Category: Prevention

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Restrictions in place for football players due to extreme heat

The first high school football games of the season are still weeks away, but practices are underway in the peak of summer’s heat.

At Kennesaw’s Harrison High School, practice began this week for the more than one hundred freshman, junior varsity and varsity football players. The air temperature is in the 90s; on the artificial turf field, it’s even hotter.

“On a day like today, you could easily add an additional 30 degrees to the temperature. There’s no cloud cover it’s direct sunlight,” said Adam Freeman, head athletic trainer for Cobb County Public Schools.

It’s Freeman’s job along with the coaches to monitor the health of the players, especially in these early season practices. Restrictions are in place for the first week helmets only, no pads.

“That’s one of the safeguards we put in place several years ago.  Because of the heat a five day aclimatization period all football players before the season starts,” said Freeman.

Harrison was one of more than twenty schools across the state that participated in a Georgia High School Association (GHSA) and University of Georgia study on how heat affects players.

They looked at “temperature data, injury data all the way down to doing it by position and class,” said Freeman.

Three years ago, new standards went into place that govern whether practice can be held outside, how long practice can last, how many breaks teams must take each hour, and whether players can be in full pads.

It’s not the temperature Freeman monitors, but a combination of the heat and humidity that reveals how efficiently players can cool off. The higher the number, the less room for evaporation and necessary cooling

“What I have is a device that can take all those factors in and give me a number the wet bulb global temperature,” Freeman said.

Freeman monitors that number several times an hour, constantly updating coaches.

It’s all in an effort to keep players safe from the intense summer heat and humidity, “heat illness is the most preventable sports injury out there,” Freeman said.

ORIGINAL ARTICLE;
http://www.wsbtv.com/news/news/local/restrictions-place-football-players-due-extreme-he/nm9n3/

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Glen Rock school board updates concussion policy

Amid ongoing health concerns about sports-related head injuries, the Glen Rock Board of Education adopted a revised concussion management policy at its July 6 public meeting.

Citing Centers for Disease Control and Prevention statistics that at least three million sports and recreation-related concussions occur in the U.S. every year, the policy language states that the “competitive athletic culture of playing through pain or ‘toughing it out’ puts student-athletes at risk of brain injury, disability and death.”

While noting that allowing a student athlete to return to play before recovering from a concussion increases the chance of more serious brain injury, the policy holds that the effects of concussion, while not preventable, can be “mitigated by proper recognition and appropriate response.”

To that end, the BOE policy now stipulates that all coaches, school nurses, school/team physicians and certified athletic trainers must complete an interscholastic head injury training program, such as the National Federation of State High School Association’s online “Concussion in Sports Training” program, or a comparable program that meets mandated criteria.

The chosen program must include training in the recognition of the symptoms of head and neck injuries, concussions and injuries related to “second impact syndrome,” and a description of the need for appropriate time to delay the return to sports competition or practice of a student athlete who has sustained a concussion or other head injury.

However, the policy also states that if no additional time is specified for a particular age group or sport, the student athlete may return “when written medical clearance is given to the athlete, stating that he or she is symptom-free and has already completed an appropriate, graduated, individualized return-to-play protocol.”

The guideline also requires annual baseline (cognitive response) testing for all middle school and high school student athletes prior to sports participation using the ImPACT online testing program.

Regarding in-game incidents, it mandates that any student athlete suspected of sustaining a concussion or “exhibiting or complaining of” concussion-related symptoms — or any student who has sustained a concussion or has become unconscious during a practice or athletic contest — be removed from play and not permitted to return that day.

In each instance, a medical evaluation must be performed by a certified athletic trainer (ATC) and/or school doctor or other certified and approved medical personnel to determine the “presence or absence of a concussion.” If a student is diagnosed with a concussion, a minimum seven-day wait before returning to activity is imposed.

The policy states the student “must be free of all concussion symptoms for seven days prior to return.”

In addition, the same cognitive ImPACT test administered previously as a baseline is to be used to determine whether physical clearance and return to activity are appropriate. The test would be administered and/or evaluated by a BOE-approved, concussion-trained doctor.

Following such clearance, the certified athletic trainer and coach are directed to implement a “gradual and acclimated” return to activity under “Zurich Consensus Statement” guidelines.

The revised policy also requires that the N.J. Department of Education Concussion and Head Injury fact sheet — and the Glen Rock district’s Concussion Policy Acknowledgement form — be distributed annually to every student athlete who participates in interscholastic sports.

Parents must sign and return the form prior to student participation in any athletic practice or event.

ORIGINAL ARTICLE:
http://www.northjersey.com/news/education/concussion-policy-updated-1.1384035

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Florida HS Association requires athletes to study up on concussions

For the past five years, the Florida High School Athletic Association has made sure its coaches were educated about concussions. Now it’s making sure student-athletes are as well.

Beginning this season, all high school athletes in Florida must complete courses on concussions provided by the National Federation of State High School Associations before being eligible. The courses are free and available online. Once student-athletes complete the course, they and their parent or guardian must sign a form. They also will get a certificate of completion which must remain on file with the coach of each sport.

The FHSAA promises random checks throughout the school year. If coaches can’t provide proof of completion, they will be suspended until all players complete the course. Student-athletes on varsity and junior varsity levels, including for non-contact events such as golf, cross country and swimming, must take the course.

“The reason behind the move was student-athlete safety,” said Justin Harrison, the FHSAA’s associate executive director for athletic services. “Overall, all concerned parties felt it was imperative to continue to educate the student-athletes on concussions. … This course was yet another way to provide the information.”

Harrison said Florida is the first state to require all student-athletes to be versed on concussions. The FHSAA board of directors passed the policy in June. Member schools’ coaches and athletic directors were made aware of the policy change soon after.

The course is available at www.nfhslearn.com, where student-athletes are directed to the proper courses.

The fall sports will be the policy’s guinea pigs. Football, with its large rosters, might have the hardest time making sure all student-athletes obtain a completion certificate. Fall sports teams can begin preseason practices in less than a week.

St. Petersburg football coach Joe Fabrizio, who has a roster of over 100 players including varsity and junior varsity, said he will gather his teams this week to view the course and take the online test.

“We’re okay with it,” Fabrizio said. “Anytime you can give the kids more knowledge on a subject like concussions I don’t have a problem with it. We’re going to show them the test (this) week and make sure it’s taken care of.”

At Plant, coach Robert Weiner has close to 150 players including varsity and junior varsity. He said he found out about the test early and made sure all his players earned a certificate well before the start of Monday’s practices.

“It might be a bit of a burden but it’s also important,” Weiner said. “We made sure we took our time and went through it to give the kids an opportunity to really learn it. We’re trying to get away from the days of being a tough guy and faking (a concussion) and trying to be a hero. The more they know the more they can deal with it honestly and communicate with us honestly.”

Hudson coach Rob Mahler said he also will make sure his players earn their certificates before practices start.

“We all have a lot on our plate and this is one more thing that adds up,” Mahler said. “There are physicals and paperwork and fundraisers. But I do think that it is important that they know this so it is something we’ll deal with.”

Not all coaches are happy about having yet another piece of paperwork. Pinellas Park coach Kenny Crawford said he didn’t find out about the new concussion rule until being told Monday.

“It’s the first I’m hearing about it,” Crawford said. “I don’t think the kids learn a whole lot from these tests. They are so common sense. To me, it’s pretty clear cut. As soon as you even think a player may have a concussion you turn it over to your medical staff. It’s out of your hands. You can’t risk it when it comes to concussions.”

Coaches have had to take courses on concussions and sudden cardiac arrests for the past five years. Pasco County recently held a clinic for football coaches funded by Florida Hospital and the Tampa Bay Bucs and run by USA Football’s Heads Up program. A designated coach from each of Pasco County’s 13 public high schools went through a one-day training focusing on in-class and onfield training about concussions, cardiac arrest, heat issues and proper hydration, equipment fitting, and tackling and blocking techniques.

“It was good to get all the coaches together in one room and talk about different circumstances that have happened to them,” Mahler said. “And we were out there going through the same drills that we put our players through. So I think it was very beneficial from that standpoint.”

Recently, Pasco County has stepped up efforts to educate its staff and the public about the health of student-athletes. Amy Lipovetsky, Pasco County’s program coordinator for athletics, said the county will have a full-time trainer at each public school for the first time. Additionally, she hopes to receive funding again next summer for another concussion training that will include middle-school coaches.

“I think it’s good to educate everyone we can about this,” Lipovetsky said. “The student-athletes and the parents are going to get this information a lot. I don’t think you can get it enough.”

ORIGINAL ARTICLE:

http://www.tampabay.com/sports/footballpreps/fhsaa-requires-athletes-to-study-up-on-concussions/2239008

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Athletic Trainer Bree Clayton Provides heat illness expertise

Warm weather brings the joys of summer, but also a few additional risks for active children and teens.

Athletic Trainer Bree Clayton from Arkansas Children’s Hospital stopped by THV11 This Morning with tips on how to keep them safe.

Why are young athletes at such risk for heat illness?

-Children and teens don’t get rid of heat through sweat as effectively as adults

-Young athletes often are disciplined enough to make themselves drink

-During practices and games, young athletes are easily distracted and they forget to take breaks and hydrate

Is heat illness still a worry for young athletes, even when we’ve had cooler weather like recently?

– Cooler weather recently means that young athletes are not as acclimatized to warmer temperatures

– Humidity is as important as temperature-with high humidity even temperatures in the 80’s can create dangerous a dangerous heat index

– Full sun exposure can also add as much as 15 degrees to the heat index

– Practice surface, especially artificial turf, also adds radiant heat

– Heat illness can even occur indoors if the temperature is not being controlled.

What are the signs parents/coaches should look for in their young athletes if they suspect heat illness?

– Noticeable Thirst

– Muscle Cramps

– Weakness

– Decreased Performance

– Nausea

– Headache

– Fatigue

– Lightheaded feeling or dizziness

– Difficulty paying attention

What is the best way to prevent it?

– Acclimatization-spending progressively longer times exercising outdoors is very important

– Good night’s sleep

– Well balanced diet consisting of fruits and vegetables

– Plenty of water and sports drinks

–Avoid products that contain lots of sugar and caffeine

–Absolutely no energy drinks! They can actually raise your body temperature.

– Wear as few layers as possible of light weight, moisture wicking material

– Change into dry clothes often

 

Will it help to wear a cooling bandana or other type of cooling towel when they are practicing in pads/helmet and playing games?

– Headbands and cooling towels are only helpful if they stay exposed to the wind.

– If they become wet and stay wet and are under shoulder pads and helmets, they are just going to trap heat in.

– Great for after practice, but probably not good to wear during practice.

What should parents ask of coaches to know that there is a plan in place to address heat illness?

– What type of rest plan does the coach have in place?

– Where can athletes go to cool off during breaks?

– How often are players allowed to drink water during practice?

– What is the school’s plan to treat an athlete that overheats?

– Does the school have an emergency action plan?

– Who monitors the athletes during practice to make sure they are not overheating?

Is water better than sports drinks for preventing heat illness or does it matter?

– Drinking compliance is the key!

– Water is better for overall hydration, but if kids do not like it they won’t drink it.

– Sports drinks have flavor so often times athletes are more likely to drink them.

What role can parents play in keeping their young athletes healthy during the heat?

– Have plenty of their favorite flavor of sports drink at home for before and after practice

– Make sure to have healthy snacks at home.

– Provide well balance meals and make sure your athlete eats-if they are tired they may not feel like, but encourage it

– Allow them to rest indoors in the air conditioning after practice

What should your first steps be if you identify heat illness in your child or another young athlete?

– If minor symptoms like dizziness, lightheadedness, or cramping:

–Rest in a cool place

–Remove wet, constricting clothes

— Give them plenty of water and sports drink

– If they collapse, lose consciousness, or become confuse this is an emergency and could be a heat stroke

–Cool them as rapidly as possible

—Ice bath is preferred method

—Ice packs over as much of body as possible

—Cold shower or ice towels

–Dial 9-1-1

–Remember to cool first and transport second

ORIGINAL ARTICLE:

http://www.thv11.com/story/news/health/2015/07/27/keeping-active-teens-children-safe-during-warm-weather/30723431/

 

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David Hamen and Aaron Sage implement New Ohio guidelines

When high school football practice begins for the 2015 season in Ohio on Saturday, coaches and players will be functioning under a new set of national guidelines addressing concussions, which was adopted and introduced by the Ohio High School Athletic Association on July 13.

In a memo to the OHSAA membership of more than 700 high schools, commissioner Dan Ross said the association “has joined dozens of states in adopting recommendations from the National Federation of State High School Associations’ Concussion Summit Task Force, which will reduce the risk in football for concussions and head impact exposure.

Ross has long stated that the top priority of the OHSAA is the safety of its athletes, and the new guidelines are designed to give football coaches some direction in the intended reduction, recognition, and treatment of head injuries in practices and games.

“With the support and leadership from the football coaches association, we have been out in front of concussion awareness and education, and these changes will now bring Ohio up to a place as a national leader in this area,” Ross stated in the memo. “Like many of our regulations, these guidelines are to be followed and monitored by member schools and coaches, but we are fortunate in Ohio that many coaches have already been following these safety measures.

“There will always be a risk for concussion, but football is safer now than it has ever been, and these guidelines will make it even safer.”

According to the OHSAA memo, the three principles that the guidelines reflect include exposure of an individual athlete to full contact in terms of frequency and duration, the cumulative effect of the exposure on an individual athlete, and recovery time for each athlete after contact.

The recommendations adopted include spring, summer and all off-season contact. Already the rule in Ohio, there is no contact permitted except during the season, and pads may not be worn at any time except during the season.

The new guidelines are aimed at preseason practice and practice during the season.

New to preseason practice, full contact will be limited during two-a-day practices.

When more than one practice takes place in a day, full contact is permitted only during one of the practices. Further, if full contact occurs during the second session of two-a-days, full contact will not be permitted during the first session the following day.

Once the season has begun, individual athletes are limited in full contact on consecutive days to 30 minutes in practice per day and to 60 minutes per practice week. An athlete can only be involved in full contact in a maximum of two practices in a seven-day span.

Contact with soft equipment such as bags, shields, sleds, etc., does not count toward full contact limitations.

“These regulations are being put into place for the safety of our student-athletes, and it is incumbent on coaches to monitor the contact in their practices,” Ross said. “Our coaches are educators and leaders. They want what’s best for kids, and these regulations are in line with these safety recommendations.

“These regulations will evolve and may become more restrictive as additional concussion research emerges.”

Adapting to the changes

The changes adopted by the OHSAA will not be viewed as drastic to most Ohio high school football programs, as many coaches had already become more vigilant to the potential for head injuries.

Head coaches at three of the Toledo area’s top football programs from recent seasons each said they have long been aware of the danger of concussions, and that the safety of their players is paramount.

Last season, coach Matt Kregel’s Perrysburg team finished 11-1 and was the top-ranked Division II team in Ohio. Greg Dempsey has coached Central Catholic to three state playoff championships in the past 10 years (2005, 2012, 2014). Whitmer’s Jerry Bell guided his 14-1 Panthers to a Division I state runner-up finish in 2012.

“I think we’ve always done a good job of controlling the hitting,” Kregel said. “We don’t have enough kids to two-platoon, so we have to monitor the hitting ourselves. I don’t think [the new OHSAA rules] will have a huge effect on us and how we coach things.

“We monitor ourselves. It’s a common-sense approach. We’ve always done it this way, and the good coaches in the area that I’ve talked to have said they’ve always done it this way.

“I don’t think this is going to have a huge effect on how guys coach high school football. At least for the guys who do the right thing and are concerned about the kids.”

Safety is first and foremost.

“I definitely think things have to be done to protect the kids that participate in football,” Dempsey said. “And, by doing so, you’re protecting the future of the sport.

“You definitely need to be better educated, and there needs to be some parameters set.

“I’d say 99 percent of the coaches are doing it right. But there’s some people who, for whatever reason, usually cause rules like this to be put into effect.”

Even though they already have the athletes’ safety in mind, there will be extra incentive for coaches to adhere tightly to the full-contact limitations.

“All it takes is one parent who’s unhappy with playing time to say ‘You’re hitting too much throughout the week,’ ” Bell said. “We’re going to monitor that throughout our practice plans and make sure we have it right.

“It’s for the safety of our kids. When you look at the way people are practicing nowadays, I think that we already err on the side of caution with concussions to begin with in making sure that the drills we’re doing are putting safety first, and teaching kids the fundamentals of the game.

“Over the years, we’ve learned how to do that without full contact. We want our kids healthy throughout the season, especially with the schedule we play. When I look at the new rules, it really doesn’t change much in how we practice. We’ve been doing this for years.”

Out with the old

Kregel, Dempsey, and Bell have each been around the game long enough to see the evolution of high school football practice from a more physically demanding and dangerous past to today’s more sensible training methods.

That includes greater awareness of head injuries.

“You can’t beat your kids up,” Kregel said. “There were years in the past when everybody was two tight ends and I-formations when that’s all you did was line up and bang. That’s not the case anymore. The guys who have sense will do it the right way.

“The guys who want to stretch the rules and do it the wrong way, I think that’s who this rule is for — to protect those kids. At the beginning of two-a-days, you’ll still have some kind of one-on-one, man-up kind of drills. You’ll do that for 10 minutes. Everybody bangs, and then you go to the next drill.

“But you do something where you’re not hitting full speed. We never just line up and knock the living crap out of each other for an hour and a half.

“I think that’s the direction football is going in. It’s not blood and guts and knocking the crap out of each other. You have to be smart about how you conduct business.”

Dempsey believes today’s high school football is a much safer version of the game.

“I feel better about kids playing football now than ever because of the awareness and the education and the protocol,” Dempsey said. “We’re much more aware and, when an event happens, the protocol for a kid’s return is much safer.

“If a concussion happens, it’s something we’ve got to watch. If two of them happen, it’s something we’ve really got to watch. Right now, I believe it’s as safe as it can be to play football.

“I think we know more about [recognizing concussions] now. It used to be macho to hide stuff as a player, and coaches used to make remarks about a kid having ‘his eggs scrambled’ and stuff like that. It’s much different now. You might even have some things now that are labeled as a concussion that really aren’t. But it’s better to err on the side of caution than it is to ignore it, which is what used to happen.”

Bell sees current high school coaches as much more enlightened regarding the dangers of the game.

“Overall, our coaching profession is very good at understanding the game and understanding the fundamentals, and how to teach the kids the fundamentals without putting them at risk,” Bell said. “The days of you running drills like ‘bull in the ring’ are long gone at the high school level. “With the research that they have done on concussions, and looking at long-term factors for kids with how it can impact them as adults, us being proactive on this is a step in the right direction.

“We can teach and do our jobs without having to put our kids at risk during the training sessions, and still have them function at a high level and be able to make a sound tackle and a good block with these new procedures in place.”

A watchful eye

According to information provided by the Mayo Clinic, signs and symptoms of a concussion might include headache or a feeling of pressure in the head, temporary loss of consciousness, confusion or feeling as if in a fog, amnesia surrounding the traumatic event, dizziness or ‘seeing stars,’ ringing in the ears, nausea, vomiting, slurred speech, delayed response to questions, appearing dazed, and fatigue.

Coaches might not have the ability to diagnose such symptoms, but they have athletic trainers on hand at nearly all practices and every game, and many high school games are staffed by a team physician.

Perrysburg, Central, and Whitmer have a team doctor on hand at every game.

The coaches rely heavily on their athletic trainers to recognize potential concussions. Whitmer, like many area schools, utilizes athletic trainers provided through Mercy Sports Medicine, a division of Mercy Health.

Athletic trainers David Hamen and Aaron Sage work full-time with Panther athletics.

Hamen has been an athletic trainer since 2003 after earning his bachelor of science degree from Bowling Green State University. He has worked with Whitmer athletes since 2008.

As the 2015 football season approaches, Hamen has been busy utilizing one of the most important tools available to medical personnel in recognizing concussions.

He has been conducting what is called baseline testing for all of Whitmer’s fall season athletes who will be competing in contact sports. Nearly the entire football team has already been tested and placed in the accompanying computer system.

The trainers utilize Mercy Health’s ImPACT evaluation procedure to help diagnose concussions in athletes.

ImPACT, which stands for Immediate Post-concussion Assessment and Cognitive Testing, utilizes neurocognitive baseline and post-injury testing to evaluate the athlete’s normal cognitive ability (baseline) versus his or her cognitive ability after a head trauma.

Mercy Health touts that this procedure — comparing baseline to post-injury function — as “the most scientifically validated computerized concussion evaluation system.”

In a nutshell, each individual athlete takes an online test to establish his or her normal “baseline” cognitive ability. When a possible head injury has occurred, athletes are retested to see if there has been a measurable dropoff in their cognitive performance.

“It’s a series of different tests,” Hamen said of ImPACT. “Some of it is a memorization of words, some of it is memorization of shapes or patterns. It gives us a baseline for where the kids are [in normal cognitive state].

“If we ever suspect there is a concussion, we’ll have the kid sit down and take the test again. It will give us a readout of where they were initially and where they are now. Depending on the score, it will give us a better idea if there’s a potential concussion there, and to seek further help. It’s a tool for us to help identify concussions, and to protect our kids.”

The high school football season, for most Ohio teams, begins Aug. 28.

ORIGINAL ARTICLE:

http://www.bcsn.tv/news_article/show/537483

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AT Mike Goforth welcomes new ACC policy for pressbox observer

least three times last football season a Virginia Tech assistant coach stationed in the press box alerted medical personnel on the sideline to an injured player. The instances reminded Mike Goforth that as watchful as he and his staff try to be during a game, they cannot see everything.

That’s why Goforth, the Hokies’ associate athletic director for sports medicine, applauds the ACC for mandating that each conference team place either a physician or athletic trainer in the press box for every game.

Following similar stances by the Big Ten, Southeastern Conference and Pacific 12, ACC commissioner John Swofford announced Monday that league athletic directors had unanimously approved the measure.

“This team-specific medical observer will have the benefit of knowing the medical history of the players,” Swofford said, “because it will be someone who is involved with them on an ongoing and day-to-day basis. They will travel with the team and observe every game, home and away, conference and non-conference.”

The observers will not have stoppage power, in the form of a direct line to the game’s referee, but they will be connected with medical officials on the sideline.

In this time of bigger, stronger and faster athletes, of more violent contact, and of more scientific data on the enduring effects of brain trauma, the more precautions the better. You don’t want to encumber the game, or those who play it, but the harrowing tales of the last 20-plus years, involving athletes at all levels, make clear the sensibility of this measure.

Though a few meaningless weeks behind — it is the offseason, after all — on press box observers, ACC schools have long been on the leading edge of concussion protocol and research, and the University of Noth Carolina’s Dr. Kevin Guskiewicz serves on the NCAA’s concussion committee.

Brain trauma is most studied in Blacksburg, where Stefan Duma heads the Virginia Tech-Wake Forest School of Biomedical Engineering and Sciences. From safety ratings for helmets to sensors that warn of high-force collisions to a Department of Defense concussions study designed to aid athletes and military personnel, Tech’s academic research has been invaluable to Goforth and the medical team.

“We’re going to make this as proactive as we can,” Goforth said of the ACC policy, “and I think it will be a big help to us. …
“If you have the right culture around an athletic department, specifically the football program, this kind of thing already occurs. Last year on at least three occasions our coaches called down for me to look at somebody.”

Goforth declined to reveal the players involved but said the injuries involved a knee, concussion and ankle. Trainers on the field had noticed the first two, not the latter.

But coaches, or medical staff, can’t be expected to notice every possible injury. The game is too fast, especially with no-huddle, hurry-up offenses en vogue. Trainers are tending to players on the bench. Coaches are hatching strategy. Medical observers, perched on high and presumably equipped with binoculars and television replay, will be less distracted and more likely to notice anything amiss.

The ACC’s policy is only a week old, but Goforth already has created a one-page, game-day concussion protocol that includes the press-box observer. There’s a photo of Goforth examining the concussed Logan Thomas at the 2013 Sun Bowl and an edict that any player diagnosed with a head injury “is ruled out of the game and their helmet is taken by the equipment manager.”

An integral part of Frank Beamer’s football program since 1998, Goforth has decided that the Hokies’ press box watchdog will be an athletic trainer, since trainers have more frequent interaction with players than physicians and are more familiar with their medical histories. Moreover, Tech’s observer will be armed with not only medical background and insurance information for every player, but also the seat location of players’ parents – cell phone service in a crowded stadium can be spotty.

Such information used to be stashed in a trunk on the sideline. Upstairs it will be more easily accessible.

“You know Coach Beamer,” Goforth said. “Coach Beamer has never, ever put pressure on us about an injury. But he will pressure me about communicating with parents. It’s of utmost importance to him that Mom and Dad know what’s going on with that kid. Practice, game, whatever.”

On game day, Goforth also positions some Tech medical staff on the opponents’ sideline, where they operate an x-ray machine. The more eyes from the more angles the better, he figures, the same premise that inspired the Big Ten, SEC, Pac-12 and ACC — the Big 12 recently limited live contact drill to two days per week, including game day.

Goforth recalled Tech running back Lee Suggs’ torn ACL in 2001. With a clear view of the play, Goforth sensed the injury even before Suggs collapsed into a heap, and that knowledge informed his immediate treatment.

Indeed, for medical personnel, there’s no such thing as too much information

“I think we’ve got a lot of things in place,” Goforth said, “some good mechanisms to help us identify student-athletes that could be injured that we might not have seen. …

“If anybody can see how it happened, that gives us a clue about what might be wrong with them. Just to have another set of eyes that can say, hey I saw this person get rolled up on their right knee, so on and so forth, that’s a big help.”

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ORIGINAL ARTICLE:

http://www.dailypress.com/sports/virginia-tech/dp-spt-teel-column-acc-medical-observer-20150726-column.html

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Athletic trainers urge caution as teenage athletes begin hot summer practices

Last year, six out of 11 high school football player deaths were blamed on heart conditions, heat stroke or drinking too much water too fast. This year, athletic trainers are asking schools to implement emergency preparedness procedures to avoid health-related issues triggered by heat.

“It shouldn’t be that a kid has to die for the school to be prepared,” Jonathan Drezner, a University of Washington sports medicine physician and co-author of an editorial in the Journal of Athletic Training, told Reuters.

Among the recommendations by the National Athletic Trainers’ Association: schools should have automated external defibrillators on hand. But only 19 states have laws mandating them. In fact, just 14 states have adopted all of the organization’s best practices.

Another recommendation: Make sure athletes acclimate to the heat and intensity. Yet another: schools should have a full-time athletic trainer; currently, 37 percent of schools do, according to the editorial in the Journal of Athletic Training. Many schools also schedule practices for evening or early morning hours to avoid the heat.

In Kansas City, Mo., for example, the football team recently started practice indoors in an air-conditioned gym, according to KMBC, heading outdoors after the sun set.

Symptoms of mild dehydration include swollen hands or feet, cramps or lightheadedness, according to Philly.com. Symptoms of more serious dehydration include confusion, lack of coordination, skin that is hot and dry, nausea, goose bumps and headaches. Athletes with those symptoms should be cooled immediately, preferably via whole body ice water immersion. And call 911, Dr. Thomas Trojian advises via Philly.com.

Some health experts think athletes should have electrocardiograms (EKGs) during their athlete physicals, the Miami Herald points out, to catch potential heart problems.  Some hospitals have even started offering them to kids for free. But others, including the American Heart Association, say both the costs and possibility of inaccurate screenings mean the tests should not be mandatory.

ORIGINAL ARTICLE:

http://bringmethenews.com/2015/07/25/athletic-trainers-urge-caution-as-teenage-athletes-begin-hot-summer-practices/

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athletic trainers, first-responders on same page for sports spinal injuries

The light came on to Jason Carruth during a murky emergency situation at a Conway Christian football game.

A player lay on the ground with a possible spinal injury.

Initially, the situation seemed to require the removal of a helmet and pads.

Carruth, an athletic trainer for Conway Regional Therapy Center who also serves as athletic trainer for CCS, rushed onto the field along with first-responders from the Conway Fire Department. Carruth began working on the facemask but encountered complications with rust on some of the parts of the helmet on the rainy night.

Fortunately for the player, removal of the helmet and a trip to the emergency room was not needed.

“The first-responders asked me about what would have happened if the helmet needed to go off right away. They told me they needed to learn that,” Carruth said.

He decided on a proactive strike, especially with new guidelines for treatment of possible spinal injuries soon coming down from the National Athletic Trainers Association (NATA).

Early this month, Carruth assembled EMTs. first-responders, local athletic trainers and firefighters for a discussion/brainstorming session about the new procedures.

“We’re all doing most of the same things but some things were a little different in how we worked these situations,” Carruth said. “We needed to get as many people as possible involved in pre-hospital care of athletes in Faulkner County in one room to discuss our protocols and how we can best work together. One of the questions to ask about our different procedures was ‘why are they different?’ We needed to have that discussion in one room rather than on the football field in a critical situation.

“We felt we needed everyone to get on the same page so everyone can do what they do and know best to give the best quality treatment to an injured athlete. Ninety-five percent of what we do is in line with one another. Any differences are because MEMS and the Conway Fire Department deal with all sorts of injuries, while the NATA guidelines were developed specifically for athletic injuries.”

During football season, Conway Regional Therapy Center athletic trainers provide coverage for the majority of the area high schools in Faulkner and Perry counties.

Athletic trainers from the University of Central Arkansas and Hendrix College also attended the brainstorming session.

That meeting and exchange of the whys and wherefores of procedures has led to a series of training sessions among athletic trainers, first-responders and medical personnel on the safest ways for removing football equipment during an emergency.

“I feel the most significant thing to come out of the meeting was the collaboration of all of the first responders in the community,” said Laura Boyd, head athletic trainer at Hendrix College. “In my 10 years at Hendrix, we’ve never all gotten together for a discussion like this, and I think that is very important and beneficial for everyone involved.”

Major Melanie Reynolds with MEMS said, “It’s important, when you have multiple agencies playing different roles, that all of the tiniest details are ironed out prior to any emergent event so that the athlete can have the best possible outcome.”

The NATA is changing its guidelines to recommend removal of the helmet and equipment, if possible, before the athlete is taken to the hospital.

“That will save valuable time for treatment in the emergency room,” Carruth said. “The medical personnel can go right to work rather than trying to figure out how to get the equipment off. It is also better to get the equipment safely off in a wide-open space of a football field rather than on a guerney in the contained space of an emergecy room.

“Athletic trainers work with equipment and understand how to remove it. We also know the athletes. Sometimes, they have special equipment along with the helmets and pads. On any time in an emergency room, there may be people with various experience on equipment removal. We don’t want them have to get in a corner and ask, ‘what’s this?’”

The complication with helmet removal in a spinal injury case involves the shoulder pads and additional equipment.

“First-responders are familiar with removing a helmet in motorcycle accidents,” Carruth added. “The problem with a football player is when the helmet goes off, the head immediately goes down because of the shoulder pads. Due to possible spinal injuries, you need to restrict movement of the head.

“It takes four people to safely and properly remove a helmet and pads. So, the athletic trainers have to have help from the first-responders. They all have to understand the procedures and work together. The helmet and shoulder pads must be removed in sync and everyone must understand what they are doing.

“Usually, there is about seven minutes between the injury and when the ambulance arrives is ready for transportation to the hospital. We are waiting, anyway, so we can do something. Getting the equipment off can save valuable time in the emergency room so doctors and medical personnel can go right to work addressing the injury. Time is important. Plus, if for some reason, we can’t or shouldn’t remove the helmet on the field, the athletic trainer can ride in the ambulance and be ready to help the medical team at the hospital with removal.”

Amanda Irby, director of the Emergency Department at Conway Regional Medical Center, added, “Pre-hospital removal of the sports equipment will allow our staff to focus on the athletes injuries upon arrival instead of worrying with equipment removal. This change should expedite overall care of the traumatically injured athlete.”

The training relates to a procedure no one wants to use.

“Since 2001, I have faced such an emergency three tines,” Carruth said. “Even if you never have to use the procedure, you have to be prepared. To be honest, when I first started talking about this to various people involved, I expected some pushback, but everyone involved has been very supportive. It’s been extremely valuable in the discussion that people are looking at various possible situations and asking, ‘what if?’ We plan to meet every year to discuss procedures. We all have each other’s cell numbers and we know who to call when situations arise.”

Emergency Action Plans developed by the athletic trainers will be placed on the ambulances that serve their area so that responding crews will have access to information such as maps of the campuses and names of athletic trainers, physicians and administrators on site.

“The important thing is everyone understanding our role as a team to work together for the benefit of the athlete. It’s five or six folks working as one team,” Carruth said.

ORIGINAL ARTICLE:

http://thecabin.net/news/2015-07-24/new-procedures-putting-athletic-trainers-first-responders-same-page-sports-spinal#.VbMLW2RViko

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Waxahachie’s AT David “Doc” Bowdoin featured in article about heat illness

Temperatures nearing triple digits, seldom cloud coverage, and long days. There isn’t a better time to be outside.

Most kids in high school are probably spending their summers inside where air conditioning is on full blast.

But for athletes on the Waxahachie football team, a typical day consists of morning workouts at the gym followed by conditioning that takes them outside where two-a-days start in a few weeks.

As it stands, football players have a grace period between spring training and the first day of official practices, which is the second Monday in August, per UIL mandate.

Coaches are not allowed to hold practices during the summer, leaving off-season training up to the athletes between May and August.

And although athletes might not like working out in the summer because of the heat, maybe instead they should embrace it, said David “Doc” Bowdoin, Waxahachie’s head athletic trainer.

“When you’re talking about heat, you’re not going to get away from it in Texas unless you get an El Niño season when it’s cooler,” Bowdoin said. “And you’re going to play in it. When we go to Midlothian, we’re going to be sitting in a hole. And on that turf, it’ll probably be 115 degrees at game time. Maybe more.”

Waxahachie opens its season at Midlothian on Aug. 28 and unlike Lumpkins Stadium, the field at Midlothian’s Multi-Purpose Stadium was built beneath the ground, making it hotter during the summertime.

But if the players at Waxahachie become as used to the heat as they should, said Bowdoin, then there won’t be any health issues come game day.

“I truly believe that you have to get those kids exposed out there. Because that’s what they’re going to be playing in,” Bowdoin said. “You have to get them out there in it, but you have to be careful. Have to be real careful.”

Heat illnesses aren’t uncommon for football players, especially those in Texas where temperatures typically reach the high 90s and stay there for the duration of the summer.

That’s why Bowdoin and Indians head coach Jon Kitna take no exception to stressing the importance of heat awareness to athletes and parents.

At a recent parent player meeting, Kitna highlighted three of the four heat related disorders: cramps, syncope, and exhaustion. Heat stroke is the final stage of a disorder and can result in death as the body stops secreting sweat to cool itself down, Bowdoin said.

Waxahachie’s goal is to avoid the final stage at all costs, which is why Kitna and Bowdoin emphasize the other three disorders with the intent to get high school athletes to understand just how vital it is to drink fluids and eat, especially in the summer.

“The heat isn’t going anywhere. It’s not disappearing at all,” Bowdoin said. “The cramps and stuff that you see during games, we can deal with that. What you don’t want is to get them so bad where they’re nauseous, vomiting, in-and-out of consciences, stuff like that because then that tells you they’re so depleted, they’ve lost so much fluid and stuff that their body doesn’t want to do it anymore and that’s when you have to make a decision.”

As severe as some of the symptoms are for heat illnesses, Bowdoin said it’s still difficult to teach athletes the importance of taking precautions and bracing yourself for working out in the heat.

Bowdoin has worked in sports medicine the last 24 years and has been the athletic trainer at Waxahachie for 21 of those years.

He’s seen it all when it comes to high school athletes working out in the summer.

Since beginning his career at Texas Christian University, he’s also seen the changing influence PlayStation’s and Xbox’s have had on students.

“They want to stay inside and play their video games and that’s cool, but when I was growing up we were outside all the time. We were used to it,” Bowdoin said. “The dynamics have changed in society.”

PlayStation, however, isn’t the only thing that’s changed since Bowdoin was a trainer for the Horned Frogs.

He’s also seen technology improve and how different medical practices are more beneficial today.

“In the old days, you fill up an ice tub full of cold water, no matter how cold it is, and you dunk them in it. That’s not good,” Bowdoin said. “We’ve learned now that if we do that with a kid that’s having some problems with heat illness, the later stages maybe or in between stages, you send the body into shock and you drive the heat that’s inside their body further down and it damages their organs. Our answer to that is cool water, not just cold cold cold water.”

In addition to changing treatment methods, Bowdoin also said teams have adjusted their workouts so athletes can respond better to the heat.

“Instead of just running wind sprints back in the old school days where you run 100 yards and turn around and run another 100 yards, the coaches do some things like dynamic stretching and dynamic ballistic stretching,” he said. “They do different types of conditioning. We’ve got a lot smarter with that.”

Given Waxahachie’s new direction on offense and defense, the Indians will rely heavily on their speed, which comes from conditioning, Bowdoin said.

Kitna and the coaching staff have been implementing a spread offense, similar to what Baylor University runs and plan to go without huddling this season.

The increase in pace could be a toll on the player’s, but the goal for the team is to suffocate each of their opponents based on their speed, Bowdoin said.

“You have to be in shape. It’s a necessity based on upon what we want to do,” he said.

ORIGINAL ARTICLE:

http://www.waxahachietx.com/waxahachietx/bowdoin-get-used-to-heat/article_da6246e3-3381-5b06-ad69-d314efcdfadb.html

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Concussion protocols heading in right direction in Indiana

It was the fall of 2013, and the Northeastern High School football team was in the middle of a run toward the program’s first Tri-Eastern Conference championship.

With an 8-0 lead against Centerville, Northeastern’s star quarterback Joey Claypoole was shaken up during a play and removed for the remainder of the game.

Claypoole stood on the sidelines, and to outsiders, looked perfectly fine.

The symptoms of a potential concussion were not visible to most spectators, and head coach Mike Roeder, Claypoole and the Knights took criticism, for it was the biggest game remaining in the conference season.

Eventually, Centerville rallied for a 34-22 victory over Northeastern, forcing what was at the time a three-way tie atop the conference.

Roeder maintains he made the right call.

“If a trainer or an official or a coach thinks there might be something there, you have to honor that,” Roeder said.

“Sometimes there is nothing there and it kind of frustrates you, but the other end of it is, if you do put someone back in, they could be harmed for the rest of their lives. Nobody wants to take that chance.”

Roeder’s coaching staff faced a dilemma seen too often from coaches and high school athletes.

Revelations from former professional athletes have shown concussions have potential for long-term damages.

The Indiana High School Athletics Association recently has implemented new standards and requirements to ensure players are cleared before returning to competition after a possible concussion.

The IHSAA also requires coaches at every level to take online courses on what to do in case of a concussion, while starting a new data collection study this past sports season.

“I think it’s very important. I think the responsibility of us collectively as an association, a staff, as a member school, administrators and coaches — I think we have a collective duty to ensure the health and safety of our athletes,” IHSAA commissioner Bobby Cox said.

“Everyone is responsible, we can do all we want with it, but if we don’t have cooperative parents, we’re not going to be successful. We can have cooperative parents, but if we have schools that don’t enforce these standards; if the association is not providing vehicles — it’s a collective effort.”

According to data provided by Cox and the IHSAA, there were a total of 2,194 instances of concussions reported to the IHSAA this past season among all sports.

Hamilton Southeastern topped the state with 65, followed by Bishop Chatard at 48.

Like the incident involving Claypoole, the symptoms of a concussion might not be visible right away, but it differs from other injuries because of the sensitivity of the brain.

“For us, obviously what makes it so bad, you’re messing with a person with a young person’s head and cognitive function potential cognitive ability. That’s one of those things there should be no gray area in regards to siding on the side of safety when it comes to concussions,” Richmond coach Matt Holeva said.

“Not to minimize other forms of injuries, but bumps and bruises are going to heal with today’s technology. Just 10, 15 years ago a torn ACL would ruin a young person’s career even at the high school level. Now with medicine — obviously no one wants to see those injures — but those injuries are repairable to some degree. Obviously, when you’re dealing with the human mind and the brain, there’s so much to learn.”

Hagerstown athletic director Gerry Keesling formerly coached football at Earlham College in Richmond. He cautions that helmets only can do so much.

“I think our football players are in the best helmets in the history of the game,” he said. “I think there’s no such thing as a concussion-preventing helmet, there’s nothing out there, because the helmet doesn’t protect the brain, it protects the skull, depending on the space between the brain and the skull. You don’t read anything about fractured skulls. We can’t protect the brain inside the skulls.”

To help prevent concussions, Keesling, Cox, Roeder and Holeva emphasize proper tackling techniques and teaching them at a younger level.

“The best thing is the way you teach tackling,” Roeder said. “We’ve taken the head completely out of it. We do not teach it that way at all. Pete Carroll (head coach) with the Seattle Seahawks has developed a style called ‘The hawkroll,’ where you teach these guys to come in and keep their heads out of it.

“It seems to work. Our kids took to it. They took some pride to learn how to do it right. As far as ball carriers, if a ball carrier lowers their head before impact, they can be penalized.”

Football gets the most attention, but it’s not the only sport where athletes suffer concussions.

A study from the University of Colorado was released earlier this week on concussions in soccer that demonstrated most concussions don’t come from heading the ball but from collisions among athletes.

“There has to be some correlation with long-term brain damage and doing that over the course of a lifetime if you continue to do it,” Richmond soccer coach Matt Haynes said. “People are more worried about dangerous high kicks, (but) head-on-head collisions are the worst.”

Haynes also alluded to a recent World Cup game where Germany forward Alexandra Popp banged heads with United States midfielder Morgan Brian.

Both returned quickly after being checked by doctors, despite the fact that Popp had blood soaking her head.

According to Germany’s coach, Popp had a laceration but no concussion.

“At that level, what does a coach say?” Haynes said. “At that level, a professional says, ‘I’m going back in.’ Kids at this (high school) level, you have a bit of authority, saying, ‘No you’re not.'”

For Courtney McCord, a two-year athletic trainer at Richmond High School, it’s taken time to adjust.

She says male athletes tend to fight back against leaving a competition more than female athletes do.

“It’s such a hot topic, I usually err on the side of caution,” she said. “They only do have one brain. High school sports are a part of their lives, but in the long term, I usually err on the side of caution. I don’t think that makes them too happy because they want to keep playing.”

When players hit their heads, or appear to be banged up, McCord checks for dilated pupils, dizziness, strange behaviors and thirst.

She also conducts memory exercises, such as asking them to recite the months backwards starting with December and giving athletes five words to check their memory recall.

There is no perfect cure for concussions, but from the IHSAA down to schools, coaches, officials and student-athletes, strides are being made to minimize the damage.

“I think that they’ve made a lot of good steps in the right direction,” McCord said. “Just seeing how old football players, old athletes are now having that problems from undiagnosed concussions, they’ve definitely made steps in educating everyone.

“… I think parents are more understanding of it, older generations of parents they’d be like, ‘Oh I did this many, many times.’ I think parents are more aware and understanding of when you want to hold their kids out.”

ORIGINAL ARTICLE:

http://www.indystar.com/story/sports/high-school/2015/07/21/indiana-high-school-football-concussion-protocol-prevention-ihsaa/30455109/