Over $4K Raised during the Annual Running with the Buckeyes Event!

Advocates for Injured Athletes, like any other non-profit organization depends heavily on donations and fundraising to support its programming, including Athletes Saving Athletes (TM).  A4IA is always thankful for the donations and other forms of support it receives from all those willing to promote its work.  This week A4IA would like to specifically thank Alexis Heimert and The Ohio State University Athletic Training Club for their hard working during the 4th Annual Running with the Buckeyes event. 

The event, a 5K race, was held on March 24, 2013 in a effort to promote National Athletic Training Month by raising money to support A4IA.  The event was a success, raising over $4,000, the highest total since the event began.  

For those of you wondering how OSU got connected with A4IA, Alex and the rest of the group found out about A4IA through the Facebook page and Tommy’s video.  They did more research to learn about the organization and its goals.  The club, impressed by A4IA’s desire to promote the profession of athletic training, a primary purpose of the club, decided to help.  They felt it was their responsibility as future professionals to advocate for organization that promotes their profession through public education, pushing for increased access to athletic trainers, and the important role athletic trainers play in athletic health care.

If you're a runner and would like to support A4IA through your running pursuits, join TEAM ASA by contacting Advocates for Injured Athletes at injuredathletes@yahoo.com.  Coming soon is the t-shirt shop so you'll be able to wear your support for A4IA very soon! Keep checking the website, www.injuredathletes.org and our Facebook page for more details.  

CHECK OUT THESE PHOTOS FROM THE RUNNING WITH THE BUCKEYES EVENT!

Submitted by Heather L. Clemons, MS, MBA, ATC

Lightning Safety Week: June 23 - 29

It wasn't too long ago that I spent some time writing about lightning safety as part of a few blogs that were intended to help you be prepared for many of the most common summer phenomena.  The National Weather Service (NWS) lightning safety week purposefully corresponds with the time of year that lightning storms are most prevalent.  According to the NWS 54 people are killed annually by lightning, while many more are injured.  There have already been seven (7) fatalities in 2013.

Lightning Strikes a Tree

The original blog that I wrote just over a month ago spent time introducing you to lightning safety specific emergency action plan resources (from the NATA), connecting you with lightning strike density statistics, keys to keeping yourself safe or getting to safety if you should get caught in a storm, and some basic first aid tips for strike victims.  I am bringing this blog to the forefront again because the information it presents is important.  In my experience as an athletic trainer I feel that sometimes people do not take this particular weather phenomenon seriously and seek shelter immediately.  I am writing to urge you to take thunderstorms and lightning seriously and respond accordingly to protect yourself and whoever you may be with.

The most concerning thing about a lightning is that it can injure you without having to be directly struck by the lightning bolt.  There are 5 mechanisms of injury associated with lightning:

1. Direct strike:  Lightning strikes person directly
2. Contact injury:  Victim touches an object that is part of lightning's pathway
3. Side flash (splash):  Lightning arcs from struck object to a nearby object
4. Ground current (step voltage):  Lightning spreads peripherally through the ground
5. Blunt trauma:  Injury results from an object that is thrown through the air during lightning strike

This is why it is important to understand what a proper safe area is and be sure you're protected.  Additionally, this is also why you shouldn't talk on the phone, take a shower or use other electronic devices during a storm.

Should you be a lightning strike victim and be fortunate enough to survive the range of long-term "side effects" of being struck is wide.  According to NWS, Medscape and other resources some long-term health concerns include:

• chronic pain syndromes
• neuromuscular pain
• headaches that are not relieved with OTC medications
• depression
• dizziness
• sleep disorders
• hypertension
• congestive heart failure
• seizures
• cataracts
• many, many more

To read real stories from lightning strike survivors, click HERE.

HEADLINES FROM THIS YEAR

Lightning Strike Injures Woman at Rising Sun Zoo (June 13, 2013)

Illinois Man Dies from Lightning Strike ( May 28, 2013)

Three People Injured by Lightning Strike in Granby (May 22, 2013)

These are just a few recent articles regarding published stories in the United States.  More recently two people died in Russia (mother and child) and two more in Bangladesh.  Again, know your lightning EAP wherever you are and take the warnings from your AT seriously when directed to seek safety.  Doing so could mean the difference between being safe and risking significant long-term complications or even death.  As lightning safety week approaches, make a plan and stick to it as you enjoy the summer season.  Lightning can strike anywhere.... at the family reunion, at the weekend sports tournament, during the big outdoor concert or camping trip.  Be prepared.

Submitted by Heather L. Clemons, MS, MBA, ATC

Sickle Cell Trait: What You Need to Know

As previous blogs have demonstrated there are a variety of conditions that can be of concern and potentially fatal if not treated quickly by trained professionals.  Some of the topics discussed include  sudden cardiac arrest, infectious mononucleosis, exertional heat illness, an asthma attack, and diabetic emergencies among others.  The topic I am going to discuss today is another one of those topics, sickle cell trait (SCT).  Understanding SCT is particularly important for certain segments of the population as it is more common in certain ethnic groups.  Additionally, exertional sickling and sickling collapse, an emergency condition that can result during intense exercise may sometimes be mistaken for exertional heat illness (EHI).  My goal today is to define SCT, differentiating it from sickle cell disease (SCD), provide you key identifiers that differentiates SCT from EHI (most often heat cramps) and provide a brief introduction to the mandated NCAA testing policy.

SICKLE CELL TRAIT (SCT) BASICS

SCT is present in those people who inherit one sickle cell gene and one normal gene (CDC).  SCT can be diagnosed with a simple blood test; infants in the United States are tested at birth.  SCT is different from sickle cell disease (SCD) because SCD requires the inheritance of two abnormal genes, one from each parent.  This gene results in the mutation of hemoglobin cells, causing them to take on a crescent or sickle shape (see image below) and making it more difficult for these cells to transport oxygen.

SCT affects 1 in 12 African Americans, but the condition can also be prevalent in those with ancestry from South American, the Caribbean, Central American and Mediterranean countries including Saudi Arabia, India, Turkey, Greece and Italy. As parents, it may be important that you ask for the results of this test for your new infant.  Despite the required testing most people do not know their sickle cell trait status unless they have sickle cell disease.  People are typically asymptomatic, but there can be potential for complications when the following conditions/situations are present:

• Increased pressure in the atmosphere (ex. when scuba diving)
• Low oxygen levels in the air (ex. very intense training, exertion at altitude)
• Dehydration
• High altitudes

SCT AND ATHLETES

As of this time, there is no recommendation that athletes with SCT should be withheld from participating in sports, however, some research has shown that athletes can be particularly at risk of complications from SCT when completing intense training.  The possibility of complications can be enhanced by training in extreme temperatures or at high altitudes (as previously mentioned).  The key to SCT is prevention is to set your own pace, rest often between drills/activities, stay hydrated before/during/after activity and keep the body as cool as possible when exercising in hot conditions according to the CDC fact sheet.

For an individual who has SCT and completing intense exercise the biggest concern is a condition called exertional sickling (and the resulting sickling collapse).  In exertional sickling the intense exercise causes normal the sickle shaped blood cells to “logjam” the blood vessels, slowing oxygen transport to the muscles.  Muscle tissue begins to breakdown after a prolonged period of a lack of oxygen resulting in a condition referred to as rhabdomyolysis.  This condition is a medical emergency and can lead to death if not treated immediately.  The biggest key to proper treatment is immediate recognition of the condition and proper treatment.  Exertional sickling/sickling collapse can sometimes be confused with exertional heat illness, particularly heat cramps.

EXERTIONAL SICKLING	EXERTIONAL HEAT ILLNESS
Typically happens within first 30 minutes on the field	Typically happens after prolonged exercise for more than 30 minutes
Core temperature is not elevated	Core temperature is typically >1040F
Pain is strong and generalized	Heat cramps:  muscle twinges and focused pain
Typically slump to ground with weak muscles; sufferers will lie fairly still and muscles will look and feel normal to the observer	Heat cramps:  suffers “hobble” and muscle are locked up and hard to touch, suffers will yell out/writhe in pain

If you or your athletic trainer suspect exertional sickling the athlete should be removed from activity immediately.  Oxygen can be administered if available (and someone is trained in its use) and the EAP should be activated.  A sickling collapse is a medical emergency.

RYAN CLARK, PROFESSIONAL ATHLETE WITH POSITIVE SCT STATUS

Want to know more about an athlete who’s competing in the NFL with sickle cell trait?  Check out Ryan Clark, Pittsburgh Steelers.  He has been able to have an NFL career despite being held out of recent games in Denver, Colorado given is SCT status.  Remember, exertion at high altitudes has the potential to result in exertional sickling/sickling collapse.  He has now started a foundation to search for a cure for the condition.

NCAA MANDATED SICKLE CELL TRAIT TESTING POLICY

The National Collegiate Athletic Association (NCAA) has mandated sickle cell testing for athletes.  This requirement is considered controversial by some based on the available (or lack thereof) research, but my goal is not to debate the merits of the requirement, but to help you understand it.  If you’d like to learn more about why some people believe the mandated testing policy is unnecessary check out this article.  Testing has been mandated for Division I athletes since 2010 and Division II since 2011.  Legislation just passed that will mandate testing at the Division III level starting this year (2013).  For those of you who are concerned and do not wish to have your child tested as part of their initial college pre-participation examination there is a waiver you can sign to opt out of the testing.  Additionally, SCT positive athletes are not restricted from participating in athletics, it simply allows the medical staff to be more aware of the possibility of a exertional sickling and sickling collapse.  Testing is expected prior to the start of the freshman year, or for any transfer whose status is not known.  Remember, if you have the SCT status of your child documented at birth, additional testing prior to the entry into college may not be necessary.  Find out more information and resources from the NCAA here or contact the sports medicine staff at the college/university your child will be attending.

RESOURCES

The documents listed here are mostly statements from various professional organizations regarding SCT trait status in athletes.  Some of the statements discuss recommendations for the safe sports participation and treatment in the instance of exertional sickling/sickling collapse.  Others discuss the need (or suggest there is no need) for SCT screening of athletes.  As always you are encouraged to take a look.

Recommendations of the Advisory Committee on Heritable Disorders in Newborns and Children (SACHDNC) to the Secretary, US Department of Health and Human Services on Screening of Student Athletes for Sickle Cell Trait

American Society of Hematology Statement on Screening for Sickle Cell Trait and Athletic Participation

American Medical Society for Sports Medicine Statement on Sickle Cell Trait

Consensus Statement:  Sickle Cell Trait and the Athlete

ACSM and NCAA Joint Statement on Sickle Cell and Exercise

National Athletic Trainers’ Association Position Statement:  Preventing Sudden Death in Sports

The Inter-Association Task Force for Preventing Sudden Death in Collegiate Conditioning Sessions:  Best Practices Recommendations

Submitted by Heather L. Clemons, MS, MBA, ATC

Are you Prepared for Your Summer Sports League?

School is ending in the coming week(s) and summer will be officially under way for many families.  With summer comes camps, vacations and travel teams.  With all this parents should be aware of how (and by whom) their children's health and safety is being managed.  Parents who have children who will be signing up for fall travel sports should also begin asking questions now about health and safety concerns. Asking questions early means that if changes need to be implemented there is time before the actual sporting season begins.  In an effort to help parents ask the right questions here are five questions every parent should ask before their children participates in organized sports.

DOES THE LEAGUE HAVE AN EMERGENCY ACTION PLAN (EAP) IN PLACE?

This post defines what an EAP in and the major components is should include.  It also refers readers to a key resource regarding EAP development, the NATA Position Statement on emergency planning.  While there are several conditions that may require specific detailed EAPs, given the focus on concussions time is spent specifically on the topic.

IS THERE AN ATHLETIC TRAINER AVAILABLE?

This post takes a significant amount of time to make you familiar with what an athletic trainer is and the skills they have.  Much time is spent on the major educational requirements and the knowledge and skill areas athletic trainers are qualified in once they pass the national certification examination and begin practicing.  The post also introduces you to the major organizations associated with athletic trainers including the NATA, BOC and CAATE.  There are also a variety of position statements put out by the NATA on topics such as heat illness, emergency planning concussions, asthma and other topics that are relevant to youth athletes and are available for public review.

IS SOMEONE WHO IS TRAINED IN CPR AVAILABLE AT ALL TIMES?

This post explains what CPR is and how you can become trained to utilize it in an emergency.  Links are provided to the three major organizations that provide courses around the topic of CPR (and AED) as well as providing information on the topic of hands-only CPR.  

IS THERE AN AUTOMATED EXTERNAL DEFIBRILLATOR (AED) AVAILABLE?

This post takes the time to explain what an AED is, how it works and how to use it.  Many states also have public access laws in place which means when you're in the airport, at the mall, or at the public pool there may be an AED available for use in an emergency.  This post can help you understand where AEDs may already be available in your state and to help you get AEDs in your school or for your league if you don't have them already.

ARE COACHES TRAINED IN KEY SPORT SAFETY GUIDELINES?

This posts lists/discusses key governing organizations for some of the most popular youth sports such as USA Football, AYSO and Little League Baseball among others.  It also discusses key equipment safety organizations such as NOCSAE and HECC and finally provided some resources for proper coaching technique around football tackling and managing baseball pitch counts in young players.

Submitted by Heather L. Clemons, MS, MBA, ATC