MATA, Symposium & AT News Ticker

Fantastic whirlwind of a weekend that began at the Annual Fall meeting Friday for the Maine Athletic Trainers' Association (MATA).  We were treated to an unorthodox topic, which was well provided by NATA Hall of Famer Marjorie King. 

Her presentation was essentially a primer on how to maintain life balance.  I found it interesting; we even meditated for 15 minutes or so.  And, I was relaxed afterwards.  I felt clearer.  To be honest, I never would have done that had I not been forced to.   She challenged us if we were truly relaxing regularly, recommended several books I hadn't heard of, but sound interesting, and introduced us (ok, maybe just me) to the Chinese Clock.  Very informative, and incredibly enlightening.  An unorthodox topic from an ATC...and one that was well heeded.  

Then it was off the Maine Athletic Training Student Symposium in Presque Isle, Maine.  Each year, one of the four ATEP's in the state host a symposium for all students.  For our students, it's a chance to experience something different in a relatively relaxed format.  For us educators, it's a chance to catch up and visit.  It's always fun.   If you haven't seen UMPI yet, you should.  It's slogan, "North of Ordinary", is quite accurate and fitting.  And I LOVE it.  The faculty and students were fantastic hosts, and put on a great program.  Bruce Hamilton Dick, MD presented on a variety of topics.  I have to say, natural teacher and orator.  Very well presented, and he consistently incorporated and challenged students during his lectures.  His topics ranged from Hip Arthroscopy and Athletic Pubalgia (phenomenal anatomy review), to the Female Athlete Triad and Asthma.  Great, great stuff.  His time was much appreciated by all.  I only wish all of our students could have attended!

Trying something a bit different; lots of smaller newsworthy (I think) items...

In a very interesting move, the Australian Football League (AFL) will require their sports trainers and medical staff to wear neutral colors next year during games.  Is this a step towards separating medical staff from the team?  Would this catch on over here?  Hmmmmmmm.  The short article actually gives a brief history of clothing worn by sports trainers in the sport throughout the years.  Before you get mad at me for calling them "sports trainers", that is what they refer to themselves in Australia.    Very rare and scary injury; football player tears vena cava on field and survives.  A bit more information on spontaneous vena cava tear here...Let's wish him luck.  Been meaning to share this for awhile, but here is a great video and article on how universities are looking at concussions and head injuries.  A must watch is information on the  system  which starts around the 1:30 mark.   A fascinating look at utilizing technology and real time data to assess athletes.  Think an MRI is always the best way to diagnose?  Maybe not.

Service Learning in Haiti

Very interesting meeting the other night.  I had a chance to meet up with Kevin Melanson, a fellow ATC who shared his experiences taking athletic training students to Haiti this past summer.  It was his first trip, and he plans on returning again this winter.   You can actually read about his experience here.

Some pictures of his students:

I can't tell you how refreshing and uplifting listening to his story was for me personally.  Having advocated or the inclusion of service learning for some time, it sure is nice to see.  I heard so many similar experiences, thoughts, revelations, etc.  All I could really do was smile!  Experiences like this always remind me of  a lingering question:   Why isn't service learning mandated as part of a core curriculum?  As part of a general education requirement, this could easily be infused into all US Colleges & Universities.  There is a need EVERYWHERE, here and abroad.

At any rate, keep up the great work Kevin!

Instant Replay for ATC's?

I blogged about how the NFL was making some changes to how medical personnel manage injuries during the game a while back.  Well, this recent newspaper article was passed along to me by a colleague, and I found it to be a quick and fun read.  Great to see how recent advancements can be used to improve communication and overall initial management.   Enjoy

Breast Cancer Awareness Month: Conflicted

October is fully upon us; leaves falling, colder weather, and pink is everywhere.  Every sporting event I seem to watch on TV or go visit our students at seems to have some eye catching pink item for sale.  High school, college and even professional sports have fully embraced the movement.  Now before I begin, I encourage you to read the entire post to understand where I'm coming from...you don't have to agree, but just understand where I'm coming from.
I don't like pink everywhere (and been quite vocal about it for years).  I also don't like saying so, because  I also don't like cancer, and saying I'm against Pink insinuates I'm against Breast Cancer Awareness.  Or at least that's the impression I sense.  I'm all for philanthropy and helping others.  I'm left with the question burning in my mind:  But is it doing anything?  I just don't think we are going about it the right way.  I think it may be more about the movement than actually helping determine what causes cancer.  I think it's much more commercialization than anything else.  And where does all that money go?  Well, enter the documentary, Think Pink Inc. Here is a brief trailer:

It's an edgy topic for sure.  How can you not like "pink movements" which promote breast cancer awareness.  My question has always been, where does the money go, and what about the other cancers?  Check out this link which shows you the death rates and occurrence of cancers.  Indeed, according to the CDC link provided, breast cancer is most common in women, but prostate cancer actually has a higher rate of occurrence  (144/100,000 as compared to 122/100,000).  Perhaps even more interesting, though, is mortality rate.  It's not even close.  Lung cancer has the highest mortality rate in both men and women (actually, almost double the rate in women when compared to breast cancer).

Well, here are a few points teased out from the documentary I watched last night which I thought were interesting.
1.  Less than 5% of money raised actually goes to researching prevention of cancer.  This means that it's not going to finding a cause or potential causes of cancer.
2.  Cancer rates have actually increased over the decades, from 1 in 22 to 1 in 8. 
3.  People need to talk.  What if all researchers stopped "racing each other", and opened up a dialogue about what they were studying; it could prevent overlap, and may gain some headway.
4.  When physicians found that early mammograms were giving too much radiation and therefore unsafe, they were shipped to developing countries for use there.  (global responsibility?)
5.  Susan G. Komen for the Cure has now expanded internationally, holding events all over the world. There is no doubt they have raised vast amounts of money and donated much...but a fair question to ask is "Is it doing what we need it to do?"
6.  Many companies actually stand to profit from increased consumerism surrounding purchasing their pink lines (Avon, Yoplait, Pharmaceutical Companies, etc.)

I think what really got to me was later in the documentary, they actually described the origin of the salmon ribbon, started by a woman to promote cancer awareness.  She was approached by both a magazine and retail provider, who wanted to market her ribbon.  Her response: No.  She didn't want it to be used for commercial purposes.  Their response:  they simply changed the color from salmon to pink and took it.  Gotta love corporate America baby!

I thought the real drive home point was that the documentary wasn't really "anti-pink", as much as they just wanted to show the real face of cancer, which isn't pretty and nice, and really use money to look at potential environmental causes, etc, rather than medications to treat.  Perhaps the most emotional part of the film was listening to the Stage IV group, who took exception to the terms "survivor" (does anyone really survive) and "fight", implying that they didn't give it their all when "fighting" cancer.  In fact, they stated that it's not really a fight as much as it is enduring difficult treatments.  For those who are unaware, Stage IV is the final stage.  There is no Stage V for cancer.  At any rate, an interesting documentary (although the geek in me wanted way more statistics) and worth a shot if you want to know where all that money you are donating is actually going to.  I won't give away too much more (you really should watch the video for yourself on Netflix)

If you navigate the Pink Ribbon website, it appears the same as others, but if you examine the homepage more closely, it differs in the fact that it actually tells you the percentage of donated money used, and where it goes.  Novel concept.  It also  has a link to the cosmetic safety database, which is an awesome tool.  You can enter your common  household items for cleaning, or beauty and see where their ingredients stack up on the carcinogen or toxic list.  It's good stuff.
One last question: Does this movement inspire hope for cancer patients...or the loved ones surrounding them...or both?  Does any of this matter?  For instance, who cares where the money goes as long as one person is helped.  Talk about an intersection topic.   At any rate, feel free to share your thoughts. 

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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!