Food Guide Pyramid Toppled

Rather quietly it seems, the USDA recently changed the pyramid format for nutrition in the U.S. to a plate.  When I typed in the old URL, www.mypyramid.gov, it redirected to http://www.choosemyplate.gov/  While many have issues with components of the recommendations, it is indeed a decent foundation in which to start understanding proper nutrition.  Personally, the plate idea isn't a bad visual, and is hopefully better to understand. Sadly, while it has recommendations for the general public, pregnant moms, and kids, it does not include athletes specifically as a sub-group.  It does ask for daily activity levels though, which is nice.  As with other topics, there are no absolutes, and information should be taken with a grain of salt.  My advice to all students and ATC's is to go to the website, enter your personal data (height, weight, age, sex) and check out what it has to say.  Like a said it's a good starting point.  Having used this site in courses in the past, at first glance and with an hour or so of playing around with the site, it does seem a bit more user friendly than the older version. 
The reason I post this is twofold; one, the NATA released a new position statement on weight loss last week in New Orleans, which I will review in my next post.  Two, we as professionals are bound to have at least a basic knowledge of nutrition, and this is a good place to start figuring it out for yourself.  How many of you have heard athlete's ask "What should I be eating?"  I for one have found it best to give broad advice, but there is no substitute for a registered dietician or nutritionist.  Their knowledge base, in my experience, has been astounding and incredibly educational.  If you get a chance, look up a local one in your area and have an assessment done.  Money well spent in my opinion. 

NATA Clinical Symposia: Helmet Issues

One of the most interesting sessions I witnessed, ,"Emerging Technologies in Helmeted Sports", featured 3 speakers, each focusing on football, hockey, and lacrosse helmets.  Here are just a few of the topics addressed:

Football Helmets: Both rotational and linear forces need to be considered when addressing concussive injuries.  It's not always the direct hit which causes a concussion.  Dr. Guskiewicz spoke about reinforcing proper technique, which is still in issue in high level athletes.  A valid reminder as well that concussions are great at protecting the head and face, but the brain itself is a separate entity which can still move violently, while the outer "shell" or cranium remains relatively uninjured. A good historical reminder that was mentioned was that football helmets were developed to prevent the high rate of catastrophic injuries that were occurring in the sport, and if we use that criteria, the helmets themselves do a great job of just that. 

Hockey Helmets:  A big problem here is fit.  Dr. Mihalik stated that during his recent study of 18 hockey helmets, none of them fit properly!  In fact, he said, 7 of them could be removed without loosening or adjusting any straps at all.  He showed one clip of a hockey athlete securely fastened to a spine board with his helmet, and had the athlete mimic cervical movement.  He had substantial motion, which may speak to the thought process of simply removing the helmet when spineboarding a hockey athlete.

Lacrosse Helmets:  This presentation detailed the lacrosse helmet and, amongst other items, the difficulty with the pop rivet.  Dr. Higgins explained and displayed video of an equipment manager removing all pop rivets and replacing them with ones that could be "unscrewed".  Some in the audience voiced concern over whether this in fact voided the helmet warranty.  There was no clear answer.  It seems the best course of action is to read the fine print, and check with the helmet manufacturer you are currently working with. 

After listening to these three speakers, and the questions which followed the session, I couldn't help but think aloud to my colleague "We're just going to be teaching to completely remove the helmet all the time when spine boarding.", to which he replied "I've been saying that for years!"  Essentially, if the helmet doesn't fit properly, it should be removed prior to spine boarding, as your main goal is to stabilize the cervical spine.  Nonetheless, a fascinating topic, and judging by the massive attendance to this session, a very topical one to today's practicing ATC.   So I ask you, are you ensuring all of your athletes are properly fitted, regardless of sport?

National Men's Health Month

Not sure if you know this, but June is National Men's Health Month here in the U.S.  As ATC's, we need to be proponents of a healthy, active lifestyle, and that includes being knowledgeable about all topics related to general health and well being.   Check out this site FMI. 

Off to New Orleans

For the 2011 NATA Annual Meeting & Clinical Symposia.  From what I've seen, this looks to be a great lineup and I'm ready to absorb some great information!  I will be back to posting after next Thursday.
 FMI, click on the following link:     62nd NATA Annual Meeting & Clinical Symposia

It's All in the Hips

A common foe of the athlete and ATC is patellofemoral pain (PFP) syndrome, or runner's knee.  This nagging issue can be difficult to successfully treat.  Often times, we can treat the immediate area with ice, massage or a combination of electrical modalities and obtain favorable results.  Sometimes, we find ourselves at a crossroads; the athlete is doing everything right in terms of appropriate rest and treatments, but their symptoms persist. A new study suggests that perhaps implementing a twice weekly hip strengthening program can reduce PFP symptoms.  While it is a relatively small sample size, I think it still has merit; remember to treat the condition, but evaluate the body.  The cause may not be where pain is located.  The article goes on to speak of some classic findings with PFP, including the abnormal contact between the femur and the patella, and the classic valgus lean upon squatting which is commonly seen those suffering from this malady.   This article really speaks to the benefits of overall strength/conditioning.

The video here is not related to the article directly, but I think it has some great examples of rehabilitative exercises that can be utilized when working with an athlete whom you feel needs "core" (and I use that term loosely) strengthening. Not all exercises may be appropriate, but it can give you a good idea of really using a combination of both verbal and visual cues to guide your athlete through the process.  I wanted to add a video of Happy Gilmore and Chubs saying "It's all in the hips", but this should do just as nicely, I suppose.

Multiculturalism and Cultural Competency

A task those of us in athletic training education face is teaching specific orthopedic skills while balancing actually dealing face to face with athletes.  These athletes may be of many different ethnic origins, and have different religious or belief systems which the ATC has to take into account.  A few years ago, I read a fantastic book called The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures  It essentially documents a specific case of a growing population in the U.S., and the disconnect which can occur when both health care professional and patient fail to fully understand where the other is coming from.  ATC's and students can work with a variety of populations, and it can prove to be challenging and frustrating for both sides when cultural practices are not fully understood.
Cultural competency is a complex definition; thankfully, the U.S. Dept. of Health and Human Services has done a nice job of explaining it here.
There are also a number of good, scholarly articles on the subject if you spend the time searching.
My question to you: Do you feel as though you are comfortable treating an athlete from a different culture than one you are familiar with?  As health care providers, we must serve our patient base regardless of ethnic origin, and we need to be prepared to do a little research in order to be most effective.  A new text was released this past fall specifically geared towards ATC's.   Cultural Competence in Sports Medicine is a huge step in the right direction.  It's on my bookshelf, and it should be on yours!

GI Issues

This topic can frustrate both the ATC and the athlete; what to do when an athlete complains of gastrointestinal issues?  Very recently, a study correlated high intensity sports with GI issues, and of particular note, crew athletes were singled out as having issues which could impact quality of life.  It makes sense from an anatomical position standpoint, spending long amounts of time in a seated position, constantly "squishing" internal organs while performing a repetitive motion.  When you hear of complaints, look at all angles.  Think beyond simply asking "Did you eat anything funny in the last 24 hours?"  Not to discount diet at all, but perhaps the nature of the activity can itself be exacerbating the condition.  When attempting to aid your athlete in performing at his/her highest level, take into account all aspects.  It really lends credence to evaluate globally, and work your way focally, rather than the other way around.  You might just find the cause that much quicker, making you and your athlete much happier.

National Running Day

Happy NRD 2011!  I know, there are a lot of "useless" holidays out there, but this is one all of us physically active folk can appreciate.  Use it as an impetus to get in a workout today, whether it means running 3 minutes, 3 miles, or 3 hours.  FMI, check out http://www.runningday.org/site/