Sports Injury Management

1. Sports Injury Management Session One

6. What is required by the State Department of Public Instruction?? NC Constitution, G.S. 115C-12(12) Article IX, Sec. 5 .0203 Athletic Injury Management (a) Each LEA must designate for each high school within each jurisdiction either a licensed athletic trainer who is qualified pursuant to Article 34 of Chapter 90 of the General Statutes of North Carolina or a first responder.

7. Requirements – con’t. (b) Afirst responder must complete and maintain certification or be in process of completing courses in the following: (1) cardio-pulmonary resuscitation as certified by an organization such as the American Red Cross or the American Heart Association; (2) first aid as certified by an organization such as the American Red Cross or the American Heart Association; and (3) injury prevention and management as certified by an organization such as the National Athletic Trainers Association, the North Carolina Athletic Trainers Association of the NC High School Athletic Association.

8. Requirements – con’t. In addition, each first responder must complete 20 hours in staff development each school year. PROBLEM ?!?!? The state does not provide the funding for this guideline. However, legislation has been introduced to fund having Licensed Athletic Trainers at every high school. But, until then, YOU are the experts in sports injury management.

9. What this course is designed to do… • Class Meeting #1 - Expectations, Course Contents - NCCA Coaches Clinic Information - Prior to August 1st - Equipment Fitting - Communication - Sideline “Bag of Tricks”

10. (Afternoon Session) - Record Keeping - Emergency Action Plans • Class Meeting #2 (June 4) - Heat Illness - Athletes with Sickle Cell - Athletes with Diabetes - Athletes with Asthma - Shoulder Injuries - Hand Injuries

11. Class Meeting #3 (June 11) - Knee Injuries - Ankle Injuries - TBA If for some reason, you have had to miss, make-up time will be offered on this day after noon.

12. At the end of this course….. You (and your school system) will receive a certificate verifying your attending 20 hours of instruction in Sports Injury Management. This will equal 2.0 CEU’s from this educational institution. This certificate does NOT license you as an athletic trainer. It satisfies the NCGS of 20 hours of instruction.

14. North Carolina Coaches Association • Monday – Thursday, typically the 3rd week in July; this year July 18 – 20 • Must be affiliated with a school to attend; LAT’s receive a “coaches card” which allows you to attend any HS game in the state of NC and a 2 tickets to some college games (ECU, NCSU, UNC, Duke, Wake Forest); FR’s receive an “associate card” which gains you admittance to HS games, but not college • 3 Levels of Injury Management taught, you will be eligible for Level 2 after this course

15. Prior to July 30th! • Physicals – new form required by NCHSAA - Read MEDICAL Hx for possible issues, concerns, prior injuries; current medications - Read evaluation to make certain athlete has been cleared / deferred

16. Equipment Fitting - Helmet • Clean and sanitize each helmet (has probably been done by professional company) • Inspect each helmet each / out - check for cracks, especially around holes drilled in shell - check condition of inside support - check facemask (for any metal showing, is it correct size for shell) - check chin strap

17. Helmets – con’t. • Be sure all required repair work has been completed. • Check every helmet for a current NOCSAE (National Operating Committee on Standards for Athletic Equipment) stamp, and that it is legible. • Fitting • Instruct, if necessary on how to put on the helmet • Wet hair to simulate sweaty game conditions

18. Helmets – con’t. • Fitting - frontal rim of helmet should be 1 inch (or finger width) above the eyebrow - chin strap fastened - padding @ posterior rim of helmet should be snug - cheek / jaw pads should be seen clearly from the front, fitting firmly, but comfortably on skin without squeezing

19. Helmets – con’t. • Facemasks: proper style for position, clearance between the end of the nose and the inside of the mask should be 2-3 finger widths; vision should not be impaired • Crown check: lock fingers on the very top of the helmet and pull down; ask where pressure is felt, if evenly distributed, good fit • Lateral movement: place hands on either side of helmet, ask athlete to hold head still, gently force head side to side, watching skin on forehead

20. Helmets – con’t. • Vertical movement: hands on sides of helmet, ask athlete to hold head still; gently force helmet up and down; skin on forehead will move with helmet and will eventually slip a little, but should not come down to nose. • Recording: which athlete is wearing what helmet?

21. Fitting - Mouthpieces • Mouthpieces should cover all upper teeth. • When athlete opens mouth, mouthpiece should remain on upper jaw. Mouthpieces come in different forms…some with straps, some without; some custom fit, some “melted” to fit.

22. Fitting – Shoulder Pads • Try pads on; secure the straps and laces. • Anterior View • Check for proper AC joint coverage; pad should extend ½ inch over deltoid. • Check for proper pectoralis muscle coverage. • Collar should provide comfortable ROM to the neck ( ½ inch ); arms raised in an upward motion should not pinch the neck • Check coverage of the deltoids (cap should fit snugly) • Check trapezius coverage • The arches should meet evenly with no overlap.

23. Fitting – Shoulder Pads • Lateral View • Check for proper AC channel; check to see whether it is off the AC joint • Check for proper coverage of the caps over the deltoids • Check the clavicle

24. Fitting – Shoulder Pads • Posterior View • Check coverage of rhomboids and latissimusdorsi; pad should fit neatly over this region, arches should not overlap • Check the neck area again. • Check the straps. • Shoulder pad should fit over the entire shoulder region, yet allow for ROM. • Player should raise arms over head. • Take FB stance, straps should be snug but not pinch or choke the athlete. • No restriction of movement of the extended arm. • Properly worn jerseys and sleeves help keep pad in place.

25. Personal Equipment • Shoes – should not be “new” the first day of practice; if worn last season, may be worn out; may get by with changing inserts • Socks – absorbent!, sometimes wearing 2 pairs of socks (one inside out) will prevent blisters • Ankle braces - if athlete has history of ankle sprains/strains, lace up braces save time and money

26. Personal Equipment – con’t. • Practice clothes – cotton is best, polyester does not allow heat to dissipate; encourage / require athletes to take smelly clothes home • Jock straps – they don’t like to wear them and many of them don’t; if athlete has only one testicle, REQUIRE IT!

27. Things to talk about with athletes… • Hydration, Water / Gatorade / Energy Drinks • Daily weigh-ins • Building a trusting relationship Things to talk about with parents… • Parent expectations of Athletic Trainer / First • Responder • LAT / FR expectations of Parent • Expectations of LEA / Athletic Department

28. WHAT SHOULD YOU HAVE IN YOUR BAG OF TRICKS? • Adhesive tape (1” to 1 ½” rolls) • Antimicrobial hand wipes or soap • Antibacterial / antiseptic cream • Band-aids (regular, large, knuckle, fingertip) • Bandage scissors or tape cutters • Biohazard bags • Butterfly bandages or steri-strips • Contact lens kit / solution • Elastic wraps (ACE 3”, 6”) • Emergency information (athlete’s home phone number, medical release forms, money, etc.) • Eyewash, sterile solution • Foot powder • Hydrogen peroxide

29. Bag of Tricks – con’t. • Instant cold packs / Zip lock bags and ice • Latex gloves • Mirror with plastic holder • Moleskin / high density foam • Mouth shield / protector • Paper bag • Pencil and paper • Providine swab stick or wipes • Roller gauze • Sterile gauze pads • Skin lubricant – petroleum jelly • Sun lotion • Thermometer • Tongue depressors • Triangular bandage / sling • Tweezers • Underwrap / Pre-wrap

30. CHEAP TRICKS • Flea markets • Great place to find crutches for under $5.00 • Can find other goodies – Fry Baby, etc. • Can possibly find a small chest freezer in which to keep ice blocks • Call companies you deal with and ask for “freebies”. The worst they can say is no. • Be creative!!! Something that you dream up may make you some money one day (as long as it is not detrimental to your athletes).

31. More Cheap Tricks… • Sport Health Catalog Rubbermaid Cooling Tub (300 gal) $276.00 Cheap, creative, innovative… Go to Walmart or somewhere similar and get a child’s pool. A small one will do for this…costs $15 - $20, maybe free at end of season.

32. Cheap tricks – con’t. • Sport Health Catalog • Mist machine $545.00 Cheap Way Out…. Again, go to Walmart – garden section, get a sprayer used to spray flowers with fertilizer, plant food, etc. Add ice and water, pump to build pressure, and spray athletes to cool them down…$18.00.

33. Still another cheap trick!!! • Don’t throw away 2 liter drink bottles! Cut off the top (at a manageable height). • Fill the bottom part ¾ of the way full and put in the freezer. When frozen, take out and use in water coolers. Block ice lasts longer than crushed (and it doesn’t get wasted).

34. BEST BRIBE !!! Go to Sam’s Club / Walmart….purchase a box (or more) of Flavor Ice Popsicles….$7.50. I can get my football players to do just about anything I need done for a popsicle. TELL ME YOUR IDEAS!!!!!

35. COMMON SENSE • Use ALL available technology to determine practice times, duration of activities, etc. More on that next class meeting. • Have a plan, but be able to adapt to specific conditions. • “Play nice” with people who can and will help you (EMS, physicians, etc.) Offer your assistance to them. They may not accept your offer, but they will remember that you offered.