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Preventing pain with athletic trainers

Article reposted from marinij.com
Author: Mark C. Volain

It was only a few days into my high school career when I realized that the padded walls in the gymnasium were not only that; one section opened into a fluorescent-lighted room with a desk and a padded table, with muffled sounds of conversation, laughter and the unmistakable sound of tape being torn starting up shortly after the final school bell rang.

I’d found the athletic trainer’s office. While I didn’t need any help before soccer practice that day, I would eventually find myself a regular visitor, establishing a relationship not just with athletic tape and bags of ice, but also with the athletic trainer who helped manage the discomfort associated with my patellar tendinitis.

I was reminded of that relationship this month, as March is National Athletic Trainer Month. This year, the campaign’s theme is, “Your protection is our priority.”

“We do what we can to promote who we are and what we do,” said Aaron Gill, Marin Academy’s athletic trainer. “Athletic trainers are health care providers that have skills to evaluate injuries and illness associated with athletics. We manage, refer, treat and help those athletes return to their sport.”

While a big part of athletic training, at any level, is dealing with injuries that have already occurred, athletic trainers also work to strengthen the problematic muscle groups so another injury doesn’t occur.

“At the high school level, injuries occur because the development of strength and ability to withstand the forces (of the sport) is a large discrepancy,” San Rafael’s athletic trainer, Shana McKeever said. “We work on strengthening the muscles as well as synchronicity of the muscles working on the joints. We try to teach them practices that will keep them involved with their sport as much as is safe for them.”

As a sports fan, I constantly hear about professional athletes who are playing through injuries, not reporting injuries and the like. While the macho ideals of sports often influence athletes to play through pain, doing so can be detrimental. As a result, athletic trainers ­— especially those on campus full-time like Gill — have placed emphasis on developing good lines of communication with the athletes. If a good relationship has been forged, athletes are more likely to disclose that they’re dealing with pain.

“Something I didn’t realize I’d enjoy so much before coming (to the high school level) is trying to create an environment, trying to create a fine line between being serious (about injuries) and being a place they can feel comfortable and crack jokes,” Gill said. “There may be three kids who come in, with two of them (just accompanying) the injured one. Now we have that built-in relationship, at least that one interaction, so they can feel comfortable.”

In Marin County, there are now athletic trainers at almost every school, something which was far from the case as recently as four years ago.

“Knowing that in Marin there’s (an athletic trainer on duty) at those schools (when teams play games on the road) is always comforting,” Gill said.

The growth of athletic trainers at high schools in the area prompted McKeever to start organizing monthly meetings with her peers. Communication with the athletes is important, but she said trading strategies can be quite beneficial, too.

“Without mentioning (student athletes) by name, we’ll swap stories with situations we’ve had. We’ll bounce ideas off of each other for how to deal with that situation. We talk about current trends and topics within our profession, help each other develop a more well-rounded understanding,” McKeever said. “We all come from different backgrounds, both in where we got our athletic training certification, and the opportunities that we’ve had along the way.”

While most schools in the area employ at least one athletic trainer now, Gill said having multiples would create more opportunities to keep the athletes on their chosen playing field.

“One of the things I wish I had more time and hands to do, is that there’s a lot of research out there,” Gill said. “When we do specific exercises to strengthen, we can decrease injuries.”

After suffering an injury that saw my knee cap grinding into my knee, I needed the help of an athletic trainer to help develop the muscles around it. After some physical therapy, I worked with an athletic trainer for an entire track season to keep up my strengthening exercises. Exercises and stretches are often a small addition to an athlete’s routine that can have a large impact on their health.

“A few years ago, I looked at injury trends in cross country. The principles of an ACL injury prevention program are warm-ups that activate the muscles,” Gill said. “I came up with a set of exercises that can be done in 10 minutes. It addresses feet, ankles, calves and hips that they can do before they start warming up to actually run.

“It has helped. The coaches (agree) that it hasn’t gotten rid of every (issue), but has decreased the duration — how long the pain was bothering them — as well as the intensity.”

High school is a transformative time, both mentally and physically, and staying healthy is a key to athletic success. With the help of a strong line of communication with an athletic trainer, staying healthy is a little easier.

“The variety of kids and personalities, the ability to develop relationships with coaches and students and see them grow from young adults into true adults, there’s a lot of change there,” Gill said. “Having equipment and resources from the school and a plan in place keeps everyone calmer.”

Mark C. Volain is the sports editor at the Marin Independent Journal. You can contact him with story ideas, corrections, issues or compliments at mvolain@marinij.com or by calling 415-382-7298. You can follow him on Twitter @MarkCVolain and “like” him on Facebook.

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California Athletic Trainers Push for Regulation

Article reposted from marinij.com
Author: Danny Schmidt

On her first day as San Rafael High’s athletic trainer, Shana McKeever approached the intern who had filled the on-campus role prior to her arrival in 2013.

She asked the young man, an undergraduate occupational therapy student, to tape her ankle to glean the depth of treatment the school’s athletes were receiving.

“It was atrocious,” said McKeever, a San Rafael graduate who went to Whitworth University for her undergraduate degree and East Tennessee State for her master’s. “He hadn’t learned anything in that field yet.”

In California, schools have the right to hire whoever they please, if anyone at all, to serve as athletic trainer.

Every school, public and private, in Marin County has an athletic trainer, and each one is credited by the Board of Certification, a requirement in every state sans California. They are referred to as ATCs (athletic trainers credential).

“California is usually pretty modern with these kinds of things, and we want our athletes safe,” said Marin Catholic athletic trainer Jamie Waterman, the county’s first full-time ATC in 2001. “It’s disappointing, but it’s great here in Marin that we have certified trainers.

“The schools in the county are definitely under good care.”

The ATCs at the local schools are Americ Alvarado (Redwood), Amanda Boivin (Branson), Steve DeHart (Novato), Aaron Gill (Marin Academy), Brendan Grayber (San Marin), Kit Holsten (Terra Linda), Sarah Merkel (Justin-Siena) and Fernando Saldana and Jessica Clark (Drake). Aubrey Yanda recently took a job at Capuchino High in San Bruno, so Redwood is searching for a replacement, as is Tomales. If they don’t all regularly connect in person, they’re constantly texting, picking each other’s brains.

AB 1890

Assembly Bill 1890 was introduced on Feb. 19, 2014, with the intention of enacting the Athletic Training Practice Act.

“This bill would make it unlawful for any person to hold himself or herself out as an athletic trainer or a certified athletic trainer,” the proposal stated, “or to use specified terms to imply or suggest that the person is an athletic trainer, unless he or she is certified by the Board of Certification, Inc., and has either graduated from a college or university, after completing an accredited athletic training education program, as specified, or completed eligibility requirements for certification by the Board of Certification.”

The bill would have eliminated the possibility of discredited ATCs from around the country to move to California to practice.

Gov. Jerry Brown’s swiftly vetoed the bill after it reached his desk by unanimous vote. In hisresponse, Brown said, “These conditions impose unnecessary burdens on athletic trainers without sufficient evidence that they are really needed.”

“We got parents and athletic directors, administrators, people in the medical field all supporting it,” McKeever said. “It was very frustrating. It was disheartening because there was so much support leading up to it.”

EDUCATING THE PUBLIC

McKeever employs multiple analogies to relay the importance of athletic trainers. A strength and conditioning coach watches countless games, but that doesn’t make he or she qualified to coach, McKeever said, and vice versa.

“People think taping is easy and that it’s all we do,” she said. “We are Allied Healthcare, not Joe Schmo. Do you want someone who’s not trained as a registered nurse to act as a registered nurse?

“It’s just about educating little by little and spreading the word.”

Waterman, who studied at Sonoma State, believes most people confuse athletic trainers and personal trainers.

Athletic trainers’ duties range from taping ankles to dealing with turf toe to treating orthopedic injuries — fractures, ligament strains — to working with EMS, all the way up to life-threatening blows, McKeever said.

“When the fire department gets to our high school, we already have half of what they need done,” Waterman said.

While football — the sport with, by far, the largest roster — typically keeps athletic trainers busiest, Gill doesn’t have to worry about that because Marin Academy doesn’t field a team.

‘NOT GIVING UP’

Gill and Waterman are both employed by their private schools, a traditional model. The rest rely on a medical model, meaning they are hired by institutions such as Marin General Hospital and UCSF Medical Center and contracted to high schools, where they work 40-plus hours a week.

“Someone might understand evaluating certain injuries but not concussions, and they don’t have the taping skills or bracing skills or understand the needs of the athletes,” said Gill, a Marin Academy alum who studied at Arizona. “There are schools out there where people don’t have all the skills, and that puts the athletes at risk.”

The local ATCs don’t have a definitive next step in the fight to ensure every athletic trainer in California is certified, but McKeever said they will attack it from another angle.

“We’re not giving up,” she said. “We care for these student-athletes too much.”

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San Rafael High first in the Bay Area to wear devices that monitor head impact

With so many unreported concussions in high-school sports, San Rafael High wanted to intervene.

After testing the technology last academic year, several San Rafael teams will wear Triax Technologies Smart Impact Monitors, beginning in the fall, to monitor and assess head impact during practices and games.

At the foreground of the movement is the Bulldogs’ football team, which will be outfitted with the devices on Monday, the first official practice day, and the duration of the season. A couple of football and boys soccer players wore the sensors — slightly larger than a quarter, nestled in headbands worn underneath players’ helmets, last fall. San Rafael is the first school in the Bay Area to adopt the technology.

“Anything we can do to increase safety, I’m all for it,” said Ted Cosgriff, San Rafael’s first-year football coach. “The two guys on my team who wore it said they never noticed it once the game started.”

When any significant force is applied to a player’s head, Shana McKeever, San Rafael’s head athletic trainer, instantly receives a text message saying which player it was and the linear and rotational forces of the blow. The devices don’t prevent injuries, they provide information.

“It tells us the level of contact an athlete is sustaining and whether we have to make adjustments at practice,” said Tim Galli, San Rafael’s athletic director.

This allows McKeever to pull a player who was struck aside and ask if they’re dizzy, have a headache, remember the hit, etc. Immediately treating the blow can lower the potential health risk.

“We want to make sure it’s safe for the athlete to return,” McKeever said.

The sensors will be worn by the school’s soccer, water polo and volleyball teams, based on how many San Rafael can purchase.

“Any sport where there’s any kind of significant potential, we want to employ the device,” Galli said. “There’s no sense putting them on tennis players.”

All of the information from the game is logged, so if an athlete tells McKeever he or she has concussion-like symptoms the Monday after a weekend game, she can go back and look.

San Rafael’s JV and varsity lacrosse and girls soccer teams wore the headbands in the spring.

“Some athletes didn’t care for the headband just because they don’t like having something on their head,” McKeever said. “But the general consensus was that after a little bit, you don’t even notice it’s there. It becomes a part of that routine.”

Galli said he’d like to see the devices worn by San Rafael wrestlers and even cheerleaders.

The same Triax Technology devices are used in Major League Lacrosse and by Abby Wambach, the decorated women’s World-Cup champion.

CONCUSSIONS IN PREPS

According to Head Case, a parent-safety resource, 67 percent of concussions in prep sports occur in games. Football sees the most concussions per year, though many studies show soccer is the equivalent on the girls side, with nearly as many. Ice hockey, lacrosse and wrestling follow soccer on the list. Statistics show more prep girls suffer concussions than boys.

Once a high-school player is diagnosed with a concussion, in any sport, he or she must sit out for at least a week.

Galli said contributions to help the school purchase the devices exceeded $5,000 last year. This year’s goal is to triple that figure. Donations can be made on the school’s website.

“All ADs are always looking for ways to keep their athletes safe,” Galli said. “When these kids leave their homes, we have to regard them as our children and do whatever’s in their best interest. That means purchasing state-of-the-art protective gear.”

While testing the technology last year, no athletes sustained any serious injuries, Galli said.

“Anytime you have useful data and you can look at it and make informed decisions, you’re better off at being successful and keeping your athletes as risk-free as possible,” Galli said. “Anytime you can reduce risk, I think you want to take a good, hard look at what can do that.”

ORIGINAL ARTICLE:
http://www.marinij.com/sports/20150816/prep-sports-san-rafael-high-athletes-the-first-in-the-bay-area-to-wear-devices-that-monitor-head-impact