Past Episodes - Page 8 of 80 - The Sports Medicine Broadcast

October 12, 2022September 9, 2022

Muscle Atrophy and Quad Inhibition

Quad Inhibition and Muscle Atrophy can really slow down the recovery process. However, Jackie Kleihege and Jena-Claire Auten know it is essential for healing. Finding the balance between helpful and hurtful is kind of an art form.

Looking at the timeline is essential so we can see the progress of where we have come.

What is the research showing us?

We do not have all the data yet from the quad tendon ACL

We have 10 years of data on it

What are some reasons we have inhibition?

In the acute phase, it looks about the same.

If we can interrupt the inhibition early then we have better outcomes

It is really hard to study the brain when we are studying the knee

How can we find this loophole or workaround to muscle atrophy?

Decrease swelling

Decrease local inflammatory response

ICE???

Is there a time frame where are going too fast in turning off the inflammation?

We still want the natural healing process to continue through that phase.

And then for that to quietly fade out.

NMES

JK: I have probably underutilized it most of my career.

I needed to give something more and then added NMES and made a difference.

What are your ideal volume and exercises to prevent muscle atrophy?

PRE-OP therapy is critical

There is not a magic wand protocol

Pre-Op nutrition is super important as well.

When we try to activate the quad and then the patient is absent for a week what is the problem?

Latency is key – I want those first 7 days like they are falling downhill, then I dial it back.

Often day 1 postop patients do not look bad, but then days 2-3 are worse.

JA: Genetics plays a role in the inflammation process.

Consistency is key, similar to Instagram and Facebook, they keep putting the ads in front of you and then you end up buying it…

Continue to use the same methods so the patients know what is coming and can buy in

Looking at the 12-16 week patient

OPEN KINETIC CHAIN – the type of graft makes a difference as well

I need to be able to read the signs and customize the options for them.

The goal is quad communication

Determining when to progress:

Biofeedback can help give visual and auditory feedback.

BFR:

It is really as good as they say.

The uses keep growing.

Femur fractures were one of the biggest changes on paper.

Watch the Muscle Atrophy presentation on the Sports Medicine Broadcast Facebook.

Contact Us:

Jena Claire Auten – JenaClaire.Auten@memorialhermann.org

Jackie Kleihege – jacquelyn.kleihege@memorialhermann.org

Contact Us:

Jeremy Jackson

Shawn Ready – shawnreadyatc@gmail.com

Dr. Mark Knoblauch – maknobla@Central.UH.EDU

Dr. Layci Harrison – lharris5@Central.UH.EDU

Bob Marley – Bob.Marley@uth.tmc.edu

ATCornerPodcast – ATCornerds@gmail.com

Joseph Eberhardt – eberhardtj@pearlandisd.org

Christina Fry – fryc@pearlandisd.org

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

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Marc Pro – Use “THESMB” to recover better.

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September 28, 2022September 9, 2022

TFCC Injuries are like Low Back Pain

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Dr. Candice Teunis discusses TFCC injuries with Dr. Layci Harrison live from the Memorial Hermann Sports Medicine Update.

You compared wrist injuries to low back pain

Low back pain has so many different causes and ulnar wrist pain is so similar

You do not always have to have all of the answers on your first interaction.

Using a differential diagnosis is super helpful.

I think it is either this or this…here are some options for both of these.

What are the red flags for ATs to be referring?

Ulnar wrist pain is fairly forgiving

If you think the DREJ is unstable then you really need to get fixed quickly

On the ulnar side are the differences in age?

Yes, all of our joints wear down over time and those needs to be considered.

We see traumatic injuries as well as chronic issues.

Recovery in age differences

In older patients we are astarting to see some wear in the joint and lengthens the recovery time. The wrist has to be unloaded in some of the older patients the you would not with younger patients.

Reinjury risk?

Pediatric patients are more likely due to the constant motion

This can be trick since the imaging show the repair. You really have to look critically at this point.

How can we help prevent reinjury of the TFCC?

Strengthening helps

Pronator strengthening

ECU work

Most of the stuff we do not have control over except for the gymnastic population due to the constant weight bearing on their wrists.

Should we be limited movement in gymnastics?

It would help but its nearly impossible.

These kids tend to live with some amount of pain and ignore but it eventually catches up with them.

What should we be teaching students about interprofessional communication?

Develop a personal relationship with the people around you.

ATs can benefit by connecting with hand therapists to help improve the outcome for the patients.

Getting a congruent plan benefits all parties.

Watch Dr. Teunis lead her breakout session on TFCC

@HandSurgeonCandice

Contact Us:

Dr. Candice Teunis – Candice.B.TeunisWashko@uth.tmc.edu

Contact Us:

ATCornerPodcast – ATCornerds@gmail.com

Joseph Eberhardt – eberhardtj@pearlandisd.org

Christina Fry – fryc@pearlandisd.org

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September 14, 2022September 9, 2022

Running Analysis – Kimberly Gandler

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Running Analysis is not just for the elite runner. Kimberly Gandler works with runners in all stages of the sport to help improve efficiency and reduce injury.

Doctor Mark Knoblauch from the University of Houston Master's of Athletic Training program follows up on her presentation at the Memorial Hermann Sports Medicine Update.

Running Analysis – who is it for?

If you are going to be a runner I would highly recommend getting a gait analysis

Shoes are important and going to a run-specific store where educated people can help you.

Fleet feet in Houston, Run on in Downtown

They can do that at Memorial Hermann on a cash pay basis.

Maximal vs Minimal vs Traditional shoes

That focuses more on cushion than support.

Think about the area you are running. Your body can not handle constant banging on concrete.

Hoka and Merrel have a pretty low heel-to-toe drop

But if you switch to an ultra runner shoe then you need to retrain your body as if you are doing a couch to 5k.

How do you balance your style of running and the shoe you need

Change your style before changing your shoes.

YOU CAN NOT BELIEVE THAT THE SHOES ARE MAGIC

If it is not broken do not fix it.

Look at the situation. Do not mess up the time of an elite runner

Weight training can be the bridge to adjusting the form and help prevent injuries.

Late-onset runners – what are you seeing?

Those who pick it up later tend to have better form because they go with what feels right rather than trying to meet the expectations of some coach.

You do not have to go run if you hate it, there are plenty of other exercises.

Marathoners

Most people who sign up for a marathon to lose weight end up using it as a free pass

How do you make it fun for them?

If you do not like it then do not do it. Find something you like and something you can maintain.

I found a way to enjoy strengthening after having 3 kids.

Watch Kimberly's Presentation

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Contact Us

Kimberly Gandler – kimberly.gandler@memorialhermann.org

Contact Us:

ATCornerPodcast – ATCornerds@gmail.com

Joseph Eberhardt – eberhardtj@pearlandisd.org

Christina Fry – fryc@pearlandisd.org

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August 31, 2022September 9, 2022

Keith Jones – Develop Relationships

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As the director of AT services for the Houston Rockets, Keith Jones has seen the entire evolution of sports performance. He knew early on that he needed this team in his corner for the health and safety of the athletes he was caring for.

Build a Team

Building the relationship with the strength coach

There was none

Then I was the strength coach

Then we hired a professional strength coach

Many of them were from colleges or football programs

It was an adjustment for us to learn what we needed from them and the athletes.

Building the relationship from the ground up is crucial for success.

Find out what is important to you

We can Assist each other better by building relationships.

Keith Jones, how have we changed for the need?

30 – 40 years ago we were fighting each other, muscle head vs medicine.

Let's sit down and figure out what is needed for success in this situation/sport

If we fail then we will have to fail together.

The ATs need to know that the strength coach can be their ally or enemy.

Get in the same room and work together often.

The triangle analogy – How do we ensure the athlete is in the center of patient-centered care?

I love people, I think all ATs love people deep down.

Let me take my skill set and help the people I am passionate about.

In 30 years of NBA experience, my greatest success is collaborating.

How have you spent time in the other spaces and stayed in our lane?

Maybe go into the weight room and enter your paperwork to catch what they are doing

Invite them to use your microwave or fridge.

Intentionally cross paths

Be bought into each other's goals

CHECK YOUR EGO.

In my setting, we spent a lot of nights together on the road and so I tried not to eat alone. We shared meals and car rides together.

How you have developed leadership?

I never really view myself as a leader, I am but do not really look at myself that way.

I want to help, I have learned a lot about what to do and what not to do.

Empathy is important – why are they doing that

Figure out how you can help.

Transformational and servant leadership combine to make the most sustainable change.

Series on Leadership in AT

Watch Keith Jones's Presentation here:

Contact Us:

Keith Jones – keith.jones@memorialhermann.org

Contact Us:

ATCornerPodcast – ATCornerds@gmail.com

Joseph Eberhardt – eberhardtj@pearlandisd.org

Christina Fry – fryc@pearlandisd.org

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August 17, 2022August 16, 2022

On Field Cervical Spine

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On-field cervical spine evaluations are an area of expertise for Dr. Mark Prasarn. He is the spine consultant for the Houston Texans and all University of Houston sports teams.

What is the initial on-field assessment look like

ABCs

When do we transport?

Anyone that is unconscious

Significant neck pain

Weakness or numbness

Bilateral is a much greater indicator.

What does it look like once we transport it?

This really depends on the group, but equipment removal

Then get them stabilized

What are our early-stage rehab focus and goals?

If there is an AT it is a huge benefit

ROM

Transient hemioplegic patient

This can be mistaken for strokes

Neck pain is the significant indicator

Education is important

Most cases resolve in a few seconds or few minutes when it is a stinger

If it does not resolve then have them evaluated

Refer for imaging per doctor's orders.

What conversations should ATs be having with local staff?

Where are they going?

You should be involved in the decision-making.

What can we do to prevent these cervical spine injuries?

There is not really much we can do to train away injuries. Strengthening is most likely going to help

Do we need acclimatization for tackling?

Data shows that tackling technique improves injury rates

Watch the presentation:

Contact Us:

ATCornerPodcast – ATCornerds@gmail.com

Joseph Eberhardt – eberhardtj@pearlandisd.org

Christina Fry – fryc@pearlandisd.org

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July 6, 2022April 20, 2022

Randy and Sandy – AT Corner Podcast

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Randy and Sandy Harris are young professionals looking to positively impact Athletic Training.

I personally listen to their podcast and love the interaction between the two of them.

At some point this summer I will have a gap in content. I will be recording a lot over the summer but I won’t release any until I get them ready. So to help you fill the void in AT content I encourage you to listen to my friends Randy and Sandy over at ATCorner Podcast.

Randy, How did y’all meet?

R: Scrolling on Instagram and WOW…I went to work and found a mutual connection. The rest was history.

S: I was actually not going to post the picture of getting my acceptance letter…luckily I did.

Sandy, what is Randy’s Favorite Podcast

S: This one is easy…the Sports Medicine Broadcast…Seriously

Other than that the British Journal of sports medicine.

Randy, what is your favorite part about hosting a podcast with Sandy?

The balance. She keeps from being too nerdy. We have different experiences and play well off each other.

Jeremy: I love the relationship and quirkiness. Watching on social media how you two are genuine and enjoy your time together is such an encouragement.

What is your favorite piece of feedback you have received regarding the podcast?

R: Hearing people comment after the show with a story that we reminded them of.

S: The growth of our audience to include college students through late careers.

Win the crowd over, what will they gain by listening to AT Corner?

We want to be the bridge between education and experience, the college student and the seasoned pro.

Plus free CEUs…

Contact:

Instagram: @ATCorner

Website: https://atcornerds.wixsite.com/home/about-us

Email: atcornerds@gmail.com

Jeremy: Do not disturb me, I am vacationing.

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June 22, 2022April 18, 2022

Head Impact Monitoring with Athlete Intelligence

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Athlete Intelligence currently has 3 products: Vector, Cue, and Cue+ to help you monitor head impacts for your athletes.

Tell me about Athlete Intelligence

Wearable device – Cue sports sensor – Bluetooth enabled device

Vector mouthguard – transmits data live and not just Bluetooth

Can receive signals up to 300 yards away

Cue+ – combo of the other two, wearable with the capability of the mouthguard.

Discuss the science behind Athlete Intelligence?

It is the only way to measure in real-time what is happening to the player's head.

Complex algorithms and really nerdy stuff aside, we use accelerometers and gyroscopes to calculate and pinpoint the impacts players receive.

Who is using it?

We built Athlete Intelligence for the youth sports crowd. It is made to be set up and run by volunteer coaches with little to no training.

What does this look like in a high school setting?

Generally, there would be a locker room table with the mouth guard cases set out. The cases would be labeled with the player's name or number.

At the end of the day, the player returns the mouthguard or Cue to the case for charging.

Inside the software, the data automatically syncs and send reports as assigned by the administrator in charge.

I do not want to add another task to Athletic Trainers, can coaches run this program?

Create a system that is easy to use
Create affordable packages
Answer the question “What do I do with the data?”
1. We are really good at data visualization

“ You can not manage what you do not measure”

How long will it last?

As long as you have a subscription…we handle that as part of our service contract.

Mark H wants to know about the data. Who owns it, where is it stored, what happens to it if we stop using AI?

Data security is super important

We are not a medical device but follow the best practices for medical records.

AI owns the data which allows them to store and analyze it.

Historical data stays with the school account.

Book a demo at www.AthelteIntelligence.com

Contact:

Kevin: kwright@athleteintelligence.com

Andrew: agolden@athleteintelligence.com

Jeremy: info@sportsmedicinebroadcast.com

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June 8, 2022April 7, 2022

Leaving the Profession

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Ed asked questions about leaving the profession.

Chad took a step.

John jumped off the diving board.

Leaving the Profession question 1

When we say that people are leaving or there is an AT shortage, are we actually talking about specifically in the traditional setting? (Not sure on % breakdown, but how many ATs are working in industrial and clinic setting now compared to 5 or 10 years ago)

John: I think both are accurate. People are leaving the profession of Athletic Training and are leaving the traditional setting. Both situations are good for the profession.

Leaving The Profession Question 2:

For those who have moved on from a setting or profession, what were some of the red flags you noticed if any, or were there smaller subtler signs that were overseen that added up?

John: Being close enough to the table to recognize budgets and spending, HR trends, and then not be given a proper salary increase or plan for the future were my major red flags. I, unfortunately, ignored all of the mini red flags of the community leading up to my decision allowing my value to drop or not be seen to be given a fair chance/raise.

Question 3

Are our governing organizations finding this trend of ATs leaving concerning, or is this what the BOC and CAATE want as we push to be more recognized and respected as healthcare professionals?

John: From a MATS perspective, we are noticing it. We are also noticing the

Question 4

If our profession is in fact trying to distance ourselves from the traditional setting, how do we maintain the same, or improve the level of care we once provided to that population if we are trying to do that with less people?

John: For me, and I think a lot of people, we want to see a well-laid-out plan complete with proactive answers to questions. Without that, it promotes anxiety and uncertainty even if a positive decision is being made. That being said, who knows? I know our skill set is unmatched but we keep changing directions and losing good athletic trainers in the shuffle.

John, how have you been treated since leaving the profession 6 months ago?

I have had nothing but respect from peers and coworkers.

Contact Us:

John

Jeremy

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May 25, 2022April 6, 2022

Toki Nakazawa’s Story

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Being at home with the kids all day gave Toki time to think. He knew he needed to practice his skills and wanted to help others. Late one night he decided to create the joint dislocation simulator.

Toki, tell us about the first time you reduced a dislocation?

Back in 2000, we were playing an hour away from San Antonio

There was no ortho available for the game.

Dr. Bud Curtis said, “Toki, you have to do the reduction.”

Tell us your AT story

1992 I came to the US from Japan. My father had business in Houston so we decided on Texas and since there were almost no Japanese people in San Antonio I knew I would have to learn English with total emersion.

Spent one year at the University of the Incarnate Word learning English

Brackenridge High School in 2000

After 14 years I needed a change

Stayed home with kids

Discuss the origin of your company

One night I started dreaming and then began collecting materials.

CAATE added 3 major standards including Reduction Techniques

I built it for ATs, but I am now getting requests from Emergency Medicine, Wilderness Medicine and a DOD contract.

When you were discussing Dr. Approved, tell us more about that.

Dr. Curtis was my team doctor and we worked with him through the whole process.

We also connected with Dr. Green, a local hand doctor , and had him test it out and give feedback.

How can Jay help you today?

Jay and I are actually going to be at NATA together sharing a vendor space.

If you are no longer in school (an ATEP) how can we get this practice?

I am hosting workshops across the country.

If you can pay for the travel expenses and the best sandwiches in town, I will be there.

What are you using for materials?

It started with an old anatomy teacher donating a broken down skeleton and me using orthoplast to replicate the bones and joints.

Do you feel guilty searching for new providers?

I do not have a problem with switching if the company can do the same thing for cheaper and better.

In the life balance you are creating, where is your line?

I do not have a lot of expectations of someone giving back.

I do a lot of things for others and do not expect anything back.

Toki, talk about Shark Tank.

I applied and presented to the first round.

If I was selected I would fly out to California, but I was not.

For me, I am glad I did not give up money and take on a loan.

What is the feedback you are getting?

My first workshop was in San Antonio ISD with former colleagues that had never reduced a dislocation before.

A lot of clinical programs do not have someone to teach the skills even though they bought the devices.

Contact:

Toki – Facebook or pretty much everywhere

Elysia – Email or @SIBoards on Socials

Jay – Instagram or Twitter

Jeremy – @MrJeremyJackson

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May 11, 2022March 11, 2022

Long COVID

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Long COVID – define it.

Symptoms after a covid infection that last past 3 months

Resurfacing of a past issue like asthma

Share some of your story.

Exposed on March 8th

Symptomatic on March 16

Body aches, shortness of breath

Sprint run chest burning

Mental fog – it was hard to learn new things

Exacerbated an autonomic condition

I tried to keep going but some friends did an intervention

You recently presented at two conferences about Long COVID. Give me the cliff notes.

San Diego Pain Summit – more theoretical and it is available to watch for free

NJATS – practical and scientific application for the Athletic Trainers

Some settings no longer require an RTP. What are your thoughts?

Most RTP does not address Long COVID

Encourage Cardiac testing

Breathing symptoms and cognitive symptoms

How do you tell the difference between out of conditioning, a cold, and long COVID?

Look at a normal deconditioning response indicator like heart rate

The aerobic system is broken.

People with cardiopulmonary testing or rehab do worse on day two, typically much worse.

It may be hard for athletes to verbalize their needs and concerns. It was hard for me as a grown adult medical provider to recognize and verbalize my needs.

The heart rate does not match what they are doing.

When I shower it may be 150 where I am 120 bpm walking upstairs.

Do they seem like they are getting sick from exercise?