Opening Day is here again!

A year ago, I posted the picture of our very wet, unplayable softball diamond on opening day.  This year, our fields aren't just wet, they are frozen!!!  I really have a hard believing that it is opening day when I see this on the weather report.  I am especially excited by the "feels like 23°" right now.  That definitely reminds me of baseball.  Thankfully, all our home events are postponed, but beat of luck to our varsity baseball team in their season opener on the road.

New TBI app for iPhone/iPod Touch

Last week, in a tweet from SportsConcussions.org, they advertised their new TBI assessment tool that is designed to work with the iPhone and iPod touch.  The Blackberry and Android versions are expected to be released in the near future, according to the website.  To begin with, the application shows great promise since "The diagnostic tests are a combination of the medically accepted SAC, SCAT2, BESS, and the CDC's On-Field Mental Status Evaluation."  

The funny part of it is that, at the moment, I could not purchase the application on my 2nd generation iPod, since it "hang in a loop" after tapping the buy button.  (I contacted the programmer, and they are working to correct this issue.  We have shared several emails and they said it seems to limited to certain models only.  I fully expect to hear from them soon letting me know that the problem has been corrected.  I also plan to update this post once I get the response.)  


The funny part is, it does work on my iPad 2.  The working screen is small since it is written for the smaller devices, but it is usable.    I suggested to the programmer that they optimize the program for the iPads.  They agreed that it was a good idea and I assume will tackle that soon. 


The frustrating part is that the tweet came 2 days after my athlete's last TBI.  (I just missed being able to try it out.)  Therefore, I was relegated to making up a fictitious athlete to see how well it worked.  I was pleased to see that it is an easy program to use and does have the potential to be used by coaches and parents as well.  Obviously, I'd prefer to see more input from other ATs and potentially from some physicians before it makes its way to the lay public.


The important part to remember with this testing is that many of the studies that examine the tests upon which this software is based indicate that they should only be used acutely (on the sidelines.)  These tests are not supposed to be used for follow-up care and and are not sensitive to the chronic issues associated with post-TBI syndrome.


I am hoping that this works as well as I expect it to and will make carrying paper and pen around to perform a SCAT2 test obsolete.  So the only question I have now is...Who wants the first big smack in the head to give me the opportunity to try this?  No volunteers?  I guess I will just have to wait it out then.

"Legal hits to the head"

The NHL, during its recent GM meetings in Florida made a whopper of a statement referring to how they intend to try to prevent TBIs.  Gary Bettman, the league commissioner said "a full 14 percent of N.H.L. concussions are caused by what Bettman called “legal head shots”; i.e., north-south hits to the head that did not specifically target the head."  The time has come to make sure that these hits are illegal as well.  Hits that target other areas of the body and end up hitting the head should be illegal regardless of their ordinal direction.  As stated in the previous post, this is highly subjective and leaves far too much room for interpretations.  I will be very disappointed if the NHL continues to maintain the hard line stance of "it's just a part of the game."  If hockey wants to survive, it had better modernize along with science and medicine.  

I also have to disagree that the team athletic trainer should have no input as to whether an athlete can return to the ice or not.  I understand that the NHL has the resources to have a "neutral physician" examine any athlete that takes a hit, however, it is the AT that spends the most time with the athlete.  The AT can give valuable information to the physician as to the athletes baseline personality and intelligence to aid in the RTP decision.  Taking the athlete away from this resource, into a quiet room away from everybody is a mistake.

There is Absolutely No Excuse for This!

There is no reason for this hit.  The NHL needs to come down extremely hard on Chara for this hit.  These guys are professionals who spend hours on the ice and know exactly where they are and how risky a hit like this is.  It sets an extremely poor example for young athletes to follow.  I would hate to see this go punished lightly and for kids to think this is acceptable in any way.  There are already several other like minded athletic trainers saying the same thing that I am here.  Dustin Fink ATC, of the concussion blog, has already posted similar sentiments. 

The NHL may consider a small redesign of that portion of the rink. Instead of a 90 degree angle of glass, they may consider a pair of 45 degree angles to help decrease the risk in this part of the rink.  However, even this small change would not excuse this kind of hit.

Finally, and most importantly, our prayers need to go out to Max Paciorietty and his family.  I hope that he recovers fully with no ill effects despite the violence of this incident.

3/15/11 ADDENDUM:

I find it very disturbing that despite the fractured vertebrae and the TBI suffered by Paciorietty that the NHL figured the hit was not intended to inflict harm and let Chara go with the penalty he served in the game.  The NHL needs to avoid interpreting intent.  This is far too subjective and leaves way to much room for interpretation.  This hit was unnecessary and ugly.  It required far more attention from the league's management.

Once again, our prayers need to continue for Paciorietty's speedy recovery and for his family.

National Athletic Training Month

March is National Athletic Training Month. Why is this significant? It means that athletic trainers across the country are going to spend the month of March trying to increase awareness and educate the public about what an athletic trainer is. This will happen in many creative ways limited only by the imagination of ATs. Twitter, Facebook, and many PSAs at local games are the primary ways of getting the word out because they are so inexpensive.

So now you will probably ask "What are the athletic trainers saying?" Most ATs will spend their time linking to the NATA website and quoting their definitions about what an AT is. Others will spend time trying to differentiate athletic trainers from personal or fitness trainers and will insist upon being called by their full title. Finally a few will also try to differentiate us from physical therapists (with whom we have a lot in common,) or other allied health professionals. Personally, I'd prefer that the differentiation be made between athletic trainers and physical therapists for the simple fact that both require college degrees for entry level. Granted, PTs require a DPT now, but it wasn't that long ago that they required a bachelor's degree like ATs. I often hesitate to contrast us with personal trainers simply because there are a great many programs with varying standards for certifying personal trainers in the country. This, as ATs discovered and corrected, is not an efficient way to develop a profession. (Albiet, athletic trainers only had two paths to certification and not many.)

In light of some recent poor reporting in a small newspaper where the qualifications of athletic trainers were questioned, the importance of getting the word out about who we are was severely underscored.  Athletic trainers need to get into their communities and spread the word through education at various youth league events and through parent education pieces.  The recent explosion of coverage in the media that TBIs have received gives all ATs an incredible opportunity to increase their exposure.  Because of our unique intimacy with this issue, we should be on the forefront doing this education.  Far too many physicians and neuropsychologists have been singing our praises about our abilities and need us to continue the work we do.  This is a more meaningful kind of exposure in my mind because it demonstrates our abilities rather than simply discussing or bragging about them.  The power of demonstration, as many of our teachers in the past have pointed out, is much more significant than simply reading about a topic.  These demonstrations of our knowledge and experience are a much more powerful example of what we can do than retweeting the last promotional message from @NATA1950 and thinking that you have fully contributed to NATM.

There are many excuses why we can't be out talking to our volunteer parents at the elementary school leagues to explain what is going on with current research and giving them the latest guidelines for safe return to play after TBIs.  However, this is the best place where we to be recognized since this becomes an investment into the future of each community.  The elementary kids are, for the most part, the future of the high schools where most of us are employed.  Getting in front of the parents at that age will only help them to trust in your decisions once their kids are under your direct care in a few years.  You may not have to do it alone either.  Local collegiate ATs and those working in other, nontraditional settings may be willing to help with the outreach education and decrease the burden for any one person.

The final point to make is that whatever you do, make sure you represent your profession properly and always do it to the best of your abilities.  Make sure people know who athletic trainers are and what it is that we do.  Too often, we are in the background doing the work that only the athletes, coaches and administrators see.  We need more than that if we are to grow as a profession.