Wound and Bleeding Care Basics PLUS What to Buy for Your First Aid Kit

Wound and Bleeding Care

The majority of wounds should be handled by putting pressure directly on the wound using sterile gauze. Gauze pads hold the blood on the wound and help the components of the blood to stick together, promoting clotting. If you don't have gauze, terrycloth towels work almost as well. If the gauze soaks through with blood, add another layer. Never remove the initial bandage since peeling blood soaked gauze off a wound removes vital clotting agents and encourages bleeding to resume.

Blood needs to clot in order to start the healing process and stop the bleeding. Step two to control bleeding is to elevate the wound above the heart. By elevating the wound, you slow the flow of blood. As the blood slows, it becomes easier to stop it with direct pressure. Remember, it must be above the heart and you must keep direct pressure on it.

Types of Wounds

The acronym PAIL identifies the four major types of wounds: puncture, abrasion, incision and laceration.

Puncture wounds caused by a pointed implement such as a nail, cleat or pin may be deep and are difficult, if not impossible, to clean. Puncture wounds have the greatest chance of tetanus due to bacteria being left in the wound as the implement is withdrawn. Determine the implement, date of last tetanus shot and depth of penetration.

Abrasions are superficial in depth and may cover large areas. Due to the large amount of skin surface, they have a high chance of infection. First aiders should rinse the surface with a wound wash, pat dry with sterile gauze, apply antibiotic ointment and cover. Moist wounds have been shown to heal faster than the old days of “letting it air out to dry”. So, first aid cream and a bandage are the order of the day.

Incision wounds are made with sharp, straight instruments such as scalpels, metal buckle edges and knives. The wound has straight edges and may be long-short or wide-narrow. The wound should be washed with water or sterile wound wash and wiped in the direction of the incision to ensure proper removal of any debris. Depending upon length and depth, stitches may be necessary.

Laceration wounds have rough, uneven edges and involve the greatest amount of tissue damage. The wound should be thoroughly irrigated and wiped lengthwise to avoid lodging any debris under the multiple edges of the wound. Stitches may be required and may involve both internal and external sutures depending upon depth and size.

Universal Precautions

As is the case when dealing with any body fluids, the use of universal precautions is prudent. Gloves, sterile bandages, dressing to hold the bandage in place, wound wash/water and referral to additional care when needed are typical wound care steps.

For the rest of your first aid kit, you'll need:

· tweezers

· wound wash

· alcohol wipes

· antiseptic hand cleaner

· medical adhesive tape

· sterile gauze elastic bandages

· several sizes of adhesive bandages

· insect bite swabs

· triple-antibiotic ointment

· bandage scissors

· triangular bandages

· instant cold packs

· exam gloves

· barrier device for CPR

 Shop a wide range of first aid and emergency supplies >>

High School Athletic Trainer MVP Award

High School Athletic Trainer MVP Award

Sports Health and Training & Conditioning Magazine are excited to announce a new awards program honoring high school athletic trainers. High school athletic trainers are the unsung heroes of interscholastic sports and many work countless hours educating and caring for student-athletes on and off the field.

Applications are being accepted to recognize the efforts of an individual who does his/her job very well, but also go beyond the expected.  Certified athletic trainers who work with athletes in schools or through outreach to schools that are respected by all those around them, but may not be recognized for all they do, now have the avenue to broaden and deepen their impact.

High school athletic trainers have always been the “make it work” and “do a lot with a little” group of professionals. Momentum Media publishers of Training & Conditioning magazine has joined with Sports Health to offer a tremendous, stand-alone program to recognize one high school athletic trainer.



The winner of the MVP award will be featured in the April issue of Training & Conditioning magazine, receive a plaque commemorating the honor, product-related prizes as well as being featured in an announcement at the national athletic trainers’ meeting in June, 2013.

Nominations can be emailed to MVatc@MomentumMedia.com before December 31, 2012.

Learn more >>

The ABC's of AEDs

An automated external defibrillator or AED is a portable electronic device that automatically diagnoses the potentially life threatening cardiac arrhythmias of ventricular fibrillation and ventricular tachycardia in patients and is able to treat them through defibrillation, the application of electrical therapy which stops the arrhythmia, allowing the heart to reestablish an effective rhythm. As reported in USA Today, November 12, 2003 a National Institute of Health showed defibrillators can double the survival rates of sudden cardiac arrest. It is estimated that 350,000 people die annually due to sudden cardiac arrest and that in ages 15-34 the incidence has risen 10% in the last decade. (Read more about sudden cardiac arrest and high school athletes here).

The first AEDwas originally designed and created by American biomedical engineer Joshua L. Koelker and Italian emergency medical professional Jordan M. Blondino to allow defibrillation in common public places. AEDs are designed to be simple to use for the layman, and the use of AEDs is taught in many first aid, first responder, and basic life support (BLS) level CPR classes in schools.

Conditions that the Device Treats

An automated external defibrillator is used in cases of life threatening cardiac arrhythmias which lead to cardiac arrest. The rhythms that the device will treat are usually limited to:

1. Pulseless Ventricular tachycardia
2. Ventricular fibrillation

In each of these two types of shockable cardiac arrhythmia, the heart is active, but in a life-threatening, dysfunctional pattern. In ventricular tachycardia, the heart beats too fast to effectively pump blood. Ultimately, ventricular tachycardia leads to ventricular fibrillation. In ventricular fibrillation, the electrical activity of the heart becomes chaotic, preventing the ventricle from effectively pumping blood. The fibrillation in the heart decreases over time, and will eventually reach asystole.
AEDs will not start a stopped heart, that is, it will not be effective in a coronary attack.  Its purpose is to counter a “fluttering” (fibrillation) of the heart muscle before it goes into cardiac arrest. The asystolic patient only has a chance of survival if, through a combination of CPR and cardiac stimulant drugs, one of the shockable rhythms can be established, which makes it imperative for CPR to be carried out prior to the arrival of a defibrillator. Estimates are that CPR alone is only 6-8% effective but CPR plus the use of an AED within 6 minutes is 80% effective.

The American Heart Association recommends automated external defibrillators in any place where there are large numbers of people. This includes airports, stadiums, large offices or industrial buildings, public buildings and large fitness centers, for example. 

Read more: American Heart Association Defibrillation Guidelines | eHow.com http://www.ehow.com/way_5577375_american-heart-association-defibrillation-guidelines.html#ixzz1NQ2GEXt1
Several states require scholastic coaches to be certified in first aid and CPR/AED usage. In 2010, the American Heart Association (AHA) released their updated guidelines for treating sudden cardiac arrest (SCA) and heart attacks.The purchasing and placement of AEDs at schools and during athletic events is both critical and legally prudent.  The American Heart Association recommendation is that an AED should be within a 2-minute walk from anywhere on school grounds/building.

Implement a School AED Program

While emergency response plans should be developed by both physical education and athletic departments, so too should be annual “simulated episodes” requiring staff to respond to various scenarios and in various locations on school grounds.

Request a free AED consultation and download the 10 common mistakes made by school AED programs >>

For additional information about AED usage and programs implementation go http://www.quickmedical.com/defibrillator/aha.html and Project ADAM at http://www.chw.org/display/PPF/DocID/26050/router.asp.

Sports Health Photo Contest Winners Announced!

Athletic Trainer for Bloomington Blaze Pro Hockey Team Wins $5,000 Award

Earlier this year, Sports Health launched “A Day in the Life of an Athletic Trainer” photo contest, giving Athletic Trainers the opportunity to submit a photo illustrating what happens during a typical day on the job. We received a great variety of entries, all of which can be viewed in the Sports Health Facebook Album.

View Album>>

Sports Health selected two Athletic Trainers to be the judges of the photos. Participating judges were Phil Hossler, MS, ATC from East Brunswick High School in New Jersey and Tory Lindley, MA, ATC and Director of Athletic Training Services at Northwestern University. Each judge ranked their top three nominations and the winner was the highest combined ranked nomination from each judge. The runner up was randomly selected from the remaining nominations.

Congratulations to Matthew Aiello, ATC (pictured right) who won 1st place and the $5,000 award with his action shot of treating one of the Bloomington Blaze pro hockey players during a game.

Connie Fernandez, MAT, ATC, LAT received the runner-up award with an image of a baseball player being checked out on the field. Connie is the Assistant Athletic Trainer at Calallen High School in Corpus Christi, TX.
View photo>>

A few additional notable entries include:

A humorous graphic of people’s perceptions of an Athletic Trainer’s job. View photo>>

This fantastic collage of Carlitta M. Moore, MS, LAT, ATC at Saint Augustine’s College. View photo>>

A close-up action shot of a wrestler being treated at Pelham High School in NH. View photo>>

To show our appreciation of the time and effort that went into all of the photo submissions, Sports Health will be sending a $100 gift card to each entrant! We would like to thank all of the teams, schools, Athletic Trainers and athletes who came together to create this powerful collection of images.

Remedies for Shin Splints

Shin Splints- an Athletic Trainer’s Perspective

Shin splints is a "syndrome" or "collect-all" term
for a variety of aches and injuries in the lower leg region. Some estimates put it as high as 31 conditions. While it is true that shin splint injuries occur mostly to athletes and those who often run or walk long distances, in my career I have seen the injury occur in football lineman and baseball center fielders that do not necessarily run long distances. I have also heard that changing surfaces, i.e. soccer players going into basketball season, may precipitate the muscle inflammation we call shin splints. But I wonder, if that is the case, why then doesn’t every one of my soccer athletes turned basketball athletes get them? Obviously there must be something different about different athletes.
I have found two predominant conditions that often lead to shin splints: foot/gait patterns of over pronation and tight heel cord muscles. With ankle over pronation (rolling inward), the entire structure from ankle to hip/low back operates at a less than peak efficiency. When muscles chronically work at less than their optimum angle, stress (inflammation) occurs. Secondly, heel cord muscles (gastrocnemius or the calf and the soleus muscle) are critical to smooth propulsion in the walking and running cycle. Calf tightness causes premature heel raising which redistributes body weight along the bottom of the foot and alters muscle contraction timing. Any change that alters what the body perceives as its optimum performance range (which is a floating definition based upon age, genetics, level of conditioning, etc.) will result in breakdown or at the least inflammation and pain.

Since shin splints may represent a variety of ailments, there are likewise a variety of ways to treat the injury. Remember the adage "everything in moderation" so ease into any changes in your exercise routine and as always when it doubt, see a professional.

Remedies for Shin Splints

Rest
Working though the discomfort must be tempered with common sense. "It hurts when I do this", then "don’t do that!"

Ice
Ice has an inflammation reducing capability. Remember that muscles that are angry with you with become inflamed. Inflammation causes pain, which causes inflammation, which causes pain...you get the idea.

Wrap
Sore muscles supported with elastic wraps, tape or neoprene sleeves often feel better. These products can hold in body heat which has relaxing (increased blood flow) results for sore muscles due to greater oxygen delivery.

Medication
The age of the athlete in front of me determines what I say about the use of aspirin or ibuprofen. Typically state laws prohibit medication dispensing in high schools and aspirin is not advised for children. Adolescents must be told "whatever your parents want to give you" while college and professional athletes can make their own decision but should be reminded not to overdo it in an attempt to mask the discomfort.

Foot-shoe Interface
In the case of an overpronator, arch supports may produce some relief, if not, prescription orthotics may be needed. For some it may be as simple as checking the insole in the shoe. Through wear, age and sweat the softness afforded by the insole may become compromised and is resulting in excessive force being transmitted up through the foot-ankle-shin.

Alternative Activities
Use cross training whenever possible to focus on different muscles, different distances and different intensities in order to "rest" the sore shins. Swimming and bicycling are good sore shin alternatives. Take this time to focus on your core strength and overall flexibility.

Warm Up & Cool Down
General warm up involves overall blood flow increase while specific warm up mirrors the demands of the activity. Dynamic warm up is a blending of these two by large muscles movements related to the activity. Warm muscles move better and are less likely to be injured. When you are done, do some simple large muscle movements on your way over to pick up the ice bag for your sore shins.

Stretching
Stretching with both straight and bent knees for 30 seconds each several times a day alleviates many cases of sore shins. Since the calf muscle does most of our propulsion and is more powerful than the shin, it usually wins the "argument". Once they get short and tight, the shin muscles are forced to function at a slightly altered angle and they do not like it...thus the pain.

More Athletic Trainer Perspectives on Shin Splints:

Here’s what other athletic trainers have to say:

• Kent Scriber, ATC Ithaca College, Ithaca, NY: Aside from the traditional care (rest, ice, stretching, and gradual return to participation), I have found that providing some sort of arch support is helpful. It seems most of these lower leg problems are triggered by some sort of biomechanical issue. Therefore taping, providing a foam or felt pad, or a more permanent orthotic often alleviates symptoms.
• Jennifer Wuyscik MS, ATC, LAT and John Geist, ATC, LAT, Knoch HS, UPMC Sports Medicine, Saxonburg, PA:
  • Jennifer: Like Maria Hutsick, I have also had several athletes, predominantly female soccer players, who have had chronic exertional compartment syndrome, which can in its beginning stages mimic shin splints. Since presenting a case study at NATA in 2010 on this topic, I have had 2 additional female soccer players and 1 male soccer player with this condition. Two of the three have had to have surgery before the end of their high school careers to be able to continue playing.
  • John: My basic thought regarding "shin splint" pain is monitoring the pain during activity and the duration of the pain after activity. Does it go away after 3, 6, 9 hrs., etc..? or does the pain linger on into the next day’s workout? Any increase in pain or duration of pain would lead me to limit the athlete’s activity and/or refer them for further evaluation/x-rays. If the athlete’s pain dissipates within a short period of time after their workout or if the athlete can start their day with pain not being any worse than the day before, I am usually comfortable allowing that athlete to continue. I also (encourage) icing, stretching both (calf muscles), checking foot biomechanics, and adding arch supports, if needed. I will take my cleated athletes (primarily screw-ins) out of their cleats for a period of time and have them workout in (athletic flats.
• Maria Hutsick, ATC, Medfield High School, Medfield, Ma.: Another area to look at especially in female athletes is the issue of compartment syndrome. Many girls end up with chronic pain and numbness and tingling in the lower leg/foot region. Further investigation results in symptoms such as muscle hardness in the lower leg, pain after or during exercise, and the symptoms may progress. This is usually an issue that shows up in 10th or 11th grade. By the time they get to be freshman in college they may need surgery to continue playing.

More Professional Input

Mayo Clinic's Definition of Shin Splints 

Class Notes, chapter 19 from Westfield HS, Houston, TX 

East Brunswick HS, East Brunswick, NJ 

Products to Ease the Pain of Shin Splints

 For products to help care for shin splints, go to www.esportshealth.com and look at

• Calf and Shin
• Podiatry: Wraps, Supports, Padding
• Rehabilitation: Hot/Cold Therapy
• Tape & Wraps: Compression Wraps & Sleeves

Phil Hossler, ATC has been an athletic trainer on the scholastic, collegiate and Olympic levels. He has authored 4 books and numerous articles and served as an officer in state and regional athletic training associations for 20 years. He is a member of four halls of fame including the National Athletic Trainers’ Association’s.

How Stability and Balance Training Improves Athletic Performance

Proprioception Separates Great Athletes from "Pretty Good" Athletes

Proprioception is the body’s ability to transmit a sense of position, analyze that information and react (consciously or unconsciously) to the stimulation with the proper movement (Houglum 2001). Put simply, it is the ability to know where a body part is without having to look.

Proprioception allows you to scratch your head without looking in the mirror or walk up a flight of stairs without having to peer at each stair. (Tarrant, 2003) Proprioception might be one of the major factors that separate the men from the boys - or more accurately the great from the pretty good athlete.

 

One Thing All Great Athletes Have in Common - And How Injury Can Quickly Decrease Performance

Think about it: look at the body control, the awareness of where they are and others around them, and the sport specific moves that the great athletes of our time are known for. The ability to turn and see the basket; dive, catch, and come up throwing; the quarterbacks that not only have amazing "field vision" but also the near instantaneous body control to avoid the tackler.

These proprioceptive abilities may be interrupted when there is an injury. Taken as a whole, proprioception includes balance, coordination and agility because the body’s proprioceptors control all these factors. Proprioceptors consist of both sensory and motor nerves that send and receive impulses to and from the central nervous system from stimuli within the skin, muscles, joints and tendons (Houglum 2001). These impulses transmit vital information, such as the amount of tension in a given muscle and the relative position of a body part during a given movement. An example of proprioceptive exercises is the use of a balance board after an ankle sprain. The unpredictable movements of the balance board teach your body to react without having to think about these movements.

For Optimal Performance, Proprioception Cannot be Overlooked or Overdone

More equipment designed to improve proprioception is on the market today than ever before. There are boards on round blocks, air “cushions”, boards on air cushions and foam rubber of varying thickness and shapes. There are balance boards, wobble discs, stability trainers, BOSU® Balance Trainers, and Thera-Band® Stability Trainers just to name a few. The improvement or restoration of proprioception should be a normal part of every athlete’s conditioning and/or reconditioning protocol. For further clarification, go to How to Improve Proprioception by Michelle L. Tarrant, Med. For an excellent selection of proprioceptive supplies go to Sports Health at www.sportshealth.com.

Phil Hossler, ATC has been an athletic trainer on the scholastic, collegiate and Olympic levels. He has authored 4 books and numerous articles and served as an officer in state and regional athletic training associations for 20 years. He is a member of four halls of fame including the National Athletic Trainers’ Association’s.

Teen Hydration FAQ's

Get the Facts on Teen Dehydration

Q: Should you drink during a workout, rinse your mouth or pour water on your head?
A: You can do all of them. Replacing fluids lost during exercise is critical to performance, stamina and comfort. Losses as little as 3% body water can have a negative impact on stamina and performance. Spraying your mouth is comfortable but does very little for actual body needs. Since up to 40% of heat lost during exercise is via your head and scalp, proper ventilation and cold water on your head and neck can be both helpful as well as overall health protecting.

Q: What is the best drink?
A: Cold water is good; sports drinks are very useful for those long days or double practice days. Avoid carbonated drinks before and during exercise. Avoid drinking excessive amounts of carbonated drinks which contain sodium and/or caffeine since they may produce dehydration.

Q: How much should you drink each day?

A: Young exercising teens should drink 10-12 glasses of water or sports drinks (before and during) as well as juices (after). You cannot count on your thirst though since it shuts off before the body is fully replenished. Q: How common is dehydration?
A: Fortunately not very common. Dehydration develops over a couple of days. This gradual loss of sufficient fluids can produce muscle cramps, headache, dizziness and fatigue. It can occur in any sport, indoors or outdoors. You should return to 90-95% of your weight by the following day; if not you have not replaced sufficient amounts of fluids. Check the color of your urine. It should be the normal light yellow not dark.

Q: What else can be done to help acclimatization?
A: When given the chance to rest....rest. Seek cool, air conditioned areas in the summer heat after practice. Eat plenty of fruits. Low fat chocolate milk after practice has the added benefit of providing protein to repair sore muscles, fluids to help hydrate and carbohydrates to restore energy.

Shop hydration products from Sports Health >>

Remember: Proper hydration begins at home!
Come to practice well hydrated and go to bed well hydrated!
Phil Hossler, ATC has been an athletic trainer on the scholastic, collegiate and Olympic levels. He has authored 4 books and numerous articles and served as an officer in state and regional athletic training associations for 20 years. He is a member of four halls of fame including the National Athletic Trainers’ Association’s.

4 Steps to Prevent Heat Illness

Heat Acclimatization Guidelines Created to Decrease Heat Illness

In 2009, the National Athletic Trainers' Association released Preseason Heat-Acclimatization Guidelines for Secondary School Athletics to decrease the occurrence of heat illness in high school athletes participating in summer practices. Unfortunately, it wasn't until after the nation experienced "the worst week in the last 35 years in terms of athlete deaths" that states began mandating the adoption of these guidelines. In summer of 2011, three heat-related deaths were reported on high school football fields, four Arkansas football players were hospitalized for dehydration, and an endurance runner died of apparent heatstroke during a race called the Warrior Dash.

Heat Related Fatalities on the Rise

According to a study by Andrew J. Grundstein, an associate professor in the department of geography at the University of Georgia, the annual death rate was around one per year from 1980 to 1994 but rose to a yearly average of 2.8 in the next 15 years.

The Reason for the Rise of Heat Illness

In the past, simply scheduling summer practices for early morning and/or evening would be enough to avoid the highest temperatures of summer and reduce the risk of heat illness. However, according to Grundstein, morning temperatures are higher than they were decades ago.

Additionally, high school athletes are bigger than they were decades ago. According to Douglas J. Casa, chief operating officer of the Korey Stringer Institute, a nonprofit dedicated to preventing sudden death in sports, "You have 300-pound high school guys walking out to practice and you have no medical staff and they're going six hours in 100-degree temperatures."

4 Steps to Help Prevent Heat Illness

1. Follow the 14-day heat-acclimatization period recommended by the NATA.
2. Use a Wet Bulb Globe Temperature Meter (WBGT) — not the heat index — when assessing whether practice conditions are safe. The WBGT index is the most widely used and accepted way to assess heat stress in the United States, but getting coaches to move away from their reliance on the heat index is a challenge.
3. Have an ice water bath available if players show signs of heat stroke. Learn more >>
4. Have an athletic trainer present during all practices and games.

States that Mandate Student Safety During High Heat

• May 2011 - New Jersey State Interscholastic Athletic Association becomes first state organization to adopt heat-acclimatization guidelines.
• October 2011 - the University Interscholastic League in Texas bans two-a-days for the first four days of training camp and on consecutive days thereafter.
• State high school activity associations in Arkansas, Connecticut, North Carolina and Georgia follows suit, with Georgia instituting fines of up to $1,000 for school found in violation of their heat acclimatization mandate. Fifteen other state high school associations are actively considering adoption.

Heat Acclimatization Guidelines by State >>

Georgia Practice Policy for Heat and Humidity:

The Danger of Giving Energy Drinks to Young Athletes

In June 2011, the American Academy of Pediatrics took the position that there is a difference between “sports drinks” and “energy drinks”. This distinction is important to adolescents and is also a microcosm of the American way of life.

As a nation we often seek the most efficient, if not the easiest, way to get a job done. Unfortunately, when it comes to athletic activities, there is no substitute for good old-fashion hard work and persistence.

What Makes Energy Drinks so Dangerous?

Many adults and adolescents will seek that little additional edge in their performance by using supplements. Energy drinks often contain “non-nutritive stimulants” such as caffeine and can run the gamut from 160 mg of caffeine per 8-ounce serving to 300 mg. The exact content and purity of energy drinks cannot be guaranteed since there is no regulatory control over these “supplements” and there may be harmful interaction with prescriptions to control ADHD.

Cola drinks and coffee are also sources of caffeine but possibly due to their long history and wide acceptance by the American public they do not often enter into the “energy drink” conversation. In the United States, cola drinks are controlled by the Food and Drug Administration (FDA) and are limited to 71 mg of caffeine per 12-ounce serving while 8-ounces of generic coffee has 95-200 mg per serving.

The Link Between Energy Drinks and Heart/Liver Problems

The National Federation of State High School Associations’ position statement on energy drinks states “energy drinks are not appropriate for rehydrating athletes during physical activity and should not be used for that purpose.” The consumption of energy drinks in teens has been linked with heart arrhythmias and liver problems. Last year the Virginia High School League became the first state high school federation to impose a ban on such drinks at high school competitions and practices.

Adolescents should not be viewed as miniature adults. Their biological systems are still developing and may react to outside influences differently than adults.

Combining Energy Drinks with Alcohol

The combination of energy drinks with alcohol can be dangerous for teens. According to the government’s Substance Abuse and Mental Health Service Administration, emergency room visits associated with energy drinks use increased nationally more than ten-fold from 2005 to 2009. Forty-four percent involved combination with alcohol, pharmaceuticals or illicit drugs.

What Makes Sports Drinks Different?

Sports drinks were developed to focus on fluid, carbohydrate and electrolyte replenishment to aid in athletic performance and recovery - typically with a 6-8% carbohydrate concentration.

The Best "Supplement" For Young Athletes

Young athletes should practice and compete without artificial supplements. The best “supplement” for teens is still hard work, eat a well-balanced diet, drink plenty of fluids and get adequate amounts of rest.

Find Safe Sports Drinks, Water Hydration Systems, Cups, Coolers, and More For Your Thirsty Athletes >>

www.nfhs.org
American Academy of Pediatrics. Clinical Report. Sports drinks and energy drinks for children and adolescents: are they appropriate? Pediatrics 2011; 6: 1182-1189
Homes News Tribune newspaper, December 11, 2011 www.THNT.com

Phil Hossler, ATC has been an athletic trainer on the scholastic, collegiate and Olympic levels. He has authored 4 books and numerous articles and served as an officer in state and regional athletic training associations for 20 years. He is a member of four halls of fame including the National Athletic Trainers’ Association’s.

The Best Place for Gatorade or Water Coolers While on the Field

A Creative Solution for Hydrating Athletes

Using coolers for outdoors sports is a standard idea which can pose unique problems. For example, where can it be positioned so as not to take a seat on the bench, be on the ground making cups/bottles difficult to fill or get caught in the dust and dirt common to dugouts?

At a local hardware store, I purchased two standard rafter hangers. These are designed to go over the top of a 2”x 4” rafter beam and provide an arm for hanging items such as bicycles. Each hanger cost less than two dollars.

Sports such as baseball, softball, track and lacrosse commonly have fences around the field, in front of the dugout, or behind the bench. A very simple and inexpensive method to facilitate safety and ease of operation is to hang the cooler on the top rail of the fence (typically a 5-foot fence), on the fence itself or in the corner of the backstop.

Begin by positioning the cooler next to the fence. Place the longer arm into the handles of the cooler. By holding both the hanger and the handles of the cooler, lift the cooler up and place the hook end of the hanger onto the top rail of the fence. This places the spout at a very convenient level for the team to refill cups and bottles.

This idea can be used with coolers of all sizes. With handles across the top of smaller coolers, one hanger would suffice. First aid ice containers and first aid kits can be positioned in clear view with this simple hanger idea as well.

To improve hydration and replenishment for your athletes consider purchasing Gatorade, coolers and cup racks, and cups and bottles from www.esportshealth.com.

Phil Hossler, ATC has been an athletic trainer on the scholastic, collegiate and Olympic levels. He has authored 4 books and numerous articles and served as an officer in state and regional athletic training associations for 20 years. He is a member of four halls of fame including the National Athletic Trainers’ Association’s.

Tips for Designing an Effective Athletic Training Room

When given the opportunity, athletic trainers would love to have input on the creation, design and implementation of a new athletic training room. A new “home” for athletic trainers could be realized via newly constructed buildings or through renovation of existing structures.
Many components are beyond the building personnel’s input since they are dictated by local, state and/or federal coding statutes. For example, the federal Americans with Disabilities Act require a certain amount of floor space and free space for wheelchair accessibility which may alter plans for lavatory and rehabilitation spaces.

There are a few common themes that should be considered in the development phase of the floor plan.

Traffic Pattern

One of the main concerns is how athletes will enter, leave, access and utilize the area without creating blockage, overflow or compromise activity within the room. Placing the “need to get to first” activities such as signing in and practice preparation taping nearest to the door can control or eliminate a headache-producing traffic pattern. Look at your design and imagine 12 athletes arriving at your door at the same time—how will you control, organize or separate the crowd?

Placing other activities such as treatments, hydro modalities, rehabilitation stations and administration work stations in non-intertwined locations will make the room more efficient and productive. It will also promote safety for the athletes using the areas.

Within the athletic training room/equipment room complex where is the best location for the ice machine? Do you want athletes getting ice/water within the athletic training room so you can supervise them? Do you want them to access ice and water from a different location so as to eliminate extra traffic not related to therapy, taping or rehabilitation? Is your room located near outside doors that lend themselves to placing ice outside the athletic training room as well as outside the building?

Disposable Supplies

Having the necessary tools-of-the-trade conveniently located is critical. Obviously the day-to-day items are near their proper location, but where are the “once-in-awhile” ones located? Can you turn around and walk 5-10 feet and find them or do you have to go down the hall to the storage room to find them? Being able to install containers or storage units that are available but not intrusive can be very useful.

Communication and Emergency Equipment

When designing a facility, ready access to whatever system of communication and emergency equipment your organization uses in vital. How many phones do you want hanging on your walls and where do you want them? Which phone(s) is restricted to local or campus? Which one(s) can make calls anywhere? If you use walkie-talkies, where will they be stored and who can access them?

Where is your automated defibrillator stored? How many do you have immediately available? Is there one in the athletic training room, outside the room in the hall, is it stored conveniently or stored in a room that is occasionally locked?

If you have oxygen, backboards, or intravenous supplies, are they stored open or locked? Who is authorized to use them and can they get to them in an emergency?

Privacy

Every athletic trainer has occasions when speaking with a parent or an athlete should really be done in private. Given the chance within your planning, include an office area which actually has windows for viewing the entire room as well as a door that can be closed if the situation dictates it. This reduced noise area also makes administering a neurocognitive assessment test on the computer to a single concussed athlete more easily accomplished than having to locate a quiet computer somewhere in the building.

Many of the items mentioned plus tables, cabinets, storage carts, ice machines, whirlpools and other modalities can be found at www.esportshealth.com.

Phil Hossler, ATC has been an athletic trainer on the scholastic, collegiate and Olympic levels. He has authored 4 books and numerous articles and served as an officer in state and regional athletic training associations for 20 years. He is a member of four halls of fame including the National Athletic Trainers’ Association’s.

61 Famous Athletes with Diabetes + Tips for the Diabetic Teen Athlete

About the Diabetic Teenaged Athlete

Adolescent diabetics who play sports need to be very good at disease management but also time, food, exercise, rest, illness and fluid management. A diabetic teenager lacks the capacity to control blood glucose without supplemental insulin.

Glucose is the primary sugar circulating in your blood. Normally, after a meal, food gets digested and broken down into easily absorbed molecules, glucose being one of them. Glucose is a simple sugar that comes mostly from the carbohydrate that you eat. It must be present in your blood in sufficient quantity that your brain and nervous system can take it up and use it as their primary fuel.

Teachers, coaches and parents all encourage teens to eat breakfast because “breakfast” is actually “break” and “fast” which means morning blood sugar levels are low due to the fast of not having eaten overnight.

Low blood sugar levels impact brain tissue negatively, causing:

• drowsiness
• fatigue
• lack of attention
• mental “drifting”

Not good qualities to have during school or sports!

Exercise is very useful to diabetics as it assist in mainlining good blood glucose control. A successful diabetic teenager who is also an athlete must become very good at organizing and preparing for the unexpected.

Balencing Diet, Exercise, and Diabetes

The interplay between insulin therapy, diet, and exercise is extremely important to athletes with diabetes. The goal is to match the type, amount, and timing of insulin to food intake and activity level. Regular monitoring of blood glucose levels is critical to ensuring that appropriate amounts of insulin are provided and metabolic complications are avoided. When insulin levels are not in balance with need, abnormalities in blood glucose and acid concentration can occur. By adjusting your insulin dose depending on the length and intensity of exercise, control of blood glucose level can be enhanced.

This is a subject you’ll want guidance on from your physician.

Including carbohydrate-containing foods with a low glycemic index can assist with blood glucose control.

Glycemic index is a tool used to rank foods according to their immediate effect on blood glucose levels. Carb-containing foods that are broken down quickly will rapidly release glucose into the bloodstream. These are known as high glycemic index foods. Those that break down slowly gradually release glucose into the bloodstream. These are known as low glycemic index foods, and this latter category can be advantageous for those with diabetes. (www.powerbar.com)

Young diabetics have a great deal to learn about the disease, exercising demands as well as rest, fluids and the type /amount of food eaten.

Exercise is important for all of us, but it is vital to diabetics.

Learn about the condition, speak with your physician often and don’t be afraid...athletes with diabetes have competed successfully on all levels.

61 Famous Athletes with Diabetes

Arthur Ashe - Tennis - Wimbledon winner.

Walter Barnes - Football and actor. Before acting career he played professional football for the NFL's Philadelphia Eagles, 1948-1951.

Ayden Byle - Runner - First insulin-dependent man to run 6521.5 km across North America.

Nick Boynton - Hockey Player - Boston Bruins.

Doug Burns – Fitness consultant, Record-holding strength athlete.

Sean Busby - Champion Snowboarder.

Bobby Clarke - NHL - Philadelphia Flyers.

Ty Cobb - MLB - Detroit Tigers.

Scott Coleman - Swimmer - first man with diabetes to swim the English Channel.

Jay Cutler - Football Player.

Chris Dudley - NBA - New York Knicks center.

James “Buster” Douglas - Heavy Weight Boxer.

Kenny Duckett - NFL - New Orleans Saints.

Scott Dunton - World Class Surfer.

Mike Echols - NFL - Tennessee Titans.

Pam Fernandes - Para Olympian.

Missy Foy - Professional Marathon Runner.

Curt Frasier - NHL - Chicago Black Hawks.
Walt Frazier - NBA - New York Knicks.

“Smokin’ Joe” Frazier - Boxing.

Kris Freeman - Olympic and National Champion Cross-Country Skier.

Joe Gibbs - NFL - Washington Redskins coach.

Jorge "Giant" Gonzalez- Professional Wrestler and Argentinian Basketball Player.

Bill Gullickson - MLB - Cincinnati Reds Pitcher.

Gary Hall Jr. - US Olympic Gold Medalist, Swimming.

Jonathan Hayes - NFL - Pittsburgh Steelers, Kansas City Chiefs.

Jay Hewitt - Ironman Triathlete.

Dave Hollins - 1993 Phillies World Series Third Baseman.

James "Catfish" Hunter - MLB - Pitcher, Baseball Hall-of-Famer.

Chuck Heidenrich - Skiing.

Chris Jarvis - World Champion Canadian Rower.

Jason Johnson - MLB - Pitcher, Cleveland Indians.

Kelli Keuhne - LPGA golfer.

Billie Jean King - Tennis.

Jay Leeuwenburg - NFL - Indianapolis Colts Lineman.

Mark Lowe - Major League Baseball.

Michelle McGann - LPGA golfer.

Brandon Morrow -Seattle Mariners Pitcher.

David Pember - MLB - Milwaukee Brewers.

Toby Petersen - NHL - Pittsburgh Penguins, Dallas Stars.

Sir Steven Redgrave - Rower - Winner of five consecutive Olympic gold medals.

Dan Reichert - MLB - Kansas City Royals.

Ham Richardson – Tennis star.

Jackie Robinson - Baseball Hall of Fame.

Sugar Ray Robinson - Boxing.

Ron Santo - MLB - Chicago Cubs legend.

Mike Sinclair - NFL - Philadelphia Eagles.

Kendall Simmons - NFL - Pittsburgh Steelers.

Ron Springs - NFL - Dallas Cowboys.

Jerry Stackhouse - NBA - Dallas Mavericks.

Hank Stram - NFL - Kansas City Chiefs Coach.

Bradley Suttle - Texas Longhorns - Second Baseman.

Bill Talbert - Hall of Fame tennis player.

Jack Tatum - NFL - Oakland Raiders.

Sherri Turner - LPGA golfer.

Scott Verplank - PGA golfer.

Jo Ann Washam - LPGA golfer.

David "Boomer" Wells - San Diego Padres Pitcher.

Dominique Wilkins - Basketball Player (Atlanta Hawks).

Wade Wilson - NFL player and Dallas Cowboys quarterback coach.

Dmitri Young - MLB Outfielder, first baseman

Use http://www.diabetes-exercise.org as a beginning point for information and Sports Health for diabetes supplies.

Phil Hossler, ATC has been an athletic trainer on the scholastic, collegiate and Olympic levels. He has authored 4 books and numerous articles and served as an officer in state and regional athletic training associations for 20 years. He is a member of four halls of fame including the National Athletic Trainers’ Association’s.

Why Heart Failure Can't Always Be Detected in the High School Athlete

Understand and Prepare for Sudden Cardiac Arrest Before An Emergency Occurs

Sudden Cardiac Arrest (SCA) is caused by sudden failure of proper heart function during or immediately following exercise. This often occurs with no known trauma. Since the heart loses its ability to effectively pump blood, the athlete quickly loses consciousness and will die. To stop this tragic cascade of events, normal rhythmical pumping of the cardiac muscle must be quickly restored using an automated external defibrillator (AED).

How Often Does SCA Occur and Who is Most at Risk?

Fortunately this tragic event is considered rare, happening about 100 reported times per year in the United States. The chances of a high school athlete suffering frame SCA is reported to be 1:200,000. SCA is more common in males, football, swimming and basketball and in African-Americans than in other races.

Heart Problems Are Difficult to Detect in High School Athletes

Typically, the athlete presents no symptoms of cardiac problems. The problem is caused by one or several cardiovascular abnormalities and electrical diseases of the heart that go unnoticed in healthy-appearing athletes. The most common cause is hypertrophic cardiomyopathy (HCM) which is an enlargement (hypertropci) of the heart muscle (myopathy) producing a thickening of the heart muscle which can cause serious heart rhythm problems and blockages to blood flow. The second cause is congenital abnormalities of the coronary arteries.

Warning signs to watch for include:

• Fainting, seizure or convulsions during physical activity
• Fainting or seizure from emotional stress or excitement
• Dizziness during exercise
• Chest pains at rest or during exercise
• Heart palpitations (skipping beats, irregular beats) during exercise or cool down periods after exercise
• Fatigue or tiring more quickly than others or than expected
• Shortness of breath limiting physical exertion

What steps can be taken to prevent tragedy during the annual pre-participation examination?

1. Parents and athletes should provide information to the examining physician about any experience with the signs and symptoms listed.
2. History of family members who died suddenly during or after exercise.
3. Any family member under the age of 50 experiencing sudden death in car accidents or drownings (unexplained heart stoppage may produce fainting or death an inopportune times).

Is There Any Tests That Can Detect These Heart Conditions?

Dr. Mark Russell, a pediatric cardiologist at the University of Michigan's C.S. Mott Children's Hospital, said no one screening test is able to detect the "several different heart conditions that can cause sudden death in a young athlete." EKGs may catch some defects, the echo others, while other problems may only be revealed in an exercise stress test.

How Can I Protect My Athletes?

Since detection can be elusive, consider the places where your athlete engages in activity - the swimming pool, the field, the gym, the weight room, the visitor's field - and consider having an AED available in these places to protect from the unexpected.

Find information on the AEDs available on the market today and request a FREE AED consultation >>

More blogs on the use of AEDs in schools >>

Articles That Make the Case for Placing AEDs in Schools:

Portable Defibrillator Helps Save Christian School Coach’s Life >>

Medical: Sudden Cardiac Arrests in Young Athletes Confounds >>

Additional Resources:

• www.suddendeathathletes.org
• www.4hcm.org
• www.heart.org

Phil Hossler, ATC has been an athletic trainer on the scholastic, collegiate and Olympic levels. He has authored 4 books and numerous articles and served as an officer in state and regional athletic training associations for 20 years. He is a member of four halls of fame including the National Athletic Trainers’ Association’s.

Tried and True Blister Prevention & Treatments

Your Burning Blister Questions Answered

Why Do Blisters Occur?

Athletic blister formations result when body tissue develops excessive heat due to friction and the body’s natural defense mechanism is to create a “water bubble” to absorb the heat and save the tissue.

Where Do Blisters Commonly Develop?

Blisters can form anywhere there is a sustained amount of friction, typically feet, toes, heels and the balls of the feet in runners, basketball players, or other athletes that run as part of the game. People who use their hands are prone to blister formation between the thumb and forefinger where an implement of some sort is held such as a bat, rake or paint brush.

Obviously the best way to treat a blister is to prevent it; be aware of that “hot spot” you are feeling before the need for localized fluid collection into a bubble results.

Are you Susceptible to Blisters?

Certain foot formations may make you more susceptible to blisters.

• Pes cavus or high arched athletes spin and spend time on the balls of their feet. Typically a blister will form on the plantar (bottom) side of the big toe knuckle.
• Hammer toes project upward and may rub against the toe box of the shoe.

Your Shoes May Cause Blisters

In addition, wearing shoes that are too narrow, too stiff, too short, not broken in gradually or too new and used too quickly may be problematic.

Treating Blisters

There are some basic techniques to treat blisters once they become “hot spots” or when they develop a bubble and before the skin tears open.

• Do not open a closed blister; the intact skin is a barrier against infection. Lubricate, protect the area, find the cause of the blister and make adjustments.
• For foot blisters: apply foam cushions/pads, petroleum jelly, wear a thin pair of socks under your regular socks, keep your feet dry, and wear fresh, dry socks.
• For hand blisters: wear gloves, lighten grip pressure.
• For blisters on other body parts: find the cause of the friction; typically friction from a repetitive movement.

When to Call a Professional

Any unusual signs of redness, pus, excessive pain or disability should be seen by your physician or podiatrist. Besides being annoying, blisters can be debilitating and if ignored may become infected.

Over-the-Counter Blister Prevention/Treatment Products That Work

There are many products available to prevent and/or reduce the presence and discomfort of blisters at www.esportshealth.com.

Here are a few tried and true products:

• Heel Pads >>
• Sore Spot Blister and Skin Bandages >>
• Ribbed Toe/Finger caps >>
• Blister Foam >>
• Blister Prevention Powder >>
• New-Skin Liquid Bandage >>
• Neosporin >>

Phil Hossler, ATC has been an athletic trainer on the scholastic, collegiate and Olympic levels. He has authored 4 books and numerous articles and served as an officer in state and regional athletic training associations for 20 years. He is a member of four halls of fame including the National Athletic Trainers’ Association’s.

Should You Really Be Taking Vitamins?

4 Common Questions About Vitamins

Q. When I feel tired can vitamins give me more energy?

A. Vitamins are catalysts to natural body functions. That is, they help the food you eat become broken down and absorbed for energy. Vitamins, by themselves, do not "pep you up". Active people need a diet high in carbohydrates, moderate in protein and low in fat while meeting your daily requirements for fruits and vegetables. Vitamins allow your body to do what it is supposed to do. When you ask what vitamin is good for energy there is no single answer. The B vitamins work together to help the body process, produce, and efficiently use energy in different forms, and each one is necessary for good health.

Q. I am lifting weights and exercising every day. Should I increase my vitamins supplements now?

A. The National Academy of Sciences has established Recommended Dietary Allowances (RDA) as a guide to establish dietary requirements. Megadoses (up to 10 times normal) of vitamins and minerals can be dangerous. When consumed in excess, vitamins can be drug-like rather than body regulators. Fat soluble vitamins (such as A and D) can actually become poisonous when taken in excess over extended periods of time. The vast majority of Americans can met their vitamin and mineral needs by merely eating a better, balanced, and diversified diet.

Q. Are vitamin pills the same as the vitamins in food?

A. Yes. However, food also provides a source of calories to be burned for energy. Vitamins alone do not provide any energy. Food also provides bulk (fiber) which aids in digestion, absorption and elimination to promote regularity.

Q. What should I do if I am still not certain if I should take vitamin supplements?

A. Check your age and look at your diet. A vitamin/mineral supplement may be useful at a certain age (improper or inadequate eating habits as we grow older) or if you have a mild medical condition (calcium deficiency); check with your physician if you have any doubts.
A balanced diet is just that: balanced. It has contributions from fruits, vegetables, breads, lean meat/fish and dairy products. An athletic diet should concentrate on complex carbohydrates (65-70%, with protein contributing 10-15% and fat consumption reduced to 20-25%).

Phil Hossler, ATC has been an athletic trainer on the scholastic, collegiate and Olympic levels. He has authored 4 books and numerous articles and served as an officer in state and regional athletic training associations for 20 years. He is a member of four halls of fame including the National Athletic Trainers’ Association’s.

Ideas For Educating the Injured Athlete on Self Care

Are Your Athletes Fully Understanding Their Care Plans?

Today’s athlete must be smarter, more sport sophisticated and rule- conscious than ever before. But in athletic sport medicine realms they often are not students "of the game". As athletic trainers, part of our caring for our athletes is to make them more cognizant of practices and routines that will keep them safe, heal faster and prevent injuries from occurring. As certified athletic trainers, we know firsthand the anxiety and depression that accompanies our athletes when they get injured. We also know that while we are explaining the initial care plans to our athletes, the athlete often can't focus on what we are saying due to the stress of the moment.

Question: What do you do to educate your athletes?

• Handouts, posters, and group talks are generally successful and are certainly a mainstay of the training room.
• What about getting a guest spot on the local cable station that covers your events? This can be seen by athletes and parents alike and is often aired multiple times.
• What about individualized computerized injury instruction?

Using Simple Technology To Educate

By creating Power Point presentations on topics of your choosing that include your own recorded voice, it is as if you were speaking to the athlete and giving them the information you want at a convenient time for both you and the athlete.

To ensure more complete care for my athletes, I set aside a corner of the training room as their area for learning. By placing a computer on the desk with headphones, I can select the presentation that the injured athlete needs to view. Since I create the slides and record my voice onto each slide, I am certain it applies in my situation and school.

I am creating a variety of Power Point presentations on topics such as ankle injuries, stretching guidelines, concussion, student assistants’ guidelines, knee and shoulder care, hydration, use of crutches, shin splints, and pre-season instructions. The inclusion of videos via YouTube and media outlet reports certainly adds to the education being presented.

Sports Health can ease the burden of finding material for you to share with your athletes. In the area of concussion, look at the Sports Concussion Tool Kit for Athletic Trainers and Coaches at www.esportshealth.com.

Phil Hossler, ATC has been an athletic trainer on the scholastic, collegiate and Olympic levels. He has authored 4 books and numerous articles and served as an officer in state and regional athletic training associations for 20 years. He is a member of four halls of fame including the National Athletic Trainers’ Association’s.

Is BMI a Reliable Measurement For You?

Your Body Mass Index (BMI) is an estimate of your body fat, based on your height and weight. The higher your BMI, the higher your risk of developing such conditions as heart disease, high blood pressure, sleep apnea, and type 2 diabetes.

BMI Measurements in Adults

Currently the standard definitions of overweight and obesity used by the Center for Disease Control (CDC) and World Health Organization (WHO) says for adults, a body mass index of 25 or more is considered "overweight" and a BMI of 30 or more is considered "obese". Basically a BMI of 19-25 is considered healthy.

BMI Measurements in Children

For children, the charts of Body-Mass-Index for Age are used, where a BMI greater than the 85th percentile is considered "at risk of overweight" and a BMI greater than the 95th percentile is considered "obese".

How BMI Can Be a Misleading Measurement:

• Body Mass Index changes with age, obviously in children but also in adults.
• For children and the elderly, BMI may be misleading since the muscle and bone to height relationship is changing.
• Men and women are different.
• Short adult women have higher BMI than taller women.
• Race/ethnicity and nationality affect body composition and BMI. In some ethnic groups, such as Pacific Islanders, BMI overestimates fatness and risk.
• Muscular people, athletes and bodybuilders particularly, have high BMI values, but are not fat.

BMI can potentially misclassify people as fat, even though their percentage of body fat is not excessive. Therefore, trust your own judgment about your own body because BMI-based body descriptions can be wrong.

Excessive anxiety is not healthy either. Eat smart, use portion size as your guide and make exercise a habit you can stick with.

There are several BMI calculators available by searching the internet. Rather than try to fit your body into a standard chart, you might wish to utilize technology that can be used by you right now. Sports Health has several BMI analyzers available for you and your athletes.

Phil Hossler, ATC has been an athletic trainer on the scholastic, collegiate and Olympic levels. He has authored 4 books and numerous articles and served as an officer in state and regional athletic training associations for 20 years. He is a member of four halls of fame including the National Athletic Trainers’ Association’s.