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Going to the Olympics

"Wonder how I got chosen to be a member of the USOC Medical Staff?"

Although their efforts aren’t recognized at the podium, the medical volunteers who go to the Olympics go through a lengthy process to get there. In order to be considered, applicants must have a minimum of three years of experience, along with licensing or certifications, a minimum of $1 million coverage for malpractice insurance, no sanctions or disciplinary actions, and no felonies.

According to Stat News, the application process begins with a $90 fee and continues through background checks, interviews, and training. The individuals who are eligible to volunteer visit one of the three U.S. Olympic Training Centers and care for athletes there.

“You have a kind of internship type of thing, where you get to know their system, [and] they get to know you, basically,” Scott Rodeo, MD, Sports Medicine Surgeon at the Hospital for Special Surgery, and volunteer with the U.S. Olympic swim team in 2004, 2008, and 2012, said. “Then you start with smaller competitions.”

The U.S. Olympic Committee’s Sports Medicine Division is in charge of recruiting volunteers who work with the Olympic teams during training, practices, and the games. There are doctors, athletic trainers, nurses, chiropractors, and others who work with the athletes; some work specifically with one team and others shift as needed.

“Sometimes you can get one of the athletes to write a letter to the committee saying that they like working with you and they want to work with you at the Olympics,” David Pascal, DC, Chiropractor at Health Institute of North Carolina, and volunteer at the 1996, 2008, 2012, and 2016 Olympic games, said.

The way athletes get to know medical volunteers is through the smaller competitions. The USOC sends notices of volunteer medical rotations for national events, including the Pan American Games or Olympic qualifiers.

Spots for the medical volunteers are assigned on a first-come, first-served basis. Traveling to the events is a personal expense for the volunteers to cover. The medical volunteers’ tasks range from helping with laundry to helping with the on-site sports medicine clinic.

“You need to be ready to work and check your ego at the door,” Rodeo said. “It’s a little bit like residency.”

This process can take anywhere from two to 15 years. Those who are chosen to go to the Olympics are typically notified the year before.

“You get an email saying you’ve been selected,” Kim Tee, DPM, Podiatrist at Thorek Memorial Hospital (Chicago, Ill.), volunteer with the U.S. golf team for the 2016 Olympics, said. “After you meet all the criteria. But the criteria, that is something only the committee knows.”

Along with the time that gets committed to applying, the process takes a lot. The positions are voluntary, which can add up with uncompensated work and travel expenses.

“Over the time I was trying out, I was away from my practice for six months, and lost about a quarter of a million dollars,” Mark Hutchinson, MD, Professor of Orthopaedics and Sports Medicine and Head Team Physician at University of Illinois Chicago, and volunteer physician at the 2016 Olympics, said.

Despite the cost, those who have volunteered say the experience was worth it. Although a lot of the issues they deal with are typical for travel events, the work is something they are passionate about doing.

“It’s volunteerism at its best,” Rodeo said. “You do it because you want to give back. You have to love it to do it.”

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Poll: 93% of coaches disagree with specialization

February 12, 2018 / Athletic Administration • Coaching

Sport specialization is a major issue in youth and high school sports. Some believe it’s the most reliable path to a college scholarship, while others say it leads to burnout and injuries.

In Coach & Athletic Director’s latest poll, we asked readers their thoughts. A staggering 93 percent of coaches said they wanted players participating in multiple sports. Here are some of their comments.

Comments from coaches

• I feel it helps them be better balanced as an athlete, and it might open doors to opportunities they were’t aware of. Who knows, they might even find out they like a sport they didn’t know they would like. I feel it helps them with an improved general athletic IQ too.

• I think you need some time off from your primary sport. It also helps develop muscles that you don’t use in the primary sport, and gets you involved with a larger group of people.

• Playing multiple sports gives athletes other situations to draw from. An example: If an athlete can get through a tough track workout, they can get through the fourth quarter and overtime of a basketball game no matter how tired they think they are. Knowing they got through a super tough workout gives them the confidence to finish anything in another sport.

• The kids are not professionals, and the odds extremely high that are they are not going to be professionals. Kids need to have a well-rounded school experience. Specialization results in overuse injuries and burnout. Multiple surveys of professional basketball players shows that most of them were multiple sports participants in high school.

• Many skills transfer from sport to sport, and I want them to be able to enjoy all of the activities they can. I do not wan’t athletes burned out on my sport because it’s the only thing they do.

• It helps keep grades up, keeps them out of trouble, and it helps to improve their athletic skills. I really like my skilled football kids to play basketball, because it helps with catching the ball and helps with the idea of finding an open window and passing to open players. I like my linemen to wrestle to learn hand to hand combat. And in the spring, I really want them to do track and field to be in shape and to work on footwork skills.

• I believe it is best to play multiple sports for the following reasons: 1) Increasing studies are showing athletes that specialize are at greater risk for injury and burnout. 2) Students and athletes grow when they are out of their comfort zone. For example, a very good soccer player who is an average basketball player becomes a better soccer player and soccer teammate by playing a lesser role on their basketball team. They will have a great appreciation for each of their teammates roles and importance on the team. 3) Kids that specialize play far too many games in one calendar year. I hear many stories of middle school aged kids playing 100 games in one particular sport in a year. This is not good in any sport. When middle school kids are playing more games than college or professional adult players there is a problem! When are they working on skill development if they are playing 100 basketball games in a year?

• This is a tricky question! And basketball is such a skill-oriented sport that if kids don’t put in ample time on their craft, they usually fall behind if they want to compete at a high level. Unless they are just a freak-athlete. In my 18 years of coaching boys varsity basketball, all of my best players, except for one, have been so-called basketball kids. And the one that wasn’t (basketball was his second love) played football at Oklahoma University and in the NFL for the Atlanta Falcons. I believe kids can learn a lot from playing multiple sports, but nowadays if you don’t put in your time on the court, you will fall behind.

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Causes of Common Injuries Among Volleyball Players and Runners

What athletic trainer hasn’t known a volleyball player with a history of sprained ankles or a runner who complained of chronic low back pain? New research has uncovered possible causes for these common injuries.

Sports medicine experts have traditionally believed that ankle injuries in volleyball players are most likely to happen when players land in a plantarflexed position. However, an article from Orthopedics This Week reports that a new analysis suggests most ankle injuries come from blocking or landing on someone else’s foot. This finding came from analyzing videos from major International Volleyball Federation tournaments.

“When landing on an opponent under the net, the attacker landed into the opponent’s court in 11 of 12 situations, but without violating the center line rule,” the study authors wrote. “Injuries mostly resulted from rapid inversion without any substantial plantarflexion.

“The majority of injuries occur while blocking, often landing on an opponent,” they continued. “The attacker is overwhelmingly to blame for injuries at the net secondary to crossing the center line.”

Regarding back pain in runners, researchers at the Ohio State University Wexner Medical Center believe that runners who have weaker deep core muscles have a higher risk of developing low back pain. As reported by ScienceDaily, they used force-measuring floor plates and motion detection technology to determine this.

“We measured the dimensions of runners’ bodies and how they moved to create a computer model that’s specific to that person. That allows us to examine how every bone moves and how much pressure is put on each joint,” Ajit Chaudhari, PhD, FACSM, Associate Professor of Physical Therapy and Biomedical Engineering at the Wexner Medical Center, said. “We can then use that simulation to virtually ‘turn off’ certain muscles and observe how the rest of the body compensates.”

Their model showed that when the deep core muscles are weak, the body compensated to allow the athlete to run in the same way. But this often meant increasing the load on the spine, which could be related to developing low back pain.

The researchers noted that many athletes turn to ab exercises like sit-ups or back extensions to help strengthen their core. Yet, these exercises do not build the deep core that is needed to improve as a runner. Instead, Dr. Chaudhari suggests using exercises that stabilize the core, such as planks.

“Working on a six-pack and trying to become a better runner is definitely not the same thing. If you look at great runners, they don’t typically have a six-pack, but their muscles are very fit,” Dr. Chaudhari said. “Static exercises that force you to fire your core and hold your body in place are what’s really going to make you a better runner."

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Vitamin D and Injury Rates

Brendon McDermott, PhD, ATC, is an Associate Professor in the Athletic Training Program at the University of Arkansas. He also serves on the Medical and Science Advisory Board of the Korey Stringer Institute. Dr. McDermott can be reached at: brendonm@uark.edu.

Athletic trainers have likely heard a lot about the correlation between vitamin D deficiencies and injury risk. At the University of Arkansas, our athletic training faculty recently teamed up with our sports medicine staff to dig into this topic for ourselves.

The sports medicine staff has been drawing preseason blood samples for years to assess athletes’ overall health, immune function, and organ function as a standard screening. What typically did not occur with these data, however, was seeing if the information could be more valuable than the standard. 

So, the next step was to team up with the athletic training faculty to run a brief analysis of documented injuries combined with preseason vitamin D levels. First, an Excel spreadsheet was created with rows for each player and columns for documented injuries (specific to type and location) for the 2015-16 competitive seasons.

Then, provided de-identified data, a researcher conducted a brief analysis in a statistical software program. The analysis itself took about 15 minutes. Our research questions included:

Is preseason vitamin D value related to fracture risk?

Is preseason vitamin D value related to overall lower extremity or core injury (sprain, strain, or fracture)?

Is preseason vitamin D value related to lower extremity or core muscle injury?

What we found was interesting. Preseason vitamin D levels were not associated with fracture risk but were mildly associated with lower extremity or core sprain or strain injury. Football players were 1.4 times more likely to sustain a sprain or strain injury during the season if their preseason vitamin D level was less than or equal to 26 nanograms per milliliter (ng/mL).

When we split out muscle injury only, we found a significant association. Players with values less than or equal to 23.2 ng/mL were 2.4 times more likely to suffer a muscle strain during the season than players who had greater values. This association was demonstrated despite a normal supplementation regimen when measured values were less than 40 ng/mL at preseason. The supplementation plan was implemented secondary to the known fracture risk factors associated with low vitamin D levels. However, our numbers—as well as some recent evidence—suggest that lower concentrations of vitamin D in the blood reflect inflated injury risk in other forms. Either way, our analysis provides evidence-based support for the current practice of recommending supplementation for football players with low vitamin D values.

In today’s evidence-based world of athletic training, clinicians should continue to work with researchers to provide support for current practices. Further, this continued practice can help raise important research questions that advance scientific support for things like injury prevention, treatment effectiveness, clinical outcomes, and augmented patient safety. Advanced advocacy for data sharing among larger sample sizes is recommended, as well, because this would help strengthen associations between different variables. Athletic trainers are encouraged to continue with analyses of data they are collecting on a routine basis in their current practices.

 

Ankle Strength

March 28, 2018

Strong ankles are essential for athletic performance. Unfortunately, this area of the body can be very susceptible to injury, which means that strengthening the ligaments and muscles around the ankles is all the more important. Here are some exercises to help make that happen.

Stana Landon of Active.com explains that ankles are put under a lot of stress any time an athlete performs a movement like running, cutting, or jumping. Strong ankles will be better able to handle this stress, and athletes will be less likely to experience chronic injuries, such as shin splints and Achilles tendonitis. That’s why she suggests incorporating a number of ankle-strengthening exercises into your training.

Balance Training

Better balance increases proprioception, which is the body’s ability to realize its place in space.

Single-Leg Squats

While standing on one leg, do a half squat. Do 10 reps with the opposite leg out in front, 10 with it to the side, and 10 with it behind. Repeat this three times on each leg.

Leg Stand

Start by standing on one leg for 30 seconds and then switch. Gradually work your way up to holding each stand for a minute.

Balance and Catch 

Stand on one leg directly across from a partner. Then, throw a ball back and forth with the partner, and have them throw it to the left and right, as well as low and high. Aim to perform three sets of 30 throws.

Building Strength

For ankle-strengthening exercises, Landon suggests using a TheraBand. This is a great tool for providing resisted range of motion in every direction, such as inversion, eversion, dorsiflexion, and plantar flexion. During these exercises, place the band around the top of the foot and curl the toes at the end of each movement. This will help work the foot’s internal muscles. Each exercise should be done in three sets of 20.

Along with using the TheraBand, Landon also suggests doing calf raises to build ankle strength. These are simple and don’t require any equipment. They should be done both seated and standing in order to target both the calf muscles and the Achilles tendon. Aim for three sets of 20. 

Lastly, Landon recommends doing plyometric exercises to toughen up the ankles. These jumping movements will help make the muscles around the ankles stronger and more explosive. Two exercises she mentions are scissor hops and standing squat jumps.

Scissor Hops

Start in the lunge position. Then, jump and switch feet in mid-air, landing with the opposite foot forward. Repeat 10 to 15 times.

Squat Jumps

Start by getting into a quarter-squat position. Then, explode up from there into a jump and land back down softly. Repeat 10 to 15 times.

 
 

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