Training & Conditioning 13.7

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TRAINING

$5.00 October 2003 Vol. XIII, No. 7

CONDITIONING

All in the Family Balancing work and personal life as an ATC

◆ How to Monitor Training ◆ Supervising High School Aides

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C ONTENTS

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Training & Conditioning • October 2003 • Vol. XIII, No. 7

F E AT U R E S ◆ Special Focus ◆

All In the Family..........13 The long-held tradition among athletic trainers to put work before family is starting to be questioned. This article offers solutions for balancing personal life with career in the athletic training profession.

By David Hill ◆ Optimum Performance ◆

P.33

Look, Listen, Log..........19 You’ve developed a sound program. Your athletes are committed. You have the right equipment. But are you monitoring their daily progress effectively? Here’s how.

By Vern Gambetta ◆ Tr e a t i n g T h e A t h l e t e ◆

The Leading Edge........27 Using stainless steel instruments and a simple set of longitudinal movements, Graston Technique offers athletic trainers a new way to diagnose and treat soft tissue injuries.

By Dr. Stephen Perle ◆ Management ◆

Is It Aide Appropriate?.........33 Student aides can make an enormous contribution to your high school athletic training program. But exactly what to delegate and how to supervise them can raise questions.

By Kenny Berkowitz

P.19

D E PA R T M E N T S ◆ Sideline ◆

The Effects of Caffeine.........3 ◆ Comeback Athlete Award ◆

This Issue’s Winner..........4 ◆ Bulletin Board ◆

New York Defines ATCs … Eye Black … Supplements..........10

P.27

◆ Competitive Edge ◆

Knowing the Score..........39 To make your basketball athletes the best they can be, consider using the Performance Index Evaluation, which scores hoops players on several different physical abilities.

By Ben Cook, Chip Sigmon, and Alan Tyson Advertising Directory..........50 Scouting Report: Pain Management..........46 Scouting Report: Hot & Cold Therapy..........49 Scouting Report: Massage Therapy..........54 More New Products..........57 Catalog Showcase..........58 Web Connections..........59

On the cover: Hayden Mullins joins his father and grandfather, Tim and Leroy Mullins, athletic trainers at the University of Mississippi, during a football team practice. Story begins on page 13. Photo

by Bruce Newman.

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TRAINING & CONDITIONING • October 2003 • Vol. XIII, No. 7

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Marjorie Albohm, MS, ATC/L Director of Sports Medicine and Orthopaedic Research, Orthopaedics Indianapolis Jon Almquist, ATC Specialist, Fairfax County (Va.) Pub. Schools Athletic Training Program Brian Awbrey, MD Dept. of Orthopaedic Surgery, Massachusetts General Hospital, and Instructor in Orthopaedics, Harvard Medical School Jim Berry, MEd, ATC, SCAT/EMT-B Director of Sports Medicine and Head Athletic Trainer, Myrtle Beach (S.C.) High School Leslie Bonci, MPH, RD Director, Sports Medicine Nutrition Program, University of Pittsburgh Medical Ctr. Health System Christine Bonci, MS, ATC Asst. A.D. for Sports Medicine, Women’s Athletics, University of Texas Cynthia “Sam” Booth, ATC, PhD Manager, Outpatient Therapy and Sportsmedicine, MeritCare Health System Debra Brooks, CNMT, LMT, PhD CEO, Iowa NeuroMuscular Therapy Center Cindy Chang, MD Head Team Physician, University of California-Berkeley Dan Cipriani, MEd, PT Assistant Professor, Dept. of Physical Therapy, Medical College of Ohio Gray Cook, MSPT, OCS, CSCS Clinic Director, Orthopedic & Sports Phys. Ther., Dunn, Cook, and Assoc.

Bernie DePalma, MEd, PT, ATC Head Athl. Trainer/Phys. Therapist, Cornell University Lori Dewald, EdD, ATC, CHES Athletic Training Program Director and Associate Professor of Health Education, University of Minnesota-Duluth Jeff Dilts Director, Business Development & Marketing, National Academy of Sports Medicine David Ellis, RD, LMNT, CSCS Sports Alliance, Inc. Boyd Epley, MEd, CSCS Asst. A.D. & Dir. of Athletic Perf., University of Nebraska Peter Friesen, ATC, NSCA-CPT, CSCS, CAT, Head Ath. Trainer/ Cond. Coach, Carolina Hurricanes Lance Fujiwara, MEd, ATC, EMT Director of Sports Medicine, Virginia Military Institute Vern Gambetta, MA President, Gambetta Sports Training Systems Joe Gieck, EdD, ATC, PT Director of Sports Medicine and Prof., Clinical Orthopaedic Surgery, University of Virginia Brian Goodstein, MS, ATC, CSCS, Head Athletic Trainer, DC United

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Gary Gray, PT President, CEO, Functional Design Systems Maria Hutsick, MS, ATC/L, CSCS Head Athletic Trainer, Boston University Christopher Ingersoll, PhD, ATC, FACSM Director, Graduate Programs in Sports Medicine/Athletic Training University of Virginia Jeff Konin, MEd, ATC, MPT Assistant Professor of Athletic Training, James Madison University Tim McClellan, MS, CSCS Director of Perf. Enhancement, Makeplays.com Center for Human Performance Michael Merk, MEd, CSCS Director of Health & Fitness, YMCA of Greater Cleveland Jenny Moshak, MS, ATC, CSCS Asst. A.D. for Sports Medicine, University of Tennessee Steve Myrland, CSCS Owner, Manager, Perf. Coach, Myrland Sports Training, LLC Instructor and Consultant, University of Wisconsin Sports Medicine Mike Nitka, MS, CSCS Director of Human Performance, Muskego (Wisc.) High School Bruno Pauletto, MS, CSCS President, Power Systems, Inc. Stephen Perle, DC, CCSP Associate Prof. of Clin. Sciences, University of Bridgeport College of Chiropractic Brian Roberts, MS, ATC Director, Sport Performance & Rehab. Ctr. Ellyn Robinson, DPE, CSCS, CPT Assistant Professor, Exercise Science Program, Bridgewater State College Kent Scriber, EdD, ATC, PT Professor/Supervisor of Athletic Training, Ithaca College

Publisher Mark Goldberg Editor-in-Chief Eleanor Frankel Circulation Director Mark Shea Associate & Assistant Editors Dennis Read Kenny Berkowitz David Hill Laura Smith Guillermo Metz Art Director Leslie Carrère Production Manager Kristin Ayers Assistant Production Manager Kristi Kempf Production Assistants Jonni Campbell Hildi Gerhart Prepress Manager Adam Berenstain IT Manager Mark Nye Business Manager Pennie Small Special Projects Dave Wohlhueter Administrative Assistants Sharon Barbell Amy Walton Daniela Reis Advertising Materials Coordinator Mike Townsend Advertising Sales Associates Diedra Harkenrider (607) 257-6970, ext. 24 Sheryl Shaffer (607) 257-6970, ext. 21 T&C editorial/business offices: 2488 N. Triphammer Road Ithaca, NY 14850 (607) 257-6970 Fax: (607) 257-7328 info@MomentumMedia.com

Chip Sigmon, CSCS Strength and Conditioning Coach, Carolina Medical Center Bonnie J. Siple, MS, ATC Coordinator, Athletic Training Education Program & Services, Slippery Rock University Chad Starkey, PhD, ATC Associate Professor, Athletic Training Educ. Program, Northeastern University Ralph Stephens, LMT, NCTMB Sports Massage Therapist, Ralph Stephens Seminars Fred Tedeschi, ATC Head Athletic Trainer, Chicago Bulls Terrence Todd, PhD Co-Director, Todd-McLean Physical Culture Collection, Dept. of Kinesiology & Health Ed., University of Texas-Austin

Training & Conditioning (ISSN 10583548) is published monthly except in January and February, May and June, and July and August, which are bimonthly issues, for a total of nine times a year, by MAG, Inc., 2488 N. Triphammer Rd., Ithaca, NY 14850. T&C is distributed without charge to qualified professionals involved with competitive athletes. The subscription rate is $24 for one year and $48 for two years in the United States, and $30 for one year and $60 for two years in Canada. The single copy price is $5. Copyright© 2003 by MAG, Inc. All rights reserved. Text may not be reproduced in any manner, in whole or in part, without the permission of the publisher. Unsolicited materials will not be returned unless accompanied by a selfaddressed, stamped envelope.

POSTMASTER: Send address changes to Training & Conditioning, P.O. Box 4806, Ithaca, NY 14852-4806.

Printed in the U.S.A.

Caffeine and Athletic Performance Some caveats With this in mind, athletes considering using caffeine before competition should consider the following:

By Lawrence L. Spriet, PhD In the athletic world, caffeine is considered a legal drug. While it has generally been difficult to perform well-controlled field studies on caffeine’s impact on performance, laboratory and field-based simulations of marathons and cycling races suggest that caffeine is ergogenic or "work enhancing."

● Make sure you know the amount of

caffeine in "energy drinks." Exercise caution if the drink has an unknown amount of caffeine, or if it contains untested ingredients (see chart).

Caffeine and endurance performance From research conducted in the late 1970s to the present, caffeine ingestion has been consistently shown to improve endurance exercise performance when compared to a placebo.

● Caffeine in low-to-moderate doses

does not act as a diuretic if taken shortly before or during exercise. ● Low-to-moderate doses of caffeine (3-6 mg/kg body mass; 1.4-2.8 mg/lb) can have mild (e.g., anxiety, tremors, etc.) to no side effects and do not produce urinary caffeine levels that are currently banned by the International Olympic Committee.

Initially, researchers attributed these improvements to a caffeineinduced cascade of events leading to the sparing of muscle glycogen.

Today, however, recent research has provided growing support for the suggestion that caffeine enhances performance by reducing the perception of effort during exercise. Doses of caffeine of 23 mg/kg body mass (155-230 mg for a 170-lb athlete; the equivalent of 3-4 cans of Mountain Dew) can improve endurance performance, suggesting that the cause lies in the central nervous system and not in the muscles.

Caffeine and short-term performance Growing evidence also suggests that caffeine may be ergogenic during short-term exercise.

Evidence shows that caffeine:

The amount of caffeine found in common products.

Product* Over The Counter Drugs NoDoz®(maximum strength) Excedrin® Anacin® Coffee/Tea Brewed Instant Decaffeinated *Espresso *Decaf Espresso Tea, leaf or bag Soft Drinks Pepsi-Cola® Mountain Dew® Chocolates Hershey® Bar (milk chocolate) Cocoa or Hot Chocolate

Caffeine (mg)

1 tablet 2 tablets 2 tablets

200 130 64

8 ounces 8 ounces 8 ounces 1 ounce 1 ounce 8 ounces

135 95 5 90 10 50

12 ounces 12 ounces

37.5 55.5

1 bar (1.5 ounces) 8 ounces

10 5

Serving sizes are based on commonly eaten portions, pharmaceutical instructions or the amount of the leading-selling container size. *No-Doz® Bristol-Myers Squibb Company; Excedrin® Bristol-Myers Squibb Company; Anacin® Wyeth; Pepsi-Cola® Pepsico, Inc.; Mountain Dew® Pepsico, Inc.; and,Hershey's® Hershey Chocolate Corporation.

● Improves performance during simulated running, cycling,

rowing and swimming races lasting between four and 30 minutes. ● Does not appear to improve sprint performance lasting

less than 90 seconds.

Serving Size

● Caffeinated drinks should

not be looked at as a substitute for the consumption of the correct amount and types of fluids and carbohydrates during exercise.

Finally, as is typical with any drug, there is large individual variation in the physiological and performance responses to caffeine. Athletes should first experiment with doses of 3-6 mg/kg body mass (1.4-2.8 mg/lb body mass) before deciding whether to include caffeine as part of their regular training program.

References: 1National Coffee Association, National Soft Drink Association, Tea Council of the USA, and information provided by food, beverage, and pharmaceutical companies and J.J. Barone, H.R. Roberts (1996).

2"Caffeine

Consumption." Food Chemistry and Toxicology, vol. 34, pp. 119-129.

3www.sleepfoundation.org*

Lawrence L. Spriet, PhD, is a professor in the department of human biology and nutritional sciences at the University of Guelph in Guelph, Ontario, Canada.

For more information on this topic, please visit the Sports Science Center at www.gssiweb.com.

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T&C’s Comeback Athlete October 2003 Winner

From Surgery to Staff Ace Two potentially life-threatening incidents didn’t stop Emory’s Reed Harvey from landing the top spot on the Eagles’ pitching staff.

R

eed Harvey doesn’t want to be remembered for cheating death—though the fact that he did so twice has given him a greater appreciation for life. He just wants to play baseball. And after helping his Emory University teammates reach the NCAA Division III tournament in the spring of 2003, he’s just getting to the top of his game.

Harvey’s first serious brush came in a water-skiing accident when he was 13. When the tip of his ski took a slight dip under the water, the back end came up with enormous force and struck Harvey in the head, just behind his ear, creating a golf ball-sized hole in his skull. He was airlifted to a children’s hospital, where neurosurgeons considered placing a metal plate under his cracked skull, but had to wait for parental consent. It took Harvey’s mother, Corky, five hours to get there, and his father, Dean, arrived shortly thereafter.

That delay might have saved Harvey’s life. While waiting, the radiologist had time to properly look over the films.

He noticed a bone fragment lodged in a tiny vein and became concerned that an operation could rupture the vein, causing Harvey to bleed to death. When Corky Harvey arrived, she sought another opinion, which led to the agreement that the best option was to close the wound and allow it to heal on its own.

Recovery primarily involved waiting. Eventually, though, Harvey was cleared to play high school baseball, but he had to wear a helmet, even in the field. Football was out of the question. That was fine with him, since he preferred baseball, and he soon moved from third base to catcher, because catchers had to wear helmets during play anyway. Occasionally, the coach would call on him to pitch, too.

By Guillermo Metz Guillermo Metz is an Associate Editor at Training & Conditioning.

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Harvey went on to play at Emory, where at 6’1” and about 175 pounds, he showed promise, but mostly, he impressed everyone with his work ethic and positive spirit. “He was one of the hardest workers on the team,” says Head Coach Mike Twardoski. “Even as a freshman, he was a leader. When he came back as a sophomore, I told him I wanted to play him more if he could get his strength up and gain some weight. But no matter how much he worked out, no matter how much he ate, he wasn’t able to gain weight.”

That concerned Harvey, as did a small lump above his eyebrow, but he didn’t draw any connection between the two.

“He came home over Christmas break of his sophomore year and, even though he’d had it for years, he finally decided to have someone look at the lump on his forehead, because it was growing,” recalls his father, Dean. “Our family doctor thought it was probably just a fatty cyst, and sent him to see a plastic surgeon about having it removed.

“The plastic surgeon took a look at it and thought there might be more going on,” he adds. “He wanted to take some

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Comeback Athlete scans before doing anything. Reed wasn’t sure it was worth the trouble, but finally agreed to it.”

As a pathologist at UCLA Medical Center, Dean Harvey knew the MRI technician. When the five-minute procedure lapsed past the 15- and 20minute marks, he grew concerned.

When the tech finally called him over, 45 minutes after starting the scan, he was downright worried.

“He called me over and showed me some of the scans,” Dean recalls. “Then he pointed out a light spot and my heart just sank. He mentioned cancer and I knew my life was over, and Reed’s life was over.”

But Dean understood the scans weren’t conclusive, so he went out to the waiting room and reassured his son, saying it was probably just a cyst. Then he rushed the scans to a friend, Ronald Rich, MD, a neurosurgeon in private practice who had overseen Reed’s care following his water-skiing accident.

“Dr. Rich looked at the images and said he thought it was a benign cyst, but that there was no way to tell until he operated,” Dean says. “He also said it was putting pressure on Reed’s pituitary gland, so even if it was benign, it had to go.”

By interfering with the pituitary gland and its huge array of hormones, the cyst was probably the cause of Reed’s metabolic problems over the past year. It was also pressing on his optic nerve, and Dr. Rich warned that within six months Reed might start losing his sight.

Three emotionally grueling weeks later, Reed underwent surgery at USC Medical Center, which has a pituitary surgery unit. Martin Weiss, MD, Chair of the Department of Neurological Surgery performed the operation. When Dr. Weiss emerged from the operating room with a smile, the Harveys breathed their first sigh of relief. He told them the cyst was actually a tumor that had become cystic, but that it was benign and that he was confident he’d been able to remove all of it.

Within two weeks of the operation, Reed and Corky were on a crosscountry train ride back to Emory. (He 6 ◆ T&C O C T O B E R 2 0 0 3 ◆

Award Winner

Reed Harvey ◆ Sport: Baseball ◆ School: Emory University ◆ Injury: Skull fracture and brain tumor ◆ Comeback Team: Mike Twardoski, Head Baseball Coach, Emory University; Ronald Rich, MD, neurosurgeon in private practice; Martin Weiss, MD, Chair, Department of Neurological Surgery, USC Medical Center; John Dunham, MS, ATC, Assistant Athletic Trainer, Emory University couldn’t fly because his skull and brain were too sensitive to the changes in air pressure.) He showed up at baseball practice, but no one was sure he’d ever be able to participate again. “I’d watch him jogging around the bases, and he’d have to rest every few minutes,” says Twardoski. “I told him there would always be a space for him on the team.

We wanted him back, but we also knew he had to take his time.”

In March 2001, Reed made his return to the field, as a pinch hitter. “I couldn’t believe after all that had happened, I was still playing college baseball,” he told the Atlanta JournalConstitution. “It really is such a bless-

ATHLETICBID.COM

ing I found [the tumor] so early. I’m lucky.”

After playing in nine games as a sophomore, Reed went home that summer and worked to get his strength back. With a new determination and the full function of his pituitary gland, he made considerable gains by the time he returned to Emory in the fall of 2001.

He was happy, and fortunate, to be backup catcher and pinch hitter, but he knew he could do more.

“Before the season started, I pulled him aside,” recalls Twardoski, “and I said, ‘The team loves you, and I want you to be a part of it. I’ll find a place for you, but it may not be as catcher. We might try you at third base.’

“He looked at me and said there was one position he wanted to try out for, and that was pitcher,” Twardoski continues. “I knew he had a great arm, so I had no problem giving him the chance. The first time I saw him pitch, I was impressed. He had a lot of raw ability.”

Late February of his junior year, Harvey’s latest dream came true when he came in as a relief pitcher for nearly two innings. “I was so excited when coach summoned me,” he told The NCAA News. “I knew then that pitching was what I wanted to do. I had finally found my niche on the team so I could contribute to its success. That game was symbolic of my reward for sticking through all the tough times when I thought about quitting.”

Harvey had a decent season—by the end of it he was the team’s closer— and both he and Twardoski knew he was just starting to reach his potential.

Twardoski told him to work hard over the summer because he was considering him for a starting pitcher slot the following year.

Harvey went back to California for the summer, playing catcher and occasionally pitching in an area league. But the team practiced and played most of its games in East L.A., a long commute from home. So Twardoski put him in touch with someone from the neighborhood: former major league pitcher Kevin Gross.

“Reed called Kevin up one day and

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Comeback Athlete

Nomination Criteria and Procedures

T

he Comeback Athlete Award Program serves to honor those outstanding athletes who have successfully returned to competition in their sport following a serious injury. It also serves to recognize those people who worked with the athlete behind the scenes: the physician who set up the treatment plan, the physical therapists and athletic trainers who oversaw the rehabilitation process, and the strength coach and sport coach who helped the athlete regain his or her competitive form.

CRITERIA FOR NOMINATIONS: Starting with our fall 2003 issues, we will no longer judge comeback athletes within a specific category (e.g., High School Male, College Female). Rather, we will honor a comeback athlete every other issue, regardless of level of play or gender. So send in your nominations as soon as you have a candidate you feel fits the bill!

TO NOMINATE AN ATHLETE: Please fill in the form below, attaching a 500- to 1,000-word description of the athlete’s rehab program, which includes the following points: • The athlete’s injury, including cause and severity.

• The physician’s initial medical assessment and treatment protocol.

• The details of the rehabilitation program.

• The details of the athlete’s conditioning program prior to returning to competition.

• The degree of success the athlete achieved upon returning to competition.

• Dates of when the above occurred.

• Names, titles, and phone numbers of those physicians, athletic trainers, other sports medicine professionals, and coaches who played a major role in the athlete’s comeback.

✁

Comeback Athlete Award NOMINATION FORM

Name of Athlete_______________________________________________ Your Name____________________________________________________ Your Affiliation________________________________________________ Your Phone No.____________________ Your Address__________________________________________________ Send nominations to: Comeback Athlete Award, Training & Conditioning 2488 N. Triphammer Rd. Ithaca, NY 14850 If you have any questions, feel free to call us at (607) 257-6970, ext. 18

8 ◆ T&C O C T O B E R 2 0 0 3 ◆

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told him who he was and asked Kevin if he’d be interested in working with him,” says Dean Harvey. “I think Kevin wasn’t all that eager—until he saw Reed throw. Then they hit it right off, and he worked with Reed, getting his strength up and working on his form and technique.”

The hours spent working out in the gym, combined with advice from Gross, did the trick. Harvey worked hard in the preseason and he found himself on the mound for Emory’s opener against Brescia University. He pitched six innings, giving up only four hits in the loss. Harvey had exceeded his dreams and become a starting pitcher.

Later in the season, the Eagles were 22-12—not bad but certainly not outstanding. “Reed was doing great on the mound,” says Twardoski, “but the team was faltering. They weren’t hitting well and they were making all kinds of mistakes. I think they were trying too hard for Reed.

“One day, Reed came into practice and said, ‘Come on guys, let’s stop trying so hard and just enjoy ourselves,’” Twardoski continues. “He realized what was going on and also knew that winning or losing wasn’t that important. He was just happy to be out there playing, and he wanted everyone else to lighten up.”

That turned the team around. Not only did the players go out with renewed enthusiasm and a different mindset; they also started winning more games. The Eagles earned a spot in the regionals, where Harvey was named MVP after leading the team there with a 2-0 record and 3.00 ERA. Harvey finished the season as one of three finalists for the region Pitcher of the Year honor, with a 2.54 earned run average, ninth best in school history. He was also one of two Eagles voted to the Verizon Academic All-District team for their athletic and academic accomplishments.

A neuroscience and behavioral biology major at Emory, Harvey graduated in May and spent some time playing with Allentown in the independent Northeast League. Now, he’s looking at two options: trying out for the pros in the fall and going to medical school. ◆

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Bulletin Board New York Redefines ATCs’ Roles New York recently became the latest state to spell out the “scope and duties” for athletic trainers working in public schools. The move is seen as part of a positive trend to delineate the important roles athletic trainers play.

The revised regulations, which went into effect July 10, 2003, define an athletic trainer’s duties in considerable detail and delineate the responsibilities into the following categories: “prevention of athletic injuries, including assessment of an athlete’s physical readiness to participate; management of athletic injuries; reconditioning to minimize the risk of re-injury; healthcare administration; education and counseling of coaches, parents, student athletic trainers, and athletes; risk management and injury prevention; management of athletic injuries; immediate care of athletic injury and physical conditions; treatment and reconditioning of athletic injuries; organization and administration; and professional development responsibilities.” The amendments also narrow ATCs’ duties from providing services to “school personnel and students” to being solely responsible for the welfare of athletes.

Andy Smith, MS, ATC, Head Athletic Trainer at Canisius College, and President of the New York State Athletic Trainers’ Association, says the changes came as a result of years of work. “We’ve been working on revising the regulations for a long time,” he says. “Basically, it makes clear what the role of an athletic trainer in the high school setting is. And I think it will help others understand what we do.”

Study Looks at Concurrent Endurance and Strength Training Combining strength and endurance training yields better results than either type of training alone, according to a recent study. Researchers showed that combining training methods improved anaerobic power better than strength training alone and improved VO2 max better than endurance training alone.

Researchers from the University of Athens and St. Savas Hospital in Athens, Greece divided 26 male basketball players into four groups, one focusing on endurance training, one focusing on strength training, another combining the two, and a control group. The first three groups trained four times a week for seven weeks. The group combining strength and endurance training performed both programs on the same day, separated by a seven-hour recovery period.

The group that combined strength and endurance training showed greater improvements in vertical jump, anaerobic power, and aerobic capacity than the endurance group or strength group. The strength training-only group increased anaerobic power, but showed decreases in aerobic capacity, and the endurance training-only group increased

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aerobic capacity at the expense of anaerobic power.

The study results were reported in the latest issue of The Journal of Strength and Conditioning Research (Vol. 71, No. 2).

Eye Black Best Against Sun’s Glare A According to a recent study, traditional eye black grease really is best for combating the sun’s glare. The mix of wax and carbon won out over anti-glare stickers that have recently hit the market, in a study from the Yale University School of Medicine published in the July issue of The Archives of Ophthalmology (Vol. 121, No. 7).

The researchers compared eye black grease to antiglare stickers, using petroleum jelly as a control. They tested 46 subjects, and found that eye black reduces glare and improves contrast sensitivity better than the other products.

Supplement Guidelines Questioned Copies of a controversial set of sports nutrition supplement guidelines for athletes 18 and younger have been circulating for several months.

Published by the Council for Responsible Nutrition, a trade association for the dietary supplement industry, the guidelines place sports nutrition supplements into three categories of safety, giving them a green light (safe), yellow light (use with caution), or red light (potentially dangerous).

Although they were intended to arm the medical community and other healthcare practitioners with easily accessible information, the guidelines have come under fire for being too simplistic, and not being based on scientific research. “Nutritional supplements ... have never been studied in children,” Jordan Metzl, MD, Medical Director of the Sports Medicine Institute for Young Athletes at the Hospital for Special Surgery, told Orthopedics Today. “We have no idea what the safety of these products may or may not be for kids, and therefore, I feel that they should universally be discouraged.”

The CRN guidelines give creatine a yellow light, which Metzl points to as a basis for his criticism. “Creatine has never been studied under the age of 18 in anybody so to say that it’s okay or it’s a yellow light is, in my opinion, irresponsible,” he said.

Metzl believes the solution is for healthcare practitioners to educate themselves on supplements—and to pass that knowledge on to young athletes, their parents, and coaches. “I think that if the medical and sports medicine community doesn’t aggressively take on this issue, we’re going to have more problems down the line,” Metzl said.

If you have any news or interesting trivia items you would like to contribute to T&C’s Bulletin Board, please e-mail them to ef@momentummedia.com, or fax them to (607) 257-7328.

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Photo: Bruce Newman

All In the Family ric Day’s epiphany came at, of all places, the National Athletic Trainers’ Association’s 1999 Hall of Fame induction luncheon. Out of school only three years, Day noticed a theme as the inductees gave their acceptance speeches.

“Six out of 10 apologized to their families for not always being there,” says Day, MA, LAT, ATC. “They said that they were glad that their families supported their career choice but they were sorry they often couldn’t make their son or daughter’s own athletic event, or play, or something like that.”

For Day, the luncheon speeches hit a nerve. Engaged to a woman he’d

E

The long-held tradition among athletic trainers to put work before family is starting to be questioned. This article offers solutions for balancing personal life with career in the athletic training setting.

BY DAVID HILL

Tim Mullins, Head Athletic Trainer, and Leroy Mullins, Director of Sports Medicine, at the University of Mississippi, explain the nuances of helmet protection to son and grandson, Hayden.

met during his sophomore year in college, he became aware that he hardly saw her at all on weekends because of his schedule as an athletic trainer.

“Basically, I received a message that in order to achieve the highest level in this profession, you’re going to have to make sacrifices, and in their cases, it was their family,” he says. “And that’s just not me.”

Now, Day is out of direct full-time athletic training. Instead, he runs a placement service linking athletic trainers with jobs, primarily at summer David Hill is an Assistant Editor at Training & Conditioning.

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Smart Delegating hen talk arises of maintaining career-personal balance, the first word that usually comes up is “delegate.” But the hardest thing to delegate can be covering the sports you love.

Bernie DePalma, MEd, ATC, PT, Head Athletic Trainer at Cornell University, still travels with the football team, but other squads are covered by staff ATCs. That proved tough last winter, when the Big Red men’s ice hockey squad, arguably the school’s highest-profile team, went to the Frozen Four. DePalma knows, though, that he and the department are better served if he is free to concentrate on administrative duties.

Mike Roberts, MS, ATC, Director of Sports Medicine at Auburn University, doesn’t cover any team, not even Tigers football. “My energies need to be spent mainly on what we need to do to make it better for all of us, not just help with what we have today,” he says. “If I spend all of my time working on and thinking about and doing just what’s in front of me, how do I ever plan for the future? How do I ever get better?”

Roberts says he also tries to instill the same thinking in his staff of six full-time certified athletic trainers. These ATCs have primarily on-field, everyday responsibility for only one team. But they also oversee a graduate assistant or intern who has that duty for other teams. That way, he says, they’re learning to manage and set priorities, too.

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sports camps, and works at home— during hours he sets.

Day might have figured it out a bit earlier than many, but the idea of sacrificing personal life for career is familiar in athletic training. Long hours, earlymorning and late-night work, weekend after weekend on the job, little downtime through the year—these are standard operating procedures, many say.

But do they need to be? Some athletic trainers are starting to question the long hours. They see the conflict driving good people out of the profession and keeping many others away.

Why is it this way? Are there alternatives? What are some ways to cope?

How can you better balance on the work-personal life tightrope?

‘GET-IT-DONE’ MENTALITY

In the view of many athletic trainers, much of the problem stems from the mentality that long hours are something to be proud of. “If you look back 50, 60, 70 years ago to the old-time guys who started the profession, that was their work ethic,” says Mike Matheny, MS, ATC, Head Athletic Trainer and Clinical Associate Professor at Ithaca College. “They really had to prove their worth to the 14 ◆ T & C O C T O B E R 2 0 0 3 ◆

administrators, and one of the ways of doing that was to always be there and always be available.”

Another part of the problem is the nature of the job, particularly in the college setting. Travel piles up working hours, and weekend contests eat up time that would otherwise be spent at home. Work has to be done around student-athletes’ class schedules, which requires early starts, late finishes, and being on duty most weekends. New NCAA rules requiring the presence of qualified medical staff at off-season voluntary workouts eat into the historically mellow summer.

In addition, the qualities that make them good professionals can make athletic trainers inseparable from their work, says Leroy Mullins, ATC, Director of Sports Medicine at the University of Mississippi. “Most athletic trainers I know who have been in the business more than 10 years are ‘get-it-done’ people,” he says. “They get things done because there’s a need.

Years ago, if administrators or coaches wanted something done, they’d give it to the athletic trainer. You will never see a full-time coach standing outside a bus seeing who gets on and who doesn’t.

Things like that get passed down to the

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athletic trainers at a lot of schools.

“Take drug testing,” Mullins continues. “That got dumped into athletic trainers’ laps because it was part of their health management duties.

Getting the athletes’ urine samples, putting the samples in cups, and sending them off to be tested became part of the job.”

Day knows of a head athletic trainer at a college who, when an equipment manager was fired, stepped in to launder the uniforms—only to be immediately made the de facto equipment manager on top of his sports medicine duties. “We’re so used to catering to the athlete, and our profession is basically to take care of people,” Day says. “We get so focused on that, that we don’t take care of ourselves.”

When Bernie DePalma, MEd, ATC, PT, took the job of Head Athletic Trainer at Cornell University, he was single and unattached. But he encountered a few staff members who attributed their divorces to the time spent at work. “I had to figure out a better way to do it,” DePalma says.

Now married with two children, he did figure out a better way, and makes sure his staff understands that the traditional mentality is not healthy for the long run. “Starting out in the profession, if you’re single, you really don’t have any boundaries,” he says. “You can go ahead and work 12- or 14-hour days, seven days a week, and love it. The problem arises when you meet someone and decide to get married or commit to that person. If you’re used to working long hours, and if you don’t put any thought into it, your relationship might be on a disaster course right away.

“Then, if you decide to have children, trying to balance the professional and the personal life with your wife and children becomes very difficult.

That’s when you have to step back and look at your staff. You’ve got to look at the responsibilities you have and delegate. You need to become a better manager to balance the aspects of your life at that point.”

For Nelson Jones, ATC, Head Athletic Trainer at Presbyterian Col-

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lege, the turning point came several years ago when he realized that, though he was single and had no problem with long hours, as the school’s only athletic trainer, neither he nor the athletes benefited from his being stretched too thin.

“There was nothing in my life that stood up and slapped me in the face,” he says. “It was a gradual process where I started saying to myself, ‘Hey, you can’t keep this up. It’s not fair to you, it’s not fair to the kids.’”

would still be working, but they would be covering the home base and not traveling. That freed up a good chunk of the year—a couple of months, at least—to get a little more balance in their life.”

DePalma also gives staff members free rein to schedule themselves. “They let me know when they’re working,” he says. “It works out great. Because they have ownership in it, they do the right thing.”

The key is to invest a little upfront

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they’ll get back around 3 a.m. Then we’ve got j.v. and freshman football Saturday morning and a varsity volleyball tournament going Friday night and Saturday. Instead of the three of us covering the varsity football game as we normally do, my two partners will go to Midland with football, and I’ll stay here and cover the volleyball tournament and sub-varsity football.”

The scheduling allows each of the three to plan their month and count on some away-from-work time. In

SMART SCHEDULING

The first step to achieving a better work-personal life balance is simply establishing a more efficient schedule.

Many sports-medicine programs are abandoning the idea that every staff member has to be in the training room first thing each morning in favor of rotating the duty or designating certain people to open and others to close.

Other programs are setting office hours for individual staff members and taking a fresh look at what it means to have the responsibility for a particular team of athletes.

Matheny’s department, for instance, builds in downtime during morning hours, based on a weekly schedule. In the fall, he has primary responsibility for Ithaca’s varsity football team, teaches in the school’s athletic training curriculum program, and has administrative duties. His weekly schedule requires him to open the athletic training room on Mondays, and he teaches class Tuesday and Thursday mornings, but on Wednesdays and Fridays, he won’t come in until lunchtime, instead spending mornings with daughter Megan, 3, or taking Carlyn, 6, to school, while his wife, Shelly, a former athletic trainer herself, works as a part-time youth sports coach.

When DePalma arrived at Cornell, he immediately lightened the load by limiting each ATC to primary responsibility for two teams instead of three.

For the third team, the ATC would have a liaison—a graduate assistant or experienced student in the athletic training department—and then have two in-season periods and an off-season, DePalma says. “In that off-season, they

At Ithaca College, Mike Matheny’s fall schedule requires him to be on campus Monday, Tuesday, and Thursday mornings, but on Wednesdays and Fridays he doesn’t come in until lunchtime, instead spending mornings with Megan, 3, or taking Carlyn, 6, to school. His wife, Shelly, works part time as a youth sports coach.

time in planning and scheduling. Steve Gruenewald, LAT, ATC, one of three athletic trainers at Americas High School in El Paso, Texas, admits that having no teaching duties and two colleagues to share his work is a great situation. But scheduling the staff takes some effort each month, he says. The three rotate early and late duty through each week, and he tries to arrange event coverage to minimize problems, such as avoiding early-morning shifts after late nights.

He also gives each staff member one Saturday off every month.

Volleyball, basketball, and baseball have games at some level on Tuesdays, Fridays, and Saturday mornings in their respective seasons.

But Gruenewald arranges things so that if someone works a Friday afternoon, someone else will work on Saturday morning.

“The first Saturday this September we have a Friday night football game in Midland, a five-hour drive, and

Gruenewald’s case, it’s enough to raise four children, hold a leadership position in his church, pursue a doctorate, and serve as commander of his Army Reserve unit.

Daily schedules can also be restructured with room for downtime.

“If you figure it out, you realize there are ways to get away,” DePalma says.

“In day-to-day coverage, can a student or a grad assistant cover the practice while you run errands or see your family and then check back? Can you leave for two hours while the team is on the field and then come back for the postpractice treatments to wrap things up?

There are ways to work around things.”

Such a schedule does require extra communication, DePalma says. For instance, athletic trainers need to tell the teams they’re working with what their schedules are—that they may need to make an appointment for treatments, or possibly see another athletic trainer at times. This, adds DePalma, is where technology comes in. Injury-

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reporting software is invaluable in allowing members of a staff to instantly know the status of a particular athlete’s case, while e-mail and cell phones allow questions to be answered and new concerns shared.

“If you communicate with your head coach, you may not need to be there all the time,” DePalma says.

“Call the coach and say, ‘I’m at home with my family and I have my cell phone. If my assistant in the training room can’t help, feel free to call me at home.’ Quite frankly, I don’t remember a time when I’ve been called.

“And when you really press an athlete,” DePalma adds, “ask him or her, ‘Why can’t you be here at noon?’ you may find there is not a conflict with a class. The athlete can come for treatments on your time.”

Cheryl Cundy, MS, ATC, Assistant Athletic Trainer at the University of Missouri, has also found that coaches and athletes can be flexible if you simply ask them. Her teams expect her to be available for most treatments as well

“There are times when I have to take Ty (2) to an appointment,” says Cheryl Cundy, an assistant athletic trainer at Missouri. “I try to write treatments for [my athletes] that are a little more independent for that day.”

Husband Tim works as a golf pro at the university’s course.

as practices and events. But they also understand that she’s working hard to balance time with husband, Tim, a golf professional at the university course, and their son, Ty, 2.

“There are times when I have to take Ty to an appointment,” she says.

“I tell the softball team, ‘I’ll be here at this time, and other than that you’ll have to get somebody else to help you.’ Or I try to write treatments for them that are a little more independent for that day, and I can do more hands-on things the next day. They’re pretty accommodating to that.

Nothing is really skipped because I’m not here.”

Mary Meier, MS, LAT, ATC, Athletic Training Program Director and Assistant Athletic Trainer at Iowa State University, juggles work with raising three small children and has a strategy similar to Cundy’s. “I tell athletes I’ll be here during specifically scheduled office hours if they want to see me,” Meier says. “Otherwise, they’ll see someone else.”

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HOW TO LET IT GO

Being able to delegate, share responsibility, and sometimes say “no” depends on trust—in oneself and one’s colleagues. For many athletic trainers, the first step is gaining perspective on the situation—trusting your own beliefs on what’s realistic and what isn’t—then communicating the problem to others.

In Jones’ case, at Presbyterian, the first move was to talk with his athletic director about his workload. After some discussion, the athletic director agreed to hire an assistant. Jones gently raised two factors: liability, particularly in light of then-developing NATA staffing standards; and equity, as he generally did not travel with women’s teams. “When you start talking in legal terms, those ears that need to listen all of a sudden perk up,” Jones says.

Now, the assistant travels with the women’s basketball team—Jones hadn’t regularly gone on the road with the Lady Blue Hose—and sees most female athletes for treatment and rehab. The college also has a certified

down to a people issue.”

Those outside sports medicine need to be involved, too. This is especially true when there are few if any colleagues with whom to share the work. At Southern Utah University, Head Athletic Trainer Ricky Mendini, MEd, ATC, says that when he explains the unique schedules of athletic trainers to coaches and administrators, they almost always understand.

“There have been instances that people wanted to practice at odd times,” Mendini says. “I’ve gone to the head coach and said, ‘That’s really difficult for us. You can practice from 8 until 10 at night, but you don’t have to come back to school until 2 in the afternoon. We can’t come in at 2 p.m.; we have to be here in the morning.’ And they’ve pretty much understood the situation and made it work for all of us.”

And sometimes, an athletic trainer simply has to learn to say “no,” especially at one-person sports-medicine departments. Christina Emrich, ATC, Athletic Trainer at Red Bank (N.J.)

graduate assistant. The result is that Jones has more time for administrative work, and, perhaps most importantly, someone with whom he can share athletic training room hours and homeevent coverage. “Taking some of that away from one person and putting it in other capable hands definitely helped alleviate burnout,” Jones says.

Trusting colleagues is also key, which is why Mike Roberts, MS, ATC, Director of Sports Medicine at Auburn University, schedules regular in-service sessions and weekly staff meetings, even during the grueling fall term.

These get-togethers help ensure everyone is on the same page, be it on emergency protocols or NCAA rules, Roberts says. The department also has a “journal club,” through which members update one another on the latest sports-medicine research.

“We try to make a oneness of our whole department, if you will, whether it’s one individual team or one group of things,” Roberts says. “We can buy all kinds of tools, but it still comes

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BALANCE FROM THE OTHER SIDE

As important as it is to trust and communicate with colleagues, coaches, and athletes, there’s another group of people who figure into the balancing act. “If you’ve got a family at home, remember them, and somewhere in the morning call them,” says Mullins. “If you live close enough, go home for lunch, even if it’s nothing but a peanut butter sandwich. And set a time every night to turn the TV off, put down the newspaper, and look at each other and talk.”

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Regional High School, says she works six days a week most of the year and accepts it. She’s the school’s only athletic trainer. About the only time she’s missed a game in her eight years there was when she had an important personal evening commitment and called on a fellow athletic trainer who worked elsewhere. But when coaches try to schedule a Sunday practice, she puts her foot down, and they respect it. “I tell them, no, that’s my day off,” Emrich says.

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For Meier, the only way to manage career and family is to carefully plan everything with her husband, Jamie, an Iowa State athletic equipment manager who travels with the football team. They have a corps of baby sitters, and Meier’s parents or 17year-old niece can come from Nebraska to take the kids for a weekend. But the logistics can be daunting.

“Jamie and I huddle once a week,” she says. “So, on a Monday morning, I’ll say, ‘I have a volleyball tournament Sept. 27. What does football have that weekend?’ But you also have to foresee what might come up. What if a game goes into overtime? Looking ahead is vital.”

Another tactic is to bring the family along for some face time.

Admittedly, this isn’t for everyone, and some settings just aren’t safe, proper, or fun for kids, especially if they are young and need constant attention.

“Spending the weekend in a hotel room with a couple of kids is no vacation for your spouse,” DePalma offers.

But a hidden perk of athletic training is that most settings are safe and pleasant enough to occasionally include the family, and that many children relish the chance to be around athletes. Mendini’s daughters regularly attend football practices, helping carry supplies to the field and chatting with the players. “They usually just hang out with me on the sidelines during practice and help get water out to the athletes or with small chores around the training room,” says Mendini.

For Mullins, the family-work blend has gone even farther. His son, Tim, started coming to campus at age 10. By his high school sophomore year, he was there most afternoons. Today, Tim Mullins, MS, ATC, is Ole Miss’s Head Athletic Trainer. Father and son work together. What’s more, three generations are present when Tim brings his son, Hayden, 3, along. The elder Mullins says Tim has already figured out how to find a work-home balance.

“I must say that he is learning to go home quicker than his dad did,” Leroy Mullins says. “He keeps saying, ‘I don’t want to be like you, the way that you had to work all the time.’” ◆

OPTIMUM PERFORMANCE

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Illustration: Adam Berenstain

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Look, Listen, Log

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ccording to the dictionary, the word monitor means to watch, to keep track of, to check. As strength and conditioning coaches, we plan, we implement, we encourage, and we test. But how much do we monitor?

I have written extensively in these pages about all aspects of training and periodically on planning. In reviewing past articles as well as my day-to-day coaching, I have come to realize that one area needing more emphasis is monitoring. It seems an obvious step in

You’ve developed a sound program. You have the right equipment. Your athletes are committed. But are you monitoring their daily progress effectively?

Here’s how. the training process, but tends to be ignored.

Monitoring is analogous to using a compass—it shows whether training is

BY VERN GAMBETTA

on the correct path. And if training is not on the right course, monitoring provides clues as to how to alter the training program to make it more effective.

We should never lose sight of the fact that, as a cumulative process, training is more than the sum of each workout. The effects accumulate not arithmetically, but geometrically. A positive result, over time, is what any Vern Gambetta, MA, is the President of Gambetta Sports Training Systems in Sarasota, Fla., and the former Director of Conditioning for the Chicago White Sox. He is a frequent contributor to Training & Conditioning and can be reached at www.gambetta.com.

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good training plan is seeking to achieve.

Monitoring training allows us to maintain control of the training process and ensure the proper adaptive response. Planning and implementing a training program are only two prongs of a three-pronged attack. Monitoring the training is the third. Only through monitoring can you tell whether the

how a monitoring process will help you and your athletes. Exactly what do you plan to do with the information you compile?

Monitoring must be more than just gathering information—it must entail gathering information you can use. Jan Olbrecht, in his book, The Science of Winning, gives the following analogy: “Testing a swimmer on a bicycle or

The best monitoring programs make the athlete a partner in the process … I try to get good feedback by stressing that training is not something we do to the athlete, but something we do with the athlete. planning and implementation are producing the desired results.

Monitoring also keeps each component of training in context. Losing context is one of the biggest pitfalls in training. Understanding the context means understanding the relationship of various physical parameters. It also means you understand the role an individual training session plays within the microcycle, and how the microcycles fit within the larger divisions of the training plan.

Much of the monitoring done today focuses on overtraining. But monitoring training can and should go much further. It can certainly spot overtraining, but proper monitoring also assesses stress, adaptation, fatigue, and individual responses to training.

With the right information, we can constantly fine-tune our workout plans to be more effective.

Also understand, however, that monitoring does not always provide immediate feedback. It takes time for patterns to emerge. But it is these patterns that paint the true picture you want to see. Looking at the big picture will help you redirect the workouts toward the ultimate goals.

TO THINK ABOUT

Before upgrading your monitoring process, there are several areas to think about. The most important is knowing 20 ◆ T & C O C T O B E R 2 0 0 3 ◆

treadmill in order to obtain the right information for water training is like taking the temperature with a barometer; both have to do with the weather but measure something quite different.” The message is clear—we must monitor what we are hoping to achieve.

Therefore, the first step is to think about the goals of your particular program. If you are working with softball infielders, and the main goals are to increase agility, lateral movement, and core strength, then you don’t need to monitor any increase or decrease in endurance. But you will want to look closely at increases in strength and movement skills. You also want to see if they are hitting with more power and snagging ground balls that were previously out of reach.

Knowing your training goals will make it easier to focus on what is truly important and what should be monitored daily. This is key, because for most coaches, the next area to ponder is, “What can I do with the resources I have?”

There are many sophisticated yet invasive methods of monitoring an athlete’s progress such as blood and urine analysis, which provide very detailed information. But, for most of us, these are completely impractical. Therefore, knowing the time you have and tools you realistically can obtain is critical.

At the simplest level, monitoring

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can entail simply recording workout results. With increased time and staff, monitoring can include extensive training logs and daily analysis. Don’t try to do more than you or the athletes have time for. As with all aspects of training, being practical will put you on the right path.

The extent of the monitoring process will also be somewhat dependent on the athletes you are working with. The best monitoring programs make the athlete a partner in the process by using the athlete’s feedback as a guiding light and working closely with the athlete to analyze the program.

However, this approach does require some maturity on the part of the athletes, since you’ll need honest and intelligent feedback from them. I try to get good feedback by stressing that training is not something we do to the athlete, but something we do with the athlete.

LOOKING AT METHODS

The main goal of any monitoring program is to know if adaptation is occurring in your athletes at the fastest rate possible without any hint of overtraining. How do you actually track this on a daily basis?

Many coaches simply test their athletes at regular intervals to check progress. One such test is a jump protocol consisting of a Squat Jump, Counter Movement Jump, Repetitive Jump, and Stiffness Jump, which will monitor the status of an athlete’s strength, elastic strength, and repetitive power. This is a simple monitoring process that has proven very effective.

One thing to keep in mind when using these tests as a baseline is that there is a learning curve. Separate from any physical progress from training, performance on these tests will improve through experience alone, which must be taken into account when evaluating the numbers.

A more sophisticated method of monitoring adaptation is to assess progress depending on the particular goal of the cycle. During training periods where particular qualities are emphasized, other qualities should be

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depressed. For example, during a heavy maximal strength block of training, the athlete’s strength should be increasing, but explosive power and maximal speed will tend to be inhibited. This can be monitored through the jump protocol. If the athlete’s elastic strength goes down by five percent, it is no cause for alarm.

While objective testing is important, I also use more subjective methods of monitoring by obtaining daily feedback from athletes at the conclusion of the workout. Two athletes can do the same workout, with the same reps and weights, and have polar opposite adaptive responses. One may have to tap deep into the adaptive reserve to achieve the result while the other requires much less effort. By finding out how tough the athlete perceived the workout to be, I can better understand what adjustments need to be made. For the athlete who had to dig deep to complete the workout, I’ll need to cut back his work or eventually he’s going to cave in. With the athlete who breezed through the workout, I will increase the intensity of future workouts.

To assess the athlete’s response to a workout, I use a perceived exertion scale (see “Training Demand,” at right).

This allows the athlete to use a quantitative measure to articulate his or her perception of the training demand.

Using the same rating scale, I also project what I think the training demand of a particular workout should be and compare that to the actual training demand as reported by the athlete.

If there is a wide divergence between the athlete’s perceived demand and my expectations, I need to reassess the training program.

Lately, I have also started obtaining similar feedback from my athletes before the start of each workout. This pre-workout assessment, which I call their “energy rating,” is designed to gauge how the athlete feels going into the workout. It uses a ten-point scale: 1=I feel great, 10=I feel absolutely awful. This allows me to both assess the athlete’s readiness for the workout ahead and know if recovery from yesterday’s workout is complete. If the 22 ◆ T & C O C T O B E R 2 0 0 3 ◆

Training Demand o help athletes articulate how much they feel a workout demanded from them, I use a “perceived exertion” rating. Perceived exertion is certainly not a new concept. It originated with Gunnar Borg, a Swedish exercise scientist, and was designed for use in monitoring training stress in cardiac rehab.

It has proven to also be quite reliable for rating exertion in the healthy athlete, and over the years it has been adapted to the world of sports performance. The implementation of it is simple: Athletes rate how hard they feel they are working by assigning a number to the sensation of their effort. The original scale developed by Borg was a 20-point scale. A 10-point scale has proven to be as effective in the athlete population, and is easier to use.

The following is a modification of the Borg scale (Training Demand Rating Scale) that I use:

T

1=easy, no effort required 2=extremely light 3=very light 4=moderately light 5=light 6=a little hard 7=hard 8=very hard 9=extremely hard 10=maximal effort Once athletes are familiar with the scale, I have found it useful to allow them to develop their own verbal descriptors for each point on the scale. This seems to personalize the process and makes the information that much more meaningful to the athletes.

athlete has lingering soreness, I may lighten the planned workout, and I will review yesterday’s workout to see why it may have been too intense. Over time, I can compare the pre-workout energy rating to the previous day’s demand rating to see how closely the two are related.

More objective tests can also be

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used for assessing your athletes’ readiness for their workout. For example, if you are working with a high jumper, you could use a simple counter-movement jump daily after warm-up to assess the athlete’s readiness to perform. The athlete places hands on hip, does a half squat, and explodes back up. If the athlete’s height is more than 10 percent off his or her best performance, you can change the workout accordingly.

Finally, you might also consider monitoring athletes’ life stresses.

Factors such as sleep, diet, and personal life can all have a dramatic effect on training and should be assessed. Both the subjective and objective pre-workout test help in this area, but any good coach also takes the time to get to know his or her athletes. Know their classes, their living situation, how they handle a tough workout, and the important relationships in their lives.

TRAINING LOG

For some coaches, the biggest challenge in monitoring training is keeping track of all the information described above. To ease the process, I suggest using standardized training logs. I have found them helpful with many different types of athletes and in various settings.

Ideally, two daily training logs should be kept, one by the coaches and one by the athletes. The coaches’ log should be as detailed as time demands allow and focus on what the athlete did or did not accomplish that day. I start by listing what was planned for the day and what was actually completed. I also list a breakdown of the time duration of each training component.

Then I rate the athletes’ response to the work: Was it too hard for them?

Or was it too easy? Did they falter at a particular part of the workout? Did they achieve the predicted outcome, but have to tap deep into the reserves to achieve that?

Finally, I try to isolate variables to identify possible patterns. For example, if they are unable to finish the armstrengthening portion of the workout planned, I mark this down. If it happens once during a cycle, no problem.

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If it happens several times in one cycle, I take a closer look at their workouts and the training log.

The athletes’ training logs have some overlap with the coaches’ log, but focus more on what the coach cannot see or know. Before athletes start their workouts, I have them record date and time, weather, and their “energy rating.”

I also ask them to list the hours of sleep they had the night before and any other “life stress” items that might affect their training, such as feeling stressed over a paper due tomorrow or feeling psyched up for next Saturday’s game.

At the end of the workout, I ask them to record the duration of the session and the actual work performed (reps, times, intervals, intensity). Then, they list their fatigue index (how tired they feel after completing the workout), and their perceived training demand rating.

When time and resources allow, I add more information to the training logs. For example, if you have a nutri-

tionist on staff, diet information can be included. If the athlete has time, you can ask him or her to answer a series of questions every day, such as: What was the hardest part of the workout today?

What was the easiest part? What were you thinking about during the workout?

DURING THE WORKOUT

While recording information before and after the workout is important, don’t forget to monitor training during the workout, too. If an athlete is struggling with a certain part of his or her planned work, I try to quickly assess the problem, then more carefully review it after the training is complete.

For example, if one of my sprinters is working on alactate short speed endurance, I will time each of her sprints. Let’s say she’s doing 50-meter sprints at 90 percent of best, with 90 second recovery and 5 minutes between sets. I know what her times should be for each sprint, and I monitor them. If the first set is fine, the sec-

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ond set starts to drop off, and her times on the third set are way off, I will stop the workout and ask her some questions. My first question is, “How do you feel?” If she says “great,” I may just go on to something else instead of destroying her confidence.

If she says she’s not feeling strong, I will ask how the warmup went. I will then ask if any muscles feel tight. If she says her hamstrings are tight I will go back to the previous days’ workouts to try to figure out why.

Once I do figure out the “why” I will explain this to the athlete.

Over the years the most effective training programs I have seen or implemented are those with a built-in monitoring system. It does not have to be anything elaborate or scientific; it just needs to be used consistently.

In essence monitoring training allows you to reconcile what was planned and what was achieved. And that, ultimately, increases training effectiveness. ◆

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TREATING THE ATHLETE

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oft tissue injuries are some of the most irritating injuries to deal with— for athletes and athletic trainers alike. The source of the pain produced by these injuries can be difficult to accurately locate and effectively treat, leaving athletes hobbled and athletic trainers frustrated. And some of the standard techniques used to treat these injuries, including transverse friction massage (TFM) and myofascial release, can cause a lot of discomfort—for the provider. A possible solution for both the athletic trainer and the athlete may be Graston Technique.

The centerpiece of Graston Instrument-Assisted Soft Tissue Mobilization (GISTM)—the key protocol in Graston Technique—is six specially designed stainless steel instruments that function as focused extensions of the clinician’s hands. These instru-

ments allow for better diagnosis and more effective treatment of soft tissue injuries by accurately locating, and allowing better access to, the trouble spots. Rather than interfering with palpation, the instruments, according to most clinicians who have used them, actually enhance their sensory perception.

Most clinicians also report that GISTM is much easier on their own hands than the manual soft tissue treatments. Thus, a day of treating patients with GISTM does not leave them with sore hands or thumbs like a day of TFM or myofascial release.

THE INSTRUMENTS

First developed in the early 1990s by competitive water skier David Graston, who sustained a serious knee injury that failed to respond to surgery and

BY DR. STEPHEN PERLE

typical therapies, Graston Technique has quickly evolved for both the diagnosis and treatment of soft tissue pathology. Each instrument is shaped and sized to work on a specific body part. Thus, there is an instrument that is small enough to be used on the Achilles tendon, fingers, and carpal tunnel, and there are instruments specifically designed to treat larger body regions such as the back, upper shoulder and neck, hamstrings, quadriceps, and iliotibial band.

The appropriate instrument is moved—generally in a longitudinal direction, either proximally or distally—over the patient’s lubricated skin Stephen Perle, DC, MS, is an Associate Professor of Clinical Sciences at the University of Bridgeport College of Chiropractic and in private practice with Connecticut Chiropractic Specialists, LLC, in Milford, Conn. He is a member of the Training & Conditioning Editorial Board.

A T H L E T I C B I D . C O M ◆ T & C O C T O B E R 2 0 0 3 ◆ 27

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TREATING THE ATHLETE

Case Study

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GT for the Knee

n athlete comes to me with a diagnosis of patellar tendinosis. How might Graston Technique work into my treatment? Here’s how I would proceed: As with any complaint, the initial clinical evaluation of a patient with knee pain begins with a thorough history and a physical, orthopedic, and neurological examination. Obviously, special attention must be given to the knee, but the entire lower-extremity kinetic chain should also be evaluated for any etiological factors not local to the knee. Assuming the examination confirmed the diagnosis of patellar tendinosis and ruled out any contraindications to treatment, I would use Graston Technique, which incorporates an advanced method of instrument-assisted soft tissue mobilization, along with more traditional treatment methods.

After an initial cardiovascular warmup, I cover the area around the anterior knee with a lubricant cream.

This is used to allow the instruments to slide over the skin easily and prevent pulling hair. First, I scan the area with GT3, an instrument that looks like a tongue depressor. The GT3 is used almost like a chisel, in short, repeated, rhythmic strokes along the patellar tendon. I use strokes of approximately one to two inches, at about one to two cycles per second, at various angles (generally plus or minus 30 degrees from the long axis of the tendon). The goal is to find an “adhesion,” which feels like a divot the instrument almost gets stuck in or like a speed bump the instrument has to pass over.

Once an adhesion is found, it is treated with a technique called Graston Instrument-Assisted Soft Tissue Mobilization (GISTM). This involves going over the adhesion repeatedly with the instrument in very short strokes (less than an inch), with greater load than when evaluating, for about a minute, until the adhesion is less apparent.

This whole process of evaluation and GISTM is repeated along the whole tendon in both an inferiorto-superior and superior-to-inferior direction. Treating the affected areas typically takes a total of three to five minutes.

Next, I use GT5, an instrument that has two treat-

A

with enough force to mobilize the soft tissues (muscle, tendon, ligament, and fascia) below. The instrument provides tactile diagnostic feedback to both the clinician and the patient. Both can feel when the instrument glides over a problem area in the soft tissue.

Normal tissue produces a smooth feel through the instruments. However, 28 ◆ T & C O C T O B E R 2 0 0 3 ◆

A clinician uses a Graston Technique tool to “frame” the knee of an athlete being treated for patellar tendinosis.

ing surfaces, concave and semicircular in design. With this instrument I do what is referred to as “framing” the patella, using very small movements (less than an inch) to evaluate and then mobilize the tissues surrounding the patella.

Finally, I use GT4, an instrument with a convex semicircular treating surface for evaluating and then treating the soft tissues just above and below the knee. Framing the patella and treating the area around the knee also typically lasts three to five minutes each. The treatment session finishes with the patient doing high-repetition, low-weight knee flexion and extension exercises; quadriceps and hamstring stretches; low-repetition, high-weight exercises; and finally, cryotherapy.

This treatment could be repeated on alternate days, or with greater separation if the patient experiences too much tenderness. Treatments continue in essentially the same way for as long as the patient is showing a positive response. The specifics of where and how treatment is performed depends on what adhesions are found at the time of the treatment. The use of objective outcome measures is important to be able to determine if the treatment is effective.

Treatment is curtailed if the patient has excessive tenderness, and it ends when the patient’s and clinician’s pain and ROM objectives have been obtained.

when the instrument glides over a problem area, it feels like it has become stuck in a divot in the soft tissue or is running over speed bumps.

These divots or speed bumps are often referred to as “adhesions.” While there is no pathological evidence that these are actually adhesions, this is a reasonable description for the soft tissue dis-

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orders the instruments find.

As a chiropractor with 20 years of experience, 12 of them teaching soft tissue treatment methods, I initially did not believe that the instruments could be a benefit from a diagnostic standpoint. I was certain that they would interfere with my palpatory skills. At my first Graston Technique seminar,

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TREATING THE ATHLETE

my lab partner took the role of clinician first, with me as the patient. As he glided the instrument over my thigh and encountered a “divot,” both of us looked at each other in total astonishment and simultaneously asked each other if we had felt that. Generally, with the Graston tools, everything the clinician feels, the patient feels too, and often, both can identify the area of the clinical complaint.

The instruments are reasonably easy to learn to use and many clinicians say that they have saved their hands from the wear and tear that TFM or myofascial release imposed on them. GISTM treatments generally take less than 10 minutes and are usually spaced with at least one day between treatments. Thus, Graston Technique fits easily into any athletic trainer’s current treatment plans.

HOW IT WORKS

According to the developer of TFM, James Cyriax, MD, TFM works in three ways: it breaks up abnormal cross-linkages between collagen fibers in tendons; between ligaments and bones; and within the muscle fascia, which allows muscles to broaden during contraction. He theorized that the massage must be transverse to the fibers because any longitudinal movement would further separate torn collagen bundles. Cyriax called the technique transverse friction massage because he thought the skin caused friction with the subcutaneous fascia.

But recent research from the University of Waterloo has found that the skin and fascia have a frictionless interface. This means that the only forces transmitted through the skin are those that are normal (90 degrees) to it.

This casts doubt upon whether transverse friction massage actually has anything to do with friction. In addition, it makes it unlikely that longitudinal movement could actually exacerbate the soft tissue disruption as Cyriax theorized.

We also know from the work of Albert Banes, PhD, at the University of North Carolina, that intermittent load-

◆

ing of fibroblasts stimulates them to both synthesize collagen and to replicate. One might hypothesize that repeatedly gliding a Graston Technique instrument over a tendon or ligament is a form of intermittent loading.

Whether true or not, research from Ball State University on a rat-tendon injury model has shown that GISTM, which is performed in a predominantly longitudinal direction, does activate fibroblasts to synthesize and replicate.

It is reasonable to assume that more fibroblasts depositing more collagen would accelerate healing for both tendon and ligament injuries.

The level of fibroblast activation is proportional to the amount of force applied by the instruments. Obviously, there must be a limit to how much force can be applied. Too much force would be too painful and there must be a point when excessive force, instead of stimulating healing, would actually cause tissue damage.

Over the past decade, the understanding of tendon injuries has greatly expanded. We now know that, due to the lack of circulation in tendons and thus the lack of inflammation (i.e., the acute vascular phase of the wound healing cycle), tendons degenerate from overuse. Treatment, in part, requires stimulating the wound-healing cycle, which starts with inflammation. GISTM, like TFM, causes what Cyriax called traumatic hyperemia.

This produces a local inflammatory response in the degenerated tissue, which stimulates healing.

The mechanism of action of GISTM in muscle disorders still isn’t clearly understood. It is theorized that GISTM breaks up adhesions within muscle and between muscle and its fascia. With more superficial problems, one might think of the instruments moving the fascia much like one can move an air bubble from under a sticker. As the “bubble” moves, the fascia detaches from the muscle beneath. For deeper problems, the instruments allow for deeper penetration in the tissue and appear to separate fascial planes.

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TREATING THE ATHLETE

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to be direction-specific. When using the instruments to perform GISTM, one moves them in the same vector that the adhesion was found in.

Different methods of moving the instruments have been developed.

One can move them over the skin in a way that reminds me of using a wood plane to “cut” away the problem area in the soft tissue. This is a basic stroke that often removes adhesions in muscle and fascia, as well as stimulating healing in tendons and ligaments. The instruments often are also used in a light brushing technique to desensitize the skin, and then like the end of a pencil to “erase” the soft tissue lesion.

GISTM can be expected to be uncomfortable. However, just like when one does TFM, the clinician can control how painful the treatment is by modulating the force and thus the depth of the treatment. Although nonathletes sometimes complain of the pain during treatment, athletes often say it finally feels like someone is get-

There are two interesting findings when using the Graston Technique instruments for diagnosis. One often hears that specificity of treatment is paramount in the success of treatment.

It appears that Graston Technique instruments are very helpful in achieving that specificity.

The exact direction of movement of the instruments that produce the abnormal divot or speed bump feeling seems to be specific to the individual adhesion. Thus, when one glides the instruments distally, one may encounter an adhesion that may not be felt when gliding proximally. Also, if moving distally at, for example, 15 degrees to the long axis of the tissue, one may find the adhesion, but not feel it when moving at –15 degrees.

Furthermore, an adhesion that is easily identified while using the instruments often cannot be palpated without the instruments. And in many cases, the clinician may not feel the lesion, but the patient can.

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ting to the root of their problem.

It is common for patients to experience some bruising after GISTM. The appearance of bruising might affect a patient’s future tolerance for the procedure if they are not forewarned. Over the 10 years of use of GISTM, clinicians have also seen a phenomenon they have termed “break out,” which is a more profound bruising. The theory is that the hematoma results from the shearing of hardened scar tissue from viable soft tissue.

While this might scare patients and initially result in a decrease in flexibility, along with swelling and discomfort, experience has shown that this is actually a harbinger of accelerated positive clinical response.

While GISTM is the foundation of Graston Technique, the Technique incorporates other appropriate treatment methods that athletic trainers and others are already using for these conditions. A typical treatment session will start with the patient doing a cardiovascular warmup, then GISTM will

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be done for three to five minutes in a localized area. GISTM treatment is followed by high-repetition, lowweight exercise, stretches, low-repetition, high-weight exercise, and finally, cryotherapy.

WHEN TO USE

This year, my colleagues and I presented a poster at the World Federation of Chiropractic’s 7th Biennial Congress of a prospective series of 1,000 cases treated with Graston Technique. We found that the technique was effective in treating a broad range of soft tissue disorders including carpal tunnel syndrome, cervical pain, de Quervain’s syndrome, epicondylitis, fibromyalgia, iliotibial band syndrome, joint sprain, lower back pain, post-fracture pain, muscle strain, painful scarring, plantar fasciitis, and tendinopathy. Treatment was effective in reducing pain and numbness and increasing patient functional capabilities.

Personally, I have found that Graston Technique has been invalu-

able in dealing with previously unresponsive patients with many types of soft tissue complaints. As an example, one of my recent patients complained of lateral epicondyle pain of nine months’ duration. This condition was unresponsive to any previous conservative treatment as well as to three corticosteroid injections. The patient had constant pain and was unable to use the arm for activities of daily living. While our series of prospective case studies found that the average patient was treated with Graston Technique for eight visits, in the patient with the lateral epicondylosis, her symptoms were reduced by 90 percent after only two Graston Technique treatments.

I have also found that Graston Technique works very well for Achilles and patellar tendinosis, significant problems for runners (see “GT for the Knee” on page 28). Colleagues have reported extensive use in the treatment of neck and lower back pain.

Current studies testing the effective-

TREATING THE ATHLETE

◆

ness of Graston Technique are looking at post-surgical lower back pain, lateral epicondylosis, and carpal tunnel syndrome.

There are a few absolute contraindications to the use of GISTM: open wounds (unhealed suture sites); unhealed fractures; thrombophlebitis; uncontrolled hypertension; kidney dysfunction; hematoma; osteomyelitis; myositis ossificans; and patient intolerance, non-compliance, or hypersensitivity. Likewise, there are some relative contraindications: anti-coagulant medications; cancer, depending on the type and location; varicose veins; burn scars; acute inflammatory condition (e.g., synovitis); inflammatory condition secondary to infection; pregnancy, because of the associated inherent ligament laxity; and osteoporosis.

With a little training, athletic trainers and others working with athletic soft tissue injuries can master Graston Technique. Both you and your athletes will appreciate the benefits a few simple instruments can bring. ◆

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MANAGEMENT

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Student aides can make an enormous contribution to your high school athletic training program.

But you need to first understand how to supervise them and what you can appropriately delegate.

BY KENNY BERKOWITZ

Is It AIDE Appropriate?

A

t Palo Verde High School in Tucson, Ariz., Head Athletic Trainer Bart Peterson, MSS, ATC, tells two stories about working with athletic training student aides.

In the first story, everything goes the way it’s supposed to: After a collision on the football field, Peterson assigns an athletic training student aide to shadow a wide receiver for signs of a possible concussion. To make sure the player doesn’t go back onto the playing field, his helmet is hidden. But 15 minutes later, while Peterson is busy working on another athlete, the wide receiver has found his helmet and is back on the sidelines, trying to check himself into the game. Because there was an aide watching the whole time, Peterson was able to intervene and keep the student-athlete from injuring himself again.

In the second story, which happened about eight years ago, nothing goes the way it should. Because Peterson is busy covering another team, a student aide travels with the volleyball squad to an away game, where a player lands hard after making a spike. Instead of relying on the home

Athletic Trainers Mike West, Chino Hills (Calif.) High School, top, Nicole Armstrong, Myrtle Beach (S.C) High School, left, and Maribeth Boeke-Ganzell, Chino Hills, right, work with student aides at their respective schools.

team’s athletic trainer, the aide improperly assesses the injury and wrongly sends the student-athlete back into the game.

It was a bad mistake. The studentathlete had suffered a moderate-tosevere ankle sprain, and her parents stopped just short of taking the school to court. The side benefit of the incident was that the school administration recognized the importance of using certified athletic trainers—an argument Peterson had been making all along.

“It was a learning experience for all of us,” says Peterson. “It showed

why we have certified athletic trainers.

It showed why athletic training student aides shouldn’t be placed in a position where they’re working unsupervised— because if they make a decision that goes beyond their abilities, they put everyone at a liability.”

LAWS & GUIDELINES

In setting up a program for athletic training student aides, the first step is finding out what kind of tasks your Kenny Berkowitz is an Assistant Editor at Training & Conditioning.

A T H L E T I C B I D . C O M ◆ T & C O C T O B E R 2 0 0 3 ◆ 33

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Keeping It Legal iven the current climate of parents threatening to sue and administrators worrying about their school’s legal liability, what do you need to know before starting a program for high school athletic training student aides? What do the laws say about student aides?

“Legally, there is no such thing as a student athletic trainer at the high school level,” says Richard Rogers, Government Affairs Manager at the National Athletic Trainers’ Association (NATA). “There is nothing officially defining them, because they don’t exist.

Of course, we know they’re there. We know they provide a service. But there are no laws dealing directly with them, and even though there are lots of new state regulations, none of them specifically deals with student trainers at the high school level.”

Rogers says there is an important distinction

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state and school district will allow your aides to perform. There are no laws that specifically regulate athletic training aides at the high school level, but there are inferences that can be drawn from laws that regulate medical professionals, college athletic training aides, and the behavior of minors in general.

The rules do vary widely from state to state and district to district, however, so you need to start by researching local guidelines, meeting with peers at other high schools, and talking to a lawyer who is familiar with your local and state regulations. (For the NATA’s perspective on following federal and state laws, see “Keeping It Legal,” above.)

When asking for legal advice, it’s important to start with the right questions, advises Jim Berry, MEd, ATC, NREMT, Director of Sports Medicine and Head Athletic Trainer at Myrtle Beach (S.C.) High School, who presented a talk on “The Appropriate Use of the Athletic Training Student Aide” at last spring’s NATA convention.

“What does your state say about students working in the athletic training room?” Berry offers. “Is there any specific language that addresses high school students? Is there any specific language that talks about how old students have to be before they participate 34 ◆ T & C O C T O B E R 2 0 0 3 ◆

between athletic training students at the college level, who are recognized by law in many states as officially pursuing athletic training as a course of study, and high school students, who aren’t recognized at all, and are only seen as pursuing a general diploma. Without having a legal definition to work with, the NATA has chosen not to write a policy for working with athletic training student aides. Instead, Rogers advises high school athletic trainers to consult their school attorney or district officials for answers to any questions about legal liability.

“If athletic trainers call me, there isn’t anything I can tell them,” says Rogers. “There’s nothing in writing, because the law doesn’t address it. Basically, we tell people, ‘Go talk to your school’s attorney. They should be able to tell you what you can do.’”

in your program?

“Next, look at local guidelines,” Berry continues. “What does your school district say about using students as aides? Are there written policies about what student aides can do?

Again, the rules are going to vary from district to district, and you have to make sure you’re following those standards. You have to know what the rules are before you can start designing your program.”

For example, in Arizona, Peterson faces strict regulations and has decided to take a conservative path in determining what his aides should and shouldn’t do. “My kids aren’t going to do an assessment without me,” says Peterson, who’s taken his stance with advice from the Arizona Athletic Trainers’ Association. “My student aides are not going to decide on a treatment protocol, and they’re not going to initiate a treatment protocol. I encourage them to tell me what they think should be done, because that helps them think like athletic trainers. But they aren’t allowed to initiate a treatment without my approval.”

On the other side of the country in South Carolina, state regulations allow Berry to delegate many more tasks— including applying ultrasound and taping ankles—to his student aides. But Berry draws the line at letting his aides

ATHLETICBID.COM

apply either procedure without him in the room, and he advises other athletic trainers to do the same.

“There are too many certified athletic trainers who allow high school students to do things they shouldn’t be doing, like applying a modality to the athlete without the presence of a certified athletic trainer,” says Berry.

“There are minors treating minors, and in my opinion, that’s not appropriate.

Now, no one can convince me that my aides aren’t capable of applying an ultrasound head to an athlete’s body and keeping it moving for five minutes. But do I let my students do that on their own? Absolutely not.”

It’s also important for everyone to understand that, if the certified athletic trainer is not present, the coach is the ultimate authority for the student-athlete’s health and safety—not the student aide. “Our coaches have enough faith in our more experienced aides that they’ll listen to their opinions, and they’ll ask them to help take care of our athletes,” says Berry. “But your coaching staff has to understand what is and is not appropriate for your kids to be doing.

“If I’m not comfortable with a coach’s understanding of the limits,” he continues, “I won’t send my aides out with them. The coaches are ultimately responsible for whatever hap-

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pens, and they need to understand that.”

Setting these types of policies is only the first step. Berry also spends time thoroughly explaining to his student aides the boundaries around what they can and can not do. “It’s your responsibility as a certified athletic trainer to make sure your student aides understand their limits,” says Berry.

“My students are very clear. They know where the line is, and they don’t cross that line. Because they know that if they do, they won’t be allowed into the training room anymore.”

However, the above cautions shouldn’t scare high school athletic trainers away from using aides. In Berry’s view, when they’re trained and supervised well, athletic training student aides can make enormous contributions to your ability to do your job well.

“It’s about running your training room efficiently,” he says. “I can teach an aide to tape an ankle just as well as

I can tape it myself—in fact, I’ve had some students who tape ankles better than I do. So once an aide has proven to me they can tape an ankle, I’ve got two or three more minutes that I can use to do something else.

“Last year, when I had four senior student training aides, I was free to evaluate injuries and talk on the telephone with doctors,” continues Berry.

“I didn’t have to worry about whether the basic, everyday taping was going to be done, because my athletic training aides knew what they were doing.”

“If you can train your student aides to do some basic record-keeping, you can save yourself a lot of time,” adds Dale Blair, MS, ATC, CSCS, Sports Medicine Instructor and Head Athletic Trainer at Wenatchee (Wash.)

High School. “It’s like when you go to a doctor’s office, and the nurse greets you, asks about your basic complaints, and takes some notes. That’s one of the roles I give to my aides. It helps me get some information, and it teaches them

MANAGEMENT

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how to take a medical history.” (For thoughts on complying with HIPAA when delegating this task, see “Privacy Issues” on page 36.)

“A lot of times we sell high school students short on knowledge,” continues Blair. “They can soak up a lot of information, and with proper training and supervision, they can be an invaluable asset to your athletic training room.”

THE APPLICATION PROCESS

Because of the importance of knowing their limits, aides should be carefully chosen by athletic trainers. At Downingtown (Pa.) West High School, Head Athletic Trainer Joe Iezzi, ATC, recruits his athletic training student aides with a series of school intercom announcements during the first few days of classes. But before they can even join his program, the candidates have to fill out an application, complete with a parent’s signature.

“The application asks for their

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MANAGEMENT

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Privacy Issues ith the implementation of the Health Insurance Portability and Accountability Act (HIPAA), it’s imperative that athletic trainers take precautions to guard the privacy of their athletes’ health care. The Federal Educational Records Privacy Act (FERPA) also requires the protection of most student information.

“The athletic training room is a public place, and because of the nature of what we do, there’s really no way to absolutely guarantee everyone’s privacy,” says Jim Berry, MEd, ATC, NREMT, Director of Sports Medicine and Head Athletic Trainer at Myrtle Beach (S.C.) High School. “But if your student aides are dealing with medical records, they need to understand that this is confidential information that can’t be discussed with anyone else.”

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name, what they’ve done, where they’re working, what kind of experience they’ve had with first aid, and whether they’ve ever been involved with sports in any way,” says Iezzi.

“They have to write a 300-word essay about why they want to be involved, and they have to have it signed by a parent.

“Right off the bat, that usually weeds some people out,” continues Iezzi. “But for the ones who stay, it says something about their dedication and work ethic. It shows me that this person is ready to give the time and effort necessary to do their job well.”

By the end of the application process, Iezzi usually has a group of two to five student athletic training aides, which he thinks is a manageable number of students to supervise. At Chino Hills (Calif.) High School, where Athletic Trainer Mike West, MS, ATC, runs a vocational program that draws 15 to 20 student aides at any given time, the screening process is even more rigorous.

“First, they fill out an application,” says West. “Then, they give us references from their teachers based on their behavior in class, and provide us with a transcript that shows their grades are acceptable. After that, there is an interview, where we ask about their interests, why they want to be in this environment, and what their goals are.

“I want people who can demon36 ◆ T & C O C T O B E R 2 0 0 3 ◆

In his athletic training room, Berry makes sure to continually emphasize the importance of confidentiality to his student aides, posting a sign where everyone can read it that says: “What you hear here, what you do here, what you see here, stays here when you leave here.”

“Our student aides realize that they’re in a special position,” says Berry. “We stress to them that they can’t go back to their classroom and say, ‘The star quarterback sprained his ankle in practice yesterday, and he may not play on Friday night.’ They take a lot of pride in knowing that there are privacy issues. And they do a good job of keeping information to themselves, because they know I’m not going to tolerate it if they don’t.”

strate leadership skills,” continues West. “I need people who are going to take charge in an emergency, and not just sit there saying, ‘What am I supposed to do?’ Of course, the interview makes them all nervous. But if they’re able to look me in the eyes and answer my questions, I know I’ve found what I’m looking for.”

STARTING SLOWLY

Once on board, aides can be given tasks gradually. At Downingtown West, Iezzi starts his athletic training student aides with basic tasks that don’t require any medical knowledge at all. They clean and inventory the training room, fill the coolers with ice, and prepare the medical kits before games and practices. Working from a detailed checklist, his aides stock the golf cart for home games and load the van for away games. Iezzi encourages all his aides to take his school’s first aid class, and if they don’t, they can’t expect to advance to more complex tasks in the training room.

At Glenbrook South High School in Glenview, Ill., Head Athletic Trainer Brian Robinson, MS, LAT, ATC, calls his state guidelines “severely limiting,” and thus takes a cautious approach to delegating duties. At the start of the year, his first-year aides spend most of their time observing. As the season progresses, Robinson gives them more responsibilities, such as

ATHLETICBID.COM

helping load the golf carts with supplies to cover home games and working on the sidelines to keep athletes hydrated.

With help from his school’s health instructors, Robinson requires his students to be certified in first aid and CPR before he’ll allow them to begin work as official athletic training student aides. Once they get their certificates, his aides are allowed to do preventative ankle-taping, act as first responders to injuries, and use a radio to communicate with Robinson from a nearby competition.

“If we have two games on adjacent fields, I’ll give a walkie-talkie to one of our student aides, and if someone gets hurt, they’ll call me over right away,” says Robinson. “That way, the aides become another pair of eyes and ears for us. And sometimes, they’ll notice an injury before I do, which makes them very valuable to the program.”

At Wenatchee, which offers a vocational program in sports medicine for about 25 students every year, Blair starts the year by giving each aide a student handbook and first aid training.

“Even before we start class, everyone has to read the student handbook,” says Blair. “We talk about their role in the program and the kind of things they can and can’t do. Then we go through all our first aid procedures, before any emergency could possibly arise.”

MANAGEMENT

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Every day, Blair’s students attend a one-hour class, followed by three to four hours in the athletic training room, where they are exposed to a wide variety of situations. During that first year, they’re put to work under Blair’s direct supervision, taking medical histories, keeping records, practicing basic evaluation skills, applying ice bags, and taping ankles. They also spend time studying their student handbook and observing athletes in their exercise routines, as well as help out around the athletic training room by filling coolers and stocking equipment.

Iezzi, Robinson, and Blair also allow their first-year aides to assist on simple exercises with rehabbing athletes. “Let’s say an athlete is throwing a medicine ball,” says Robinson.

“We’ll have one of our student aides play catch with them. That way, the aide isn’t considered to be directing anything—they’re helping us implement our protocols. They get a little one-on-one interaction with the athletes, and they feel some responsibility for helping them get back on the field again, which is the best part of the job for most people.”

After teaching student aides the basic skills they’ll need to begin, many athletic trainers test their students before giving them additional responsibility. Blair, for example, conducts quarterly evaluations of all his student aides.

“We have written exams to test their knowledge of the classroom material and hands-on tests for them to demonstrate they can use that knowledge in a practical manner,” he says.

“We have 18 different areas where they need to show competency. Even if these are skills they won’t be using every day, it’s important for our students to know them.”

At Chino Hills, West has set up a checklist to test his student aides’ level of proficiency, and he also expects them to pass a series of competencies before they can be rewarded with new tasks. “I have a check-off sheet, and before I actually put them in the field, they have to prove they’re ready,” says West. “One of the first things they do is

become first aid and CPR certified.

And before they’re allowed to do any preventative taping on our athletes, they have to prove that they’re proficient at it.”

West then assigns student aides to travel with a team based on who has worked the hardest and learned the most. “In the fall, I rotate the student aides, so they get a sense of the different teams and I get a sense of who I can rely on for each of the sports,” he says.

“Then during the winter I take the ones

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I feel are best and give them the prime jobs with specific teams.”

TEACHING SUCCESS

Along with delegating to and overseeing your aides with the utmost care, it’s important to take the time to reward your students—both in material and non-material ways. At Wenatchee, Blair provides special awards to his student aides.

“We have a Student of the Quarter award, which is partly based upon the

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Circle No. 19 A T H L E T I C B I D . C O M ◆ T & C O C T O B E R 2 0 0 3 ◆ 37

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MANAGEMENT

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recommendation of their peers, although I make the final determination,” says Blair. “We give our aides on-field recognition, and each year, we pick a distinguished alumni from our program. We also have a year-end ceremony with various awards, and the student aides can earn letters, just like the athletes, if they travel with a team and work a certain number of hours over the course of a season.”

To reinforce the idea of being part of a team, Blair outfits his aides with shirts, sweatshirts, and team jackets.

“We want them to see themselves as part of our sports medicine team,” he says. “That sense of teamwork and camaraderie are probably the most important reasons why they’re here.

Getting everyone together for activities is sometimes difficult, but we really try to do things as a group.”

West makes sure the athletic teams honor their aides. “The teams embrace their aides, and give them sweatshirts and T-shirts to make them really feel they’re a part of the squad,” he says.

Peterson requires his students to continually set goals to know what direction they want to go in. “… As soon as the aides achieve one goal, they have to set a new one,” he says.

“That’s very rewarding for the aides, and it motivates them to keep going.”

Less obvious forms of reward include providing them with mentoring and direction. Peterson, for example, requires his students to continually set goals to know what direction they want to go in. “Goal setting is a constant thing here, because as soon as the aides achieve one goal, they have to set a new one,” he says. “At the first student meeting of the year, we set program goals and individual goals, and then about once a month we see how we’re doing.”

Berry feels that showing aides respect is critical. “They shouldn’t be in the training room just to give us an additional pair of hands,” he says.

“We need to respect our student aides—respect their knowledge and their abilities. We have an obligation to make sure they’re learning something every time they come into the training room. It may be something small, but we’ve got to teach them something they didn’t know the day before.”

Peterson adds that trust is important, too. “Your aides have to trust you to give them the skills that they need,” he says. “They have to trust that you’re not going to put them in a position where they can fail. They may have to struggle, but if they have your trust, they’re going to succeed.”

Case in point returns us to Peterson’s second story: Peterson made sure the student aide who misdiagnosed the volleyball injury never lost his trust. Today, she is a certified athletic trainer herself. ◆

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E

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Score

the

To make your basketball athletes the best they can be, consider using the Performance Index Evaluation, which scores hoops players on several different physical abilities.

BY BEN COOK, CHIP SIGMON, & ALAN TYSON

valuating basketball ability is a tall order. Improving it is harder still.

Some athletes develop great shooting and dribbling skills but physical limitations prevent their bodies from moving through suitable ranges of motion. In others, muscular tightness or weaknesses result in a reduced base of athletic abilities, such as speed, power and strength, balance, and flexibility. If not addressed, these physical limitations can encumber a player’s basketball skills and may cause the athlete to engage in a series of physical compensations that can lead to injury.

In response, at the Carolinas Sports Performance Center, we developed a Performance Index Evaluation (PIE) for basketball players at the high school level. The PIE scoring system combines numerical grades of several separate tests, aimed at helping coaches better understand athletes’ physical abilities and, if needed,

Ben Cook, MA, CSCS, NSCACPT, Chip Sigmon, CSCS, and Alan Tyson, PT, LAT, ATC, SCS, CSCS, work at the Carolinas Sports Performance Center in Charlotte, N.C. Cook is the former strength and conditioning coach for men’s basketball at North Carolina and author of Total Basketball Fitness, published

by Coaches Choice. Sigmon is the former strength and conditioning coach for the Charlotte Hornets and author of 52-Week Basketball Training, published by Human Kinetics.

A T H L E T I C B I D . C O M ◆ T & C O C T O B E R 2 0 0 3 ◆ 39

C O M P E T I T I V E

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▼ Figure 1 CRAB WALK TEST

Score: 2

Score: 4

Score: 2

Score: 1

Figure 2 SNATCH POSITION TEST

Start

Score: 4

create a sound plan of corrective exercise.

The individual parts of the PIE were specifically selected to encompass the basic physical attributes all basketball players must possess in order to perform effectively and safely.

These tests evaluate physical stature, muscular endurance, functional movement or positioning, lateral quickness and speed, and muscular power through jumping ability. Some also take into account the differing physical requirements for each position.

The following details the tests and how to score athletes on them. Once the PIE has been conducted it falls back on the player, coach, and athletic trainer to correct any physical limitations.

THE CRABWALK

Having your players perform the crabwalk is a 40 ◆ T & C O C T O B E R 2 0 0 3 ◆

Score: 3

Score: 2

quick and easy way to assess core strength and muscular endurance of the torso and shoulders. The core is critical to a basketball player because it controls twisting and turning of the shoulders and hips. A basketball player with greater core strength can better control his or her body as well as deal with the push-and-pull style of play in the post areas and around screens.

To conduct the test, have the athlete assume a push-up position with both arms fully extended. Keeping the body completely straight from the head to the back of the heels, have the athlete begin to move laterally. To facilitate the movement, have the athlete move his or her opposite arm and leg laterally at the same time. Have more experienced athletes crab from the baseline to halfcourt and back. Lower level ATHLETICBID.COM

Score: 2

Score: 2

players should move from the baseline to the top of the key and back.

Athletes who are unable to complete the assigned distance should receive the lowest grade, a 1. If at any time they bend either upward or downward at the hips, even if they complete the course, they should receive a grade of 2 or 3 depending on the number of breakdowns. If the athlete completes the distance and remains straight, he or she should receive the highest grade offered, a 4.

(See Figure One, on this page.)

Athletes can improve their core strength by focusing on lower abdominal exercises, prone elbow supports, oblique crunches, and knee-ups from a hanging position. Upper-body strength can be gained with these exercises: push-ups with various grip widths, zig-zag push-ups, bench

Score: 1

presses, decline presses, and alternate dumbbell presses.

SNATCH POSITION

To test your players’ flexibility, have them perform squats with a dowel instead of a weighted bar. This is the most efficient way to assess bilateral mobility of the shoulders, hips, knees, ankles, and low, middle, and upper back.

To conduct the test, the athlete assumes a shoulderwidth standing posture. He or she places a dowel across the shoulders and grips it so that the arms create 90degree angles at the elbows.

The dowel is extended at arm’s length overhead.

Have the athlete perform three or four slow, controlled squat movements by flexing the knees, hips, and ankles. The heels should be kept on the floor, the knees should be in line with the second and third toes, and

the head and chest should face straight ahead. The dowel should be pressed fully overhead during the entire motion, and the athlete should be able to squat slightly below parallel.

The most common area of tightness is the hip flexor region. If an athlete is tight in this region, he or she will not be able to squat past parallel.

A second common area of tightness is the shoulders. If the athlete has tight shoulders, the stick will move forward as he or she squats. A third area of tightness is in the calf and Achilles region. The athlete may be able to squat past parallel, but will not be able to keep the heels on the ground or keep the feet square. (See Figure Two, on page 40, for assigning scores.)

Here are some ways to improve flexibility: • Hip flexor stretching can be accomplished by the athlete taking a kneeling position and stretching the arms as far as possible, or by having an athletic trainer, coach, or teammate stretch the athlete off the edge of a table (the Thomas Test stretch). Hold the stretch for 30 seconds.

• Focus on shoulder flexibility by having the athlete perform the prayer stretch. Get on all fours on the ground. Keeping the hands flat on the ground, rock back, taking the buttocks toward the heels. To increase the stretch, the hands may be positioned further out in front or turned so that the palms face upward. This stretch should be felt in the shoulder and latissimus region but should never create discomfort. Hold for 30 seconds.

• Stretch the calves both with the knee straight and knee bent (the kneebent position focuses on the Achilles region). Hold the stretches for 30 seconds.

• Practice the snatch position each day. Repeating this movement will help stretch many joints at once and encourage muscles to work

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▼ Figure 3 LATERAL LUNGE TEST

Score: 4

Score: 3

together as a team, not in isolation. After one week of practice, the athlete should notice improvement.

LATERAL LUNGE

Basketball players must move laterally to play defense and offense. If a player is unable to assume suitable ranges of motion in the lunge, this will carry over to the athlete’s side-to-side mobility and reduce the ground he or she can cover.

It can also indicate a susceptibility to groin injuries.

Have the athlete assume a posture with the feet double the shoulder width. The athlete then lunges laterally by allowing one leg to flex at the

Score: 2

knee, hip, and ankle while at-tempting to keep both feet flat to the floor. The arms may be held out in front to help distribute body weight and maintain a better center of gravity.

This will also test the inversion flexibility of the out-stretched ankle.

The keys to the lateral lunge are not letting the knee go past the toes, not sitting back on the buttocks, not letting the trail foot come off the ground, and keeping the buttocks and knees parallel. (See Figure Three, above, for assigning scores.)

Athletes can improve their groin flexibility with specific stretches. One is

Score: 1

the classic butterfly stretch, where the athletes sit on the floor and bring their feet together with soles touching, and push their bent knees toward the floor. A second exercise positions both legs out in front of the body. While seated and keeping the knees straight, separate the legs as far as possible. Slowly move the upper body forward while keeping the back straight until a stretch is felt in the hamstrings and groin.

Achieving this position requires some strength, so side-to-side squats or lunges and strength training of the outer hips will help.

These positions should be practiced daily.

Table 2: I-SHUTTLE

Table 1: VERTICAL JUMP (inches beyond standing reach) POINTS 4 3 2 GUARDS Male >32 29-31 26-28 Female >26 22-25 18-21

1

(seconds to complete) 4 3 2

1

<26 <18

6.75 7.0

6.76-6.81 7.01-7.2

6.82-7.2 7.21-7.5

>7.21 >7.51

FORWARDS Male Female

>31 >25

28-30 21-24

24-27 17-20

<24 <17

6.8 7.2

6.81-7.1 7.21-7.39

7.11-7.65 7.4-7.6

>7.66 >7.60

CENTERS Male Female

>28 >24

24-27 20-23

21-23 16-19

<21 <16

7.21 7.51

7.21-7.50 7.51-7.8

7.51-7.80 7.81-7.99

>7.81 >8.0

42 ◆ T & C O C T O B E R 2 0 0 3 ◆

ATHLETICBID.COM

THE VERTICAL JUMP

The number one question that basketball players ask strength coaches is, “How do I improve my vertical jump?” Jump height is always critical in a basketball game, but from a coach’s perspective, testing the vertical jump can also give you a good indication of the overall explosiveness and power of an athlete.

First, record the athlete’s vertical reach by having him or her stand with both feet on the floor and reach up as high as possible with the dominant shoulder and arm against the wall.

Then have the player jump using a no-step, two-footed take-off, and measure the distance between the maximum standing reach and highest jump-mark. (See Table One, at left, for assigning points.)

There are many ways to increase vertical jump, but the most important aspect of the movement is proper mechanics: • Keep the chest up throughout the entire movement.

• Bend at the knees instead of the waist.

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E D G E

▼ • Have hands track right beside the legs on the downward and upward swing of the arms.

• Always look at what you are reaching for.

• Once you hit the bottom of the knee bend, jump without any hesitation or delay.

Vertical-jump exercises include: • Simple jumping and bounding drills, such as double- or single-leg hops, or bounding on and off boxes.

• Using a weighted vest to increase resistance and create overload when jumping.

• Weight-training exercises such as the squat, leg press, and even the bench press will help create the extra strength and power that is critical to vertical lift.

• Trying to touch or reach for an object just out of reach can really improve jump height.

I-SHUTTLE

The I-Shuttle is a great way to test an athlete’s speed, agility, acceleration, and deceleration. Knowing how to decelerate, change direction, and accelerate will help players’ movements in game situations.

The equipment needed for the shuttle test is two socks and a stopwatch. The athlete straddles the midcourt line within the tipoff circle. He or she then turns and sprints to a sock placed on one of the free-throw lines. The athlete picks up the sock, turns, and sprints to the other free-throw line and picks up the other sock,

44 ◆ T & C O C T O B E R 2 0 0 3 ◆

Table 3: LANE BOX DRILL (seconds to complete course) POINTS 4 3 GUARDS Male 10.2 10.21-10.9 Female 11.22 11.23-11.0

2

1

10.91-11.6 11.01-12.5

>11.61 >12.51

11.5-12.5 12.11-12.99

>12.51 >13.00

FORWARDS Male Female

11.0 11.45

11.01-11.49 11.46-12.1

CENTERS Male Female

11.78 12.12

11.79-12.39 12.4-12.8 12.13-12.99 13.0-13.7

then turns and sprints back to the mid-court line, finishing with a sock in each hand.

Improving performance in this test entails performing agility drills similar to the I-Shuttle. (See Table Two, on page 42, for assigning points).

THE LANE BOX DRILL

The Lane Box Drill is another great way to test change of direction. (See Figure Four, at right.) This agility test examines forward, lateral, and backward movements in one package.

The athlete starts at the top of the lane at the right elbow (cone 1) and sprints to the base line. When the athlete reaches cone 2, he or she power slides to the opposite side of the lane while facing away from the court. When passing cone 3 at the bottom of the lane, he or she then back-pedals up the lane and past cone 4. Once past cone 4, the athlete shuffles across the free throw line facing the near basket. Once past cone 1, he or she reverses course, shuffles back to

ATHLETICBID.COM

>12.81 >13.71

cone 4, and continues the drill in the opposite direction by sprinting to cone 3.

After power sliding across the base line to cone 2, the athlete will finish the drill when they cross cone 1 while back pedaling. (See Table Three, above, for assigning scores.)

When working on their lateral movement, players should stay low, keep the chest up, hips back, and the back flat. They should also stay on the balls of the feet

Figure 4 LANE BOX DRILL

3

2

4

1

and not bring the feet together during the movement. When practicing backward runs, athletes should again stay low and use forceful shoulder and arm movements to create acceleration. Also concentrate on keeping the head slightly out over the toes while running on the balls of the feet. An eight- to 15-pound weighted vest or resistance tubing will add the overload that helps the athlete’s body build the strength and power needed to increase acceleration and speed.

ADDING IT ALL UP

When we use the above tests with basketball players in the Charlotte area, we add up the scores of the tests and compare them to grades we have developed based on the abilities of athletes with whom we have worked. A score of 21 to 24 equals an “A” and 18 to 20 a “B,” for instance. A score of 12 to 19 may indicate that the athlete needs to focus on developing certain abilities in order to pursue the sport at a higher level.

Ultimately, the overall score an athlete receives is not the most important point, however. The key is using the scores to see where an athlete needs improvement and then developing programs to help him or her improve in the problem areas. ◆ A version of this article also appears in our sister publication, Coaching ManagementBasketball.

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First-Class Fuels

By JULIE BURNS, M.S., R.D. Founder of SportFuel, Inc. and sports nutrition consultant for the Chicago Bears, Chicago Blackhawks, Chicago Bulls and Northwestern University athletes

The hours athletes spend in practices, training and competing place large demands on the physical conditioning of players. The peak energy level and power needed to compete in any sport can be maximized with a balanced diet focused on whole-grain carbohydrates, high-quality protein and healthy fats.

To fuel power workouts, enhance stamina, energy, strength and quickness, athletes need to eat and drink the proper foods. Use these recommendations to assist the athlete in reaching their goals:

Eat adequate dietary carbohydrates daily to fuel training and competition Many athletes need help identifying foods that contain carbohydrates. They may know that pasta is a good source of carbohydrates, but they are not aware that fruits, vegetables, dried peas and beans, whole-grain cereals, breads and potatoes also contain carbohydrates.

✓ Athletes should incorporate a variety of natural fats into

their daily diet, such as nuts, nut butters, oils and seeds, cold water fish, olives and avocados. Large amounts of saturated fat (from animal products, such as dairy and meat), and “trans” fats (from hydrogenated and partially hydrogenated oils in many packaged products) should be avoided.

INSTEAD OF THIS…

TRY THIS...

Donut or sweet roll

Whole-grain bagel with nut butter

Chips and dip for a snack

Albacore tuna on whole wheat bread

Sugar cereal with 2% milk and a fruit bar

Whole-grain cereal with non-fat milk or soy milk, handful of nuts, and a piece of fresh fruit

Hamburger on a white bun

Salmon, turkey or veggie burger on a whole-grain roll with lettuce and tomato

Choose high-quality protein

Cake or cookies

✓ While protein is not a primary fuel for working muscles,

Fresh fruit dipped in natural peanut butter

Sausage or pepperoni pizza

Vegetable pizza and garden salad

Choose mostly whole-grain carbs, when possible Some athletes rely heavily on highly processed foods with refined ingredients rather than whole-grains. Whole-grain bagels, breads, muffins and cereals contain more nutrients and less unhealthy fats than highly processed products.

it is a component of muscles, organs, enzymes, and oxygen-carrying hemoglobin. Amino acids are the building blocks of protein. High-quality protein foods contain all the essential amino acids needed to build and repair body tissues.

✓ Athletes should consume a wide variety of high-quality protein foods, such as chicken, turkey, beef, pork, soybeans, milk, eggs, legumes (beans) and nuts.

✓ Fat is needed in the diet. Aside from being a

concentrated source of dietary energy, fats form essential tissue-building blocks and hormone-regulating substances.

Nutrition practices can have a significant impact on the overall development of a first-class athlete. The proper fuel can help athletes reach their potential.

ScoutingReport Pain Management BLISTERSHIELD (603) 924-7847, www.Blistershield.com BlisterShield Miracle Foot Powder dramatically reduces friction, keeps moisture away from your foot and shields skin without forming a sticky coating. It remains effective over long periods of activity, cutting down on heat build-up that leads to soreness. It reduces foot fatigue making feet feel more energized. Plus, try our new Roll-on to prevent chafing on the body! Simply rollon high friction areas, no staining, no fragrance, waterproof, petroleum and animal fat free.

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BRACE INTERNATIONAL, INC. (800) 545-1161, www.braceint.com Brace International offers the MAX™, a major advancement in the design of shoulder girdle support. The snug-fitting, lightweight material allows for comfort with movement, yet at the same time helps protect the glenohumeral joint from subluxations and dislocations. Its strap design system allows many options for maximal stability where needed, while giving the required range of motion.

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CHO-PAT (800) 221-1601, www.cho-pat.com Cho-Pat’s patented Dual Action Knee Strap provides an extra level of relief for painful and weakened knees. It applies pressure upon the tendon below the knee to reduce patellar subluxation and improve tracking and elevation. It also places pressure on the tendon above the knee to give added support and stability. It allows full mobility.

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DYNATRONICS (800) 874-6251, www.dynatronics.com Dynatronics’ iontophoresis electrodes feature top fill ports reducing skin irritation and excessive pH shifts.

DynaPaks are a unique way of packaging electrodes to help you save up to 50 percent on iontophoresis treatment costs. Each DynaPak kit contains six delivery electrodes and one reusable return electrode, eliminating the cost of five electrodes. DynaPak electrodes can also be used with any iontophoresis delivery system, including the Dynatron iontophor PM/DX device.

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Dynatronics has introduced Solaris, featuring the New Infrared Cluster Probe generating 500 mW of power at multiple wavelengths—five times the power of competing devices—reducing average treatment times by 80 percent at a fraction of the cost. That’s not all. Solaris has also included Ultrasound and seven Stim waveforms, making Solaris the most powerful and versatile line in the industry.

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EXERTOOLS (800) 235-1559, www.exertools.com Akin to the B.A.P.S.™ Board, The Focus Board Package, from Exertools, consists of: three rocker board fulcrums, each of a different difficulty, one wobble board bat wing, two wobble balls, each of a different level of difficulty, one wall mounted accessory rack, one 30" round board and one 204" x 40" rectangle board. With this package your customers will be able to easily treat three patients at the same time; one using the round board as a wobble,

rocker or Dyna board, one using the rectangle board as a wobble, rocker or Dyna board and one using just a Dyna Disc to sit, stand or lay down on.

Circle No. 47 on Reader Inquiry Card Over the past decade, FOLLER™ (foam rollers), from Exertools, have become one of the most widely used therapeutic and conditioning products available.

Don’t let its simple design fool you, the FOLLERS’™ uses are virtually limitless.

The FOLLERS™ easily adapt to a variety of techniques, including mobilization, balance and strength training, and can be used in supine, prone, sitting, kneeling side lying, standing. They are available in a variety of sizes and in fulland half-round. EXERTOOLS provide the most extensive offering of foam rollers on the market today.

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FOOT MANAGEMENT, INC. (800) HOT-FOOT, www.footmanagement.com Wear what the Pros wear. Foot Management, Inc. has served professional and collegiate sports teams, podiatrists, physical therapists, athletic trainers and other health care professionals for over 25 years. The company manufactures a variety of quality custom foot orthotics, from your casts or impression trays.

From its Tenderfoot® Soft to its rigid Graphite, the company can provide the perfect orthotic for any need at reasonable prices. Foot Management also carries several styles of prefabricated insoles, Turf Toe™ plates, footpads, felt, foam and moleskin.

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The newest product available from Foot Management is the Static Calf Stretcher. Made from durable, weather resistant materials, it’s designed to help relieve the pain of plantar fasciitis and to increase calf flexibility. Lightweight and portable, it’s perfect in any setting.

Check out www.AthleticBid.com to contact these companies.

46 ◆ T & C O C T O B E R 2 0 0 3 ◆

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Pain Management Ideal for use with cleats of all types. No more slipping when trying to stretch out on the field or court.

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the mess—in seconds—so athletes can get back in the game faster.

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GRASTON TECHNIQUE (866) 926-2828 (toll-free), www.grastontechnique.com The Graston Technique, an innovative form of instrument-assisted soft tissue mobilization, is designed to detect and resolve soft tissue injuries more completely. Performed by skillfully-trained ATCs, PTs, OTs and DCs, the Technique is effective in helping injured athletes achieve higher levels of function and pain relief. The result is better resolution for soft tissue injuries and a quicker return to normal activity.

THE GEBAUER COMPANY (800) 321-9348, www.gebauerco.com Gebauer’s Ethyl Chloride® is now available in two easy-to-carry spray can delivery systems: Pain-Ease® Stream Spray and Pain-Ease® Mist Spray. Athletic trainers can choose the spray can that works best for them to relieve minor sports injuries such as bruising, contusions, swelling, and minor sprains. It works as fast as ice without

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JUMP STRETCH, INC. (800) 344-3539, www.jumpstretch.com Jump Stretch, Inc., offers six sizes of heavy-duty continuous-loop rubber-

bands (Flex Bands™) for strength training, flexibility work, rehab, and even powerlifting. By combining the bands with the company’s customized pipe arrangements (for resisted walking/running and weighted abdominal exercises) and patented tubular steel bases (for squats and squat thrusts), Jump Stretch can help you make the most of any available space in your workout area.

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KYTEC ATHLETIC SPEED EQUIPMENT (800) 732-4883, www.kytec.us The Active Ankle, from Kytec, features a Neoprene padding system combined with the patented performance hinge which provides maximum “Ankle Flexibility”.

Orlando, FL / January 3 – 4, 2004 BASEBALL topics to include…

FOOTBALL topics to include…

• Off-season baseball conditioning

• Position-specific speed training for football

• Conditioning differences between high school, college, and professional athletes

• World class strength and conditioning facility opens at US Air Force Academy

• In-season maintenance—nutrition and wellness in baseball

• In season complex training

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National Strength and Conditioning Association P.O. Box 9908, Colorado Springs, CO 80932 • www.nsca-lift.org • 800-815-6826 Circle No. 24 A T H L E T I C B I D . C O M ◆ T & C O C T O B E R 2 0 0 3 ◆ 47

ScoutingReport Pain Management The double strap and solid U-shaped design promote “Early Activity After Injury” and “Long-term” ankle protection.

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NASM (800) 460-6276, www.nasm.org A Web-based master’s degree is being offered through California University of Pennsylvania to fitness professionals as part of NASM’s cutting-edge programming. The new degree is a Master of Science focusing on performance enhancement and injury prevention.

The online program was developed collaboratively by CUP professors and NASM educators and was approved by the Board of Governors of the Pennsylvania State System of Higher Education. Interest in the program is apparent, with applications from over 400 prospective students.

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The aim of NASM is not simply to help you maintain status as a trainer, but to fuel your journey in becoming a premiere fitness professional. NASM offers over 30 options to expand your knowledge in health and fitness, including: CD-ROM courses, online newsletters and articles, home study textbooks and videos, and live workshops. In addition, all of these continuing educational units (CEUs) are honored by the industry’s leading organizations (NATA, ACE, NSCA, and others.)

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OPTP (800) 367-7393, www.optp.com Treat Your Own Strains, Sprains and Bruises provides sensible advice for the immediate and ongoing self-treatment of uncomplicated musculoskeletal injuries. Written by Lindsay, Watson, Hickmott, Broadfoot and Bruynel, with a foreword by Robin McKenzie, this

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1-800-752-2255 or www.fitball.com Circle No. 25 48 ◆ T & C O C T O B E R 2 0 0 3 ◆

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THE PRESSURE POSITIVE COMPANY (800) 603-5107, www.pressurepositive.com The Backnobber II is a deep muscle, self care, trigger point compression tool designed primarily to help manage muscular back pain and dysfunction resulting from injury or overuse.

The Backnobber II tool is particularly effective in conjunction with professional treatment and rehabilitation. Comes apart for convenient travel and storage. Comes with illustrated, 35 page User Guide.

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book highlights the most common soft-tissue injuries, treatment principles, different types of pain, when to consult a health care clinician, and how to prevent injuries from recurring.

Common injuries of specific joint complexes along with the illustrated selftreatment protocols are also available.

A valuable resource for active adults.

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3-POINT PRODUCTS (888) 378-7763, www.3pointproducts.com 3-Point Products has announced a new line of Exercise Putty. Reflex® Putty with Memoryflex® increases resistance the more it is pulled.

Reflex® Putty can be pulled and stretched like exercise bands but, unlike bands, it provides consistent resistance throughout the range of stretch. Muscles receive resistance throughout their contraction for a more effective strengthening regime.

Available in three resistance levels and in the new Pro Series for athletes and others requiring a higher resistance level for rehabilitation.

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ScoutingReport Hot & Cold Therapy AIRCAST, INC. (800) 526-8785, www.aircast.com The Aircast® Cryo/Cuff, from Aircast, Inc., combines the therapeutic benefits of controlled compression to minimize hemarthosis and swelling and cold to minimize pain. Each cuff is anatomically designed to provide maximum coverage to the injured area.

The Cryo/Cuff line includes cuffs to fit most areas of the body, including the knee, ankle, shoulder, and foot.

Simplicity of application and operation makes the Cryo/Cuff ideal for both the athletic training room and home.

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DURA*KOLD (800) 541-7199, www.dura-kold.com The Dura*Kold Foot/Ankle Ice Wrap provides total coverage of the foot and ankle. The outside velvet loop fabric and three-inch elastic strap allows desired compression and fit for all sizes. Like all Dura*Kold Ice Wraps, the uniquely designed wrap provides up to two hours of cold treatment at a safe temperature.

Additionally, four other anatomically designed and two multi-purpose wraps are available.

GAME READY (888) 426-3732, www.gameready.com Used by over 60 professional teams and top universities, the Game Ready™ Injury Treatment System is the first portable system to simultaneously provide deep tissue cooling and intermittent compression to help speed recovery from musculoskeletal injuries and post-operative symptoms. “I’ve seen a two-fold increase in recovery rates. Players that normally would have been out for a week or more are back in half the time.”

Stan Conte, head trainer, San Francisco Giants.

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THE GEBAUER COMPANY (800) 321-9348, www.gebauerco.com Gebauer’s Instant Ice™ is a non-pre-

scription, nonflammable topical skin refrigerant. Gebauer’s Instant Ice comes in either mist or stream spray cans. Both are ideal for the temporary relief of minor pain and swelling from sprains, strains, bruising, contusions, and minor sports injuries. Stream spray is also used for the temporary relief of muscle spasms.

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PERFORMANCE HEALTH, INC. (800) 246-3733, www.biofreeze.com For pain management programs, Performance Health, Inc., offers Biofreeze®, which can help reduce swelling, pain, and stiffness, increase mobility and recovery time, and effectively aid in the overall healing process.

Apply Biofreeze before, during, and after each therapy session to Continued on page 53

"Best glide on the market" Bruce Stephens MT

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The Dura*Kold Knee Wrap provides up to two hours of icing for the knee, hamstring, thigh, or calf. Due to the “open patella” design, the wrap can be applied over the knee cap to minimize discomfort. The outside velvet loop fabric allows desired compression and fit for all sizes. Rip Stop Nylon is the inside fabric, which allows quick transfer of safe temperature cold.

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Foot Management . . . . . . . . . . . . . .34 . . . . . . . .57

Oakworks (Adjustable Tables) . . . . . . . . .37 . . . . . . . .BC

Aircast . . . . . . . . . . . . . . . . . . . . . . 9 . . . . . . . .18

Free-Up/PrePak Products . . . . . . . .26 . . . . . . . .49

Oakworks (Portable Taping Table) . . . . . . 6 . . . . . . . .12

Athletics Plus (SpringCo) . . . . . . . . . . .20 . . . . . . . .38

Functional Design Systems . . . . . . . . 7 . . . . . . . .16

OPTP . . . . . . . . . . . . . . . . . . . . . . .16 . . . . . . . .31

Biofreeze . . . . . . . . . . . . . . . . . . . . 5 . . . . . . . .11

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Brace International (Bar-1) . . . . . . . .33 . . . . . . . .55

Gebauer . . . . . . . . . . . . . . . . . . . . 8 . . . . . . . .17

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Graston Technique . . . . . . . . . . . . . . 4 . . . . . . . . 7

Pressure Positive Company . . . . . . .39 . . . . . . . .24

Cho-Pat . . . . . . . . . . . . . . . . . . . . . 2 . . . . . . . . 2

Jump Stretch . . . . . . . . . . . . . . . . .35 . . . . . . . .59

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Kytec Athletic . . . . . . . . . . . . . . . . .22 . . . . . . . .41

Total Gym/efi Sports Medicine . . . . . 3 . . . . . . . . 5

Dynatronics . . . . . . . . . . . . . . . . . .36 . . . . . . .IBC

Massage Warehouse . . . . . . . . . . . .23 . . . . . . . .43

TurfCordz/NZ Manufacturing . . . . . .29 . . . . . . . .51

Exertools . . . . . . . . . . . . . . . . . . . .10 . . . . . . . .21

NASM . . . . . . . . . . . . . . . . . . . . . .19 . . . . . . . .37

VertiMax . . . . . . . . . . . . . . . . . . . .27 . . . . . . . .50

Exertools . . . . . . . . . . . . . . . . . . . .11 . . . . . . . .23

NCTMB . . . . . . . . . . . . . . . . . . . . . .17 . . . . . . . .32

Whitehall Manufacturing . . . . . . . . .18 . . . . . . . .35

FitBALL USA (Ball Dynamics) . . . . . . . . .25 . . . . . . . .48

NSCA (Sport-Specific Conference) . . . . . . .24 . . . . . . . .47

IF YOU WANT TO SEE SOME REAL EXCITEMENT AND PRODUCE NEW PERSONAL BESTS FOR YOUR ATHLETES

IS THE ANSWER! • NO trainer–anywhere, at any price, will increase an athlete’s vertical jump and first-step-quickness like VertiMax. Rapid, large gains are guaranteed! Your athletes will feel and see their improvements immediately!

Adding VertiMax to your arsenal will give you a whole new training dimension, expand your client base, and increase your revenue.

• Patented Hip Trackers move laterally with the

athlete to sustain a proper gravity vector and preserve balance and form during lunges and other sports specific exercises.

• Engineering under the platform applies a non varying level of resistance through the complete concentric and eccentric movements, optimizing the proprioceptive response.

• VertiMax has been featured in Sports Illustrated and seen on ESPN, HBO, and Fox Sports Networks.

• Individually tailored resistances

can be set in seconds!

1-800-699-5867

www.vertimax.com DON’T WAIT FOR YOUR CLIENTS TO ASK ABOUT IT. HAVE IT! Circle No. 27 50 ◆

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3-Point Products . . . . . . . . . . . . . . .59 . . . . . . . . .48

Foot Management (custom foot orthotics) .49 . . . . . . . . .46

NASM (Web-based master’s degree) . . . . . .55 . . . . . . . . .48

Aircast . . . . . . . . . . . . . . . . . . . . .60 . . . . . . . . .49

Foot Management (Static Calf Stretcher) .50 . . . . . . . . .46

Oakworks (Portable Taping Table) . . . . . .78 . . . . . . . . .55

Athletics Plus (Springco) . . . . . . . . . . .88 . . . . . . . . .57

Functional Design (3D Dumbbell Matrix) .86 . . . . . . . . .57

Oakworks (The Boss) . . . . . . . . . . . . .77 . . . . . . . . .54

Ball Dynamics International . . . . . . .72 . . . . . . . . .54

Functional Design (Lower Extremity) . . . .85 . . . . . . . . .57

OPTP (Strains/Sprains book) . . . . . . . . . .57 . . . . . . . . .48

Biofreeze . . . . . . . . . . . . . . . . . . .65 . . . . . . . . .49

Game Ready . . . . . . . . . . . . . . . . .63 . . . . . . . . .49

OPTP (Thera Cane) . . . . . . . . . . . . . . .79 . . . . . . . . .55

Biofreeze (no-touch roll-on) . . . . . . . . .66 . . . . . . . . .53

Gebauer (Ethyl Chloride) . . . . . . . . . . .51 . . . . . . . . .47

Perform Better (Biofoam Rollers) . . . . . .80 . . . . . . . . .55

BlisterShield . . . . . . . . . . . . . . . . . .42 . . . . . . . . .46

Gebauer (Instant Ice) . . . . . . . . . . . . .64 . . . . . . . . .49

Perform Better (catalog) . . . . . . . . . . .91 . . . . . . . . .58

Brace International . . . . . . . . . . . . .43 . . . . . . . . .46

General Physiotherapy (G5 Massuer) . .74 . . . . . . . . .54

Power Systems (catalog) . . . . . . . . . . .90 . . . . . . . . .58

Cho-Pat . . . . . . . . . . . . . . . . . . . . .44 . . . . . . . . .46

General Physiotherapy (GBM) . . . . . .73 . . . . . . . . .54

Power Systems (Massage Peanut) . . . . . .81 . . . . . . . . .56

Creative Health Products . . . . . . . . .89 . . . . . . . . .58

Graston Technique . . . . . . . . . . . . . .52 . . . . . . . . .47

Power Systems (The Stick) . . . . . . . . . .82 . . . . . . . . .56

Dura*Kold (Foot/Ankle Ice Wrap) . . . . . .61 . . . . . . . . .49

Jump Stretch . . . . . . . . . . . . . . . . .53 . . . . . . . . .47

PrePak Products . . . . . . . . . . . . . . .83 . . . . . . . . .56

Dura*Kold (Knee Wrap) . . . . . . . . . . . .62 . . . . . . . . .49

Kytec Athletic (Active Ankle) . . . . . . . . .54 . . . . . . . . .47

Pressure Positive . . . . . . . . . . . . . .58 . . . . . . . . .48

Dynatronics (DynaPaks) . . . . . . . . . . .45 . . . . . . . . .46

Kytec Athletic (catalog) . . . . . . . . . . . .92 . . . . . . . . .58

The Football Bar . . . . . . . . . . . . . . .87 . . . . . . . . .57

Dynatronics (Solaris) . . . . . . . . . . . . .46 . . . . . . . . .46

Kytec (ExerFlex Ball) . . . . . . . . . . . . . .75 . . . . . . . . .54

Whitehall Manufacturing (moist heat) . .67 . . . . . . . . .53

Exertools (Focus Board Package) . . . . . . .47 . . . . . . . . .46

Massage Warehouse . . . . . . . . . . . .76 . . . . . . . . .54

Whitehall Manufacturing (ThermaSplint) .68 . . . . . . . . .53

Exertools (FOLLER) . . . . . . . . . . . . . . .48 . . . . . . . . .46

NASM . . . . . . . . . . . . . . . . . . . . . .56 . . . . . . . . .48

TurfCordz Super Bungie... Safe, Strong and Reliable Progressive Resistance Training!

• Created for the extreme demands of professional resistance training!

• Made from high strength large diameter bungie with strong steel snaps!

• Available in a variety of resistance levels, kits and interchangeable accessories, with the safety and security features leading professional athletes demand!

• To learn more about TurfCordz and all of our innovative products, see our 2003 Catalog!

Call us for a copy, or visit us online! © 2003 NZ MFG LLC, Tallmadge, OH

800-5886-6621 • www.nzmfg.com Circle No. 28

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www.AthleticBid.com

www.AthleticBid.com

www.AthleticBid.co Looking for companies and products via the INTERNET? AtleticBid.com gives you the tools to research products

A

thleticBid.com is a free service to help buyers at schools and athletic organizations research and contact companies in the most efficient fashion. AthleticBid.com offers the following services.

Online Buyer’s Guide Using AthleticBid.com’s on-line Buyer’s Guide, you are able to: • View the complete product line of companies.

• View catalog pages or spec sheets from many of the top companies. Click on the “View Company Brochures” button for these companies, and you will find PDF

files titled by product or category. Print them out for easy reference.

• Read a profile or description of select companies by clicking on the “About the Company” button.

• Request to be contacted by a company representative.

• Request catalog and sales literature from companies. Simply click on a button and fill in your address and an e-mail with your request is sent directly to the supplier.

Place an RFP

Dealer Locator •Locate your nearest dealer for many leading manufacturers and suppliers.

The Market Place • Purchase inventory closeouts, discontinued items and products on sale from national suppliers. The products featured in this section are being sold at significant savings.

The Product Connection • Products for your team or organization are highlighted through both descriptions and photos. You can request sales literature on products you’re interested in with just a click.

• You can use this service to request and receive information from numerous suppliers by providing your product specs only once and letting AthleticBid.com do the rest.

Jersey Field Products Park City, NJ 08832 Phone: (800) 275-8000;

(973) 222-3300 | Fax: (973) 222-3333 Contact Name: John Jame s Email address: Jersey@a ol.net Company Description: Your “One-Stop Source” for America’s Leading Spor Supplies! Special mixes t Surfaces and for infields, pitcher’s mou nds, home plate areas and by over 100 pro teams and warning tracks. Used 5000 colleges, with 200 products from more than and bulk plants across the 20 distribution centers country. Call 1-800-275-80 00 for more information.

View Product Line

leticBid.com www.A

Hot & Cold Therapy Continued from page 49

reduce swelling and stiffness enabling greater range of motion and flexibility for therapeutic exercises. Biofreeze can enhance any situation that would require the use of ice and breathable wraps and also enhances and prolongs the benefits of ultrasound, electrical stimulation, and massage therapy treatments. Biofreeze is endorsed by the Florida Chiropractic Association Sports Injury Council, The United States Taekwondo Union, The American Occupational Therapy Association, The California Chiropractic Association, and The Florida State Massage Therapy Association. Contact the company for more information and your no-charge trial package.

Circle No. 65 on Reader Inquiry Card Biofreeze® is an extremely effective topical pain reliever used in pain management programs to treat athletic injuries, muscle injuries, and strains, stiff joints, and upper/lower back pain and spasm. Biofreeze helps with both deep trigger and soft tissue work.

Prior to massage, it helps athletes

relax for a more effective treatment and minimizes post-treatment swelling when applied after massage. Athletes who rarely bother to use ice can be counted on to use Biofreeze. Athletes can also use Biofreeze at home to relieve pain. It is available in a no-touch roll-on, perfect for trainers’ supply bag.

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WHITEHALL MANUFACTURING (800) 782-7706, www.whitehallmfg.com Whitehall Manufacturing’s complete line of moist heat therapy treatment products is designed to be easy and convenient to use. Each heating unit is fabricated from heavy gauge stainless steel and polished to a satin finish. Standard

Secure Footing Value Pricing Designed to fit either right or left foot, the PRO 610 Arizona Ankle Brace is constructed of heavy duty nylon for a low-profile, durable and lightweight brace. Two straps encircle the foot in a figure eight pattern providing easily adjustable lateral and medial support. A neoprene tongue provides a comfortable pad under the laces. Used by thousands of athletes from the pro's to high school, this low-profile brace will not change your shoe size.

All for $14.95.

features include a snap-off thermal protector that prevents overheating and rounded bottoms that minimize bacteria build-up. The heating units are available in various sizes and colors.

Circle No. 67 on Reader Inquiry Card The ThermaSplint™, from Whitehall Manufacturing, features dual voltage, an illuminated on/off switch, and quick heat-up time. The unit operates on a solar powered digital thermometer that allows the temperature to be adjusted with digital readouts for different splinting thermoplastics. The ThermaSplint is constructed from heavy gauge stainless steel.

Circle No. 68 on Reader Inquiry Card

Stabilize Chronic Shoulder Dislocators, Separators, and Subluxators With over a decade of experience in shoulder brace design the MAXTM Shoulder Brace by Brace International, Inc. is an evolution in shoulder girdle support. The snug-fitting, lightweight material (under 2 pounds) allows for comfort with movement while its strap design system allows for many options to help protect the glenohumeral joint.

Maximum Protection, Maximum Range of Motion

We highly recommend its use for all sports.

To order, or for more information, call PRO at

1-800-523-5611.

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800-545-1161 Toll Free - www.braceint.com Circle No. 31 A T H L E T I C B I D . C O M ◆ T & C O C T O B E R 2 0 0 3 ◆ 53

ScoutingReport Massage Therapy BALL DYNAMICS INTERNATIONAL (800) 752-2255, www.balldynamics.com Achieve deep muscular and fascial release with this groundbreaking body therapy program. The FitBALL® Small Ball Release Program provides complete step-bystep instructions for releasing tension in the pelvic, hip, back, neck, and shoulder areas. Use three balls of decreasing size for increasing challenge as you enhance your skill level on this selfguided journey. The professional set includes one ball of each size, a 45minute instructional video and an 80page manual.

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GENERAL PHYSIOTHERAPY (800) 237-1832, www.g5.com Designed for the professional who needs both power and portability. The GBM, from General Physiotherapy, is equipped with the company’s patented directionalstroking action, for smooth and powerful penetration of muscles and tissues and variable speed, solid state digital controls, providing a speed range of 20 to 50 cycles per second. The GBM massage head accepts all Genuine G5 brand massage applicators.

Circle No. 73 on Reader Inquiry Card

The G5® Workout Massuer stimulates peak performance and reduces the risk of injury by enhancing flexibility, increasing range of motion and delivering consistent deep-penetrating treatment. This unit features a continuously-variable

speed range of 20-60 cycles per second. Equipped with the patented G5®Directional-Stroking® applicator action and a wide selection of massage applicators, the Workout Massuer deeply penetrates muscle tissue to improve circulation, reduce pain and decrease the likelihood of injury.

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KYTEC ATHLETIC SPEED EQUIPMENT (800) 732-4883, www.kytec.us Use the Exerflex™ Ball, from Kytec, for fitness, rehab, or just for fun. It helps to develop flexibility and coordination. The ball provides a total body workout. It also helps to reduce lower back pain and tightness. Exerflex comes with a training video and an exercise manual. It adjusts from 50cm to 65cm.

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MASSAGE WAREHOUSE (800) 910-9955, www.massagewarehouse.com TheraPro Multi Purpose Cream is just one of the many oils, creams, and lotions you'll find on sale at Massage Warehouse.com. Call Massage Warehouse for guidance on the best massage lubricant for your needs today or visit the company's Web site.

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OAKWORKS, INC. (800) 558-8850, www.oakworks.com The Boss is a great treatment table designed specifically for ATCs. Its lightweight design and protective carrying case help it travel easily from training rooms to sidelines. The unique aluminum understructure is tough

To request information from these companies, go to www.AthleticBid.com and visit the Buyer’s Guide section.

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C USTOMER T ESTIMONIAL

QuadStar® Four Channel Muscle Stimulator Device BioMedical Life Systems, is proud to introduce its new generation in Electro-Therapy Devices, the QuadStar® four channel NMS Muscle Stimulator Device. Its compact size and user friendly programming features make the QuadStar’s® design unique among Electro-Therapy Devices. The unit measures 6.75" by 2.75" by 1.25” and has an easy to read LCD screen and a digital keypad.

Simple to understand instructions guide the user through nine pre-programmed protocols; two types of waveforms; symmetrical or asymmetrical biphasic square, continuous, cycled or reciprocating stimulation, adjustable pulse rate and pulse width.

The device has a patient lock system that, when activated prevents the patient from changing any of the set parameters. The device features a graphic representation of the timing parameters directly on the screen.

When the Patient Lock System is turned off, a patient compliance meter is displayed showing how long the device was used. A timer allows the patient to use the device for a specified period of time. The four channel device incorporates touch proof design and is run by four AA Batteries or a Nova® Wall Adaptor.

BioMedical Life Systems P.O. Box 1360 Vista, CA 92085-1360

800.726.8367 www.bmls.com

Massage Therapy enough to support a 600 Ibs UL weight load rating and the sealed seams and removable field feet mean the Boss works rain or shine. Easy height adjustments make the Boss the ergonomic answer for every ATC. Circle No. 77 on Reader Inquiry Card Because the game isn’t played in the locker room, you need the Oakworks Portable Taping Table. The only portable adjustable height table on the market.

Weighing only 35 lbs, this table folds flat for easy storage and

transportation. Features like a marinegrade plastic top, adjustable height range of 32 - 42 inches, UL weight rating of 500 lbs., and durable carrying case will maximize effectiveness for every ATC. Circle No. 78 on Reader Inquiry Card

OPTP (800)367-7393, www.optp.com Thera Cane® is a unique device that facilitates solo, deep-pressure massage of trigger points and sore muscles.

Appropriate for deep muscle massage to the back, neck, shoulders, legs, feet, arms, chest, ribs, abdomen and buttocks, the versatile Thera Cane is suitable for use in both clinical and home treatment regimens. Each Thera Cane comes with

a user’s manual, featuring stretches, myofascial trigger point information and 39 illustrated uses.

Circle No. 79 on Reader Inquiry Card

PERFORM BETTER (800) 556-7464, www.performbetter.com Simple but so practical. These Perform Better Biofoam Rollers are actually two products in one. Use them for selfmyofascial release massage and also as a training aid to improve balance, alignment and stability. Your choice of full round or half-round shapes in 1’ and 3’ lengths. They are extremely durable, the highest density made. For prices or a copy of the Perform Better Catalog, contact Perform Better or visit its Web site.

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HOW TO REQUEST OR RENEW A FREE SUBSCRIPTION: The easiest way is to complete the subscription request card provided in every issue. If a request card is not available, then on your institution’s letterhead provide us with your: 1. request to receive or renew a free subscription 2. signature and date of request 3. title and school name 4. mailing address

ARE YOU MOVING? The USPS will not forward your subscription. In order to keep receiving your free subscription, you must notify us and provide us with your: 1. new mailing address 2. title and school name 3. signature and date of request All subscription requests and changes of address must be in writing, and mailed to: TRAINING & CONDITIONING, SUBSCRIPTION DEPT., PO BOX 4806, ITHACA, NY 14852-4806 or faxed to: 607-257-7328 Attn: TRAINING & CONDITIONING, SUBSCRIPTION DEPT.

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ScoutingReport Massage Therapy POWER SYSTEMS, INC. (800) 321-6975, www.power-systems.com The unique spiked peanut shape of the Massage Peanut from Power Systems will rejuvenate tired, sore muscles. Use it for relaxation and massage by rolling it back and forth over affected area. It is great for foot massage after a hard day of training. For more information on this and all of the company’s other products call Power Systems or visit its Web site.

Circle No. 81 on Reader Inquiry Card

The Stick, from Power Systems, is an easy to use device designed to massage muscle tissue. The rotating spindles encourage increased circulation to muscle fibers prior to exercise, disperse lactic acid after workouts, and diffuse muscle stiffness and knots.

There are three sizes to accommodate

all body types—the Marathon Stick for individuals with lean body mass, the Original Body Stick for individuals with average body mass and the Big Stick for individuals with heavy body mass.

Circle No. 82 on Reader Inquiry Card

PREPAK PRODUCTS, INC. (800) 544-7257, dept. TC02, www.prepakproducts.com Free-Up Soft Tissue Massage Cream from PrePak Products is formulated for healthcare professionals who require superb glide, lubricity, and tissue perception in a cost effective massage medium. Free-Up lets you work both surface and deep tissue while promoting exquisite tissue sense to your fingers and hands. Because of its slow absorption rate, a little Free-Up goes a long way. Unlike oily or slick substances, Free-Up’s excellent lubricity won’t inhibit deep tissue perception and discrimination. Ask for product sample and full-color catalog.

Circle No. 83 on Reader Inquiry Card

C USTOMER T ESTIMONIAL

Lippincott Williams & Wilkins (LWW) is a leading international publisher of professional health information. LWW provides essential information for athletic trainers, massage therapists, coaches and other allied health professionals in print and electronic formats, including textbooks, journals, and multi-media products.

One of LWW's best-sellers for massage therapy is Basic Clinical Massage Therapy: Integrating Anatomy and Treatment by James H. Clay and David M. Pounds.

Customers and reviewers agree that Basic Clinical Massage Therapy is extraordinary.

The strengths and beauty of this book lie in its extraordinary graphics.

Illustrations of internal anatomical structures are embedded into photographs of live models, both in anatomical charts and in techniques descriptions.

Massage Therapy Journal Summer 2003, Vol. 42, No. 2 Book Review The text serves as an instruction guide on how to access, palpate and massage each muscle or muscle group. The text and illustrations are very clear and easy to follow, which makes this book not only an excellent text for the student, but a handy reference guide for the experienced massage therapist to learn something new or reinforce what he or she may not have practiced for awhile.

Massage Today August 2003, Volume 3, Number 8 Book Review

Lippincott Williams & Wilkins 351 W. Camden Street Baltimore, MD 21201

800.638.3030 www.LWW.com

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More New Products FUNCTIONAL DESIGN (866) 230-8300 (toll-free), www.functionaldesign.com Functional Design offers Basketball – Lower Extremity Performance and Prevention with Gary Gray & Vern Gambetta.

This functional Basketball Quest video builds upon the Lower Extremity Performance and Prevention video by demonstrating how three dimensional, functional biomechanical principles of performance and prevention can be integrated into a BASKETBALL setting. Beginning with an active warmup, this video takes you through a progression of various two-player, three-player, and five-player weaves that are tweaked in the three planes (3D) of motion, many with the use of a medicine ball.

Circle No. 85 on Reader Inquiry Card

Functional Design also offers 3D Dumbbell Matrix by Gary Gray. The exer-

cises provide conditioning in all three planes of motion (the sagittal, frontal, and transverse planes) to impact the total “3D” of human biomechanics. The basic “3D Matrix” is presented in addition to 16 variations to customize the program to the needs of the individual. In addition, the ability to vary the workout keeps it fresh, interesting, and stimulating.

Circle No. 86 on Reader Inquiry Card

THE FOOTBALL BAR (800) 541-4755, www.repsdirect.net Thumbs up, Elbows in - Drive! The Football Bar is a total weight training tool for all sports. In addition to reducing stress

on the shoulder rotator cuff and strengthening the wrists, the Football Bar can also increase straight bar bench strength.

Three different grip widths and two grip

angles are available for any exercise performed, which recruits different muscle fibers from each position.

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SPRINGCO ATHLETICS (800) 383-0305, www.springcoathletics.com The Winged Water Walker, offered exclusively by Springco Athletics, is a necessary component of any serious track and field training program. It benefits throwers, sprinters, jumpers, and distance warriors.

Coaches from across the country have begun using this device with great success. Once you try a pair, you will realize how much time you have been “wasting” in the pool training without the Winged Water Walker. You will also realize that you can do many of the same drills and exercises you normally perform on the field, but with greater range of motion and loading if desired.

Circle No. 88 on Reader Inquiry Card

AN ORTHOTIC IS...

In plain words an orthotic is a brace to control the foot while standing or walking. But that’s a lot to do, so take a minute and we’ll try to explain. Think of your body as a house, standing strong and erect. If a foundation is not laid properly or as any foundation settles with time you will start seeing cracks in the floors, walls and ceiling from the stress. So it is with your body that when your foot is out of line it can put the skeletal structures under stress. It has been proven that an unbalanced foot can cause problems as high in the kinetic chain as the cervical vertebrae (the neck). The foot may be the basis for neck pain, back pain, hip and knee pain, not to mention foot pain itself.

The foot has 26 bones connected by ligaments, tendons, and muscles and as time goes on with repetitive stress from walking, standing, and running, the foot can become misaligned and cause problems, such as heel pain, arch pain, metatarsal pain, and bunions. This is where a custom made orthotic can help. An orthotic can support the foot and control the alignment of these 26 bones to a neutral position, while still allowing the foot to function as a mobile adapter.

Orthotics are used by professional athletes, runners, tennis players, dancers, and most importantly, -YOU- the everyday person who needs relief from foot discomfort. Orthotics are used to help control structural misalignments, correct gait abnormalities, relieve pressure, and serve as a shock absorbing cushion (footbed). Your custom made orthotics will help control your foot whether you are walking on level ground, uphill, downhill, or on a rocky road.

Please don’t be fooled by imitations sold over the counter without a prescription. Custom orthotics are exactly that: custom made from a cast of your feet. They will fit no one else and are made by prescription only. Your health care specialist will make a cast or impression of your non weight bearing feet and send it to an orthotic lab where exact replicas will be made of your feet. These replicas are then corrected to your health care specialist’s measurements and diagnosis. The lab will use specialized materials to custom design an orthotic to correct your problem. Ask your health care provider if the lab they are using is accredited by the Prescription Foot Orthotic Laboratories Association (PFOLA).

How long will you have to wear orthotics? That depends on your problem, but think of your orthotics as you would your eyeglasses.

They won’t cure your problem, but with their use, they will allow you to function with a minimum of discomfort. The break-in period for your orthotics should be 4-6 weeks with reasonable comfort.

Hopefully this has been helpful to you in understanding what a custom orthotic is and what it can do for you. This only briefly explains the complexity of orthotics, but your health care specialist can further review your personal need – so please ask.

Foot Management, Inc. 1-800-HOT-FOOT www.footmanagement.com Circle No. 34 A T H L E T I C B I D . C O M ◆ T & C O C T O B E R 2 0 0 3 ◆ 57

Catalog Showcase Creative Health

Power Systems, Inc.

(800) 742-4478, www.chponline.com Creative Health Products, in business since 1976, is a leading discount supplier of Rehabilitation, Fitness, Exercise and Athletic Equipment and also Health, Medical, Fitness Testing and Measuring Products, all at discounted prices. Products include Heart Rate Monitors, Blood Pressure Testers, Pulse Oximeters, Bodyfat Calipers, Scales, Strength Testers, Flexibility Testers, Stethoscopes, Pedometers, Exercise Bikes, Ergometers, Stopwatches, Fitness Books and Software, Exercise Bands, Step Benches, Hand and Finger Exercisers, Heating Pads and more.

(800) 321-6975, www.power-systems.com Since 1986 Power Systems has made it a number one priority to become a leading supplier of sport training, health, and fitness products. Its new 2003 catalog is re-worked to provide the best possible resource for all your training needs.

Included areas are core strength, medicine balls, speed, plyometrics, agility, strength equipment, strength accessories, and flooring. You’ll find the catalog full of new products as well as some products that have been improved. Not only will you find these changes, but you will also find that the company has lowered some prices, enabling the customer to get premium products at great pricing. Go online or call Power Systems to request a free 2003 catalog today.

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Perform Better

Kytec Athletic Speed Equipment

(800) 556-7464, www.performbetter.com Now increased to 60 pages, the 2003 edition of the Perform Better catalog includes a wide array of high-quality products for training, coordination, and rehab.

The items selected focus on speed and agility, plyometric, strength, and weight training, as well as balance and stabilization application to both training and rehab of the individual. The focus of the entire presentation is on functional training and rehab.

(800) 732-4883, www.kytec.us Kytec Athletic Speed Equipment has been a proven name in sports training for 12 years. Kytec offers a wide variety of products dealing with fitness, strength, rehabilitation, speed, flexibility for all types of athletes and individuals. Its goal is to have a wide variety of superior merchandise at the best possible prices, to handle your order courteously and to ship merchandise as quickly as possible, usually within 24 hours. There is a difference in Kytec products. It's the difference between being the runner-up and the winner. It is the difference between nearing the top and reaching it. When you buy Kytec products the difference is quality factory direct savings and prompt delivery. Begin to feel the benefits of the highest quality and lowest priced athletic speed, strength and rehabilitation equipment in the USA. Circle No. 92 on Reader Inquiry Card

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How

to

order

from...

The Best of Both Worlds

As a sports medicine provider, you depend on your local supplier for personal, on-site service and technical support. At the same time, you desire the benefits a national company can provide: a broad choice of quality products, immediate availability, and low prices. The National Medical Alliance (NMA) offers your the best of both worlds.

The Wall Crawler, a product of the NMA, truly represents the cutting edge in rehabilitation technology. Now with its unique design, you can exercise athletes in a functional standing position. Whether it is post-operative hips, knees, ankles, or simple sit-to-stand training, you can produce better results. By utilizing assistance bands, the athlete’s bodyweight may be off-loaded to decrease the amount of weight they are supporting. This allows them to complete rehabilitative exercises using full or partial bodyweight.

Call us toll-free at 800.662.7283 Fax us at 800.406.0440 E-mail us at jeff@therapythings.com 58 ◆ T & C O C T O B E R 2 0 0 3 ◆

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Visit us on the Web at

www.nmadirect.com

WebConnections BIOMEDICAL LIFE SYSTEMS, INC. WWW.BMLS.COM

DURA-KOLD CORPORATION WWW.DURA-KOLD.COM

OPTP WWW.OPTP.COM

BioMedical Life Systems, Inc., Vista, California, has been manufacturing portable Electro-Therapy Devices and accessories for over 15 years. The result is a comprehensive family of devices meeting the range of needs from Workers Compensation to advanced physical therapy.

There are five Point Specific and two Multi-Use Ice Wraps available from DuraKold. The athlete can be mobile and the wraps can be used repeatedly. Dura-Kold wraps are used by athletes of all levels of competition.

OPTP is an internationally recognized leader in providing healthcare professionals with conservative care and physical therapy products.

CSSI RESILIENT SURFACING PRODUCTS WWW.CARLSURF.COM Providing the finest in shock and sound absorbing surfacing made from recycled rubber, CSSI is the exclusive supplier of PlayGuard ULTRA, Traditional PlayGuard, SoftPave ULTRA, Traditional SoftPave, and SoftRoll resilient surfacing systems.

EXTRACTOR CORPORATION WWW.SUITMATE.COM Extractor Corporation offers its Suitmate water extractor, designed to extract 95 percent of the water out of wet swimsuits and return them dry in five to 10 seconds.

The product is for customer convenience and preventative locker room maintenance.

FOOT MANAGEMENT, INC. WWW.FOOTMANAGEMENT.COM

DM SYSTEMS, INC. WWW.DMSYSTEMS.COM Manufacturer of wound care and orthopedic rehab products, including the Cadlow™ Shoulder Stabilizer, a multisport shoulder stabilizing brace that provides glenohumeral stability while maintaining an athlete’s full range of motion, and AnkleTough® Resistance Exercise Straps.

Foot Management, Inc., has more than 27 years of experience providing quality custom orthotics, prefabricated insoles, foot pads, felt, foam, and heel cups to professional sports teams and medical professionals.

POWER SYSTEMS, INC. WWW.POWER-SYSTEMS.COM Power Systems, Inc. is an international distributor of sport performance, health and fitness products. With over 800 products and instructional programs, its the one resource for all your training needs. Its Web site features over 75 new innovative products for 2004 and dozens of exclusive Power Systems products.

RICH-MAR WWW.RICHMARWEB.COM This site is full of detailed information on all Rich-Mar’s ultrasound, stimulation, and combination products complete with photos, descriptions, spec sheets, and contact information, including a dealer locator.

You can also download manuals, service information, and MSDS sheets.

What can you really DO with giant rubber bands?!

Run Faster Reduce Injuries

Jump Higher

Play Lower

Add Resistance to Machine Lifts

Improve Endurance

Increase Flexibility

Stay Ahead of Your Competition with Flex Bands!

The Best-Kept Secret in Pro Sports Used by the Patriots, Cowboys, Yankees, Indians, Red Sox, Mariners, Hornets, Heat and many more!

Flex Bands have been improving athletic performance since 1980.

Jump Stretch, Inc. 1230 N. Meridian Rd. Youngstown, OH 44509 www.jumpstretch.com 1-800-344-3539 Fax: 1-330-793-8719 Circle No. 35

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Association Corner The following associations offer services of interest to our T&C readers.

ECA/MIAMI NOV. 14-16, 2003 Sports Sports Training Training && Fitness Fitness Conference Conference

The Voice of the Doctors who care for the Pros The PTP provides resources and services for all sports medicine professionals.

Visit www.proteamphysicians.com to find a PTP doctor, ask a question of a PTP doctor, or explore the educational materials from PTP regarding prevention, treatment and performance.

Don’t miss our Sports Training Mini-Camp!

Call: 800-322-3976 or 516-432-6877 for a FREE brochure

www.ecaworldfitness.com

SPECIALIST IN SPORTS CONDITIONING ISSA Certification Program • • • •

Be the conditioning coach for your team.

Expand strength & conditioning programs.

Maximize earning potential as a coach.

Learn to enhance athletic performance.

CALL FOR FREE INFO:

1.800.892.4772

www.FitnessEducation.com

International Sports Sciences Association

Take Your Career to New Heights PERFORMANCE ENHANCEMENT CONTINUING EDUCATION ● CERTIFICATION

• Earn CEUs for NASM, NATA, NSCA • Live workshops, home-study and online courses • Flexibility, core, balance, power, speed and strength training

• Clinical applications • Proven methods

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Athletic Therapy. Rapid return to work and play.

Athletic Therapists are dedicated to the promotion and delivery of quality care through injury prevention and rehabilitation and emergency services.

In collaboration with other health care professionals, athletic therapists work to create a healthier environment that encompasses the needs of the active community, including the high-performance athlete.

For more information please visit us online at www.athletictherapy.org

All NATA certified athletic trainers are eligible to receive a free subscription to T&C.

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Because the game isn’t played in the locker room ...

®

... there’s OAKWORKS .

Portable Adjustable Taping Tables

Portable Adjustable Treatment Tables

800.558.8850 www.oakworks.com © 2002 OAKWORKS®, Inc.

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