual cramps were affected by drinking it either.

Sofia’s Athlete using Krampade

Varsity female soccer player goes down with cramps. Sofia administers the Krampade and within minutes the athlete is back up and running like nothing happened.

John Ciecko’s thoughts –

One swig in and one swig out…if you are not ready for the saltiness then you will spit it back out like he did.

Contraindications – 

Heart or kidney issues check with your doctor

Dietary contraindications –

nope…but two 4ks back to back will create osmotic diarrhea

Watch our Krampade talk on Facebook:

Krampade Live Q & A

Posted by Sports Medicine Broadcast on Friday, March 27, 2020

Contact Us:

Sean Murphy

John Ciecko

Jeremy Jackson

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

Frio Hydration – Superior Hydration products.

MioTech – meeting all of your sports medicine supply needs – use promo code “1FREECOURSE” to start for free

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.

Smart Cuffs by Smart Tools Plus – 645

We are ordering Smart Cuffs by Smart Tools to provide Blood Flow Restriction training to our patients. Sofia has taken the course and we are excited to add this tool to the high school. First, we have some questions for Nick and Ed.

BFR is the ultimate biohack and tricks your body into “thinking it is doing a heavy load without the heavy load”

Ed LeCera
Smart Tools

Talk about the Gen 3 BFR cuffs that are fully automatic.

Gen 1 cuff in 2017 was kinda a POS

But they quickly learned that was not best practice

Multi-chamber system does not allow for limb occlusion.

The new systems are single chamber which are much more effective.

5 sizes of the cuffs that are over 4 inches

External doppler was chosen because it is close to the computer monitored systems

SmartToolsPlus is focused on taking what the expensive units do and making it affordable and compact.

Currently Two models of Smart Cuffs: commercial and consumer

It auto measures the LOP

3 steps, inflates in 45 seconds

The manual model is available, but the system auto senses occlusion and auto shuts off.

Keep it connected for autoregulation of pressure.

What is in Level 1 Smart Tools Training?

Level 1 is a rehab or clinical-based training that is from scratch.

It focused on getting the cuffs on and doing a hands-on workshop.

Discuss the recommended frequency and duration of treatment. 

It depends on the goal.

You can train multiple times per day as there is not any damage being done

One study showed D1 basketball players – 11% increase by using the cuffs on walking programs.

2-3x per week is as effective over the long run

I always have to ask about my elderly parents and grandparents.  How can Smart Tools be used with them safely?

Ischemic preconditioning – getting ready for surgery and being under a tourniquet

Cellular swelling protocol is great for reducing swelling.  As the limb starts to swell from the cuff, then the cells start to reabsorb the fluid which leads to muscle protein synthesis without the muscle damage

Lots of growth factors start moving

Bottom Line: We want to drive growth hormone

SmartTools and BFR

Blood Flow Restriction is an awesome tool that has been for the most part out of reach for the secondary setting due to the nearly $6,000 price tag.SmartTools has a new model of fully automatic BFR tools that makes this great rehab product available obtainable for almost every AT setting.

Posted by Sports Medicine Broadcast on Friday, April 3, 2020

Smart Tools Resources

We currently have a Spring Sale going on. 25% off and free shipping SmartCuffs Basic and Personal sets (code: smart25):

Our Level 1 live courses booked for this year: course for $59 How to Train Clients Online: A Guide to Virtual BFR Training :

Contact Us – email preferred

Joel –

Jeremy / Sofia –

Sports Nutrition with Mandy Tyler – 644

Mandy Tyler is a RD working with pro, collegiate and high school athletes in the San Antonio Area.

She joins us for some key points to remember when fueling for performance

Mandy Tyler

Fueling for performance for games and practice

Eating frequently throughout the day and establish an eating routine for each day

Improving variety in your diet

Timing and wholesomeness of the foods for snacks

Eat every 3-4 hours everyday and plan your meals out

Follow the rule of 3s (3 meals, 3 snacks)

Mandy Tyler presents 3 keys to fueling performance

Key #1 – Do Not Workout on EMPTY 

You can train your stomach like you train your lungs and muscles…work up to a regular breakfast

DON’T eat high fat or fried foods low fiber

Game Day meals closer to the event- hi-carb low protein 

Meal day before high protein (steak, spaghetti with lean meat sauce)

Key #2 – Recover after a workout

Ideal goal recover time within 30-60 min after

Fuel up as you cool down

Need carbs and protein

Freebird or Chipotle might be a great recovery meal

Key #3 Stay hydrated

Decrease performance can happen when 2-3% dehydrated

Post pee color posters in the bathrooms.

Water throughout the day and save sports drinks for competitions

An ounce is about the equivalent of a big gulp.

Need 4-6 ounces of water per 20 mins

Cool not ice cold

Drink do not pour it on your head

Supplements are NOT well regulated

If a supplement works then it might have a banned substance

You are responsible for anything you put in your body.

If it says “boost testosterone” it is likely got a steroid in it

Careful taking pre-workout because they throw everything in them

Look for third party testing for supplements

Do not model drinking energy drinks… it’s just bad practice

Food is energy

Alcohol – interferes with recovery

5 drinks delays up to 72 hours

Other points presented today:

Athletes plates versus my plate model

Olympic committee has an example of this

Consuming adequate calories and protein especially recovery

Immune Health – stay hydrated

Use herbs and spices

Omega-3 fatty acids

Increase variety of fruit and vegetables (more color the better)

Vitamin D

Tart Cherry Juice 


Eating out – make the best of the worst choices

Get it on a bun

Get it on wheat when you can

Milk or juice instead of soda

Avoid supersizing

BUILDING muscle mass

Rule of 3 is important

Eating machine – schedule

Prepare meals and snacks

End day with a large evening snack

Energy Dense foods (avocados)

Weight control – do not sacrifice performance nutrition for weight loss.

Avoid sugary drinks

Nutritious snacks, lean protein to stay satisfied 

Avoid empty calories (frappuccinos, soda, energy drinks) to cut calories 

Ideal body weight has little relevance to performance. 

Focus on performance not body weight

Importance of sleep – get 30 extra minutes of sleep per night


We do science podcast

Mandy Tyler’s Lessons learned: 

  • Nutrition common sense
  • Expect the unexpected
  • Ask questions
  • Be creative and find solutions
  • Work as a team
  • Keep learning

Facebook Live video

Sports Nutrition with Mandy Tyler

Live from the Trinity University Sorts Medicine Symposium 2020.Athletic Trainer and RD Mandy Tyler shares some of the latest tools we can use to fuel our athletes

Posted by Sports Medicine Broadcast on Thursday, 9 January 2020

Links to all the trinity live streams

Sports Nutrition; Mandy Tyler, M.Ed., RD, CSSD, LD, LAT 

Shoulder Evaluation Made Easy; Ralph “Bud” Curtis, MD 

Hip Impingement Eval; Geoffrey Glebus, MD 

When to Refer the Ankle and Foot: Timothy Palomera, MD: Link OneLink Two, and Link Three

The Throwers Elbow; Matt Holland, PT, SCS, CSCS 

Concussions are Treatable: A Multi-Modal Approach to Evaluating and Treating Concussions: Kenneth Podell, Ph.D 

Upper Extremity Neuro Eval: Jason Mogonye, MD

Spinal Deformities: Shawn Scott, DC

Contact Us

Shawn Ready –

Marc Powell –

Jeremy Jackson – @MrJeremyJackson on Facebook, Twitter, Instagram

Financial supporters

Frio Hydration – Superior Hydration products.

MioTech – meeting all of your sports medicine supply needs – use promo code “1FREECOURSE” to start for free

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.

Hoist logo; rapid hydration; Mandy Tyler; Hoist

Why Athletic Trainers – 643

Dr. David Schmidt and Marc Powell discuss Why Athletic Trainers are so important.

Why Athletic Trainers

What was your first interaction with an Athletic Trainer?

He did not have an AT in high school

Dr. Schmidt’s first experience was as a resident

He learned why Athletic Trainers are crucial…on field evaluations.

How did you and Marc Powell meet?

Marc called Dr. Schmidt pretty much everyday…then it became a habit.

Now he looks forward to the regular interaction.

Why are ATs important from the physicians standpoint?

  • unique skill set
  • on field evaluation

Share some stories

  • Dr. Schmidt always took the phone calls… every day
  • He was a mentor and allowed me to grow as an Athletic Trainer
  • Dr, Schmidt endorsed Marc and really pushed him forward
  • Marc can not shoot a deer

Did you intentionally mentor Marc Powell?

well, I did not have a choice…

I really try to treat all ATs the same

Dr. Schmidt wants each AT to know that are not an island. You are not practicing all alone.

What is an important to growth as an AT?

We need to continue to push the envelope for ATs

insurance recognition is critical

Push it forward with each setting – Tactical, Industrial, Collegiate, Secondary

How can a young AT build a similar relationship?

  • Listen
  • Pay attention
  • Ask Questions

What makes a good team physician?


Ability to get athletes in quickly

What are you currently doing to advance sports Medicine

  • Prevention
  • Load Management
  • Understanding the importance of recovery

Thoughts on Why Athletic Trainers are important?

Always seek to get better and tools to your tool box.

Explain who we are…just keep talking.

Contact Us:

Marc Powell –

Dr. David Schmidt – Contact Marc

Jeremy Jackson –

Email the companies that help keep this going and say thanks

Frio Hydration – Superior Hydration products.

MioTech – meeting all of your sports medicine supply needs – use promo code “1FREECOURSE” to start for free

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.

Concussions ARE Treatable – 642

Dr. Podell says concussions are treatable. I have traditionally heard you do not treat a concussion, instead you manage it.

Join Dr. Podell for a discussion live from the Trinity University Sports medicine Workshop 2020.

treatable, ken podell, concussions, trinity

Cervical Strain is Treatable – 3 min

Neck issues can play a big role in prolonged headaches.

Location of headaches may correlate to the c-spine that has been affected.

Role of Myodural connection – 5 minutes

“Effect of the Suboccipital Musculature on Symptom Severity and Recovery after Mild Traumatic Brain Injury”:

Study done in 2016 on myodural bridge and its connection to post-concussive symptoms, may suggest that treating suboccipital musculature early on may reduce post-concussive headaches and/or other symptoms.

Neck strengthening and conditioning – 6-9 min

Neck girth and strength = reduced impact to the head and neck

Strength exercises must be done in all planes!

“The effects of rest and treatment following sport-related concussion: a systematic review of the literature”

Studies revealed that those who reported pre-season baseline symptoms had an increased risk for concussions during the season.

“Sex Differences in Head Acceleration During Heading While Wearing Soccer Headgear”

The study revealed that soccer females wearing headgear had greater head acceleration compared to males who had a slight decrease in head acceleration. This suggests that headgear may not be appropriate for all athletes.

Measuring Neck Strength – 10 min

“Neck Strength: A Protective Factor Reducing Risk for Concussion in High School Sports”

This study showed that “smaller mean neck circumference, smaller mean neck to head circumference ratio, and weaker mean overall neck strength were significantly associated with concussion.”

Vestibular balance is also treatable – 15 min

BESS/ Sway app / Force plate

Balance work = decreased risk of lower body injuries relating to prior concussions

Vestibular-ocular – 17 minutes

“Does it feel unstable to you?” “Rocky boat” 

Are they experiencing vertigo?

Increased s/s if they were previously experiencing motion sickness

Vestibular-ocular issues are a “major source of fatigue, headaches, and cognitive problems

Vestibular Ocular Motor Screen (VOMS); 

smooth pursuits, horizontal and vertical saccades, horizontal vestibulo-ocular reflex, near point convergence, visual motion sensitivity

Home exercises; Eply/Brandt-Daroff exercises and gaze stabilization

Beginning vestibular therapy at two weeks will greatly impact and help during post concussion recovery

Training for professionals in vestibular rehab techniques is available


v-o issues may cause difficulties while driving, showering, and going downstairs

Ocular-Motor exercises 24-28 min

Newer technology;

SyncThink, RightEye, and Oculogica (FDA approved)

Home program “Eyecanlearn” (

Cognitive – 29min

Baseline assessments can be viewed as more of a luxury than a necessity. 

Computerized testing;

Impact, C3 Logix, and CNS Vital Signs

Important qualities needed;

“Appropriate psychometric properties, interpretation by a qualified professional, and an appropriate environment and motivation are key factors.”

They can be more useful in RTP clearance than as a diagnostic tool.

Symptom Reporting – 31 minutes

Post-Concussion Symptom Scale can be helpful in individualizing treatment and rehab.

Psychological / Emotional – 33

Some individuals experience;

Increased anxiety levels and withdrawal (missing school, work, sport)

Depression and Poor sleep (may cause an increase in s/s)

Autonomic Dysfunction – 34 min

Damage of the long fibers that connect the brain stem and midbrain to the cortex which cause dysfunction in communication. 

This is an imbalance of the sympathetic and parasympathetic nervous systems.

Signs and symptoms of Dysautonomia:

  • Orthostatic hypotension
  • Diaphoresis
  • Blurred/double vision
  • Photophobia
  • Bowel problems
  • Exercise intolerance
  • Feeling winded
  • Insomnia
  • Dizziness
  • HR (tachycardia/bradycardia)
  • Tunnel vision
  • Weakness
  • Vertigo
  • Brain fog

Many cardio-vascular responses in concussive patients are altered. 

Assessment – 38 minutes

Ways to assess autonomic dysfunction; orthostatic BP/HR (lying and standing), exercise intolerance, Valsalva maneuver (baroreceptor functioning), HRV, head-up tilt table. 

Buffalo Concussion Treadmill Test (BCTT), assesses “physiologic measures of ANS to help differentiate if post-concussive symptoms are physiologically based.” 

Take away – 42min

After about 48hrs you can begin manual treatment of the head and neck. 

After about 72hrs, if the symptom checklist has decreased, you may begin a controlled exercise program. 

Begin treatment in the EARLY recovery phase. 

Incorporate neck strengthening as a concussion prevention tool. 

A concussion is a multi-system and functional injury that requires comprehensive evaluations.

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