Athletic Training: Why I Love My Job

A great read! And excellent write up!

I Train Therefore I Eat.

I’m an Athletic Trainer.

Oh, so you’re a gym teacher? NO. 

Oh, so you’re a personal trainer? NO

Oh, so you’re a strength coach? NO

Wait, so what do you do?

Believe it or not, this type of exchange actually happens a lot.  It’s funny, because athletic trainers (ATs) are everywhere. Most high schools, colleges, semi-pro teams, Olympic teams, professional teams, and basically any organized athletic association has them. Athletic Trainers work for corporations, for the military, as physician extenders, and in the performing arts (Yes, Cirque du Soleil employs athletic trainers for the performers).

Athletic Trainers are on TV all the time. Although they’re usually being called “trainers” by the talent at ESPN or your local news organization, so I don’t blame you if you don’t know who we are.

athletictrainer

I work at a small Division III college in Boston, and along with my colleagues, am responsible for the…

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Mouth Guards (5/5/14) — How is this study not retracted?

It has been nearly a year since I wrote this up, but it has been making the rounds again.  I honestly want to know why this “peer-reviewed” article has not been retracted.  This is one of the most blatant oversights I have witnessed in publications, and that is not hyperbole.  Read the following for yourself:

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Is it a bombshell or is it just a plain dud?  I say bombshell, but not in a good way for anyone involved with this “research”.

Last week I was inundated with emails regarding this “new” research about mouth guards and concussions.  There were roughly 16 emails in a one hour time span; some wanting comment, some telling me I have been wrong all along, some promoting the research.  This was a “huge” development in my area and my little corner in the blogosphere.  To fully understand perhaps some history is needed (“mouth gear” search on this blog) when it comes to my feelings on mouth gear and concussions.  Here are some selected comments attributed to me;

The basic fundamentals we should be cognizant of here are: concussion is a BRAIN injury, the BRAIN floats inside skull, Physics dictates that the BRAIN will move depending on the forces applied to the skull/head (not always from a blow to that area), mouth gear cannot stop the BRAIN from moving, mouth gear cannot attenuate any forces to the skull/head that are not in the oral region, mouth gear does nothing for the skull/head when forces are placed on it in rotational, angular, acceleration or deceleration fashion.

Now that we have that all out-of-the-way this is the General Dentistry article I was asked to comment on.  On face value and from a “peer-reviewed” angle itseems all good.  A significant finding between custom mouth gear (noted as LM MG in article) and over the counter “boil and bite” mouth gear (noted as OTC MG).  However once you take a deeper look there are some peculiar problems, in my humble opinion – that comes later.

First, we should look at the possible limitations of this study that seems well populated and well thought out (honestly these were my first concerns before finding the real issue):

  • Were the injuries controlled for by football position? (we have documented this issue here)
  • Were the injuries controlled for by size of players/school they were playing?
  • Were the injuries controlled for by playing time? (more exposure more risk)
  • Were the injuries controlled for by game vs. practice?
  • Were all the injuries seen and recorded by a single MD or was it the ATC at each school?
  • Did any of the players have a previous history of concussion?
  • Was the study controlled based on practice habits of the teams? (do some hit more than others)
  • How do we know that every player complied with the “no wedging or chewing” rule? (this plays a massive role later)
  • The study says that all 412 subjects wore the same exact helmet, I find that: A) hard to believe and B) was the fit on every player the relatively the same?
  • Who funded this research? (no disclosure)

As you can see there is a litany of reasons I would have dismissed this research, if I were peer reviewing because those limitations are extremely real and realistic Continue reading

Borland, Now What?

If you are interested in sports or the brain trauma/concussion debate you probably did not miss the news about Chris Borland’s abrupt retirement from the NFL and the San Francisco 49ers.  In case you missed it, he broke this news to Outside the Lines on ESPN.

Since he made his decision there has been quite the discussion regarding why and what this means in the long-term; not only for football but for the awareness angle of this injury he has cited for his reason for hanging them up.

But what does it really mean, beyond the #hottakes from all over the internet?

When Borland decided it was his time walk away he knew there would be great interest, well had to know.  It has not been the norm to see a 24-year-old to retire due to concerns over long-term effects of repetitive brain trauma.  Most people in his position, now and going forward, are probably more concerned about making a living playing a game they love and a good one at that.  But think about the ripple effect of this news.

First, remember when Jake Locker decided to retire?  Hardly now, I bet.  Or Patrick Willis, from the same 49er team?  A bit more memorable because of his stature, I bet.

But both of those decisions were pale in comparison to the news from Borland, who until he retired I and many hardly knew him outside of very devout followers of the league and team.  The reaction was a combination of mass hysteria and shock with everyone waiting to chime in their opinion.  We saw nothing like that from the other two more “high-profile” players before Borland.  Why was this… Continue reading

NATM 2011 Letter (3/22/11)

This post is from March 22, 2011 and is great to bring back for all to read.  I am unaware of any changes in Paul’s professional life, but this remains relevant!

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During the month of March we will continually highlight the work of an athletic trainer.  This series will incorporate open letters about the men and women of the profession from other professionals, the aim is to have at least one a week.  If there are others out there; parents, coaches, teachers, doctors, lawyers, athletes or anyone that would like to form a letter please do so and send it to theconcussionblog@comcast.net.

I have saved this letter for publishing toward the end of the month, because we should be thinking about what an athletic trainer does every month, and every day if you are lucky enough to have one around.  Paul LaDuke Jr. is a full-time athletic trainer for a public high school in Pennsylvania and has “uber” years devoted to athletic training.  Not only does he provide daily coverage, he has recently created a blog entitled “Promote The Profession” devoted to Athletic Training.  Paul has been a wonderful resource and “reality check” for me during my process.  It is an honor that he took time to write this letter;

What is it like to be an Athletic Trainer? Continue reading

Taylor Twellman Story (9/21/2010)

Originally posted on The Concussion Blog in September of 2010.  I would be interested to see Taylor talk about this in a reflecting manner and see if anything has changed with him and his thoughts on concussions in the sport he loves.

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Just ask Taylor Twellman, a soccer player from the New England Revolution how unpredictable they are.  In 2008 near the top of his game and the American leagues he ran full speed into the goal keeper, creating a whiplash effect on his body, most namely the skull.

To this day Twellman has not had a single day without some post-concussive effects.  He was only just recently, June, released to begin light activities.  Granted this is a professional athlete that has a career to think about, his health remains his number one priority.

Monique Walker of Boston.com ran a story about him and his not so quick recovery from concussion.

For our adolescent population this can be even more devastating, a delay in recovery could mean a decline in grades, an emotional disconnect from teammates, and a social decline in school.  All while the brain and personality are still developing.

If you get your “bell-rung” make sure you communicate that with someone who can help.

We Prepare – You Perform

It is that time of the year again to point the spotlight on the countless, often faceless, professionals that do much more that many know in protecting your physically active peers.  This year the message is “We Prepare You Perform” and has many different meanings to many different people.  I want to take this time and space today to tell you what this means to me.

It still happens, I get the occasional “what do you exactly do” comment/question from people.  Certainly most of that comes from those that are not in a sporting type setting, be it at the HS level or connected to professional sports in an interest type of way.  However, it is a great question that I love to answer even though it can get tiresome realizing that our profession is not universally understood.

What “I” do is not that different from what other athletic trainer does.  Bringing it to a more practical analogy, it is not much different that what one does a parent; as I have learned being a father of three.  What we do is make the lives of those in an active lifestyle or profession safer and when warranted BETTER.  The core foundation of this comes from preparation, period.

WE PREPARE.  You imagine it, there is a good chance we have prepared for it in the active arena.  This goes for sports, where the vast majority of athletic trainers are employed, to the industrial setting where the hard-working, blue-collar workers need to be at their best as well.

The easy cop-out would be to say this comes from our education, at least four but increasingly more like six years of study.  Sure that is some of it, but the reality is that no matter what you learn in a classroom setting has little to do with what we do on the “ground” in our profession.  The more complex and reality of the preparation we do comes from experience and adapting.  Constantly thinking of what could happen — and we don’t want to happen — and how to react in those situations.  The first time Continue reading