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SDSU’s Steve Fisher: How California can keep athletes safe

Article reposted from San Diego Union Tribune
Author: Steve Fisher

It’s every parent’s nightmare: You’re watching your son play basketball and all of a sudden he collapses. You don’t know what’s happening, how to help or even if he is going to be all right.

In my tenures as head basketball coach at San Diego State University and University of Michigan, all of the players under my charge were my sons. I still remember vividly watching Dwayne Polee II running down the court and suddenly collapsing in a 2014 SDSU game against UC Riverside. Polee may have been in a world of hurt if it weren’t for our certified athletic trainer at the time, Tom Abdenour, who was formerly the head athletic trainer for the Golden State Warriors.

I credit Abdenour with helping save Polee’s life by implementing crucial emergency procedures to restart his heart.

But, every day, Californians are putting their athletes at risk because there are not enough athletic trainers and the ones we have are unregulated.

In fact, according to a recent study by the University of Connecticut’s Korey Stringer Institute, we are ranked second to last in the nation for implementing policies that are intended to keep the state’s more than 785,000 high school athletes safe every year and help prevent sudden death and catastrophic injury.

One critical reason for this appalling rating is that California is the only state that does not regulate athletic trainers — professionals charged with the prevention, treatment and rehabilitation of injuries and illnesses sustained by athletes and other individuals of all ages. Athletic trainers are the medical experts on the sidelines and a player’s first line of defense when an injury occurs.

I was lucky that the schools I worked at had certified athletic trainers to protect our talented athletes, but many athletes are not so fortunate.

Every state except ours requires that anyone who is hired as an athletic trainer has the required education and certification to provide lifesaving care. In California, anyone can be hired to act as an athletic trainer and provide treatment to athletes.

“Unqualified individuals are falsely representing themselves as athletic trainers to California athletes and their family members,” said Dr. Cindy Chang, a UC San Francisco clinical professor and past president of the American Medical Society for Sports Medicine. “We’re aware of serious mistakes that have resulted from this lack of licensure.”

Last school year, the California Interscholastic Federation (CIF), surveyed 1,406 high schools across the state and found that more than 45 percent of high schools did not have an athletic trainer. Of those that did, more than 15 percent had an athletic trainer who was not certified.

That means more than 60 percent of our kids who play high school sports are at risk of not having a qualified athletic trainer to protect them in cases of cardiac arrest, concussions and heat illness, among other issues.

Even if your school has a certified athletic trainer on its staff, when athletes play at other schools, there’s no guarantee these institutions do.

To keep our athletes safe, Assemblyman Matt Dababneh, D-Woodland Hills, has introduced Assembly Bill 1510, which would require individuals to be certified by the Board of Certification before they can call themselves “athletic trainers” — notably, at no cost to taxpayers.

This bill has tremendous support, including from the American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, CIF, NCAA, National Federation of State High School Associations and nearly 40 other organizations.

I credit San Diego State’s athletic trainers as members of the core team that make the Aztecs’ success possible. Multiple severe ankle problems, dislocated fingers and other injuries are common in basketball. It’s imperative that teams have a certified athletic trainer on-site to address them.

I’ve seen athletic trainers rehabilitate incoming athletes who were injured and may have had their careers halted before they even began, such as Tim Shelton and Chase Tapley, who both played on SDSU’s 2010-11 basketball team, with a school record 34-3 season and SDSU’s first Sweet 16.

Concerned athletes, parents and community members can keep our players safe by learning more at the California Athletic Trainers’ Association’s website at ca-at.org and supporting AB 1510. Parents should also ask their children’s schools if they have a certified athletic trainer on staff, and verify athletic training credentials at www.bocatc.org/public-protection.

As Dababneh said, “No parent should wonder if their child will be safe on the field or court.”

Fisher was the head basketball coach for San Diego State University from 1999-2017 and is also known for coaching as the University of Michigan, where his team won the 1989 NCAA championship and where he later coached the Fab Five. He currently holds a part-time role with SDSU’s athletic department.

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New Testing has SDSU on Top of its Game

In a space that once served as the Peterson Gym concession stand, Zylan Cheatham, clad only in shorts and sneakers, looks infinitely more like The Six Million Dollar Man than San Diego State power forward.

Affixed to Cheatham’s body are 75 reflective markers positioned to work in tandem with 16 infrared cameras. Part of a 3D motion capture system common to all video games, the cameras will catalog Cheatham’s every move as he performs four sports-specific tasks measuring not only forces acting upon the body, but also serving to identify precursors to potential injury.

Over the course of the next 60 minutes, the cameras will generate more than 19,000 images of Cheatham’s movements as he squats, hops, jumps and undergoes balance testing atop a series of five force plates, each costing approximately $15,000.

This is the science of sports biomechanics, or the physics of sports. A collaboration between academics and athletics, the idea to turn a former hot dog stand into a rehabilitation biomechanics lab was hatched last spring when Sara Gombatto, an assistant professor in the university’s Doctor of Physical Therapy program, met with Tom Abdenour, SDSU’s head athletic trainer.

Clearly, Abdenour, who just completed his fifth season at SDSU, is in rare company. Having spent nearly 40 years mastering his craft, including 24 seasons in the NBA and as a member of the U.S. Olympic Team’s medical staff in 2000, Abdenour’s praises are sung loudly and often by Aztecs Coach Steve Fisher. A man who relies as much on evidence-based science as he does Epsom salts, he was once referred to as a “magician” by former SDSU player Garrett Green.

Yet when Gombatto, who has a Ph.D. in movement science, approached Abdenour last year about joining forces to enhance athletic performance and identify dysfunctions that could lead to injury, the result was the creation of a program involving research practices being utilized nowhere else in San Diego or the Mountain West.

“Tom and I started working together, because there is a lot of evidence in the (sports medicine) literature to support what kind of things can contribute to injury,” Gambotto said. “What are the risk factors? But the problem is, it isn’t often translated into practice.

“So I approached Tom and said, ‘What do you say we start a program where we can start screening our athletes to compare their measures to those in the literature and see who’s at risk, identify those people and then decide on maybe changing their strength and conditioning program or change things during their rehab? Then, when we do have an athlete who’s injured, who’s gone through rehab, let’s test them and see what their measures are again and see if they’re ready to return.'”

Exhibit A? Junior wing Matt Shrigley, who was one of the first two student-athletes to be tested by Gombatto and Abdenour last fall. Whereas even elite athletes can require eight months to return from reconstructive knee surgery, Shrigley, who underwent such a procedure after suffering a torn anterior cruciate ligament in his right knee in July, was back in five, making his first appearance against Utah State on Jan. 23. And while he did not score, much to the chagrin of those wanting the fairy tale to end in the usual fashion, Shrigley’s zero in the box score was nothing but a bonus in the eyes of Fisher.

“I love Matt Shrigley,” Fisher said. “From the moment he had the surgery, he was committed to whatever he had to do to get himself ready to play. We all feel sorry for ourselves, and I’m sure he did for a period of time after he found out he had the ACL injury. But he worked so hard.”

Work done under the watchful eyes of Gombatto and Abdenour, who will retest Shrigley this fall. Others who will be closely monitored, Abdenour said, are transfers Max Hoetzel and Montaque “Teki” Gill-Caesar, both of whom have undergone knee surgeries in the past. Cheatham redshirted his freshman season after suffering a broken bone in his foot.

“We’re in a gold mine here with our student-athletes and their aches and pains,” Abdenour said. “We’re just tapping into it so we can try and prevent (injuries).”

And not just injuries to men’s basketball players. While sports biomechanics research and applications run the gamut from track and field to the trampoline, it’s Gombatto’s hope that the program will ultimately include the majority of SDSU student-athletes. Gombatto and Abdenour hope to have concluded initial testing of the entire men’s basketball roster by the end of the week, at which point measurements of strengths and weaknesses can be relayed to strength and conditioning coach Randy Shelton.

“Our long-term vision is to expand this to our other teams,” said Gombatto, the lab’s co-director. “I think a lot of it depends on the individual trainer, as well as the strength and conditioning coaches and the players. I think it’s really important that we’re all going over this together, with each individual giving their own perspective.

“There aren’t a lot of people who are trying to do this. Most of the time people stay on the research side or stay on the clinical side, because it’s hard. You have to have willing and able collaborators to pull something like this off. Tom’s expertise is invaluable. As soon as I approached him about doing this, he knew exactly what I was talking about and what I wanted to do. He doesn’t know about biomechanics analysis, but he knows how to relate the information to the kids and to the surgeons and he knows where a particular player fits into the team. He knows their (physical) history, as well.

“Tom and I really wanted to do something that was general enough to cover a variety of lower-extremity injuries like an ACL tear, patellar tendinitis, chronic ankle instability, hip injuries and the spine. Tom has been on the cutting edge. He’s doing the standardized testing that’s in the (sports medicine) literature. He’s doing everything he can with the tools that are available to him. Now that we’ve added those tools to the biomechanics expertise that I have, we can enhance what Tom has already been doing.”

Even if it never culminates in a certain San Diego State power being transformed into The Six Million Dollar Man.

“I have a little different way of watching the team play during the season, because I’m watching their movements and body mechanics,” Gombatto said. “I’m watching as a biomechanist, but I’m also watching as a fan. It’s hard to separate the two.”

No harder, apparently, than turning a hot dog stand into a vision of the future.

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