New Safety Devices for Football Players

Gotta love innovation. The Kerr Collar is being marketed as a way to absorb some of the impact forces during collisions in football.  Here's how it works:

What I really like about this is not just the way it's explained, but the process by which it's promoted/defended/marketed (I do not mean to use those terms negatively at all; it's simply necessary when pitching any product to consumers). Dr. Kerr sums up the anatomical implications quite nicely here.  He clearly has paid close attention to allowing neck extension to still occur (something it's predecessors limited).  This is very important, as you don't want to create an axial load to occur.  Key Point:  Disperse Forces Imposed over a Greater Area.  Check out his site:  It's incredibly self explanatory and about as user friendly of a site as I've seen.  If nothing else, watch it for a fantastic video of a mannequin getting hit. 

Preventing Horse Collar Tackles
Does anyone remember this play a few years back?  Not long ago, the "horse collar" tackle was actually a legal means to bring stop your opponent.  As you can see, it was very easy for the player being collared to suffer a serious injury.  The feet remained planted while momentum keeps the upper ody moving...aNd something's gotta give; be it a ligament, tendons, bones, etc.

Well, a new device has been recently approved for use .  The X Collar  which provides a tear-away component to the outer part of the football pad. It's a nice little snippet, first developed as a science project, which has since evolved into a product which is currently being marketed.  Be sure to check out the schematic design and short video at the end of the article.  Good stuff
 Let's face it, while an opponent might not want to hurt someone, it can be hard to teach them NOT to try and grab any available part of the the opponent in the middle of gameplay.  I love this.  Simple, and likely pretty effective.  We'll see if it catches on.  At less than $30, it can be a nice inexpensive way to help limit this, especially in the beginning or middle levels of football. 

Anybody have any thoughts on the possible limitations or negative consequences of these devices?

Classic AT: Taping an Ankle

Students: You asked for it, here it is.

So many times, I hear AT's and students upset that public perception is that we tape ankles and get ice. Not sure why, but it's never really  bothered me.  Yes, we do much more than that, but I'd be more concerned if we had NO public perception.  At least we are being noticed.

Anyway, a co-worker of mine is adamant about applying a clean, neat and functional taping technique.  He describes taping as an "ATC's signature".  I love that!  Take pride in it; make sure it works and don't try to rush it.  

When teaching traditional taping techniques to university students, I seem to find that while there are hundreds of variations and personal preferences on taping.  That said, the instructor HAS to teach one method for the student to capture the basics and learn the skill.  I frequently hear from clinical instructors questioning the technique involved when students displays their skills at a clinical site.  While I do teach one method; it is just that; one method.  I fully expect each student's taping to evolve as they progress clinically, and even encourage it.  However, there are several taping basics which can easily be lost or discarded over time. We should be sure that the evolution is one of sound clinical reasoning and not just clinician preference.  This can potentially decrease the effectiveness of the tape itself, delaying rehabilitation or even exacerbating the injury.
Some general rules on taping:
The first assumption here is that I am discussing taping an injured ankle, not simply taping a healthy one. 
1.  Avoid continuous tape.  This means don't wrap with one or two long strips of tape completely circling the joint.  Use smaller, shorter strips for greater tensile strength.  An added danger with continuous tape is that it may only provide compression, not support.

2.  Know what you are taping for.  In this video, we are taping to help lock the talus into the ankle mortise. I am applying a basic variation of the closed basket weave taping technique.
3.  Overlap the tape by half all the time, and you will have both a neat AND functional taping.
4.  I've heard colleagues say for years that taping with white tape is going out the door.  This, coupled with the proliferation of over the counter braces and advances such as  Kinesio tape (among others) certainly would lend credence to that argument.  However, I think that sometimes nothing beats regular tape.  In addition, much like anything in health care, I think it's more damaging to completely discard something when a) it still works for some athletes and some injuries, and b)it's the athlete's preference.  At the end of the day, I think that's what drives the discussion for me.
5.  Make sure it's latex free.  Most, but not all tape is nowadays.  Be sure to ask and double check before applying directly to your athlete!

Lastly, I'm not against other styles of taping, nor am I against bracing.  As an educator I believe that all are beneficial when used correctly, and it's up to the ATC, athlete and injury to determine which is the best specific tool for that specific scenario.

Random Question: When did we start calling these "Ankle Tape Jobs"?  Does "Nice ankle taping." not suffice?  Does anyone know the origin of the phrase "tape jobs"?  It is so awkward sounding; both to type and speak.  

I'm back baby!

 This has been one tough summer; but I am finally looking forward and able to get back to blogging.  Here are some miscellaneous thoughts/tips/experiences I've had throughout, and hopefully back to some blogging normalcy.  I returned this week from another trip to the Dominican republic, my 11th trip in the past six years.  It's difficult for me to encapsulate the service learning experience concisely, but I'll give it a shot.
1.  First time bitten by a centipede.  I hope it never happens again.
2.  While writing a SOAP note on a patient, an AT student asked "how do you spell machete"? How many educators have heard that before?
3. Watching students educate injured patients on proper posture, lifting techniques, and making on the fly adjustments to improve quality of life is one of the most beautiful things I've ever seen.  I will never tire of it.
4. Don't think that just because your patient doesn't walk with a limp (antalgic gait) that they don't have significant pain and/or dysfunction in their lower extremity.  Some people make subtle adjustments without even knowing it.  Fully evaluate with a careful history, palpation, range of motion and manual muscle testing and then special tests before you complete your assessment.
5. Look your patient in the eyes directly when they are speaking to you, and LISTEN.  Sometimes listening and expressing compassion is the best care you can give someone.

That's it for now,  but look for more coming soon!

Athletic Trainers & Nurses: A Healthy Collaborative

Haven't blogged in awhile, because I haven't seen much that I considered blogworthy.  Happens I guess.  I stumbled upon this article while reviewing potential collaborations, and this will immediately become required reading in my sophomore level AT course.  In our field, we often speak of working collaboratively with other disciplines, and in fact, on clinical rotations students will often witness/participate in discussions/debates with other health care professionals addressing the student athlete.  While learning to practice interdisciplinary care is in my opinion the best option for athletes, it can admittedly be at times difficult and/or frustrating.
Some key points prior to reading the article:
1.  Understand that most everyone is coming from an angle in which they believe that their plan of care is the BEST way for the athlete to heal and return to activity in a safe and expedient way.
2.  Listen.  Listen to counterpoints; often times we tend to "zero in" on orthopedic or gen med issues as they are presented from faculty or textbooks.  As we all know, unfortunately cases do not always present this way, and we can learn much from other professionals who have experience in dealing with those issues.
3.  Share knowledge.  Don't be afraid to speak your mind in a calm and professional demeanor.  Emotion tends to force others into a defensive stance, which can alter the level of care for the athlete.
4.  More is more.  I love this adaptation to "less is more".  The more information you and your colleagues have, the more informed decisions can be made, and outcomes can be enhanced (read: improved standard of care).
I have been fortunate enough to work closely with nurses and nursing students the past several years during our coursework in the Dominican Republic, and the exchange of knowledge in both directions has made me much more informed regarding general medical conditions; including signs, symptoms and overall management.  Working side by side on real patients has incredible benefits, including my own progression as a clinician.

The article itself, published in the May 2012 edition of the National Association of School Nurses (NASN), can be found here:  http://nas.sagepub.com/content/27/3/136.full.pdf+html?ijkey=xo5hF791ez6E6&keytype=ref&siteid=spnas

I really believe this can serve as a nice informational piece when either creating or modifying the Emergency Action Plan (EAP).    Hope you enjoy!

Congratulations to the Class of 2012!

This group you see above are the 2012 graduates of the University of Southern Maine's Athletic Training Education Program.  One of my favorite times of year are watching the next group of seniors move on to
the next stages of their life.  I had the privilege yesterday of watching this group of men and women at our graduation. They were a great group, and are going on to do great things; some as Graduate Assistant Athletic Trainers at Auburn University, University of North Carolina, Thomas University, Providence College; some onto obtain their Doctorates of Physical Therapy and Physician Assistants degrees.  Either way, a heartfelt congrats to an amazing class.  Great Job Gang!

Concussion Management

Watching the exciting UEFA semi-finals, I was struck by a concussion and it's management during the game.
Check out the video here first:

It should also be noted that after a quick evaluation he was allowed back on the pitch and, eventually, several minutes later, subbed off.  Watching this left me with some questions.
1.  Does UEFA have specific rules regarding this?  For instance, if this were the NHL/NFL, etc., he would be out of the game immediately, right? Why isn't unconsciousness grounds for immediate removal from game play? Perhaps the rules are different?  Lastly, how does this align with the Zurich Protocol?
Of course, I had the benefit of TV and countless replays, while this medical staff was in a pivotal moment at a crucial match.  I would never question the decision made, as I was not present personally, but as a teacher, I have to understand to better explain why some injuries are managed differently from our position statements to the clinical world.  

Looking further into this, I found an interesting blog which seems to be neat resource for all things concussion.  You can check it out at http://theconcussionblog.com/

Spring Motivation

Each spring I get fired up, sign up for a few 10k's, maybe a sprint tri, and try to get going again.  I guess it's my way of breaking out of winter hibernation in Maine.  Last night I came across this video which was both emotional and inspiring.  Amazing stuff. 

Check out a Runners World Article on Ben here:


His personal blog/website: Ben Does Life            Hope you enjoy as much as I did!