Connecting PTs with the Athletic Training Facility

Connecting PTs and ATs to create a high-performance sports medicine team is part of the mission Dr. Eddis Smith is accomplishing with Ellie Roenig.

Connecting PTs

As an AT I want people to know why we should collaborate.

We need to move things forward in creating high-performance teams

PT, AT, Team Doc, Mental Health, Sports Science.

We send our residents 4 days a week to the AT Facility

And available after school and on Saturday

Load management – How do you do it?

Create high-performance teams

Communicate

Close those gaps

Athletes need to be weight room ready when they leave your care

How else are we connecting PTs?

PT asked the manager how they can work it out.

Find a company that values the community integration

It has created a significant increase in referrals

Eliana Roeing

Contact Us:

eddiePTATC

Contact Us:

Jeremy Jackson

Shawn Readyshawnreadyatc@gmail.com

Dr. Mark Knoblauchmaknobla@Central.UH.EDU

Dr. Layci Harrisonlharris5@Central.UH.EDU

Bob MarleyBob.Marley@uth.tmc.edu

ATCornerPodcastATCornerds@gmail.com

Joseph Eberhardteberhardtj@pearlandisd.org

Christina Fry – fryc@pearlandisd.org

These people LOVE Athletic Trainers and help support the podcast:

Frio Hydration – Superior Hydration products.

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

HOIST – No matter your reason for dehydration DRINK HOIST

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

Marc Pro – Use “THESMB” to recover better.

PhysicalTherapy.com; 1freecourse; continued; Physical therapy

Eye Injuries in Sports

Up to 90% of eye injuries in sports can be prevented with proper eyewear. Dr. Alireza Somji, OD joins me, Jeremy Jackson to discuss some of what he sees and how we can help prevent eye injuries.

Eye Injuries

International sports vision association – eye safety awareness program

WileyX are ballistic rated

Sportsvision.pro

Protect prevent play

Over half of the brain is dedicated to visual processing.

But we almost never train the visual performance

Alexander Arnold from the redbull documentary

Steph Curry, Matt Ryan.

First step should be getting a full eye evaluation.

Make sure they have an examination and not a screening.

Contact Us:

Jeremy Jackson

Shawn Readyshawnreadyatc@gmail.com

Dr. Mark Knoblauchmaknobla@Central.UH.EDU

Dr. Layci Harrisonlharris5@Central.UH.EDU

Bob MarleyBob.Marley@uth.tmc.edu

ATCornerPodcastATCornerds@gmail.com

Joseph Eberhardteberhardtj@pearlandisd.org

Christina Fry – fryc@pearlandisd.org

These people LOVE Athletic Trainers and help support the podcast:

Frio Hydration – Superior Hydration products.

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

HOIST – No matter your reason for dehydration DRINK HOIST

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

Marc Pro – Use “THESMB” to recover better.

Amy Metiva, snocross, HOIST

Female Athlete Care

Females Athlete Care is not the same as male athlete care. Dr. Jill Moschelli is making a career specializing in it. Megan Smith, the chairperson for Women In Athletic Training, leads the interview.

https://mm.linkedin.com/posts/cassie-monaco-2803b3202_flathead-valley-high-school-students-win-activity-7034338310130974721-xSV0

Looking into your bio, you specialize in Female Sports Medicine. Can you share with us what that entails?

Female athletes are just different than men

Female athlete triad.

Concussion recovery is different

Predisposed to different types of injuries

How popular is being a female sports medicine-specific doctor?

It is not really common, but some of it is due to comfort level.

There has been an increased discussion about women training on their menstrual cycles and understanding how each phase affects your training. When someone is looking into this- do you have any recommendations on how to get started or a basis of understanding while training during different phases?

Educating in general is the biggest first step

Educate them about their own body and their cycle

Know what is normal for you and be aware of what changes look like.

Some of those changes can be due to oral contraceptives for whatever reasons.

Basic menstrual tracking app.

Perceived performance scales but nothing has been clear or consistent…so more research is needed.

How do we ask: are you on your period?

Make it not taboo…make it part of their general health

I am going to ask a lot of questions and if you feel like you can't or do not want to answer that is fine.

“How has your menstrual cycle been?”

“Are you on any medicines that would impact it?”

We bring up topics like that at the beginning of the season so it is less taboo and breaks through the barrier.

Over the years I have taken many female-specific continuing eds, but one stood out to me which was pelvic floor dysfunction in female athletes. Is this something that you’re seeing in the clinic or refer out to a pelvic floor PT? Can you share how this can affect the training of our female athletes?

It happens more than we are aware of.  It is not discussed as much. 

Up to about 30% of elite female athletes experience incontinence.

Impact sports have a greater incidence.

Bringing up the conversation more often helps teach people about it.

Finding a pelvic floor therapist can be difficult

Stress Incontinence:

Inability to control the flow of urine during stress.

How can Athletic Trainers bridge that gap?

The more we talk about it the more it normalizes it.

You can be the first line of defense for those athletes.

Maybe set up a regular schedule to discuss it so they know to expect it.

Have the resources available or posted for them. 

Are there areas of female patient care that you believe would be beneficial for athletic trainers to be better versed on? What are those areas? Is there training that you recommend?

Reproductive/menstrual cycle/ pelvic floor in your education as you get your degree.

Spend time discussing the differences between male and female athletes.

Have grand round discussions on female athlete care.

Females recover differently from concussions

Timetables are different for females

The treatments are similar but they might take longer.

The Female Athlete Conference every other year in Boston to tackle issues concerning female athlete care.

Jeremy Jackson

Dr. Jill Moschelli – sadoskij@msu.edu

Megan Smith – Twitter

These people LOVE Athletic Trainers and help support the podcast:

Frio Hydration – Superior Hydration products.

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

HOIST – No matter your reason for dehydration DRINK HOIST

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

Marc Pro – Use “THESMB” to recover better.

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Post Exercise Recovery Nutrition

Post Exercise Recovery Nutrition is one of the topics Brett Singer addresses with high school, college, and professional sports in Houston as part of the Ironman Sports Medicine team.

Post Exercise Recovery Nutrition

Doubling carb intake prior to an event

Cliff Bar and Gatorade

Gatorade and a banana

Applesauce and Gatorade

Gummy bears or Fruit snack

Choose any two of them and that should get you to the right amount.

Is there a chart for glycemic reference?

Brett uses the USOC recovery chart

Glycemic Index Chart by National Library of Medicine

Post-exercise nutrition can minimize the NEED after for a recovery drink

Milk is more effective at rehydration than just water.

If you are eating then you probably do not need the recovery drink

Electrolyte drink vs Gatorade

Situations dictate different needs.

The 10-year-old kid will likely need less than an adult

Sodium and Chloride are the most important components of the recovery drinks

Professional soccer players may lose 6-7 pounds during the course of practice

A meal and water with an electrolyte drink between meals.

Youth bodies can handle the heat better?

2% of body weight loss shows visible effects of performance

In general, water should suffice if trying to recover 12 ounces (kid) versus 72 ounces (adult)

What are some dehydration signs to look for in Youth Sports?

Losing abnormal amounts of sweat

Headaches 

Nausea

Fatigue

Cramping

Weighing in and out should be done with caution.

High School and Rec athletes – Are there ideal mixes? 

There is not one that has all of the needs of an athlete.

Most products are insufficient for high-level athlete carb needs

3 to1 or 4 to 1 ratio is ideal for carbs/protein but needs to look at the big picture.

20-40 grams of protein

High-glycemic foods in recovery are OK

Creatine and Post Exercise Recovery Nutrition

I do not push it for high school athletes but it is safe.

Following the guidelines is important

The benefit is really for the high-level athletes

It also helps with glycogen replenishment

Whey vs casein protein?

It does matter how much protein you take in?

As far as protein synthesis goes 20-40 grams is the general window

Adding glycogen to protein does not improve glycogen uptake

Focus on carbs if there are small windows between competitions or training sessions.

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

Don’t Be THAT Preceptor

Don't be that preceptor who is just trying to get CEUs or the one who only uses MAT students as grunt labor.

Don't Be That Preceptor

Being a Mentor is a choice.  A choice to give of yourself for the good of others.  So is adoption.  DJ tell me some of your adoption story.

Taylor has been such a fantastic part of our life.  She is a part of my life as an Athletic Trainer and my life as a preceptor and mentor.

Worst preceptor story you have heard?

Worst mistake I made as a preceptor was right out of Grad School.

  • My responsibility is to the team and athletes, not the students.
  • I did not want to invest in the students
  • I did not want to give up control
  • I only allowed them to set up the field
  • It is finally my time to be the Licensed Health Care Provider and make decisions
  • It is about me now

Communicate the roles and expectations

Some other bad examples?

I am not getting any feedback

I am doing what they ask but I am not getting any feedback

How to avoid being average as a preceptor:

Do not complain about students on social media

What are some of the struggles for preceptors?

Accountability

Set expectations

  • Have an orientation
  • What can the program cover before the kids get to you
  • What do you need to cover

Dress code

Look at this as a semester-long interview process.

For scheduling purposes

  • We try to keep a really structured process
  • Immersion should be a minimum 40 hours per week
  • 85 hours /2 weeks
  • 1 day off every 7
  • And at least 8 hours between shifts

Shout out to my administrators and my co-worker for giving us the opportunity to be preceptors for U of H MAT.

JP: I felt like my hands were being held the whole time… I was either setting up the field or observing.

Jeremy Jackson

These people LOVE Athletic Trainers and help support the podcast:

Frio Hydration – Superior Hydration products.

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

HOIST – No matter your reason for dehydration DRINK HOIST

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

Marc Pro – Use “THESMB” to recover better.

Marc Pro

Leadership In Crisis

Dr. Josh Yellen presented Leadership in Crisis at the Memorial Hermann Sports Medicine Update. Shawn ready had some questions to follow up on his talk.

Leadership In Crisis

Leadership in COVID – 

Planning in athletic – speaking to your AD, your coaches, school leaders…this is one setting.

How do we as qualified healthcare providers help function in the world?

I am Head FOOTBALL Athletic Trainer or I am an AT with a lot of experience with football.

Compare primary care vs AT

There is a shortage of primary care physicians.

The definition of Athletic Trainer and primary care doctor is almost identical

Practicing Scared – 

We as directors need to understand the CAATE standards, the state practice acts, and the BOC requirements.

We need to keep pushing into the village of medicine.

PA is a master's degree program but is much more respected.

We were comfortable staying in the sports setting for many years.

To have direct access to patients you have to have a physician oversite.

Bachelor's degrees will not be reimbursed by CMS.

WHY DO WE USE OTHER PROFESSIONS TO EXPLAIN OUR PROFESSION?

Medical Model's effect on Leadership In Crisis – 

The Physician is the top and we are all extensions of the physician.

If we do not move into a better role and stake our ground then someone is going to take our role.

Sports Medicine Student Aides – appropriate vernacular is important

This gives the impression that a high school student without training can do your job

Watch the presentation on the SMB Facebook

Contact Us:

Jeremy Jackson

Shawn Readyshawnreadyatc@gmail.com

Dr. Mark Knoblauchmaknobla@Central.UH.EDU

Dr. Layci Harrisonlharris5@Central.UH.EDU

Bob MarleyBob.Marley@uth.tmc.edu

ATCornerPodcastATCornerds@gmail.com

Joseph Eberhardteberhardtj@pearlandisd.org

Christina Fry – fryc@pearlandisd.org

These people LOVE Athletic Trainers and help support the podcast:

Frio Hydration – Superior Hydration products.

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

HOIST – No matter your reason for dehydration DRINK HOIST

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

Marc Pro – Use “THESMB” to recover better.

These people LOVE Athletic Trainers and help support the podcast:

Frio Hydration – Superior Hydration products.

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

HOIST – No matter your reason for dehydration DRINK HOIST

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

Marc Pro – Use “THESMB” to recover better.

Preceptor Tips with DJ Gilliland

Preceptors are an important part of the MAT program for future Athletic Trainers. Dr. DJ Gilliland shares what makes a good

Preceptor Tips

Call out by name a few of the best preceptors you have known.

David Stuckey at Hardin Simmons – instilled in us the desire to give back to the profession.

It was our responsibility to mentor someone

David Colt or DC hired me out of undergrad. He guided us on how to teach and interact with our students.

Kyle Southall at Briarwood Christian in Alabama

48 local preceptors

Dustin Rush – What you see is what you get

He does a great job of letting students take chances and risks.

Dustin has a fantastic debrief with the students.

Frank Perez – He is a tough preceptor with a ton of experience.  He is really good.

He spent several years with Cirque De Soleil and brings dance medicine into the equation

He has a large administrative component to his site.

  • Great communication skills with coaches and admin, and team docs
  • He is an alumnus
  • Always an ear to listen or a shoulder to guide them…we need to guide them more

Administrative work:

  • Documentation practices are on par with what is needed for professional communication
  • Team management – day-to-day injury report presentations
  • Working alongside the nutritionist for the team
  • Physician referrals
  • Scheduling
    • Second-year students should be involved with scheduling and communicating with the opponents' medical staff.
    • 5% of the BOC is now about Administration
    • Allow the MAT students to schedule the student coverage
    • Teach them how to manage the student aides
    • Allow them to create an evaluation system
    • Have them look at and update the policies and procedures.
    • Have them look at and update the EAP
    • Teach them to be a mentor to the kids
    • Understanding professional boundaries

Mike Ramirez – 

  • “You can not work in the NFL unless you work at a college”
  • Great with organization and teaching the students what to expect.
  • He puts students in charge of making sure the gear is ready
  • They learn inventory
  • Real-world problem solving
  • Writing rehab plans

Brenna Ellis

She transformed the experience for our students. They leave feeling like they have grown as an individual and professionals.

AT is a family.

Supervised Autonomy – 

The preceptor should be the patient's advocate

Build up the student's trust and confidence by having mock scenarios in downtime.

The really good preceptors take advantage of that time.

  • EMS situations
  • Knowing the rules of the sport
  • Use the scaffolding approach to build trust
  • Give them more freedom in lower-pressure situations first.
  • Give them a comfortable environment to fall forward

From the students:

JP: I felt like my hands were being held the whole time… I was either setting up the field or observing.

JP: One preceptor gave us printed steps for taping. So we could use them during independent practice

JP: Having a written plan for the athletes to follow helps us grow, but also gives me the opportunity to develop a plan.

Jeremy Jackson

These people LOVE Athletic Trainers and help support the podcast:

Frio Hydration – Superior Hydration products.

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

HOIST – No matter your reason for dehydration DRINK HOIST

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

Marc Pro – Use “THESMB” to recover better.

Amy Metiva, snocross, HOIST

Cryotherapy Research with Sean Kennedy

Cryotherapy Research discussion with Sean Kennedy, live from the Memorial Hermann Sports Medicine Update. What is current science telling us?

Cryotherapy research

Cryotherapy – What do you tell them?

We have a lot of interpretations, so it makes it hard for there to be clear guidance

Cryo after injuries – there is no hard science about dosing for ice

Think about the messaging (chemical and nerve) that may be delayed

There is a place to allow the swelling to do its job.

Evidence shows compression edges out ice but can be used together easily.

Listen to the theories and allow your mind to be open. Do not be a stagnant clinician.

Cold water emersion

We used to believe it would send them into shock and the heat would stay in the core

All position statements say full body immersion is the standard to lower core temperature

Joint application only could take 80 minutes to cool the body

It could be 3-5 minutes with cold water immersion

Cryotherapy Recovery from workout

What is the value of reducing the perceived soreness from the damage that was done?

If you are trying to mask the fatigue by ice bath you are increasing the risk of injury.

Contact Us:

Jeremy Jackson

Shawn Readyshawnreadyatc@gmail.com

Dr. Mark Knoblauchmaknobla@Central.UH.EDU

Dr. Layci Harrisonlharris5@Central.UH.EDU

Bob MarleyBob.Marley@uth.tmc.edu

ATCornerPodcastATCornerds@gmail.com

Joseph Eberhardteberhardtj@pearlandisd.org

Christina Fry – fryc@pearlandisd.org

These people LOVE Athletic Trainers and help support the podcast:

Frio Hydration – Superior Hydration products.

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

HOIST – No matter your reason for dehydration DRINK HOIST

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

Marc Pro – Use “THESMB” to recover better.

Instead of Icing try MarcPro

Marc Pro

Supply Chain Concerns for 2023

Supply chain issues are still causing problems for Athletic Trainers. Thankfully Paul Calloway has the inside scoop to help us stay ahead of it.

Supply Chain Concerns 2023 with Paul Calloway

AEDs – there has been a shortage for a little while.

Shortage in components and an uptick with purchasing after Damar Hamlin incident

Hospital suppliers have more access than sports medicine suppliers

Aerosols 

Tough to get – QDA, Tuff Skin, Adhesive, Cold Spray

  • All are unavailable for the foreseeable future possibly until 2024.
  • Magic spray and stick em’
  • May not be available in as many varieties

Shortages cause price increases

M-tack from Mueller is a pump spray

Gatorade chews 

Still in short supply

They have basically taken those out of the options

Cliff bar energy chew is an alternative

Foam

There has been a bit of pressure in the foam market.

Pre-wrap and under wrap continue to be problems for sourcing

Price increases should be expected

Looking at about $1 per roll

OTC meds 

More so with Medique brand products

They have been struggling for about 2 years to get things leveled out.

You may need to buy in the bulk bottle

Athletic Tape

Coach tape from J&J was bought by BSN Medical

The price has gone up but it is back and available again.

Elasticon has been brought back as well

Zonas 1-inch box tape is back in production as well.

Other concerns

There tends to be consolidation of SKUs…like there may be fewer options for ankle braces

Mueller has discontinued some of the medkit lines.

Not a whole lot of new products out this year

Prices will continue to generally increase

Freight

We are paying more in freight now than last year.  Even if it says free shipping, it still has to come out of the costs.

Tips

If there are a few sacred items put no substitutions but be willing to consider alternatives on most other products.

Andover was bought by Millican…they are the same, but just now switching branding

They did discontinue some of the niche items

Jeremy Jackson

Paul Calloway – Twitter or Facebook

These people LOVE Athletic Trainers and help support the podcast:

Frio Hydration – Superior Hydration products.

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

HOIST – No matter your reason for dehydration DRINK HOIST

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

Marc Pro – Use “THESMB” to recover better.

Marc Pro

Patellar Instability

Patellar Instability is a specialty for Dr. Jeremy Rush's orthopedic practice in San Antonio.

Tell me about the first patellar instability you remember seeing.

Chronic instability up to dislocation

It is a very heterogeneous group

Patella dislocation and patella subluxation

And patella instability

Addressing the first-time dislocator

Be super aggressive with the rehab

Step one: reduce the dislocation

Brace them for a week but then get them moving

Try to get started in PT within one week

See them back about 6 weeks and then again at 3 months

At 6 weeks with effusion makes you think there is a loose body.

Ability to do straight leg raises

Apprehension with manual pressure

Instability vs dislocation.

Dislocation = all the way out – 95% are lateral

  • Usually traumatic events
  • Some are from anatomic risk factors

Subluxation is partially out of the groove

Instability is a chronic form of Subluxation

First timer tips

Get them to relax

Move them into extension

Calm them and even cover the dislocation if needed

Maybe get them up and it could self-reduce

Top patient complaints/ indicators of patellar instability

Knee feels unstable or it is slipping

Or my knee just hurts

Buckling

Recurrent effusion

Anterior knee pain

Start with rehab

Target

Positive patellar apprehension

J-Sign

Predisposed to instability

Patella alta

Women are at higher risk due to q-angle hyperlaxity

Rotational abnormalities

On exam

J-sign

Apprehension

Lateral pressure

MRI on chronic instability

MPFL damage

If the injury is unclear then I get an MRI to rule out any sort of cartilage or loose body.  

A huge effusion indicates a loose body.

Contact:

Dr. Jeremy Rush – IG @satxsportsmedicine

Jeremy – @jhjacksonlat

These people LOVE Athletic Trainers and help support the podcast:

Frio Hydration – Superior Hydration products.

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

HOIST – No matter your reason for dehydration DRINK HOIST

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

Marc Pro – Use “THESMB” to recover better.

Amy Metiva, snocross, HOIST