Energy Bus by Michelle Vryhof

We know that the inevitable factor of change keeps life interesting, but also challenging. When I consider the past few years of my own life, the situations have been fluidly changing but my “to-do” list is almost always a constant in length. The encouraging thing in my mind is that my never-die work ethic to be productive and be involved hasn’t wavered. The struggle, however, is teetering the line of burnout when trying to balance work and life. Also, keeping upbeat and having a positive attitude toward the daily aspects of the grind can become more difficult as the sport seasons or responsibilities go on and on without rest for the weary athletic trainers.

If you are feeling a little worn out and perhaps not quite your usual self, let me suggest that you take the time to read a small book that that could possibly change your life forever. I know, I know…why am I asking you to do then one more thing that takes up time from busy life? It’s a very short, easy read and the story demonstrates the pearls of wisdom in a way that keeps you interested to read it from cover to cover in one sitting. The book is titled The Energy Bus by Jon Gordon. The 10 valuable rules to fuel your life are:

1.       You’re the driver of the bus.

2.       Desire, vision and focus move your bus in the right direction.

3.       Fuel your ride with positive energy

4.       Invite people on your bus and share your vision for the road ahead.

5.       Don’t waste your energy on those who don’t get on your bus.

6.       Post a sign that says “No energy vampires allowed” on your bus.

7.       Enthusiasm attracts more passengers and energized then during the ride.

8.       Love your passengers.

9.       Drive with purpose.

10.   Have fun and enjoy the ride.

These rules make perfect sense when you read the whole book and find the ways to apply these principles. But here are some additional thoughts of how to keep up the positivity in your daily life, things that I try to remind myself all the time. First, in order to balance energy with work and life, we have to let go of some things in our work life. As athletic trainers, we wish we could do it all and we sure try to. We have to accept and then let go that we perhaps didn’t get to everything on our to-do list or didn’t finish a task quite as well as we would have liked. Do your best, but when it is time to say “no” you are helping yourself and those around you by not stretching yourself too thin and jeopardizing the quality of care you give. Second, stay positive by celebrating the smallest successes or improvements in others. It really spreads enthusiasm and encourages patients in dealing with their pain or struggle. I share this with you in hopes to help anyone who needs a little positive energy pick-me-up as we look ahead to a fresh new year full of great potential!! 

Blog by Kimber Rodgers

I had a patient this week that really made me think.  He has a low grade ankle sprain… something I’m sure most athletic trainers deal with on a weekly basis.  His strength and ROM were normal, but he was not able to complete functional tests. 

I will admit… I don’t like to be wrong.  I’m competitive and I like to be right.  But with this patient, I was at a loss.  I threw everything I had in my arsenal of tricks at him.  But it seemed no matter what I did, he didn’t show improvement. 

I woke up yesterday and remembered: an Airrosti Certified Chiropractor, who moved to my area this summer, met with me in late July and offered his services and conveyed his interest in treating athletes.  So, I called him; I explained the situation, gave him some history on the patient, and he happened to have an appointment available that morning.  With a few tests and a couple of new corrective exercises, he discovered a muscle strain secondary to the ankle sprain I had not even thought to consider.  After one treatment, the patient’s pain was 60% better and his functional status was dramatically improved.

I am so fortunate to have such a talented group of health care professionals in my area!  I would definitely encourage everyone out there to use all of the tools you have at your disposal.  Whether it’s an Airrosti Certified Provider, sports massage therapist, someone with certifications in manual therapy or other alternative techniques, etc. make contact with other healthcare professionals in your area and develop relationships with them.   Those relationships can help improve patient outcomes and help us to become better athletic trainers by learning new “tools” from other healthcare professionals.

Developing a Student Aid program in the Secondary School Setting

I’ve had several friends and colleagues, even coaches at my school, ask me how I find and keep so many good student aids.  We treat our student aid program just like we would if we worked at the college level or if these students were employed through us.  We have high expectations of our students and hold them to a high standard.

I think there are several things that contribute to developing and sustaining an effective student aid program.  These are things we do at the high school where I work; there definitely is not a right or best way to do it… but this has been working for us over the past 5 years, and interest in our student aid program continues to grow. 

I think the first step is evaluating the needs of your athletic programs to determine how large, or small, you would like your staff.  We start the year with around 20 student aids, and typically have an additional 3 or 4 students in class that do not have obligations after school.  Inevitably, you will have student aids quit.  They either don’t know what they are truly getting in to, decide they want to spend their time doing other things, or move; but for whatever reason you will lose at least one student aid every year.  The extra students who start the year with no obligations can serve to fill those spaces, in the eventuality you have a student aid leave your staff.

Next, we have an application that all students interested in the student aid program complete.  The application includes a summation of duties and expectations, a brief questionnaire, and a grade report to be completed by the student’s current teachers.  We evaluate each application before contacting students for an interview.

During the interview, we go into more detail about what will be expected and required of the student aids in our program.  We stress the amount of time that is required to become a student aid, and try to reiterate that point several times during the interview.  We get to know each student to determine if they would be a good fit with our current staff.  Then, we answer questions the student may have for us.

Upon completion of the interviews, we send a letter to each student informing them whether we are offering them a position on our student aid staff, desiring them to take our class with no extracurricular obligations, or (in rare cases) saying “Thank you for your interest, but….”  I believe by treating the process of selecting our student aids as a professional application, we emphasize the importance we place on our program and give students selected a sense of pride and accomplishment.

Before the school year begins, we hold an in-service with our newly selected student aids to teach them basic skills we want them to know early on (e.g. CPR and First Aid, basic taping techniques, etc.), and then another with our entire staff to go over rules and procedures, brush up on basic skills, and prepare the athletic training room for the coming season.  Throughout the year, we hold monthly meetings to inform student aids on upcoming events and to discuss any issues that may have occurred.

We also try to have fun with our students. We carve pumpkins together at Halloween, have a Christmas party, and several other things throughout the year to show our student aids that we appreciate their hard work and dedication.   I know our students look forward to having homemade lasagna and Secret Santa at the Christmas party every year.

While this has worked for my school, you have to find something that works for you and your situation.  However, I encourage you to expect more from your student aids; if you hold them to a higher standard, they will begin to do the same for themselves and may surprise you with what they are capable of.

ATC’s and Impact: Not just Cognitive Recall

Often the world of athletic training, we hear the word “impact”.  There can often be a common misconception of what the true word of “impact” means.  Any athletic trainer will tell you that when they hear the word “impact”, they automatically think of ImPACT testing.  An ImPACT test was developed by clinical experts who pioneered the field of helping treat concussions.  ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) is the most-widely used and most scientifically validated computerized concussion evaluation system.  ImPACT provides trained clinicians with neurocognitive assessment tools and services that have been medically accepted as state-of-the-art best practices -- as part of determining safe return to play decisions. Though this is appealing and VERY important in decision making regarding athlete’s return to play protocol, I prefer to think of impact as something that we ensure as health care professionals…something that we choose to do.  Here is how we can make an ImPACT of our own in the profession of athletic training:

 Get involved!! – How often do we see those people just “sitting” on a job?  One thing comes to mind…supervisor.  Yes, we all know that CEO’s and big Whigs of major corporations are apparently making the “big bucks”.  But what is it that they really do? Sure, they might be a pencil pusher and big “high man on the totem pole” who calls the shots.  BUT, are they actually teaching you anything?  What is it that you are learning from your superior?  Are you learning anything at all?  If you commonly find yourself stuck between a rock and a hard sport regarding the “day in and day out” normal work grind of the run of the mill job, you are spinning your wheels.  I challenge you all to broaden your knowledge base of sports medicine and to get involved in an organization in some way or another. Reach out and join a committee, or volunteer to help others.  You’d be surprised how much this would make a difference. Even if you don’t learn anything new, there is always the chance you could educate someone else and become a teacher!

Vote!!-  Every couple of years, there is always the opportunity to elect new board members into new organizations.  Some of which you may have heard of: SWATA, NATA, GHATS, YPC…etc. The list is endless.  How are we able to broaden our base of knowledge and implement knowledge construction in place of knowledge reproduction if we don’t elect new leaders or teachers of our own?  Remember that old hag you had in grade school who was mean to everyone.  20 years later, you realize that she’s still around and now it’s not you dealing with her, only your children are.  Sound familiar?!  Need I say more?  I rest my case!

Stay abreast on current research!!-  Yes, yes, yes.  I know. Last thing that we all want to hear are the words “statistically significant” or “the null hypothesis showed that p is less than 0.5….” blah blah blah.  I myself hated statistics and am NOT a research person. But let me ask you this: The first time you ate some of grandma’s cookies that were dry and tasted like chocolate chip corn bread, did you ask for more?  No!!  You found a way to bake something better right?! Why? Because who wants to eat something that tastes atrocious?  I sure don’t. So, does it make sense to keep “spinning” our wheels? I think you can answer that one. 

There are new trends of research and medicine that are evolving every day.  As health care professionals, how are we to treat the hurt and wounded if we aren’t up to speed on current research and medicine? 

These are just a few of what I can think of off the top of my head.  The list goes on and on.  Like I said, athletic trainers are some of the most unnoticed and disregarded professionals in their line of work.  However, we are called on to help those in times of dire need and emergencies.  If we lose focus for just a second in this line of work, than we too start to spin our wheels. Only then do we make an impact on others, but in a negative way. 

Life of an ATC: Is It in You?

As many of us enter the working world as a young aspiring professional in our field, we tend to wonder what it would be like first rattle out of the cage.  We are afraid, excited, and yet somewhat apprehensive of it all.  Prior to entering the world of young professionals, our lives as young adults in college are spent in burning the late night oil trying to accomplish our one goal: graduating.  Afterwards, we seek out what we think would be the easiest thing-securing the job. But, we are still unsure of what to expect once we begin our career. I use to think that a day job would be easy. Though athletic trainers don’t really follow the typical 8am-5PM protocol of work, there is still a lot to say for what we do.  Here are a few reasons why I love being an athletic trainer:

1)  Every day is something new- In this line of work, you can expect the unexpected.  Whether it’s being on the sideline at a football game, sitting under a tent at a soccer match, or getting up close and personal on the basketball court, every day presents it’s own challenges.  I personally have witnessed a variety of injuries and issues that have been personally challenging for me.  At the end of the day, you have dealt with or seen an injury, a psychosocial issue with an athlete, dealt with a parent, or witnessed that big “W” from your favorite team. 

2) It keeps me young- It takes a special kind of person to do what we do. Being a former athlete myself, I couldn’t get enough play time.  Whether it was for myself, or for my father, there was never enough time for me to obtain all the play time that could satisfy me.  Sometimes I reflect back on what times where like when I was a kid- often wishing that I could go back in time and relive those glory days on the field.  I often watch kids catch the hail mary that allows them to score the winning touchdown in a game that separates the men from the boys. Seeing young student athletes achieve something that I would not consider a small feat, makes me feel like I’m a high school kid again.  Not to mention being around student athletic trainers who are half my age.  They alone keep me on my toes.

3) Personal satisfaction- I hate to admit it but there are those times when we all witness an athlete go down on the field. Whether it’s a sprained ankle, a subluxed shoulder, or a torn ACL, we are called on as a confidant and health care professional to use our skills and knowledge and utilize it to the fullest, so we can return that particular student athlete or “all star” back to full player’s status.  For me, there is nothing more rewarding then having a student athlete bounce back from such a horrific injury, only to score the highest percentage points in a district game.  Not to mention, there is always that  big “thank you” from the parent themselves J

4) You become a mentor-  Yes, yes, yes. I hate to admit it too, but I did have ill feelings towards school counselors and mentors when I was in school.  We used to think that all of those health and nutrition classes we took wouldn’t be necessary. Little did I know, I was wrong.  I cannot tell you how many times I have been asked about nutrition, health, or even weight training.  You will soon realize that after you develop a rapport with athletes, you will be the one that they come to in dire needs of advice. 

As you can see, there is a lot more to athletic training that just taping and give the typical “ice water” treatment.  Athletic trainers are what I always consider the step children of the athletic program.  Like musical composers, we are the ones who remain in the background and wait in the wings in case we there is a medical emergency.   We are underpaid and overworked but to me, there is nothing in the world like sitting in the dugout eating sunflower seeds and watching the game from an up close and personal view. In  my opinion, sometimes as the bench warmer, you not only get the best seat in the house, but also hold the most important position on the team.  

Annie's Advice

One group of young professionals that we like to give advice to are the recently graduated, and recently certified/licensed athletic trainers. We all remember our first year on the job, and the challenges we faced. I quickly learned that everything I learned in the classroom, was just a foundation for what was going to be thrown at me. Having a mentor with some tips to help along the way is a saving grace for many fresh athletic trainers. Below I have complied a list of “tips and tricks” to help the new athletic trainer get through the first few years in the profession.

-Get or Stay close to a mentor from the HS setting

-Know and learn your limitations

-Utilize fellow ATCs

-Be confident in your abilities

-Communicate with your team physician

-Evaluate the whole athlete, not just the suspected injury

-Don't be afraid to refer when necessary

-Work to educate your student athletes and others

-Be honest and straightforward with your athletes, parents, and coaches

-Don't be afraid to say NO

-Take time to have some fun

-Think of it as a marathon, not a sprint. Take everything one-step at a time

-Listen to the Kids

-Get to know the janitors and secretaries

-Set up reasonable protocols

-Introduce yourself to the other team's ATC

-Don't be afraid to a risk

-Listen to those that have more experience than you, but also your students

-You're not going to get everything right 100% of the time. Failing is a part of it. 

-Try not to take work home with you

-Don't be afraid to ask for help

-Talk to the kids like they are adults

-Get to know your AD

http://www.nata.org/nata-news-blog/secondary-school-resources

Good luck on your career as an athletic trainer! Take it one day at a time, lean on others for advice and assistance, and most importantly, Have FUN! Welcome to the best profession out there. 

How to cruise through speed bumps and avoid traffic jams of the secondary school ATR

I cannot emphasis enough my passion for the secondary setting however it often comes with professionals in the early phases of burn-out. When I see these professionals I want to shake them and help them speed through the chaos of the secondary traffic jams that usually occur from 6:30-9am and 1:30-9pm. I have found that when speaking to my colleagues that are in this situation they often times refuse to change their ways and believe burn-out, stress and extreme tiredness are all part of our profession that we have to accept. This is not true!
A close classmate of mine realized this the hard way. In a classroom setting round table discussion a group of Athletic Trainers from across the nation drilled him with questions often beginning with why, such as “why do you put out water”, “why do you work on Sundays”, “why are you juggling patients” after the intense questioning he broke down. His simple answer was, “I don’t know why, maybe it’s because I have always done it.” This response got me thinking, how could I help him…….?
After collaborating with dozens of secondary athletic trainers from across the nation here is a short and simple map to beginning the steps of avoiding burn-out, lowering your stress level and enjoying your job once again-
1. Make your presence known- yes it may take more time at the beginning however in the end you’ll stop chasing your tail
  a. Speak at booster club, PTA or open house meetings- parents need to know who you are and what your title is.
    i. This is the perfect time to correct vocabulary and emphasis our title as “Athletic Trainers NOT Trainers.”
    ii. Explain your treatment protocol, concussion policy, referral policy etc.
    iii. Communicate with parents, if they have a child that is an athlete they should know you just as if you where the Head Coach
  b. Speak to the faculty- Ask your principle for a 20 minute time slot during your teacher in-service. This again gives you the upper hand in informing the staff of your title and policies
  c. Speak to each of the sports teams- This step is crucial! Do not allow a coach to speak to their athletes about your treatment policies, title, and overall athletic training room procedures. When you allow someone else to inform the athletes you give room for error
2. Make the ATR a clinic- when speaking to your parents, faculty and athletes inform them that they will be treated in a clinic not a “room”. This helps the individuals understand what you are expecting such as:
  a. Schedule appointments with your patients- have your athletes sign an appointment book when they walk in, first come first serve mind-set.
    i. Require all patients to attend am clinical treatments and if needed they can schedule an additional appointment for lunch, athletic period or after school. This gives you the opportunity to create a schedule and provide space between each treatment.
    ii. Require a sense of etiquette within the clinic- low voices, no cell phones, no food, no shoes etc. This will help the athlete understand the importance of their treatment and provide a calming environment
    iii. Slow down- yes you have too many patients for the amount of time you have with them and yes you might not be able to do the entire treatment that you would like or would be beneficial, however you must slow down
1. Learn to prioritize your patients and their treatments- try to see your patients twice a day so that you have the opportunity to do two different treatments. This will provide you time between the treatments to reflect on your patient notes and research any new treatments you would like to do in the second treatment time
2. Stop running around the ATR like a crazy person, it freaks out your patients and causes them to become anxious. Instead take your time with each patient, ask about their day, the upcoming game etc.
3. Give away hydration- yes, this has been a part of our profession forever but when you are treating 30 athletes in a 45 minute window at a 6A high school, water should be the least of your worries. Your focus should be to treat, care, prevent and rehabilitate your patients like the medical professionals we are.
  a. Most high school sports have a manager, spend one class period teaching them how to clean coolers, location of all supplies and process of setting up for practice vs. games.
    i. This allows for more responsibility from the manager which is a skill all teenagers should learn and provides you time to treat patients. This allows for the coach to communicate any schedule changes to a student whom they already have in their class instead of calling you or you worrying about what practice will be like today.
4. Be a professional- This one is going to be the hardest but will make the most impact.
  a. Dress like a professional- Don’t dress like a coach, you are not a coach, you are a medical professional with an extensive background in sports medicine. Don’t be scared to wear something other than khakis. I choose a few years ago to start wearing scrubs in the clinic and for inside sports. I have them in school colors with a monogram of the schools logo and my title. I found that the patients, parents and faculty’s attitude changed remarkably in a positive way. I am treated with respect and curiosity because I have made my presence known that I am a medical professional. This curiosity comes from patients, parents and faculty wanting to know more about athletic training and our skills.
With these 4 easy steps I hope you are cruising through your day and avoiding all traffic jams that occur in the secondary setting. Of course there are countless ways to improve our setting however these have made the most impact on my setting and many others. Please pass along any other ideas that have worked in your setting so I can add them to the list, we are only as good as our weakest link

Concussions- question your surroundings

This blog post is a challenge to you to enhance your practice of evidence based medicine and learn to question your surroundings-
Unlike most sports injuries, concussion are often referred to as an invisible injury1. Concussions are defined as a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces2. An estimated 300,000 sports related concussions occur annually in the United States, which is nearly 20% of the 1.5 million head injuries recorded3. This invisible injury can occur with several symptoms, many that are subjective in nature. Typical symptoms of a concussion may include somatic complaints (e.g., headache, dizziness, and fatigue), neurocognitive deficits (e.g., concentration and attention problems, information processing, and memory dysfunction), and emotional signs and symptoms (irritability, anxiety, low motivation).4,5 The presentation of concussion symptoms varies considerably patient to patient and without a formal way to identify the patient reported symptoms clinicians are unable to treat the patient accordingly6.
In recognition of the need for better concussion management strategies, the International Ice Hockey Federation (IIHF), in conjunction with the International Olympic Committee (IOC) and the Federation Internationale de Football Association (FIFA), convened in Vienna in October of 2001 to evaluate the current status of concussion management guidelines and to draft practical recommendations for making return-to-play decisions (Aubry et al., 2002). It was during this conference that the recognition of utilizing a symptoms scale during return to play protocols and the importance of documenting the self-reporting symptoms of the concussion patient became evident. It became clear that symptom reporting scales where important in treating the patient and that several scales addressed the same symptoms, but there was not one scale that was viewed as the golden standard. To identify these symptoms the post-concussion symptom scale (PCSS) was developed to provide a formal method of documenting post-concussion symptoms, as perceived and reported by the patient7. The PCS scale items were constructed to reflect actual player reports rather than medical jargon7. The PCS scale measures the severity of patient reported concussion symptoms on a 0-6 Likert scale, while providing the clinician a formal way of documenting these post-concussion symptoms8-10. The PCSS includes the following 22 items: headache, nausea, vomiting, balance problems, dizziness, fatigue, trouble falling asleep, sleeping more than usual, sleeping less than usual, drowsiness, sensitivity to light, sensitivity to noise, irritability, sadness, nervous, feeling more emotional, numbness or tingling, feeling slowed down, feeling foggy, difficulty concentrating, difficulty remembering, and visual problems. The PCSS was developed to provide an adjunct to other tools, such as neuropsychological testing, and is commonly found within on-field concussion assessment tools (e.g., Sport Concussion Assessment Tool 2 [SCAT2]) and post-acute computerized neurocognitive tests (e.g., Immediate Post-concussion Assessment and Cognitive Test [ImPACT], CogSport)6.
The PCSS is found to be broken into four factors: seven cognitive symptom factors (e.g., concentration, attention, memory and reaction time), three sleep disturbance symptom factors (e.g., sleeping more or less than usual) four emotional symptom factors (irritability, nervousness, sadness, more emotional than usual) and eight somatic symptom factors (e.g., headache, dizziness, fatigue, nausea)6. This scale is scored as a total overall score that includes all four of the factors. The instrument is documented as having a low score if the patient reports 0, a borderline normal score if the patient reports 1-5, a borderline score if the patient reports 6-12, a very high score if the patient reports 13-26 and extremely high if the patient reports 27+. It is not understood or well researched what these different scores mean or how they should be treated. Kontos 2006, reports that as clinicians we should
not only look at the total score of reporting symptoms but the individual score of each of the four factors2; this would allow clinicians a more in depth way of a multidisciplinary clinical management approach, rehabilitation treatments and return to play protocols6.
Researchers have found, through factor analysis of the PCSS scale and multiple other symptom scales, that the emergent four factors may reflect different subtypes of concussions6. Researchers report that, as clinicians, we should not only look at the total score of reporting symptoms but the individual score of each of the four factors. This would provide clinicians with a more in-depth approach of analyzing and controlling rehabilitation treatments and return to play (RTP) protocols6.
So…….… My question to my colleagues is this- Have you ever researched the tools given to you and may be required of you to use with your patients? Have you or do you understand the foundation of the numerous concussion scales, test or policies you are treating your patients with? I understand that concussions are a hot topic, however I feel this line of questioning should be utilized in all areas of athletic training. I know that being in the secondary setting myself we become comfortable and I find myself stuck, not able to explain a treatment method on a foundational scientific level or concussion scale with supporting research evidence. Once I realized this speed bump I began questioning everything, as I challenge you to do as well.
Which brings me back to the PCSS that I find absolutely fascinating. I have watched numerous sports medicine professionals ask the symptoms check-list and leave the patient with a mindset of “yes they have symptoms” or “no they do not have symptoms”. Did you ever stop to think what each of those symptoms mean or where those symptoms are located in the brain? Did you stop to think of what the difference of somatic and cognitive symptoms could mean for your patient? I know I didn’t at first and then it all became clear. These symptoms mean something and that something is crucial for their return to play or return to learn. So I CHALLENGE you to take a closer look at your patients symptoms and figure out what they truly MEAN.
~Cathlene Webb MS, ATC, LAT
University of Idaho Doctoral Student
1. Bloom GA, Horton AS, McCrory P, Johnston KM. Sport psychology and concussion: new impacts to explore. British Journal Of Sports Medicine. October 1, 2004 2004;38(5):519-521.
2. Meehan WP, d’Hemecourt P, Comstock RD. High School Concussions in the 2008-2009 Academic Year. The American Journal of Sports Medicine. December 1, 2010 2010;38(12):2405-2409.
3. Kelly JP, Nichols JS, Filley CM, Lillehei KO, Rubinstein D, Kleinschmidt-DeMasters BK. Concussion in sports. Guidelines for the prevention of catastrophic outcome. JAMA : the journal of the American Medical Association. 1991;266(20):2867-2869.
4. Barr WB, McCrea M. Sensitivity and specificity of standardized neurocognitive testing immediately following sports concussion. Journal of Neurophysiology. 2001;7:693-702.
5. McCrea M, KM G, SW M. Acute effects and recovery time following concussion in collegiate football players: the NCAA Concussion Study. JAMA : The Journal of the American Medical Association. 2003;290:2556-2563.
6. Kontos AP, Elbin RJ, Schatz P, et al. A Revised Factor Structure for the Post-Concussion Symptom Scale: Baseline and Postconcussion Factors. American Journal of Sports Medicine. 2012;40(10):2375-2384.
7. Lovell M, Iverson G, Collins M, et al. Measurement of Symptoms Following Sports-Related Concussion: Reliability and Normative Data for the Post-Concussion Scale. Applied Neuropsychology. 2006;13(3):166-174.
8. Iverson GL, Gaetz M, Lovell MR, Collins MW. Cumulative effects of concussion in amateur athletes. Brain Injury. 2004;18(5):433-443.
9. Echemendia RJ. Assessment and Management of Traumatic Brain Injury. Sports Neuropsychology. 2006.
10. Iverson GL, Lange RT. Examination of "Postconcussion-Like" Symptoms in a Healthy Sample. Applied Neuropsychology. 2003;10(3):137.

David Gish

Passing of David Gish SWATA President It is with great sadness that I announce the passing of our NATA District VI President, David Gish. David “fought like hell” just like he promised, but lost his battle with cancer overnight. David served his athletes, his students, and his members with professionalism, integrity, and character, and he will be severely missed. Though David’s tenure as President was very short, his impact and legacy to his colleagues, students, Board, and members was tremendous. He gave us the greatest gift of all, his time. A service to honor David’s life will be announced at a later date. Please keep his wife Karen, and his children Madison and Hayden in your thoughts and prayers. Kathy I. Dieringer District VI Director

AED “Expirations?”

This month, as I began my routine of checking all of the AEDs in our facilities, I noticed we had one in particular that was not cooperating.  Further investigation lead to the discovery that said AED was out of warranty, and it was recommended by the manufacturer that it be removed from use.  Obviously, this came as a shock to me.  I have never heard of an AED “expiring,” only the pads and batteries, which I replace regularly.  I also found it shocking that this warranty date was not posted on the AED itself, or on the manufacturer’s website.  How then, I questioned the customer service representative, does one know if their AED is out of warranty or not? 

All of us rely on the services of an AED at practices and competitions, regardless if we actually put them to use or not.  We should have confidence in the fact that when we need it, it will not fail.  It is, after all, a proven life-saving device.  No sane person would ever put a faulty device into rotation, so why then would a company not make this little tidbit known? 

The situation was quickly remedied with the purchase of a new machine, but it left lingering questions.  In addition to a mass inquiry as to when the remainder of our AEDs expire, I question the company’s lack of education on their products as well.  What is the standard practice here?  What is it that the FDA and American Heart Association recommend?  And is this something that needs to be brought to the attention of other practicing health care professionals?  I leave with posing you the question of how you would handle this situation at your jobsite, and yes, helpful comments are certainly welcomed!

Indy is Around the Corner!

Every year the members of the NATA YPC are responsible for various educational and social opportunities for their peers at the NATA convention.

"Your First Leadership Position: A Conversation with the Young Professional," a peer-to-peer session, is on Friday, June 27. When a YP assumes a leadership position, it can come with a unique set of challenges. Often the early struggles of management leave the YP wondering what they did wrong or how they could have done it better. This will be an open forum where members of the YPC will share  experiences and resources to help clinicians avoid pitfalls in their work environment and in their lives.

The YPC will also be hosting a financial planning workshop as a part of regular programming on Saturday, June 28, featuring both YPs and financial professional, discussing the needs of those trying to strike a balance between obligations and paychecks. This session is not designed just for the YP, but for any athletic trainer looking for financial guidance.

And as always, the Remembering our Roots and Forging our Future YP social. This annual event is always one of the highlights for me during the symposium.  It is a time for YPs, Hall of Farmers and other influential members of our profession to network and socialize in an easy atmosphere over a cocktail.

Don't forget the YPC Lounge any day of the convention if you need a place to sit, bring your lunch, or meet up with other YPs.

There is so much more planned for Indy and our profession that week. Hope to see you all there!

-summarized from the May 2014 issue of NATA News

Getting Involved

There are traditional views of involvement that we have all read about: be a member of your local, regional and national associations and serve on committees.  But is that really it? Is that the only way to promote the profession of athletic training? There are so many ways to serve the organization on the smaller scale that we can all fit into our very busy schedules.

Surveys! Almost weekly I read an email from an athletic training student asking me to complete a survey that will take about 5 minutes to complete.  This is a simple way to continue to advancement in athletic training.  If everyone filled out these surveys in order to assist in research, I am sure not only would the academic world be very appreciative, all athletic trainers and our patients would benefit. 

Vote! As a member in any organization the best perk you have is the right to vote!  Make sure that you cast your ballot at elections in your associations.  And not to get political, but your vote counts for athletic training when voting for local, state and federal elections as well. Do your research and vote on those elected officials who support our cause (you can find all of this info through the NATA offices).  Voting is involvement.

Send a letter!  Once an elected official is in office, make sure they know what you (their constituent) want.  When asked to send a letter to your elected official, usually a letter that is already written for you, please get involved and send it (again, these letters are already made for you on the NATA website).

Get involved at your work place! By stepping out of the athletic training room and serving on committees and projects you are promoting athletic training.   They are plenty of different projects going on some really need the skills of an athletic trainer, so get involved where can help. This usually reaps the best rewards because your employer will take note! If at a high school make sure you are being recognized as a Safe Sports School.

Communicate!  Social media has changed the world, use it to be an involved athletic trainer.  Encourage students to use social media properly and in a way to promote what we do.

Get an NPI number, it free, easy, identifies you as a medical professional and helps promote the profession.

Be a mentor – go to NATA website for more information.

Finally if you want to become a committee member, sign up on the website and/or send an email to the committee chair.  Volunteer at a convention or symposium. There are so many ways to get involved without having to invest too much time.

-Stephanie Nelson

Using LinkedIn

In today’s world, we have multiple ways to communicate with others. From Facebook to Twitter to Instagram to SnapChat, there are tons of different means of communication with friends and family. LinkedIn was best described to me as “professional Facebook”. You can go on LinkedIn and create a profile that includes all education, work experience, certifications and volunteer opportunities. This profile will give you access to all of the information and opportunities available by LinkedIn. You can connect to groups in order to receive updates and news. You can look at interesting news articles that apply to you in your particular industry. 

You can also reach out to other individuals for networking. I’ve used LinkedIn to advance my career. I’ve used it to reach out to mentors, keep up with friends and family, and continue connections I’ve made in the workplace, as well as advertise myself to future employers. I’ve created a quick to-do list for all of those who are new to LinkedIn.

1.       Get a LinkedIn Profile

2.       Get a PROFESSIONAL photo (no party photos!)

3.       Update your work experience and educational information

a.       Undergraduate Work

b.      Graduate Work

c.       Research Experience

d.      Any other relevant work information

e.      Certifications

4.       Connect with all co-workers in order to build your “connections”

5.       Reach out to your connection’s connections

6.       Personalize your “Pulse”

a.       Basically, this is the stream of news articles suggested for you based on your industry

7.       Join a group

a.       National Athletic Trainers’ Association

8.       Talk about it!

a.       No one knows you have a LinkedIn if you don’t bring it up!

In today’s job search, everything can be “googled”. This can either help you or hurt you. Let LinkedIn help you in your next job search today. If you don’t have a LinkedIn, GET A LINKEDIN!! This is such a great resource that can be tapped into by Young Professionals in order to move forward in your career.

-Roger Sancho

Extra CEU Opportunities!

As you plan your summer CEU's opportunities either through SWATA or the NATA convention, please add to your schedule the opportunity to get 6 FREE CEU's towards your NATA BOC or State requirements.

The SMU Sports Medicine Staff and the WB Carrel Clinic are hosting NATA Hall of Fame Athletic Trainer, Rod Walters on Saturday, 6/7/14. 

A few of the topics that will be covered in this year’s seminars are:

·       Injury Treatment and Rehabilitation

·       Cardiac Screening

·       Treatment of Heat Related Illness

·       Emergency Action Plans

·       Concussion Management

You can sign up online at:  http://rodwalters.com/seminars/  Find the ATEO seminar in Dallas and click on the link to register. 

If you have any questions regarding this opportunity please contact Becky Rolke or Rod Walters directly. 

Thanks and we look forward to seeing you!

Rebecca Rolke

Assistant Athletic Trainer

Southern Methodist University

5800 Ownby Drive

PO Box 750315

Dallas, TX 75275

Office: 214-768-2429

Ask not what NATA can do for you...

As chair of the YPC in District 6, I often hear the cry from the general public that NATA doesn’t do enough for our profession.  My reply always is, “Well, what do you want from them? What do you think they should be doing?”  Half the time this question is met with a glassy stare and a few vapid blinks.  The other half of the time it’s something along the lines of “they should be passing laws to make us have better salaries and better work conditions!”

So let me start there. The NATA is not a union and they are not there to regulate salary for us. I’m not sure I’d want them to. I’m not sure if a blanket salary would be beneficial or feasible. An athletic trainer working in Los Angeles certainly needs a bigger salary to meet cost of living than one in rural Texas. NOR do we want the NATA mandating our working conditions. What works in one high school may not work in one college.  With that being said, the NATA is there to help give each athletic trainer the tools necessary for each of these hypothetical ATs to get the best situation they can.

In 2013, only 494 NATA members contributed to NATAPAC.  That is less that 1% of our professional organization.  This is a huge problem.  For all those that say NATA should be changing laws and demanding better working conditions, I’m sorry to inform you, you have the wrong organization in mind.  The NATAPAC is the one that can get the ball rolling on those things.

The NATAPAC enables employees or members of groups, like the NATA, to pool their resources and make political contributions to candidates that support issues related to the group.  Monies have to be given to the PAC by individuals in the group, and cannot be given by the group themselves.  Meaning NATA cannot give support to politicians who support third party reimbursement for ATs (support = MONEY!), the individuals within the group (US!) must do it.  You know? All that checks and balances stuff we learned about once upon a time…

The PAC does the hard work for us. They find the politicians on both sides of the political poles that support what athletic trainers do and what they are capable of doing, and then work with those to formulate those laws that protect athletic trainer’s wants and needs.  A small gift by you to the NATAPAC would help accomplished a lot of the goals that our general public thinks that NATA should be doing for us.  If nothing, the NATAPAC breakfast held every year at the annual symposium is a great opportunity for networking, socializing, and fundraising for the profession.  I’ve attended for several years and it has always been worth the early wake up time.

And while contributions to the NATAPAC (or any other PAC for that matter!) are not tax write-offs, contributions to the NATA Foundation are.  So, in this tax season, if you are looking to beef up your deductions, please consider the Foundation.  The NATA Foundation works to give scholarships and grants to researchers within the profession.  One reason that ATs struggle to make footing with our professional peers is that our research pool is fairly limited. Sure, there is tons of research taking place in sports medicine, but it is not being done by athletic trainers.  That is a very important distinction and certainly one that will help us create a better image of the profession.

For more information on both organizations, visit:

http://www.natafoundation.org/

http://natapac.org/

-Tiffany McGuffin

The Debate: Part Deux

Our profession is involved in a heavy discussion.  No, not the name change, AGAIN.  For those of you following the developments on the entry-level master’s (ELM) discussion over the past 6-12 months, and in particular in the last few weeks after the release of the NATA’s Entry-level degree evaluation document, you may have an opinion one way or the other.

For those of you in the dark, you need to be brought into the light.  Please read now: http://www.nata.org/sites/default/files/The_Professional_Degree_in_Athletic_Training.pdf. 

Before we dive too much into this, let’s make a quick clarification.  What we have, as a profession, known to be an Entry Level Masters is what we are going to be here on referring to as a “professional degree.”  That increase in professionalism is the goal of this whole process.  As was stressed this weekend at the NATA Joint Committee Meeting, the “white papers” are just step one into the future of the profession.  Once NATA comes up with their recommendation, it will have to present to CAATE and the BOC, making this process very long.  It won’t be many, many years until this is enacted. If we make a parallel to the PT world, it took them 15 years to make the transition to their professional degrees. So we have to think as a profession as a whole, where are we headed, and where do we want to go?

As I said, the NATA Joint Committee meeting was held this past weekend in Dallas and served as an opportunity for all National Committee Appointments to gather and plan for the future of the NATA.  It was a valuable experience, allowing me to see what our volunteers in all of our special interest groups are up to.  Naturally, this Professional Degree was a large topic of discussion.  I had read the white papers prior to and was firmly planted on the fence, but, man!, the ladies and gentlemen behind this research have done a fantastic job thoroughly investigating it.  You may not for a moment think this is a hasty decision, I can promise you that.  So here are some things that I have heard in the last few weeks, and what I have learned regarding each one.

This first part that was super appealing to me was the idea that with Professional Degrees, we could align ourselves more with other Allied Health Care Professionals on campus.  I’m not sure this was spelled out so well in the white papers, but when some of the researchers were presenting, it was a major “AHA!” moment for me.  If you are taking a lower extremity course in a health care department, not a kines department, your classmates will be other health care professions.  We won’t have to prove how much we know when faced with other therapists because they will know what we know.  Our education foundation would be in the same EXACT class! Brilliant! On top of that, aligning ourselves with colleges of health care, not kinesiology, will allow us to escape the Rule of Athletics.  Like the super successful model at Boston University, this switch would pave the way for ATs who do not work for coaches and athletic directors.  That’s a whole other blog post, but, the job of an AT should not be influenced by a boss who has other motives.  This move will help that.

I also think the ECE’s point about basic courses competing with AT courses is valid. Letting the students get their GE requirements out of the way before being immersed in their clinical rotations will increase their drive, focus, and passion for athletic training.  I know first-hand, taking English and Modalities in the same semester, is a daunting task.  Why not let our students be fully immersed in what is they are trying to become?  

This new undergrad experience will allow for more science-based pre-requisites, one area identified as lacking in our Evidence Based world.  If you think for a second that physics are necessary for modalities and rehab, you are dead wrong.

One of the biggest draws, is student maturity and making athletic training a terminal profession.  I know the previous post already addressed this, so I won’t go bananas, but let’s all briefly reflect on the student we were at 18 and the student we were at 22.  For those of you in our secondary schools, its equivalent to the difference between a middle schooler and a high schooler, bless those little 7^th graders’ hearts!

One of the common “cons” is the cost of education vs. the salary return.  For most in our profession, I would be willing to venture, this is already a reality. I know GA positions are sold to us as being “free education,” but I still left grad school with loans as do most of our newest grads.  It was not free, nor was my stipend “liveable” for a certified professional.  Bringing academics into the graduate level allows for greater scholarships and grants. 

Again, this education reform is not the solution to our salary issue, nor is that the design, and I know that is what everyone wants. Until we align ourselves with peers deserving of an increased salary that will never happen.  Remember, we are classified as “technicians” in the current healthcare model because we lack a professional degree.  Translation: we are no more skilled than a medical assistant or an EMT.  I know that not to be true.  That alone should send everyone knocking down the ELM door.

Another argument I have heard through the grapevine is that we are eliminating the GA position and that is a bad thing.  This was one of the ones I sided with when I read through the white papers the first few times, but have changed my mind. From meeting with those involved in this investigation this weekend, our advanced degrees, included skilled residencies, Specialty Certifications, and higher education (Doctorates in Athletic training and Advanced Masters) will be enacted sooner than our Professional Degree.  The authors were unanimous in our need for higher education and more enriching educational opportunities, not just the letters behind the name.  In our current model, that is what grad school does.  It gets us the letters and attempts to make a bridge from student to certified professional.  But, speaking from experience, my GA position had very little bridging.  I was a (wo)man all unto myself.  Sure it was a valuable experience, but it was an unguided experience.  Name any other profession that an entry level job is a lone gig.  There is none.  No first year doctor would open his own practice.  No first year nurse, would run an ER by himself. No first year PT would open his own clinic.  But we surly send a first year ATC out to cover 1,000 of athletes at the high school level.  We are sending our lambs to the slaughter!!!

Residency programs are now being accredited by CAATE and will be the future of athletic training.  The pay is on-par with other professions’ residencies, and they are full time positions with benefits.  Which our GA positions are not.  An even bigger plus for the profession, they are guided, educational opportunities.

And the quickly on the R Word tied to the S word: Reimbursement.  Again, as long as we are classified as technicians, we won’t be eligible for reimbursement.  It’s a fight we will keep fighting for sure, but will continuously struggle with reimbursement until all states have licensure and until we have a professional education standard.

One more thing before I close would be to argue against one of the most common “cons” I have heard. Honestly, I felt the same way, until presented with truth and evidence this weekend at the Joint Committee meeting. “We are cutting clinical time and we are already lacking in clinical experience!!!!” “We expect students to get better in 2 years when they aren’t good in 4 years!” The Professional Degree would incorporate just as much, if not more, clinical experience than our traditional bachelors.  Remember, we are eliminating the “fluff” of undergrad: student organizations, general studies, Greek Life, etc. Also, the degree outline is non-stop, beginning June 1 and ending August 31, two years later.  There is no summer break and there are no lulls in education.  Many of the pilot programs have even allowed a full Fall (where we know we get some of our richest clinical experiences) to be strictly clinical rotations. That’s right folks: a full “40 hour work week” of just clinic for our students.  No undergrad is experiencing that right now.

In the name of time, this post will conclude.  Please send me your thoughts, comments and concerns, and I will do my best to share with you what I have learned.  Plus, you will give me fodder for Blog, Part 3. :)

-Tiffany McGuffin

One Side of the ELM Debate

After following the developments on the entry-level master’s (ELM) discussion over the past 6-12 months, and in particular after reading the NATA’s Entry-level degree evaluation document, I have hopped down off the fence and stepped confidently onto the side in favor of making this change to a Master’s degree.  What follows is one girl’s opinion including what I believe to be the most important points of this issue in favor of a transition to an ELM degree.  If you’re looking for evidence behind these points, you’ll find it in the degree evaluation document by following this link: http://www.nata.org/sites/default/files/The_Professional_Degree_in_Athletic_Training.pdf.  Be warned I am only presenting one side of the argument.  I was planning on presenting both sides but it turns out that one side of the story is pretty lengthy!!  Either that or I’m just long-winded…

For some historical perspective, it is important to note that the NATA’s Vision Quest (VQ) report, which was intended to give us direction and vision for the profession into the year 2020, said the Bachelor’s degree is currently meeting our needs, but that requirements will continue to be evaluated contingent upon the health care market.  It seems that is what we are doing, so in this way things are going according to the VQ plan.

Switching to an ELM is going to be a huge undertaking when it happens, and I believe it will happen eventually.  The NATA/CAATE/BOC have already used a significant amount of time, manpower, energy, and money to examine our entry level degree and figure out if this is the right move.  I imagine that if we decide not to make this change, the NATA will wait 3-5 years, someone else will bring it up, and we will repeat this process all over again (ahem….nomenclature), thereby using more money, manpower and energy that could be put somewhere else.  I don’t think anyone can deny this change needs to happen eventually, so unless we see some huge red flags during the research and investigation, let’s just make the right decision now and go for it.  It will be hard, but if we take our time and make sure we do it right, we will look back as those who made the decision about eliminating the internship route did and know that even through all the struggle and stress it was worth it because it was the right thing for the profession.

We have too many AT programs. If you ask me, its straight up redonkulous and I think if we lost a few programs, or 100, it would be better for the profession and better for our students. We are wide and shallow.  It is time for us to become narrower and deeper. Would cutting the number of AT Programs be hard for a lot of people? Definitely, and that is absolutely unfortunate. But ultimately it would be for the greater good and so it will be worth it, and the strong will survive which will strengthen our profession.  Additionally, a lot of AT programs have “numbers” requirements to keep them afloat which further contributes to the dilution of AT-focused students in our programs.  Decrease the number of programs and the students per program should increase, therby solving the numbers problem. I just can’t get the vision out of my head of what kind of profession we would have if we really focused on the students who want to do what we do.  Can you imagine?

Regarding the "stepping stone" concept, I believe this issue is very complex and has so many layers, that it will be hard to adequately address here.  Briefly, though, I think most students who come through our ATPs fall into one of four categories:

1.   they want to end up as a PT/PA/etc from the get go and truly are using AT as a stepping stone

2.   they go into it wanting to be ATs and then somewhere during their education decide they don’t like the idea of being overworked, underpaid, and disrespected for what might be the rest of their lives so they decide they will finish the ATP and then focus on something else for their post-graduate work

3.   they finish the ATP, maybe go to grad school for AT-related study, enter the workforce, decide they can’t or don’t want to deal with being overworked/underpaid/disrespected so they go back to school for PT/PA/etc and end up leaving the profession

4.   they finish the ATP, end up working as an AT, and stay in it for the extent of their career. 

Changing the degree to an ELM would probably all but eliminate groups 1 and 2, thus eliminating our “stepping stone” problem for the most part.  I’m not sure groups 3 and 4 will be affected directly by a change to an ELM because these individuals’ end-goal is AT.  What is the best move for the students who will be ATs for the rest of their lives?  Our focus should always be here, and all the others will find their way, and they will be okay.  We can mentor them and encourage them and help them find their way, but we can’t make our plans around them.

I also think the ECE’s point about basic courses competing with AT courses is valid. Letting the students get their GE requirements out of the way before being immersed in their clinical rotations will increase their drive, focus, and passion for athletic training. 

That’s all I have as far as a point-by-point perspective regarding the ELM degree debate. Hopefully I have adequately represented my perspective, and I hope someone will provide a thoughtful presentation of the potential drawbacks of an entry-level degree change. The fact is we don't REALLY know what this change will do to our profession. This degree evaluation document is the closest thing we have to an idea of what kind of chain reaction a degree change could set off. 

We have many other problems that need fixing (salary, ATs lacking in secondary school, only 48 states with licensure, lack of recognition and respect from others, and our identity crisis).  There is no way to know how an ELM will affect these problems, but I don’t think this is something we should expect to be able to predict.  Most of these other problems I just listed are OUR problems, and if WE don’t put our energy, time, and passion into fixing them, we will never see our dreams realized.  Our salaries, being respected, and our identity crisis are not problems the NATA, CAATE, or BOC can fix. Only we can.  So let’s let the powers that be use their wisdom and resources to make this decision, and as we stay informed and speak our minds about this, let’s daily wage war against apathy, self-loathing, and the status quo and move this profession forward.

So what do you think about the ELM degree debate?  …and please don’t comment until you’ve read the document – make sure you’re opinion is educated!

-Kim Detwiler