Author: clm16105

National Winter Sports Traumatic Brain Injury (TBI) Awareness Month

Brad Endres, MS, ATC, CSCS

Assistant Director of Sport Safety, Korey Stringer Institute

The new year is upon us, and with the changing of the calendar comes the increased participation in our beloved winter sports. Fittingly, January is National Winter Sports Traumatic Brain Injury (TBI) Awareness Month, so before you dust off the skates or head up the ski-lift, here is a breakdown of what you need to know to stay safe out on the slopes or in the rink.

What is a traumatic brain injury (TBI)?

The types of traumatic brain injuries include sport-related concussion (SRC), diffuse brain injury, second impact syndrome, subdural hematoma, and epidural hematoma.  Although cerebral concussions rarely cause death, they can be the starting point for other deadly brain injuries.

 

How often does TBI occur?

Between 1.6 million-3.8 million TBIs are seen in sports each year in the United States. Athletes under the age of 15 represent the majority of TBIs. Also, in every age group males show a higher rate of TBIs than females.

 

What is a sport-related concussion?

According to the 5th International Conference on Concussion in Sport held in Berlin, October 2016, a SRC is defined as a TBI induced by biomechanical forces. Several common features that may be utilized in clinically defining the nature of a concussive head injury include:

  • SRC may be caused either by a direct blow to the head, face, neck or elsewhere on the body with an impulsive force transmitted to the head.
  • SRC typically results in the rapid onset of short-lived impairment of neurological function that resolves spontaneously. However, in some cases, signs and symptoms evolve over a number of minutes to hours.
  • SRC may result in neuropathological changes, but the acute clinical signs and symptoms largely reflect a functional disturbance rather than a structural injury and, as such, no abnormality is seen on standard structural neuroimaging studies.
  • SRC results in a range of clinical signs and symptoms that may or may not involve loss of consciousness. Resolution of the clinical and cognitive features typically follows a sequential course. However, in some cases symptoms may be prolonged.

 

What are the signs and symptoms of a SRC?

The suspected diagnosis of SRC can include one or more of the following:

  1. Mechanism of Injury (eg, direct blow to the head)
  2. Physical signs (eg, loss of consciousness, memory loss, neurological deficit)
  3. Balance impairment (eg, unsteady gait)
  4. Behavioral changes (eg, irritability)
  5. Cognitive impairment (eg, slowed reaction times)
  6. Sleep/wake disturbance (eg, sleepiness, drowsiness)
  7. Signs and Symptoms including the following:
Signs Symptoms
  • Disorientation, confusion
  • Retrograde/anterograde amnesia
  • Loss of consciousness
  • Automatism
  • Unequal pupil size
  • Combativeness
  • Slowness to answer questions
  • Loss of balance
  • Atypical behavior/personality changes
  • Vacant stare
  • Nystagmus
  • Headache
  • Nausea
  • Balance issues/dizziness
  • Tinnitus (ringing in the ears)
  • Diplopia (double vision)
  • Blurred vision
  • Trouble sleeping
  • Trouble concentrating
  • Memory issues
  • Irritability, sadness,
  • Sensitivity to light or noise

 

What to do if a TBI / SRC is suspected?

Any person suspected of a SRC should be removed from the mountain or event area immediately and evaluated by a licensed healthcare professional who is trained in the evaluation and management of concussions. The injured person suspected of a SRC should not return to activity on the same day as injury. Finally, continued monitoring of an athlete evaluated of having a SRC is necessary in order to observe any deterioration of physical or mental status (which warrants transport to local healthcare facility).

 

How do you treat an individual with a TBI / SRC?

After being evaluated by a health professional, treatment and management of a TBI/SRC includes:

  • Physical and Cognitive Rest: Physical and Cognitive activities that result in an increase in symptoms should be avoided during the acute phase of concussion treatment
  • Medications that mask the symptoms of a concussion (NSAIDS, Aspirin, stimulants, and antidepressant) should be avoided, especially in the acute phase of the injury.
  • The use of acetaminophen (Tylenol) may be considered in treating symptoms such as headache but should be used after the acute phase of the injury
  • Athletes sustaining a concussion should have a follow-up appointment with their general practitioner to evaluate the mechanism of injury, the course of symptoms, and any previous history of concussive injuries.
  • Return-to-play following a concussion should follow a graded return-to-play protocol. This protocol should consist of 5-7 stages and take 5-7 days to complete (if there is no recurrence of symptoms). The graded return to play protocol should begin once the athlete has a cessation of symptoms for at least 24 hours. An athlete must be prohibited from returning to activity if they are still experiencing symptoms.
  • The goal of the return to play protocol is to progressively increase the duration and intensity of exercise to ensure that there is no return of symptoms with physical exertion. See the table below to see an example of a 6-stage return-to-play protocol.
Rehabilitation Stage Functional Exercise at each Stage of Rehabilitation
1.  No activity Complete physical and cognitive rest
2.  Light aerobic exercise Walking, swimming, or stationary cycling keeping intensity <70%
No resistance training
3.  Sport specific exercise Skating skills in ice hockey, slide board for skiing, general agility drills
No head impact activity
4.  Non-contact training drills Progression to more complex training drills (eg: passing drills in ice hockey, bunny slopes for skiing/snowboarding)
May begin progressive resistance training
5.  Full-contact practice Participate in normal training activities
6.  Return to play Normal game play or event competition

 

How do I prevent a TBI / SRC?

Based on the most updated consensus statement created by a committee of sports medicine professionals at the 5th International Conference on Concussion in Sport, the following steps were recommended for TBI prevention:

  • Protective Equipment: There is sufficient evidence in terms of reduction of overall head injury in skiing/snowboarding to support strong recommendations and policy to mandate helmet use in skiing/snowboarding. The evidence for mouthguard use in preventing SRC is mixed, but suggests a positive trend towards a protective effect in collision sports (such as hockey).
  • Rule Change/Risk Compensation: The strongest and most consistent evidence evaluating policy is related to body checking in youth ice hockey (ie, disallowing body checking under age 13), which demonstrates a consistent protective effect in reducing the risk of SRC.
  • Aggression/Violence: Appropriate competition and the aggressive nature of some sports is not discouraged, however unnecessary violence or other aspects should be evaluated based on the merit they provide in the sport.
  • Education: The ability to detect and deal with a TBI is enhanced when everyone on the slope or ice is looking out for the safety of the athletes.  Education should include the athletes themselves, coaches, administrators, and parents.  It should cover basic tools for recognition, what to do if they suspect a concussion, and the process of treatment and returning to participation.

What are the risk factors for SRC?

  • Previous concussions: A previous history of a concussion increases the risk of sustaining another concussion on the order of 2-5.8 times greater risk
  • Number, severity and duration of symptoms: Evidence has shown that those who report a greater number of symptoms, or report a greater severity of symptoms or duration, may experience a longer recovery than those who experience less severe symptoms.
  • Sex: Research has shown that females experience a higher incidence of concussion in addition to reporting a increased number/severity/duration of symptoms, and prolonged recovery.
  • Age: Young athletes may experience a prolonged recovery from a concussion and may be due to the differences in the developing brain of a child/adolescent compared to that of an adult brain
  • Sport, position, and style of play: Depending on the sport, position, and the athlete’s style of play increases the risk of concussion. In sports where there is player-to-player contact, the risk of concussion increases. The table below outlines the incidence the risk of concussion for various sport.
  • Mood Disorders: Mood disorders such as depression, anxiety, and irritability may complicate both the diagnosis and management of a concussion
  • Learning disabilities and attention disorders: Learning disabilities such as ADD/ADHD or others that result in some form of cognitive dysfunction can complicate the management of a concussion and may lead to a longer recovery time post-concussion

So bundle up, have fun, and most importantly stay safe this Winter! For further information, check out the TBI page at the Korey Stringer Institute’s website at https://ksi.uconn.edu/emergency-conditions/traumatic-brain-injury/. The 5th International Conference on Concussion in Sport publication can be found at https://bjsm.bmj.com/content/51/11/837.full.pdf.

KSI Summer 2018 Conferences

 

 

 

 

 

 

 

 

2018 ACSM National Conference

Yasuki Sekiguchi, MS, CSCS, Associate Director of Athlete Performance and Safety

The American College of Sports Medicine (ACSM) Annual Meeting was held in Minneapolis from May 29 – June 2. Most of the KSI staff attended this outstanding conference and they were honored with the opportunities to present their research. We had great discussions with other attendees and received feedback for future work via these presentations.

  • Douglas J. Casa, PhD, ATC, FACSM- Alcohol and hydration
  • Ryan M. Curtis, MS, ATC, CSCS- The effects of sleep duration on sleep quality in elite soccer athletes
  • Courteney L. Benjamin, MS, CSCS- Sleeping patterns of NCAA D1 collegiate athletes: A sex comparison
  • Gabrielle EW. Giersch, MS- Validity and reliability of a short-based integrated GPS sensor
  • Gabe also did an excellent job as a moderator of the hydration thematic poster session with Dr. Cheuvront
  • Rachel K. Katch, MS, ATC- Effects of wrist cooling on balance and cognitive performance in the heat
  • Yasuki Sekiguchi, MS, CSCS- Factors influencing hydration status during a NCAA Division 1 soccer preseason
  • William M. Adams, PhD, ATC- Hormonal, steroidal and inflammatory responses in collegiate male soccer players and female cross-country runners
  • Yuri Hosokawa, PhD, ATC- Comparison of rectal temperature responses during a modified heat tolerance test

Attending this conference allows the KSI staff to obtain further knowledge, skills and new ideas as well as make new relationships with other professionals. This conference certainly helps to develop KSI and execute our goals to maximize performance, optimize safety and prevent sudden death for the athlete, soldier and laborer. The KSI staff members are thankful to all of the presenters and attendees for their contributions to this field as well as helping make this conference one where individuals who are passionate about similar topics can meet, collaborate, and enjoy one another.

 

 

 

 

2018 NATA Clinical Symposia

Alicia Pike, MS, ATC, Director of Education

View of the Mississippi River near the Convention Center

During the last week of June, a majority of the KSI staff traveled to the “Big Easy” for the 69thannual National Athletic Trainers’ Association Clinical Symposia. New Orleans may have been ready for us, but we sure weren’t ready to face the very hot and humid days. Despite the sweltering weather, this year’s conference was filled with presentations and meetings that not only showcased the numerous projects KSI is actively engaged in, but also served as a platform to continue our mission of optimizing safety and preventing sudden death in sport.

 

The week kicked off with our Medical & Science Advisory Board Meeting at one of Dr. Casa’s favorite restaurants – Bubba Gump Shrimp Co. We were very thankful to have so many familiar faces in the room, and even saw a little competitiveness come out in a friendly game of Bubba Gump Trivia. Following dinner and a lot of laughs, Dr. Casa spoke to the Board regarding the recent accomplishments of KSI, especially three primary initiatives that have been the focus over the last couple years: (1) the ‘Raise Your Rank Campaign’, a state-specific approach aimed at improving mandated best practices policies to reduce catastrophic injuries in sport, (2) the Athletic Training Locations and Services (ATLAS) database, which has now officially mapped the extent of athletic trainer services provided to every public and private secondary schoolacross the United States, and (3) the Perceptions of Athletic Training study, which is currently assessing perceptions of the profession from athletic directors, principals, superintendents, legislators, coaches, and parents in order to develop educational strategies to further raise awareness of the value of the athletic training profession.

The remaining days of the conference flew by, as they always do, with various presentations by our staff members. The following presentations showcased the work of KSI at this year’s conference:

  • Rebecca Stearns & Alicia Pike- Legislators Perceptions of the Athletic Training Profession
  • Samantha Scarneo- Implementation of Emergency Action Plan Policies in Secondary School Athletics Without Previous Athletic Training Services
  • Brad Endres- Epidemiology of Sudden Death in Adult Organized Recreational Sport in the United States, 2007-2016
  • Robert Huggins:- Athletic Trainer Services in the Secondary School Setting: The ATLAS Project
  • Rebecca Stearns- Heat Tolerance Test Results from Exertional Heat Stroke Patients Receiving Cold Water Immersion Treatment
  • Sarah Attanasio- Athletic Trainer Education Level and Employment Models: The ATLAS Project

In addition to the presentations, our staff enjoyed manning the KSI booth at the NATA Expo. We love when people stop by; even if it’s to tell us a personal story, talk to us about one of our presentations they attended, or reach out to us as a resource for whatever circumstance they may be encountering in their current clinical position or state. Every year we have more attendees stop by and share with us how they’ve heard about KSI or thank us for the work we do to improve health and safety for student-athletes. It really is the biggest motivation to continue our mission day after day.

The 2018 conference was a unique one for KSI, since we also held two separate events to raise awareness and support initiatives we are currently engaged in. The first was a ‘launch event’ for the Comprehensive Safety Initiative (CSI), a collaborative effort between KSI, University of Connecticut, University of North Carolina at Chapel Hill, and Player’s Health, to help secondary school athletic trainers identify areas for improvement related to health and safety best practice adoption. A comprehensive library of resources will be accessible on the Player’s Health platform by the end of 2018. All secondary school athletic trainers are encouraged to complete the Safety Needs Assessment located at: assessment.playershealth.com.

The second event was held for all athletic trainers currently employed at high schools who were recipients of the NFL Athletic Trainer Pilot Grant, an initiative aimed at providing secondary schools with resources to start or enhance their athletic training programs. June 2018 marked the end of year one of the pilot grant program, so we invited the athletic trainers currently employed at these schools to attend the meeting, provide them with more detailed information related to the grant program, but more importantly, debrief about their first year and offer as much support to them as possible. The meeting was a success, and not only gave us the chance to meet the athletic trainers in person, but also served as a platform to receive valuable feedback to improve the program in the next two pilot years.

Now the conference really can’t be all work and no play…when in New Orleans, do as the New Orleaners do! We were very fortunate to have our own personal tour of the city from a KSI benefactor, massive supporter, and close friend of Dr. Casa’s, Scott Chafin. Scott, along with colleagues from his law firm, brought us around NOLA for four hours of unforgettable fun. From the Garden District, to an amazing seafood dinner, followed by authentic Italian dessert, and of course, some trolley karaoke, it was a night we are forever thankful for and will never forget.

 

 

It was a very busy, yet rewarding week, and the perfect opportunity to share the work of KSI with athletic trainers across the country. Perhaps my favorite quote of all time is “Alone we can do so little; together we can do so much,” and this year’s conference truly made me realize how muchwe’ve done and how muchwe will continue to do.

 

 

 

 

 

2018 Hydration for Health Conference 

Gabrielle Giersch, MS, Associate Director of Research

 

I had the great opportunity to attend the 10th Annual Hydration for Health Conference in Evian, France. I was able to present research from a study done in collaboration with Dr. Lawrence Armstrong and Dr. Elaine Lee that investigated the role of fluid restriction on perceived sleep duration and quality. This research was presented as a part of the “Pitch Your Science” contest for the Young Researcher Award that consisted of a consolidated 3-minute presentation in a specific session of the conference. This conference is unique in that it unites several disciplines all with specific interest in hydration for health outcomes. This conference provides a great opportunity for a variety of disciplines to discuss with international colleagues on the role of hydration on overall health.

 

 

 

 

 

 

2018 NSCA National Conference

Courteney Benjamin, MS, CSCS, Director of Education & Associate Director of Athlete Performance and Safety

The 2018 NSCA National Conference was held in the beautiful city of Indianapolis, Indiana- home to the NCAA and ACSM headquarters. Members of KSI had the great opportunity to present some of our research during this July conference.

  • Yasuki Sekiguchi- Relationships between resting heart rate, heart rate variability, and sleep characteristics among female collegiate cross-country athletes
  • Ryan Curtis- Sleep Distribution and heart rate-derived autonomic nervous system responses to acute training load changes in collegiate soccer players
  • Courteney Benjamin- Effects of Early Morning Training on Sleep in NCAA Division 1 Female Cross-Country Runners

I was also awarded the opportunity to give a featured presentation titled, “What S&C coaches need to know to prevent sudden death in sports.” During this talk, I reviewed the 2012 best practices document related to collegiate strength and conditioning as well as discussed how this profession can continue to advance by ensuring the safety of athletes.

This talk could not have come at a better time as the NSCA president, Dr. Greg Hoff would announce exciting changes surrounding requirements for obtaining a CSCS certification at the opening ceremonies. According to an article released by the NSCA on July 12th, 2018 the certification process will change as follows.

There will be two principal changes to the certification process:

  1. Effective target date 2030, all CSCS exam candidates must hold a Bachelor’s degree in a strength and conditioning related field, or be enrolled as a senior in such a program.
  2. Effective target date 2030, candidates will need to obtain those degrees from a college or university that has a program accredited by an NSCA-approved accrediting agency.

This conference was a great opportunity to meet other professionals in this field as well as establish relationships for future collaborations. We look forward to attending this conference again next year!

 

Loudoun County Public Schools Approves EHS Protocol

Paul A. Peterson MA, LAT, ATC

Athletic Trainer, Woodgrove High School

(May 17, 2018 Virginia)-  We are proud to announce that Loudoun County Public Schools has approved an exertional heat stroke (EHS) protocol that includes the use of rectal thermometry.  We hope this decision will encourage other secondary school districts in the state of Virginia and throughout the United States, who are having difficulties convincing their administrators the vital importance of rectal thermometry, to continue their pursuit.

In the past, our school district administration was adamantly opposed to approving rectal thermometry.  They denied our athletic trainers, on numerous requests, permission to purchase and use rectal thermistors.  Ironically, this past fall, one of our student-athlete cross-country runners suffered EHS during a championship meet.  The athletic trainers and EMS volunteers immediately assessed the student-athlete’s internal body temperature at 107.7°F via rectal thermometry, placed him in an ice water immersion tub and didn’t transport him to the ER until his internal body temperature dropped to 102°F.  Fortunately, the student-athlete was released from the ER later that night with no organ damage and made a full recovery.

By following best practice guidelines in the treatment of EHS, the athletic trainers and EMS volunteers, almost certainly prevented a catastrophic outcome.  This incident, once again, brought the need for our school district administration to approve the use of rectal thermometry in the treatment of EHS to the forefront.  After an eight-month process to help educate the administration on the vital importance of rectal thermometry, we finally received consent and this policy is now officially part of our EHS protocol.

This policy implementation would not have been possible without the support of several individuals. First and foremost, we had the support of our Athletics Supervisor. Second, we received support and the go ahead from our Health Services’ Supervisors and Director.  Third, we received support and further go ahead from our Risk Management Supervisor.  Then finally, we received approval from our School Administration Director to include our EHS protocol in the LCPS policies and procedures section of the student-athlete handbook.

The key to our success was a team effort approach.  With help and support from many individuals most notably, the LCPS athletic trainers, the orthopedic physicians and staff from The National Sports Medicine Institute (NSMI), the researchers at the Korey Stringer Institute (KSI), Dr. Kevin Miller at Central Michigan University, and Darryl Conway at The University of Michigan, we were finally able to convince our administration to allow the medical professionals in the school system to make the medical decisions and act within published best practices.

With patience and perseverance, the LCPS athletic trainers were able to accomplish the goal of getting an appropriate EHS protocol approved to ensure the future health and safety of LCPS student-athletes who may suffer from EHS.

Korey Stringer Institute Announces 2018 Lifesaving Awards

KSI Perfomance/Safety Logo(May 14th, 2018) — The Korey Stringer Institute (KSI) is proud to honor three individuals for theiroutstanding contributions to preventing sudden death in sport through the KSI’s 2018 lifesaving awards.The awards were presented at NFL headquarters in New York City, NY during the KSI’s annualfundraising gala on May 10, 2018.

Located at the University of Connecticut, the Korey Stringer Institute is a national research and advocacy organization dedicated to maximizing performance, optimizing safety, and preventing sudden death among athletes, warfighters, and laborers.

The 2018 award recipients are:

KSI Lifesaving Research Award

This award recognizes exceptional dedication and work in research aimed to advance knowledge regarding the prevention of sudden death in sport.

Scott Anderson, ATC

Head Athletic Trainer University of Oklahoma

The head athletic trainer for the University of Oklahoma since 1996, Scott Anderson is currently president of the College Athletic Trainers’ Society and the Big 12 Conference representative to the NCAA Concussion Safety Committee. He is former co-director of the Summit on Safety in College Football (2014, 2016). His prior service includes

membership on the NCAA Concussion Task Force (2014) and the Inter-Association Task Force on Safety in Football: Off-Season Conditioning (2012). He was co-chair of the National Athletic Trainers’Association Inter-Association Task Force on Sickle Cell Trait in Athletes (2007) and a member of the Inter-Association Task Force on Exertional Heat Illness (2003). He served as chair of the Big 12 Conference Medical Aspects of Sport Committee from 1999 to 2002.

Recognitions: College/University – Athletic Trainer of the Year 2006; All-American Football Foundation, Inc – Outstanding Athletic Trainer 2005; and 2000-01 Big 12 Conference Athletic Training Staff of the Year, and Oklahoma Athletic Trainers Association Hall of Fame.

KSI Lifesaving Service Award

This award recognizes exceptional service aimed to improve policies and advocate for the adoption of policies in order to reduce sudden death in sport.

Larry Cooper, MS, LAT, ATC

Teacher & Athletic Trainer Penn-Trafford High School

Larry Cooper has been a tireless advocate for secondary school athletic trainers.

He has been involved locally, regionally, and nationally on various committees, projects, and several inter-association task forces. Recently, he served as the NATA Secondary School Athletic Trainers Committee (SSATC) Chair and also the District 2 SSATC Representative. Cooper has been a teacher and certified athletic trainer for 35 years. For the last 27 years, he has served as a sports medicine, health, and physical education instructor at Penn-Trafford High School in Harrison City, Pennsylvania. Cooper has also served as a member of the National Federation of State High School Associations (NFHS) Sports Medicine Advisory Committee. In addition, he has held numerous positions within the Pennsylvania Athletic Trainers Society (PATS) including being a member of the Board of Directors and Secondary School Committee Chair. Cooper is a founding member of the Western Pennsylvania Interscholastic Athletic Leagues (WPIAL) Sports Medicine Advisory Committee. He continues to work as a master assessor for the Pennsylvania Interscholastic Athletic Association’s (PIAA) Wrestling Weight Loss rule. Cooper has been an active member in the KSI’s ATLAS Projectsince its inception. This collaborative effort between the NATA and KSI has led to new policies and policy changes that have increased secondary school athlete safety across the country.

Cooper was inducted into the Pennsylvania Athletic Trainer Hall of Fame in 2014. He received the NATA Athletic Trainer Service Award in 2014 and the NATA Most Distinguished Athletic Trainer Award in 2016. In addition, he received the School Health/ Training and Conditioning Magazine Most Valuable Athletic Trainer Award in 2015; The Micro Bio-Medics Scholastic Athletic Trainer Award in 2003; the PATS Service Award in 2005; and the PATS Distinguished Merit Award in 2011.

His favorite role has been that as loving husband to Lisa and father to their three daughters, Sara, Molly, and Delaney.

KSI Lifesaving Education Award

This award recognizes exceptional work to advance knowledge and education in the realm of preventing sudden death in sport.

Cindy Chang, MD

Professor, Primary Care Sports Medicine University of California San Francisco

Dr. Cindy Chang is a primary care sports medicine physician specializing in the prevention, diagnosis, and treatment of injuries and illnesses related to exercise and sports participation in children and adults.

She serves as chair of the California Interscholastic Federation’s SportsMedicine Advisory Committee, and also served on the Sports Medicine Advisory Committee for the National Federation of State High School Associations (NFHS). She is a board member of Racing Hearts, a non-profit organization that increases awareness of and improves access to automated external defibrillators (AEDs) in communities. After co-founding the California Concussion Coalition, Dr. Chang is now co-chair of the Sports Concussion Program at UCSF Benioff Children’s Hospital. She was an elected four-year member of the Board of Directors for the American Medical Society for Sports Medicine (AMSSM), one the largest organizations of primary care sports medicine physicians in the world, and later served as its President in 2011-2012. She is also a fellow of the American College of Sports Medicine (ACSM) and is currently an elected member of its Board of Trustees.

Dr. Chang has worked at the U.S. Olympic Training Center in Colorado Springs and was part of the USA medical team for the Winter Paralympic Games in Nagano, Japan, in 1998 and in Salt Lake City in 2002. She served as Chief Medical Officer for the USA delegation at the 2007 Parapan American Games in Rio de Janeiro, the 2008 Summer Paralympic Games in Beijing, and the 2012 Olympic Games in London.

She was the 2003 recipient of the AMSSM Founders Award, given to a sports medicine physician who demonstrates outstanding professional achievement and service to the community. She was also selected to receive the 2013 Dr. Ernst Jokl Sports Medicine Award, given annually to an individual for his/her contributions to the growth and development of sport medicine through practice and/or scholarly activity. In 2016, Dr. Chang was honored with the National Athletic Trainers’Association Jack Weakley Award of Distinction, for a lifetime of outstanding contributions that directly impact health care in the area of athletics, athletic training, or sports medicine and are of major and lasting importance.

Dr. Chang is currently a Clinical Professor at the University of California San Francisco in the Departments of Orthopaedics and Family & Community Medicine. She continues at Cal as a team physician and sports medicine consultant, and volunteers as the team physician at Berkeley High School. She is very invested in supporting her athletic trainer colleagues and advocating for their licensure inCalifornia. Chang is medical director of Emergency Education Services at UCSF Benioff Children’sHospital, and has become credentialed to train others including athletic trainers to become certified instructors in First Aid and CPR/AED. She frequently speaks to community groups, schools, club teams, and the media on a wide range of topics affecting the health and safety of our young athletes.

 

New Jersey Champions Sports Safety Campaign

KSI Logo

New Jersey Leads National Effort to Adopt 

Lifesaving Measures for High School Athletes

 

“Raise Your Rank” campaign encourages all states to adopt important safety guidelines

NEW JERSEY– Many states across the country are not fully implementing important safety guidelines intended to protect student athletes from potentially life-threatening conditions. Research has shown that nearly 90 percent of all sudden death in sports is caused by four conditions: sudden cardiac arrest, traumatic head injury, exertional heat stroke, and exertional sickling. Adopting evidence-based safety measures significantly reduces these risks. With more than 7.8 million high school students participating in sanctioned sports each year, it is vital that individual states begin taking proper steps to ensure their high school athletes are protected. The call for action came this past fall when the University of Connecticut’s Korey Stringer Institute (KSI), a national sports safety research and advocacy organization, released a comprehensive state-by-state assessment of high school sports health and safety policies. New Jersey currently ranks 4thnationally in terms of meeting all of the recommended safety guidelines with a score of 67%.

 

KEY INITIATIVES:

In response to the findings, New Jersey officials are collaborating with the KSI in addressing existing gaps in state policy to improve high school athlete safety. New Jersey is the first state to join the KSI’s national “Raise Your Rank” campaign, which started in 2018. The campaign aims to raise funds to support meetings with state representatives in order to improve mandated best practice policies and increase implementation of those policies.

 

“With support and guidance from the experts at the Korey Stringer Institute, the New Jersey State Interscholastic Athletic Association and Senator Patrick Diegnan (D-Middlesex) will convene this week to begin taking the necessary steps to improve the health and safety of our secondary school athletes,” says David Csillan (Ewing HS Athletic Trainer and NJSIAA Sports Medicine Advisory Committee). “Our goal is to be the first state to be 100% compliant with the recommended safety guidelines.”

 

This is not the first time New Jersey has led the way in improving the health and safety of high school athletes.  New Jersey was the first state to implement heat acclimatization policies for high school athletes in 2011. Acclimatization policies require teams to allow athletes to adjust to hot conditions in late summer by phasing in practices, participating without heavy equipment, and requiring frequent breaks to allow athletes to recover and stay hydrated. Since 2011, six states have implemented similar heat acclimatization policies with positive results; there have been no reports of exertional heat stroke deaths in states where acclimatization policies are in place and properly followed.

 

“A hallmark of my tenure of as a legislator, working collaboratively with the Athletic Trainers’ Society of New Jersey, is to make New Jersey high school sports safer for our children by creating researched-based state policies to address preventable sudden deaths,” says Sen. Diegnan. “My hope is that through this conscientiousness partnership, we will shine a light on the great measures this state legislature has taken to restrict cardiac arrest, exertional heat stroke, and head injury deaths in our student athletes and to develop further needed changes to ensure all athletes enjoy their high school sports experiences — and live to tell about them.”

 

KSI CEO Douglas Casa has been leading KSI since its inception in 2010 and has made athlete safety a focused effort of the institute. “We know that implementation of these important health and safety policies has dramatically reduced sport-related fatalities,” says Casa. “We are excited that New Jersey is taking action to continue to improve its policies and become a leader in minimizing sport-related high school deaths.”

 

For more information about the Raise Your Rank campaign, including how to apply for KSI support and how to donate to the cause, please visit ksi.uconn.edu.

 

 

 

Media Contacts

Douglas Casa, Korey Stringer Institute, UConn                      David Csillan, NJ Sports Medicine Advisory Committee

Douglas.casa@uconn.edu                                                                     njatc5@gmail.com

(860) 486-0265 (office)                                                                         (609) 651-3053 (cell)

 

 

ATLAS Update

Sarah Antasio, ATC

Assistant Director of Research

As of February 21st 2018, the ATLAS project is 100% Mapped. Translation = we have identified every high school with an athletics program in the United States (including the District of Columbia) and whether or not the student-athletes have access to an athletic trainer (AT). We have identified 20,443 high schools, those being public, private, magnet, alternative and special education schools. Within these high schools we have identified a total of , working either full or part time and providing care for the student-athletes during treatments and rehabilitation programs, practices and game competition.

A mission of KSI is to promote the athletic training profession as well as increase the number of ATs and appropriate health care provided to the athletes across all levels of sport. Our ATLAS data has determined that 66% (n = 13,492) of schools with athletic programs have access to an AT in some capacity. The National Athletic Trainers’ Association District 2 (DE, NY, NJ, PA), has the highest percentage of ATs, providing 57% of full-time coverage and 25% part-time.

The ATLAS survey began in June 2015 and we currently have a 49% completion rate. Surveys  have been completed by secondary school athletic trainers throughout the country.

The ATLAS project is a thirteen-person staff, consisting of 1 KSI faculty member, Dr. Robert Huggins, 2 Masters’ students: Brad Andres and Sarah Attanasio as well as ten undergraduate students volunteering their time to KSI and the project.

Click this link for type of AT services by district

Applied Performance Science: Stress, Travel Fatigue and Recovery Techniques

Ryan Curtis MS, ATC, CSCS

Director of Athlete Safety and Performance

Stress and subsequent fatigue are a normal part of sport and life and often desired in order to augment adaption to training. The concept of periodization, being the organization of training stress and recovery, is usually on the forefront of performance and medical practitioner’s minds. When training and physical stress is balanced with adequate rest and recovery, acute fatigue is often diminished in a matter of hours or days. However, if the body is not allowed to return to a balanced state (homeostasis) before excess stresses are introduced, maladaptation occurs. In optimizing performance for sport or life, it’s important to note that not all stresses are desired or accounted for.In the midst of a hectic season or normal life demands, it’s easy to forget to acknowledge and appropriately prepare for things such as the stress of travel, sleep impairment, poor nutrition and/or hydration and injury. Implementing fatigue countermeasures begins first with recognition of outside stressors and then adherence to a few best-practice techniques.Below are a few visuals to help us become aware of undesired stress outside of training and techniques in combating travel fatigue and promotion of optimal recovery.

2018 Collaborative Solutions for Safety in Sport Florida Meeting

SAMANTHA SCARNEO, PHD, ATC

VICE PRESIDENT OF SPORT SAFETY

Last week, Dr. Casa and I were fortunate to attend the 2018 Collaborative Solutions for Safety in Sport (CSSS) meeting for the state of Florida. Stemming from the national CSSS meeting, the goal for this meeting was to implement the best practice policies at a state level for high school athletes. This same meeting occurred in 2017, and while the program was educational and facilitated some changes, the ultimate goal of the current meeting was to bring well thought-out policies to the sports medicine advisory committee and board of directors to pass. While this program was meant educational, it was not meant to be continuing education; rather a workshop with the goal to create and fully vet the wording of policy to be implemented by the Florida High School Athletics Association.

 

 

 

The program, designed and facilitated by Bob Sefcik, ATC, included dinner and a keynote address from Dr. Casa on Monday evening. Dr. Casa’s presentation provided context to the reasoning behind and the methodology utilized for the creation of the policy rubric and the rankings. Starting bright and early on Tuesday, the meeting was kicked off by Dr. George Canizares and Dr. Casa who discussed the current policies and stated that the current meeting was held based on the foundation that was laid in the 2017 meeting. They also noted that the goal of this meeting was to leave with written policy language.

 

Following the morning speakers, we heard from two families whose children suffered catastrophic injuries while playing high school sports in Florida. Courtney Sapp’s son, Payton, suffered a catastrophic head injury while participating in a junior varsity football. She described the pain and long-term consequences that not only Payton, but her entire family has ensued since his injury. Lori and Ed Giordano’s son, Zach Martin, suffered a fatal exertional heat stroke during a football practice in the summer of 2016. Unfortunately, in both cases, there was no athletic trainer present to care for the safety of the student athletes. Further, the families advocated for increased education of sport related injuries such as concussion, exertional heat stroke, and cardiac arrest. They charged the members in attendance to remember their stories and to do everything in their power to make sports safer.

 

For the purpose of this meeting, there were five specific areas to focus on creating policies for – cold-water immersion, environmental monitoring, concussion, coach education, and minimal expectations for high schools. Each topic area had its own break-out group with a variety of stakeholders (athletic trainers, physicians, administrators, coaches, and parents) represented in each meeting. Prior to the start of the meeting, a white paper document corresponding to the group you were assigned were disseminated, and thus a majority of the discussion surrounded the material provided on this white paper. I was fortunate to facilitate the Environmental Monitoring group with Dr. Seth Smith. Having tangible, realistic goals of creating specific wording for policies from the breakout sessions allowed for a focused message and resulting actionable items for the sports medicine advisory committee (SMAC) to discuss at their meeting that night.

 

I was honored to be invited to the SMAC meeting that evening to provide additional insight and expertise, if needed. The members of the FHSAA SMAC are a very professional, determined and organized with the common goal of wanting to improve the health and safety standards for student athletes. I was very grateful for the invitation, and thoroughly enjoyed listening to the discussions that occurred.

 

To conclude, it was remarkable to see the amount that can be accomplished when key stakeholders within a state, with a common goal, collaborate to improve the current standards. It is truly a team effort and the comradery between the members in attendance was aspiring to be a part of. The policy ranking project was meant to be a project to help states identify areas of strengths and areas of improvement. We are excited to see states such as Florida take the findings of the project and use it as ignition to help improve the safety for our athletes. We fully believe that through policy change at the state level, and thus influencing the local implementation, that we can significantly reduce the amount of catastrophic injuries.

 

I would like to reiterate our deepest gratitude to Bob Sefcick for his generosity, helpfulness and invitation for Dr. Casa and I to participate in this event. We would also like to thank George Tomyn and the FHSAA for hosting the meeting.

98th American Meteorological Society Meeting

Korey Stringer Institute Medical and Science Advisory Board Member

Yuri Hosokawa PhD, ATC

 

As one of my last tasks as the Vice President of Education and Communication, I attended the 98th American Meteorological Society (AMS) Meeting in Austin to present at the joint session, Informing Heat-Health Practitioners to Reduce Risk through Impact-Based Decision Support. The first half of the session was comprised of case study presentations that showcased the use of weather data, such as the wet bulb globe temperature (WBGT), to conduct health risk assessment in public health, occupational health, and athletics. While there still remain limitations in deducing the association between WBGT and health outcomes, use of weather data to make informed decisions for future heat events to minimize its adverse effects on health, economy, and productivity are being investigated across the U.S.A continued effort in observational and intervention-based studies are warranted to identify successful models.

Presentations included in the latter half of the session, including my presentation from the KSI, were reports from current initiatives supported by the National Integrated Heat Health Information System (NIHHIS). The NIHHIS is being developed by the Centers for Disease Control and Prevention (CDC), the National Oceanic and Atmospheric Administration, and domestic and international partners to understand this problem, develop a robust and science-informed response, and build capacity and communication networks to improve resilience. My presentation at the session featured KSI’s on-going inter-agency collaboration in drafting a round table document among athletics, military, and occupational settings to use WBGT for activity modifications in the heat. Other NIHHIS projects featured in the session included a project lead by the National Oceanic and Atmospheric Administration in North Carolina that investigated the use of web-based forecasting tool (Heat Health Vulnerability Tool) by community stakeholders and the Hot Spots project, which aimed to increase the heat resilience in Mexico border region through education and evidence-driven public health interventions.

 

As depicted by presentations in the session, a successful environmental heat risk assessment requires an inter-agency and interdisciplinary network. Projects led by NIHHIS provide great examples for others to follow, and it is no doubt that exercise physiologist and athletic trainers play integral roles in examining the impact of heat.

EATA Meeting 2017

Kelsey Rynkiewicz, ATC, NREMT

Assistant Director of Education

The winter weather did not stop the 70th Annual Eastern Athletic Trainers’ Association (EATA) Meeting and Clinical Symposium from being held in Boston, MA on January 5th-January 8th.

 

The 4-day conference started off with an Educators Conference in which numerous professionals presented information on competency based learning, fostering clinical capabilities, incorporating research components, and integrating evidence based practice within Athletic Training Education. The Educator’s Conference also included a Profession Development & Peer to Peer Session.  Jessica Barrett and Dr. Stephanie Mazerolle, both members of the UConn Department of Kinesiology, facilitated the Young Educators Peer to Peer Session.

 

The EATA Student Program provided additional opportunities for student learning and involvement. The annual District 1 and District 2 Quiz Bowls were hosted Friday night. Patrick Coley, a senior in UConn’s undergraduate Athletic Training Program and the President of UConn’s Athletic Training Society, represented UConn during the District 1 Quiz Bowl. Presentations as part of the Student Program included topics such as Blood Flow Restriction Therapy, Current Topics of Concussion Evaluation and Management, and Prosthetics. There was a panel presentation known as “Stories from The Sidelines” in which panelists discussed their involvement in caring for victims of the Boston Marathon bombing and introduced the ATs Care peer support group.

 

The EATA General Session included a wide variety of presentations including injury response behaviors, eating disorders, athletic insurance, concussions, healthcare communication, and the rehabilitation and treatment of athletic-related injuries.  Attendees also had an opportunity to earn evidence based practice continuing education units which are part of the Athletic Training Board of Certification continuing education requirements.

 

Members of KSI had the opportunity to not only attend the conference, but also share recent research with the Athletic Training community.

 

Dr. Douglas Casa presented a lecture titled “The KSI State Rankings of Health and Safety Policies for High School Athletes: What it Means for the EATA Member States.” Dr. Casa discussed the rankings of the 51 State High School Athletics Associations which were released on August 8, 2017.  The states were ranked based on a 100-point rubric that assessed compliance with the current best practices for health and safety in high school athletics. Dr. Casa focused on the EATA member states and provided suggestions and strategies for improving health and safety standards.

Kelly Coleman presented original research in the form of a poster presentation titled “Junior Faculty Knowledge of Institutional Expectations for Tenure and Promotion.” Justin Rush also presented a poster titled “Spatting Increases Ankle Stability in Collegiate Field Sport Athletes: A Critically Appraised Topic” from his undergraduate work.

 

As always, the EATA provided a great weekend of education, sharing important research, and networking. Next year’s conference will be held in Valley Forge, PA.  We hope to share more research from KSI in the future to continue to educate others and promote the Athletic Training profession.