Sorry!

Hey everyone, looks like my last blog had some technical difficulties!  I apologize for that, I really don't know why the formatting screwed all up... :/
Anyway, I just copied and pasted a link from ESPN about Marcus Lattimore's injury.  I'm sure all of you heard by now the rumors of a broken fibula are not true.  He did suffer a dislocation (that was obvious from the game highlight) and some ligament damage.  I would recommend trying to get the highlight video for anyone who is teaching care and prevention or assessment in an ATEP.  The relocation was done very well and could be a great tool to teach.  You could also use it as a tool for shock assessment/care.
I'm not making light of this horrific injury.  I am very proud that the ATC's and medical staff at South Carolina responded so well.  I think it gives a great name to our profession, and I think it's because of us that athletes like Marcus are able to return to play.  I'm praying for a speedy and very healthy recovery for him, and for comfort for his family.

http://www.cbssports.com/collegefootball/blog/eye-on-college-football/20727498/official-word-on-lattimore-injury-extensive-ligament-damage-no-fracture

How many of us were watching the South Carolina game when Marcus Lattimore suffered the knee
 dislocation?  And how many of us watched it the following Monday on you-tube with our 
co-workers?  It was horrific, that's for sure, and my thoughts and prayers go out to him and his 
family.  I can say that so far in my career, I thankfully have never had such a devastating injury to 
one of my athletes (knock on wood).  I am just proud to be a part of a profession who was 
represented well and who responded amazingly to this devastating injury.  Best of luck with the recovery
Marcus!

Personal Trainer? Horse Trainer? Oh, Athletic Trainer...

Stranger: What do you do?
Athletic Trainer: Oh, I'm and athletic trainer.
Stranger: Oh how great!  Listen, can you give me some tips on how to lose a few pounds around my waistline.
How many times has this happened to you?  I know as athletic trainers, we've combed over this whole nomenclature things until there's nothing left.  But has it really gotten us anywhere?  We can agree to disagree on that, but one thing I think we can all say is that the above conversation has happened to each of us more times than we can stand.  It's frustrating, and if you catch some of us on a bad day, you can really get an earful. 
I come from an undergraduate program whose clinical coordinator and program directors were sticklers about the "athletic trainer" terminology.  Anyone who was anyone got corrected on this if they referred to us simply as "trainers."  It is engrained in me to cringe when I am introduced as "the trainer."  I have politely corrected all of my athletes and coaches to no avail.  I am still referred to as "the trainer" (or sometimes Momma Bear, but that's an entire different blog). 
I am offering no solutions to remedy this issue, if it is in fact an issue to anyone besides me.  I'm just hoping for some comments, and maybe a good old fashioned debate.  At least I know then you guys are reading this :)

"Athletic Related" Issues

It's the bottom of the fourth, and your short stop takes a short hop ball to the face.  Obviously the teeth that were knocked out and needed immediate dental assistance were "athletically related."  But what about the distance runner with the abscessed tooth and no dental insurance?  What about the freshman lineman who needs contacts in the middle of spring ball?  The starting point guard who slips in the mud in front of the dorms, and damages their medial meniscus they just had repaired 3 weeks prior?  Do theses issues fall under the umbrella of "athletic related?"
Many DI schools do cover most dental and eye issues that are directly related to an injury, or that interfere with in-season play.  They also cover most major medical issues that may arise while the student-athlete is enrolled and practicing at the university.  But many smaller schools do not have such luxuries.  Student athletes are left to pay for contacts and dental work themselves despite any interference with play.
The issues lie with the grey, fuzzy line that is "athletic related."  One could argue many points on this phrase, and be very persuasive either way.  For example, what about previous conditions the student-athlete came in with, like serious dental issues that led to the much needed root canal?  If we are going so far as to say that the issue is interfering with play, where do we stop?  What about ADD medication and testing?  If the student athlete has difficulty focusing, and is diagnosed with ADD but cannot pay for the medication, is it the school's responsibility if this issue is effecting their playing ability?  What about birth control if the female athlete is diagnosed with amenorrhea?  As you can see, the line does get pretty hazy without set explanations.
I encourage anyone in the collegiate setting to bring this up at the next staff meeting if you do not currently have a policy regarding athletic related issues.  Make sure the coaches are aware of the policy, especially if they have international athletes, and athletes without personal insurance.  Another resource to look into would be a special opportunity or enhancement fund.  These are often set up to assist student-athletes with some of the issues that the sports medicine department may not cover.  Make sure as a staff that you are aware of the process for filing for these funds, as you often have to submit an estimate in writing weeks before funds can be allocated for a specific issue.  Hopefully with a little bit of ground rules from institutions (and maybe the NCAA???) these can be laid out for everyone to abide by.  No questions asked.

Dressing the Part

We've all been to conventions, and we've all seen it.  Our fellow peers in shorts, too short skirts, raggedy flip flops, etc.  I understand some of us may work in a more relaxed setting, but as cliche as it sounds, there's a time and a place for everything.  A district, regional, and/or national meeting is not the place for your well worn in Saints t-shirt.  We need to be taken seriously as a profession, which means dressing the part.  We need to set the example for our up-and-coming students on what is appropriate and what isn't.  A skin-tight, too short, leather skirt is by no means is appropriate; neither is a low-cut blouse.  You never know who you will run into at a convention: a future boss or co-worker, a board member, or even a committee chair.  What about the person who takes your order from Chili's when you leave for lunch?  Are you dressed in a way that shows the profession in a good light?  See this blog as a "call to arms" if you will.  Discuss with your students what is appropriate and what is not.  Have them leave to go change if they are not dressed appropriately.  After all, they are representing your, program are they not?  Don't be afraid to speak to a peer whom you feel may not be dressed appropriately, but by all means, do it tactfully.  Our profession is on the rise people, it's time to set up and take care of the little things!

Try outs. Where is the Line Drawn?

Those of us who work in the collegiate setting have had to deal with try outs at least once a year.  Many institutions are quickly moving towards multiple try outs verses one large open try out each year.  As Athletic Trainers, we must be aware that these athletes are often asked to practice against our varsity athletes in order to "make the team."  It often places some in an unfair position when they have not been exposed to the type of training that the varsity athletes have undergone.  One could argue that it may even put them at risk for injury.
It is imperative that the sports medicine staff visit with their team physicians, as well as their legal departments, to discuss the institutions's liability in case one such athlete is injured during their try out.  Rules should be set in place to determine: (1) How long will the try out last?
(2) Will the athlete who is trying out be practicing against a current varsity team member(s).
(3) If an athlete is injured while trying out, what will be the institutions financial responsibility- or if they sign a waiver, is the institution no longer liable?
(4) What type of try out forms must be completed first?  For example, would the athlete who is potentially trying out need to be cleared through compliance, or medically first?
(5) If the try out is conducted off campus, is the practice site liable for any injuries that may occur?
(6) Is the try out documentation different when dealing with a potential recruit?
(7) Does the try out need to be covered by a member of the sports medicine staff if the coach is CPR and First Aid certified?
These are just some of the many examples of angles that should be addressed when the sports medicine staff is beginning to look at their try policy.  It is also important that the sports medicine staff involve the coaches and compliance office in the decision making process, as they often delegate who can and cannot try out for the team(s).

Dealing with the note “rest for 2 weeks”

If you have ever worked in the secondary setting you have received this note, “no athletics for 1-2 weeks” or  “no physical activity for 1-2 weeks”

This phrase can be the most frustrating phrase you read as a student athlete, your patient, walks in the athletic training room not dressed out for practice and announces, “I went to the doctor and I can’t work out.”  What is even more frustrating is if you were never informed the student was injured, you did the evaluation and recommended modified practice, a treatment and rehabilitation regimen confident that you could get them back to playing very soon, or even better yet, the doctor on your sideline evaluated the student, along with yourself and recommended a plan spoke with the parent and they still went to a different doctor and got the 1-2 weeks rest note.

I find that this type of scenario tends to happen most often in off-season or sub-varsity sports. 

I always blame myself first, and ask the questions;

            Did I not take enough time in my evaluation, or explain the injury or the plan to the student and parent?  Why do they not trust me? Why do they not want to see the sports medicine orthopedic that works on our sideline every week?

Sometimes I find the answer to these questions and find that it was a lack of communication or the parents have a connection with a different doctor in town that they trust.  But the problem I am still left with a kid that thinks they can’t do anything for 2 weeks, oh how it would be so nice if the note read, “limited activity with the affected limb, continue cardiovascular fitness and progressive rehabilitative exercises” that way when I try to explain this to the student and parents they do not look at me like I am ignoring the note that says no activity. 

We try hard as athletic trainers to let our community know who we are and what we do.  At our school we encourage student athletes to come and tell us about injuries and pains, we tell them and their parents they can see any physician that they please, we try to suggest those that work closely with us as team physicians, and those that specialize in sports medicine and offer sports injury clinics.  We do all that we can not to have a student sitting on the sideline doing nothing.  I know that the physician that wrote the note usually expects the student to do rehabilitation exercises and that rest will allow time for the injury to heal and that they too have the best interest for their patient, so do we, the frustrating part is when the student athlete is content with not doing anything.  When the patient, a student athlete is content sitting on the sideline, I am so frustrated; I must work to put in the effort to motivate them to try to do something to get back in the game.

This is me on my soap box for the day, please feel leave a comment, a suggestion or idea.

Shout Outs!

It is now time to begin submitting names to the NATA for athletic trainers who deserve recognition for all their hard work and outstanding professionalism.  I know that everyone reading this knows of one YP who is worthy of an award, so please nominate him or her.

This summer at the NATAPAC breakfast, the guest of honor Dale Mildenberger, proclaimed that we need to banish the "unsung hero" title: that we work too hard and too tired and too passionately to be just someone happy to be in the background.  He felt that we should be proud of our education and our expertise as health care providers.  He felt that we are failing to get recognition in legislation because we fail to recognize our own special properties and celebrate those.  He encouraged us all to be our own advocate. I could not agree more.

So give the ultimate shout out, the ultimate pat on the back, and nominate those who you feel represent the strengths in our profession.  You can find all the information you need here: http://www.nata.org/young-professionals-committee-ypc-national-distinction-award