Author: clm16105

Paving the Way for Heat Safety in Athletes, Warfighters, and Laborers

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Yuri Hosokawa, PhD, ATC

Vice President of Communication and Vice President of Education

 

Every October, members of KSI travel to Washington D.C. to volunteer at the Marine Corps Marathon medical tent. This year’s trip was also a special one because we were able to continue our efforts from last year in building relationships and exchange ideas with the National Oceanic and Atmospheric Administration (NOAA), Uniformed Services University of the Health Sciences (USUHS), the Occupational Safety and Health Administration (OSHA), and the National Institute for Occupational Safety and Health (NIOSH).

 

On Thursday, October 19th, KSI had the honor of gathering representatives from federal sectors that regulate heat activity modification guidelines or study implications of heat in the welfare of warfighters and laborers. The meeting was sponsored by the National Integrated Heat Health Information System (NIHHIS: https://toolkit.climate.gov/nihhis/), whose mission is to understand global health threat from extreme heat, develop a robust and science-informed response, and build capacity and communication networks to improve resilience. Participating agencies of NIHHIS include: Office of the Assistant Secretary for Preparedness and Response (ASP), Centers for Disease Control and Prevention (CDC), United States Environmental Protection Agency (EPA), the Federal Emergency Management Agency (FEMA), NIOSH, NOAA, OSHA, and the Substance Abuse and Mental Health Services Administration (SAMHSA).

 

KSI has a good history in working collaboratively with the occupational and military sectors, however, it was not until last year that we were able to gather representatives from all three sectors– athletic, occupational, and military­– to convene at single location and exchange ideas for future collaborations. Integration of climate and weather data from NOAA is also critical in making data driven decision to enhance the policies and guidelines for the people in these settings who are often exposed to extreme heat. Participants of this year’s meeting are currently working on a manuscript that gathers current consensus regarding heat activity modification guidelines for the physically active population (athletes, warfighters, and laborers), which we hope to release next year.

 

 

On the following day, we attended the IIRM Sports Medicine Conference hosted by the International Institute for Race Medicine, MedStar Sports Medicine, and MedStar National Rehabilitation Network. The meeting was attended by many medical providers and students who were also volunteering at the Marine Corps Marathon. At the meeting, Dr. Douglas Casa gave a presentation regarding wearable technologies in sport. Despite the recent advancement in wearable technology, his presentation warned that there is yet to be reliable, real-time, noninvasive hydration and internal body temperature assessment devices on the market. As the field of wearable technology continues to grow, researchers and clinicians must stay up-to-date with the technology advancement while also acknowledging the technological limitations to make the best-informed decisions about using data from these devices.

 

 

Later in the afternoon of the conference, we also participated in a workshop that was designed to review various treatment algorithms for medical conditions commonly seen at race medical tents in the form of problem-based-learning scenarios.  Exercise-associated collapse, cardiovascular arrest, exertional heat stroke, exertional hyponatremia, exercise associated muscle cramping and bleeding-control were covered in the workshop, all lead by the content experts. The hands-on workshop provided opportunities for young professionals to practice the skills for the first time and stimulated the exchange of various experiences from the veteran providers.

 

 

KSI was stationed at the Aid Station 9 on the day of the race, which was located between mile-21 and 22. The wet bulb globe temperature reading one-hour past the start of the race was in the mid-60’s, but quickly reached the high 70’s by noon, placing this year’s race as one of the warmer race in the history of the Marine Corps Marathon. The coordination of work among the corpsmen, athletic trainers, nurses, physical therapists, and physicians at the aid station was great. We also treated several exertional heat stroke patients on-site, where we made sure to cool the patients below 39°C before transport.

 

Our trip to Washington D.C. is a true demonstration of our mission statement– to provide research, education, advocacy and consultation to maximize performance, optimize safety and prevent sudden death for the athlete, warfighter and laborer. Whether we are treating marathon runners from exertional heat stroke or optimizing the regulations for worker safety in the heat, the physiological premise and impact of exertional heat stress is the “same” across athletes, warfighters, and laborers. Integration of minds across disciplines, such as the NIHHIS meeting, and continued advocacy to provide evidence based exertional heat stroke care are some of the core missions we will continue to carry forward from KSI.  #Strive2Protect

CamelBak Elite Athlete Testing

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Gabe Giersch, MS

Associate Director of Education and Assistant Director of Athlete Performance and Safety

KSI had the awesome, unique opportunity to test two CamelBak sponsored pro-athletes over

the course of two days! The athletes were Lea Davison, a two-time Olympian Mountain Biker (2012 & 2016), and Gediminas Grinius a decorated Lithuanian trail runner. Some very fit, athletically decorated media personnel underwent testing as well. The athletes were able to undergo heat and sweat testing, where they exercised for 60-minutes total. Because it was a hot environment, the athletes were asked to collect their sweat in a specially prepared towel,and atthe end of their hour, we didwhole-body wash downs to collect samples to assess their sweat electrolyte concentrations. Whole-body wash downs are the gold standard for assessing whole-body sweat electrolyte concentration and very few labs across the country still use this technique. Many have moved over to local collection in sweat pouches, which is a great method of assessing local sweat, but not necessarily valid for whole-body calculations.

The athletes were also able to complete an anaerobic threshold test or a VO2max test where we tested their ability to ward-off an accumulation of lactate (a by-product of anaerobic metabolism) where we could extrapolate their anaerobic threshold based on continual readings, or their maximal oxygen uptake by exercising until volitional fatigue, respectively. This was a great opportunity for KSI and allowed us to use our expertise to interact with some incredible athletes.

2017 Summer Intern KSI Fellowship Experience

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Miwako Suzuki, KSI Intern Fellow

My name is Miwako Suzuki, and I am an Athletic Training student at Indiana State University. Gratefully, I was chosen to receive the opportunity to intern at the Korey Stringer Institute in the Summer Fellowship Program. I am originally from Japan, and I studied Athletic Training there as well. While receiving my education in Japan, I found it necessary to learn more about prevention and management of emergency conditions, and this sense of mission brought me to the United States. I became aware of the KSI four years ago when I was still in Japan through Dr. Yuri Hosokawa, Vice President of Education and Communication at the KSI, and I have been attracted to the KSI since then. The past two months and ten days that I spent with the KSI members were full of great experiences and learning.

Among the several projects that I worked on during the summer, the main focus was placed on the Athletic Training Locations and Services (ATLAS) Project. The aim of the ATLAS Project is to determine the extent of current athletic training services provided in the secondary school setting, and it was launched in January 2016 with these goals:

  • Create a real-time database of athletic training services in secondary schools
  • Create a directory for each state’s athletic training association and high school athletics association
  • Assist states in moving toward full-time athletic training services
  • Provide useful data to each state’s athletic training association and high school athletic association
  • Identify common factors associated with increased athletic training services across the country
  • Provide data to assist with legislative efforts to improve healthcare for high school athletes

 

At the beginning of the summer, the ATLAS Project was at the stage of figuring out the extent of athletic training services in the last 10% of high schools that we had been unable to reach. To reach those schools, I have tried multiple methods such as making phone calls, writing emails to athletic directors, and searching their website for athletic trainer’s information. Even though I made some progress with these strategies, the most effective method was reaching out to athletic trainers of the neighboring high schools of the unknown schools for help. From this experience, I have learned firsthand that ATLAS is not only a great database but also a very useful communication tool. While interacting with high school athletic trainers throughout the nation, many of them showed their appreciation and support for this study. I am very grateful to be one of the members to propel this important project forward. I would like to thank Dr. Robert Huggins for including me in this project and always guiding me. I also would like to thank Sarah Attanasio, ATC, for teaching me and providing help whenever I asked.

Testing for the Falmouth Road Race study began in mid July. We conducted a modified heat tolerance test on recreational runners of a wide range of ages who are participating in the New Balance Falmouth Road Race on August 20th, 2017. Although the study will not be completed until the race day, collecting data on individuals’ physiological responses to exercise in the heat was a great learning opportunity for me. I believe that the wide distribution of demographics of this study allowed me to encounter various responses among the subjects. With regard to conducting a laboratory test, I observed the effort of the KSI members to make the study robust. I was very fortunate to learn from such experienced and passionate colleagues. I would like to express my deepest gratitude to Dr. Yuri Hosokawa and Kelsey Rynkiewicz, ATC, for their effort to involve me in this study.

 

On August 20th, which will be my last day as a KSI fellow, I will be at the New BalanceFalmouth Road Race and will serve as a medical volunteer with the KSI staff. The Falmouth Road Race has been recognized for its high incidence rate of exertional heat illnesses because of the environmental conditions and its short duration (7.1 miles), which allows runners to maintain relatively high intensity throughout the entire duration of the course. According to a previous study from the KSI, this race has saved multiple exertional heat stroke patients each year. Since I have never encountered a real exertional heat stroke case, I would like to take this opportunity as a great hands-on learning experience.

 

I appreciate every aspect of the activities that I had the opportunity to take part in at the KSI. The KSI was an even greater place than I expected. All the members are making a great effort for their projects with the strong passion and commitment for the KSI’s mission. I believe that this is the reason why the KSI has been successfully leading our profession. Lastly, I would like to thank Dr. Douglas Casa for providing such a great opportunity. I fully enjoyed summer 2017 with such great colleagues.

NSCA 40th Annual National Conference

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Courteney Benjamin MS, CSCS

Associate Director of Communication and Assistant Director of Athlete Performance and Safety

Members of KSI had the opportunity to travel to Las Vegas, Nevada for the 40th annual National Strength and Conditioning Conference
where strength and conditioning coaches, personal trainers, sport scientists, sport nutritionists, and health enthusiasts gathered to present, network, and honor certain outstanding members.

 

We were fortunate to attend a lecture given by this year’s Sport Scientists of the Year, Shawn M, Arent, and Dave DiFabio from Polar, whom we had the opportunity to work with in the past. They discussed the use of wearable technology and how coaches and sport scientists should start thinking about applying the knowledge we gather from this data to practice.

Ryan Curtis, Yasuki Sekiguchi, and I presented some of the recent research findings from the KSI. I presented a poster titled, “Analysis of Women’s Cross Country Lab Tests Results and Training Over the Course of a Competitive Fall Season” on Thursday (7/13/17). I examined the change in lactate testing, VO2 max and training of the UCONN Women’s Cross Country team during their fall season. The major finding of this study was the vOBLA (velocity at onset of blood lactate) was significantly higher during the middle of the season while VO2 max did not change throughout the season. During my presentation, I was very excited to reconnect with two of my former colleagues from Florida State University. Daniel Shaefer was the former director of strength and conditioning at FSU and is now working on is PhD at the University of Wisconsin-Madison. Jon Jost was the former FSU director of strength and conditioning and recently accepted a position with Gatorade. I am hopeful that we will get an opportunity to collaborate on future research. I also had the fortune to meet Kristen Holmes-Winn, from WHOOP, who funded the research Ryan and I presented at this conference.

 

Yasuki Sekiguchi presented a poster titled “Heartrate Variability between Starters and Nonstarters throughout a Collegiate Soccer Season.” During this study, HRV and training load metrics were monitored over the course of D1
college soccer season. The relationship between these variables were examined for all players, starters, and nonstarters. The major finding of this research was that acute:chronic training load ratio might be used to explain the changes in HRV over the course of a Division 1 male soccer team

Ryan Curtis did an oral presentation on Saturday (7/15/17) titled “Relationship between Sleep, Training Load and Fitness in Collegiate Soccer.” Overall this study illustrated that sleep quality may be more sensitive to increased training load than sleep quantity. Collegiate athletes with increased training loads have increased light sleep but not REM sleep or overall sleep duration.

Outside of the conference, we had a fantastic time exploring the Las Vegas strip and the beautiful hotel hosting us and the conference, Paris Las Vegas. I am extremely thankful to the NSCA and KSI for the opportunity to collaborate and learn from others in the field while making memories that will last a lifetime. I look forward to attending this event next year and present the results from our upcoming projects.

 

NATA Clinical Symposia & Expo

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Alexandra Finn

Assistant Director of Education

Athletic trainers from around the country gathered in Houston, Texas for the 2017 Annual NATA Clinical Symposia & AT Expo. The four day Clinical Symposia provided athletic trainers with the ability to explore new areas and benefit from the latest research. KSI was well represented by fifteen presenters who continued the mission of educating athletic trainers about our latest research. The warm weather of Texas was a constant reminder of the significance of heat in our southern states, but the strong interest showed by attendees from across the country demonstrated that athletic trainers are gaining an understanding that exertional heat illnesses are an issue of national concern. The selection of so many KSI members provided a unique opportunity for KSI to further its educational mission to maximize performance, optimize safety and prevent sudden death in sport.

Presentations kicked off early Tuesday morning when Andres Almeraya presented in the Master’s Oral Student Finalist session. His research about “Implementation of Automated Defibrillator Policies in Secondary School Athletics” demonstrated the strong need for additional state legislation to mandate that all secondary schools follow best practices. Andres entered the day as a finalist and was selected overall the best oral presentation in this section. Congratulations and well done, Andres! Dr. William Adams presented his work on the “Implementation of Heat Acclimatization Policies in Secondary School Athletics” during the Treat the Heat Session.

This year four KSI staff members: Luke Belval, Alexandra Finn, Rachel Katch and Brad Endres were selected to present a Free Communication Poster Presentation on Tuesday morning. Luke Belval presented on “Sex-based Comparison of Exertional Heat Stroke Incidence in a Warm-Weather Road Race.” Alexandra Finn presented on the “Implementation of Wet Bulb Globe Temperature Policies in Secondary School Athletics.” This research revealed that currently there are only three states that meet all the best practice recommendations in this area. Rachel Katch presented data titled “Cold Water Immersion in the Treatment of Exertional Heat Stroke Remains the Gold Standard at the Falmouth Road Race,” which demonstrated the significance of a road race having immediate cold water immersion available to treat exertional heat stroke. Finally, Brad Endres presented on the “Epidemiology of Sudden Cardiac Death in American Youth Sports.” Congratulations to both Alexandra Finn and Brad Endres who were selected as Master’s Poster Presentation Finalists. Brad’s poster proved to be the judges’ favorite taking home top honors for KSI in this category. Well done Brad and his research team!

Dr. Rebecca Stearns presented research during the session “When Exercise Gets Hot.” Her study focused on “Repeated Exertional Heat Stroke Incidence in a Warm-Weather Road Race.” Following Dr. Stearns presentation, two KSI members; Kelly Coleman and Alicia Pike spoke during the Diversity and Inclusion Considerations in Athletic Training session. Kelly Coleman presented data about the “Perceptions of Race and Ethnic Diversity on Athletic Training Clinical Practice” while Alicia Pike spoke about “Providing Medical Care to Male Sports Teams: Attractors to Employment for Female Athletic Trainers.

To finish the day, Dr. Robert Huggins provided an update on “An Overview of Secondary Schools ATLAS Project: Where Are We Now?” demonstrating the progress in mapping secondary schools across the nation.

The second day started off strong with three KSI members presenting. First, Sarah Attanasio provided insightful information about the ATLAS project. In a well-attended session, Dr. Douglas Casa discussed “Catastrophic Heat and Exertional-Related Condition Among Athletes.” Lastly, Samantha Scarneo presented data about “Implementation of Emergency Action Plan Policies in Secondary School Athletics.” Her study focused on the importance of every high school having an athletic trainer prepare an emergency care plan.

On the final day of presentations KSI members Kelsey Rynkiewicz, Dr. Robert Huggins, Dr. Yuri Hosokawa, Dr. William Adams and Alicia Pike all had an opportunity to present their data. Kelsey Rynkiewicz presented data on the “Implementation of Concussion Policies in Secondary School Athletics.” Dr. Robert Huggins presented on three different topics on Thursday. The first presentation looked at the “Presence of Athletic Trainers, Emergency Action Plans, and Emergency Training at the Time of Sudden Death in Secondary Athletics.” His second presentation provided data to support why all athletic trainers should be staffed and the importance of an athletic trainer in the ability to reduce risk and save lives. His last presentation was titled “State High School Athletic Policy Change Successes and Barriers: Results from Collaborative Solutions for Safety in Sports Meeting.” Dr. Yuri Hosokawa presented information on “Optimizing the Direction of Care: A Secondary Insurance Claim Analysis.” Dr. William Adams presented information on the “Current Status of Evidence-Based Best Practice Recommendations in Secondary School Athletics.”  Lastly, Alicia Pike looked at “Examining Sport Safety Policies in Secondary Schools: An Analysis of States’ Progress Toward and Barriers to Policy Implementation.”

It was a privilege for so many KSI members to have the opportunity to provide much needed information about subject matters such as the prevention and care of exertional heat illnesses to athletic trainers who are heading to summer sport training camps or planning for preseason training for fall sports. When not presenting, KSI staff members took advantage of the tremendous opportunity to learn from colleagues from other institutions. The annual conference, which will be moving to New Orleans, LA next year, is well worth the investment to attend!

University of Wisconsin Medical School Seminar

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Rachel Katch, MS, ATC

Associate Director of Military and Occupational Safety

One of the dedicated missions of the Korey Stringer Institute (KSI) is to provide the most evidence-based information and education on preventing sudden death in sport and physical activity, and on June 24th, 2017, KSI had the opportunity to work on that mission. After traveling to Wisconsin, Dr. William Adams and I disseminated an eight-hour seminar with the specific focus of preventing sudden death in sport and physical activity. Our hosts were affiliates of the University of Wisconsin Medical School, and many individuals attending the seminar were local high school and collegiate athletic trainers. There were four individual presentations followed by a lab portion, in which participants received hands-on training and practice regarding the gold standard method of recognizing and treating exertional heat stroke (i.e., rectal temperature, cold water immersion). For many individuals, this was the first time practicing the skills needed to save a life from exertional heat stroke. The presentations given, including one evidence based practice session, included the following:

  • Preventing Sudden Death in Sport: Overview of Current Epidemiology and Prevention Strategies
  • Development and Implementation of Health and Safety Policies in Youth Student Athletes
  •  Optimizing Safety and Performance During Exercise: The Role of Hydration and Fluid Regulation
  •  Evidence Medicine in the Realm of Heat Stroke and Sudden Death: The Long Journey from Evidence to Policy

One of the more interactive portions of the seminar was the exertional heat stroke lab. After receiving a presentation on the best-practice recommendations, the participants were able to translate their knowledge into practice; some, if not all, for the first time. With the gold standard recognition and care of exertional heat stroke being well documented for decades, being able to practice these skills and break down the negative stigma around rectal thermometry and cold-water immersion is imperative to positive patient outcomes.

KSI is humbled to be able to not only provide the evidence-based research and literature, but also the means of translating that research into practice, and we are grateful to our hosts for providing us the opportunity to get our message out to fellow medical professionals.

American Society for Safety Engineers Heat Stress Panel Discussion

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Gabrielle Giersch, MS

Associate Director of Education & Assistant Director of Athlete Performance and Safety

On Tuesday June 20th, I had the pleasure of representing KSI and sitting on a panel for the American Society of Safety Engineers entitled “An athletic approach to heat stress – beyond water, rest, and shade.” On this panel, we discussed the importance of keeping laborers safe, and using the knowledge we’ve garnered on athletes to do so. We discussed the causes of heat related illnesses, contributing factors, and how to best prevent heat illnesses from occurring in a working population. This panel could definitely be considered a conversation with a very active audience who was very interested in the topic and asked a lot of great questions! While the panel was only an hour long, some great information was put forth and hopefully with collaborations and putting the knowledge that we all have together, we can reduce the amount of heat related illnesses and deaths among laborers!

2017 ACSM Annual Meeting Recap

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Yasuki Sekiguchi, MS, CSCS, Assistant Director of Athlete Performance

 

The American College of Sports Medicine (ACSM) Annual Meeting was held in Denver, CO from May 30-June 3. Most of the KSI staff attended this outstanding conference and they were honored with the opportunities to present their research. We had great discussion with the audiences and received critical feedback for future work via these presentations.

  • Douglas J. Casa, PhD, ATC, FACSM- Catastrophic Heat and Exertional-Related Conditions among Athletes
  • Robert A. Huggins, PhD, ATC- Biomarkers of Endocrine, Muscle, and Inflammatory Health Track Training Loads of a Collegiate Soccer Season

  • William M. Adams, PhD, ATC- Monitoring Cardiovascular, Hepatic, Renal, and Hematological Markers of Health in Collegiate Soccer Players
  • Yuri Hosokawa, PhD, ATC- Outcomes from a Modified Heat Tolerance Test to Track Thermal Strain

  • Samantha E. Scarneo, MS, ATC- Assessing the Reliability and Validity of an Objective Method of Measuring Postural Stability: Preliminary Data

  • Luke N. Belval, MS, ATC, CSCS- Comparison of Rectal Temperature Prediction Models Utilizing Machine Learning

  • Ryan M. Curtis, MS, ATC, CSCS- Starters and Non-starters Require Separate Load Monitoring and Analyses Throughout a Collegiate Soccer Season
  • Rachel K. Katch, MS, ATC- Weighted Heat Stress Score as a Predictor of Rectal Temperature in a Warm Weather Race

  • Courteney L. Benjamin, MS, CSCS- Monitoring Markers of Nutrition Status Throughout a Collegiate Soccer Season

  • Gabrielle EW. Giersch, MS- The Effect of the Cypla2 -163 c>A Polymorphism on the Metabolism of Caffeine and Effect on Performance

  • Yasuki Sekiguchi, MS, CSCS- Thirst Modulates Cycling Performance in the Heat in Dehydrated Males
  • Andrea R. Fortunati, MS, ATC- Monitoring Markers of Oxygen Transport Throughout a Collegiate Soccer Season
  • Brad D. Endres, BS, ATC- Epidemiology of Sudden Death in American Youth Sports.

 

 

Furthermore, the ACSM annual meeting provided great opportunities to meet with former colleagues. The University of Connecticut Alumni Association Reception was held on Thursday night (6/1). A lot of attendees spent time with old friends and shared current work with them. This kind of reunion always enables us to recall great memories and have energy for future work. We are grateful for all of the people who helped coordinate this event.

 

 

This conference also allows attendees to make new relationships with other professionals through attending various sessions and meetings. These opportunities lead KSI staff to obtain further knowledge, skills and new ideas. They certainly help to develop KSI and execute our mission “to provide research, education, advocacy and consultation 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. We look forward to seeing everyone again soon!!!

 

121st Boston Marathon

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William M. Adams, PhD, ATC Vice President of Sport Safety

Robert A. Huggins, PhD, ATC Vice President of Research and Vice President of Athlete Performance and Safety

April 17, 2017 was the 121st running of the Boston Marathon, a race considered by many as the world’s most elite marathon drawing over 30,000 participants in the 26.2-mile trek from Hopkinton, MA to Boylston Street in downtown Boston. This years’ race was warmer (70-75°F) than the average year, thus resulting in a greater number of runner’s seeking medical care during or following the completion of the race. In total, ~2,400 runners were treated in medical tents both at the finish and along the course throughout the day ranging from minor issues (muscle cramps, dehydration and musculoskeletal injuries) to more severe injuries such as exertional heat stroke and hyponatremia. As a result of the heat, 20-25 runners were treated for exertional heat stroke (EHS) both on the course and at the finish line. Why so many EHS’s you might ask? Well given the time of the year (April) and provided that many runners training throughout the winter months have limited heat exposure during training, there is a greater risk of exertional heat stroke when environmental conditions become warmer than average conditions, which was evident at this year’s race.

For KSI’s William Adams, PhD, ATC and Robert Huggins, PhD, ATC, it was their 6th time being part of the medical staff that volunteers their time on Marathon Monday to assist the runners in need of medical care. Below is a reflection from both Dr. Adams and Dr. Huggins on their experiences at this year’s race and from their previous years as medical volunteers

Dr. Adams’ Perspective

For the 2017 Boston Marathon, I was assigned to the finish line chute, which is located from behind the finish line to the medical tent in front of Boston Public Library. I was responsible for observing the finishers crossing the finish line and identifying those runners who were injured or suspected of having potential issues (e.g. exertional heat stroke). In previous years, I have worked in the medical tents located at finish line, so this year was a new experience for myself as a clinician as I transitioned from treating runners triaged to the medical tent to identifying runners in need of medical care upon finishing the race.

Overall, the Boston Marathon is an amazing experience and it has been a privilege to work alongside great clinicians over the past 6 years. It is a gratifying feeling having runners stop after finishing the race and thanking you for being there and making their race experience the best it can be. Marathon Monday also has special meaning for myself personally as I met my now wife 6 years ago at the race as we both volunteered to be a part of the medical staff in 2011.

For clinicians wanting to get a sense of what it is like to provide medical care at a mass participation event, I would strongly encourage anyone to sign up to volunteer for the Boston Marathon and get to experience what the world’s best marathon has to offer.

Dr. Huggins’ Perspective

Every year on Partriot’s Day I wake up at 4:00 am and drive with some of my colleagues to Boston, MA to volunteer my services in the finish line medical tent at the Boston Marathon. Each year I am amazed at the sheer number of medical professionals who gather to be there for the runners. Hundreds of healthcare professionals, students, and volunteers work together to provide care to thousands of runners for approximately 6 hours. The entire team is under the direction of the BAA Medical Directors (Chris Tryanos, ATC, Pierre d’Hemecourt, MD, Aaron Baggish, MD, and Sophia Dyer, MD). Every year, myself and all of the other medical professionals show up at 6:00am, get our credentials, head to the medical meeting, assemble with our respective group leaders for our assignments (Lawrence Venus for the Athletic Trainers), get our lunch, and report to our sections. This year I had a little time to spare before reporting to the medical tent and took a moment to visit one of the bombing sites near the finish on Boylston Street. Attached to the tree nearest the site, (see image) there was a memorial on the tree to remind those of the tragedy that happened back in 2013. Although I was not present in the medical tent that year, I was so proud of how my fellow Athletic Trainers and the other medical professionals responded to that emergency. Each year we are reminded of that tragic event and certainly it is in the back of our minds, but each year since, we push on for if we dwell on that day and live in fear, “they” win and “they” WILL NEVER WIN! #BOSTONSTRONG

My first 3 years I worked in Medical Tent A, however for the past 3 I have had the honor of working in Medical Tent B on the heat team. Good ole’ section 19! This year was like the rest in that my primary responsibility was to assist in the administration of the cold-water immersion treatment for any runners whose core body temperatures exceeded 104°F.  Given the number of EHS patients is not nearly that experienced in Med Tent A, in addition to being on the heat team, my section also provided care in a similar fashion to the other sections of the tent. I had the honor of working with two fantastic nurses, two physical therapists, and a medical student in charge of documentation. Each year I meet new people and it is always a great experience. Although, the weather this year brought more dehydrated, slightly hyponatremic (low blood sodium), and muscle cramping athletes our way than years past, it was another successful day in Boston and I strongly encourage anyone who is interested in working the medical tent to volunteer and come see a side of the marathon that most don’t even know about. I promise it will be an experience that you will always remember!

2017 Collaborative Solutions for Safety in Sport

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William M. Adams, PhD, LAT, ATC Vice President of Sport Safety

March 28-29, 2017 Kansas City, MO

The 3rd annual Collaborative Solutions for Safety in Sport meeting was held last week in Kansas City, MO that brought over 100 individuals representing all 50 states and the District of Columbia together to continue the task of enhancing the health and safety policies for high school athletics. This meeting, hosted by the National Athletic Trainers’ Association and the American Medical Society for Sports Medicine and supported by the Korey Stringer Institute and Gatorade, began out of an idea spawned by Drs. Douglas Casa, PhD, ATC, FACSM, FNATA, FNAK and Jonathan Drezner, MD to make high school sports safer for the participating athletes.

This years’ meeting was constructed so that the attendees decided on the topics to be discussed. Prior to the meeting, all of the attendees were sent a survey that asked them which topics they would either want to learn more about or have in depth discussions about. From the survey, 16 breakout sessions were formed where the attendees who wanted to learn more about one particular topic were able to come together in small groups to have further discussions.

 

Overall, these breakout sessions were immensely successful as they stimulated many fruitful discussions over the successes, barriers, and other strategies to help develop and implement health and safety policies across the US. It was great to see states that have been successful in implementing change in a certain area (i.e. heat acclimatization) providing feedback and suggestions to states that have not been successful in implementing such policies. These discussions provided great peer-to-peer feedback, which may have been better received for some individuals.

 

Having attended all of Collaborative Solutions for Safety in Sport meetings over the past three years, it has been amazing to see the efforts taken by leaders within state high school athletics associations and sports medicine advisory committees following the meeting to develop and implement health and safety policies. States like Vermont, Illinois, South Carolina, Utah, New Jersey and many others have taken advantage of these meetings to implement best-practice policies in their state with many crediting the Collaborative Solutions meeting as the event that was the impetus for change.

 

While many states have made great strides in improving the health and safety of their student athletes, others have remained resistant to change and often citing “We haven’t had anything happen in our state, so there is no reason to change.” We must remember that implementing evidence-based minimum best practice policies such as emergency action plans, heat acclimatization, access to AEDs, environmental-based activity modification guidelines and the management of sport related concussion, cost little to no money to implement and there should be no reason not to take the proactive steps to keeping our young student athletes safe.

 

Keeping the forward progress mindset and further cultivating relationships between sports medicine advisory committees, high school athletics associations and coaches with the mindset of having the most up-to-date evidence-based policies in place is needed to ensure that our young athletes are protected while playing the sports that they love.