Showing posts with label sports med. Show all posts
Showing posts with label sports med. Show all posts

Feb 19, 2014

Where Have I Been?

Howdy Folks! I am sorry that I haven't been blogging even a quarter as much as I would like to be lately. However, in all fairness I have been pretty busy. What have I been busy with you might ask? Well...on top of being an athletic trainer for a collegiate basketball team (that is ranked #4 in its division for the entire country and likely to win their second conference championship in a row), I have been busy working on and trying to complete the research project for my master's thesis.

Dr. Erson Religioso over at The Manual Therapist has been interested in my research project and asked me to write a guest blog for him where I would discuss what I was doing with and looking at for my research. I was honored but it also gave him some time off from blogging to spend with his new-born baby girl! Congrats to him for sure! Anyways, here is a link to my guest blog where I talk about my research! I need to get back on the blogging train and finish my self-SFMA series as well! Sorry for the delay, everyone.

I've got some cool cases related to my patients, SFMA, PRI, and Rock Tape to blog about once I get some more free time! Can't wait to share them all!

Jan 1, 2014

A Year in Review: 13 Lessons of 2013

Happy New Year and welcome to 2014! This is my first post of the year and my 75th post overall.  This is going to be a reflection on some of the things that I learned in the previous 365 days. I was inspired to write this post after reading many of Mike Reinold's similar posts over the last few years. I guess I learned a lot this year because this turned into an epically long post. Sorry.

Nov 5, 2013

1 Month of The SFMA: My Reflections

It has now been exactly a month since I took the Selective Functional Movement Assessment certification course in St. Louis, MO. You can read my initial course review here. I have been trying to incorporate the SFMA into my clinical practice as much and as often as possible since then. I wanted to take the time to highlight some thoughts and self-reflections from this process so far.

Sep 30, 2013

HEP for the HIP: Self Hip IR mobilization!

This is a quick video that I shot in the Athletic Training clinic the other day when working with a basketball player. This is a self-hip internal rotation mobilization that I have my patients perform on their own.

This helps to maintain the benefits gained from treatment and manual therapy when working with me in the clinic.  Ideally, this would be done about once an hour for a single set of 10-20 reps but it can be hard to have a student-athlete comply with this and fit it into their busy schedules.  I also have some of them do this before practice and lifting weights for temporary mobility gains.

This is done by the athlete applying an active-assisted hip internal movement while simultaneously providing slight distraction/traction. Check it out!

I have this athlete using an Edge Mobility Band in this video but they could also do this without the band. However, I feel that using the band is more efficacious due to the better hand-hold and compression provided by it.

In other news, I found an old but good video about pain by Lorimer Moseley on "Why Things Hurt". It is actually a pretty funny video and I am sad that I have only just now found this video. For some of you this will be old but for some of you it may be new. This guy's book is on my current to-read list.

Enjoy and Happy Monday!

Sep 18, 2013

Bilateral Femoral Acetabular Impingement In a Collegiate Soccer Player

Today's case comes to us from one of my colleagues and classmates, Kathryn Deterding, ATC. Kathryn consulted with me about this case and then went on to implement a treatment protocol based off our discussion.

A Case of Bilateral Femoral Acetabular Impingement(FAI) and Labral Tears in a Collegiate Soccer Player. 


History: This was a 21 year old male collegiate soccer player. In the fall of 2011 he began to experience hip pain that he played through. In the upcoming spring of 2012 he was diagnosed with bilateral FAI and tried to rehabilitate his injury to prepare for the fall season of 2012. The fall season was just as painful as the previous season. This athlete then underwent two different surgical procedures in the winter of 2012. One for each hip, in attempt to lessen his FAI and correct additional labral tears of the hip. The athlete had minimal rehab for a month or so after his surgeries and refrained from heavy activity for a few months. 

Upon increasing activity to prepare for the fall 2013 season of soccer the athlete began to experience the same pain and symptoms. He consulted with an orthopaedic surgeon during the preseason and the physician told him that he may not see any improvements and that this was something that he most likely was going to have to live with.

It was at this point that Kathryn and I discussed the athlete's case together and came up with a plan of care.  The first thing that I did was discuss thought viruses with the athlete and talked about how current neuroscience is teaching us that pain is not necessarily patho-anatomically based but is a construct of the central nervous system. The athlete admitted to thinking that all of this discussion was a load of hogwash and didn't buy into any of what I said. Nevertheless, we continued on with our plan of care.

Sep 16, 2013

Case of The Week: Persistant Postural Headache

Today's case is hot off the press. Hot as in I just saw and treated this patient today.

History: This was a 22 year old collegiate softball player this plays catcher. She has a previous history of occasional headaches that weren't associated with general medical illness. Four days prior to seeing my this patient began suffering from an unusually strong headache. The pain was focal behind her eyebrows and began while she was busy studying and reading in the evening. The patient took ibuprofen but found no relief from it.

Day 2: The patient awoke the next morning with the headache again. This lingered throughout the day and ibuprofen still provided no relief. The headache was severe enough to cause nausea and dizziness as a result. The patient then tried Excedrin which provided minor relief enough to allow her to fall asleep that night.

Day 3: The patient awoke with the same searing headache and once again took Excedrin. This time it only provided minor relief for an hour or two at most. As the day went on the pain increased and induced nausea once again. This night the patient was unable to find sleep at all.

Day 4: A repeat of the previous day began with daybreak and this student-athlete had a lot of reading and studying to do for school. These activities only exacerbated her symptoms even more. Over-the-counter medications now provided no relief and her symptoms continued into the next day when she consulted with me.

Observation: On day 5 of this the patient presented me with her history and symptoms. Upon inspection she had a forward head posture, Bilaterally elevated and protracted shoulders, and an excessively forward slouching posture. I like Jay Dicharry's acronym for this postural presentation "F.A.T.S." aka female adolescent texting syndrome.

Treatment:  I began her treatment much like I do most of my treatments and that was with some light instrument assisted soft tissue mobilization (IASTM). I did IASTM along a cervical pattern and a little bit of her upper traps as well.

Next, I had her do some foam rolling rolling of her thoracic spine to help with increasing thoracic extension and to promote better posture. After this, I had the patient lie supine on the treatment table and had her perform 15-20 cervical retractions into the table. While she would hold the retraction into the table I would apply a light bilateral - posterior to anterior force with the pads of my index fingers just lateral to her C2 spinous process.

The next technique I applied was passive cervical retraction using my right shoulder to her forehead with manual traction/distraction by gripping the occiput with my right hand. I held this for about 20 seconds and did a few repeated retractions as well.

I then instructed the patient on how to perform repeated cervical retractions to cervical extension with manual overpressure. I had her do this for a set of twenty and instructed her that this would be her home exercise program to repeat. Here is a quick video on how these look.

After completion of this I asked the patient how she felt. She told me that her headache was completely abolished and that she an indescribable sensation of clarity. She felt as if she could see further and think more clearly...Funny how pain can cloud our judgement sometimes?

I educated the patient on proper posture and ergonomics for reading and studying. I also lectured her on the necessity to repeat her HEP because of the transient benefits from my treatment.  I told her that she should be able to self-medicate without medication and all that she needed was some quality movement.

I feel that this case highlights a few important things, some are repeat themes to my blog so far:
  • Pain can be debilitating even if it from seemingly common and minor issues such as headaches or migraines.
  • A rapid onset of pain can usually be rapidly reduced
  • Sometimes the best medicine is movement
    • This patient wasn't ill and her body wasn't short on OTC meds like ibuprofen or acetaminophen. These drugs aren't helping to fix your pain, just mask it.
  • Posture can be paramount but it is not as simple just remembering to sit up straight.
  • Patient education and empowerment 
    • Patients shouldn't have to rely on my hands or treatments. We should teach them how to carry on the benefits that we provide them and how to treat themselves in the future.

*Case Update*
I just consulted with the patient again and it is the day after my treatment session with her. Her headache did not return later that evening even after heavy exertion at softball practice.  She still feels great and not even a slight migraine to complain about.

Aug 26, 2013

Ten Handy Apps for In The Clinic and On The Field.

I recently got a new phone and I have been in the process of downloading new apps for it. This is my first Android phone so I am getting used to it but it has made me think about how much I use different apps on a daily basis in the clinic, on the field or in the classroom.

This also gave me the idea of telling you all about ten different apps that I find myself using quite frequently. I am always looking for more apps that will help keep me organized and productive so if you have any suggestions please feel free to comment below.

I have both an iPad and a Samsung Galaxy S4 so this list will include both android and Apple apps but many are available to users of many different devices. Now onto the list and in no particular order...

Jul 30, 2013

My First Guest Blog at ATCHacks!

For my second and final year of graduate school I will be featured as a semi-regular guest blogger at ATC Hacks. The series will be called "Grad Life" and as you might guess it will be about my time as a graduate student and graduate assistant athletic trainer.

I will be discussing things like advice for prospective graduate students, reflections on my own experiences, and anecdotes related to my own trials and tribulations. Here is a link to my first post! It isn't very long or informative, it is just more of an introductory post! This is the same website that featured me on their "In The ATR" series and you can find that post here if you haven't checked it out yet.

My next post will be my 50th blog post which I am considering a mini milestone, so I hope that I can make it something interesting for you all! To also go along with that piece of news is the fact that you can now type in and it will redirect you to my site. No more worries about the long URL or spelling rehabilitate correctly! ;)

Jul 18, 2013

I'm Getting Heated About The Heat

No, Not This.

Nor This!

This is the type of heat that I am talking about.

     Here comes another rant or a pet peeve that I have related to recent warm weather and people exercising in it. Just like this photo displays I hate that people think safely exercising in warm weather is all about preventing dehydration, and drinking copious amounts of fluids. Some athletes and coaches think that they can work vigorously and non-stop in extreme conditions as long as there is an adequate water supply. It doesn't matter how much you drink, it won't prevent your core body temperature from rising. The real danger is exercising in a way that allows the core temperature to reach unsafe levels where heat stroke can occur.

Jul 17, 2013

Stay A-Head of the Game: Concussion Literature

Concussions are still a hot topic and will continue to be for the foreseeable future. The media loves to discuss them, coaches loathe them, parents fear them, and the research is still within its infancy. It isn't time for anyone to jump to conclusions or panic but it is definitely a good time to stay informed and properly educated on the topic.

This blog post came as a result of the latest edition of the Journal of Athletic Training, which had several concussion related articles. To begin the issue there was a special editorial written by concussion research expert, Kevin Guskiewicz, PhD, ATC, FNATA, FACSM. He is also the chair of the Department of Exercise and Sport Science at the University of North Carolina at Chapel Hill.
Dr. Guskiewicz recommends that sports medicine professionals stay informed on upcoming concussion research to be published within the next 6 months. 

This includes the ‘‘Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport, Zurich, November 2012’’ that was published in this edition of the Journal of Athletic Training and originally published in the British Journal of Sports Medicine in March, 2013. He advises that these documents "will define the standard of care for athletic trainers and team physicians for at least the next 4 to 5 years. These documents are very well prepared and will make significant contributions to the sports medicine community." 

He also had these three major closing points:

  1. Read these documents,
  2. Develop and implement a sound concussion-management program and policy
  3. Check the boxes each time you manage a patient with a concussion. 

Dr. Guskiewicz had one last closing piece of advice that is very important for concussion management but is applicable to everything we do as clinicians and arguable important for any person to learn. I know football season for me is fast approaching so I know I need to make sure I get caught up on my concussion literature.  I will leave you with his advice in quotes and a link to the latest journal issue!

"But just as important, be sure you go the extra mile to educate yourself and your athletes and to ensure that both you and your athletes are protected. "

Jul 14, 2013

Biphasic or Premod? Who cares!

Therapeutic modalities had an entire course devoted to it in my educational curriculum and there is more and more research being done on the topic. There is plenty to learn about the theory and application of each individual type of modality from ultrasound to electrical stimulation and plain old ice.

I definitely learned a lot and the use of modalities has been definitely beneficial for me as a clinician, especially for acute injuries. However, I have found myself and others at fault for relying upon modalities too much. There are too many clinicians relying upon the "powers" of modalities instead of using the power of movement and rehabilitative exercises. I'm not saying that they don't have their place because they definitely do but they often are too heavily relied upon.

Jul 10, 2013

ATC Hacks Profiles Moi! And More!

I was recently asked by the guys over at ATCHacks if I was willing to answer some questions for their "In The ATR" series. I have been following @ATCHacks on twitter for awhile now and I love what they have been doing, what they are about and how they are doing good things for the profession of Athletic Training. Their "In The ATR" series features athletic trainers and asks them questions about their history, methods, tips and med-kits. 

I was not only honored to have them ask me to be part of In The ATR, but they have also asked me on to regularly guest blog for them about my experiences as a graduate assistant athletic trainer. This next year is going to be an exciting and fast paced time for me! Head on over ATC Hacks to see their feature on me and don't be afraid to register at their site to get full access to their information for free. They have some insightful articles for athletic trainers and aspiring athletic training students.

Jul 2, 2013

3 Lessons I Learned In My First Year As A Clinician

I am quickly reaching my one year anniversary since finishing my undergraduate education and becoming a certified athletic trainer. A lot has happened since then including starting work on my master's degree, my master's thesis and working with many different athletes and teams via my graduate assistant position. I have learned a lot and it would be impossible to list everything but I figured it would be a good idea to reflect back on a few major themes.

Jun 20, 2013

Building Bridges: Inter & Intra-Profession Collaboration

Somehow, someway during my initial years of schooling I developed this idea that the profession of athletic training needed to compete heavily with other professions. I used to think that I needed to boycott the teachings of other professions like physical therapists, strength and conditioning specialists and person trainers.  I also had an urge to compete against others within my own profession and try to be most intelligent or most competent clinician/academic. Finishing school and starting my professional career has definitely changed my thought processes.

While some level of competitiveness is necessary in a world where multiple professions compete for patients or clients from the same pool of people due to similar skill sets. However, I have begun to realize that this previous thought process hurt three groups of people. Thinking and behaving the way I did disadvantaged myself (the clinician), potential patients, and the different professions.

Recently, I have worked to open myself up to the ideas of others and other professions. Just think, where would human intelligence even be now without the collective body of knowledge that is shared between individuals? We might be able to think the same but the accumulation of knowledge that is passed around and down through time is what makes it special.


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