Resources for High School Coaches

Below is a list of resources that high school coaches may find useful in planning their practices and other activities.  It is my hope that this page will be updated often and have new content added regularly.

I) Heat Illness

   A) This is a urine color chart excerpted from the NATA position statement on hydration in athletes.  This allows athletes to have a quick reference to know how hydrated they are. Here is a link to a PDF format of the urine chart.

   B) This is the temperature and humidity chart for determining the risk of heat illness in a given practice. Pictured is a temperature and humidity chart, a link to a colorized version of the temperature and humidity chart, and a third, colorized chart that has some additional information on it.  I leave all three up here since some people will want to print these graphics while others will keep them on their mobile devices, each with different screen resolutions.

   
C) Weight loss calculation charts and instructions

D) Coach Smart App by Vanderbilt Sports Medicine--Free (iOS, Android)

   E) OHSAA heat index guidelines for practices

II) Lightning Safety

   A) A sample lightning safety protocol sheet

   B) Coach Smart App by Vanderbilt Sports Medicine--Free (iOS, Android)

   C) Boltmeter by Allisonhouse LLC-- $1.99 (iOS)

D) Mobile Storm by Skywatcher-- (Android)

E) Weatherbug - (Spark) (iOS, Android)

III) Traumatic Brain Injury (TBI)

   A) A TBI information sheet (Lake Health)

   B) TBI information Sheet (National Athletic Trainers Association)

   C) A list of TBI myth

   D) Concussion Recognition and Response App: Coach and Parent Version by PAR-- $3.99 (iOS, Android)

   E) Proper Football Helmet Fitting Guidelines:

      1) Riddell Football Helmets (PDF files are on the right and videos are lower on the page)

      2) Schutt Helmet Videos

         a) AIR-XP

         b) DNA Recruit

         c) Youth Ion 4D

      3) Generic Video

      4) USA Football Video (partnered with Riddell)

   F) ImPACT (Neurocognitive testing software purchased by Lake Health for its contract schools)

   G) www.theconcussionblog.com

   H) www.sportsconcussions.org TBI information

   I)  Nowinski, C. (2006). Head Games: Football'sConcussion Crisis from the NFL to Youth Leagues. Plymouth: Drummond Publishing Group.

   J) Carroll, L., & Rosner, D. (2011). The Concussion Crisis: Anatomy of a Silent Epidemic. Philadelphia: Simon & Schuster.

IV) Nutrition

   A) A general nutrition guidelines handout

   B) My Fitness Pal (www.myfitnesspal.com) --Free (iOS, Android, Blackberry, Windows Mobile)

   C) www.fda.gov (Federal Drug Administration)     

   D) http://www.ftc.gov (Federal Trade Commission)

   E) www.healthycompetition.org/hc/main.html (Blue Cross/Blue Shield)

   F) www.nal.usda.gov / http://www.nal.usda.gov/fnic (United States Dept. of Agriculture)

V) Injury Treatment

   A) Information on the R.I.C.E. principle

   B) American Red Cross First Aid App--Free (iOS, Android)

VI) Record Keeping

   A) A sample emergency action plan

   B) First aid kit supply list (Football)- This list is broken down into "essential, recommended, and luxury" supplies that are commonly found in first aid kits.
   C) A sample lightning emergency action plan

VII) Infection Control

   A) MRSA information sheet

VIII) Drug and Supplement Assistance

   A) World Anti-Doping Agency App by WADA--Free (iOS, Android)

   B) www.wada-ama.org (World Anti-Doping Agency)

IX) Injury Prevention - Equipment Fitting

   A) Football shoulder pad fitting video

   B) Proper helmet fitting videos---See above in TBI resources (Section III)

   C) Soccer shin guard video

   D) Hockey Helmet

   E) Running Shoes (Runner's World Article)

X) Lake Health PASP Information

   A) Ohio Department of Education Information

   B) The bibliography handout from the lectures

   C) www.lakehealth.org  (Lake Health website)

XI) Miscellaneous Online Classes, Links, and Videos

   A) www.nfhslearn.org

     1) The National Federation of High Schools has a host of free classes that cover topics like concussions, heat acclimatization, and sportsmanship.

     2) The NFHS also has several courses for learning the techniques of coaching most common high school sports for a fee. $50-$75

   B) www.vimeo.com/nata1950 -- A host of videos sponsored by the National Athletic Trainers' Association on a wide range of topics.

   C) NATA recorded webinars -- Webinars designed for athletic trainers on a wide variety of sports medicine topics.

   D) My social bookmarking site -- My social bookmarking site where there are thousands of articles and videos tagged.

   E) www.glata.org (The Great Lakes Athletic Trainers’ Association)

   F) www.nata.org (The National Athletic Trainers’ Association)

   G) www.medscape.com

   H) www.momsteam.com

   I) www.ncaa.com (The National Collegiate Athletic Association)

   J) www.nfhs.org (The National Federation of High Schools

   K) www.oata.org (The Ohio Athletic Trainers’ Association)

   L) www.ohsaa.org (The Ohio High School Athletic Association)

   M) www.olympic.org  (The International Olympic Committee)

   N) www.webmd.com

  

Please note: If you have any other resources that you feel should be added to this list, think something is missing from it, or you find a dead/broken link, please leave a comment below so that I may address the issue.  This is not an exhaustive list and you may know of a resource that is even better than what is listed here. This also means that this is a dynamic blog post that is intended to change often and updated regularly.  I highly recommend that you check back often.

Peyton Manning Makes a Joke?

I have to say that I have had nothing but respect for Peyton Manning and the way he has conducted himself.  He has appeared, to date, to take his position as a role model seriously and has stayed out of trouble.  Therefore, is was disappointing to see the article written recently in which he admitted to dogging the neurocognitive baseline tests in order to allow himself an easier return to play after a TBI.  In a time where kids in middle school and high school work very hard to emulate those that they look up to, I found this comment disturbing.  The fact that Mr. Manning more recently called it all a joke doesn't help matters.  He has basically encouraged kids to try to subvert the system in any manner that they can to be able to return to play as quickly as possible.  I  hope that over the next few weeks, he will continue to try to retract his statement in full and promote taking the exams much more seriously.

"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.

No surprises with RTP delay increases after TBI

According to a recent article in the American Journal of Sports Medicine, kids who sustain a TBI are less likely to return to play within a week if they have neurocognitive testing performed as part of their treatment.  While this is probably a valid reason for using the testing, (and I doubt that the testing is that cause of any increase in impairments) I can think of several coaches who will have a very difficult time with understanding this issue.  I have already have heard several comments about how coaches will not refer to an ATC who will use the testing so that they can get their star athlete back in the game sooner.  Talk about a disgusting problem waiting to happen.  Fortunately, these coaches are in the overwhelming minority and I pray they are not in a head position that could result in an unfortunate situation.

Of course, the other disturbing finding in this study was that the vast majority of the TBIs were a result of a head to head hit.  The kind of hit that was called far too infrequently in high school football this past season as a penalty.

Finally, ESPN The Magazine also had an interesting, informal poll that asked various people who are involved in high school athletics and their attitudes towards TBIs.  The Concussion Blog as a short summary of it on their pages.

TBI symptoms differ between genders

It is interesting to note that according to recent research cited here, that boys and girls will report different symptoms after sustaining a TBI.  According to this article and the research it cites, boys will more often complain of "amnesia and confusion/disorientation, whereas girls tend to report drowsiness and greater sensitivity to noise more often."

The fun part about this research is that I have been closely tied to it for about 4 or 5 years.  The research is called "High School Reporting Information Online."  It is run by Dr. Dawn Comstock of the Ohio State University medical center and tracks injury rates of children across the country in various high school sports.  I have been reporting our schools' injuries to the study for several years.  It is always fun to see that our school is contributing (even if it just a small percentage) to the kind of research that is being done here.  While this is not the first time I have seen this High School RIO study cited in an article, this is one of the more interesting results that have been found by the study.  It is certainly very practical and useful information in the hands of all high school ATCs.

I will also be looking forward to the January Journal of Athletic Training to see the article that is mentioned in this publication.

I hope the NATA sends the AAN a big fruit basket for Christmas this year.

The American Academy of Neurology (AAN) released a statement that gave athletic trainers a huge endorsement for what we do every day.  "The AAN issued five specific guidelines in the statement, which recommends that any athlete suspected of having a concussion should be removed from participation until he or she is seen by a physician trained in the evaluation and management of sports concussions, and that an athletic trainer should be present at all practices and games where a concussion might occur."  Needless to say, this can offer athletic trainers some additional job security in this very tight economy.  That is something that everybody is looking for today.

Another part of their statement states that a neurologist or a physician with proper training should be referred to when return to play decisions are being made for any athlete who has been diagnosed with a TBI.  Once again, I feel they are reinforcing a point that all athletic trainers would agree with.  In particular, I would hate to see a physician allow a kid to RTP when their field of practice doesn't require them to be well versed in TBIs, such as a urologist or an obstetrician.  While they may be very good at what they do, most specialists who have not been trained to work with TBIs have not been exposed to it since medical school.

Congressional Hearings on TBIs

In this article, Lindy Washburn describes the testimony of a seventeen year old basketball player who appeared before a congressional committee to talk about her long term symptoms related to her repetitive TBIs.  She stated she had as many as seven TBIs from playing basketball over her short career and has since had five more due to other incidents after she quit basketball.  While I realize the severity and the consequences of second impact syndrome and the effect that multiple TBIs can have on a young brain, I have a big problem with congressional hearings on the subject and the potential for federal guidelines as a result.  At one point in the article, the writer makes a very dubious remark about the reliance on athletic trainers and physicians for determining the RTP standards for each athlete.  While the TBI testing software is a very useful tool for helping doctors and ATs to determine how much progress an athlete has made, it is still not the final answer.  There is much to be said about the clinical experience and expertise of physicians and ATs using the tools.  Even the developers of the software suites are quick to point this out.  This article makes it sound as if the software is the only determining factor in the RTP decision.  This seems to be a little irresponsible to overstate the value of the software.

Repeated TBI and Lou Gehrig's Disease?

Researchers will publish an article tomorrow in the Journal of Neuropathology and Experimental Neurology that links repeated head injuries to Lou Gehrig's disease, according to Alan Schwarz of the New York Times. In Mr. Schwarz's article he describes that Lou Gehrig's disease may not be the same as A.L.S. as it has been thought for the last 70 years. In fact, the researchers hypothesize that it is an entirely new condition that presents like A.L.S. The researchers site different protein strains are at work in the brain for Lou Gehrig's disease that aren't found with A.L.S.

Mr. Schwarz also does an exceptional job recounting the number of reported injuries that Lou Gehrig suffered during his career in his article. With the details that he gives, it makes me shudder to think that he was allowed to RTP. Of course, that was a different era of sports medicine that didn't recognize the risks involved with letting him RTP. I will look forward to reading the research tomorrow and see what their findings are.