Month: June 2016

NATA Clinical Symposia & AT Expo

By Alicia Pike, Associate Director of Research

The staff at KSI spent the past week at the 67th Annual NATA Clinical Symposia & AT Expo in Baltimore, MD. Although the meeting brings athletic trainers from all around the country to one location year after year, this year’s attendance was noteworthy. NATA’s Associate Executive Director, Rachael Oates, confirmed this year’s symposia was the second most attended in NATA history, falling close behind Las Vegas’ 15,000 attendees with an impressive 13,000!

This meeting is always a unique opportunity for KSI to showcase all of the notable research that has been conducted over the past years. It serves as a means of educating the athletic trainers in attendance with novel research topics and findings. William Adams, Vice President of Sport Safety, kicked the list of KSI presentations off with his minicourse titled, “Developing and Implementing Evidence-Based Best Practice and Procedure for the Prevention of Sudden Death in Sport.” On Thursday morning, Lesley Vandermark presented information about medical care provided in lieu of an athletic trainer in the public secondary school setting, a small subset of data that came from the CATCH-ON study investigating the prevalence of athletic training services in the public sector. Congratulations to Lesley, as she was one of the Doctoral Oral Student Award Finalists!

On Thursday afternoon, three of our staff members all had Free Communication Poster Presentations at this year’s symposia. Rachel Vanscoy presented data  on the shortened environmental symptoms questionnaire and it’s ability to represent physiological adaptations following heat acclimation. Yuri Hosokawa, Director of Communication and Education, presented on the effectiveness of tarp-assisted cooling as a method for cooling hyperthermic individuals. KSI’s Director of Research and Military and Occupational Safety, Luke Belval, also presented data on cooling individuals with exercise-induced hyperthermia, but with a novel cooling vest. The day’s presentations from KSI staff continued with William Adams, Rachel Katch, and Sarah Attanasio presenting in a rapid-fire oral presentation session titled “Trends & Interventions for Heat & Hydration Risk Reduction.” Will spoke about policy changes reducing exertional sickling related deaths in DI football players. Similarly, pertaining to policy changes, Sarah, Assistant Director of Research, presented data on the occurrence of exertional heat stroke in high school football athletes prior to and following the implementation of heat acclimatization guidelines. Rachel, KSI’s Associate Director of Military and Occupational Safety, was the last KSI staff member presenting her work in this session from her Master’s thesis titled, “Use of the Heat Stress Score to Predict Preparedness to Run in an Outdoor, Warm Weather Race.”

NATA 2016

Yuri Hosokawa and Dr. Douglas Casa, KSI’s CEO, both presented in a feature presentation on malignant hyperthermia in physically active populations. Yuri provided attendees with a summary of case reports, while Dr. Casa followed up with clinical implications. Alicia Pike, Associate Director of Research, presented data on the various individuals that secondary schools use to provide medical care when an athletic trainer is not employed. KSI’s Director of Sport Safety, Samantha Scarneo, presented data on agility and injury risk in youth basketball players. Last but certainly not least, Rebecca Stearns, KSI’s COO, had the opportunity to present a special topic on the effectiveness of protein as an ingredient in hydration beverages. It was a special year as almost all staff members at KSI were given the opportunity to present their research and knowledge to the attendees.


This year’s symposium was especially unique as the NATA Research and Education Foundation turned 25! In celebrating the silver anniversary, the NATA Foundation hosted a remarkable dinner on Friday night to celebrate their yearlong theme of “Remembering Our Roots, Growing Our Future.” The staff at KSI had the opportunity to attend the spectacular event and support all the Foundation has accomplished and what they will continue to do in the coming years! The attendees heard from Dr. Brian Hainline, chief medical officer of the NCAA, who championed for athletic trainers and showed utmost support for the profession.

Former Eagles star Brian Westbrook at athletic trainers convention: ‘Manage the expectations’ (The Baltimore Sun)

The injuries still linger in Brian Westbrook’s mind. The high-ankle sprain about 10 years ago, when Westbrook missed maybe a week before rushing back and playing a step slow. The concussion in Washington in 2009, when Westbrook was knocked out in the first quarter of a Monday night game and wanted to resume playing two days later.

Now he has to wonder: At 36, when he forgets names, is it because he wasn’t paying attention when he heard it? Or is it because of hits like those that he sustained during a nine-year NFL career?

Westbrook, a two-time Pro Bowler with the Philadelphia Eagles, says now that if he could do it over again, he would still play football, just a bit more cautiously than he did. As a guest speaker at the National Athletic Trainers’ Association conference at the Baltimore Convention Center on Thursday, he used his own experience as a cautionary tale.

“Protect your athletes from themselves,” he urged the trainers in attendance.

Westbrook was a guest speaker on a panel with seven athletic training experts from various fields, including education, the workplace and the military.

Westbrook spoke highly of his experience with athletic trainers such as Rick Burkholder, his athletic trainer for all eight years he played for the Eagles. Burkholder urged Westbrook to take time to recover from his 2009 concussion. Westbrook ended up missing three weeks.

“Manage the expectations,” said Westbrook, a Fort Washington native and DeMatha alumnus. “So many coaches, if you have an ankle injury, it’s two days, [then] back out on the field. The truth is, sometimes it’s not a two-day injury. Sometimes it’s a two-week injury. So you have to manage those expectations.”

Sometimes, Westbrook acknowledged, athletic trainers can push players to return to the field, but often they have to hold players back. That’s a tall order for some athletes who, like Westbrook, want to be on the field relentlessly.

Westbrook played the same way — if you’re able to run and catch, you’re healthy enough to play. Though he says he’s doing well for the most part, as a retired player who already feels some of the consequences of a grueling career, he wants to teach those athletes the dangers of that mindset.

“All you can do is tell them the stories,” he said after the panel. “All you can do is try to educate them. All you can do is give them all the information that you possibly can, and allow them to make the decision and help them make the decision. That’s all you can do.”

Westbrook is one of a number of former NFL players who have spoken out about their past as the league’s problem with traumatic brain injuries takes up more of the conversation. But Thursday’s discussion wasn’t limited to concussions.

According to Dr. Douglas Casa, chief executive officer of the Korey Stringer Institute at the University of Connecticut, the four leading causes of death in sport are, in descending order of frequency: cardiac issues, head injuries, heatstroke and exertional sickling (decreased blood flow upon exertion for athletes with the sickle-cell trait). He said together, those four ailments make up more than 90 percent of deaths.

The Korey Stringer Institute, created and named in honor of the former Pro Bowl offensive lineman who died of heatstroke on the practice field in 2001, works with sporting entities to preserve player safety. The institute promotes measures such as slowly phasing in activity in hot weather and testing athletes for the sickle-cell trait before practice. Both reduce the incidence of sudden death on the field, and both are free to implement.

Casa also cited a study that athletes have a 90 percent survival rate from cardiac issues with an automated external defibrillator accessible within two minutes.

Meanwhile, Dr. Tamara McLeod of A.T. Still University labeled concussions as a public health concern. The Center for Disease Control estimates the annual incidence of concussions is between 1.6 and 3.8 million, with many going unreported. According to McLeod, sport-related brain injuries generate annual hospital costs of more than $6 million.

Those numbers can go down if athletes report concussions and take the proper steps to recover, a decision they must continue to make to be safe.

“At the end of the day, especially for professionals, they’re going to have to make that decision for themselves,” Westbrook said. “For the kids, it’s a little bit easier, because you can say, ‘OK, you’re not playing. Two weeks.’ But when you’re talking about in the big leagues, it’s a different world.”

Source: The Baltimore Sun

Understanding risk and protocols key to concussion management (USA Today Sports)

BALTIMORE — Former Pro Bowl running back Brian Westbrook doesn’t know where he’d be today without former Philadelphia Eagles athletic trainer Rick Burkholder.

On Oct. 26, 2009, Westbrook suffered his first concussion when he was hit in the back of the head and blacked out during the Eagles’ game against the Washington Redskins. Two days later, he wanted to practice again.

Burkholder stopped him.

“Burkholder said, ‘We’re not going to let you touch that football field until you’re absolutely ready,’” Westbrook said. “It was that decision and those words that changed my life dramatically for the better. It’s what allows me to go out there on the radio and TV and speak to young people today without worrying about head and brain disease.”

Westbrook spoke at the National Athletic Trainers’ Association Convention in Baltimore on Thursday, where a panel of athletic trainers gave tips on preventing concussions in youth and high school sports. NATA also unveiled new research and guidelines related to concussions, osteoarthritis and sudden cardiac death.

Among children, those ages 15 to 17 visit the emergency room the most often, while thousands of high school athletes have long-term complications resulting from injuries. Many youth athletes, their parents and coaches don’t understand the risk of severe injuries during competition. Westbrook, for example, didn’t even consider the thought of getting a concussion until he endured his first one.

Tamara McLeod, the director of athletic training programs at A.T. Still University’s Arizona School of Health Sciences, said most states have laws that require high schools to educate athletes about concussions, but usually these teachings are basic and don’t grasp the athletes’ full attention.

“Some of them just give a handout,” McLeod said. “The key is education before the injury happens.”

McLeod has studied and advocated for a collaborative approach to care that includes athletic trainers, school nurses, administrators, teachers and coaches when it comes to managing athletes’ care and preparing them to return to play.

According to NATA, only 12 states have a written emergency action plan; 16 states meet “minimum best practices” for heat acclimatization; and only 25 states have access to an “external defibrillator on a school property and at all school sanctioned athletic activities.”

By using video of professional athletes, McLeod said she’s had more success getting her message across, but she believes each age group should be targeted in a different way to emphasize concussion protocol. Heads Up Football, a USA Football education program, is another way to inform coaches and players on concussions, she said.

University of Connecticut kinesiology professor Douglas Casa cited a study recently done with Fairfax County High Schools in Virginia, and found that athletes playing under Heads Up Football certified coaches underwent 25 percent less injuries and 43 percent less concussions.

McLeod said that every school needs to have a policy for athletes who experience concussions, including treatment, how to ease athletes back into competition and when to allow them to play again. Having an athletic trainer helps this plan work, said Kristen Kucera, an assistant professor at the University of North Carolina at Chapel Hill’s Department of Exercise and Sport Science.

“Athletic trainers specialize in the prevention, recognition, management, treatment and rehabilitation of sport injuries and illness,” Kucera said.

Westbrook said athletes and their parents should be informed about the risk of concussions when they begin playing tackle football. The NFL has reduced the amount of physicality in practice since Westbrook began playing in the league, but he said it’s still difficult to manage injuries while coaches pressure their athletes to return to action.

“So many coaches expect you to be back on the field after two days,” Westbrook said.

The National Trainers’ Association launched a campaign called “At Your Own Risk” to educate, prevent and heal athletic injuries. The website includes an interactive map with the sports safety protocols for all 50 states.

According to the National Center for Catastrophic Sport Injury Research, there 80 catastrophic injuries and illnesses among high school and college athletes, with 78 percent at the high school level, from July 2013 to July 2014.

In 2015, 50 high school athletes died during sports or physical activity and high school athletes lead t the nation in athletic-related deaths.

Westbrook said he was lucky to have an educated athletic trainer when he played for the Eagles, but not all athletes are that fortunate. Some players put themselves at risk of long-term injuries by returning to competition too early, or not informing their coach or athletic trainer about concussion symptoms.

If Westbrook had not waited to recover, he might join myriad other football players who display symptoms of Alzheimer’s disease and chronic traumatic encephalopathy.

“As athletes, we’re not thinking about injury,” Westbrook said. “We’re thinking about playing. I want [athletic trainers] to say, ‘We’re not trying to keep you off the field, but we want to make sure when you’re on the field, you’re the best player you can be.”

Source: USA Today Sports

BEATING THE HEAT: IHSA introduces heat safety policy for postseason (The Telegraph)

BLOOMINGTON — The Illinois High School Association Board of Directors voted to enact new heat safety guidelines for all IHSA postseason contests beginning with the 2016-17 school year. The new comprehensive policy was approved at the Board of Directors meeting June 13.

Officially called “Specific Guidelines for Managing Heat and Heat Illness”, the policy was created by the IHSA Sports Medicine Advisory Committee. It applies only to State Series contests (Regionals, Sectionals, Super-Sectionals, State Finals, Football Playoffs), but the IHSA Board of Directors, Staff, Sports Medicine Advisory Committee and Illinois Advisory Council on Player Safety encourage all member schools to use the policy as their minimum standard for managing heat at athletic competitions.

“This policy builds on the IHSA’s tradition of putting student-athlete safety at the forefront,” said IHSA Executive Director Craig Anderson. “We believe we now have a policy that is very effective in safeguarding student-athletes, however schools are certainly welcome to impose even more stringent guidelines related to regular-season athletic competition in extreme heat if they choose to do so.”

The policy is built upon Wet Bulb Globe Temperature readings, which take into account factors such as humidity, wind speed, sun angle and cloud cover, in addition to air temperature, and is considered the most effective way of judging dangerous conditions by the Korey Stringer Institute and other industry experts.

As the WBGT rises, the policy builds in different types of safety measures. For example, at a WBGT range of 80.0-84.5 degrees Fahrenheit, hosts would provide “cooling stations using methods such as ice towels”, while a WBGT range of 87.6-89.9 degrees Fahrenheit would require four separate four-minute water breaks within an hour of competition. At a WBGT of 90, all events would be postponed to a cooler time of day or the next applicable day.

“According to the CDC, heat illness during practice or competition is the leading cause of death among U.S. high school athletes,” said Lindenwood University Department of Athletic Training Chair William Dill, who is a member of the IHSA Sports Medicine Advisory Committee. “The first step for player safety is always prevention and this policy aims to prevent exertional heat illnesses by modifying competitions based on the WBGT. Hopefully, this policy will also raise awareness that exercising in the heat can be dangerous, but good policies can go a long way in protecting student-athletes.”

Anderson stressed that the IHSA Board and staff understand there may be initial resistance from coaches that extreme heat could significantly alter playing schedules, especially in sports like baseball, where rest for pitchers is an important part of game-planning.

The IHSA piloted the policy during the IHSA Class 3A and Class 4A Baseball and Softball State Finals on June 10 and 11 at Silver Cross Field in Joliet and the Eastside Centre in East Peoria, respectively. The IHSA altered game times to avoid playing during the hottest hours of the day and also added in ice towels and water breaks, among other measures, as the WBGT dictated.

“Even with the extreme temperatures we saw on June 10 and 11, the WBGT never reached the threshold where we had to suspend or postpone play,” said Anderson. “Much of this policy is really aimed at common sense precautions, or making measures like in-game water breaks that schools were already imploring in hot temperatures a requirement instead of a suggestion.”

The IHSA used a Wet Bulb Globe Thermometer, which can provide an immediate WGBT reading, at both state final sites, however the device, which can range from approximately $100 dollars to $500 dollars, is not a requirement to adhere to the IHSA policy. The policy provides a WBGT conversion chart for tournament managers, who can attain the necessary information from most smart phone weather applications.

“It will undoubtedly take some time, resources and training to apply this policy,” said Anderson. “However, we know our schools understand the importance of putting student safety first. The Play Smart. Play Hard. motto is built around that ideal.”

The IHSA established Play Smart. Play Hard. in 2015, which is a player-safety initiative aimed at empowering student-athletes, parents, coaches and fans to educate themselves on player safety issues and the steps that have been taken in Illinois to protect student-athletes. Those efforts included forming a new IHSA committee, the Illinois Advisory Council on Player Safety, who also endorsed the new policy.

“Heat-related illness and death is 100% preventable,” said Northwestern University Associate Athletic Director and Director of Athletic Training Services Tory Lindley (MA, ATC), who is a member of the Illinois Advisory Council on Player Safety. “I am proud of the IHSA for instituting this policy. Athletic Trainers are now armed with the support needed to direct and educate athletes, coaches and administrators on who is at greatest risk and what actions can be taken to prevent a heat-related issue.”

The IHSA will hold a series of interactive webinars to help educate member school coaches and administrators on the new policy in preparation for the fall season, and again prior to the start of the 2017 spring sports seasons.

Source: The Telegraph

Guidelines Stop Heat Stroke Deaths in High School Athletes (US News & World Report)

By Don Rauf
HealthDay Reporter

THURSDAY, June 23, 2016 (HealthDay News) — There have been no deaths among high school football players during preseason practice in states with guidelines to help students get used to the heat over time, a new study says.

In contrast, heat stroke deaths during preseason practices were 2.5 times higher in states before they adopted the guidelines, the study found.

“A lot of people don’t realize that heat stroke is preventable, and a bigger number of people may not realize that heat stroke is 100 percent survivable if it’s treated appropriately,” said study author Douglas Casa.

“The guidelines are an example of a policy change that can help prevent heat stroke,” Casa said. He is chief executive officer at the Korey Stringer Institute at the University of Connecticut in Storrs.

The National Athletic Trainers’ Association released protocols for helping athletes get used to the heat (heat acclimatization) in 2009. The guidelines were developed by an inter-association task force, which included representatives from the American Academy of Pediatrics, the American College of Sports Medicine, the U.S. Centers for Disease Control and Prevention (CDC), and other organizations.

The guidelines were developed in response to heat-related deaths in high school athletes. Between 1980 and 2015, there were 44 exertional heat stroke-related deaths during preseason high school football practices. A total of 22 of these deaths occurred in states that eventually went on to adopt the guidelines, the researchers said.

Exertional heat stroke is a life-threatening medical condition. It occurs when the body’s core temperature gets too high because of excessive physical activity. It often occurs in hot weather, but can occur any time, according to the Korey Stringer Institute.

 When preseason training begins, athletes may not be prepared to cope with the hot weather and the physical demands required because they’re not used to exercising in the heat, the Institute notes.

Heat acclimatization methods help a body adapt to exercising in the heat and cope with heat stress. The guidelines include limiting practice to no more than one per day during the first one to five days of practice, and limiting practice sessions to no more than three hours in a day.

The study included 48 high school football preseasons. The high schools were in 14 states that had adopted heat stroke prevention guidelines since 2011. Casa noted only one exertional heat stroke death during these preseasons. And, that incident occurred at a school that “blatantly violated the state policy,” he said.

David Csillan is head athletic trainer at Ewing High School in New Jersey. He said that “the data clearly shows that catastrophic events, resulting from exertional heat stroke, continue to be present in those schools neglecting to adopt the heat acclimatization guidelines as a minimum best practice.”

According to Csillan, “Ensuring that proper guidelines are in place, that athletic trainers and others on the sports medicine team are closely monitoring activity, and that athletes recognize the signs and symptoms of exertional heat stroke are all important steps in reducing incidence.”

Even though the guidelines have led to a drop in student-athlete deaths, Casa said that changing policies on a high school level is daunting. “You have to change them state by state because there’s no national governing body that can set those guidelines,” he said. “It’s quite a process and probably one of the reasons that change is so slow for high school sports.”

 Casa, who served as co-chair of the task force that put together the guidelines, added that some states have a hard time breaking with tradition.

“States all make changes after they’ve had a tragedy,” he said. “Very few states are proactive and say, ‘We haven’t had a tragedy, but this is working in all these other places, so to avert our potential tragedy we’re going to make the change.’ That doesn’t happen often, unfortunately. But they all make the push once there’s a death. We are constantly saying, do whatever you can before they die.”

The CDC says that muscle cramping can be a first sign of heat-related illness that can lead to heat stroke. Other symptoms may include heavy sweating, weakness, cold and clammy skin, fast pulse, nausea or vomiting, and fainting.

If experiencing heat-related illness, it’s important to get to a cooler location and lie down. If the condition is severe, call 911 and try to reduce body temperature with cool cloths or possibly a cool bath, the CDC advises. Do not give fluids in this situation.

Findings from the study were scheduled to be presented Thursday at the National Athletic Trainers’ Association meeting in Baltimore. Findings presented at meetings are generally viewed as preliminary until they’ve been published in a peer-reviewed journal.

Source: US News & World Report

Army-approved exercise tips to help you beat the summer heat (New York Post)

This season’s predicted to be a scorcher, but if you’re worried about exercising in the heat, doctors say, “Don’t sweat it.”

That’s because we’re actually pretty well-suited to the hot weather and require less adaptation to high heat than to cooler climes. Plus, our natural defense mechanism against high temps — sweating — is unique to humans. “No other animal can do that like us,” says Dr. Samuel Cheuvront of the US Army Research Institute of Environmental Medicine, which studies the health and performance of Army personnel.

Even better? Heat training also has health benefits — good news for active New Yorkers who want to continue exercising even as the National Weather Service forecasts higher than usual temperatures this summer. The heat helps more blood get to your heart, says Dr. Rebecca Stearns, from the University of Connecticut’s Korey Stringer Institute, which studies sudden death and focuses on heat stroke. “This can fuel the muscles during exercise — like natural, legal doping.”

Still, basic precautions are necessary when exercising outdoors come summertime. High temperatures, especially combined with humidity, can wreak havoc on the body, so use common sense.

“You don’t have to kill it all the time,” says Peter Ciaccia, New York Road Runners’ events president and New York City Marathon race director. “You can get your miles in, but you don’t have to do it at race pace.”

Here are seven other ways to beat the heat and stay safe while getting fit.
You need a week to 10 days to acclimate to heat, during which you should gradually ramp up your routine and start monitoring your urine color — a good indicator of whether you’re properly hydrated. “It should be pale yellow, like lemonade,” Stearns says.Check your hydration before exercising

Calculate your water intake

The American College of Sports Medicinerecommends that athletes drink 24 ounces for every pound shed within two hours after exercising (weigh yourself naked before and after to figure out how much you’ve lost).

Make sure you don’t gulp down too much at once, though. “Normally people can only handle [roughly] 34 to 40 ounces of fluid an hour in their stomachs,” says William Adams, Ph.D., of the Korey Stringer Institute.

While bikers or hikers can carry drinks, it’s tougher for runners, who may need to wear hydration vests or fuel belts. “Some people place bottles at certain parts of a run if they’re doing loops in the park,” says

Ciaccia. “Plan your route in advance — look for one that’s shady [to limit direct sun exposure] and has water fountains.”

Gulp down two parts water to one part Day-Glo drink

Everyone knows sports drinks help restore the fluids and electrolytes lost during sweating, but there’s actually a formula behind how much you should drink.

“We use a 2-to-1 ratio between water and sports drinks — two 16-ounce bottles of water for [every] one 16-ounce bottle of an isotonic drink” like Powerade or Gatorade, says Kevin Christen, head athletic trainer for the soccer club New York City FC.

But don’t drink too much

Yes, there is such a thing as drinking too much water — and it can even be dangerous. Overhydration can cause hyponatremia, a k a low blood sodium. “Some of the symptoms are the same as heat exhaustion, which can make it difficult to diagnose without a blood test,” says Army doctor Cheuvront.

Salt is your friend — really

When you’re getting used to hot weather, you tend to lose more salt in your sweat, which means that you may become hyponatremic if you don’t replace it — and Gatorade alone won’t cut it in the beginning, since the amount of salt in one bottle is only about one-third to one-half of what’s in our sweat.

“The main thing we advocate is that people eat,” says Cheuvront. “Salt is found more in canned vegetables, canned soups, luncheon meats, cheese. When soldiers are first deployed or go [into] training, we recommend that they salt their food for the first few days.”

Women tend to be more susceptible to hyponatremia due to their smaller sizes. “You see that in marathons,” says Cheuvront. “Women are smaller and tend to run more slowly, so they tend to be on the course longer and to drink more.”

Watch out for painkillers

If you take drugs, regardless of whether they’re over-the-counter or prescription, consult your doctor or pharmacist — or at least pay close attention to labels — before exercising, because some medicine can impede sweating.

“Antihistamines can reduce sweating rate,” says Cheuvront. “Certain stimulants [such as] ephedrine [and] some supplements that are not regulated very well have been implicated in problems related to heat tolerance.”

Know the signs of heat exhaustion

Dizziness? Nausea? Stop and chill!

“Heat exhaustion is a cardiovascular and low-blood-pressure problem, and we’re generally upright, so more blood pools in the feet and legs,” Cheuvront says. “Being on your back in the shade [and] elevating your feet will help you return to normal [body temperature].”

Just beware of the degrees in heat illnesses, and be on the lookout for more serious heat-related illnesses. After heat exhaustion comes heat injury (symptoms include unsteady walk and chills), followed by heat stroke, in which body temperature rises above 104 degrees, and you can become disoriented. In that case, it’s best to call 911. “You need to get that person off [his or her] feet and cool them quickly,” Cheuvront says.

Source: New York Post

The ATLAS Project: The Start of Something Big

By Robert Huggins, PhD, ATC, VP of Research, VP of Athlete Health and Safety


There are countless new and innovative ideas that we have at KSI every day, but every once in a while there is that truly life changing idea. Even as daunting as that idea may seem, there is something deep within your gut, I mean really deep down, that you know can make and impact and is worth doing. The ATLAS Project was one of those ideas for us here at KSI and in true KSI fashion this idea would not be possible without the collaboration of the NATA Secondary School Committee and the members of the NATA.


The Athletic Training Locations And Services Project was developed by KSI from the “Athletic Training Services in Public Secondary Schools: A Benchmark Study” with the main goals to:


  • 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

Since its official launch in January, over 4,500 surveys have been taken by Secondary School Athletic Trainers all across the country. The Eastern Athletic Trainers’ Association has the largest percentage of high school athletic trainers who have taken the ATLAS Survey closely followed by Mid-America Mid-Atlantic and Southwest Athletic Training Associations as depicted below. In terms of raw number of surveys California leads with 220 surveys taken and Pennsylvania is in close second with 203 surveys. However, if we look at percentage of surveys taken, District of Columbia, New Mexico, and Utah are in the lead with 80%, 71%, and 55% respectively.


Currently KSI uses Zeemapsä by Zeesource to map each states’ Athletic Training services and we are proud to say that Vermont and Maine were the first two states to be 100% mapped. Delaware, District of Columbia, Rhode Island and Wyoming are all within 40 schools of being 100% mapped and additional efforts in those states by KSI and their athletic training associations are being made as we speak.
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Recently Robert Huggins PhD, LAT, ATC and Larry Cooper, NATA Secondary School Committee Chair, presented the ATLAS project data at the Collaborative Solutions For Safety In Sport Meeting held at the NCAA headquarters in Indianapolis and will also be discussing this with Athletic Trainers at the NATA Symposium next week in Baltimore where they hope the project will continue to gain more momentum so be sure to stop by booth #2057 at the NATA Expo to map your high school!

How Much Water Do You Need? (WNPR)

Most of us have heard that our bodies need eight cups of water every day to stay healthy and hydrated. Some think that’s the minimum we should drink to prevent the chronic dehydration that doesn’t trigger the usual warnings of dryness, like thirst.

But some experts are pushing back on this rule, saying there is little science to back up the claim. They say we need drink only when we’re thirsty since our bodies are good at telling us what we need. Plus, some studies show a little dehydration may improve athletic performance.

The reality is no one really knows how much water we need. We do know that water makes up half our weight; keeps our cells, kidneys and cardiovascular system finely tuned; and may have a role in protecting us from some illnesses. We can survive without food far longer than we can go without water. It is safe to say that water is one of the most important elements to life.


Source: WNPR

2016 American College of Sports Medicine Annual Meeting

By Samantha Scarneo, MS, ATC, Director of Sport Safety

ACSM 2016

As conference season is upon us, KSI kicked off the summer first attending the American College of Sports Medicine (ACSM) Annual Meeting. This year’s ACSM annual meeting was held in Boston, MA and proved to be one of the most special conferences for KSI. KSI’s CEO, Dr. Douglas Casa was honored with the opportunity to give one of the President’s Lectures on Thursday morning of the conference. Dr. Casa’s presentation began with his personal story of his own heat stroke and how that grew to his passion for saving lives in the realm of exertional heat stroke and other causes sudden death in sport and physical activity. The presentation also included a detailed timeline of he inception of KSI and the work that KSI is doing to this day.  Change takes time, dedication, and perseverance; Dr. Casa certainly made that known to those in attendance.

Over the course of several years, KSI has been able to assist over 30 states in their quest to make policy changes to make sport safer at all levels of competition. Heat acclimatization, environmental conditions, AED policies, coaching education, and conditioning sessions were some of the policy change topics presented upon. However, despite the positive changes, we have observed an increase in non-traumatic deaths over the past few years. Dr. Casa stressed, that although important changes have been made, there is still work to be done to identify why this trend is occurring and how we can mitigate these deaths. The presentation was well received to a ballroom full of attendees. Congratulations to Dr. Casa on this milestone achievement!

The conference also included presentations by other KSI staff:

  • William Adams, PhD, ATC – Thirst As A Marker of Hydration Status During an After Exercise in the heat
  • Lesley Vandermark, PhD, ATC– Beverage Content Influences Voluntary Fluid Intake During Exercise: A Systematic Review
  • Yuri Hosokawa, MAT, ATC – Assessing Warm Weather Race Preparedness Using the Heat Stress Score
  • Samantha Scarneo, MS, ATC – Lower Extremity Injury Risk in Youth Female Basketball Athletes with and without a History of Concussion

Annual meetings allow professionals to re-connect with old colleagues, make new relationships and build upon their knowledge base by attending the several sessions. ACSM has always been an educational event that each of us look forward to every year, and this year was no different. We thank all the presenters at the meeting along with the staff who were able to put on such a great event. It was great to see all of our former colleagues and friends and we look forward to seeing everyone again soon!