One of my clinical goals this semester is to learn more about blood restriction training, and learn the implications in the rehab setting for this type of training. In the past, about three years ago, I had read an article that wasn’t really from a relatively non-credible source about this type of training. I thought the article was pretty interesting at the time so I attempted to research some things about this type of training. During my research I found that there wasn’t much information about blood restrictive training when talking about using it in the rehabilitation setting, only using it in the bodybuilding setting. According to a group of bodybuilders, blood restriction training allowed them to see huge gains in strength and muscle size, in much less time training. So instead of spending literally half the day training, they were able to reduce their training to 3-4 hours per day. There was no explanation of the science behind this type of training really, just an explanation that pretty much said that it worked. Now I’m not sure how much of this was placebo effect, or if there is any credibility to their statements, but it did peak my interest. From this, I have decided to do my clinical question research on this topic, and possibly pursue this topic for my senior research project. I have talked to some people in the strength training realm about this and it seems as if they are not really sure how this works either, so I feel that research on this type of training could be beneficial in terms of rehabilitation and strength training. Through my clinical question I would like to find out if there is any credibility to this training, and figure out if there is a way to implicate this into rehabilitation programs and possibly get athletes back on the field sooner, with better rehabilitation results.
As a senior ATS, what do you perceive to be your greatest strengths and weaknesses?
As a senior Athletic Training Student, I feel that I am pretty in tune with my strengths and weaknesses as of right now. A few of my strengths include Evaluation of injuries, understanding patients concerns regarding an injury, and communicating with patients and my preceptors. I have done many evaluations in my time in the Athletic Training Program and I am thankful for all of the opportunities I have had to complete these evaluations. For example, I was able to do a couple evaluations this past Saturday at the Emory & Henry football game. For one of them the athlete came to me during the middle of the game and was describing to me that he had hurt his hand. By using my evaluation skills I was able to determine that the athlete had suffered a grade 1 UCL sprain of his 5th PIP joint. I confirmed this with my preceptor and then discussed with the athlete that he could finish playing the game, but I would like to apply buddy taping to the finger in order to reduce the movement of the joint. I also instructed the athlete to come into the clinic after the game so that we could get a better evaluation. Even after this evaluation by Cole, he told me that my sideline evaluation was good. I felt that this instance also shows my strengths in understanding patients. I kind of had to do this evaluation on the fly and the athlete didn’t really know exactly what happened. I had to piece this puzzle together with the little information that the athlete provided. I think this example also shows how I am able to communicate with my preceptors in a positive way.
I believe that my main weakness is always wanting to voice my opinion when speaking to a preceptor or an athlete. I feel like sometimes this makes my preceptors a little angry with me. One way I could improve this is to take in the whole situation before I interject what I think into the conversation. This has happened a couple times in the past when speaking about evaluations, one happened this past Saturday. Overall I feel that my strengths far outweigh my weaknesses.
Reflect on your "final" pre-season experience. Compare it to your previous years.
How do you feel different as a senior ATS? What has helped you so far? What has continued to be a hindrance?
How has your growth as an AT student influenced your interactions with patients and preceptors? Give an example.
Wow, senior year already! I cannot believe my time at Emory & Henry is almost over. Anyway, back to the journal prompt. My final pre-season experience was pretty good. I learned many new things this year during administration time. For example, I was able to work a lot with filing paperwork for old and new athletes, and making sure that they had everything they needed in order to compete in collegiate athletics this year. I completed tasks like filing physicals, and going through various teams’ paperwork and determining whether or not all of the athletes on the team needed to submit more paperwork. I think this was a good experience for me because I feel that I haven’t completed a whole lot of administration type duties in the past, and it gave me an idea about good ways to file paperwork, and how to communicate with athletes that still needed things.
I feel different as a senior this year because all of the other students have been looking at me as a role model and asking me various questions about how and why I do certain things. This has helped me further my confidence with athletes and with other various things such as general knowledge about how an entire Athletic Training staff works together to run smoothly. So far this semester I truly believe that all of the administration duties have helped me grow as I stated above. I think the main thing that has hindered me is one of the new staff members that is with football. We have had a few clashes this pre-season and I feel that it has kind of made me a little testy at times. I am open to changes in staff and even changes in the way things are done, but in this particular circumstance I feel that the changes haven’t benefitted me or any of the other students for that matter. We haven’t been able to do things that increase our knowledge in the clinic very often such as doing evaluations or rehabs, because it seems like we are always stuck doing all of the cleaning, or filling up all of the water bottles. Overall this has been my biggest hindrance.
I feel that I have grown into a pretty knowledgeable student in the ATP, and it has enabled me to question preceptors, and interact with patients more confidently. I feel like I can do things in the clinic now without asking if that is the right thing to do. I am able to make many decisions on my own, and my preceptors almost always agree with me that these decisions are the correct ones.
I feel that this semester I have progressed tremendously in a few areas at my clinical site. I have been with Kris, mainly working with baseball players this semester. I have learned so much about general athlete maintenance. For example, there are a couple of baseball players who frequently use the athletic training clinic in order to feel at their best for the season. Some of the general things they do include flexibility work, trying to relieve muscle soreness, dealing with nagging muscle tightness unilaterally due to the nature of baseball, as well as other small things. A good way to work with athletes on maintaining flexibility is PNF stretching. I have been able to experiment with PNF stretches for multiple areas of the body with many baseball players this year. A great way to relieve muscle soreness is a cold whirlpool. There are a few of the guys on the baseball team who love a cold whirlpool after double headers. They claim that it really helps to decrease soreness in the days after a couple games. A great way to deal with muscle tightness is using the dolphin to do instrument assisted myofascial release. There are many athletes who love scraping because it helps them loosen up and increases blood flow to the area. I do enjoy working with the guys on my team. Working with these guys that I know well has really helped me with my confidence in the clinic. They are always joking around with me while I am completing any kind of treatment with them and this has helped me tremendously to be confident when I am trying new things. But that is also a double-edged sword. Since I am always with the baseball team I don’t get the chance very often to work with athletes in other sports. I think the worst thing about working baseball is how difficult it is to get my clinical hours while being with my team for the semester. I also do not get to clinically experience the games like the other students are able to, since I am playing at that time. This experience has been pretty similar to what I imagined it would be in January.
After taking my second BOC practice exam, I feel that I am making good progress. According to our clinical coordinator, Beth Funkhouser, everyone in the junior class is doing well for this point in the athletic training program. My scores in every category went up, and I actually did very well in three of the categories. There is one category that is giving everyone trouble right now, and that is rehabilitation. I think the reason rehab is so tough on everyone is the fact that all the questions that deal with rehab are very nit-picky. They are also the weird questions that have you match up certain exercises with certain stages of rehab, and these could be interpreted differently depending on who is taking the test. For example, one person might like to do one exercise with very little resistance early in a rehab, and another person might like to do the same exercise with more resistance later in the rehab. Technically both aren’t right, but according to this practice BOC, one of them is right and one is wrong. These types of questions are very hard for me, because somehow I tend to be the person that picks the wrong way to interpret questions like this (funny, but not funny). Overall I do like taking these practice tests, especially since we students do not have to pay for them. These practice tests are great in helping me and my professors determine where I am at in comparison with my classmates, and it will help my professors know what to focus on in class as we get closer to the day that I take the real BOC.
During my clinical experience this week I was able to work with one of the baseball players who fouled a ball off of his shin a couple weeks ago. By this time much of the swelling was gone but there was still some swelling hanging around that I was trying to get rid of. I decided that we should do ultrasound and laser to try and get some of the swelling off of his shin. It’s like there is a small little capsule just medial to his shin where all the swelling is located. The swelling would still not change at all with just ultrasound and laser treatments. I tried cupping after that. The cupping looked like it worked some, but still not as much as I would have liked for it to. I was taking the cup and suctioning right over the swelling, and moving the cup up the athletes leg and around to the back of the knee to try and get some of the swelling closer to a more lymphatic site. The athlete had to go to class right after this.
The next day the athlete came in and we tried to see if massage would help move the swelling. I massaged over the swelling and did the same thing as I did with the cupping, tried to bring the swelling up the athlete’s leg and to the knee. I saw that this was working pretty well so I continued for around 7 minutes. After I was finished with the massage I took another closer look at the swelling. It looked to me like almost half of the swelling was gone. The massage treatment must have worked well! I haven’t gotten the chance to work with the athlete anymore since then so I am not sure how he is progressing with this, but I will be excited to see how the athlete’s leg looks this coming week.
This specific occurrence kind of put another tool in my Athletic Training tool belt. I now know that if this type of injury ever happens again, I have a way to combat the stubborn swelling that will come with the injury.
One of my goals this semester is to become more knowledgeable about baseball arm care by researching and helping Kris Johnston plan a daily arm care protocol for our baseball team.
This goal has been going pretty well so far. Kris and I have looked over multiple arm care protocols, throwing programs, and training programs to help pitchers take care of their arm, and hopefully help them be at their best for every game they appear in. We have looked at a couple resistance band and throwing combination programs from Crossover Symmetry and a custom protocol that was created by the Baltimore Orioles Head Athletic Trainer. Kris was able to speak with him at a NATA convention and pick his brain about the Orioles pitching staff and their recovery and care protocol. He gave Kris a copy of his starting pitcher protocol since they are on a set schedule to throw around once every 6 days. Basically on day one the pitchers are on strict orders to not throw anything, or complete any upper body exercises, only lower body. Day two the pitchers have very light recovery training with resistance bands. Day three the pitchers can throw a flat ground bullpen with proper warm up. On day four the pitchers can throw a light bullpen off the mound. Day five is pretty much active rest with very little upper body work, and then day six is of course their start.
Obviously this can be very tricky when talking about relief pitchers, especially closers since there is a possibility that they could throw 5 games in a week. The good news here is that they are normally limited on pitches due to the fact they only throw one inning a game. For these players almost all of their arm care during the season is done on off days, and what is not done on off days is very low intensity and duration.
The crossover symmetry program is much broader and can be manipulated more just due to the vagueness of the program. Basically this program lets the coach or AT decide when it would be a good time to throw a bullpen, and only focuses on the resistance band exercises, and which exercises should be used on what days. There is a recovery exercise set, a warm up exercise set, and a strengthening exercise set for the shoulder. This program also does a good job of incorporating exercises that benefit the muscles around the elbow.
Overall I feel like I am accomplishing this goal. I have learned a great amount of information about how to help pitchers take care of their arms. The only problem now is putting it into action with the baseball team.
Athletic Training is more than just filling up water bottles and checking to see if the “star athlete is o.k.” This week’s journal prompt discusses the NATA slogan. “Your Protection is Our Priority” How does this promote AT? This slogan promotes athletic training an a couple ways.
First, the slogan includes the word protection. The main job of an athletic trainer is to prevent and protect from injury. Whether this involves prescribing someone an ankle brace or doing preventative exercises for back pain this is still the main focus of athletic trainers. Without injury prevention, there would be more athletes hurt, more athletic programs suffering, and multiple unhappy coaches. In my opinion, most coaches and athletic programs have no idea how much athletic trainers do to hold together every team and every athletic program. In my opinion, the majority athletic trainers are not recognized enough for what they do. Overall, protection and prevention are our main focus.
The next part of the slogan “our priority” is pretty self-explanatory. Our job as athletic trainers is injury prevention, injury management, and rehabilitation for the most part. Many programs, athletes, and coaches do not realize that this really is the main priority to athletic trainers. Athletic trainers do help all kinds of athletes in various ways. From what I have seen so far in my clinical experience, the priority of an athletic trainer or student is to protect people.
I believe that this slogan promotes athletic training very well. It gives the community around us an idea of what our goal is. It gives athletes a feeling of peace that we are there for them, and to make sure that they are physically at their best for every contest. It gives coaches the confidence that if anything does happen during a game or match that we will be there to assist the best that we can, and hopefully resolve or diagnose anything that could happen at a game. It gives an athletic department faith in their athletic training staff.
This is a great slogan for the NATA. I feel that athletic trainers and athletic training students can apply this slogan to their clinical practice and hopefully use its meaning to become better clinicians.
This week during my clinical experience, I was able to work with a few of the baseball players on either their rehab, or preventative conditioning. There is one person that stands out to me that I have been working with lately. The athelte has been doing great with his rehab since his ACL surgery and has finally gotten back all of his extension and much of his leg strength. This week Kris kind of put me in charge of the athletes rehab for a couple days because we were scheduled at the same time. I decided that the athlete needed to continue to strengthen his quads as well as his hamstrings and glutes, as well as work on some balance exercises and maybe mix up some of the monotony of his rehab. The athlete’s physician also cleared him to start doing some running work so he was pretty happy about that, which is completely out of character for him! Thursdays rehab looked a little bit like this.
Jog 10 min. treadmill
Wall sit with ball squeeze 5x1 min, 30 second break
Leg extension machine 3x10
Hamstring curl machine 3x8
Leg press 3x8
Squat free throws (will explain later) 2x15
Balance pad ball toss (with baseball) 5x1 min.
Hamstring PNF stretching
With the leg extensions we went up in weight each set as tolerated. The athtlete finished at 120 lbs. and said he was finally feeling like he had most of his quad strength back. Leg curls were the same; we finished at 120 on the machine. For the squat free throws, I made him do 5 deep squats every time he missed a free throw, which he missed quite a few, He ended up doing 60 squats there. The athlete did well with the Balance pad tosses so we will have to progress that some more here this week. I enjoy doing this athlete’s rehab with him because I feel like I know him very well and I know how to push him to just the right point. Towards the end of the athlete’s rehab he sometimes gets to where he is trying to find ways to cheat reps, or he gets tired and doesn’t do them to his full ability. I feel like adding the free throws and baseball toss at the end of his rehab gave him something to push toward and look forward to at the end of his rehab. Overall, doing this and knowing how to change someone’s rehab to help them push themselves harder will help me and my athletes in the future because it may cut down on recovery time.
I completed 12 attempts this week in my clinical packet.
Compare and contrast your clinical placement from last semester to the one you are experiencing now. What do you enjoy about each, what makes each unique? What challenges have you faced at each? How have these experiences affected you?
Last semester I was placed with Bre Davenport, Washington County Schools head athletic trainer. This semester I am placed with Kris Johnston here at Emory and Henry College. Last semester was really fun, being in a different setting rather than being at Emory. I got to see the high school side of things, which included some major differences such as team managers, a much smaller budget, many more athletes for just one athletic trainer, and many more games going on at one time. In the high school most of what we experienced were games for volleyball, football, wrestling or basketball. It was really neat to get to be a part of all the different sport’s games, and to see how each differed from the other in terms of injury management and things of that nature. It was also pretty neat to be with someone that was not affiliated with Emory and to see how they do things differently. For example, Bre was in charge of 4 athletic training rooms total, even though they were small. We would be in any of those 4 rooms at any given time, depending on which school we were at and what games we were covering. It was a great experiencing how Bre was able to keep up with this many places and athletes at one time, with only one assistant athletic trainer. With all of the teams having a manager, we never had to fill up coolers or cater to disrespectful players who wouldn’t put their water back where they got it. I feel like here that is an issue. For some reason I feel like a lot of the athletes do not respect all of what the athletic training students or the certified athletic trainers do for them. We also got to see a different side of the rehab part of athletic training at the high schools. Often with more serious injuries, the athletes would go to a physical therapy clinic to do their rehab, and Bre would work with the physical therapists to make good decisions regarding practice load and return to play for these athletes. Overall I have enjoyed my experience both off site, and here at Emory. They have both taught me many things about the profession.