Training & Conditioning 14.2 by Momentummedia

TRAINING

March 2004 Vol. XIV, No. 2 $5.00

CONDITIONING

A Second Opinion Selecting and supervising team physicians ◆ Strength Strength for for Throwers Throwers ◆ ◆ Latest Latest Concussion Concussion Research Research ◆ ◆ Weight Weight Loss Loss Plans Plans ◆

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Training & Conditioning • March 2004 • Vol. XIV, No. 2

F E AT U R E S ◆ Tr e a t i n g t h e A t h l e t e ◆

Heads in the Game..........12 When it comes to evaluating and treating concussions, there’s a lot we don’t know. A bonanza of new research is trying to change that. By R.J. Anderson ◆ Optimum Performance ◆

What to Watch ..........21 Watching your players in action can reveal what is working— and what is not—in your strength and conditioning program. But you must first learn how to see “the game within the game.” By Vern Gambetta

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◆ Nutrition ◆

An Ounce A Day ..........27 An athlete in need of weight loss is vulnerable in many ways. A sports nutritionist details how to develop a sane weight-loss plan with measured goals. By Leslie Bonci ◆ Special Focus ◆

A Second Opinion..........33 Selecting and supervising team physicians is not as straightforward as it once was. Opinions vary on everything from what the doctor’s background should be to who should oversee the MD. By David Hill

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D E PA R T M E N T S ◆ Sideline ◆

Nutrition Myths..........3 ◆ Comeback Athlete Award ◆

Volleyball Standout Overcomes TOS..........4 Nomination Form..........9 ◆ Nutrition Roundup ◆

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Six Steps to Evaluating Supplements..........10 ◆ Competitive Edge ◆

Big Throws..........40 Sequencing and core strength are the keys to a championship throwing program, explains a top collegiate track and field coach. By Dr. Larry Judge Advertisers Directory..........54 Catalog Showcase..........44 Hot & Cold Therapy.........48 Aquatic Therapy..........51 Performance Apparel..........55 Concussion Management..........56 More Products..........58 Web News..........59

On the cover: William and Mary Team Physician Michael Potter (on left) works with Director of Sports Medicine Steven Cole to evaluate a student-athlete. Article begins on page 33.

Great Ideas For Athletes...

TRAINING & CONDITIONING • March 2004 • Vol. XIV, No. 2

Editorial Board 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

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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

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 RJ Anderson Editorial Assistant Greg Scholand 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

Mike Nitka, MS, CSCS Director of Human Performance, Muskego (Wisc.) High School

Special Projects Dave Wohlhueter

Bruno Pauletto, MS, CSCS President, Power Systems, Inc.

Administrative Assistants Sharon Barbell Amy Walton Daniela Reis

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

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© 2004 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.

Sorting Through Sports Nutrition Myths By Christine Rosenbloom, Ph.D., R.D.

Athletes are always looking for a leg up on the competition and many look to foods and fluids to provide that edge. Sports nutrition is always evolving and so too are its myths and misconceptions. You may have heard all of them, but do you know the facts? Myth Number 1: Avoid sugar before training and competition Eating sugar (carbohydrate) before training or competition increases blood levels of glucose and insulin. For most athletes, that’s a good thing because it helps muscles take up the glucose and use it for energy. In fact, sugar taken before exercise can improve performance. An athlete who is not fueled will soon be a tired athlete who can’t perform at his or her best. Myth Number 2: Athletes only need sports drinks if they’re exercising for more than an hour Sports drinks can help prevent dehydration and improve performance during activity that lasts less than one hour, especially if it’s intense or takes place in hot and humid conditions. Professional athletes aren’t the only ones who benefit from sports drinks. Competitive athletes who play stop-andgo sports such as football, soccer, tennis, field hockey and basketball can also benefit from the carbohydrate and electrolytes in these beverages. They also encourage athletes to drink more and stay better hydrated. Myth Number 3: Choose foods based on "net carbs" or "impact carbs" These terms keep popping up on food labels and in advertising from fast foods to light beer. However, the U.S. Food and Drug Administration has not defined them yet. Individual food companies created these terms for their products so the definitions are not uniform. Some subtract the dietary fiber, some the sugar alcohols and others a combination of these things. Consumers believe that only "net" carbs count in weight control. Don’t be fooled—it’s calories that count and most of the products labeled with "net" carbs contain the same number of calories as the original product. Myth Number 4: Vitamins and minerals give athletes extra energy and improve performance Vitamins and minerals act together to unlock the chemical energy stored in food. By themselves, however, they do not give athletes extra energy. A diet rich in grains, vegetables, fruits, meat and dairy gives athletes the energy they need to train and compete.

Myth Number 5: High protein diets are best for athletes Athletes often pit protein against carbohydrate, but the truth is that both nutrients are crucial for athletic performance. Protein is the building block for making hormones, enzymes and blood cells, and it also helps build and repair muscles and helps maintain healthy immune systems. Carbohydrate is indispensable for training and competing and is the preferred fuel for working muscles. When carbohydrate is in short supply, protein can be used as a fuel. But that means it gets diverted from its more important roles. For that reason, carbohydrate foods should comprise the majority of an athlete’s diet to provide athletes with the energy they need for exercise. A little bit of protein goes a long way. Athletes can easily meet their daily protein needs by consuming 8 grams of protein for every 10 pounds of body weight (e.g., 96 grams for a 120-lb athlete; 160 grams for a 200-lb athlete). Excess protein intake can be dehydrating because more water is needed to rid the body of the excess nitrogen from a high-protein diet. This is usually not a problem for those athletes who remain well hydrated, but can be an issue for those who are chronically dehydrated. Fight sports nutrition myths Now that you understand the realities behind the misconceptions, how can you spot a myth when it’s presented to you? Here are some tips: ● Be wary of information on commercial web sites. Sports nutrition companies are often trying to sell products that may not be backed by adequate published research. ● Look for information that’s been sanctioned by respected organizations such as the American College of Sports Medicine (ASCM) and the American Dietetic Association (ADA). ● Bring in a sports nutritionist for a workshop with your team to help translate the science of nutrition into practical food plans your athletes can follow. ● Visit www.gssiweb.com for more information on sports nutrition provided by many of the world’s leading experts. CHRISTINE ROSENBLOOM, Ph.D., R.D. is an associate dean in the college of Health and Human Sciences, an associate professor in the Department of Nutrition at Georgia State University and a nutrition consultant for the Georgia Tech Athletic Association in Atlanta.

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

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By Christopher Mohr

Evaluating Dietary Supplements The manufacture and sale of dietary supplements is an $18 billion per year industry. Sorting through the advertisements and associated claims for the 29,000-plus dietary supplements available can be difficult and confusing. But if an individual is going to be ingesting something, it’s important to learn about it first. In this Nutrition Roundup column I provide six guidelines and recommendations on how to evaluate any dietary supplements on the market.

1. Are there legitimate physiological mechanisms associated with the supplement? The purpose of an ergogenic aid is to enhance performance in one way or another, whether it is to allow athletes to lift more weight, run faster, or increase endurance. When evaluating the product, ask yourself, “Is it possible for the supplement to enhance the pathway from point A to point B?” For example, creatine phosphate is useful in energy reactions to regenerate ATP, the body’s “energy currency.” The next step is to consider whether the supplement in question is necessary for the reaction to occur, may enhance the speed of the reaction, or will do nothing to change what normally goes on in the body.

2. Is this product useful for the intended sport? Certain supplements are designed for high-intensity, short-duration events, such as weight lifting or sprinting. Others are designed to increase endurance. Therefore, depending on the sport one is involved in, certain supplements should not even be considered. Again using creatine as the example, it is not beneficial for long-duration, endurance-type activities, such as marathons. Using such a supplement to train or compete in these types of events would be nothing more than a waste of money.

3. Are there scientific, placebo-controlled studies to support or refute the claims being made for the supplement? Have the results been duplicated? Dietary supplements are being developed, improved, and launched practically every single day. Unfortunately, well-conducted scientific studies take much longer than this, and in the meantime athletes are being drawn to them. Dietary supplements do not have to endure the same rigor as pharmaceutical agents. However, some supplements have had a number of safety and efficacy studies conducted on them. Such studies are published in peer reviewed, scientific journals. It is also important to find out if the research has been duplicated. If one study was conducted in the laboratory of the company that produces the supplement, and there has never been any follow-up research conducted, one should be

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hesitant about putting too much faith in their claims. Access to thousands of well-respected journals can be found for free on PubMed, a resource of the National Library of Medicine at www.ncbi.nlm.nih.gov/pubmed.

4. Is there adequate safety data on the particular dietary supplement? The importance of long-term health can be difficult to get across to young, otherwise healthy athletes. However, it’s vital to stress the safety concern that’s associated with dietary supplements. If the athlete’s goal is to gain lean body mass, and the supplement he or she is taking will do so at the expense of curtailing his or her adult life, it’s too high a price to pay. This caution is obviously a bit extreme, but excess stress on the kidneys, liver, and other organs should be a concern with some supplements.

5. What is the source of information regarding the dietary supplement? Did the athlete hear about the dietary supplement in question from a friend, coach, magazine, etc.? Remember that most mainstream fitness magazines are owned by supplement companies. Therefore, it is common to read articles that are very slanted towards promoting a particular product(s). Magazines are a good way to be introduced to a product, but then the consumer must continue the investigative work to determine if there is any truth behind the supplement’s claims.

6. Is the product banned by any governing agencies? This is of particular concern for collegiate and professional athletes. There are a number of products that are banned by the NCAA, IOC, NFL, and other organizations. Whether or not a product may work, it is not worth risking a career over. The banned supplement list should be posted so athletes know and understand what products are included on the list. This is a basic list of questions and concerns that should be answered prior to consuming any dietary ergogenic aids. And remember to emphasize the importance of real food whenever talking to athletes about supplements. Dietary supplements are called supplements for a reason—they are intended to supplement whole foods in the diet. No dietary supplement can or will ever be able to replace what can be obtained through the diet. Consuming adequate energy and fluids should be the first concern. Dietary supplements should then fill in the very tip of the “iceberg,” but only if they are proven to be safe, legal, and beneficial. Christopher Mohr, MS, RD, LDN, is currently a doctoral student in Exercise Physiology at the University of Pittsburgh. He is a Registered and Licensed Dietitian and was a Sports Nutritionist at the University of Massachusetts for two years.

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Heads

in the Game

When it comes to evaluating and treating concussions, there’s a lot we don’t know. A bonanza of new research is trying

randon Manning, a junior linebacker at Virginia Tech, is known for being in the right place at the right time. But during the team’s loss to West Virginia this past fall, Manning seemed to be in a different stratosphere. While reviewing video of the second half of the game, a member of the coaching staff turned to Manning and asked, “Brandon, what in the heck were you doing on that play?” After careful consideration, Manning answered that he didn’t know—in fact, he didn’t even remember being on the field for that play. A few minutes later, he realized that he was seeing many parts of the game for the first time. After getting over their surprise,

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Photo: © Getty Images

to change that.

Virginia Tech linebacker Brandon Manning takes a knee to the chin while stopping Miami’s Kellen Winslow last season.

coaches relayed word of Manning’s amnesia to the sports medical staff, who quickly went to their computers. During the game, Manning was wearing one of the team’s eight helmets outfitted with Head Impact Telemetry (HIT) System technology, a wireless impact-measuring device. The special

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helmet contains six tiny accelerometers similar to the sensors used in automobiles to trigger air bag deployment during a collision. The sensors gather information about the force and directionality of each blow to the helmet and transfer the data to a microchip imbedded inside the crown of the helmet. A small antenna is attached to the microchip and transmits the data to a

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receiver connected to a laptop computer on the sideline, where the information is stored and monitored. HIT System technology was used at Virginia Tech last season to study the types of blows football players receive and what types cause concussions. In Manning’s case, it also helped the sports medicine staff uncover a concussion they otherwise would have missed. Examining the readings from Manning’s helmet, the medical staff discovered that a relatively high load had been delivered in the first half of the game. They were then able to timesynch the game video with the HIT System data and view the play which led to Manning’s concussion: a helmetto-helmet collision with West Virginia tailback Quincy Wilson, followed by Manning’s head hitting the turf. To Manning, the Hokies’ leading tackler, the hit seemed no different than any other of the hundreds of blows he had dished out during his career. He didn’t leave the field following the play and he never reported anything to the coaches during or after the game. But unbeknownst to him, Manning was the first person to ever have a concussion recorded by HIT System technology. “The technology is spectacular, because for the first time it allows us to evaluate these hits in real time,” says Gunnar Brolinson, DO, Team Physician for Virginia Tech football. “It’s an opportunity to prevent players from sustaining additional blows to the head after having sustained a concussive load to the brain.” Hits measured in real time? Accelerometer sensors? Microchips in helmets? Concussion-reading computers? Welcome to the wave of the future in concussion research. Only five years ago, most athletic trainers assessed concussions according to whether or not a player lost consciousness, and determined if they were ready to return to play based on one of the many arbitrary grading scales available. Today, a rapid succession of research has shed new light on assessing these injuries and has even broken new ground on treatment ideas. In this article, we’ll update you on the

most recent research and review how it can help you, right now, better assess concussions. LATEST RESEARCH

In 2003, the Sports Concussion Program at the University of Pittsburgh Medical Center published several studies on concussions in high school athletes. Among the UPMC findings was information that high school athletes take longer to recover from initial concussions than do college athletes. One study, published in

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ly related to the duration of symptoms. Neither a brief loss of consciousness nor a history of concussion was a useful predictor of the duration of postconcussion symptoms.” An article published by UPMC researchers in the July 2003 issue of the Clinical Journal of Sports Medicine found similar results. “Our study showed that many athletes with mild concussions whose symptoms disappeared within 15 minutes still showed significant decline in memory processing and other symptoms within

The results indicated that concussions are more likely to result from translational acceleration where impact causes the head to move in a straight line, rather than from the neck twisting from side to side. the May 2003 Journal of Pediatrics, found that even seven days after suffering a concussion, high school athletes still reported significant symptoms, such as headaches and nausea, and also performed worse on neurocognitive tests than those who were uninjured. College athletes typically returned to near-normal levels within three days, despite suffering more serious injuries. Other studies call into question traditional concussion evaluation for athletes of all ages. In a study published in the March 2003 issue of the Journal of Neurosurgery, David Erlanger, PhD, et al., found that amnesia—as opposed to loss of consciousness—was the most important symptom for measuring severity. “Selfreported memory problems apparent 24 hours postconcussion were robust indicators of the severity of sportsrelated concussion and should be a primary consideration in determining an athlete’s readiness to return to competition,” the article concluded. “A decline on neurocognitive testing was the only objective measure significant-

one week post-injury, which means they weren’t healed,” says Mark Lovell, PhD, Director of the Sports Concussion Program at UPMC. Based on this research, Lovell encourages athletic trainers to revisit the way they judge the severity of a concussion. “You want to find out if the player remembers what happened during the first five or 10 minutes before and after the injury,” he says. “Ask the athlete to remember three words. Ask them to recount details of what happened to them. We think it’s very, very important to evaluate that on the field, at the time of the injury. If we can detect any amnesia on the field, if there’s any detectable mental status change, if they have a significant headache, or if their balance is off, then we hold them out for the rest of the contest.” The reason assessing concussions is so critical was underscored in an article in the Nov. 19, 2003 issue of the Journal of the American Medical Association. It indicates that once an athlete is concussed, the probability that he or she will experience a second

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concussion during the same season is greatly increased. Conducted by Kevin Guskiewicz, PhD, ATC, Director of the Sports Medicine Research Laboratory at the University of North Carolina, the study also indicates that players who reported a history of three or more concussions are three times more likely to experience the injury again compared to players with no concussion history. However, unlike Erlanger’s study, Guskiewicz found that recovery is slower in players with a history of concussions. His study notes that 30 percent of the players with three or more previous concussions had symptoms lasting longer than a week, compared with only about seven percent of those with no history of concussion. Researchers found that 92 percent of repeat concussions occurred within 10 days of the initial injury, and 75 percent occurred within seven days. “This underscores the critical importance of making certain that athletes are without symptoms before they are allowed to return to participation,” says Guskiewicz. “Concussed players may still be vulnerable during the first few days following the injury, but they are unlikely to sit out unless a physician or athletic trainer holds them out.” The study, which is part of the NCAA Concussion Study, is currently the largest multi-site study on recovery and outcome following sports-related concussion. The investigation took place at 25 colleges over a three-year span ending in 2001. During that time, nearly 200 concussive injuries were reported in 2,905 football players. Guskiewicz and his colleagues reported 184 players (6.3 percent) experienced a concussion during that period, and 12 players suffered at least two. Positions that incurred the most concussions were linebackers, offensive linemen, and defensive backs. While many of the recently published studies examine the effects of collision-induced concussions, the next wave of research concentrates on the biomechanics involved with concussion-causing impacts. The first of these studies was introduced in the October 2003 issue of Neurosurgery

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and was commissioned by the National Football League along with NFL Charities and directed by Elliot Pellman, MD, Chair of the NFL Committee on Mild Traumatic Brain Injury (MTBI) and Team Physician for the New York Jets. The purpose of the research was to break down the impacts that caused concussions by utilizing NFL game footage. The researchers obtained 182 cases on

to be a milestone for concussion research, as it was the first to look at the speed of impact and the amount of head acceleration that occurred on impact. With a precedent now set, other groups are set to carry that research a step or two further. One such group is at Virginia Tech, where Manning and his teammates are helping researchers gauge the speed and directionality of the blows they receive. While Pellman and the MTBI Committee painstakingly worked to estimate and re-enact the impact in a laboratory, the medical staff and engineers at Virginia Tech aim to measure the impacts in real time as they occur on the playing field. CAPTURING THE DATA

The special helmets used in the Virginia Tech project gather information about the force and directionality of each blow and transfer the data to a computer sitting on the sidelines.

video for analysis that took place between 1996 and 2001. A cinematographic analysis was developed to determine the speed at which the players were moving prior to the concussion-causing collision. For 31 of the incidents, footage containing multiple camera angles of the impact was available. These viewings allowed the researchers to perform three-dimensional laboratory reconstructions using helmeted crash-test dummies. The results indicated that concussions are more likely to result from translational acceleration where impact causes the head to move in a straight line, rather than from the neck twisting from side to side. The footage also revealed that most concussions occurred when players were hit on the side of the helmet, on the facemask, or when the back of the helmet absorbed the impact. The Pellman study was considered

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The Virginia Tech project, which is funded by the Center for Injury Biomechanics at the Virginia Tech College of Engineering in conjunction with the Edward Via Virginia College of Osteopathic Medicine, the National Center for Medical Rehabilitation Research at the National Institutes of Health, and the Virginia Tech Sports Medicine Department, was implemented at the beginning of the 2003 football season. Every two weeks the team rotated eight sets of sensors to eight helmets belonging to different players. By the end of the season, 38 players had worn helmets with HIT System sensors during games and practices. The sensors are designed to track a range of blows, which are measured in gravitational forces (g’s) with ranges from 15 to 150 g’s. “An impact of 120 g’s would be like a severe car accident, which you could survive while wearing a seat belt,” says Stefan Duma, PhD, Director of the Virginia TechWake Forest Center for Injury Biomechanics. Half of the blows registered measured more than 30 g’s, while blows exceeding 150 g’s were rare, but did occur. “We rotated the sensors to get a valid assessment of which position is taking what kind of blows,” says Brolinson, adding that the system captured data from over 3,300 high-impact blows during the season. “One of the

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things I think is going to come out of this study is the need for position-specific helmets. I think we’re seeing that linemen sustain certain kinds of loads compared with defensive backs, running backs, and so on. We already have position-specific shoulder pads, why not position-specific helmets, too?” One particular finding that surprised Brolinson and his colleagues was the abnormally high number of hits that offensive and defensive linemen experience during a game. “It was not unusual for our linemen to sustain 50 or 60 significant blows to the head during a game,” he says. In follow-up studies, Brolinson says he would like to find the clinical significance of repeated nonconcussive blows. “We see multiple loads occurring with linemen,” he says. “They are below the level of concussion, but almost any lineman that you talk to— high school, college, or professional— will tell you that a lot of them have headaches following games. We have previously thought these headaches

A player who sustains a 130-g frontal impact might walk away from the play without a concussion, while the same player could take a 70-g lateral or posterior blow that could leave them with concussion symptoms. were simple muscle tension headaches, and that may in fact be the case, but at this point, given the number of blows and amount of g-loading sustained over the course of a game, we’ve identified an area we want to investigate more thoroughly.” Brolinson also wants to continue to investigate the type of hits that cause concussions. “Ultimately what we want to do, using regression equations,

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is predict risk of concussion based on the directionality of the blow and the load that is sustained, and then evaluate the athlete accordingly,” he says. “We want to identify what level of blow we need to be concerned about, even in a player that retains consciousness. If a player sustains a 120-g hit, what is his risk of significant brain injury? Is it 25 percent, is it 50 percent, is it 75 percent? We want to identify the at-risk player based on the magnitude of the blow and we would also like to identify the at-risk player based on the cumulative blows.” The directionality of the blow, Brolinson stresses, is just as important to causing a concussion as the force of the impact. A player who sustains a 130-g frontal impact might walk away from the play without a concussion, while the same player could take a 70g lateral or posterior blow that could leave them with concussion symptoms. It is one of the variables their study is exploring—using risk modeling to decode concussion-causing impacts.

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“Once we accumulate enough data to build these logistic models, we’ll have the ability to look at an 80- or 90g blow, see where it comes from, and keeping in mind who it’s happening to, have an idea of what their risk of concussion is,” says Brolinson. “If that’s somebody with, for example, a 75 percent risk of concussion, then we can immediately get him to the sideline. And if their sideline evaluation indicates they have a concussion, then that is somebody we can take out of the game and avoid subjecting to further risks.” Last season the system was part of a pilot study and used strictly as a research gathering tool, but by next season, Virginia Tech plans to outfit 64 helmets with accelerometers and begin using the system to help diagnose concussions. “Our goal is for this to be another tool in the athletic training staff’s arsenal,” says Rick Greenwald, PhD, President and co-founder of Simbex, the company that manufactures the HIT System. “This would

alert them that an impact above the threshold that has been determined for that player or that group has been exceeded. Therefore they might want to trigger their other steps.” While the current cost of the HIT System is prohibitive for smaller colleges and high schools—to equip a team of 50 to 75 players would cost $165,000 to $195,000, says Greenwald—Brolinson is confident that over time, the HIT System will be accessible for more mainstream use. Brolinson also hypothesizes that perhaps one day, hospital emergency rooms will be outfitted with the software to read the accelerometer chips, making it unnecessary for high schools to purchase the diagnostic technology. Then, if a player takes a hit that the athletic trainer believes could be concussive, the player’s helmet can be taken to the emergency room to have the impact tested. Brolinson feels this scenario is feasible for a variety of helmeted activities such as hockey, cycling, and skateboarding, because

the sensors and chips are relatively inexpensive to produce. WHAT’S NEXT

Researchers on many fronts are excited about the implications of HIT System technology. “We’ve got a grant out and are proposing to do the same sort of project next year,” says Guskiewicz. “But we’re going to take a little different angle.” Instead of focusing on the thresholds of concussions, Guskiewicz will be investigating how biomechanical measures correlate to the follow-up assessments of postural stability and cognitive function, and whether there is a threshold for tissue damage. “We’re going to be doing MRI’s on all of our subjects,” he says. “We’re examining the correlation between biomechanical and clinical measures. “We need to somehow hone in on what the cause is, and try to prevent concussion,” he adds. “And I’m not convinced it’s going to be through improving helmets or changing the

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rules of the game—for whatever sport.” One of Brolinson’s goals for the study at Virginia Tech is to eventually develop a more sophisticated paradigm for treating concussion. “We can see a scenario that would develop based on an enhanced understanding of what’s going on with the brain that might result in some kind of pharmacological treatment to enhance healing,” he says. “We have a multitude of pharmacological treatments for people who suffer migraines, strokes, and other neurological disorders. Why can’t we develop something to treat concussion?” Lovell also believes that there is a lot of work to be done in terms of developing medication to treat the neurochemical imbalance that occurs following a concussion. “Some of the work we’ve done with medications for post-traumatic migraines might be very useful for developing something to treat concussions,” he says. “We’re starting to get into that, but first, we need to make sure people are diagnosed properly.”

The most important piece of advice from the researchers is to not rely so heavily on traditional grading scales. Instead, researchers suggest focusing more on individualized testing and using as many tools as possible. TAKE HOME MESSAGE

The best news about all this exciting research is that many of its findings can be translated into new assessment techniques right now. The most important piece of advice from the researchers is to not rely so heavily on traditional grading scales. Instead, researchers suggest focusing more on individualized testing and using as

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many tools as possible. Those tools include balance testing, awareness testing, and knowing the athletes. Virginia Tech currently uses a stabilogram, which measures a player’s balance and physical stability, and a Web-based neuropsychological exam called HeadMinder, which measures neurocognitive skills such as reaction time and memory retention. “All of that can be done on a sideline or in a locker room, which allows the medical staff to make a well-calculated decision on whether or not to return that player to the game,” says Brolinson. Virginia Tech athletic trainers also make sure they have personalized knowledge of the athletes themselves. “At this level, the bottom line is, you have to know the athlete and how they respond to certain situations, because there are subtleties that will tip you off,” says Mike Goforth, MS, ATC, Head Athletic Trainer at Virginia Tech. “They might pass a neuropsych test or a balance test, but you’ll notice that there is something that just isn’t right

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factors that become vulnerable during a concussion, such as an athlete’s reaction time, processing speed, problem solving, and memory. If an athlete is suspected of having a concussion, he or she re-takes the exam and the results are measured against their baseline score. These types of exams are helpful in that they allow a clinician to evaluate the athlete based on more objective criteria before making a decision on whether or not it is safe for the athlete to play again.

about them and you have to hold them out. You don’t notice those kinds of things unless you know the athlete.” For athletic trainers who don’t have the luxury of getting to know all of the athletes under their care, computer-based neuropsychological testing may be most important. There are a variety of computer-based neuropsychological examinations available, but the basic premise of each is for the athlete to develop a baseline score before any injury based on neurocognitive

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“In the high school setting, where there are more athletes per athletic trainer, I think the computer-based testing will become more and more important,” says Timothy Neal, MS, ATC, Head Athletic Trainer at Syracuse University. “In the college setting, I think the use of neuropsychological testing will be more of an adjunct to what people are already doing.” Neal, whose program currently uses the pencil and paper-based Standardized Assessment of Concussion (SAC) evaluation, is in the process of implementing the Head-Minder system with the Syracuse football team and plans to use both systems simultaneously in 2004. The school’s men’s and women’s soccer teams began using the HeadMinder system last season. Another benefit of computer-based neuropsychological testing is the message it sends athletes about the seriousness of reporting their symptoms. “They sit down and take a baseline test that goes over all the symptoms of concussion,” says Michael Collins, PhD, Assistant Director of the Sports Concussion Program at UPMC. “And at that point [the coach or athletic trainer] can say, ‘Look guys, this is why we’re taking this test. If you have any symptoms, let me know.’” Lovell, who along with Collins developed a neuropsychological test called ImPACT, says that such tests are a useful tool, but they are not the only tool. “We aren’t suggesting that it be the only criteria by which return-toplay issues are settled,” he says. “But it can be very helpful because athletes are notorious for lying about their symptoms—and they aren’t able to do that with this kind of testing.” With new information being released all the time, Guskiewicz advises clinicians to keep up to date on the subject and make return-to-play decisions based on the resources they have in their particular setting. He also stresses the importance of instituting some kind of baseline assessment, as well as a postural stability testing program. “I describe it as a concussion puzzle,” says Guskiewicz. “And in order to piece it all together, you have to be educated.” ◆

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WHAT to Watch Watching your players in action can reveal what is working—and what is not—in your strength and conditioning program. But you must first learn how to see the game within the game.

Photo: © Getty Images

BY VERN GAMBETTA

"You can see a lot by watching." hat famous quote by Yogi Berra speaks volumes. But is everyone involved in a sports event really watching the same game? Probably not. Several years ago, when I was talking on the sidelines with a sport coach, I was struck by how differently we saw the same game. For both of us, watching the players in action was critical—it allowed us to see the culmination of our work. But the sport coach was

much more focused on winning and losing: Was the offense productive? Was the defense working? As a conditioning coach, I have learned to watch a game through a different lens. I am not a spectator or a fan. In fact, I cannot afford to be, because it would detract from my objectivity. Rather, I am an observer of movement. I watch competitions to gather information to improve the athletes that I am working with, period. Granted, this is not always easy to

do. But I try to think of myself as a scout or a referee—unaware of first downs, baskets made, or who got the assist—but keenly aware of the parts of the game that concern my area of expertise. The outcome of the game is still important to me. Whether my athletes win or lose is the ultimate measure in their own minds, so it needs to be a measurement for me, too. But to do my job as a conditioning coach, I need to get beyond the score to see the game within the game—the patterns and movements that really make things happen, the strength/power demands, and the effects of fatigue. Every game 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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Camera Help used to laugh when I heard a coach say that he had to watch the film to see what had happened in the game. Now I understand what he meant. In reviewing game videos, I am occasionally amazed at the discrepancy between what I thought happened and what actually happened. Observation in “real time” can be very misleading. I now believe in the importance of using video to complement live observation whenever possible. Watching the game again, and being able to stop and start the action, helps me pick up more nuances. I’ve found it especially helpful to film from a different angle than from where I am watching the game. I have also discovered isolated video to be particularly helpful. At times, I have a camera focus on one player for the entire game. I then use the video to analyze, correct, and reinforce particular movements that we have been working on in training. Make the most of the video technology that’s available. For example, I use a Dartfish video analysis program to overlay practice efforts with competition efforts to assess the quality of movement. This analysis program allows me to video training footage and then video the same action in a game and superimpose one upon the other to detect any differences. I find this a great tool for comparing training efforts with game performance.

represents an opportunity to reinforce the positives and find ways to improve the negatives. VANTAGE POINTS

How do you watch a game from a perspective of movement, strength, and conditioning? To start, consider where you are positioned, how to use all your senses, and what to look for. First: Determine the optimal vantage point to observe the action. As part of the coaching staff, we often position ourselves on the sideline. However, this is a confining view that gives us a distorted picture of the action. Instead, try to observe the game from in front or behind your athletes. The area behind the end zone, goal, or basket is a great vantage point to see the game develop and patterns emerge. In a stadium or arena, having a vantage point above the action can also be quite revealing. However, do not limit yourself to one vantage point. Try to move around and see the game from different angles. Second: If it is a ballgame, do not watch the ball. Train yourself to take in the big picture. Focus away from the 22 ◆

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ball and observe how patterns of movement influence play. Sometimes what players do to get the ball is as important as what they do when they have it. This is true in both team and individual sports. For example, at a tennis match, the tendency is to watch the server. Instead, on selected points, watch the player receiving the serve. Look at his feet and see how he moves laterally. If you try to watch him after the ball is served, you will miss your chance to see how he gathers his power. Third: It is important to remain objective. Know what you are looking for, but don’t look so hard that you always find it. You may be looking for a particular outcome to a movement that you have been training, but be astute enough to see why it did or did not occur. Do not become a fan—be as dispassionate and critical as you can. Fourth: Listen as well as look. Listening can give a feel for the rhythm of the action and provide great insights into technical execution and proficiency. This is especially true in the jumping and hurdle events in track and field. During competition in these

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events try turning away from the action and just listen for a rhythm—it is quite revealing! The difficulty of watching team sports is that everything takes place in two- to four-second bursts, which is much too fast for the ocular system to process the entire field of play. To overcome this limitation, it is important to know exactly what you’re looking for. You can’t see everything, so focus on the actions or patterns you’re working on in practice that may need correcting. Kevin McGill, an internationally renowned coach of track and field throwers, draws an analogy to bird watching. In that context, you only have two to four seconds to recognize a pattern of colors that are the key to identifying the particular bird. It is the same for us watching a game. We need to look for patterns that will direct us to relevant points of action. It is also important to recognize that we all have a bias. I know that I often spend too much time looking at hip position in a multidirectional sport. That bias causes me to miss other things, at times, so I have to be sure to constantly redirect my attention. WHAT TO LOOK FOR

With the right vantage point and an objective mind, you can start zeroing in on what you want to discover while watching the game. The main thing to look for is whether your athletes are transferring the movements and strength gains they have been working on in practice. If they are working to gain a more powerful first step, I will study how the players accelerate. I will notice their movements and the power behind their movements. I will watch if fatigue is a factor in the strength and agility of their movement patterns. Here are some other suggestions on what to watch: Breakdowns: Gary Winckler, Head Coach of Women’s Track and Field at the University of Illinois, videotapes his team’s competitions. When one of his athletes is performing under par, he uses the video to understand why. He observes the action to

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compare what they have been doing in a closed-skill practice environment with their performance in an open-skill competitive environment. From this observation, he then seeks to determine whether a psychological or a physical breakdown has caused the difference between training and competition. If he notices his athletes overstriding, for example, he knows they’ll need to focus on that in future practices. But if the athletes’ movement and timing look great, he knows he needs to concentrate on the psychological aspects of competition. Hip Position: Jim Radcliffe, Head Strength and Conditioning Coach at the University of Oregon, always watches his athletes’ hip position. He tries to determine if their hips are going where they need to go and whether his athletes can transfer the agility work done in a training drill environment to the reactive game environment. Speed: Perhaps it relates to my infatuation with speed, but when I

Listen as well as look. Listening can give a feel for the rhythm of the action and provide great insights into technical execution and proficiency. This is especially true in the jumping and hurdle events in track and field. watch multidirectional sports I am always carefully observing “game speed”—how quick an athlete is to get open, position herself for defense, and react to the ball and other athletes’ movements. As a conditioning coach I see reconciling the difference between

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training drills and game speed as my most difficult task. Individual Assessments: As a coach, you know your athletes, so keep an eye out for key people. Some typical situations I look for include: • The hard driver who does everything in training with reckless abandon, but doesn’t excel in games. This athlete may be your star in training, but the hard-driving mindset can lead to playing out of control in game situations. • The worker bee is the athlete who works so hard in training that there is nothing left for the game. This type of athlete will often play well for the first half of the season or even for half a game, but begins to fall apart because they have overworked themselves in training. • The coaster, who saves it for the game. These athletes’ practice efforts never come close to their game performance. Watching a game will give you

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feedback that can help make each of these athletes better. The hard driver may need to work on more body control, the worker bee may need to be watched carefully and reined in, and the coaster may need to be challenged differently in practice. Warmup: The game is important, but watch the warmup also. If the team or athlete always starts slowly, the problem may be with the warmup. Pregame can give tremendous insights into how a team will play. For example, in observing the University of North Carolina women’s soccer warmup several years ago, I noticed that static stretching was placed very late in the routine, which resulted in the first minutes of play being very lethargic. I pointed this out to the coaches, who moved the stretching earlier and added a brisk nervous system activation exercise immediately preceding kick-off. This may seem like a small suggestion, but the result was a better start for the team. In addition, watch to see if the team warms up again at halftime or during breaks in action. How do your substitutes perform? How do they get ready to go into the game? Fatigue: Closely follow the tempo of the game. I always preach owning the second half and being the best at crunch time, so watch who can step up. Don’t just look at who seems to have the most energy, but take note if the movement was acceptable at the early stages of the game but then declined as fatigue set in.

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I’ve found that this type of feedback allows me to better communicate with my athletes. It helps them know I care about their performance, and it works well as a motivational tool. FEEDBACK

In doing game analysis, remember that the information is not just for yourself. If you see something of note, be sure to pass it along to your athletes. I’ve found that this type of feedback allows me to better communicate with my athletes. It helps them know I care about their performance, and it works well as a motivational tool. For example, game speed is hard to measure but easy to observe, so I always try to find a way to give feedback to my athletes about their game speed: “Hey, John, your footwork was fabulous—when you sped past your defender to make that first-half goal, it was because your feet had no wasted movement.” Don’t miss out. Use each game as an opportunity to gather more information to make you and your athletes better. Look for the game within the game. Let the sport coaches worry about the score. ◆

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In the next issue of Training & Conditioning: ◆ New Ideas in Rotator Cuff Rehab ◆ Another Look at HIPAA ◆ Breaking Down Carbohydrates

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An Ounce A Day

ike was a very successful high school defensive back who was offered a full scholarship to a highly ranked NCAA Division I college football program. Throughout high school, his coach had told him that bigger was better, so he decided to eat more at every meal and spend more time in the weight room. This resulted in an increase in mass, strength, and performance. The summer before his freshman year at college, he sustained a knee injury in a pick-up basketball game. His activity decreased dramatically, but his eating didn’t, and by the time he reported to the first day of training camp at college, he was 25 pounds heavier than his playing weight. He was told to lose the weight fast, doing

An athlete in need of WEIGHT LOSS is vulnerable in many ways. A sports nutritionist explains how to develop a sane weight-loss plan with measured goals.

whatever it took, and to exercise after practice by doing some extra running or stationary biking. Worried that he wouldn’t see playing time if he didn’t lose the weight, Mike started skipping breakfast and lunch and eating a large salad and two grilled chicken breasts for dinner. He

BY LESLIE BONCI

went to bed hungry, woke up irritable, and was extremely tired and lightheaded during practice. His weight dropped but his performance suffered—and the extra activity aggravated the knee injury. He saw very little playing time. Obviously, this is an example of what not to do when an athlete needs to lose weight. The timing was wrong, there were no realistic goals, and communication was almost nil. Weight management is difficult for all involved, and it needs to be treated with care. The individual who is trying to change his or her weight is very sensitive and may feel pressure to do it quickly. The individual who is Leslie Bonci, MPH, RD, is Director of Sports Nutrition at the University of Pittsburgh Medical Center and serves as a consultant to the Pittsburgh Steelers, Pitt athletics, and several area high schools.

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Table One: Elbow Breadth he measurements listed below correspond to a medium frame for the given height. If elbow breadth is less than the numbers listed here, the athlete has a small frame. If elbow breadth is greater than the numbers listed here, the athlete has a large frame. To measure elbow breadth the athlete should be standing, with dominant arm extended forward and palm down. Bend elbow to a 90 degree angle so that the back of the hand faces the athlete. Measure the distance around the narrowest part of the elbow joint.

FOR A MALE Height 5-2 to 5-3 5-4 to 5-7 5-8 to 5-11 6-0 to 6-3 6-4 to 6-7

Elbow Breadth (inches) 2-1/2 to 2-7/8 2-5/8 to 2-7/8 2-3/4 to 3 2-3/4 to 3-1/8 2-7/8 to 3-1/4

FOR A FEMALE Height 4-10 to 4-11 5-0 to 5-3 5-4 to 5-7 5-8 to 5-11 6-0 to 6-4

Elbow Breadth (inches) 2-1/4 to 2-1/2 2-1/4 to 2-1/2 2-3/8 to 2-5/8 2-3/8 to 2-5/8 2-1/2 to 2-3/4

Source: “Elbow breadth as a measure of frame size for US males and females,” by Frisancho AR, Flegel PN. AJCN Vol. 37, 311-314, 1983.

making the recommendation may be well intentioned, but misinformed— hence, a disconnect develops that results in an uncomfortable and sometimes confrontational situation. In order to do best by the athlete, you must help him or her put a plan in place, with very specific goals, a timeline, and a strategy for assessing progress. The process also requires communication and an understanding that each athlete and each weight-loss situation is unique. THE RIGHT QUESTIONS

When an athlete is interested in losing weight, it is a good idea to sit down with him or her and gather some information prior to goal setting. Questions to ask might include: • Why are you interested in losing weight? • Has anyone told you that you have to lose weight? • Do you have particular health concerns? 28 ◆ T & C M A R C H 2 0 0 4 ◆

• Have you lost weight in the past? If so, how? • What do you expect to notice in your performance as a result of weight loss? • How much time do you have to commit to working on weight goals? • What are obstacles that may hinder your efforts to lose weight? • Do you have a support system in place? • Do you have a time frame for weight loss? It is important to ask these questions so that you start a dialogue with the athlete on what may or may not be realistic goals. Athletes should know what they can change in their bodies: fluid balance, muscle mass, and body fat. And they should know what they cannot change: height, frame size, and body shape. The athlete who diets to have broader shoulders or smaller hips needs to be educated about realistic body goals. With changes in exercise

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and diet, one can change their size, but not their body type. The red flag is when someone is overly concerned about the look of their body. These individuals may employ drastic measures to change their bodies, such as dehydration, starvation, and the use of supplements, laxatives, or diuretics. The outcome is not body fat loss, but a change in fluid balance and lean body mass, both of which may adversely affect performance and health. The athlete who seems overly obsessed with his or her body should be referred for counseling. GOAL SETTING

In the absence of any red flags, the process of weight loss can begin with realistic goal setting. To do this, you’ll need to assess the athlete through baseline measurements. I believe the most important baseline measurement to take is the athlete’s body fat percentage. Why focus on body fat and not weight? The goal is enhanced performance, and that will not be achieved by a decrease in body weight alone. It is the loss of body fat—without loss of muscle mass—that will lead to a better athlete. If an athlete loses five pounds a week, it does not indicate fat loss alone, but also fluid and muscle mass loss, which will have a negative effect on performance. In addition, because body weight can fluctuate several pounds in the course of a day due to fluid changes, it can be extremely demoralizing to the athlete who has had a “good” week only to see the scale read higher. To start out, you’ll need a baseline measurement of the athlete’s body fat percentage. Underwater weighing and DEXA (Dual Energy Xray Absorptiometry) provide the best measurements, but you can also use skinfold calipers or bioelectrical impedance. For some athletes, another important baseline measurement is frame size. Even if you explain the importance of body fat measurement, some athletes will still obsess about their weight and want their numbers to match those on a standard height-

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Quick Tips weight chart. For these athletes, it may be helpful to make frame size a part of the equation, since someone with a larger frame size should expect to weigh more than someone of the same height with a small frame. (An assessment of frame size can be computed using elbow breadth as illustrated in Table One, on page 28.) Once you obtain baseline measurements, how do you set goals for reducing body fat? I usually start with goals of reducing 10 to 15 pounds of body fat over a period of six months. That would equal about two pounds of body fat a month—a small number for a goal-oriented athlete. Long-term goals are important, because in order to avoid losing muscle mass, an athlete needs to lose weight slowly. Measure body fat at six-week intervals, looking for body fat reductions of three to four pounds. Also ask athletes to assess success in non-scale related ways such as energy levels, better sleep patterns, and improved performance. This is the best way I’ve

THE FOLLOWING TIPS CAN HELP WITH WEIGHT LOSS: CUTTING CALORIES: • Use a smaller plate, bowl, or glass to control portion sizes. • Look at the serving sizes on packages of foods to keep the portions in check. • Do not reduce carbohydrates, but decrease the serving size. • Understand that fat-free and sugar-free foods are not necessarily caloriefree. • Be aware of calories in condiments. • Use a smaller amount of real salad dressing, peanut butter, or mayonnaise instead of large amounts of fat-free versions. • When eating out, order half-size portions or have an appetizer and salad, or soup and half a sandwich. EATING HABITS: • Try to eat more early in the day to prevent overeating in the evening. • Always eat breakfast. • Eat something every three to four hours. • Be consistent with the number of meals a day, seven days a week. • Sit down when eating. • Put all foods, even snack foods, on a plate. • Try to eat when hungry, and on a fullness scale of 1-10, stop at about a 5. • Try not to eat when at the computer or watching television. • Put tempting foods out of sight, or better yet, out of the house, apartment, or dorm room.

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Table Two: What Do You Eat? hen starting a weight-loss plan, ask athletes to write down next to each food item how many times they eat that food per week. Also ask them to put a TF next to any “trigger foods” they eat to reduce stress, when hanging out, or as a quick meal solution.

CARBOHYDRATECONTAINING FOODS ___ Bread ___ Bagels ___ Cereal ___ Pasta ___ Rice ___ Fruit ___ Vegetables ___ Juice ___ Sports drinks ___ Soda ___ Candy ___ Cookies ___ Cakes/pies ___ Pastries ___ Crackers ___ Pretzels ___ Chips ___ Potatoes ___ Yogurt ___ Ice cream/frozen desserts PROTEIN-CONTAINING FOODS ___ Beef ___ Veal ___ Lamb ___ Pork

Fish Shellfish Chicken Turkey Eggs Cheese Nuts Nut butter Dried beans (kidney, lentil, etc.) ___ Soy products (tofu, soy milk, veggie burgers) ___ Milk ___ Yogurt FAT-CONTAINING FOODS ___ Margarine ___ Butter ___ Salad dressing ___ Mayonnaise ___ Oil ___ Bacon ___ Cream cheese HIGH-CALORIE DRINKS ___ Alcohol ___ Beer ___ Wine ___ Mixed drinks

found to keep the athlete motivated and the goals performance-based. If your athlete needs some shortterm goals to keep motivated, be sure to add them in. A good goal to start with is 1/2 to 3/4 pound of body fat lost per week, which might equal two pounds per week on the traditional scale. Again, ask about energy levels and mood. It is also important to start any weight-loss program at the end of the season with the final goal to be achieved by the following preseason. Too often, the athlete may wait until the start of the season, or until the season is already under way, to work on weight goals. It is extremely difficult to focus one’s undivided attention on the rigors of training, conditioning, com-

petition, and academic demands, while simultaneously addressing body goals. Timing is a key component of weight loss and trying to lose weight in-season more often than not leads to decreased performance.

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CHOICES & BEHAVIORS

It would be impossible to adequately address weight management without talking about diet. However, do realize that one’s diet is composed of two areas: what and how much actually goes into one’s mouth; and the when, where, and how of eating. Let’s start with the “what” of the diet, the food. A meal plan should not translate to a decrease in strength, speed, stamina, or mental clarity. Therefore, athletes should not adopt an

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eating pattern that eliminates or severely restricts an entire macronutrient, such as carbohydrate- or fat-containing foods. Nor should they skip meals. It is important to remind athletes that carbohydrate and fat are the primary fuel substrates for the exercising muscles. Protein is essential for tissue growth and repair and supporting a healthy immune system, but it is an inefficient fuel substrate for exercise. One may drop some pounds by using a high-protein diet, but will pay the price by being too tired to make it through a practice or conditioning session. What about the actual food choices? Is there one sports diet? Besides eating the proper balance of carbohydrates, proteins, and fat (60/15/25 for the endurance athlete, 50/20/30 for the power athlete), the answer is no. Overall, you want to reduce caloric intake, but there is not one meal plan or calorie level that will be appropriate for every athlete. The idea is for the reduced calorie level to result in the desired changes in the body while still providing enough energy for the demands of exercise. To determine appropriate calorie reduction, first figure out the athlete’s Resting Metabolic Rate (RMR), which is body weight multiplied by 10, plus 70 percent of that number (to account for an athlete’s activity). That gives you the number of calories for weight maintenance. Then, subtract 20 percent from the equation for weight loss. So, for a 150-pound athlete, the equation would be: 150 x 10 + .7(1500) = 2550; 2550 - .2(2550) = 2040. The athlete should consume 2040 calories for weight loss to occur without negative energy levels. (If an athlete is not exercising, the 70 percent of RMR should go down to 20 to 40 percent.) There is absolutely no advantage in cutting calories to a minimum. In this example, if our 150-pound athlete had a goal of 130 pounds and decided to eat only 1200 calories a day for weight loss, he or she would end up very hungry, tired, and irritable, and would most definitely notice a decline in performance. Too low is not better when it comes to calories for weight

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loss. Although most athletes don’t know the calorie cost of foods consumed, there are some on-line tools such as the Interactive Healthy Eating Index (www.usda.gov/cnpp), where one can log food intake and get a printout of calories consumed daily. The next step is to take into account the psychological side of food consumption. Eating is supposed to be a pleasurable experience, thus the athlete’s meal choices need to be based on his or her food preferences as well as when and where he or she likes to eat. A simple concept, but one that people forget to take into account! To help athletes figure out how to change their diets, I give them a chart that lists many popular food items. I ask them to circle the foods they eat frequently, then list how often they eat them. I also ask them to indicate “trigger foods,” things that they pig out on or eat for stress reduction, as well as foods they never consume. (See Table Two on page 30.) From looking at the chart, I can see if they are consuming

There is absolutely no advantage in cutting calories to a minimum. If a 150-pound athlete decided to eat only 1200 calories a day, he or she would end up very hungry, tired, and irritable, and would most definitely notice a decline in performance. too much or too little of one thing, and whether there may be some psychological factors behind their food choices. For example, if an athlete eats primarily carbs or protein, I would have him or her look at the food choices in the other categories and develop a plan that would include a mix of nutrients at each meal and snack.

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I also ask them to describe their eating patterns: Do they eat a lot at any one meal? Do they use snacks as a way to reduce stress, get through a long night of studying, or when hanging out with friends? This helps to determine troublesome times of the day and hungry times, and allows us to concentrate on problem areas rather than the entire day. I want to understand how to take away the calories that have little meaning, while leaving in the calories that do have meaning. A final tip on setting weight-loss goals: make sure the athlete has input. The athlete must be ready and willing to change, which can more readily happen if he or she has had a thoughtful dialogue about the dieting process. The most superb meal plan will only be effective if the athlete perceives the value of it. Ultimately, it is the athlete, not the coach, health professional, or athletic trainer, who decides what, when, and how much he or she is going to eat and drink.

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SUPPORT TEAM

Along with having goals and an overall plan in place, some thought must be put into who will monitor the athlete. If there is not a nutritionist on staff, the athletic trainer is an ideal person to meet regularly with the athlete. Accountability is a huge part of goal setting, so be sure to check body fat percentages or go over eating plans when you say you will. Most athletes need to know that someone is monitoring them for their efforts to be successful. It is also important to build in incentives so that the athlete perceives the value in going through the effort. Ideas for incentives might include positive comments, talking about effects on performance, an effort award, and even letting a successful weight-loser be a peer counselor for athletes just starting out on a weight-loss plan. Some additional tips for those on the support team: • Always focus on what works for the individual. Even if you have personally found a meal plan and lifestyle pat-

Accountability is a huge part of goal setting, so be sure to check body fat percentages or go over eating plans when you say you will. Most athletes need to know that someone is monitoring them for their efforts to be successful. tern that works for you, you should not assume it will work for someone else. • Take a positive approach. Losing weight can be much more difficult for some athletes than lifting a heavier weight or learning a new play. Do not belittle or criticize, or else your efforts may backfire. The environment and support system need to be positive.

• Remind athletes that weight loss is a series of steps, not a slide, so there are going to be weeks when their weight doesn’t change. Explain that this is the body’s adaptation to the process of weight loss, and it is not necessary to eat less or exercise more. • Suggest that the athlete take pride in what he or she has accomplished so far and what they notice in terms of performance. Tell them there is no such thing as perfection. When an athlete hits a plateau, it is a good idea to encourage him or her to monitor intake for a few days to see if perhaps calories are on the high side, or perhaps they just need to have patience. Weight loss does not occur overnight, and so far, no magic pill is available. It takes time, effort, and commitment on everyone’s part. The underlying goal is performance enhancement and positive body changes. If weight loss is approached in a healthy way, the athlete will be proud of his or her accomplishment and see the results in his or her performance. ◆

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William and Mary Team Physician Michael Potter (left) works with Director of Sports Medicine Steven Cole to evaluate a student-athlete.

A SECOND OPINION Selecting and supervising team physicians is not as straightforward as it once was. Opinions vary on everything from what the doctor’s background should be to who should oversee the MD.

BY DAVID HILL

Photo: © Steve Clawson

f there were a Norman Rockwell image of the team physician, he would be a gray-at-the-temples, kind-but-respected veteran practitioner, dressed in school colors, a well-worn stethoscope around his neck. He—and it would definitely be a he—would be at all the games, home and away, check on rehabs at the crack of dawn, know each athlete by first-name (and their parents, too) and happily make residence-hall calls, black bag in hand. He’d do it all just for the love of his alma mater, and expect no more in return than a seat at the end-of-theyear banquet. Ah, simpler times. Both medicine and college athletics are more complex today, and so is the role of the team physician. Hiring, working out financial arrangements with, and managing a team physician are complicated and demanding tasks, requiring an understanding of liability, insurance rules, and medical specialties. The options for structuring the relationship between an athletics department and its team physicians seem to multiply every year, and what may have worked for decades may no longer be in anyone’s best interests. The questions athletic trainers have been struggling with are numerous: • Should the physician be a member of the athletics staff, the campus health center, or neither? • Should you publicly designate an “official provider of health care” or maintain a less-formal arrangement? • Do you want one head team physician, or a team physician for each sport? • Should you seek a general practitioner or an orthopedist? Is extensive sports-medicine training and experience crucial? To help answer these questions, we’ll examine how several athletic departments have navigated this complex relationship. We’ll look at the David Hill is an Assistant Editor at Training & Conditioning.

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Outside The Bases n structuring the role of the team physician, there is one model not to use: allowing coaches to choose and oversee their own team doctors. The University of Washington found this out the hard way last fall when state health officials suspended the medical license of Huskies softball team physician Dr. William Scheyer after investigators determined he had improperly prescribed and dispensed large quantities of narcotics, tranquilizers, and other prescription drugs to UW softball players. According to numerous news reports, most Washington student-athletes are treated by doctors from the University of Washington Medical Center. But Head Softball Coach Teresa Wilson requested Scheyer be kept as an outside team physician for softball, and administrators allowed it. Wilson told administrators that team doctors based at the UW Medical Center weren’t always as reachable and didn’t act as promptly or seem as concerned about student-athletes’ welfare as Scheyer was. In December, after further investigation into the scandal, Wilson was let go as Head Coach of the softball program, which she had built into a national power. Scheyer later denied he acted improperly and sought to have his license reinstated. What can other athletic departments learn from UW’s crisis? Administrators and athletic trainers at other schools are reluctant to discuss Washington’s situation. But Marcia Saneholtz, Senior Associate Athletic Director at Washington State University, says her school made some key changes in how it administers sports medicine after a problem arose in the late 1990s over a staff athletic trainer’s handling of medications. One of those changes entailed switching from using private physicians in the Pullman area to those at the campus health center—though a private orthopedist is also regularly consulted, under the direction of the head team physician. “A priority here for many years has been to inte-

advantages and disadvantages of each set-up, and discuss how to assess whether a particular physician will keep your team in the game—black bag and stethoscope optional. DOC ON THE TEAM

When a Clemson University studentathlete needs to see the doctor, Danny Poole, ATC, Director of Sports Medicine/Head Athletic Trainer, doesn’t have to spend much time thinking 34 ◆ T & C M A R C H 2 0 0 4 ◆

grate the athletic department into the university as much as possible, so this made sense,” Saneholtz says. “It also takes hiring the physicians out of the direct hands of the athletic department, and I think it takes away most of the potential for conflict of interest and allows greater protection for student-athletes.” Coaches are not allowed to refer student-athletes to other physicians. “If a coach has an idea about something,” Saneholtz says, “he or she can sit down and talk to the team doctors about it, and sometimes the team doctors will investigate and agree to consult a specialist in a certain field. But frankly, a lot of times those kinds of inquiries are turned down.” A major component of keeping tabs on physicians—and all aspects of the sports medicine department—is good communication, says Saneholtz, and that’s facilitated at WSU through weekly staff meetings. “Our athletic training staff and our docs meet every Monday morning and talk about each studentathlete on the injury list,” she says. “They talk about the treatment protocols and options and get everybody on the same page. When you have that kind of communication, you’re much more protected. “When you have anybody working in isolation, that would be a red flag,” she continues, “and you would hope to have a system that would prevent that from happening.” Another important consideration is attitude, Saneholtz says. “In the heat of battle, it’s easy for a coach to feel a lot of pressure and maybe try to wield some influence and put pressures on doctors and the athletic training staff,” she explains. “So those sports medicine folks have to be levelheaded, not get overly emotional, and not get overly enthralled with intercollegiate athletics. We’re a very addicting and alluring enterprise. And some people get stars in their eyes and get enthralled with the whole thing, and sometimes that leads to bad decisions.”

about who that athlete will see. In fact, Byron Harder, MD, may already be seeing the patient. Harder, a general practitioner, is the full-time team physician for Clemson athletics, and a staff-member of the athletics department. “He’s here at 7:15 in the morning and leaves whenever we’re through at night,” says Poole. “And he covers basically every sport. If there’s a soccer game at night, he’ll work all day

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and then cover the soccer game.” The previous head team physician was officially an employee of the campus health center, but when he retired, Clemson hired Harder and his salary became the full responsibility of the athletic department. The main advantage is that Harder can devote all of his time to sports medicine, Poole says. “Even though he’s employed by the athletic department,” says Poole, “Harder has made it clear to coaches,

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administrators, and players that the student-athletes’ welfare comes first. It has to be that way to work.” Harder works with Larry Bowman, MD, an orthopedic surgeon whose office is about 15 minutes away and who conducts a clinic at the athletic complex each Tuesday. Bowman is not on retainer, but is paid by billing for each case. Poole maintains a list of other specialists who are prepared to see Clemson athletes as needed, such as neurologists, cardiovascular specialists, and general surgeons. There’s also a part-time assistant team physician, Len Reeves, MD, who was an athletic training student of Poole’s before earning an MD and completing a sports-medicine rotation. Reeves, who also has a private practice, works closely with the basketball teams and is the on-duty physician when Harder travels to away games. Having a full-time physician on staff offers many advantages. “He sees kids on a day-to-day basis, as he or any

athletic trainer deems necessary,” Poole says. “In other words he may see an athlete who is sick in the morning, put him or her on some medication, and then come back that afternoon and see the athlete again. Having him inhouse means we’ve got a go-to person right there with any type of medical problem, whether it’s injury or illness. And it takes some of the burden off the athletic trainer when trying to decide if a kid needs to go to the doctor or not. A physician is really the only one who can diagnose anything.”

At the College of William and Mary, administrators took a path different from Clemson’s the last time a head team physician was hired, says Steven Cole, MEd, ATC, CSCS, Director of Sports Medicine. To start, the student health center was responsible for hiring the team doctor and pays the physician’s salary. “The athletic department does not

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pay any physician a stipend,” says Cole. “This is what they’re running into in pro athletics: If the athlete says, ‘You’re the physician who’s going to make the decision if I should play or not, and you’re employed by the people who sponsor the event, where is your allegiance? Am I really sure that you’re concerned about my health, or are you concerned about whether I play Saturday because we’re going to have 90,000 people in the stands?’ “So we in the athletic department don’t pay any physician,” Cole continues. “The institution, working through the health center, says to the physician, ‘We’re going to employ you to look after these students. You make decisions that are best for the student, and you protect the institution from liability. You don’t make a decision thinking it’s a big game and they’ve got to play.’” With the model William and Mary maintains, the school also asks the team physician to protect students from themselves, says Cole. “There

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was a pro basketball player who dropped dead after he’d had five different physicians tell him he had a cardiac problem that made him susceptible to sudden death,” he says. “So he found somebody who said, ‘Oh, I think you’ll

who has the expertise not just in understanding various medical conditions, but in understanding how that medical condition is going to affect a person in intense physical activity.” All these needs together made the

instance—to this physician, so they keep it within their practice,” Cole says. “Not only was it good for us, but it could be good for their organization.” Another advantage, Cole adds, is that as a member of the practice, the new team physician is able to expedite referrals to specialists within the partnership. ATC OVERSIGHT

James Madison University recently hired David Knitter, the Medical Director of the school’s athletic training curriculum program, as its team physician. Above, Knitter works with a baseball athlete while Athletic Trainer Maureen Thompson looks on.

be okay, I’ll go ahead and clear you.’ Our theory here is that it is the team physician’s job to resist that. Kids will go and see somebody else who says it’s okay. It’s the team physician’s job to say, ‘We’re still not going to clear you.’” William and Mary also felt it didn’t need a team physician on-site full-time. “If you have athletic trainers there and you have planned access to a physician, I’m not sure you need a physician at all times at all events,” says Cole. The next step for William and Mary officials was to brainstorm what they would need from a team doctor. “We were looking at students who are athletes who are going to have health care needs,” Cole says. “That kind of defined the expertise we were looking for. For instance, you have students who have asthma, but [when] you have student-athletes with asthma it becomes another issue. How is that asthma going to affect their athletic participation? So you want a person 36 ◆ T & C M A R C H 2 0 0 4 ◆

college seek a primary-care fellowship-trained physician who was board-certified with a sports medicine emphasis. (Sports medicine is not an official specialty, but rather doctors may perform a sports medicine fellowship or residency.) The idea was that there are orthopedic surgeons readily available, and that a generalmedicine doctor can manage most of the non-surgical orthopedic conditions and other medical needs. “Need to put the athlete in a cast? They can do that. Need an MRI? They can do that. The orthopedist now doesn’t have to spend as much time in the office because they’ve got a competent and skilled physician who can kind of triage them,” Cole says. William and Mary approached the members of a large medical practice seeking to grow and suggested hiring a sports-medicine doctor to share with the college. “Now, the physicians in that practice will refer the non-surgical orthopedic care—the tennis elbow, for

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At James Madison University, the athletic department also wanted to hire one part-time head team physician. But, in its case, there were no sports medicine fellowship-trained general practitioners in the community. That made them think harder about what type of doctor to seek. “We asked ourselves, what is it that we want our team physician to oversee primarily?” says Jeff Konin, MEd, ATC, MPT, Director of Sports Medicine. “We have very qualified and competent orthopedic physicians who are readily available to us, so we decided to go with a general practitioner who understands more general-medicine conditions, which in our environment works out well.” However, Konin says they did want a doctor with an understanding of sports-medicine. “If somebody walks in here with a cold, is it a sports cold just because they’re an athlete, or is a cold a cold?” Konin asks. “In our opinion a cold’s a cold, and our general practitioner is very qualified to treat that cold. What our general practitioner needs to understand as a sports team physician, however, is that this cold will affect the student-athlete’s ability to perform or participate today or tomorrow or the next day. It’s not the clinical skills, but the additional nuances, that go along with the environment of sports that our team physician needs to understand.” JMU found a perfect solution to its needs in David Knitter, MD, the medical director for the school’s athletic training curriculum program, where he also teaches pharmacology and general medicine. Knitter’s education includes a residency in internal medicine and a fellowship in pulmonary diseases. “He

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has an office in our sports medicine department, and for a couple hours each day, on a walk-in or a scheduled appointment basis, he will see our student-athletes. And of course he’s responsible for some event coverage as well,” says Konin. The other issue JMU considered was who should oversee the team physician. Or should the team doctor oversee others? The school ultimately decided that as sports medicine director, Konin should be responsible for supervising the team physician, even though by professional standing, Knitter supervises Konin and his athletic training staff in medical matters. Konin says it’s a matter of administrative duties. “It’s a nonissue what that individual’s credentials are,” Konin says. “My role is to direct a department, which involves a number of individuals with different skill sets, and to make the department work effectively. It just so happens that one of the individuals is a medical doctor. I don’t see that as being different than directing any other department.” JMU did consider hiring team physicians for each sport, but preferred the one-doctor model. “Hiring several team physicians has its advantages,” Konin acknowledges. “You reduce the workload of the team physician, which is critical because they’re spending a lot of time helping. But you change the continuity and consistency of care. What about when an athlete comes in and their team physician isn’t available? They see who is available. But now they’re seeing a person who’s foreign to them and not familiar with their medical history.” A staff doctor also promotes communication, Konin adds. “You might disagree at times for the sake of making sure you’re making the most accurate and appropriate decisions, but ultimately the decisions are always made jointly,” he says. “And you certainly can’t have the same communication level when your physician is not with you on a daily basis. Most legal issues come about not only due to negligence, but due to a lack of communication. Having one physi-

“Most legal issues come about not only due to negligence, but due to a lack of communication. Having one physician certainly enhances communication, thus decreasing our risk of potential liability.”

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cian certainly enhances communication, thus decreasing our risk of potential liability.” A FULL TEAM

Other athletics programs, however, prefer to have an array of team physicians, typically one for each sport. Among them is the University of Denver. There’s some overlap—for instance, the doctor for volleyball also covers men’s lacrosse and works at the university health center. But more

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importantly, the MDs have various specialties among them, and doctors will often see student-athletes who are not on their assigned teams. The situation allows sports-medicine staff members to direct each case to the physician who seems best-suited for the injury or condition they assess. “We have a head surgical team physician, a head orthopedic team physician, and a head non-surgical team physi-

University of Denver hockey jersey and a University of Colorado football jersey up on the wall. This is a very health-conscious community, with people who look at themselves as athletes—they’ll want to go to a doctor who known athletes go to.” FORMING A PARTNERSHIP

Western Carolina University has also chosen to use a team of team physi-

The physicians at Denver are compensated through case-bycase billing … They also get perks like complimentary tickets and Denver-athletics merchandise. And the doctors benefit from the public association with an NCAA Division I program. cian,” says Erik Rasmussen, ATC, Head Athletic Trainer at Denver. “So, obviously, if we’ve got injuries affecting knees, shoulders, hips, or ankles, athletes are going to be steered toward the orthopedist. On the flip side, if we’ve got an illness or we’re dealing with something like asthma or a concussion, then we steer our kids toward our non-surgical, primary-care physicians.” The approach also avoids overloading any one person. “The key is to find a balance for your team physicians,” Rasmussen says. “If you’re making them cover everything, there’s not a doctor who’s going to want to be your team physician. If they’re here all the time, it’s going to affect their outside life and they’re not going to be around for long.” The physicians at Denver are compensated through case-by-case billing—as well as for administering physicals, flu shots, and the like, Rasmussen says. They also get perks like complimentary tickets and Denver-athletics merchandise. And the doctors benefit from the public association with an NCAA Division I program. “Our head orthopedist’s group also covers the University of Colorado Buffaloes,” Rasmussen says. “Here or up in Boulder, it’s the same thing: You walk in their office and they’ve got a 38 ◆ T & C M A R C H 2 0 0 4 ◆

cians for its sports medicine coverage. However, their team is from a single business entity, and the relationship with the university is more proscribed than at Denver. The idea began when Jeff Compher became Athletic Director and noticed that there was no firm arrangement for quickly obtaining X-rays. So he arranged a meeting with Sylva Orthopedics, the practice named for the nearby town. Sylva and Compher began to discuss several ideas, and much more came of it than expedited radiology. Today, more than three years later, Sylva Orthopedics, doing business as Carolina West Sports Medicine, provides a team of team physicians who are readily available, hold regular office and clinic hours, and cover contests. They also rent space in the WCU athletic training room, in which they hold a twiceweekly public sports medicine clinic at hours student-athletes are unlikely to be in, such as weekdays between 10 and 2 and Saturday mornings. It helps the practice carry out its marketing promise of being able to see sportsrelated injuries quickly and provides an extra facility, one that may be better equipped than its own clinic. “We have a signed agreement by the university, the orthopedic practice,

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and the hospital,” Compher says. The practice covers athletic events and bills WCU’s student-athletes’ and the university’s secondary insurance coverage for examining and treating athletes. “It definitely makes the roles much more clear. We now know there will be a physician at football games and at men’s and women’s basketball games, there’ll be office hours, and there’ll be a physician for athletes to easily see. Before, the doctor would come and see athletes, but what if the doctor couldn’t come some time? Now, it’s formally provided for, and we have five doctors compared to one before.” Thomas Mallette, MS, ATC-L, Head Athletic Trainer, says the set-up helped attract him to WCU because it guarantees a level of care not found at all small colleges and universities. “In coming to a small community such as this,” Mallette says, “you want to be confident that you can get follow-up care for your athletes—that the physicians are going to be able to follow through on their end of the bargain. With this arrangement, they do. They’re very willing to help out, they’re there when we need them.” Unlike at JMU and William and Mary, the Western Carolina doctors specialize in orthopedics, which Mallette favors—though generalpractice physicians at the campus health center and in the Cullowhee area are referred to for many nonorthopedic conditions and injuries. “Our daily duties are a lot more orthopedic-based than general practice,” Mallette says. In addition, the rent has helped improve WCU’s athletic training facilities. “We’ve got a fluoroscan in the physician’s office so we can do X-rays,” Mallette says. “Everything’s business these days, and I think administrators have to treat it that way, and find a group that really wants to be there, not just to make money, but to give the best quality of care and give something back monetarily. That’s going to add to your athletic training program, so that you have the best equipment for your athletes and you’re not scrounging to buy tape at the end of the year.”

â&#x2014;&#x2020;

Mallette says the set-up does have some limitations that the school is working through. For instance, a doctor who treated National Football League and Major League Baseball athletes during a Cleveland Clinic residency recently moved to the region, and student-athletes respond well to him. Heâ&#x20AC;&#x2122;s in the Carolina West system but not a full-fledged member, and referrals can be delicate. â&#x20AC;&#x153;The administrationâ&#x20AC;&#x2122;s been very supportive of doing whatâ&#x20AC;&#x2122;s best for the athletes,â&#x20AC;? Mallette says. â&#x20AC;&#x153;If we canâ&#x20AC;&#x2122;t send somebody to Carolina West and get the best care, then weâ&#x20AC;&#x2122;re free to send them to someone else. We know we may jeopardize that relationship with our primary orthopedic group, but the administration has said we can bend the rules a little bit to get the best care for our athletes.â&#x20AC;? Compher says the flexibility was part of the original agreement, and he advises anyone entering such an arrangement to be honest about it. â&#x20AC;&#x153;I give credit to the doctors,â&#x20AC;? he says.

â&#x20AC;&#x153;Theyâ&#x20AC;&#x2122;ll refer a patient to someone else if itâ&#x20AC;&#x2122;s beyond their expertise. They understand that the bottom line is getting our student-athletes well. Our first line should be our physicians who serve us. But if things arenâ&#x20AC;&#x2122;t progressing satisfactorily, we have an obligation to get

SPECIAL FOCUS

â&#x2014;&#x2020;

the athlete the best care we reasonably can. Our doctors donâ&#x20AC;&#x2122;t have a lot of ego where thatâ&#x20AC;&#x2122;s concerned.â&#x20AC;? â&#x2014;&#x2020; A version of this article also appears in T&Câ&#x20AC;&#x2122;s sister publication, Athletic Management.

WEB RESOURCES Before hiring a new team physician, itâ&#x20AC;&#x2122;s a good idea to check his or her practice background. Here are some resources: â&#x2014;&#x2020; Basic educational and professional information on nearly all licensed physicians is available without charge at the American Medical Associationâ&#x20AC;&#x2122;s Physician Select service: http://dbapps.ama-assn.org/aps/amahg.htm. â&#x2014;&#x2020; More details, including state disciplinary actions, are available from most state medical boards, which are listed at the Web site of The Federation of State Medical Boards, www.fsmb.org. â&#x2014;&#x2020; The Federation also offers a fee-based ($9.95 for each doctor you want to check) online and mail-in service that allows the public to check whether physicians have been disciplined by state medical boards: www.docinfo.org.

SPORTS HEALTH Division of School Health Corp. phone fax web mail

ě?˝ (800) 323-1305 (800) 235-1305 www.esportshealth.com 865 Muirfield Drive Hanover Park, IL 60133

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▼ Sequencing and core strength are the keys to a championship throwing program, explains a top collegiate track and field coach.

BIG Throws BY DR. LARRY JUDGE

40 ◆ T & C M A R C H 2 0 0 4 ◆

Photo: Jim Burgess

n the University of Florida women’s track and field team, throwers work very hard in the weight room to increase their strength, and it shows. They helped the team win the Southeastern Conference outdoor championships, place 2nd in the indoor and 4th in the outdoor NCAA Division I championships last year. As a group, they racked up 13 AllAmerica honors including two national champions. To help them achieve their best, we structure their yearly training program very carefully. First, we split the year into two macrocycles. One has athletes peaking for the indoor national championships, and the other has them peaking at the time of the outdoor nationals. Each macrocycle is then broken up into three phases, which emphasize general training exercises, special training exercises, and competition-specific exercises, respectively. The physical components periodized over the year include resistance training, medicine ball throws, running, plyometrics, bodyweight circuits, and throws. Throughout all training, we

give special attention to developing the neuromuscular and biomechanical qualities required of a thrower. We make extensive use of Olympic lift variations, which are ideal because they develop functional hypertrophy, strength, speed, speed-strength, coordination, balance, and kinesthetic awareness. We also are careful to develop our athletes in a balanced manner. Overdevelopment of a given quality at the expense of other important qualities will diminish performance. A great

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example of this may be found in the general training period of throwers, where many coaches overemphasize hypertrophy in all muscle groups while sacrificing the basic development of the crucial explosive qualities needed for the events. Larry Judge, PhD, CSCS, is the Associate Head Women’s Track and Field Coach at the University of Florida. He was named USATF Assistant Throws Coach of the Year in 2003.

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▼ That said, however, strength remains the basis for all other aspects of training for throwers. A stronger individual will be able to do more things technically and will achieve higher levels of performance. The percentage of strength and power in the resistance training program will vary based on the stage of training, but strength training is always a major element in the training of our throwing athletes. Specificity is another concept that is vital to success in the throws, as it is in all sports. The exercises performed in training must be specifically designed for the demands of the sport. Effective program design must consider bioenergetics and metabolic parameters and movement characteristics. Movement characteristics include force magnitude, velocity, power, movement patterns, and time factors. A great sport-specific exercise for the female thrower is the mid-thigh high pull. This exercise allows maximum power development without the wear and tear of the full movement. THE CYCLES

Through the training year, we sequence exercises from high volume to low volume and from less to more sport-specific. The total program at the University of Florida is based on the concept of phase potentiation. This concept is based on the premise that specific physiological characteristics can be developed by emphasizing specific training variables. Previous phases of training will affect the outcome of future training. As mentioned at the start of this article, our program is broken up into two macrocycles. These are further broken into three to four mesocycles, each lasting three to four weeks (which is the amount of time it usually takes for adaptation to occur). Each mesocycle has a specific theme and is designed to build on the previous one. Here is how we structure our phases of training throughout the year: 1. We begin with a general preparation phase in the fall. Athletes per-

Table One: Periodization Sample his table can be used for all of the mesocycles. The only change is the number of repetitions. These percentages are based on a repetition maximum.

WEEK 1 2 3 4 • • • •

M MH H VH L

T M L VL VL

W H M L M

Very Heavy (VH) = 95-100% Heavy (H) = 85-90% Medium Heavy (MH) = 80-85% Medium (M) = 75-80%

TH M H M L

F ML L L L

S M M ML ML

• Medium Light (ML) = 70-75% • Light (L) = 65-70% • Very Light (VL) = 60-65%

Table Two: One Week

he following is an example of a one-week microcycle during the general preparation phase for throwers.

MONDAY: Warm Up, Form Drills, Plyometrics, Technique, Long Sprints, Weights, Flexibility, Cool Down

THURSDAY: Warm Up, Strength Circuit, Technique, Medicine Ball, Short Sprints, Weights, Flexibility, Cool Down

TUESDAY: Warm Up, Strength Circuit, Technique, Medicine Ball, Short Sprints, Weights, Flexibility, Cool Down

FRIDAY: Warm Up, Form Drills, Plyometrics, Technique, Long Sprints, Weights, Flexibility, Cool Down

WEDNESDAY: Warm Up, Jump Rope Circuit, Individual Technique Work, Weights, Cool Down, Flexibility

SATURDAY: Warm Up, Flexibility, Time Trial, Weights

form 10 to 12 repetitions of strength lifts and 5 to 6 repetitions of Olympic lifts. This is when our athletes complete the first mesocycle, which emphasizes strength endurance and basic conditioning. 2. The special preparation phase extends through October and November. Repetitions for strength lifts go down to 6 or 8 and for Olympic lifts, they drop to 3 or 4. During this time our second and third mesocycles are completed: the second mesocycle emphasizes squat strength (basic strength), and the third focuses on

pulling strength (speed and strength). 3. December is the specific preparation phase. Here, the number of repetitions goes up slightly from the previous phase and we complete our fourth mesocycle, which emphasizes power development (speed). 4. January and February are the months of the precompetitive phase, when strength development is the focus. Athletes perform 4 to 5 repetitions of strength lifts and 2 to 3 repetitions of Olympic lifts. We repeat our second and third mesocycles. 5. A three-week peaking and com-

SUNDAY: 10-15 Min. Easy Recovery Run, Heart Rate <100

A T H L E T I C B I D . C O M ◆ T & C M A R C H 2 0 0 4 ◆ 41

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▼ Table Three: Exercises The following are the exercises we use during the first week of the third mesocycle. DAY 1 (85%) Bench Press Speed Bench Incline Press Push Jerks Close Grips Push Downs Dips D.B. Pullovers Russian Twists Tri Crunches V-ups

DAY 3 (85%) 4x8, 1x3 3x3 3x8 4x4 3x8 3x8 3x8 2x8 3x20 3x30 3x20

Hang Snatch Snatch Pull Chin Ups Lat Pulls Seated Row D.B. Row Preacher Curl D.B. Curl Roman Situp (bands) Plate Walk

DAY 5 (75%) 4x4, 1x2 3x4 3x6 3x8 3x8 3x8 3x8 3x8 3x20 3x20

Cleans Clean Pull Squats Speed Squats Leg Curls Leg Extensions Calf Raises Back Hypers (bands) Leg Raises Russian Twists Wtd Crunch

5x8 3x4 3x8 5x4 3x8 3x8 3x8 2x8 3x20 3x30 3x20

DAY 6 (75%)

5x4 3x4 5x8 2x4 3x8 3x8 3x15 3x10 3x20 3x10 3x20

DAY 4 (75%) DAY 2 (85%) Cleans Clean Pull Squats Speed Squats Leg Curls Leg Extensions Calf Raises Back Hypers (bands) Leg Raises Russian Twists Wtd Crunch

4x4, 1x2 3x4 4x8 2x3 3x8 3x8 3x15 3x10 3x20 3x10 3x20

petitive phase coincides with the climax of the indoor season at the end of February and the beginning of March. In this phase, repetitions go down from the previous phase. We do sets of three on the strength lifts and singles on the Olympic lifts. The fourth mesocycle is repeated. 6. Another special preparation phase occurs in late March and early April, which is similar to the one in October/November, and we begin our first mesocycle again. 7. A precompetitive phase follows in May, similar to January/February. 8. A peaking phase winds up the outdoor season in June. 9. A transition phase will follow the last peaking phase. Our mesocycles are broken down into one-week microcycles. One concept we use in planning each mesocycle is overreaching, which is a planned short-term increase in training volume and/or intensity (this may actually 42 ◆ T & C M A R C H 2 0 0 4 ◆

Bench Press Speed Bench Incline Press Push Jerks Close Grips Push Downs Dips D.B. Pullovers Russian Twists Tri Crunches V-ups

result in a short-term performance reduction). The first week in each mesocycle is an overreaching microcycle. The athletes get a huge hormonal and nervous system stimulation from this high-volume microcycle, which really sets up the mesocycle. The negative signs and symptoms of overreaching that can occur are not typically as extensive or severe as those associated with overtraining. This can be reversed in two to five days with a subsequent increase in performance. The in-season peaking mesocycle is the same for the indoor and outdoor seasons. The phase is designed with a dual purpose in mind. Each week is designed for a mini-peak at the end of each week, with a major peak at the end of the phase. A typical week consists of heavy weightlifting early in the week. The repetitions are low (1-3), the exercises are basic (bench, squat, clean), and the intensity is high (80-90 percent). The

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Hang Snatch Snatch Pull Chip Ups Lat Pulls Seated Row D.B. Row Preacher Curl D.B. Curl Roman Situp (bands) Plate Walk

5x4 3x4 3x6 3x8 3x8 3x8 3x8 3x8 3x20 3x20

middle of the week consists of light lifting, mostly for nerve stimulation. The end of the week is issued for rest. As we get closer to the important competitions, the work load is decreased, and the quality is stressed. Two weeks prior to an important competition, heavy squats are discontinued and replaced with step ups, and the lifting becomes light and fast. At the end of each alternating mesocycle, an unload/testing week is employed. An unload week is a lowvolume week that is generally used for recovery and regeneration. We often use this week for some physical testing and performance trials. Tests include the standing long jump, overhead back shot throw, flying 30m, vertical jump, standing triple jump, sit and reach test, and the seated medicine ball throw. We also test our athletes on repetition maximums in the bench press, squat, power clean and snatch, and jerk. When we move into the prepara-

C O M P E T I T I V E

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▼ tion phase, we hold performance trials, which include things like standing throw tests in the shot put and discus, one turn test in the weight throw, 12 lb. shot put test, 12 lb. hammer test, 1.5 kg discus test, and 25 lb. weight throw test. Certain tests are selected for different points in the preparation phase. AT THE CORE

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One area that can not be stressed enough is core training. Trunk movements are the vital link in the body’s kinetic chain, especially for throwers. The core also has a critical role in the maintenance of stability and balance when performing movements with the extremities. It is the center of all body movements in throwing and can be critical in maintaining the stability of an anatomically correct body position. The first phase of our core training program emphasizes static sustained contractions and serves as the foundation for later strength and speed training. We start with pedestal work as part

of the training. The mid-torso musculature consists of postural muscles with a high percentage of slow-twitch muscle fibers. The athletes must hold contractions for long periods to maximize trunk stability. To best condition this region, we use variations on the weighted crunch and sit-up. Exercises should be performed slowly while working all muscle groups in the midtorso region in order to maximize abdominal development and minimize stress placed on the lower back. A good exercise to begin with is the pelvic tilt. In this exercise, the athlete lies on her back and contracts the abdominals until the low back presses into the floor. The contraction should be held for three to six seconds, followed by three to six seconds of rest, and repeated for a total duration of a minute. Once the athlete can perform acceptable slow isotonic mid-torso exercises, more exercises that demand balance can be introduced, such as exercises with physioballs.

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The next step to a more powerful trunk is strength. Exercises using kettlebells, puds, and powerballs are usually employed during the pre-competitive phase. This is also accomplished through medicine ball exercises and the general strength circuit. These exercises are performed in a more active or ballistic manner. Core exercises like the squat and variations of the squat and Olympic lifting movements are also essential for core strength. For optimal increases in strength, repetitions must be kept below 20 and all exercises must be performed with resistance. Have the athlete start with a weight she can do for 10 repetitions and keep it the same until she can perform 20. Then, increase the weight. In general, there should be a multi-faceted approach to core training that includes medicine ball work, body weight circuits, slow controlled movements, weighted abdominal exercises, ballistic release work with puds, squats, and Olympic lifts. ◆

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Catalog Showcase Power Systems, Inc.

Jump Stretch, Inc.

Biofreeze

800-321-6975, www.power-systems.com Since 1986 Power Systems has been a leading supplier of sport training, health and fitness products. The company prides itself in being the one resource for all of your training needs. Its new 2004 catalog has a new look with better graphics and photos. Included areas are core strength, medicine balls, speed, plyometrics, agility, strength equipment, strength accessories and flooring. You will find the catalog full of hundreds of new products and dozens of products available exclusively from Power Systems. It has also lowered some prices to enable the customer to get premium products at great prices. Go online or call Power Systems to request a FREE 2004 catalog today.

800-344-3539, www.jumpstretch.com Jump Stretch, inc. features the complete line of Flex-Band exercise equipment, including six sizes of large continuous-loop rubber bands that provide up to 200 lbs. of resistance per band. These heavy-duty bands are used by pro, college, and high school teams in all sports to improve speed, vertical jump, endurance, and flexibility.

800-246-3733, email: health@biofreeze.com For pain management programs, use Biofreeze to reduce swelling, pain & stiffness, next day aches and pains, and recovery time. It can also help to increase mobility and flexibility, and will aid in the overall healing process. Biofreeze can be used in situations requiring ice and breathable wraps and can be blended with water for ice cups. Biofreeze will also prolong the effects and benefits of Ultrasound and Massage Therapy treatments. For more information and your free trial package, please contact Biofreeze.

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Rich-Mar

Ferno

efi Sports Medicine

800-762-4665, www.richmarweb.com Rich-Mar is proud to announce its new 2004 catalog. The catalog details information on the 32 different models of Hands-Free Ultrasound, Hands-Free Combination devices, Stimulators, Manual Ultrasounds and Manual Combination Devices offered by Rich-Mar. For over 32 years Rich-Mar has been the leader and innovator in the field of ultrasound and electrotherapy. Call or visit Rich-Mar’s Web site to order the new catalog.

888-206-7802, www.fernoperformancepools.com Ferno Performance Pools, the leader in aquatic therapy, rehabilitation, fitness, and sports systems, offers a complete line of custom-built pools and underwater treadmill systems. Ferno offers over 250 custom pool configurations that are designed to meet any facility's need. Visit www.fernoperformancepools.com to see how you can keep your athletes in the game with low-impact, high-resistant training.

800-541-4900, www.efisportsmedicine.com efi Sports Medicine offers a wide variety of products to improve strength, power, endurance, body composition and range of motion. The noncompressive nature of efi’s flagship product, Total Gym, uses body weight as resistance and creates a safe environment for athletes to begin or continue strength training.

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Perform Better

Cho-Pat, Inc.

3-Point Products, Inc

800-556-7464, www.performbetter.com The 60-page edition of the 2004 Perform Better catalog includes a top-notch selection of high quality products for training and rehabilitation. Items are categorized into separate sections that emphasize speed and agility, plyometrics, strength and weight training, balance and stabilization. All items shown reflect the firm’s total dedication to the Functional Training concept as a way to improve training and rehab techniques. Request your FREE copy by calling toll-free or check the company's Web site.

800-221-1601, www.cho-pat.com Cho-Pat designs and manufactures specific and innovative preventive and pain-reducing sports/medical devices for the arm, leg, and knee. Incorporating unique design characteristics, excellent craftsmanship, and quality materials, our American made products are effective, dependable, durable and highly recommended by medical professionals, physical therapists, athletic trainers, athletes, and active individuals for their role in preventing or lessening pain and discomfort.

888-378-7763, www.3pointproducts.com 3-Point Products, Inc. offers innovative products for the hand and upper extremity- all designed with the active participant in mind. 3-Point’s catalog features the popular Action® Wrap line, with more choices in soft flexible thumb and wrist splints, Action® Ultra semi-flexible thumb splints, and patented Reflex® Putty for successful upper extremity strengthening. Call or visit the company’s Web site for a free catalog.

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Catalog Showcase The Gebauer Company 800-321-9348, www.gebauerco.com Gebauer’s Instant Ice™ is non-prescription and can be used like ice for minor sports injuries, minor pain and swelling from sprains, strains, bruising and contusions. In addition, stream spray can be used for muscle spasms. Gebauer’s Instant Ice works in seconds so athletes can get back in the game faster.

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National Academy of Sports Medicine

OPTP

800-460-NASM, www.nasm.org NASM has just launched its all-new Web site and online catalog at www.nasm.org. Featuring enhanced navigation, expanded information and new member benefits, the site will quickly become an industry favorite for education and development. And coming soon, NASM will debut the industry’s first interactive education resource center, a state-of-theart online universe that will revolutionize the way athletic trainers do business. Previews now available at www.nasm.org. And while you’re there, be sure to register for a complimentary membership, which includes bimonthly newsletters, special discounts and more.

800-367-7393, www.optp.com The Volume Sixteen Catalog features new publications from internationally renowned experts such as Spinal Stabilization 2nd edition by Rick Jemmett, PT The Thorax by Diane Lee, PT or Cervical Spinal Stabilization Exercises by Donald Murphy, DC. OPTP still offers such favorites as Thera-Band®, new formulated Rep-Band™, Gymnic® Balls, OPTP Foam Rollers and The Original McKenzie® Lumbar Rolls, the Stretch Out® Strap, as well as new resources based on Pilates, Post-Partum Health and Core Stability.

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VertiMax

Oakworks

NZ MFG, LLC

800-699-5867, www.vertimax.com This full-color brochure explains HOW and WHY VertiMax produces radical new improvements in explosive leg power. It shows the design and engineering that combine to produce LARGE gains in an athlete’s vertical jump and first-stepquickness. When you request VertiMax information, you get this brochure and a great demo CD showing high schools, colleges, and pro teams using VertiMax in their own weight rooms. It is in wide use in the NFL, NBA, MLB, and NHL, as well as a LONG list of Div 1 colleges. Write No. 57 on Card

800-558-8850, www.oakworks.com Oakworks therapeutic tables and chairs: quality and innovation since 1978. Having built treatment tables to therapist’s specs from the very first, Oakworks continues to strive for your absolute satisfaction through products that meet specific needs for strength, safety, durability and versatility. Oakworks began with the manufacture of massage therapy equipment more than 20 years ago and now extends the same quality and integrity to its broad product line serving the Athletic Training and Physical Therapy markets.

800-886-6621, www.nzmfg.com TurfCordz™ by NZ MFG, LLC offers the latest in high quality resistance exercise products designed to fulfill any sports training, fitness, and rehabilitation application. The catalog is filled with an extensive line of training and rehabilitation products including: TurfCordz products for strength training, MediCordz® products for rehabilitation and conditioning, and StrechCordz® products for swim training needs. Its patent-pending Safety Bungie™ and Safety Cord™ products provide the ultimate in safety for clinician and patient alike.

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Foot Management, Inc.

FLA Orthopedics, Inc.

Tanita Corporation

800-HOT FOOT, www.footmanagement.com Foot Management has provided quality foot orthotics to athletic trainers for more than 25 years. We manufacture a wide variety of orthotics to suit the needs of any patient. We also supply a variety of prefabricated insoles, footpads, foam, felt, and heel cups. We pride ourselves on our quality products and excellent customer service.

800-327-4110, www.flaorthopedics.com FLA Orthopedics® Professional Foot and Ankle Product Guide is a comprehensive guide of professional foot and ankle products available from FLA Orthopedics. Ideal for healthcare professionals treating conditions of the lower extremities. Includes product and ordering information for our extensive line of Soft Point® and PressureLite® Footcare products, ankle supports and braces, Activa® Graduated Compression Athletic Socks, StepLite® Ankle Walkers and the popular HealWell® Cub Plantar Fasciitis Night Splint.

877-682-6482, www.tanita.com Tanita manufactures a full line of digital locker room scales and body composition analyzers complete with goal-setting software to provide custom education and tracking for your athletes. Wrestler mode also available. Contact the company for more information or for a FREE demo.

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Catalog Showcase Concordia University

Creative Health

708-209-3555, www.curf.edu/~klattla/biomechanics.htm Essential viewing for coaches, athletes, parents, and rehab specialists, The Biomechanics of Throwing is a complete discussion and analysis of throwing. Proper throwing technique is essential for increasing velocity while reducing the likelihood of injury. The preparation and follow-through phases are each described in detail. The discussion and analysis of each phase is concluded with appropriate exercise progressions to enhance performance and prevent injury.

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.

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Orthopedic Pharmaceuticals 866-456-4687, www.orthogel.com Orthopedic Pharmaceuticals’ ORTHOGEL™ is an advanced pain relieving gel with natural Cox II inhibitors. ORTHOGEL™ is believed to be the premier topical to reduce pain and enhance the effects of healthcare professional’s treatments. Orthopedic Pharmaceuticals also sells a line of complementary nutraceutical products under the brand name Orthopedic Nutraceuticals™ that can be used in conjunction with the topical OTC products. Write No. 65 on Card

CogSport

Ortho-Therm

PROTEAM by Hausmann

sales@cogsport.com, www.cogsport.com The CogSport Complete Concussion Management System incorporates the CogSport test and the latest evidence-based concussion management guidelines to assist physicians provide state-of-the-art medical management of concussed athletes. The CogSport computerized neuropsychological test is a highly reliable and sensitive measure of post-concussion cognitive function. CogSport is designed for use as a component of the pre-participation medical examination (baseline testing) and as the critical component of the post-concussion medical examination (post-concussion testing).

888-296-7846, www.ortho-therm.com Ortho-Therm's brochure contains the complete listing of the individual bandage wraps, including the features and benefits. It also provides a listing of the parts included in each travel kit, plus a listing of additional accessories. It describes how to change the ortho pad; i.e., the turning of a shoulder wrap into a knee or back wrap. This in turn increases OrthoTherm’s flexibility plus saves money in the process.

888-HAUSMANN, www.proteamtables.com PROTEAM by Hausmann, a Specialty Division of Hausmann Industries, Inc., has recently introduced a new concept in athletic trainer’s tables and treatment furniture. PROTEAM provides customized, modular taping stations to fit any space and any need. PROTEAM provides professional teams, colleges, and high schools with a full line of treatment and exam tables, split leg tables, mat platforms, stools, benches, cabinets, and stadium lockers. PROTEAM’s durable laminates allow for ease of maintenance, contamination control, and stain resistance. School colors can be matched on contract sales. New catalog available in June 2004.

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BodyGlide

ImPACT Applications, Inc.

Sports Health

888-263-9454, www.bodyglide.com BODYGLIDE® products are revolutionary. They are reliable, long lasting, allow perspiration to escape, and they won’t sweat off. No petroleum or oils, and they are non-greasy. BODYGLIDE® Skin Lubricant comes with or without sunscreen. WarmFX™ Muscle Conditioner stays hot—and you don’t need gloves to apply it. Not just better—simply the best.

877-646-7991, www.impacttest.com ImPACT is a research-based software program designed to help evaluate and manage concussions. ImPACT is practical, userfriendly, and easily administered by an athletic trainer. Ideally, athletes are tested in the preseason, providing a baseline of each individual’s cognitive abilities. If an athlete sustains a concussion, ImPACT can be used to evaluate cognitive functioning; it provides objective and sensitive information helpful in determining complete recovery from injury and safe return to play.

800-323-1305, www.esportshealth.com Sports Health, a division of School Health Corporation, offers one-stop shopping for all of your sports medicine needs! The new 2004 catalog is filled with thousands of products and resources to help you train and condition the athletes in your care. As long-time supporters of professionals in the field of sports medicine the company specializes in personalized service, ontime delivery, zero product substitutions and product expertise. From athletic tape to vital signs monitoring, from training room furnishings to foams and felts—Sports Health has it all.

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AliMed 800-225-2610, www.alimed.com AliMed has introduced its newest catalog devoted exclusively to Sports Medicine, featuring a comprehensive selection of products relating to performance and the treatment and rehab of sportsrelated injuries. You'll find training, physical therapy, and orthopedic supplies, along with braces, modalities, exercise equipment and much more. AliMed is one of the leading manufacturers and distributors of healthcare supplies, distributing more than 25,000 products worldwide. Write No. 72 on Card

PowerPlyos 866-672-1700, www.poweringathletics.com PowerPlyos from PoweringAthletics is designed to develop flexibility, strength, and explosive power through plyometric training. The unit can be configured for several different eccentric and concentric exercises, including jumps, flexions, and trunk rotations. On the ice, on the court, or on the field, every athlete can benefit from this versatile training aid. Call or visit PoweringAthletics on the web to request a free product catalog. Write No. 73 on Card

Hammer Strength 800-634-8637, www.hammerstrength.com Hammer Strength, the global leader of plateloaded equipment, offers customers a product brochure highlighting its extensive plate-loaded Ground Base and benches and racks offerings. The indepth brochure includes product specifications, options, and colors. The brochure also lists its top customers, including the NFL, NBA, NHL, MLB, top collegiate programs, and health clubs. To request a brochure or for more information, call Hammer Strength or visit its Web site. Write No. 74 on Card

Therapy pool speeds Educational programs available for sports rehab process for medicine and rehab Clemson professionals

Four years ago, Clemson University searched for a therapy and rehabilitation pool that would help their athletes get back in the game faster. They chose a Ferno Performance Pool and AquaGaiter™ Underwater Treadmill because the system could be customized to their specific needs, and was affordable. Ferno also answered Clemson’s needs by developing an AquaGaiter lift to make raising and lowering the system into the pool easier and more efficient. In addition to customized options, Ferno’s aquatic equipment offers Clemson athletes a low-impact, high resistance workout or therapy session.

Clemson’s Ferno Performance Pool and AquaGaiter Underwater Treadmill were instrumental in rehabilitating a former Clemson quarterback, who is now a running back for the Atlanta Falcons.

"(Our former quarterback) suffered a serious ankle injury, but we were able to rehabilitate and train him in a Ferno pool, which he wouldn’t have been able to do on the field. He was able to finish the season and put himself in position to be drafted and continue his quest to play in the NFL."

Danny Poole Head Trainer/Sports Medicine Clemson University

The Functional Video Digest Series, from Functional Design Systems, is a monthly subscription service approved by the NATA, NASM, NSCA, and APTA in most states for Continuing Education Units. These 90minute videos cover a wide variety of topics important to trainers and other athletics professionals (see list of current titles below). FDS also produces QUEST videos (Quality Understanding and Enhancing Sports Training), and biomechanicallydesigned fitness products, such as True Stretch and the Functional 3D Testing System. Owner/operator Gary Gray is a physical therapist, trainer, author, and is considered one of the pioneers of functional training. Functional Video Digest Series (current titles & topics): The Knee: From Bottom to Top/From Top to Bottom/From Inside Out/From Outside In The Trunk: The Core, The Belly, The Crossroads of our Body The Mostability Shoulder: Every Which Way but Loose The Foot: Our Foundation The Hip: 3D Power Balance: The Time of Transformation Lumbar Spine: The Transverse Plane Transformer Thoracic Spine: The 3D Cage Cervical Spine: Both Ends of the Chain Walking: Simple Complexity Throwing: The Chain Reaction Whip Lifting: 3D Loading ACL Prevention: Threshold Training Abdominals: Power Potential The Elbow: Hinge Reaction Jumping: Unleashing the Load Patella Femoral: The Train & The Track Scapula: The PeltrunkULA Running: More Than Just Faster Walking SI Sacroiliac: Dynamic Fixture of Function Calf: The Achilles Hip

Ferno Performance Pools 70 Weil Way, Wilmington, OH 45177 888-206-7802 info@fernoperformancepools.com

Functional Design Systems, LLC 1042 Sutton Rd., Ste. 1, Adrian, MI 49221 517-266-4653 info@functionaldesign.com

WWW.FERNOPERFORMANCEPOOLS.COM

WWW.FUNCTIONALDESIGN.COM

Hot & Cold Therapy CREATIVE HEALTH PRODUCTS 800-742-4478 WWW.CHPONLINE.COM Creative Health Products, a leading discount supplier of rehabilitation, fitness, therapy, exercise and athletic testing and measuring products, offers the Battle Creek Thermophore Heating Pad. The unique design promotes very effective, moist, deep heat with a wider range of temperature settings possible than with other heating pads. Great for therapy of the back, hips, chest, legs, abdomen etc… Available in three sizes: 4” by 17”, 14” by 14”, and 14” by 25”. Write No. 75 on Card

BIOFREEZE 800-246-3733 E-MAIL: HEALTH@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 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. For more information and your no-charge trial package please contact the company. Write No. 76 on 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 mini-

TAKE YOUR TRAINING TO THE TOP CORE STABILIZATION FOR ATHLETES Steve Brown, CSCS University of Wisconsin-Whitewater ©2003 • 827008957033 • VHS 80 minutes • $40.00 Presents an arsenal of exercises aimed at strengthening and stabilizing the athlete’s core. The video features exercise progressions that offer coaches and trainers the ability to train athletes of various strength and skill levels. Key points for ensuring proper execution of exercises are shown, allowing for easier incorporation into training programs. Among the topics covered are: Execution of the drawing-in maneuver, abdominal exercises for the inner and outer abdominal musculature, isometric core stability exercises, extension exercises for the back, stability ball exercises, core strength and stabilization exercises performed in a standing position. Produced in cooperation with the National Strength and Conditioning Association.

FITNESS PROFESSIONALS' GUIDE TO MUSCULOSKELETAL ANATOMY AND HUMAN MOVEMENT Lawrence A. Golding, Ph.D., FACSM Univ. of Nevada, Las Vegas & Scott Golding, M.S. E-2 Systems ©2003 • 1585187062 • Book & CD • 256 pp. • $59.95 Provides a comprehensive overview of musculoskeletal anatomy and human movement. Features a full-color illustration and a brief description of each muscle, as well as information on its joint crossings, associated body actions, blood supply, controlling nerves, and insertion and origin. Includes a one-of-a-kind, easyto-use CD-ROM, developed specifically as a companion to this text, that provides live-action video demonstrations to vividly illustrate how each of the muscles and body actions described in the book applies to over 300 specific exercises and physical activities.

Momentum Media 2488 North Triphammer Rd Ithaca, New York 14860 Shipping is $6.50 for 1st item; $1.50 for each add’l item

607.257.6970

mizes 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. Biofreeze is available in a no-touch rollon, perfect for a trainers’ supply bag. Write No. 77 on Card

FLA ORTHOPEDICS, INC. 800-327-4110 WWW.FLAORTHOPEDICS.COM Thermal Lumbar Supports, from FLA Orthopedics, Inc., are ideal for treating minor back aches and pains resulting from sprains, muscle soreness and strains, cramping, or contusion (bruising). The supports feature a reusable soft gel pack with thermal gel that is microwavable for therapeutic heat and freezable for cold therapy. The supports also offer plush, ventilated elastic panels—lightweight for cool, comfortable compression. The panels overlap to give a contouring shape to most body types. Thermal Lumbar Supports are available in black and beige, and offer easy application. Write No. 78 on Card

GAME READY INC. 866-266-5797 WWW.GAMEREADY.COM Trainers for more than 50 pro teams and 70 universities turn to the Game Ready Accelerated Recovery System to help their injured athletes heal faster. The portable system consists of a control unit, which delivers adjustable cold therapy and four levels of intermittent compression, and patented wraps based on NASA spacesuit technology. The easy-to-administer treatment reduces pain and swelling, resulting in accelerated recovery time and stronger healing. Write No. 79 on Card

THE GEBAUER COMPANY 800-321-9348 WWW.GEBAUERCO.COM The Gebauer Company has introduced Gebauer’s Spray and Stretch, which replaces

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Hot & Cold Therapy Gebauer’s Fluori-Methane. Non-ozone depleting Gebauer’s Spray and Stretch is a nonflammable topical skin refrigerant intended for use with the Spray & Stretch Technique in the management of myofascial pain, restricted motion, muscle spasms and the temporary relief of minor sports injuries. Used to reduce or relieve the initial trauma of an injury, Gebauer’s Spray and Stretch controls the pain of bruises, contusions, swelling and minor sprains. Write No. 80 on Card From the most trusted name in skin refrigerants for over 100 years comes a new, nonprescription topical skin refrigerant, Gebauer’s Instant Ice™. Use it like ice for the temporary relief of minor pain and swelling from sprains and strains, minor sports injuries, bruising and contusions. Now instead of using ice to treat on-the-scene minor sports injuries, high school and recreational league coaches, high school athletic trainers, and others will now be able to use

what professional athletic trainers use. In fact, Jim Ramsay, head athletic trainer for the New York Rangers, has been using Gebauer topical skin refrigerants for years. “Instant Ice is great for on-the-scene care,” said Ramsay. “If a player gets hit on the wrist or takes a puck off the shin, I can easily anesthetize the area with Instant Ice to reduce the pain, allowing the player to get back in the game quickly.” Write No. 81 on Card

JUDAH MANUFACTURING CORP. 800-618-9793 WWW.JUDAHMANUFACTURING.COM Judah Analgesic Cream is a nongreasy topical cream that is used to relieve pain, swelling, sore muscles, sprains, strains, backaches, and stiffness. The

product can be used either before or after exercise. To relieve muscle tension, massage it into the affected area for 20 seconds, and then apply a second treatment 60 seconds later. Judah Analgesic doesn’t have a strong smell like other topicals on the market, and its deep-penetrating formula provides relief immediately. Write No. 82 on Card

ORTHOPEDIC PHARMACEUTICALS 866-456-4687 WWW.ORTHOGEL.COM ORTHOGEL™ Cold Therapy advanced pain relieving gel contains menthol (3.5%), camphor (.2%), Ilex, Aloe, E, Glucosamine, Boswellia, Curcumin and OptiMSM. Healthcare Professional’s patients will feel less pain and their purchasing agents will too with this advanced product. ORTHOGEL™ is believed to be the premier topical to enhance the effects of treatments. Write No. 83 on Card

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Write us, Fax us at PERFORM BETTER • 11 Amflex Drive • P.O. Box 8090 • Cranston, RI 02920-0090 • Toll-Free Fax 800-682-6950 Request No. 29 A T H L E T I C B I D . C O M ◆ T & C M A R C H 2 0 0 4 ◆ 49

Hot & Cold Therapy Orthopedic Pharmaceuticals ORTHOGEL can be used in conjunction with Joint Formula with OptiMSM to assist the body with the natural healing process. The product contains Glucosamine 1,500 mg, Chondroitin 600 mg, MSM 600 mg, Bromelain, Zinc, Vitamin C and natural Cox II Inhibitors such as Boswellia Serrata and Curcumin. This high quality product utilizes capsules from CAPSUGEL, a division of Pfizer. These products are used by leading healthcare professionals. For more information call the company or visit www.4joints.com. Write No. 84 on Card

injury prevention. For heat therapy to be effective, it must be safe, timed, and controlled. Only OrthoTherm provides all three. It is powered by 12 volts for safety; it is timed to automatically shut off at 30 minutes for maximum benefits; and it is controlled to give 107˚F to 110˚F for maximum results. Write No. 85 on Card

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.

ORTHO-THERM 888-296-7846 WWW.ORTHO-THERM.COM Ortho-Therm is an ortho wrap plus heat therapy pad for injury rehabilitation and warm-up

Standard 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. Write No. 86 on 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. Write No. 87 on Card

foot management, inc. Custom Orthotics & Foot Related Products

Static Calf Stretcher: O O

O O O

$18.00 + Shipping

Designed to help relieve Plantar Fasciitis and tight sore calf muscles Made with a weather resistant material that can be used on the sideline, around the pool, or indoors without scratching the ﬂoor Perfect for use with cleats; no slipping while stretching Lightweight for easy packing and travel Can be used in the weight room for maximizing lower leg exercises

“Wear What the Pros Wear” 1-800-HOT-FOOT www.FootManagement.com info@FootManagement.com Request No. 30 50 ◆ T & C M A R C H 2 0 0 4 ◆

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Aquatic Therapy FERNO PERFORMANCE POOLS 888-206-7802 WWW.FERNOPERFORMANCEPOOLS.COM Ferno offers over 250 custom and fiberglass therapy, rehabilitation, and fitness pools. With various sizes, depths, and custom configurations available, Ferno offers a pool for every facility. Add an underwater treadmill, aquatic bike, or high-resistance therapy jets for the ultimate low-impact workout or therapy session. Other accessories include pool lifts, benches, and exercise bars. Ferno pools include professional installation by factory technicians. Maximize your athletes’ performance with Ferno Performance Pools. Write No. 88 on Card

Transform a traditional swimming or lap pool into an aquatic exercise environment with the Ferno AquaGaiter™ Underwater Treadmill. Combining traditional treadmill training with the natural properties of water such as buoyancy, resistance and heat, the AquaGaiter is perfect for a lowimpact workout. The AquaGaiter features variable speed adjustments ranging from .5 to 8 mph for any level of conditioning. The AquaGaiter provides athletes the ultimate water workout by strengthening muscles and reducing joint impact. Write No. 89 on Card

Advanced Heat Treatment Ortho-Therm offers: ● Safe...Timed...Controlled heat plus the compressive support of an ortho wrap ●

OPTP 800-367-7393 WWW.OPTP.COM OPTP offers Fin & Flipper® Exercise Logs that can be used on either the hands or feet. Simply slide the hand or foot through the innovative Fin & Flipper slot and begin to exercise. The unique soft foam is comfortable and the grip-free design does not require grip strength. The Fin & Flipper Exercise Logs can be used for a variety of functions. They can be used as a gentle flotation aid for relaxing, resistance in the water for muscle strengthening and conditioning, and for cardiovascular training. Write No. 90 on Card

More than 5,000 Products for Sports Medicine

For rehabilitation and wear during warm up

Available for: ● Shoulders ● Knees ● Hip/Lower Back/Ham Strings ● Hand & Wrist

Call or Visit Us! (888) 296-1846 or www.ortho-therm.com BCB Products 5520 East 2nd Street Long Beach, CA 90803

Request No. 31

The Dorsal PF Night Splint is part of AliMed’s new line of orthotics offered in its 2004 Sports Medicine Catalog.

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Aquatic Therapy The AquaBodyCiser, also from OPTP, is a unique product that is perfect for overall body fitness and targeting low back pain. A physical therapist and a team of rehabilitation specialists specifically designed the AquaBodyCiser to help the medical and fitness communities. Use it to incorporate versatile, exciting, and innovative approaches to exercise and rehabilitation programs. It may be used for strengthening the muscles in the lumbopelvic and abdominal regions, lumbar stabilization, cardiovascular exercise, and rehabilitation of the knee and shoulder. The AquaBodyCiser also encourages stabilization and strengthening of the spine through low-impact exercise. Write No. 91 on Card

POWER SYSTEMS, INC. 800-321-6975 WWW.POWER-SYSTEMS.COM Reduce strain and stress on the body and perform exercises you might be unable to do on land. During long vigorous workouts, individuals who are overweight or have joint/muscle pain due to injuries cannot complete dynamic tasks due to the high demands being placed on their body. In weight loss or rehabilitation exercises, individuals need to be able to reduce the amount of stress being placed on their body while also be challenged so that they can get the results they need and desire. The Flotation belt allows individuals to exercise and rehab injuries at a high level of intensity without overloading the body’s physical ability/limits. Power Systems offers a complete line of Aquatic Training equipment to fit your needs. Write No. 92 on Card

Weight training for the water? ECO Bells from Power Systems are just what they look like, dumbbells. The only twist to these dumbbells is that they float. Instead of providing you with a set amount of weight the ECO Bells are designed to provide you with various levels of resistance while under water. They can also be used on top of the water for buoyant support and stabilization while performing lower body exercises. You will be able to achieve a full range of motion while activating muscles, which will in turn improve joint stability and stimulate muscle growth. Power Systems offers a complete line of Aquatic Training equipment to fit your needs. Write No. 93 on Card

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Oakworks . . . . . . . . . . . . . . . . . . .107 . . . . . . . .58 OPTP (AquaBodyCiser) . . . . . . . . . . . . . 91 . . . . . . . .52 OPTP (Fin & Flipper Exercise Logs) . . . . . . . 90 . . . . . . . .51 Ortho-Therm . . . . . . . . . . . . . . . . . . 85 . . . . . . . .50 Orthogel . . . . . . . . . . . . . . . . . . . . 83 . . . . . . . .49 Power Systems (ECO Bells) . . . . . . . . . 93 . . . . . . . .52 Power Systems (Flotation Belt) . . . . . . . 92 . . . . . . . .52 PROTEAM by Hausmann . . . . . . . . .108 . . . . . . . .58 Scandinavian Consulting (Lojer Twin Tower)109 . . . . . . . .59 Scandinavian Consulting (Plyo Jumper) .110 . . . . . . . .59 Sports Health (BODY DOME) . . . . . . . . .112 . . . . . . . .59 Sports Health (NONIN 3100 Wrist OX) . . .111 . . . . . . . .59 Train To Play . . . . . . . . . . . . . . . . . .113 . . . . . . . .59 Whitehall Manufacturing (moist heat) . . 86 . . . . . . . .50 Whitehall Manufacturing (ThermaSplint) 87 . . . . . . . .50 CATALOG SHOWCASE 3-Point Products . . . . . . . . . . . . . . .53 . . . . . . . . .44 AliMed . . . . . . . . . . . . . . . . . . . . . .72 . . . . . . . . .47 Biofreeze . . . . . . . . . . . . . . . . . . .47 . . . . . . . . .44 BodyGlide . . . . . . . . . . . . . . . . . . .69 . . . . . . . . .46 Cho-Pat . . . . . . . . . . . . . . . . . . . . .52 . . . . . . . . .44 CogSport . . . . . . . . . . . . . . . . . . . .66 . . . . . . . . .46 Concordia University . . . . . . . . . . . .63 . . . . . . . . .46

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Creative Health Products . . . . . . . . .64 . . . . . . . . .46 efi Sports Medicine . . . . . . . . . . . . .50 . . . . . . . . .44 Ferno . . . . . . . . . . . . . . . . . . . . . .49 . . . . . . . . .44 FLA Orthopedics . . . . . . . . . . . . . . .61 . . . . . . . . .45 Foot Management . . . . . . . . . . . . . .60 . . . . . . . . .45 Gebauer . . . . . . . . . . . . . . . . . . . .54 . . . . . . . . .45 Hammer Strength . . . . . . . . . . . . . .74 . . . . . . . . .47 ImPACT Applications . . . . . . . . . . . .70 . . . . . . . . .46 Jump Stretch . . . . . . . . . . . . . . . . .46 . . . . . . . . .44 NASM . . . . . . . . . . . . . . . . . . . . . .55 . . . . . . . . .45 NZ Manufacturing . . . . . . . . . . . . . .59 . . . . . . . . .45 Oakworks . . . . . . . . . . . . . . . . . . . .58 . . . . . . . . .45 OPTP . . . . . . . . . . . . . . . . . . . . . . .56 . . . . . . . . .45 Ortho-Therm . . . . . . . . . . . . . . . . . .67 . . . . . . . . .46 Orthogel . . . . . . . . . . . . . . . . . . . .65 . . . . . . . . .46 Perform Better . . . . . . . . . . . . . . . .51 . . . . . . . . .44 Power Systems . . . . . . . . . . . . . . . .45 . . . . . . . . .44 PoweringAthletics . . . . . . . . . . . . . .73 . . . . . . . . .47 PROTEAM by Hausmann . . . . . . . . .68 . . . . . . . . .46 Rich-Mar . . . . . . . . . . . . . . . . . . . .48 . . . . . . . . .44 Sports Health . . . . . . . . . . . . . . . . .71 . . . . . . . . .46 Tanita . . . . . . . . . . . . . . . . . . . . . .62 . . . . . . . . .45 VertiMax . . . . . . . . . . . . . . . . . . . .57 . . . . . . . . .45

Performance Apparel What athletes are wearing underneath their uniforms. By Dale Strauf, Athletic Equipment Manager, Cornell University, and President of the Athletic Equipment Managers Association You don’t want to purchase any type of undergarment until you have had an opportunity to field-test it. In conducting the field-test, evaluate the garment in the following areas: O O O O

Does it perform the way it is supposed to on the athlete? Does it hold its shape during use? Does the fabric appear to be durable? Are the seams finished off and reinforced so that they’ll hold over time? O Is the waistband stitched enough so that it won’t be abrasive to the athlete? O Does it hold its color when you wash it?

MCDAVID SPORTS/MEDICAL PRODUCTS 800-237-8254 WWW.MCDAVIDINC.COM Product Name: McDavid Body Shirts (hDc Performance Apparel) Features: Nylon/spandex construction with hDc Technology offers premium compression support Fabric content: 85% nylon, 15% spandex Styles Offered: Long sleeve, short sleeve, sleeveless (mock/crew) Single-layer or multi-layer construction? Single-layer Perspiration Wicking Qualities: hDc is a permanent compound that absorbs moisture and disperses it into the fabric evaporating moisture quickly. Chemical Treatments Used: Ultra hDc, hDc Write No. 94 on Card Product Name: Microfiber Shirts (hDc Performance Apparel) Features: Microfiber loosewear is an ultra light micro polyester that provides maximum comfort. Fabric content: 100% micro polyester Styles Offered: Long sleeve, short sleeve, sleeveless (mock/crew)

You should field-test the garment by letting one of your more active players—someone who’s really going to give it a lot of punishment—wear it during workouts. It’s best to conduct the testing right after the season is over during conditioning workouts. Have the athlete wear it for a minimum of two weeks to properly test it. You shouldn’t have any problems getting companies to provide you with product to field-test. The companies that are really confident in their product will have no problem giving you a sample to test. Let the company know that you will return the sample to them at their request. If the undergarment holds up to its claims during the fieldtestings, and the price and features meet your needs, then you know you are purchasing the right undergarment for your athletes.

Single-layer or multilayer construction? Single-layer Perspiration Wicking Qualities: hDc is a permanent compound that absorbs moisture and disperses it into the fabric evaporating moisture quickly. Chemical Treatments Used: Ultra hDc, hDc Write No. 95 on Card

NIKE WWW.NIKETOWN.COM Product Name: Nike Pro Compression Features: Nike Pro Compression is featured in sleeveless, long sleeve, mock, and tees, as well as shorts and tights. Nike Pro Compression provides cool, lightweight support for your workout. Made with stretch Dri-FIT technology designed to keep you dry and comfortable while enhancing athletic performance. Fabric Content: 62% polyester, 22% nylon, 16% spandex Styles Offered: Nike Pro featured in a sleeveless, long sleeve, mock, tee, short, and tight.

Single-layer or multi-layer construction? Single-layer Perspiration Wicking Qualities: Made with stretch Dri-FIT technology designed to keep you dry and comfortable while enhancing athletic performance. Chemical Treatments Used: In addition to fiber construction there is a wicking chemical finish. Write No. 96 on Card Product Name: Nike Pro Vent Features: Nike Pro Vent provides cool, lightweight support for your workout. Strategically placed vents are laminated to DriFIT fabric to improve air flow and keep you dry and comfortable while enhancing athletic performance. Fabric Content: Body: 82% polyester, 18% spandex Mesh: 86% polyester, 10% spandex, 4% other Styles Offered: Nike Pro Vent is featured in a sleeveless, long sleeve, and short sleeve top. Perspiration Wicking Qualities: Made with stretch Dri-FIT technology designed to keep you dry and comfortable while enhancing athletic performance. Chemical Treatments Used: In addition to fiber construction there is a wicking chemical finish. Write No. 97 on Card

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Concussion Management Q. WHAT DOES YOUR COMPANY OFFER TO MINIMIZE OR TO REDUCE THE LIKELIHOOD OF CONCUSSIONS?

The complete concussion management system

CogSport WWW.COGSPORT.COM E-MAIL: SALES@COGSPORT.COM

Brain-Pad, Inc. WWW.BRAINPADS.COM E-MAIL: INFO@BRAINPADS.COM FOUNDED: 1996

he CogSport Complete Concussion Management System incorporates the CogSport test and the latest evidence-based concussion management guidelines to assist physicians in providing state-of-the-art medical management of concussed athletes. The CogSport computerized neuropsychological test is a highly reliable and sensitive measure of post-concussion cognitive function. It is free of the confounding effects of culture, language, education and intelligence, using motivating playing cards as stimuli. CogSport is designed for use as a component of the pre-participation medical examination (baseline testing) and as the critical component of the post-concussion medical examination (post-concussion testing). “The CogSport complete concussion management system allows sporting organizations to provide their athletes with the best possible medical care and ensure their safe and efficient return to sport.” Dr Paul McCrory, Neurologist and Sports Physician Editor, British Journal of Sports Medicine

Write No. 98 on Card

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he Brain-Pad® mouthguard is unlike upper only mouthguards. It protects against lower jaw impact concussions and skull fractures at the base of the brain. Its patented bimolar design stabilizes and secures the lower jaw, providing protection from impacts to the helmet, facemasks and retention systems. The lower jaw is automatically repositioned into a slightly down and forward position creating a safety space at the base of the skull and it is secured by the upper/lower design. This greatly lessens the risk of the jaw slamming into the base of the brain and other vital nerves and blood vessels located around the jaw joint structure. The Brain Pad protects the upper and lower teeth, fits over braces and increases endurance by allowing athletes to breath through the mouth even while maintaining a stable jaw position.

Write No. 99 on Card

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ImPACT Concussion Management Software WWW.IMPACTTEST.COM E-MAIL: LRUSSO@IMPACTTEST.COM FOUNDED: 2001

mPACT is a research-based software program designed to help evaluate and manage concussion in athletes. The program is practical, user-friendly, and easily administered by an athletic trainer or physician. Ideally, athletes involved in contact sports are tested in the preseason, providing a baseline of each individual’s cognitive abilities. If an athlete sustains a concussion, ImPACT can be used to evaluate cognitive functioning (memory, processing speed, reaction time), as well as post-concussive symptoms. ImPACT is highly sensitive and can document even subtle deficits associated with concussion. Research demonstrates that athletes are at greater risk for chronic difficulties from concussion if they continue to experience deficits from an initial concussion. Using ImPACT provides objective and sensitive information helpful in determining complete recovery from injury and safe return to play.

Write No. 100 on Card

Concussion Management

Kansas City Chiefs dentist teams with Cramer to produce safer mouthguards Cramer Sports Medicine was looking to create a safer mouthguard, and it turned to Dr. Kevin Cummings, team dentist of the Kansas City Chiefs to come up with a solution. The result is the ProShox Mouthguard, a comfortable mouthguard which is thick enough to help minimize the impact of a bone-jarring hit to a football player and reduce the likelihood of a concussion.

However, a thick mouthguard may feel too bulky and be uncomfortable for the athlete to wear. “We worked with Dupont on developing a shock absorbing material with the right thickness, and we tested the prototype thoroughly,” said Dr. Cummings. “We came up with the right materials and thickness so that it is comfortable for the athlete and still thick enough to provide proper protection.” Through the combined efforts of Cummings and Cramer, the ProShox offers the benefits of a customized-fitting, dentist-fitting mouthguard at a lower price—without an expensive trip to the dentist. “A mouthguard cutomized by a dentist would cost about $150,” said Cummings. “The ProShox provides a similar fit and protection as a dentistdesigned guard at a cost of less than $20.” The beauty behind the ProShox is that it is fitted to the athlete in the same manner that a dentist would take upper teeth impressions, yet the fitting can be done by the athlete through the familiar “boiland-bite” process. “The ProShox is contained in a carrier tray with a handle,” explains Cummings. “The guard stays in the tray while it is heated. The handle allows the athlete to make the type of impression that a dentist would make, and this allows you to really customize the piece to the athlete’s needs and comfort. No other mouthguard uses this type of rigid tray to fit the athlete.”

Cramer Products, Inc. P.O. Box 1001 Gardner, KS 66030 913-856-7511

A mouthguard constructed of ethylene vinyl acetate materials with the proper thickness can reduce the likelihood of a concussion. If the mouthguard is thick enough, it will act as a shock-absorber between the upper and lower set of teeth, thereby displacing the joint and reducing the chance that the bone in front of the inner ear will be traumatized and cause a jaw-related concussion.

Another innovation behind the ProShox is that each unit comes with an informational CD-ROM that contains instructions for initializing the mouthguard so that it properly fits the athlete. “The CD gives step-by-step directions on how to heat the ProShox and create the correct fit,” explains Cummings. “No other mouthguard comes with these types of instructions in such an easy-to-apply format.”

WWW.CRAMERSPORTSMED.COM

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More Products ALIMED 800-225-2610 WWW.ALIMED.COM The FREEDOM Dorsal PF Night Splint, from Alimed, is part of the new line of orthotics offered in the company’s 86page 2004 sports medicine catalog. The FREEDOM Splint features a low-profile, lightweight design with extra padding that provides total comfort during sleep. Splint cradles the foot in a neutral position through the night or anytime—it’s safe for ambulation. The straps adjust easily to ensure a perfect fit every time. Write No. 101 on Card

BRAIN-PAD, INC. 888-424-9477 WWW.BRAINPADS.COM LoProFEM™, from Brain-Pad, Inc., is the first oral appliance specifically designed to protect female athletes from high-impact related and dental sports injuries. The LoProFEM allows for a do-it-yourself perfect custom fitted mouthguard at a fraction of the cost of a fabricated dental appliance, and it is available in a youth size that will fit over braces. It also allows the athlete to speak and breathe easily. Manufacturer's suggested retail price is $12.95. Write No. 102 on Card

MAJOR LEAGUE MUSCLE 330-620-1511 WWW.MAJORLEAGUEMUSCLE.COM The Buster Forearm Developer by Major League Muscle was designed to develop the most overlooked area of any player, the forearms and hands. Exercise and condition top and bottom of both forearms simultaneously with constant resistance. Pitchers will increase velocity, and by changing the grip on the ball they develop secondary muscles used for dif-

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ferent pitches in the hand and forearm. Improve throwing, hitting and fielding quickly and easily while preventing injury. Visit the company’s Web site for more details. Write No. 103 on Card

MISTRAL COOLING SYSTEMS 888-540-8770 WWW.MISTRALCOOLING.COM The new 2004 line of misting fans, from Mistral Cooling Systems, includes a portable model and a wide range of wall mounted systems. A Mistral system provides economically viable means of providing a safe and comfortable open-air area, regardless of weather. The operator can set the mist to match the conditions, giving maximum cooling and conserving water. The industrial-grade construction insures that Mistral systems will perform for years to come. Write No. 104 on Card

NASM 800-460-6276 WWW.NASM.ORG The athlete’s ability to consistently perform at higher levels while avoiding injury is essential to his long-term success in any sporting arena. Drawing on the exclusive Optimum Performance Training™ (OPT™) method—a system that has successfully empowered peak performance in professional, Olympic, college and highschool athletes—Optimum Performance Training™ for the Performance Enhancement Specialist sets the international pace for athletic-training and sportsmedicine professionals. Write No. 105 on Card Flexibility is one of the most overlooked components in today’s fitness programs but can make or break even the most carefully designed training program. With several types of flexibility available, it is important to understand how to incorporate each technique into a workout. The

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IFS course from NASM explores the most common stretching techniques, static, neuromuscular, selfmyofascial, active and dynamic, for improved performance and decreased risk of injury. Write No. 106 on Card

OAKWORKS 800-558-8850 WWW.OAKWORKS.COM The Portable Taping Table Carry Case, from Oakworks, is the perfect teammate with the portable taping table. This heavy duty ballistic nylon carrying case, specially designed to fit our portable taping table, features dual side zippers, a nonslip shoulder strap and includes a convenient outside pocket for field feet. Completely padded, this case will protect your table through many seasons both at home and on the road. Write No. 107 on Card

PROTEAM BY HAUSMANN 888-428-7626 WWW.PROTEAMTABLES.COM PROTEAM by Hausmann, a Specialty Division of Hausmann Industries, Inc., introduces a new concept in athletic trainer’s tables and treatment furniture. PROTEAM provides customized, modular taping stations to fit any space and any need. You can add, change or relocate modules as your needs change. PROTEAM products feature maintenance-free, laminate surfaces for years of carefree use. PROTEAM’s high-density foam tops and optional nylon-reinforced vinyl ensures the extra durability you are looking for. School colors can be matched on contract sales. Write No. 108 on Card

More Products SCANDINAVIAN CONSULTING, INC. 602-442-2088 WWW.SCIPULLEYS.COM The Lojer Twin Tower is a 5’ x 6’ freestanding ultimate exercise machine for all functional qualities of soft tissues. Its two-pound weight increments allow for early exercise intervention. Its speed properties allow for dosing an exercise according to functional speed of movement without the weight stack overcoming inertia. It addresses core stability by dosing the extremities unevenly forcing the multifidib to respond in order to maintain posture alignment in space. It aids in improving joint mobility by using the stacks to aid normal glide of joint surfaces during active movement. The 6:1 ratio speed weight stacks allow up to 30 feet of resistive gait with a resistance of up to 80 pounds. Write No. 109 on Card The new Plyo Jumper, created by Scandinavian Consulting, Inc., is designed to treat the post-op and low-level patient, as well as help your sports enhancement people make their gains. The Plyo Jumper can be adjusted from 10 to 60 degrees, and can also be loaded with a speed (low inertia)

pulley. This gives the therapist the versatility of a deloading function all the way up to high end plyometric training. Write No. 110 on Card

SPORTS HEALTH 800-323-1305 WWW.ESPORTSHEALTH.COM Sports Health offers the NONIN 3100 Wrist OX. This small, lightweight pulse oximeter is designed to be worn comfortably on the patient’s wrist. This versatile product is ideal for monitoring daily activities. Its compact design gives the patient greater freedom while improving patient compliance. Its powerful design contains 24 hours of battery life and 33 hours of non-volatile memory. With its large easy-to-read LCD, it is easyto-use – simply plug in the sensor and go. The product comes with a three-year warranty. Carrying case, Data Management Software, PC Interface Cable and other accessories are also available. Write No. 111 on Card Whether you are a competitive athlete, weekend warrior or even a kid that wants to stay in shape, the BODY DOME, from Sports Health, helps to strengthen and coordinate your body by targeting those core muscles around your abdominal and back area. You can not only gain strength, trim, and tone, but also bring a higher level of coordination for your entire body. The BODY DOME combines the balance of a gymball with the strength training of tubing. Great to work out on either at home or at the gym. Reinforced surface with a

nubby texture increases traction to minimize slipping. Unique two sets of tubing are attached with adjustable handles to add strength training while stabilizing your core muscles. It includes: three instructional videos: 10 Minute Total Tone, CardioDome Workout, and AbDome; a daily nutritional guide; an illustrated exercise program; and a hand air pump. Write No. 112 on Card

TRAIN TO PLAY 608-824-0068 WWW.TRAINTOPLAY.COM Train To Play has introduced the NEW SMART-HURDLE™ SYSTEM that features four different training hurdles for improving mobility, agility, strength, and power for all sports. The SMART-HURDLE™ features: four different sizes, two that are adjustable in height; and three-point basing for improved stability on all surfaces; the products’ bright yellow and black color makes the hurdles stand out; they are durable, yet light for easy carrying and they fold flat for storage. Write No. 113 on Card

Web News AQUATIC THERAPY COMPANY LAUNCHES NEW SITE FOR ENHANCED CUSTOMER COMMUNICATIONS SwimEx, Inc., premier innovator of total aquatic therapy and sports conditioning solutions, announced the launch of its newly designed Web site: www.swimex.com. The new site features a dedicated focus for each of the company's commercial and residential market segments. Other enhancements to the Web site include comprehensive product descriptions for the company's other products, the SPT Underwater Treadmill and Aqua Bike, both recently featured on NBC's The Today Show. The new Web site is designed to provide customers with the specific information required to make the right purchasing decisions. www.swimex.com

Check out www.AthleticBid.com to contact these companies. A T H L E T I C B I D . C O M ◆ T & C M A R C H 2 0 0 4 ◆ 59

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

ECA/MIAMI2004 SPORTS TRAINING & FITNESS CONFERENCE, NOV. 12-13-14 1-800-ECA EXPO

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

OR REGISTER ONLINE

www.ecaworldfitness.com

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.

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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ATHLETICBID.COM

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.

Request No. 37

teamwork.

The

BOSS

Bodies talk. We listen. Portable Taping Table Request No. 38