The toughest decisions

A recent article by  a staff writer at MDNews.com (and was also commented on by D. Fink at The Concussion Blog) does a great job of expressing the difficulty that both physicians and athletic trainers often face when deciding whether or not to return a kid to play safely or not.  The article points out that while a clinician's exam should lead the AT or physician to a reasonable idea of what is going on, it isn't always the only factor influencing the decision.  Often, there are great pressures brought by parents, coaches, and the players themselves to try to get the athlete back into play.  It is often very easy to sit from the sideline and assess whether or not the right thing was done, especially several hours after the incident has occurred.  (A familiar idiom often used in athletics comes to mind about hindsight being 20/20.) The other issue that everyone need to keep in mind is that not all TBI symptoms appear immediately at the time of injury.  Occasionally, it takes a few minutes to half an hour for the symptoms to become detectable.  While there are always those hits that everyone cringes about and it is obvious something is wrong, that isn't always the case.  To further complicate things, sports like wrestling give the AT or physician only a minute and a half to perform their evaluation and come to a conclusion.  This is where the rules need to change BADLY.  This is a near impossibility in most cases to be able to determine if the athlete has suffered a TBI or not in such a short amount of time.  Hopefully, this will be addressed in this upcoming off season.

Custom shoes may be not all they are supposed to be.

In an article that is surely going to have many cross country and track coaches scratching their heads (and probably a few shoe manufacturers and salespeople screaming its illegitimacy,) the author shows some recent research that demonstrates custom shoes may have no real benefit.  It may be a little counter-intuitive, and certainly requires a few more trials of the study to be certain, but it looks like the very expensive running shoes may not actually help reduce injury.  For about 20 years now, there have been three kinds of shoes on the market for every kind of runner and their foot type.  Even more recently, there are now over the counter orthodics with a computerized foot measuring device that determines what kind of orthodic you should buy.  The shoes go by different names based on the manufacturer, but the premise is the same.  They are either extra soft, or cushioned, for people with very high arches, extra rigid (supportive) for those who have flat feet and pronate excessively, and a mid-range shoe for those with relatively normal feet.  The interesting part of this study is that there was no significant change in the injury rate for from those people who ran with a shoe that was custom versus those that ran with another shoe.  The study was performed about 1400 Marines during 12 weeks of their training.  It certainly flies in the face of what runners have been taught to look for in a shoe for quite some time.  In the end, it should probably just come down to what feels comfortable and "run with it."



Another insult

So the columnist decided to not follow through and perform any research since he had his mind made up already about how effective ATC's can be. Instead, he holds to his insults and defended his comments from his initial post. I will admit that I found this extremely irritating and responded with a scathing email in which I pointed out that all professions have those in their ranks that are barely minimally competent. This should not reflect the majority. Finally, I flatly refuse to give this marginally competent columnist any more press. This discussion is over since it is now obvious all this columnist wants is the press.

At least the NATA had a reasonable response to this garbage. I include the link, but it is password protected for NATA members only.
http://bit.ly/dE1mpA

Response to the previous post.

It seems it didn't take long for the newspaper to respond to the outrage generated by Mr. Carpenter's comments late last week. Below is a link to what the paper had to say. http://bit.ly/i50sLk Needless to say, I look forward to the promised response from Mr. Carpenter in tomorrow's publications.

Another author needs an update

I was looking through my series of news alert when I saw headline that grabbed my attention.  "Bill to ease concussions is bogus" was how the headline read and it immediately got me to wondering what the author was getting at.  Paul Carpenter, a writer for the "The Morning Call," was trying to relate his experiences while participating in athletics 30 years ago and somehow call it relevant today.  He makes a serious charge when he states "trainers are nothing but flunkies for coaches, some of whom are willing to do anything to win."  The problem here is that we are not "trainers."  We are athletic trainers.  This subtle, but important distinction allows us to distinguish ourselves from personal trainers and fitness trainers who do not have the background in studying mild traumatic brain injuries (mTBIs) and should not be able to make a return to play decision.  By demeaning athletic trainers in the way you have, you only made yourself look foolish.  I was hoping that when I read your story, that you would have been more focused on the rules changes that are trying to decrease the number of risky hits, the style of helmet, or some other aspect to the TBI controversy a the moment.  In closing, I would like to invite Mr. Carpenter to visit the National Athletic Trainers' Association website through the link provided below.  I would hope that in the future, he would take the time to ask a few more questions before jumping into the fray with terribly outdated statements.