Training & Conditioning 15.2 by Momentummedia

March 2005 Vol. XV, No. 2 $5.00

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Circle No. 100

CONTENTS

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Training & Conditioning • March 2005 • Vol. XV, No. 2

F E AT U R E S ◆ Tre a t in g T h e A t h le te ◆

From Hands to Head..........10 With new research and guidelines out on how to assess concussions, now is the time to update your protocols. By R.J. Anderson ◆ O p t im u m P e r f o r mance ◆

Not Pretty..........21 What do you do with athletes who aren’t naturally agile? Here are some tips on how to turn even your clumsiest players into graceful, quick competitors. By David Pollitt

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◆ N u t ri t io n ◆

The Latest Buzz..........27 Whether it’s consumed to enhance performance or as part of a daily diet, caffeine can be a negative for today’s competitive athlete. By Laura Smith ◆ M a n a g e me n t ◆

On The Record..........34 With legal worries and insurance changes, record-keeping has become an important aspect of an athletic trainer’s job. This article explains how Boston University has recently upgraded its documenting system. By Maria Hutsick

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D E PA R T M E N T S ◆ S id e l in e ◆

Hydration for Endurance Athletes..........3 ◆ S t u d e n t Co r n e r ◆

Grad School vs. Work..........4 By Dr. Brian Toy ◆ A b o ve t h e Call Aw ar d ◆

This Issue’s Winner..........6 Nomination Form..........9 ◆ Co m p e t it iv e E dge ◆

Big Jumps..........42 Increasing explosive power is a goal of most volleyball players. A progressive plyometrics program will help them reach it. By Tim McClellan Advertisers Directory..........56 Aquatic Therapy..........47 Hot & Cold Therapy..........48 Athlete Monitoring Systems..........54 Concussion Management..........58 More Products..........58

CEU Quiz: For NATA and NSCA members ..........60 Cover Photo by Mark Morelli

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Great Ideas For Athletes...

TRAINING & CONDITIONING • March 2005 • Vol. XV, 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 Director of Athletic Development, New York Mets 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, PhD, ATC, PT Assistant Athletic Director for Sports Medicine, 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

Publisher Mark Goldberg Editorial Staff Eleanor Frankel, Director R.J. Anderson Kenny Berkowitz Abigail Funk David Hill Dennis Read Greg Scholand Laura Smith Circulation Staff Dave Dubin, Director John Callaghan Joan Doria Art Direction tuesdaythursday Brand Advertising Production Staff Kristin Ayers, Director Adam Berenstain Jonni Campbell Jim Harper

Steve Myrland, CSCS Owner, Manager, Perf. Coach, Myrland Sports Training, LLC Instructor and Consultant, University of Wisconsin Sports Medicine

IT Manager Mark Nye

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

Special Projects Dave Wohlhueter

Bruno Pauletto, MS, CSCS President, Power Systems, Inc. Stephen Perle, DC, CCSP Associate Prof. of Clin. Sciences, University of Bridgeport College of Chiropractic Brian Roberts, MS, ATC Director, Sport Performance & Rehab. Ctr. Ellyn Robinson, DPE, CSCS, CPT Assistant Professor, Exercise Science Program, Bridgewater State College Kent Scriber, EdD, ATC, PT Professor/Supervisor of Athletic Training, Ithaca College 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

Business Manager Pennie Small

Administrative Assistant Sharon Barbell Advertising Materials Coordinator Mike Townsend Advertising Sales Associates Diedra Harkenrider (607) 257-6970, ext. 24 Sheryl Shaffer (607) 257-6970, ext. 21 Marketing/Sales Assistant Danielle Catalano T&C editorial/business offices: 2488 N. Triphammer Road Ithaca, NY 14850 (607) 257-6970 Fax: (607) 257-7328 info@MomentumMedia.com Training & Conditioning (ISSN 1058-3548) 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© 2005 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 self-addressed, stamped envelope. POSTMASTER: Send address changes to Training & Conditioning, P.O. Box 4806, Ithaca, NY 14852-4806. Printed in the U.S.A.

Gatorade introduces specialized sports drink for athletes’ longer, more intense workouts After years of extensive research, scientists at the Gatorade Sports Science Institute have developed Gatorade Endurance Formula – a specialized sports drink with a unique blend of electrolytes designed to meet the needs of athletes during their longer, more intense occasions when fluid and electrolyte losses can be very significant.

Gatorade Endurance Formula or Gatorade Thirst Quencher for your athletes? Both Gatorade Thirst Quencher and Gatorade Endurance Formula are scientifically formulated to meet the needs of athletes and are great hydration solutions when athletes are sweating. For most active people and athletes, Gatorade Thirst Quencher is the appropriate beverage to help replace the fluid and electrolytes lost through sweat and provide energy to fuel working muscles.

Gatorade Endurance Formula Gatorade Endurance Formula is a specialized sports drink with a five electrolyte blend including nearly twice the sodium (200 mg) and three times the potassium (90 mg) of Gatorade Thirst Quencher. This specialized formula helps to more fully replace the fluids and electrolytes lost in sweat during longer, more intense workouts and competitions such as: ●

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Training for or competing in a marathon or triathlon Two-a-day football practices An all-day soccer or track and field tournament Any other occasion when athletes can experience large sweat losses due to intense or prolonged activity

Athletes have different needs during different athletic situations. In longer more, intense occasions, fluid and electrolyte losses can become significant and that calls for a unique hydration solution such as Gatorade Endurance Formula.

"Athletes have different needs during different athletic situations," says Bob Murray, Ph.D., director of the Gatorade Sports Science Institute. "In longer, more intense occasions, fluid and electrolyte losses can be enormous and that calls for a unique hydration solution such as Gatorade Endurance Formula." Gatorade Endurance Formula contains the same scientifically balanced 6% carbohydrate blend found in Gatorade Thirst Quencher that helps speed fluid replacement in the body and fuel working muscles.

However, Gatorade Endurance Formula may be the right choice during longer, more intense athletic occasions when sweat and electrolyte losses are substantial.

How to Use Gatorade Endurance Formula Sweat rates and fluid needs vary based on the athlete, the activity, and the environment, so the goal for each athlete should be to drink enough before, during and after exercise to minimize loss of body weight without over-drinking. Athletes should drink enough to keep dehydration to less than 2% of pre-exercise body weight for best performance (e.g., less than a 3-lb weight loss in a 150-lb athlete). When the activity is prolonged or very intense, fluid and electrolyte losses substantially increase and maintaining hydration becomes both more difficult and more important. It is for these occasions that Gatorade Endurance Formula was created.

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

A special feature for your athletic training students

Student Corner . . . .

Sponsored by

T&C’s Above The Call Award March 2005 Winner

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Integrated Dedication Cliff Chulada takes the big-picture view of work, school, and his profession. By Kenny Berkowitz he Bow (N.H.) High School Falcons started the 2004 football season with significant injuries to four of their senior stars. But with the help of Athletic Trainer Cliff Chulada, the team ended the season with all four student-athletes back on the field—and the first state football championship in school history. “Over the course of the season, Cliff was able to rehab each of them, and they all returned to play exactly when we needed them,” says Head Football and Strength Coach Paul Cohen, PhD, MBA, CSCS. “He spent a lot of time with them on bands, balance boards, medicine balls, and various lower body exercises. We couldn’t have asked for more than what Cliff delivered. These athletes didn’t just contribute to our championship, they dominated the games. “I started in education in 1986, and I’ve been in different sports at all different levels,” continues Cohen. “In that time, I’ve seen a lot of athletic trainers, but Cliff is the best.” One of only a few high school athletic trainers in the region, Chulada arrives at school early in the morning and leaves late in the evening, juggling a family and a full teaching load in Bow’s health education program. During the spring, he also leads an

Bow (N.H.) High School Athletic Trainer Cliff Chulada helped the football team win its first state championship in school history last fall. independent study for athletic training student aides, and makes time to complete his paperwork whenever he can—usually late at night. “It’s a lot of time, no doubt about it,” says Chulada, MS, LAT, ATC, CAPE. “But I’m here because that’s what the students need. People ask me, ‘Why do you do it? Why do you work all these hours?’ I tell them I’m doing something I really believe in. I don’t think there are a lot of people who can say that. “I don’t see this as a 9-to-5 job, I see it as being a part of the school,” continues Chulada. “There’s so much that can be taught, and I see my two positions as teacher and athletic trainer fitting together. It’s a lot of hours and a real commitment, but that’s the way I want to do it.”

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As a teenager attending nearby Londonderry High School, Chulada decided to become an athletic trainer after attending his first course in the care and prevention of athletic injuries. At the conclusion of those classes, he began work as an athletic training student aide, and while pursuing his degree at the University of New Hampshire, Chulada continued to work at LHS as an assistant athletic trainer. After graduation, he worked for three years as LHS’s Head Athletic Trainer before moving to Florida, where he taught physical education to students with mental and physical disabilities at Miami’s Poinciana Park Elementary School, worked as Athletic Trainer for Kenny Berkowitz is an Assistant Editor at Training & Conditioning.

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Above The Call Award the Fort Lauderdale Strikers professional soccer team, and became Head Athletic Trainer at Nova High School in Davie. In 12 years at Nova, Chulada built the athletic training program from scratch, then rebuilt it after a fire destroyed the original facility. He created a successful college intern program to improve coverage for Nova’s athletic teams, and even saved the life of a spectator who had passed out in the stands at a j.v. football game. Then in 1999, he moved with his wife and twin daughters back to New Hampshire, after cold-calling around the state turned up an opening for a Head Athletic Trainer at Bow High School, which had opened its doors two years earlier. Chulada’s first task at Bow was to improve the school’s emergency response program. “When Cliff first came into the school, we had only the most basic Red Cross training and no CPR information available to the students,” says Laurie McDonald, President of the Bow High School Boosters Club, whose two sons have been rehabbed by Chulada. “So Cliff started setting aside money from his paycheck to buy a defibrillator. He went through Red Cross training to become certified as an AED instructor. Then he persuaded the school board to add it to the curriculum of his 11th grade health education class. There are probably 400 students who’ve gone through the training, all because of him.” At the same time, he began updating the school’s athletic training facilities, two small rooms with no space for expansion. From home, Chulada brought his own custom-made athletic training cart, refrigerator, hydrocolator, and therapy equipment for ultrasound and e-stim. Then, he persuaded the manufacturer to donate a whirlpool to the school. He later found another company that was willing to discount 25 sports heart rate monitors. “I wish we didn’t have to rely on Cliff’s generosity to equip the program, but it’s something that he really

Award Winner

Cliff Chulada Athletic Trainer, Bow (N.H.) High School

wants to do,” says Principal George Edwards, whose son was one of the four rehabbed seniors on the football team. “He’s been very dedicated to upgrading the program and providing our students with opportunities that they wouldn’t otherwise have. He’s really raised the standard of care that our student-athletes receive.” Chulada has created a volunteer medical team consisting of a family physician, an orthopedic surgeon, and a podiatrist, and Bow is now among the few schools in New Hampshire with at least two doctors at all home football games. “In the five years that Cliff has been here, the athletic training program has become much more user-friendly for the student-athletes,” says Athletic Director Jim Kaufman. “Instead of trying to hide an injury, the studentathletes are more willing to visit the athletic trainer. “Cliff is professional, knowledgeable, and calm,” continues Kaufman. “Because of the way he approaches injuries, we’ve never had an instance where an athlete who should have been on the sidelines was on the field.

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Cliff just makes the right call, and our program has improved because he’s been able to keep more athletes in competitive shape.” In the last five years, Bow has won 24 state championships, including titles in baseball, basketball, cross country, football, golf, gymnastics, lacrosse, skiing, soccer, tennis, and track and field. Chulada credits Bow’s performance to Kaufman’s vision and the philosophy of the athletic department, where coaches encourage students to play multiple sports. Of his own philosophy, Chulada talks about seeing each student-athlete as an individual, and draws on his experience teaching physical education to students with disabilities. “At Poinciana, we had a very interdisciplinary approach, with occupational and physical therapists, which taught me about assessment and working with other medical professionals,” says Chulada. “I’ve carried that experience into treating injuries. Even when I’m working with two athletes who have similar injuries, I know that I’m dealing with individuals who have different characteristics, both mentally and physically, and that’s going to dictate how I tailor treatment for each of them. “I’ve learned that if I treat them as individuals, they’ll respect that and know that I care,” continues Chulada. “I was fortunate to learn that when I worked with the handicapped.” McDonald, whose son Ryan was recently injured in an away ice hockey game, supports Chulada’s approach. “Another athletic trainer examined my son on the ice and okayed him to play,” says McDonald. “He played, but he was still incredibly sore. So I asked Cliff to take a look at him. He spent about 20 minutes with Ryan, examined his ankle, assessed the problem, and put him on crutches for two weeks.” Chulada sees his job as going beyond rehab to educate student-athletes about their injuries. “As high school athletic trainers, one of the biggest challenges we have is teaching kids to understand the difference

Above The Call Award between pain and injury,” says Chulada. “Some things will hurt for a day or two and then be fine. Other things will feel like they’re all better when they’re not. Helping student-athletes understand the difference plays a big part in what I do here.” As a teacher in Bow’s health education program, which is called Building Essential Skills for Tomorrow (BEST), Chulada has created a curriculum that covers personal fitness, nutrition, career and college planning, and prevention and care of illness and injury, which includes Red Cross CPR certification. And when the school was forced to cut its budget, Chulada turned his course on athletic training into an independent study, where students receive class credit for completing modules on their own as well as helping him cover spring sports. “There are a lot of people who have a passion for their subject area but aren’t able to translate that to their students,” says Edwards. “Cliff is able to share that passion with his students, which is one of his greatest strengths as a teacher. He makes strong connections with his students and shares his knowledge very effectively. The passion Cliff brings to his job makes him a role model for all of us.” Outside of school, Chulada enjoys competing in an adult soccer league, skiing with his family, and spending time with his 11-year-old twin daughters, who play field hockey and lacrosse. He keeps up with developments in the profession by attending seminars during the summer, reading journal articles, and integrating the information into his work with coaches and student-athletes. He also puts effort into educating others about the importance of athletic training. “Along with providing care, I see part of my job as getting the word out, so other schools can see the benefits of athletic training and the risks they assume by not having a medical professional on site,” says Chulada. “I’m fortunate because I believe in what I’m doing, I love what I’m doing, and I have fun doing it. That’s what keeps me going.” ◆

Nomination Criteria and Procedures he “Above The Call” Awards Program serves to honor outstanding athletic trainers for work not otherwise recognized. This may include someone who has shown exemplary dedication and devotion to his or her job or outstanding work outside of the everyday ATC duties. The goal is to honor those athletic trainers who go above and beyond the already extraordinary demands placed on anyone in the profession.

EXAMPLES INCLUDE: ◆

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Someone who is doing something different and exciting in the profession. Someone who serves as a role model and mentor to others.

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Someone who has taken on additional significant duties in the field. Someone who gives 110 percent in all that he or she does. Someone who has a special way with athletes.

TO NOMINATE AN ATHLETIC TRAINER:

Please fill in the form below, and attach a 500- to 1,000-word description of the athletic trainer’s achievements, including: ◆ Why you think this athletic trainer stands out from the crowd. ◆ Where he or she is currently working and any pertinent academic or work history. ◆ Testimony and/or quotes from those he or she works with.

✁ Above The Call Award Nomination Form Name of Athletic Trainer: ___________________________________ His/Her Phone No.: ________________________________________ Your Name: _______________________________________________ Your Affiliation: ____________________________________________ __________________________________________________________ Your Phone No.: ___________________________________________ Your Address: _____________________________________________ __________________________________________________________ Send nominations to: Above The Call Award Training & Conditioning 2488 N. Triphammer Road Ithaca, NY 14850 If you have any questions, feel free to call us at (607) 257-6970, xt. 18, or e-mail us at info@momentummedia.com.

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TREATING THE ATHLETE

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With new research and guidelines out on how to assess concussions, now is the time to update your protocols. found that it falls in line with the NATA Guidelines on sport-related concussions issued last fall. Starting his concussion review process three years ago, Mildenberger was ahead of the curve. Today, however, as parents and the mainstream media pay more attention to the risks associated with concussions, every athletic trainer clearly needs a return-to-play protocol that takes into account the latest research and advice on concussions. WHO DECIDES?

Utah State Athletic Trainer Dale Mildenberger tests football player Brady Holt for a concussion.

ELI LUCERO

By R.J. Anderson Three years ago, Dale Mildenberger, MS, ATC, Associate Athletic Director and Head Athletic Trainer at Utah State University, decided that he did not feel comfortable with how his athletic department assessed concussions. The protocols did not provide adequate direction, were not based on objective measures, and were not in line with the latest research, he says. So with the school’s team physician

by his side, Mildenberger began looking for something better. He knew he wanted to incorporate some baseline testing, and he wanted to measure his athletes’ cognitive recovery as well as their physical balance. After doing extensive research, Mildenberger instituted a concussion protocol that has made his decisions easier and his athletes safer. He fine-tunes his protocol annually and after reviewing it this year,

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The first step in updating concussion assessment procedures is to make sure your institution’s overall policy on return-to-play decisions is appropriate. There should be a medical chain of command, whereby an injured studentathlete can only return to play when authorized by designated personnel. And this policy should be in writing, cleared by those in charge of studentathlete health and safety. Although this policy should cover more than concussions, it is especially helpful when dealing with something as controversial as head injuries. “The whole purpose of having policy-backed procedures in place is to have some predictability in what you’re going to do in difficult circumstances,” says Richard Ray, EdD, ATC, Athletic Trainer and Program Director for the Athletic Training Education Program at Hope College. R.J. Anderson is an Assistant Editor at Training & Conditioning.

Are you prepared for concussions?

Athletic trainers see 70,000 concussions each year in football, that’s 70,000 difficult decisions regarding whether it’s safe for an athlete to return-to-play. That’s why the NATA issued recommendations stating: “Evaluating and Making the Return-to-Play Decisions For athletes playing sports with a high risk of concussion, baseline cognitive … testing should be considered. Concussion Assessment Tools Formal cognitive … testing is recommended to assist in determining injury severity and readiness to return to play (RTP). Once symptom-free, the athlete should be reassessed to establish that cognition … (has) returned to normal for that player”

Concussion Sentinel takes the guesswork out of return-to-play decisions.

Protect the athlete’s in your care. It’s not too late to take advantage of FREE Concussion Sentinel testing. Simply administer your baseline tests before June 30, 2005 and your athlete’s are protected for the next season.

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TREATING THE ATHLETE

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Does Soccer Need Headgear? well worth it. “I’d challenge any of these doctors who feel this has no value to run into the goal post without a Full90 and with it, then tell me, if they were forced to do it a third time, whether or not they would wear it,” Dorrance told The New York Times. But Kevin Guskiewicz, who studies concussions as a Professor and Director of the Sports Medicine Research Laboratory at the University of North Carolina, is not smitten with the idea. Guskiewicz says that by wearing headgear, players could gain a false sense of invulnerability, thereby making them more aggressive. He also says adding extra weight to the heads of young players may be detrimental. “Quite frankly, headgear has not been studied well enough and it is entirely too early in the game to mandate headgear for soccer players at any level of play,” says Guskiewicz. Brian Goodstein, Athletic Trainer for Major League Soccer’s DC United, says that most of the head injuries he sees in soccer are more a result of a jarring of the brain than a direct blow to the head. “With that in mind, I feel that wearing the headgear can’t hurt,” says Goodstein. “But how much does it help? That’s something I don’t know.”

“The policy needs to state that the person who has the final authority over participation when it comes to medical issues is the designated team physician or the highest ranking medical authority employed by the school—the athletic trainer,” says Ray, who is the author of Management Strategies in Athletic Training, Counseling in Sports Medicine, and Case Studies in Athletic Training Administration. “He or she should be empowered by the school board or by the board of trustees at the institution to make medical decisions regarding fitness for participation.” In other words, if an athlete’s personal physician clears him or her to play, but the athletic trainer or team physician does not feel the concussion has healed, the athlete will be kept on the sidelines. If the athlete or parents

complain, the athletic trainer can direct them to the institutional policy. If the policy states, as Ray suggests, that the team physician is at the top of the chain, it’s also important that your athletic department retain a team physician you can work with on building a concussion protocol. “The most important thing is to have a dedicated, knowledgeable, committed physician who is willing to serve as the medical director for your program,” says Ray. “That person should be willing to make judgements to withhold participation in the face of highly motivated athletes, parents, and sometimes coaches who don’t completely understand the risks of allowing a kid to return to participation too soon.” The team physician and athletic trainer should work on the specific concussion guidelines as a team. Along

with looking at the latest research and advice, they can receive guidance from the NATA’s position statement on handling concussions released last fall. Most important, they should agree on a philosophy and a consistent approach, regardless of the athlete, sport, or circumstances surrounding the injury.

Richard Orr Sports

When the Santa Clara University women’s soccer team played its way into the NCAA Division I semifinals last December, they got recognition not just for their on-the-field moves, but also for the funky headgear they were wearing. To help prevent concussions, the majority of team members competed last season with protective equipment that looks like an enlarged headband and provides padded coverage to the forehead, temples, and occipital bone in the back of the head.

A handful of soccer players, from youth leagues to the 2004 Olympics, have also donned the headgear, but the jury is still very much out on whether they are needed or effective. In a study conducted at Washington University in St. Louis, researchers tested four models of headgear for their effectiveness in decreasing impact forces during heading of the ball. Researchers exposed the headgear to soccer balls at various inflation levels, propelled at speeds of 20, 26, and 34 miles per hour. “In terms of heading the soccer ball, we found that really only at the highest speed did it make a difference, and it was a very small difference,” says Rosanne Naunheim, the study’s lead author and an Assistant Professor of Emergency Medicine at Washington. Because a soccer ball and the headgear are about equal in terms of softness, there’s not much change in the soccer ball force and acceleration when the ball hits the headgear, she explains. But what about concussions caused by collisions? The University of North Carolina’s women’s soccer team is sponsored by one of the headgear companies, Full90, and Head Coach Anson Dorrance feels anything that can reduce peak impact forces during a collision is

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USING BASELINES

One of the key decisions the athletic trainer and physician will need to make is whether to use baseline testing when assessing concussions. Such testing measures healthy athletes’ neurological functions, which establishes a “normal” baseline—a score that is revisited following a suspected concussion. Athletes should not return to play until their scores on the test return to their own baseline. Most agree that baseline testing is the most accurate way to determine

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if an athlete is ready to return to play. But it does take some up front work. The most sophisticated and timeefficient method of baseline testing involves computer-based neuropsychological exams. “We baseline all of the incoming freshmen and players new to the school,” says Detroit Country Day School Athletic Trainer Cheryl Williams, ATC. “The test is good for two years. Then we rebaseline them before their third year so we have an updated version in the system.” The test takes 25-30 minutes per student, and is administered in the school’s computer lab, where 10 people can be tested at one time. Computer-based tests measure aspects of brain function that are most vulnerable to the injury such as memory, attention, concentration, reaction time, problem solving, mental speed, and processing speed. “It’s made my life 100 percent easier, because before, the role of the athletic trainer was just to keep con-

cussed athletes out,” says Williams. “Now, we have more data to back us up in holding them out and managing their injuries. I feel like my athletes are safer because of it.” Utah State decided it did not want to use computer-based testing, but still wanted to baseline its athletes’ cognitive levels and balance. Mildenberger thus chose two tests to use: The Standard Assessment of Concussion (SAC) and the Balance Error Scoring System (BESS). “We chose those tests because they were fairly inexpensive, wellrespected, and the most widely used in terms of measuring cognitive values and balance,” says Mildenberger. The SAC is a mental-status exam that tests orientation, immediate and delayed memory, and concentration, while allowing for neurologic examination and clinical evaluation of exertion, coordination, strength, and sensation. The BESS is a clinical test battery that uses modified stances on different surfaces to assess postural stability.

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Establishing baseline scores for both tests takes about 20 minutes per athlete, says Mildenberger, and is part of each incoming athlete’s pre-participation physical. The scores are put into each athlete’s medical file and are kept on hand in their team’s travel kits. Scores are used for the duration of the athlete’s career. Because of the time requirement of the testing, Mildenberger says the key is to train other staff members to help conduct the exams. “Part of our protocol is the annual training of our staff to administer the tests so that we have consistency,” he says. “By doing this, we’re not dependent on having the same person available to do baseline testing and follow-up exams.” Mildenberger has also developed a videotape of the procedure, which each athletic trainer views and is tested on. Currently, Mildenberger is testing whether coaches can administer the baseline testing at three nearby high schools, which are in the process of

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installing the protocol used by Utah State. “It has taken an effort on our part to train people in the proper administration of those tests, but it is not extensive,” says Mildenberger. “Coaches and athletic trainers meet with us for three hours. We also do individual training with those people collecting the baseline data.” Because of the developmental changes that an adolescent goes through during the high school years, Mildenberger is also investigating the need to re-baseline high school athletes, as Williams does. “This year we will begin testing to see if a follow-up exam between the sophomore and junior years reveals any significant difference in balance or intellectual ability,” he says. For those time-crunched athletic trainers with concerns about being able to schedule baseline exams for all their athletes, John Reynolds, MS, ATC, Athletic Trainer at George C. Marshall High School in Falls Church, Va., recommends prioritizing teams that are

at greater risk of having athletes sustain concussions. Then, when putting together a baseline testing schedule, make sure those higher-risk athletes are the first to be screened. After all, the odds of golfers getting a concussion aren’t nearly as high as those of football or soccer players. RETURN-TO-PLAY DECISIONS

Whether or not you choose to use baseline testing, developing return-toplay protocols is a critical step. Most experts agree that the protocols need to include a combination of screening tools appropriate for sideline use that test cognition as well as postural stability. Sideline evaluations should also include a symptom checklist that can be filled out immediately following a head injury. The NATA mentions three approaches in its position statement on Management of Sport-Related Concussion: • Grading the concussion at the time of the injury.

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• Deferring final grading until all symptoms have been resolved. • Rather than using a grading scale, focusing attention on the athlete’s symptoms, neurocognitive testing, and postural-stability testing. Mildenberger’s return-to-play criteria follows the NATA’s third suggestion. And it is the same process whether he’s evaluating an athlete 15 minutes after the initial injury or seven days later. When an athlete is suspected to have sustained a concussion, an athletic trainer administers the SAC and the BESS on the sideline or in the locker room, and compares the athlete’s scores against his or her baseline numbers. A postinjury portion of the SAC also requires evaluating symptoms with regards to exertion, coordination, strength, and sensation. Before allowing an athlete to return to play, Mildenberger also initiates an exertional maneuvers test, in which the SAC and the BESS test are re-administered after the athlete has been put through a series of exercises.

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Reynolds, who utilizes baseline screening whenever possible, has established a return-to-play protocol that hinges on athletes being symptom-free after strenuous exercise. “Once they can pass exertion tests that include push-ups, sit-ups, and some running without becoming symptomatic—headache, dizziness, anything unusual—then you can begin to reevaluate their status as far as practice goes,” says Reynolds. “That can be a fairly lengthy process, and the studentathletes, coaches, and parents need to understand that there’s a real need to reintroduce the individual gradually to increasing demands of activity.” At Detroit Country Day, students with head injuries are given a sideline evaluation and subsequent neuropsychological test. If a student is found to have Untitled-2 1

A version of this article is also appearing in T&C’s sister magazine, Athletic Management.

Message to Coaches To help high school coaches get on board with new concussion guidelines, the state high school athletic association in Texas has begun to provide coaches with a pocket-sized concussion-grading card. The card contains instructions on how to recognize symptoms of concussions and provides treatment recommendations. “For athletic trainers, it’s not new information, but for those people who don’t deal with injuries on a daily basis, it makes a big difference,” says William “Hondo” Schneider, MS, ATC, Head Athletic Trainer at Midland Lee High School in Texas. “It’s not a perfect instrument, but it gives people on the sidelines a better idea of what to do. It’s a start in the right direction.” Kenneth Podell, PhD, co-founder and Director of the Sports Concussion Safety Program at Henry Ford Hospital in Detroit says the card serves a couple of purposes. “Number one, it increases awareness, and number two, it creates a level of accountability,” he says. “The card sends a message to coaches saying, ‘Things are changing and you guys need to change too.’” The card lists the symptoms of three grades of concussion and explains what a coach’s course of action should be for each grade. Schneider says that at his school, coaches are required to call the athletic trainers if they suspect a concussion of Grade 2 or higher. There are also recovery guidelines that suggest when an athlete can return to play. “The card explains to coaches what the new standard of care for a concussion is,” says Podell. “It explains how a concussion should be treated, and that if one of their players has a concussion that player had better be evaluated. It’s now 8/24/04 holding11:09:32 AM the coaches responsible.” For more information about the Management of Concussion in Sports card, call the Brain Injury Association of America’s bookstore at (800) 565-0668.

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TREATING THE ATHLETE

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a concussion, he or she is restricted from competition and Williams is responsible for contacting Kenneth Podell, PhD, co-founder and Director of the Sports Concussion Safety Program at Henry Ford Hospital in Detroit. Podell, who initiated the program at Detroit Country Day, re-tests the athlete 48 hours later during an examination at his office. If the athlete’s follow-up score matches his or her baseline number, the athlete goes through exertional training and takes a symptom test to see if any symptoms recur. Then, based on whether or not symptoms exist, and the athlete’s concussion history, Williams and Podell determine if that athlete should be allowed to return to play. Even though baseline testing is highly recommended by authorities such as the NATA, it is important to note that even without having baseline scores to use as comparisons, the SAC and BESS tests have both been proven to be effective sideline assessment measures. When baseline scores are not available, it is important to conduct an evaluation immediately following the injury. Then, while closely monitoring any symptoms and behavior, re-testing should take place 15 to 20 minutes following the injury, when the athletic trainer can compare the scores to determine whether or not the athlete’s cognitive ability and postural stability have improved. If the athlete is symptom-free, the athletic trainer may allow that athlete to return to competition. However, if symptoms remain, or if their SAC or BESS scores have not improved, the athlete should be pulled from competition and remain under the careful observation of the athletic trainer until further testing can be completed. “It’s not quite as good as having a baseline number to compare it to, but it does allow us to say, ‘You scored this a half an hour ago, and now you scored this,’” says Reynolds. “Based on the scores, the athlete is either staying the same, improving, or not improving. That helps you make your immediate decision: Are they going home with mom and dad to be observed? Or are they being rushed to the hospital in an ambulance?” EDUCATION

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An important component of any concussion management protocol is education. By sharing what they know about the latest in concussion research with coaches, student-athletes, and parents, athletic trainers can back their treatment with science and expert opinion. One convenient way to educate student-athletes and parents is to share your athletic department’s concussion protocol on your school’s Web site. You can also add links to the latest concussion research as well as e-mail addresses for the sports medicine staff. Another method is to present a five-minute speech at teams’ preseason parents meetings, especially in sports with a higher incidence of concussion. Reynolds does this as well as providing handouts that include the school’s injury assessment and management guidelines. He says that this approach has been very effective at his school for fostering awareness about the symptoms of the injury and the dan-

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TREATING THE ATHLETE

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gers of returning before being fully healed. In fact, it helped lead one athlete to spot a concussion in a teammate. “One of our student-athletes came to us during a football practice and said his teammate was laughing and being very silly in the huddle—which was very atypical for that athlete—and that he thought something was wrong,” says Reynolds. “So I pulled that kid to the side and started talking to him and it was very clear that something was not right. I continued the evaluation process, and sure enough, he had sustained a fairly significant concussion and the only symptom that was initially recognizable was a change in personality.” If an athlete does experience a concussion, Ray suggests seizing that time to intensify the educational message program-wide. “When we have an athlete with a concussion, not only do we educate the athlete about the procedure and what needs to happen before he or she can play again, we talk to the coach in the very same terms, so the coach feels like a partner in the process,” says Ray. “That way, a coach feels fully informed, and a fully informed coach is more likely to be on board with the program. I think it’s counterproductive to say to a coach, ‘We’ll just let you know when a kid is ready to go back.’” At the high school level, it may also be important to educate other health care professionals in the community about your updated concussion procedures. “Especially with smaller schools,” says Jon Almquist, ATC, Athletic Training Program Specialist at Fairfax County (Va.) Schools, “you want to get the physicians in the community on board with your ideas. Because a lot of times, the typical pediatrician has very little understanding of what the new research is in concussions.” SYMPTOM-FREE

Despite all of the research and subsequent guidelines that have accompanied heightened concussion attention, one message remains consistent: No athlete should return to play unless he or she is 100-percent healed and completely symptom-free. So whatever course is taken, athletic trainers needs to develop policy-backed protocol that is focused on the student-athlete’s safety and long-term health. A comprehensive policy gives athletic trainers confidence, and allows them to tune out all peripheral distractions when making a decision. And by building that policy around objective assessment tools or even computer-based neuropsychological tests, athletic trainers are able to put themselves in the best possible position to make decisions that are in the best interests of their student-athletes. ◆

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Associated Press

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What do you do with athletes who aren’t naturally agile? Here are some tips on how to turn even your clumsiest players into graceful, quick competitors.

Not Pretty By David Pollitt

f all the athletes I’ve worked with over the years, one of my biggest challenges came from a group of ice hockey defensemen. At first, they looked like a strength and conditioning coach’s dream team. They were big and strong. They were aggressive. They skated fast and checked hard. But as preseason training camp progressed, it became clear that many of our smaller forwards could outmaneuver them and easily beat them in one-on-one situations. Agility and first-step quickness were not in their repertoire.

The coaching philosophy of ice hockey revolves around getting to the puck first and winning every oneon-one challenge to control the play. Therefore, my job was to address these skaters’ mobility issues—to turn these players into agile athletes who could use their strength and size as assets instead of liabilities. On paper, that didn’t sound too hard to the sport coaches. But, as any strength coach knows, it is. Improving athletes’ agility may be the most elusive goal for any coach to achieve. Working with athletes who are unagile from the start makes the task even harder.

NO EASY TASK

In every sport, on every team, there are players who simply cannot move or react to fast-changing situations during competition as well as other players. There are many reasons. Sometimes, it’s the bulky football lineman who is overweight for his David Pollitt, CSCS, is the Owner of Optimal Performance Strength and Conditioning Consulting in Riverside, Calif., and the former Strength and Conditioning Coach for the Banff Hockey Academy, in Alberta, Canada. He can be reached at superdave2010@yahoo.com.

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Quickness Drills Quickness drills are designed around short bursts of movement in various directions to improve the ability to move the feet and develop first-step quickness. These drills can be done either for a set distance or as read and react type drills where players change direction after a whistle from the coach. Back-to-front runs. Running backward to forward, or forward to backward helps an athlete improve his or her stopping ability and quickness to change direction. This drill is best done with a coach dictating the change of direction. Side shuffles. Moving sideways, the athlete shuffles from one foot to the other. This builds medial and lateral strength in the upper leg, coordination, flexibility, and quick feet. Outside edges. The athlete moves forward by crossing one foot in front of the other, then moves the foot that was just crossed

position. Other times, it’s the tall and clumsy basketball player who has not fully grown into his or her body. But, in most cases, there are multiple factors that contribute to an athlete’s inability to be agile on the court, rink, or field. These factors may include a lack of strength, power, sport-specific skill, balance, or flexibility; the ratio of slowtwitch to fast-twitch muscle fibers; muscle balance; the ability to read and react to competitive situations; excess bodyweight; or the level of proprioceptive ability. In other words, there are no simple solutions to solving the unagile athlete problem. Making the task even harder is that there is no consensus on the best way to improve agility. Last year, when the National Strength and Conditioning Association asked its Research Committee to issue a position paper on speed and agility, it found that the available information on the topic did not provide a basis for a position statement. While many different forums have been held to discuss training methodology, which program works and why is difficult to scientifically validate. Therefore, strength and conditioning coaches faced with training unagile athletes must start each program from scratch. They must take into account

over the first foot. This forces the athlete to always land and move on the outside edge of the foot. The result is development of the hip in terms of strength, flexibility, coordination, and balance. Grapevine. While moving sideways, have the athlete cross one foot over in front, and then behind the other. This drill is good for building coordination and footwork. Line drills. On any type of playing surface with lines (basketball court, tennis court, hockey rink) have players sprint between lines moving in all directions (forward, backward, sideways, crossovers, etc.) with the coach signaling changes. Iron Cross. This hockey drill involves running or skating in a cross type pattern within a small circle. This idea is to get the feet moving and learn to cross over and push off from both sides of either foot.

the particular athletes, the sport, and the resources available. To start, coaches should understand the basics of agility. It is defined as the ability to change direction of the body or body parts rapidly and under control. The process begins with the central nervous system (CNS) as it receives commands from the brain to perform a certain action and then decides which muscles it needs to use, and in which order. As it receives feedback from the muscle fibers on details such as muscle length, tension, pressure, speed, direction, and rate of change, the CNS matches up the original commands with the feedback and makes adjustments to the movement as necessary. Each time you train agility, it reinforces the motor pathways of the action, making it easier to repeat the next time. Traditional types of training focus on the obvious forms of agility seen in competition, such as accelerating, decelerating, changing direction, or stopping. But agility training should also encompass all kinds of movements that may be seen during the sport, like falling down and getting back up, jumping over objects, hitting and taking a hit while staying in balance, ducking, or reading the play to anticipate movements.

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I have found that the most successful programs include two components. The first is thoroughly testing each athlete to better understand his or her deficiencies. The second is making the entire program very sport-specific. TESTING

The first step in solving the problem of poor agility is objective and repeatable testing. The goal is to determine which athletes may need more work than others and where their deficiencies lie. The testing guidelines should be designed by the entire coaching staff with three criteria in mind. The first criterion is that the testing drills mimic the movements and conditions faced in competition. By focusing on sport actions instead of general agility drills, the testing becomes much more sport-specific and the carryover effect for athletes is usually higher. The second criterion is that the drills allow coaches to objectively measure the movements. This is the only way to know precisely where problems are arising and whether improvement is occurring as a program is implemented. The third criterion is that the drills should reveal any potential weaknesses in specific areas, such as skill, agility, power, proprioception, muscle balance,

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flexibility, speed, and strength. By zeroing in on specific areas, a plan can be developed to address those areas most in need of help. For example, with my ice hockey team, I set up a series of drills that were sport-specific and measurable, and tested different movements. The drills included: • Timed skating around a short obstacle course of pylons forward and backward, with and without the puck. • Timed skating from one part of the ice to another, such as from the front of the net to the boards and back. • Two-player drills with and without the puck to see how players battle for the puck, balance, and coordinate movements, and what result occurs from each drill. • Passing the puck, then moving to a target for a return pass, then taking a shot on goal. If videotaping is possible, it is great to record the tests. Then, instead of evaluating just by times and your first impressions, you can carefully review the tapes to better spot deficiencies in athletes. If an athlete, for example, completed the obstacle course in 10.5 seconds when turning to the left and in 13.2 seconds when turning to the right, we knew there was some problem with his left-side agility. Looking at the video, we would compare the triple extension of the ankle, knee, and hip, as well as the angle of the trunk, from the athlete’s right and left sides. I would also compare his movements to those of more agile skaters on the team to examine what the differences were.

as the snatch, clean and jerk, swings, squat pulls, and plyometrics. Make sure to use the one-arm variations of these movements using kettlebells or dumbbells to promote muscle balance and unilateral strength and stability. Vary the landings for these lifts (such as the split style landing or sumo type landing) so that you teach the feet to move quickly. The more power the athlete is able to generate, the better the agility will be during competition.

OPTIMUM PERFORMANCE

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Improve general body balance, muscle coordination, and stabilizing ability in the core and lower body so there is a stable platform to develop and improve agility. The old saying “you can’t shoot a cannon from a canoe,” is the idea behind this principle. Improve the fundamental skill level of the athlete by breaking down skills into the basics and teaching athletes to be proficient at a slow speed before adding more complex drills or increasing the speed of the

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Through the testing you should learn exactly which areas of agility your athletes need the most work in. From there, you can implement a periodized program, starting with basic exercises and leading up to more sport-specific drills. The following is a collection of training suggestions to help you design your program. Improve pure power in the legs and torso with quick movements such

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drills. By eliminating technical flaws in the basic skills, players are able to eventually compete at a much faster level because they do not have to think about what skill to perform during the action. Develop proprioception by teaching athletes to learn where their bodies are in space. Use a wide variety of basic skills like catching, hitting, or throwing objects, or cross train with other sports such as football, soccer, or volleyball to provide stimuli for proprioception development. Because these drills are not all that sport-specific, it is best to use them as a warmup prior to sport activities or during the off-season when specificity is not as important. Improve the flexibility of the unagile athlete, if needed. A flexible muscle moves without impingement, while a limited range of motion is a recipe for inefficient movement.

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Teach correct positional play ... by knowing where to look and the specific movement objective, an athlete is less likely to get caught off balance or exhibit confused body movements. Teach correct positional play so that athletes know where to be and what to do when they are called to act. In ice hockey, for example, the defensemen should look at the center of the opposing player who is trying to get to the net, keep him or her to the outside with their own body between the other player and the net, and then angle them off into the corner areas of the rink where they are less of a scoring threat. By knowing

where to look and the specific movement objective, an athlete is less likely to get caught off balance or exhibit confused body movements. Address bodyweight problems in athletes, if possible. Some athletes’ agility problems stem from being overweight, and reducing the excess baggage will go a long way toward improving the strength-to-bodyweight ratio and allow the athlete to move more freely.

Read & React Drills One important component of agility is the athlete’s ability to read and react. The following drills aim to improve the athlete’s efficiency in reading what is happening (seeing where a person or an object is going to move) and reacting to that movement by making a counter-movement. All of these read and react drills involve several athletes or a group of athletes and a coach. Reaction balls. Using a reaction ball (a multi-sided object that bounces unpredictably when dropped or thrown), set up a game of bouncing the reaction ball between two players, off a wall, or with a coach as a warm-up for athletic activity. Allow two bounces for the athlete to catch the ball. The athlete must move very quickly in reaction to the ball’s unpredictable bounce. Hacky sack. Athletes stand in a circle and attempt to keep the sack in the air as long as possible. You can allow athletes to use both hands and feet, just feet, or just hands. This is a great warmup for sports, and also works to improve agility and proprioception, especially in the lower body. Reaction belts. The reaction belt is attached to two athletes with a VelcroTM section holding the athletes together. The drill involves the first athlete trying to move away from the other, and the second athlete trying to counter-move toward the first athlete so the VelcroTM does not break apart. The drill continues until the Velcro separates. Shadow drills. This idea can be used in a variety of ways, from follow the leader type drills to copying action movements.

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One athlete is instructed to follow another athlete and copy his or her movements and skills. This is a great drill for teams as it allows weaker athletes to train with faster athletes to improve agility and quickness. Rule the circle. Inside a large circle, two athletes hold onto one stick and compete to see who can either knock the other off balance or take the stick away. Variations to this drill involve pushing or wrestling each other in the circle to knock the other person out, sumo style. This is a great drill for contact sports as it develops balance, agility, and strength along with reaction ability. Medicine balls. While medicine balls are primarily used to improve core strength and balance, they can also assist with reaction training. A coach can throw the medballs to an athlete in an unpredictable pattern or two athletes can throw medballs back and forth, each trying to get the ball past the other. Bouncing balls. Using a tennis ball, racquet ball, or another similar type of ball, bounce one or two balls between two or more athletes. Balls can be thrown at the athletes, bounced on the ground, or bounced off of a wall. Fun Games. Activities like tag, dodge ball, monkey-in-themiddle, and keep-away teach athletes to read and react with games they already know how to play and enjoyed as younger kids. These drills can also be used as a warmup or cooldown from the bulk of the workout.

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Use quick feet drills to condition players to move in all directions with greater ease. These drills can be used as a warmup to any sport training program, or separately to focus on specific agility problems. (See “Quickness Drills,” on page 22, for examples.) Use read and react drills that relate to game-type situations. Improving these skills can be done in a wide variety of settings, with several players or the whole team. Many read and react drills can provide friendly competition within the team as less agile players strive to keep up with more agile or faster players. (See “Read & React Drills,” on page 24, for examples.) Choose quality training over quantity. Repeating drills at half speed teaches athletes to move slowly. Since agility training is about conditioning the CNS to respond and move faster and faster, it is unproductive to practice at anything less than full speed once the fundamental skills are in place. Place drills carefully so they have the greatest positive effect. Make sure agility training is done at the start of a workout when the athletes are fresh, instead of thrown into the mix at the end of practice to finish off the day. After each drill it is also important to use active rest such as jogging or other slow but steady movements to speed recovery. Use testing results to tweak the program. If an athlete’s agility is being hampered by an ankle problem, prescribe specific exercises for this. If an athlete is having trouble turning with speed, start them with more core work. You can also combine the testing with weightroom training to spot deficiencies. Watching the athletes’ overhead squats, lunges, medball drills, and deadlift reaches allows a coach to see any further weaknesses and tweak the program to remedy them.

of positional play from the coaches, and many lost weight through our intense training and with a few nutritional tips. By the end of the year we had a more mobile and much better-conditioned group of players who were able to contain the best forwards in the league. We also retested our hockey players at the midway point and then again at the end of the season, using the same testing drills we had used at the start of the season. Other options are

OPTIMUM PERFORMANCE

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to retest some aspect of the original test every few weeks with the weaker athletes, and less often with the more skilled players. Conditioning the unagile athlete is a difficult task for the strength and conditioning professional since there are no hard and fast rules. But, as long as you analyze the athletes and the sport they play, and make the plan progressive, you will see the deficiencies disappear and the clumsiness turn to gracefulness. ◆

MAKING IT WORK

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NUTRITION

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The Latest

BUZZ

Whether it’s consumed to enhance performance or as part of the daily diet, caffeine can be a negative for today’s competitive athlete. By Laura Smith t’s a psychoactive drug affecting several powerful neurotransmitters. When consumed, it triggers changes in the same area of the brain activated by nicotine, cocaine, and heroin. Used regularly, it leads to tolerance and addiction. Attempting to discontinue use prompts painful withdrawal. As many as nine out of 10 of your athletes may be using it, and in fact, you probably had a dose of it today yourself.

Caffeine. Eighty to 90 percent of American adults consume it every day, and student-athletes on college campuses are no exception. Increasingly, high schoolers are rivaling adults in their caffeine use, downing sodas and visiting coffee shops for frozen or sweetened caffeinated drinks. In addition, many student-athletes turn to the drug to enhance their athletic performance. Certainly, concern about caffeine use pales in comparison to the use

of substances like steroids and ephedra. But heavy consumption can have some very real downsides for studentathletes’ health and performance. And while there is laboratory evidence that caffeine enhances performance, athletes who use it as an ergogenic aid need to be educated about the risks and realities of competing under its influence. Laura Smith is an Assistant Editor at Training & Conditioning.

A T H L E T I C B I D . C O M ◆ T & C M A R C H 2 0 0 5 ◆ 27

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CAFFEINE CHEMISTRY

Structurally, caffeine mimics one of the body’s natural chemicals, a neuromodulator called adenosine. Under normal circumstances, adenosine acts as the “brakes” in the central nervous system, inhibiting neuronal firing and neurotransmitter release. As adenosine concentration builds slowly in the body over the course of the day, its “slow down” effect leads to feelings of sleepiness and, eventually, to sleep. When caffeine is ingested, because it is similar to adenosine, it binds to adenosine receptors and “plugs them up,” according to Laura Juliano, PhD, caffeine researcher and Assistant Professor of Psychology at American University. “With caffeine blocking adenosine receptors, adenosine cannot have its normal effect, so you feel less fatigued and more alert,” she says. Caffeine also increases the availability of many neurotransmitters, which can affect the body in several different ways. “Caffeine doesn’t target one neurotransmitter—it targets adenosine, and through its effect on adenosine, it affects everything else,” Juliano says. With the flood of neurotransmitters and the short-circuiting of fatigue-producing adenosine, it makes sense that most people feel more energized and better able to focus with caffeine, whether they’re recalling answers for a physics exam or completing a tough practice. Why is caffeine so addictive? Researchers recently uncovered at least part of the answer when they discovered that caffeine releases dopamine (the “pleasure and reward” neurotransmitter) in the part of the brain called the nucleus accumbens— an area that plays an important role in all addictive drugs. Researchers believe this may explain why casual caffeine users often become dedicated, and then addicted, users. THE DAILY GRIND

When student-athletes become daily caffeine users, particularly with heavy use, both their health and performance may suffer in ways they aren’t even aware are happening. One

Does Caffeine Dehydrate? For many years, the idea of “caffeine as a diuretic” was common wisdom. But recent research suggests that, at least in this respect, caffeine has been getting a bad rap. Lawrence Armstrong, PhD, FACSM, Professor at the University of Connecticut’s Human Performance Laboratory, published a study in 2002 debunking the dehydration myth. “We took 59 healthy college males and studied them during 11 days of controlled caffeine intake,” Armstrong says. “One group took no caffeine, a second took three milligrams per kilogram of body mass, and a third took six milligrams per kilogram of body mass. We evaluated them on 20 hydration indices, and the results across all three groups were virtually identical. “The amount of water retained by the body from a caffeinated beverage is virtually identical to the amount retained from a non-caffeinated beverage,” Armstrong continues. “There is no evidence that caffeine dehydrates the body.” Other studies have found similar results, prompting researchers to conclude that any increases in urine output after consuming caffeine are not a result of the caffeine, but of the water typically ingested along with it. Sports nutritionists, however, are quick to point out that caffeinated beverages still should not be the hydration source of choice for athletes. “Dehydration is such a huge issue for student-athletes,” says Leah Moore Thomas, MS, RD, LD, Sports Nutritionist at Georgia Tech, “that the message still needs to be, ‘Caffeine itself may not dehydrate you, but colas and energy drinks are also not designed to properly hydrate you, and they should not be your major source of fluids.’”

of the biggest risks is that caffeine use disrupts sleep, and student-athletes are often sleep-deprived to begin with. “High school and college students are notorious for not getting enough sleep, and especially when they are athletes, it’s absolutely essential that they get enough rest to repair muscle tissue and perform optimally,” Juliano says. “Caffeine increases the length of time it takes to fall asleep and decreases total sleep time.” It doesn’t require downing a grande coffee right before bed to see the effect, either. Studies have shown that consuming a moderate amount of caffeine early in the day can reduce the quality and quantity of that night’s sleep. Another concern involves caffeine’s ability to produce anxiety. Again, the effect does not require huge doses. Starbucks reports that its

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16-ounce coffee contains 400 milligrams of caffeine—the exact amount researchers administer in the laboratory to induce anxiety, according to Juliano. “There is already a lot of anxiety in the lives of most studentathletes,” she says. “And caffeine is going to magnify it.” A student-athlete who has an exam looming, a paper due, and a game coming up may down a mug or two of coffee to make it through the day, then attribute feelings of stress and anxiety to the workload. “In reality, caffeine is probably making them feel much worse, but they don’t realize it,” says Juliano. Daily consumption of coffee and colas also deprives the body of calcium, according to Barbara Lewin, RD, LD, who sees professional and studentathletes at a Fort Myers, Fla.-based

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Last but not least, student-athletes who use caffeine daily will build up a tolerance, gradually needing more and more to achieve the same effect. They’ll also develop dependence and feel like they need caffeine to function normally. “When it comes to chronic caffeine users, it’s often difficult to separate the effect of the drug from the effect of not having the drug,” Juliano says. “In other words, they may think caffeine makes them feel and perform better, but in reality, it just keeps them from feeling bad from not having it.” Few sports nutritionists advise college athletes to avoid caffeine altogether. It’s simply too pervasive an ingredient in many foods and drinks. But how much is too much? “If a student-athlete does not want to be physically addicted to caffeine, he or she needs to use well below 100 milligrams a day, which means drinking only one caffeinated soft drink or a very small cup of coffee a day,” Juliano says.

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For student-athletes who find that recommendation unrealistic, nutritionists advise that they keep their daily intake under 300 to 400 milligrams a day. While this amount does cause dependence on the substance, other side effects, such as anxiety, sleeplessness, and digestive disturbance, generally don’t occur. Staying under 400 milligrams requires limiting intake to about two cups of coffee or three caffeinated soft drinks a day. (See “By the Numbers” on page 30.) CAFFEINE & PERFORMANCE

Beyond consuming coffee as part of their daily routines, many athletes are turning to caffeine as an ergogenic aid. “The prevalence of caffeine as a performance aid is something I’m seeing more and more,” says Josh Hingst, MS, RD, CSCS, USAW, Assistant Strength and Conditioning Coach and Sports Nutritionist at Florida State University. “I don’t see student-athletes taking caffeine pills, but I do see them

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private practice. “Coffee and colas are high in phosphorus, and the body requires a certain phosphorus-to-calcium ratio,” Lewin says. “If your phosphorus intake is high, and you don’t ingest enough calcium, your body will pull calcium from your bones. Most student-athletes don’t get enough calcium in their diets as it is. Often, when I look at a student-athlete’s daily calcium intake alongside their use of coffee and colas, they are in a negative calcium balance.” There are two other nutrition negatives to be aware of. First, since caffeine increases the production of stomach acid, large amounts can induce an upset stomach or acid reflux. Second, while caffeine is no longer believed to be a diuretic, most caffeinated beverages are not particularly good sources of hydration. If they replace water or sports drinks in an athlete’s diet, chances of dehydration increase. (See “Does Caffeine Dehydrate?” at left.)

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drinking more caffeinated beverages, especially the so-called energy drinks, before games or meets,” agrees Leah Moore Thomas, MS, RD, LD, Sports Nutritionist at Georgia Tech. “And I’ve had more athletes ask, ‘If I drink coffee before my swim meet or my race, is it going to help me?’”

The answer, according to a solid body of literature, is probably yes— but with some big caveats. Caffeine may boost performance, depending on the student-athlete’s sport and his or her individual response to the substance. Particularly with endurance exercise, multiple studies have shown

By the Numbers Student-athletes who ingest 100 milligrams or more of caffeine per day will develop caffeine dependence and experience withdrawal symptoms if they discontinue use. Those who ingest more than 400 milligrams per day are likely to experience anxiety, sleep disturbance, digestive problems, and other side effects. Below is a list of commonly used products along with their caffeine content. Product Product

Serving Size Serving Size

Typical Caffeine Typical Caffeine Content (mg) Content (mg)

Coffee (brewed) Coffee (Starbucks) Coffee (espresso) Coffee (decaf)

6 oz 16 oz 1 oz 6 oz

100 400 40 4

Tea (brewed) Tea (bottled, iced)

6 oz 12 oz

40 20

Soft drink (caffeinated) Jolt Cola

12 oz 12 oz

40 71.5

Energy Drinks (typical) Red Bull

8.4 oz 8.45 oz

80 80

Coffee ice cream Coffee yogurt

8 oz 8 oz

50 50

Stimulants (typical) Vivarin

1 tablet 1 tablet

Weight loss products/ Sports supplements (typical) Dexatrim Natural Stacker 3

2-3 tablets 1 caplet 1 caplet

100 or 200 200

80-250 80 250

The above amounts were obtained by permission from the book Substance Abuse: A Comprehensive Textbook, Fourth Edition, by Laura Juliano and Roland Griffiths, to be published this year by Lippincott Williams & Wilkins.

To help student-athletes pinpoint their exact caffeine intake with an interactive calculator, direct them to the National Sleep Foundation’s Web site at: www.sleepfoundation.org/caffeine.cfm.

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that athletes given caffeine prior to workouts in the laboratory outperform those given a placebo. “There is a wealth of information to suggest that caffeine allows people to exercise harder and longer in aerobic events lasting 20 minutes or more,” says Lawrence Spriet, PhD, an exercise physiologist, caffeine researcher, and Professor at Canada’s University of Guelph. “Caffeine holds up as a solid performance enhancer in endurance events.” The support for performance improvement in shorter-duration events is less definitive, but growing. “Recent studies provide increasing evidence that caffeine can also improve performance during sprinting events lasting 90 seconds or more,” Spriet says. “There are few studies looking at throwing events, power events, or sprints lasting 90 seconds or less, and most researchers agree it’s unlikely that caffeine produces any true physiologic effects in these events. But even there, an improved sense of alertness and awareness caused by caffeine could translate to improved performance.” Until recently, physiologists believed that caffeine aided performance by allowing the body to tap into fatty acid stores more quickly, thus sparing muscle glycogen to be used later in the event as the body fatigues. However, that theory has not held up in newer research. Researchers now believe the majority of caffeine’s performance effect results from simple central nervous system stimulation. “As the athlete gets tired, he or she is better able to maintain focus and level of effort with caffeine,” Spriet says. “Caffeine also reduces perceived exertion, so athletes report that they don’t feel like they are working as hard.” In laboratory studies, caffeine’s CNS stimulant effect also seems to boost awareness, vigilance, and alertness, particularly during boring, long-term exercise bouts. However, the real question mark comes when one attempts to translate laboratory findings to real life competition. Research studies typically put

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“If you were a betting person and you were looking for something legal you could take that was likely to give you a performance benefit, caffeine would be at the top of the list.” athletes through very specific physical challenges with few variables, like treadmill running or stationary cycling. “Clearly the translation from that to running a 1500-meter race is quite easy,” Spriet says. “But with sports like soccer, ice hockey, and basketball, the translation is very complicated. When you introduce all the variables that are involved with team sports, it becomes much harder to measure whether caffeine has improved an individual athlete’s performance.” However, even with these caveats, it’s likely that many athletes will see some performance improvement with caffeine. “The majority of the lab studies and the few field studies that have been done suggest very strongly that caffeine does boost performance,” Spriet says. “If you were a betting person and you were looking for something legal you could take that was likely to give you a performance benefit, caffeine would be at the top of the list.” HIGH SCHOOL ATHLETES

If caffeine can possibly boost performance, should athletic trainers advocate student-athletes use it? When it comes to high school studentathletes, Spriet has an unequivocal answer: absolutely not. “I do not recommend caffeine use with developing individuals,” he says. “In fact, if it was up to me, it would be banned for athletes under 18.” Juliano agrees. “For one thing, from a chemical standpoint, we don’t know whether caffeine affects a developing central nervous system differently from an adult central nervous system, because that research cannot be done for ethical reasons,” she says. “We know that the brain is still devel-

oping, and that caffeine affects brain neurotransmitters, but beyond that, we just don’t know.” In addition, advocating that high school athletes use caffeine to perform better may put them at increased risk for trying other, and more dangerous, ergogenic aids. “Telling a 14- or 15-year-old athlete that caffeine supplementation is an okay idea sends a dangerous message,” says Lewin. “It opens them up to the idea of a quick fix, of taking a pill to become a better athlete. Can it lead to abuse of other performance enhancers? We don’t know for sure, but it’s certainly an issue to be aware of.” The fact is, however, that high school student-athletes are getting the message that caffeine will help them play better from other sources, so it falls to athletic trainers to offset that message with education. “We know that children and adolescents are using more caffeine than ever before,” Juliano says. “They are a huge share of the market for soda and energy drinks. For athletic trainers working with adolescents, it’s critical to educate them that caffeine is a drug, that it causes physical dependence, and that there are much better ways to achieve more on the court or field.” It’s also important to be aware of the messages high school athletes are getting from their coaches regarding caffeine. “Ask the coaches you work with how they feel about caffeine use,” Juliano says. “Are they neutral, or are they encouraging or discouraging its use? And take that opportunity to educate coaches about the issue, because they are the ones most likely to notice if athletes are using caffeine to enhance performance, and their messages go a long way.” Circle No. 116 A T H L E T I C B I D . C O M ◆ T & C M A R C H 2 0 0 5 ◆ 31

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Kicking Caffeine For student-athletes who need to lower their caffeine intake, it’s essential to help them develop a strategy, because withdrawal symptoms can hit harder than they expect. Caffeine researcher and Assistant Professor of Psychology at American University Laura Juliano, PhD, and her colleague Roland Griffiths recently conducted a review of existing literature on caffeine withdrawal. “One of our most important conclusions was that caffeine withdrawal is clinically significant,” she says. “Some people become so ill that they mistake the withdrawal for the flu. It’s important to take caffeine withdrawal seriously.” The most pronounced symptom is usually a pounding headache, and caffeine’s affect on adenosine is to blame. “Adenosine is a vascular dilator in the cerebral system,” Juliano explains. “Caffeine is a vasoconstrictor, so when it’s used regularly, it fights adenosine to constrict blood flow in the brain. The body fights back to keep veins open. During withdrawal, the body is still pushing those veins open, but there is no caffeine there to fight against. At that point, the veins blow open, causing a pulsating headache that is sensitive to movement. The headaches can last anywhere from one to three weeks and can be more pronounced during physical activity.” An often-unanticipated symptom of caffeine withdrawal is mood disturbance. Since caffeine works to make several of the brain’s “feel good” neurotransmitters more available, suddenly eliminating it can cause irritability, difficulty

COLLEGE ATHLETES

With older student-athletes, a message that combines information about caffeine’s risks with education about using it safely may be a more realistic approach. “Once athletes are in college, many of them are going to use it as an ergogenic aid whether athletic trainers advocate it or not,” Spriet says. “So athletic trainers need to be there to say, ‘If you are going to use it, here are some guidelines so you don’t harm your body.’” Hingst agrees. “I think the message from college athletic trainers needs to be, ‘There are a lot more important things to consider when you’re trying to improve your performance, like

concentrating, and depression. Fatigue is another common symptom of caffeine withdrawal, since the central nervous system must adjust to no longer receiving a regular chemical stimulant. Juliano suggests helping student-athletes cut back by letting them know what to expect. “Explain to the studentathlete that whenever you use a drug regularly, your body makes a series of adjustments,” she says. “When your body doesn’t get the drug, it is forced to go through a period of readjustment—and that can significantly interfere with performance in school and athletics. Help them choose an appropriate time to cut back. Right before final exams or an important game is probably not the best time.” Leah Moore Thomas, MS, RD, LD, Sports Nutritionist at Georgia Tech, advises student-athletes to reduce caffeine gradually. She first has the athlete tally up all the sources of caffeine they typically use, especially hidden ones like coffeeflavored yogurt, or caffeine-containing medications. “Then I ask them to reduce it a little at a time,” she says. “If caffeine is present at three meals a day, I have them replace it at one meal with juice or water or a decaffeinated soda or coffee. Once they do that for a while, I ask them to try including caffeine only once a day, and then go to every other day. My goal is for our student-athletes to reach a level of use where if they don’t have caffeine for a day, they don’t feel any adverse effects.”

nutrition, hydration, training, and rest. But if you are going to use caffeine in an attempt to boost your performance, here is how to do it safely,’” he says. Education on the safe use of caffeine as an ergogenic aid needs to include the following factors: Dose: Research indicates that doses of three to five milligrams per kilogram of body weight will provide a performance effect without health risks. “For a 70-kilogram (154-pound) athlete, three milligrams per kilogram is only 210 milligrams of caffeine,” Spriet says. “You can easily get that from two cups of coffee.” Athletes who ingest too much caffeine before an event are more

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likely to see a performance detriment than a benefit, from caffeine-induced headaches, anxiety, stomachaches, and focusing problems. They may also approach the caffeine limits set by the NCAA, which require athletes to have less than 15 micrograms per milliliter of urine. (The average 175-pound athlete would have to drink seven to 10 cups of coffee one hour prior to a test to exceed the NCAA limit, according to Spriet.) Source: Spriet advises against using energy drinks, since they typically contain many other ingredients not regulated by the FDA. He believes the safest source is simply coffee. “For an adult athlete, one to three cups of

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coffee before an event, depending on the athlete’s weight, is very safe and is likely to provide them with a performance benefit, without adding sugar or other ingredients,” he says. Timing: In general, caffeine should be consumed a half-hour to an hour before the start of the event. “The blood level of caffeine is maximized one hour after it’s taken, but effects start to show up by 30 minutes,” Spriet says. For events lasting longer than an hour, caffeine can be ingested right before the event. Tolerance: Athletes who use caffeine as part of their daily diet are less likely to see a performance benefit from using it prior to exercise. “To avoid building up a tolerance, an athlete needs to abstain from caffeine for a few days prior to taking it before their event,” Lewin says. Testing: “Advise athletes to try it during practices or workouts before using it during a game or meet,” Hingst says. “They need to have some

experience using it first to see how they respond.” Mixing: Perhaps most importantly, advise student-athletes to be very aware of the ingredients in any other supplements they are taking. Combining caffeine and other stimulants often found in dietary supplements can be a deadly mistake. “Both ephedrine and ephedra, in and of themselves, can decrease fibrillatory potential and put an athlete at higher risk for a sudden arrhythmic death,” says Richard Stein, MD, Cardiologist at Beth Israel Hospital in New York City and a national spokesperson for the American Heart Association. “Adding the tachycardic influence of caffeine could certainly make that worse and would definitely increase the risk.” While ephedra is banned from sale in the United States, athletes are still able to obtain it on the black market. Ephedrine is readily available in many cold remedies and “fat burning” supplements.

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BOTTOM LINE

Even with new research on caffeine and performance available, nutritionists still recommend downplaying its role to athletes. “When athletes ask me about boosting performance with caffeine, I ask them, ‘What have you done to improve your breakfast, lunch, dinner, and recovery meals? How is your hydration, training, and rest?’” Lewin says. “Depending on their sport, their individual response, and a host of other variables, caffeine may give them a slight boost. But it is not going to make up for not having these foundational pieces in place.” “Athletes need to be reminded that there is a difference between feeling really energized and actually being energized,” Stein adds. “Actually being energized is dependent on attention to proper fueling, hydration, and training, and those are the things that we need to be emphasizing.” ◆

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MANAGEMENT

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On the

Record With legal worries and insurance changes, record-keeping has become an important aspect of an athletic trainer’s job. Here’s a look at how one school has upgraded its system. By Maria Hutsick

wenty-five years ago, record-keeping in athletic training was pretty simple. Here at Boston University, we used a recipe box and index cards. Each team had a section in the box, each injury was recorded on a card in SOAP note format, and daily treatments were recorded on the backside. That was it. Today, documentation is a more complicated aspect of the athletic trainer’s job. Records should be very comprehensive and include outside medical services. We need to ensure our athletes’ files are kept private, and our record-keeping system must keep up with changing legal and insurance issues. Over the past several years, as education reform has raised the stature of the athletic trainer within the medical community, there is an even greater responsibility to maintain complete records of all patients evaluated and treated, regardless of work setting. The recent push by the NATA to have Medicare programs recognize athletic trainers as an important part of allied health care has also raised the need for clear, concise record-keeping. And most importantly, maintaining accurate records is a way to ensure a thorough and organized thought process for athlete care. On both a daily and long-term basis, these notes help provide a structure for thinking and problem solving.

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Maria Hutsick, MS, ATC, LATC, CSCS, is the Director of Sports Medicine at Boston University. She has also served on the NCAA Competitive Safeguards Committee and the NATA’s Board of Certification.

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Boston University's Maria Hutsick with her files

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How does the busy athletic trainer keep up with the new trends in recordkeeping? How can you figure out the best system for your department? In this article, I’ll provide some suggestions based on upgrades we’ve been working on at Boston University. REVIEWING YOUR SYSTEM

The first step to upgrading your record-keeping system is to thoroughly review your current system. This review should involve administrators outside the athletic training room, including your athletic director and legal counsel. Athletic trainers need to be proactive with their administrators on many topics, but establishing, maintaining, or upgrading your institution’s medical record-keeping system should be near the top of the list. Medical records not only serve the practical purpose of documenting an organized plan of care, they are also the institution’s first line of legal defense in the case of a wrongful-injury lawsuit. The questions you should answer, with help from athletic administrators and legal counsel, include: • How in-depth should our records be? Explain your current system and ask if the notes you keep provide enough detail in case of a lawsuit. • What is the length of time the athletes’ records must be retained? Most states require that medical records be retained for at least seven years. • Will our record-keeping process stand a test in court? Ask your legal counsel to ascertain if a judge or “expert witness” might be able to find any flaws in the way your department keeps its records. • Is the storage of our records adequate? To comply with HIPAA and FERPA regulations, printed records need to remain in locked file cabinets, ideally behind locked doors, and computer records need to have limited, password-only access. Discuss whether your system is secure enough.

The next step is to review your system with your athletic training staff. Some questions to consider include: • What are our goals for recordkeeping? Do we simply want to document our athletes’ daily treatments, or might we use these records to write case studies or conduct research? • Does our system include clearly stated procedures? • Does everyone who handles these files understand the correct procedure for writing and storing the records? • Do our records provide the information needed for any kind of outside agency review, such as NCAA redshirt requests or insurance company inquiries? • What type of technology do we have, or might we need, to improve our medical records? Another worthwhile step in assessing the quality of your recordkeeping system is to test it. A simple test is to compile the records from a significant injury that occurred one or

two years ago and review them. Can a complete story be told? Do the records indicate the description of the injury, care provided, and dates of the progression back to full participation? If there was a question as to the efficacy of the treatment provided at any stage, would the records explain and justify the actions taken? If your current record-keeping system satisfies legal and administrative needs, your next step is to evaluate the efficiency of the system. Is there technology that would reduce the amount of time athletic trainers spend keeping records? There are many computer software options for athletic training record-keeping, and some schools may choose to write their own software. In many cases, the above reviews will lead to the realization that you may need more resources to help upgrade your system. This, of course, leads to another discussion with upperlevel administrators. How can you get more resources at a time of shrinking budgets? Pointing out the liability risks of poor record-

Do's and Don'ts A medical record should “tell the story” of the athlete, allowing other health care providers to quickly read and understand the athlete’s past and current health conditions. Each medical record is a legal document that protects both the health care provider and the athlete. The following general guidelines should be kept in mind when compiling medical records: • Be certain that your entries are clear and readable.

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• Don’t squeeze words into a line or leave blank spaces. • Draw a line through all blank spaces after each entry. • Never erase, write over, or try to ink out a record. If you make a mistake, draw a single line through the mistake with the date and your initials in the margin. • Use only standardized medical abbreviations. • Date and sign each entry made in the record. • Use a full signature when signing notes. • Always note when and by whom medical records are photocopied. • Require athletes to sign a medical release when sharing their record with anyone. • Use specific language and avoid generalizations and lengthy descriptions. • Document athletes’ statements verbatim. For example: The athlete states, “I heard a pop when I landed on my knee.” • Record all instructions, including limitations, restrictions, and follow-ups.

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keeping is a good place to start. But it’s also critical to educate your administrators about our ever-changing profession whenever a chance arises. It’s a good idea to look for openings within specific situations. For example, several years ago, one of our coaches insisted that an athlete sustained an injury and requested a medical redshirt letter in order to add a year of eligibility for the athlete. We had no record of an injury for the athlete in question, and so the coach accused us of not keeping adequate records. It turned out the coach was trying to obtain the extra season due to the skill of the athlete and not because of a substantial injury. This incident opened up an opportunity to discuss with the athletic director our record-keeping system and how we might make it better. Because of this incident and consequent discussion, I was provided funds to computerize our record-keeping system. I was given the okay to purchase the supplies and hire the

computer support needed to implement a more in-depth and professional system, which we have been upgrading and revising ever since. Another situation involved an athletic departmental review of staff job descriptions. Recently my administration requested that all athletic department heads re-write their staff’s job descriptions and break down percentages of how much time is generally spent on different job tasks. When I handed in my report, administrators were shocked at how much time my staff spends completing paper work. In response, they finally relented to my previous requests for the services of a secretary to help with record-keeping. TYPES OF RECORDS

Once you have analyzed your current procedures and gotten feedback from athletic administrators, the next step is to discuss how you might want to upgrade your system. A good starting point is to simply categorize and make

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rules for the different types of records you keep. Here are some suggestions: Evaluation & Treatment: Accurate medical records are your most important tools in legal defense. A case can be won or lost based on the detail, quality, and content of your records. Entries must fully describe the athlete’s history, your physical evaluation, all special tests, your assessment, treatment plan, referrals, and follow-up. Each entry should be clear, be concise, use medical terminology, and be dated and signed. Physician Records: These may include office visit notes, post-operative notes, and clinical notes. If your physicians hold clinics in your facility, their notes must be transcribed and made part of the athletes’ records. All visits to off-campus physicians should be recorded on a separate sheet of notes and clearly define the reason for seeing the physician and the plan of care. Also, any special tests required or medical prescriptions must be recorded.

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Checking It Twice The following is a list of questions you can ask yourself when reviewing your record-keeping procedures. Organization of the Record 1. Is there an internal organization of the charts in the athlete’s file? 2. Is there a systematic filing of medical records? 3. Are medical records individualized by athlete name or ID number? 4. Is there is a place for demographics in the medical records? 5. Are pages and forms secure in the files? 6. Is there a signed consent to treat form? 7. Is there a signed medical information release form? 8. Is there a medical history that includes shot records and is signed by the family physician and athlete? Confidentiality 1. Are confidentiality rules in place? Do all staff members who handle medical records sign a confidentiality statement? 2. Are there policies and procedures in place regarding the release of information? 3. Are medical records stored in a secure manner away from unauthorized access? Documentation Practices 1. Do all entries contain author identification? 2. Are all entries dated? 3. Are all entries legible? 4. Are record-keeping practices and procedures reviewed yearly?

Medications: If your facility chooses to provide any medicine, either by prescription or over-the-counter, you need to keep a record of all drugs you have on the premises and when they are distributed. The drugs must be stored in a locked cabinet in individual dose packs clearly labeled with the drug’s name, directions, expiration date, and lot number. When they are administered, staff members must follow the legal requirements for disbursing them. Insurance Records: The responsibility for insurance claims will vary from one institution to another depending on what procedures are used and if your facility is a high school, boarding school, college/university, or professional sports organization. The athletic trainer should be the initiator of the insurance claim, but the administration of the claim should then be handed off to someone in your business office who is trained to handle insurance. Clearance To Play: For an athlete to participate in athletics at any level, a physician’s clearance must be kept on file. We ask each incoming

athlete’s primary care physician to sign underneath a statement that says: “I, the undersigned health care provider, find this student-athlete physically able to participate in highly competitive intercollegiate athletics.” When athletes arrives on campus with their forms, they are further screened by both our general medicine and orthopedic physicians. If all is in order, they are cleared to participate. OUR STORY

Once you have formulated rules for all the types of records you keep, you can start looking at how to refine the system at your particular setting. Here at Boston University, we began upgrading our record-keeping system about 10 years ago. The system evolved with the help of our academic program director, assisted by some experts in computer programming. Our first upgrade was to our hardcopy files. We purchased a lateral file cabinet, which is kept in our office area. The office is locked and the facility is locked so a double-lock system is in place. Only authorized personnel have

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access to these records, and the files only leave the cabinet to be updated by staff. Each athlete has one file folder. Each team is assigned a specific color so its athletes’ records can be found quickly in the lateral file cabinet. A medical tab system identifies each athlete by last name. Each athlete’s record is divided into sections. The front of the folder, along with having the athlete’s name, has his or her date of birth, student identification number, and year of graduation. We place a sticker on the outside if they have an HMO or allergies to any medications. A bar code sticker is also placed on the front of the folder, which works with our scanner medication inventory system. Each time an athlete is prescribed a medication by our physicians, all information is scanned into the system. Inside the folder, on the left side, we place the athlete’s medical history booklet. This includes the dates of each orthopedic and general medicine pre-participation screening exam, demographic information on insurance, emergency contact, and a place for the athlete to verify that the information is true and accurate. There is a consent to treat, medical information release, and informed consent and waiver of claim form. These forms must be signed and dated. If the athlete is under 18, his or her parents must also sign them. The booklet also includes an in-depth medical history for illness, joint injury, and each body part. The last page includes shot records and clearance to play signatures. All orthopedic and general medicine clinic records and dictation are also placed in the left side of the folder. Our physicians conduct on-site clinics during the week and dictate their records via phone to a medical transcription office. These dictation records are e-mailed back to us and placed in the athletes’ files. They are also color-coded: General medicine is printed on pink paper and orthopedic on green paper. The middle pages of the folder have post-op notes and any MRI, Xray, or other diagnostic reports. The back of the middle pages have insur-

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ance records and referrals. Each time an athlete is sent to an outside health care provider that charges a fee for service, our computer generates a claim form with referral information, insurance information, and the name and address of the treatment provider. The claim form requires the athletic trainer’s signature. A business office staff person follows up on insurance claims and works with parents and athletes to expedite insurance claim processing. The inside right side of the folder is where the treatment notes are kept. These are SOAP notes, progress notes, and records of phone conversations with insurance companies, parents, and health care providers. Medical release forms are also kept here. All athletic training students and staff must sign and date each entry in the record. All student entries must be reviewed and signed by the supervising athletic trainer. The system works well. However, in more recent years, we have found

ourselves drowning in a sea of paperwork with all this record-keeping. Therefore, our next step was computerizing some of our records. One of my assistants is very computer savvy and he was able to write a program that fits our needs. This is the database that we use for insurance and comprehensive records. He continues to update our database and refine it on a yearly basis. ENTER THE COMPUTER

We have begun computerizing our records with our insurance and referrals paperwork. Our database allows us to print an initial insurance claim form, a referral form, and any of the X-ray, MRI, or bone scan forms that our radiography services require. The data is entered into the athlete’s record and the software automatically files information where it is needed. We have several desktop computers and each staff person also has a laptop and PDA. We can download

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our team files onto the PDA and have all insurance and injury data for that team on hand when we travel, as well as access to the Internet and scheduling information. We will eventually upgrade to BlackBerry® devices so we will have a phone, e-mail, and all the rest in one tool that eliminates the need to carry a laptop, PDA, and cell phone. We are currently working with a computer expert to write a program that will allow us to send compliance and injury reports, compile statistics for research, insurance needs and forms, and maintain an injury tracking database, with SOAP notes and ongoing treatment notes. We will also be able to download any teams’ insurance and emergency contact information on our PDAs and carry them with us on away trips. Next, we will incorporate an interactive Web site, which will allow our student-athletes and parents to complete most of their medical history online. It will be a password-protected program

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that students will access. Forms that need a signature will be downloadable with easy printing. Our system is in transition and we will continue working to streamline as much of the paperwork as possible. We hope to eventually have all of our injuries entered in to the database so we can track injury trends, write case studies, and conduct research projects. The only staff person who is doing this now is our men’s ice hockey athletic trainer, who has a separate athletic training room and was able to upgrade more quickly. STAFFING ISSUES

Of course, all the systems in the world won’t work unless your staff is committed to using them. Thus, the director of sports medicine should conduct a yearly review on the proper way to document the care of athletes at the facility. There must also be formal instruction for all physicians, administrative staff, and students on how to use the medical record-keeping system.

If your facility utilizes athletic training students, they must be instructed in the proper recording of your medical record-keeping system and all notes must be signed by their supervising athletic trainer. If your department uses clerical help, a non-disclosure agreement should be signed and on file. We are fortunate at Boston University to have a highly motivated and professional staff that practices a high level of care. Even though each staff member is responsible for specific athletic teams, we all see walk-ins at the athletic training facility. Therefore, each of us knows our notes may be read by others on staff. Every Monday morning we have a staff meeting and one of the topics we discuss is called the “Hit Parade.” The Hit Parade is a list of all injured athletes who require follow-up care. We go over each one, discuss what needs to be done, and assign someone to do it. This way, teams that don’t have an athletic trainer assigned to cover their practices will not be neglected.

The clinical staff and the academic staff work very well together to educate our athletic training students. The students are taught the proper way to perform medical record-keeping and must practice and have regular cognitive and psychomotor skills development (CPSDs) check-offs that are specific to our record-keeping system. The students are graded on these skills and each staff person is assigned to supervise several students. The staff must cosign any notes that the students enter into the record. A good record-keeping system can protect you and help in your organizational plan for your facility. Assess your needs, review your current system, and talk to others in the field about how you can make your record-keeping system the best it can be. ◆ The author would like to thank Jon Almquist, ATC, for his help and feedback on this article.

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Big gJUMPS Increasing explosive power is a goal of most volleyball players. A progressive plyometrics program will help them reach it.

By Tim McClellan sk any volleyball player what her primary objective is for her off-season training efforts, and the answer is always the same. Ask any club, high school, or college coach what his or her training goals are for their team, and you’ll hear an echo. They will all say, “Increase vertical jump.” The key to increasing vertical jumping ability is to incorporate plyometrics into a training program. Most coaches today understand the value of plyometrics, but few understand how to safely and effectively make it a part of their offseason training programs.

HISTORY & DEFINITIONS

It is often said that plyometrics were invented in the 1970s by Soviet Bloc and Eastern European coaches. This is actually not true. The term “plyometrics” may not have been popularized until that time, but there are much earlier accounts of Japanese judo athletes hopping up steps, track athletes performing hurdle hops, and boxers jumping rope. The effectiveness of such training has been known for at least 100 years. But there are still many misconceptions about what plyometrics are and how they work. Simply stated, an exercise is deemed plyometric if the Tim McClellan, MS, CSCS, is the Performance Enhancement Director at Makeplays.com. He has coached volleyball players for over 20 years, ranging from professionals to youth club competitors. Associated Press, THE GAZETTE 42 ◆ T & C M A R C H 2 0 0 5 ◆ A T H L E T I C B I D . C O M

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▼ muscle groups utilized contract rapidly in a shortening fashion, after previously lengthening. The classic volleyball example is a middle blocker touching down after blocking a ball and immediately having to jump again to block another. The plyometric effect is present when the muscles of the thighs, glutes, calves, and core lengthen upon floor contact (eccentric contraction) and are then asked to immediately shorten (concentric contraction) in the propulsion of the next jump. The goal of training with plyometrics is to increase the rate of this stretching and shortening, as well as the power behind it, so that the stored elastic energy more rapidly transfers to the next explosive movement. In the above example, it means the volleyball player will spend as little time as possible on the floor between jumps, while elevating as high as possible during both jumps. This rapid transfer of elastic energy into the shortening phase is believed by many to be the most productive training stimulus for improving explosive muscle contraction and increasing vertical jump capability. Understanding plyometrics also requires knowing the difference between strength and power. Power is defined as the amount of force an athlete can apply over a distance in the amount of time it takes to do so. It differs from strength in that the strength equation does not take into account the time component. For example, if Kaylin squats 200 pounds x 3 feet over the course of 6 seconds, her power ratio is 200x3/6 = 600/6 = 100 foot pounds/second. If her twin sister Ashley squats 150 pounds x 3 feet over the course of 3 seconds her power ratio is 150x3/3 = 150 foot pounds/second. Ashley isn’t as strong as Kaylin, but she demonstrates more power. Since the leg extension movement required in jumping takes between 0.2 and 0.3 seconds, and maximal strength development takes usually between 0.5 and 0.7 seconds, it makes sense for athletes to incorporate exercises aimed at increasing power. Increasing strength is important for increasing power, but

speed of movement is a critical second step. And speed of movement is a big component of plyometrics. ARE THEY SAFE?

With this sound scientific reasoning for enhanced power development, and knowledge that most elite-level volleyball players, basketball players, and jumping field-events athletes use this type of training, it would seem that there should be instant incorporation of plyometrics into all volleyball training programs. However, plyometrics have been criticized for having a greater risk of injury than other methods due to increased forces of landing and immediate rebounding. In reality, these fears won’t materialize if a progressive program is implemented. Consider these facts: Volleyball is a plyometric sport, as are football, basketball, hockey, tennis, and most other sports. Competitors are required to decelerate and accelerate in a different direction, be it a libero exploding laterally to dig a ball and then getting back to original position, or a middle blocker having to jump quickly to make consecutive blocks. Sending an athlete into a plyometric sport unprepared to make plyometric movements is like sending someone to a piano recital after having them practice extensively on the tuba. Many of the reported injuries resulting from plyometrics occur in populations that are very different from competitive sport-specific athletes. For example, one article that calls plyometrics dangerous is talking about participants in aerobics classes. Comparing hard-training athletes to the bulk of participants in an aerobics class is simply inaccurate. Many aerobics participants aren’t used to plyometric activity or lack a sufficient strength base to safely perform plyometrics. Most volleyball players have extensive, though possibly informal, histories with plyometric exercise and many have access to adequate strength programs, giving those athletes a leg up when it comes to avoiding injury.

Table One: For Beginners The following plyometric program is for beginners. Speed/agility ladder Running, 1 foot per box Running, 2 feet per box Shuffling, right and left Double-leg hops, forward Double-leg hops, right and left Hopscotch Right-leg hops, forward Left-leg hops, forward Ali shuffle, right and left Mobility Movement Sequence Knee-to-chest walk Leg cradles Inch worm Spiderman Backwards hamstring RDL walk Quads Cross-over toe touch Kicks Laterals Twisting lunges Kick skips Six-inch hurdle drills Shuffling Double-leg hops Shuffle 6 hurdles, side hop 6 hurdles Side hop 6 hurdles, shuffle 6 hurdles 12-Inch Box Depth Jumps: 3 sets of 5 reps, without plyometric jump (Technically not plyometric, but it is a great drill to strengthen and teach proper landing biomechanics so that one can progress into intermediate level plyometrics.) Strength-training program for legs: general exercises such as step-ups, lunges, presses, and squats if mechanics dictate Core Training Program

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▼ The National Strength and Conditioning Association has issued a position paper with regards to plyometric exercises, which touts its benefits over its risks. The paper says, “Carefully applied plyometric exercise programs are no more harmful than other forms of sports training and competition, and may be necessary for safe adaptation to the rigors of explosive sports.” PROPER USE

So what constitutes a “carefully applied” and “safe” plyometrics program? The first step is to understand that plyometrics tax the athletes’ muscles, connective tissue, and nervous system, and thus should be implemented with care. Consider these important guidelines from the NSCA position statement: • A thorough set of warm-up exercises should be performed before beginning a plyometric training session.

• Footwear and landing surfaces used in plyometric drills must have good shock absorbing qualities. • Only athletes who have already achieved high levels of strength training through standard resistance training should engage in plyometric drills. • Less demanding drills should be mastered prior to attempting more complex and intense drills. In terms of the strength needed before starting a plyometrics program, there is no hard-and-fast rule. It has been mentioned in previous literature that a player should be able to squat twice his or her weight before beginning plyometric training, but this lacks substantiation and is not accepted by most diligent performance enhancement coaches. The National Football League, for example, is full of 350-pound linemen who cannot squat 700 pounds, yet they routinely train with plyometrics.

Strength

Rather than risk injury by making athletes “max-out” on squats, I feel it is more important to observe strength levels exhibited during play. If the athlete shows sufficient and functional strength movements while fulfilling sport requirements, he or she is ready for a plyometric program. For example, one of our current clients is a 6’3”, 16-year-old female who cannot squat twice her bodyweight. Few players her age, height, and weight would be ready for medium or advanced-level plyometrics, but this athlete actually started functional strength training when she turned 13, then started on very low levels of plyos as she developed her strength. Her years of strength work prepared her for the demands of higher-level plyometrics at a younger age. She now possesses the strength, physique, and movement skills of a college-age player, and actually has already made an

Balance

Flexibility

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www.thera-band.com 800-321-2135

C O M P E T I T I V E

E D G E

▼ oral commitment to accept a volleyball scholarship at a prestigious university. To implement a progressive plyometrics program, start with lower level exercises and progress slowly into medium and more advanced stages. Vern Gambetta, who has coached national and world-class athletes for three decades, has devised a rating scale that is educational and effective (see “Rating Scale,” below). Gambetta says the key is to understand the stress of different types of drills and to only progress to higher stress exercises when the athlete is ready. (The chart also points out recovery times needed.) WHEN TO PROGRESS

How do you actually know when the athlete is ready to progress to the next level? Coaches, above all, must be great observers. If the player is struggling to complete the plyometric movement, then the exercise is inappropriate for that individual. If the athlete has mastered the exercise repeatedly, she is ready to move to the next level. For example, double-leg hops down an agility ladder can be successfully used by groups of females as young as 13 on their first day of training. My past experience has shown they can handle this very low-level plyometric activity using appropriate mechanics at almost no risk of injury. Most at this age can then progress to performing the same exercise over sixinch hurdles, while some can do the same over 12-inch hurdles. However, if an athlete exhibits a lack of ability

Figure One

Figure Two

to maintain proper biomechanics, then the exercise opens the athlete up to a greater risk of injury. At that point the athlete should return to a lower level of exercise. Some examples that might indicate that the athlete is not ready for the next level include the following: • If the athlete shows extensive bending at the waist or her torso flops forward or from side-to side, more core work may be needed. • If the athlete exhibits prolonged contact with the floor, she may not have the overall body strength and power necessary to proceed. • If the athlete’s knees are collapsing towards each other, this can mean lack of quadriceps strength (see Figure One, above). This can occur on landing during the eccentric contraction or on push-off of the concentric phase. If the level of exercise is not decreased, these movements can lead to joint pain, tendonitis, excessive heaviness of the legs, and a decreased demonstrated ability to explode. Ideally, the knees should be aligned over

Figure Three

the middle toe of each foot (see Figure Two, above). Along with the position of the knees, the position of the feet is also important during landing. It has been said that all athletes doing plyometrics should land first on their toes and balls of feet, then make contact with their heels to help absorb force. This is correct for high-level jumps and plyometrics such as depth jumps, box jumps, tuck jumps, and many repeat hops. However, this is not correct for very low-level plyometrics, such as ankle flips, rope jumping, and agility ladder drills. In these low-level exercises, the athlete’s entire floor contact should be made with the toes and balls of the feet. There should be no contact between the floor and the athlete’s heels. In addition, there should be as little noise as possible made by the athlete’s feet when landing. The athlete should also try to keep her head up during all drills (see Figure Three, above). This helps prepare her for on-court situations, when jumping and viewing the court need to be done simultaneously.

Table Two: Plyometric Demand Rating Scale Rating

Example

Recovery Time

1 = very low stress

Rope-jumping, ankle bounces, or other similar low-amplitude jumps

Very rapid

2 = low stress

Tuck jumps or other similar in-place jumps

Rapid, one day required

3 = moderate stress

Stair jumps or other similar short jumps

One to two days

4 = high stress

Hops, bounds for distance, or other similar long jumps

Slow, two days required

5 = very high stress

Depth jumps or other similar shock-type jumps

Very slow, three days required, highest nervous system demand

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▼ EXERCISE CHOICES

In designing your own program, it’s important to start with low-level plyometrics. Here are some examples: • Rope jumping (various patterns) • Speed-agility ladder • Six-inch hurdle hops (forward hops, side hops, side-to-side hops over one hurdle, side hop with a vertical block)

• Ankle flips • Power skips • Side-to-side hops to create a distance (such as hitting dots on a dot drill pad). Here are some mid-level plyometric exercises: • Rope jumping (double jumps) • 12-inch hurdle hops (repeat forward hops, forward hops with

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• • • •

block, side-to-side hops with block, hop-scotch) Low-level depth jumps Dumbbell squat jumps Low-level single-leg box or hurdle hops Resisted/assisted lateral hops (can include vertical block).

High-level plyometric exercises include: • Depth jumps • Depth jumps onto or over another object • Single-leg hurdle hops (both forward and lateral) • Dumbbell split-squat jumps • Bounding • Lateral bounding • Side step-up jumps over a bench • Resisted/assisted hops or shuffles over hurdles. As your athletes move into the higher levels of plyometrics, it’s especially important to be position-specific when developing a regimen. For front row players, repeat hops are a solid choice (assuming the player is ready for such training). Repeat hops can be performed as consecutive vertical movements, lateral movements, or preferably a combination of both. For the “movement based” positions of setter, libero, or the defensive specialist in high school play, lateral movements are more appropriate. One exercise particularly helpful for this group is to attach a resisted/assisted bungee cord to the athlete via a belt. If it is attached to the left hip, the athlete would jump to the right against the resistance, usually over chalk lines or a taped area. Upon touching down they would then pop back to starting position with assistance from the stretched cord. Repeat for the desired number of repetitions (such as a set of 10 reps) then switch direction. With any and all of the exercises, the keys to keep in mind are minimizing contact time with the ground and maintaining appropriate biomechanics. As the athletes progress, you’ll see improvement in the drills, then on the playing court. ◆

Aquatic Exercise Products Aquatics by Sprint 800-235-2156 WWW.SPRINTAQUATICS.COM AquaLogix has created a revolution in water-based training to rival the land-based “aerobics” phenomenon of the 1980s. The AquaLogix hand bells are an excellent training tool to help develop the upper body. They are made of durable and long-lasting high-impact plastic, and they are lightweight. AquaLogix hand bells will challenge you to reach your physical limits, creating resistance in almost every direction you push or pull. There are three resistance levels to choose from: low, medium, and high. Circle No. 500

Ferno Performance Pools 888-206-7802 WWW.FERNOPERFORMANCEPOOLS.COM 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, which include 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. It provides athletes the ultimate water workout by strengthening muscles and reducing joint impact. Circle No. 501 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. Circle No. 502

Fitness First Products 800-421-1791 WWW.FITNESS1ST.COM Professional Aqua Cuffs offer coaches, athletic trainers, and instructors versatility in exercise design. Athletes will see improved muscle strength, aerobic enhancement, and increased flexibility with the cuffs’ added resistance and buoyancy. Available in medium or heavy resistance, the cuffs can be used in shallow or deep water exercises while reducing impact during walking, plyo, or running drills. They are effective for group exercise programs, team workouts, and personal training. The durable foam cuffs offer a secure, sturdy fit with adjustable Velcro straps that wrap around the leg and under the foot. Aqua cuffs are successful tools for all aquatic professionals. Contact Fitness First for a 2005 catalog. Circle No. 503

designed for use with both hands to create a tandem exercise pattern that provides challenging core bodywork. The AquaBodyCiser is made of dense plastic, so it won’t bend with increased resistance. It has adjustable resistance levels and is designed to float. A sample exercise insert is included. Circle No. 505

Power Systems, Inc. 800-321-6975 WWW.POWER-SYSTEMS.COM Add resistance and increase the effectiveness of water workouts by wearing the Power Systems Water Cuffs on the ankles or wrists. These soft, non-abrasive, closed-cell foam cuffs also improve the body’s buoyancy and add drag to strengthen muscles. The fully adjustable straps secure the cuffs around the ankle and under the foot. Call today or go online for more information on Power Systems’ products and programs, to order a catalog, or to place an order. Circle No. 506

OPTP 800-367-7393 WWW.OPTP.COM Fin & Flipper® Exercise Logs are ideal tools for both upper- and lower-extremity exercises. These buoyant logs provide added resistance to any aquatic program, and the innovative slot makes them perfect for those with a weak grip. They can be used in shallow or deep water, and are available in two sizes and various colors. Circle No. 504 The AquaBodyCiser™ from OPTP is made for lumbar stabilization exercises, but can also be used for cardiovascular, knee, or shoulder rehab. It’s

Finally, there’s resistance tubing made specifically for the pool that resists the damaging effects of chlorine. Enhance aqua cardio and strength workouts with Power Systems’ Aqua VersaTubes™. These latex-free, water-specific tubes improve muscle tone, strength, and flexibility when used in training, rehabilitation, and group or individual workouts by providing resistance through the full range of motion. The powder-free tubes have unique contoured, pliable handles that provide a secure grip in the water. The handles and tubes will not absorb water, dry out, or crack. Circle No. 507

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Hot & Cold Therapy Aircast®, LLC 800-526-8785 WWW.AIRCAST.COM The Hand and Wrist Cryo/Cuff™ by Aircast® combines the therapeutic benefits of cold and compression to help reduce swelling and pain, quickly restoring range of motion and reducing the need for pain medication and rehab sessions. The versatile cuff design allows the user to reposition the cuff for more or less hand coverage, and removable support bars are incorporated for added stability. The Cryo/Cuff is easy to use in the training room, on the playing field, and at home. Circle No. 508 The Aircast® Shoulder Cryo/Cuff™ applies soothing cryo-compression to the shoulder to help reduce swelling and pain, reducing the need for pain

medication and rehab sessions, and quickly restoring range of motion. The anatomical design of the cuff conforms to the shoulder to provide complete coverage for optimal treatment. The Shoulder Cryo/Cuff is easy to use in the training room, on the playing field, and at home. An extra-long strap is available to accommodate chest circumferences of up to 54 inches. Circle No. 509

thermal gel that’s microwavable for therapeutic heat and freezable for cold therapy. The Thermal Lumbar Support has plush, ventilated elastic panels for cool, lightweight, comfortable compression. The panels overlap to give a contouring shape to most body types. Application is easy, and the product is available in black or beige. Circle No. 510

Game Ready FLA Orthopedics, Inc. 800-327-4110 WWW.FLAORTHOPEDICS.COM The Thermal Lumbar Support, from FLA Orthopedics, is ideal for treating minor backaches and pains resulting from sprains, muscle soreness, strains, cramping, or contusions (bruising). It features a reusable soft gel pack, with

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Used by almost every pro football team, the Game Ready Accelerated Recovery System simultaneously provides controllable cold therapy and adjustable intermittent compression to help accelerate the healing of acute or chronic injuries. It is also useful for post-opera-

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Hot & Cold Therapy tive recovery. “The results have been outstanding, and Game Ready has become our modality of choice for acute and chronic injuries,” says Chuck Barta, Head Athletic Trainer of the NFL’s Minnesota Vikings. Circle No. 511

Gebauer Co. 800-321-9348 WWW.GEBAUERCO.COM Gebauer’s Spray and Stretch doesn’t deplete the ozone, and is intended for use with the Spray and Stretch Technique in the management of myofascial pain, restricted motion, and muscle spasms. The topical anesthetic is also great for the tem-

porary relief of minor sports injuries. Call or visit the company’s Web site for product and prescribing information, and to find a local distributor. Circle No. 512

Biofreeze 800-246-3733 WWW.BIOFREEZE.COM

Gebauer’s first non-prescription topical skin refrigerant, Instant Ice™ stream spray is ideal for the temporary relief of muscle spasms. Physical therapists, massage therapists, athletic trainers, chiropractors, coaches, school nurses, and other professionals will now be able to use a nonflammable and non-ozone-depleting topical anesthetic for temporary muscle spasm relief. Call for product and distributor information, or visit Gebauer on the Web. Circle No. 513

The Biofreeze® family of pain relieving products includes a soothing gel, convenient roll-on, and the new natural Cryospray™. Biofreeze effectively relieves pain from athletic injuries, muscle injuries, strains, sprains, and stiff joints. Apply before, during, and after workouts to reduce swelling and stiffness, and enable greater range of motion and flexibility. Biofreeze gel is available in 16-oz., 32-oz., and gallon professional pump bottles; 16-oz. spray bottles; and gravity dispenser boxes with 100 fivegram doses. The 4-oz. gel tubes, 4-oz. spray bottles, and 3-oz. roll-ons are for patient self-care at home. Biofreeze is endorsed by the World Olympians Association of the Americas and the United States Taekwondo Union. Circle No. 514

ImPACT© The Best Approach To Concussion Management The management of concussion has become an increasingly important concern for the sports medicine clinician. ImPACT is a user-friendly computer based tool designed to aid in the proper diagnosis and treatment of concussion. ImPACT measures aspects of brain function affected by concussion such as memory, processing speed, and reaction time. ImPACT helps to assure when the athlete is ready to return to the playing field following a concussion.

Developed following years of university-based research: ■ ■ ■ ■ ■ ■ ■

Valid and reliable Sensitive to subtle changes in brain function Easy to administer Baseline and Post-Injury Testing Comprehensive Clinical Report A valuable tool employed within numerous research studies worldwide Utilized throughout professional and amateur sports: ✔ 16 NFL teams ✔ Professional Hockey ✔ IRL, CART, Formula One ✔ New Zealand Rugby Football Union ✔ US Soccer ✔ US Women’s Olympic Hockey ✔ Professional Baseball ✔ Swedish World Cup Soccer ✔ 300+ High Schools ✔ 55+ Sports Medicine Centers ✔ 125+ Universities ✔ 25+ Neuropsychology Clinics

For more information, contact: ImPACT Applications, Inc. Phone Toll-Free: (877) 646-7991 • Website: www.impacttest.com

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Hot & Cold Therapy Prossage™

Pro-Tec Athletics

866-477-6772 WWW.PROSSAGE.US

ThermoTek, Inc

800-779-3372 WWW.INJURYBEGONE.COM

Prossage™ Heat is a uniquely blended, area-specific, non-slip, controllableglide warming ointment that’s 100-percent natural. It’s formulated specifically for deep tissue work, myofascial release, and trigger point therapy. Prossage Heat makes it easier to “hook” the deep fascia, allowing you to work faster and more efficiently, with less pain for the athlete. Heating the tissues with Prossage Heat reduces spasms in muscles, ligaments, and joint capsules. Prossage Heat is available in 3-oz., 8-oz., and 16-oz. bottles. Call 866-PROSSAGE today for a free sample. Circle No. 515

877-242-3232 WWW.PROTHERMO.COM

Feel the benefits of direct, active ice massage with the Ice-Up™ portable ice massager from Pro-Tec Athletics. It offers effective treatment in just five to seven minutes, making it three times faster than ice. Experience deep tissue relief for ligament, tendon, and muscle injuries. Immediate ice massage increases treatment effectiveness and speeds recovery. The leak-proof design keeps your sports bag dry, and it stays frozen for up to 10 hours in a portable carrying cooler. Circle No. 516

Check out

www.AthleticBid.com to contact these companies.

TurfCordz Speed Belt gives you... • Explosive off-the-bag starts! • Faster base running and fielding! • The safety, security and reliability professional baseball players demand! • Call us to learn more, or view us online!

800-886-6621 • www.nzmfg.com Circle No. 128 50 ◆ T & C M A R C H 2 0 0 5 ◆ A T H L E T I C B I D . C O M

Whitehall Mfg., Inc. 800-782-7706 WWW.WHITEHALLMFG.COM Whitehall Manufacturing offers a complete line of moist heat-therapy treatment products that are convenient and easy to use. Each heating unit is fabricated from heavy-gauge stainless steel and polished to a satin finish. Standard features include a snap-off thermal protector that prevents overheating, and a rounded bottom that minimizes bacteria build-up. The heating units are available in various sizes and colors. Circle No. 518

This Spring Training be Faster! Quicker! Stronger!

Get out of the ice age and into the future with a ProThermo therapy unit. ProThermo allows you to control the application of cold, heat, and compression therapy. Bring the temperature down to 37 degrees without ice, or up to 105 degrees. Compression can be administered constantly or intermittently for the management of chronic or acute pain. The product is ideal for acute sports injuries, post-operative care, and chronic injuries. The attachments can be used to treat all areas of the body. Circle No. 517

The ThermaSplint™, from Whitehall Manufacturing, features dual voltage, an illuminated on/off switch, and quick heatup time. The unit operates on a solar-powered digital thermometer that allows the temperature to be adjusted with digital readouts for different splinting thermoplastics. the ThermaSplint is constructed from heavy-gauge stainless steel. Circle No. 519

Company Q & A

Sports-Medicine Manufacturer Puts its Full Product Catalog Online In June of 2004, Cramer Sports Medicine became one of the first manufacturers in the sports-medicine industry to put its full product catalog online. Ed Christman, the Vice President of Marketing at Cramer, discusses the launch of its online catalog.

Why did Cramer decide to make the move to a Web-based catalog? We found that the consumers in our industry, the coaches and athletic trainers, have a great deal of access to computers and have become very techsavvy. The online catalog allows them

Even though our catalog is now online, ordering is still carried out through Cramer’s dedicated network of dealers. But with the Web site’s Bid Builder feature, customers can quickly prepare bid sheets with everything they need, and then send the information directly to their dealer.

How does the Bid Builder work? It’s a very efficient and user-friendly way to put together a bid sheet. Customers can go into the catalog and click on any product, enter the quantity they want, and build their entire order. Once they’re finished, they can print it and fax it to the dealer of their choice, or send it as an e-mail. This method streamlines the ordering process, and it gives customers an immediate record of all their purchases.

Does Cramer still offer some printed material about its products?

the opportunity to get all the information they want quickly and easily. It’s always available and it can be updated instantly when we release new products, so it’s the most convenient way for consumers to find out about any product they’re interested in.

What are the main advantages of the online catalog?

Cramer Products, Inc. P.O. BOX 1001 GARDNER, KS 66030 800-345-2231 FAX: 913-884-5626 INFO@CRAMERSPORTSMED.COM WWW.CRAMERSPORTSMED.COM

For one thing, it allows the consumer to see the most accurate information on a timely basis. When we introduce a new product at a trade show, it’s up on the Web right away and anyone can go online and learn more about it. A printed catalog that comes out once a year can be outdated soon after it’s released. Another big advantage is that it makes ordering products easier than ever.

Yes. For people who are looking for traditional product literature, we have developed a printed piece which highlights about a dozen new products and featured products for the team market, and it’s available for our dealers to hand out to coaches and athletic trainers. In addition, we recognize that while the response to our online catalog has been extremely positive thus far, there are some people who would prefer to have the option of looking at printed material. For these customers, we have made every page of the catalog printable from the Web site. If they would like to, someone could even print out the entire catalog. In fact, Cramer was the first company in the industry to offer a .pdf version of its complete catalog online. We’re proud to be offering an innovative new way for people to learn about our products, but we’ve kept the needs of all our customers in mind.

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Catalog Showcase Antibody, Inc.

Ball Dynamics Intn’l.

Cho-Pat, Inc.

301-782-3700 WWW.ANTIBODYWEAR.COM The patented BodyGuard line of compression sportswear has revolutionized how muscle injury is prevented and treated. BodyGuard offers a unique combination of muscle support and performance enhancement in easy-to-use, lightweight, comfortable sportswear products for the shoulder, groin/thigh, knee, elbow, and ankle. The BodyGuard’s compressive energy transfer assists muscles in generating torque, reduces muscle vibration and tissue damage, delays muscle fatigue, and keeps muscles warm. BodyGuard offers maximum compression, superior muscle support, and performance enhancement. Circle No. 525

800-752-2255 WWW.FITBALL.COM Ball Dynamics is proud to introduce its 2005 catalog, featuring both the extensive FitBALL and Gymnic lines of high-quality exercise balls, plus balance training, massage, and sensory products. There is also a comprehensive selection of instructional books, videos, and DVDs, along with mats and accessories. Call the company or visit its Web site today. Circle No. 526

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, its 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. Circle No. 527

Concussion Sentinel

Creative Health Products, Inc.

Exertools

INFO@CONCUSSIONSENTINEL.COM WWW.CONCUSSIONSENTINEL.COM Concussion Sentinel is an easy-to-use, computer-based cognitive testing system that’s used by athletic trainers and physicians in the management of concussions. The innovative use of familiar playing cards provides a fun and interactive experience for athletes. Concussion Sentinel is different because the program was developed for athletic trainers to use in youth, high school, and college settings. Concussion Sentinel takes the guesswork out of concussion management by providing an objective tool that allows you to make confident return-toplay decisions. Circle No. 528

800-742-4478 WWW.CHPONLINE.COM Creative Health Products has been in DISCOUNT CATALOG business since 1976 as a leading discount supplier of rehabilitation, fitness, exercise, and athletic equipment, as well as health, medical, and fitness testing and measuring products, all available at reduced prices. The products offered 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. Circle No. 529

800-235-1559 WWW.EXERTOOLS.COM Exertools is proud to introduce its 2005 product catalog and price list. This catalog has more than twice as many products as Exertools has ever offered in the past. It’s one-stop shopping for today’s training, conditioning, and rehabilitation professionals. The table of contents helps the user to easily locate products for training, mobility, stability, balance, lateral stability, speed, strength, power, flexibility, agility, and motor control. Circle No. 530

Fitness First Products

FLA Orthopedics, Inc.

Life Fitness

800-421-1791 WWW.FITNESS1ST.COM Fitness First’s 2005 catalog features exercise equipment for both commercial facilities and individual home users. Popular aerobic products such as The Step, dumbbells, and plates, plus yoga products, water aerobic products, exercise mats, resistance tubing and bands, and rehab and training weights are all available. You’ll also find health and wellness products like bodyfat monitors, calipers, pedometers, and heart rate monitors. Check out the company’s products in the catalog or on its Web site. Circle No. 531

800-327-4110 WWW.FLAORTHOPEDICS.COM The new FLA Orthopedics Complete Professional Products Guide features the company’s extensive range of Americanmade products. It includes orthopedic bracing, specialty splints and orthoses, sports-medicine products, and soft bracing supports. With 30 years of experience, FLA offers one of the most complete and innovative product lines in the industry. An extensive patent portfolio outlines FLA’s innovative products. Circle No. 532

800-634-8637 WWW.LIFEFITNESS.COM Life Fitness recently released a new brochure highlighting its full line of products and services. The comprehensive brochure has an inspiring new look and includes information about the company and its cardiovascular products, strength training lines, and service and support offerings. To request a brochure or for more information, call Life Fitness or visit its Web site. Circle No. 533

C R E AT I V E H E A LT H P R O D U C T S

2005 CATALOG #100 PRICE $2.00

Plymouth, Michigan

WE DO NOT MAKE REPEATED MAILINGS OF THIS CATALOG, SO BE SURE TO KEEP FOR REFERENCE. FOR THE MOST CURRENT INFORMATION SEE OUR WEBSITE AT: WWW.CHPONLINE.COM

Health, Fitness, Exercise, Rehabilitation, Therapy and Sports Medicine Products. Leaders since 1976

ANTHROPOMETRIC MEASUREMENT PAGE 4

BICYCLES & ERGOMETERS PAGE 21 & 22

BLOOD PRESSURE PAGES 6-10

BLOOD CHEMISTRY ANALYZERS PAGE 5

BODY FAT MEASURING PAGES 1, 2, 24 & 25 BOOKS & VIDEO’S PAGES 15 - 20

ERGOMETERS & BICYCLES PAGE 21 & 22

EXERCISE BANDS PAGE 18

EXERCISE EQUIPMENT PAGES 21 & 22

FITNESS APPRAISAL KITS PAGE 11

GONIOMETERS PAGE 3

HEART RATE MONITORS & PULSE OXIMETER PAGES 11-14

LUNG CAPACITY TESTERS PAGE 3

LUNG MUSCLE EXERCISERS PAGE 6

METRONOMES PAGE 20

OTOSCOPES & OPHTHALMOSCOPES PAGE 10

REHABILITATION PRODUCTS PAGES 18-20

SCALES PAGES 23 - 25 SPIROMETERS PAGE 3

Creative Health Products

5148 Saddle Ridge Road • Plymouth, Michigan 48170

800-742-4478 Overseas orders 734-996-5900 Visit our Web Sites at:

You can order by phone, fax, e-mail or online. e-mail: sales@chponline.com

24-hour FAX Orders to:

734-996-4650

www.chponline.com www.polarservicecenter.com www.powerbreathe-usa.com

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STOPWATCHES & COUNTERS PAGE 20 & 21

STRENGTH & FLEXIBILITY TESTERS PAGES 2 & 3 See Detailed Index on Back Cover

Catalog Showcase Perform Better 800-556-7464 WWW.PERFORMBETTER.COM The 68-page 2005 Perform Better catalog is now available upon request. Neatly organized into sections, it allows readers to quickly find products to meet their immediate needs. Among the 17 sections in the catalog, youâ&#x20AC;&#x2122;ll find headings such as speed and agility training, dumbbell training, weight training, cardiovascular training, and more. Each of the major sections is supplemented with editorial â&#x20AC;&#x153;how toâ&#x20AC;? commentary authored by a member of the companyâ&#x20AC;&#x2122;s team of professional advisors, all of whom are well known in the field of functional training and rehabilitation. Circle No. 534

NZ Mfg., LLC

Oakworks

800-886-6621 WWW.NZMFG.COM TurfCordzâ&#x201E;˘ by NZ Mfg. offers the latest in highquality resistance exercise designed to fulfill any sports training, fitness, or rehabilitation application. The companyâ&#x20AC;&#x2122;s catalog is filled with an extensive line of training and rehabilitation products, including TurfCordz products for strength training, MediCordzÂŽ products for rehabilitation and conditioning, and StrechCordzÂŽ products for swim training. The patent-pending Safety Bungieâ&#x201E;˘ and Safety Cordâ&#x201E;˘ products provide the ultimate in safety for clinicians and patients alike. Circle No. 535

800-916-4603 WWW.OAKWORKSPT.COM Oakworks therapeutic tables and chairs have offered quality and innovation since 1978. Having built treatment tables to therapist specifications from the very beginning, the company continues to strive for your absolute satisfaction through products that meet your 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. Circle No. 536

OPTP

BiofreezeÂŽ

Power Systems, Inc.

800-367-7393 WWW.OPTP.COM The Volume 17 Product Catalog from OPTP features products from renowned experts Robin McKenzie, Freddy Kaltenborn, Diane Lee, PT, and many more. Also featured are OPTPâ&#x20AC;&#x2122;s exclusive products, such as â&#x20AC;&#x2DC;The Next Core Challengeâ&#x20AC;&#x2122; and â&#x20AC;&#x2DC;FitBall Roller Workoutâ&#x20AC;&#x2122; DVDs. The companyâ&#x20AC;&#x2122;s selection is always growing, and you can count on OPTP for the latest innovations, such as the FitBall Roller and the BOSU Balance Trainer. And of course, OPTP still offers favorites like GymnicÂŽ balls, OPTP foam rollers, and McKenzieÂŽ lumbar rolls. Circle No. 537

800-246-3733 WWW.BIOFREEZE.COM For pain-management programs, use BiofreezeÂŽ gel, roll-on, or spray to reduce swelling, pain, stiffness, and next-day aches and pains, and to speed recovery. Biofreeze can also help to increase mobility and flexibility, and aid in the overall healing process. Biofreeze can be used in situations requiring ice and breathable wraps, or it 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 the company. Circle No. 538

800-321-6975 WWW.POWER-SYSTEMS.COM Since 1986, Power Systems has been a leading supplier of sports performance, fitness, and rehabilitation products and programming. The company prides itself on being the one resource for all your training needs. The 2005 catalog has a new look, with better graphics and photos. It includes sections on core strength, medicine balls, speed, plyometrics, agility, strength equipment, strength accessories, and fitness assessment. The catalog features hundreds of new products and dozens of products available exclusively from Power Systems. The company has even lowered some of its prices, enabling the customer to get premium products for less. Call or visit the company Web site for your free copy. Circle No. 539

Spencer Medical, Inc.

Sports Health

efi Sports Medicine

877-348-6692 WWW.SPENCERMEDICAL.COM Athletic trainers and strength coaches have long recognized the importance of accurately measuring their athletesâ&#x20AC;&#x2122; bodyfat. The most successful ones know how bodyfat analysis can help their athletes reach full potential. Futrexâ&#x20AC;&#x2122;s patented near-infrared body composition analyzers have helped thousands of athletic trainers and coaches do exactly that. Best of all, Futrex is accurate and portable, enabling you to measure your athletes anytime, anywhere. Circle No. 540

800-323-1305 WWW.ESPORTSHEALTH.COM Sports Health, a division of School Health Corporation, is the leading distributor of medical supplies and equipment to athletic trainers, physical therapists, and other sports-medicine professionals. The company offers onestop shopping on over 7,000 products, including taping supplies, trainersâ&#x20AC;&#x2122; kits, defibrillators, quality furniture, and training room supplies. Sports Health invites you to use its Web site to order online, access health information, and link to medical sites worldwide. Circle No. 541

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 non-compressive nature of efiâ&#x20AC;&#x2122;s flagship product, Total Gym, uses bodyweight as resistance and creates a safe environment for athletes to begin or continue strength training. Circle No. 542

&542%8 4-

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s 3UPERIOR .EAR )NFRARED 4ECHNOLOGY s $IRECT MEASUREMENT OF PERCENT BODY FAT s 3IMPLIFIED TESTING PROTOCOL s .ON INVASIVE TEST RESULTS s 'OLD 3TANDARD !CCURACY s ,IGHTWEIGHT 0ORTABLE Â&#x2C6; 5SE )T !NYWHERE !NYTIME

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!LL &542%8 "ODY #OMPOSITION !NALYZERS CONTAIN A POWERFUL COMPUTER CHIP AND SPECIALIZED OPERATING SOFTWARE 4HIS SOFTWARE PROVIDES &ITNESS !NALYSES THAT CAN BE PRINTED USING AN OPTIONAL EXTERNAL %PSON PRINTER IN A UNIQUE FOUR PAGE COLOR REPORT 4HE PRINTOUT COMPARES THE INDIVIDUAL S CURRENT DATA I E PERCENT BODY FAT AGE HEIGHT WEIGHT SEX ETC TO .ATIONAL )NSTITUTES OF (EALTH .)( REFERENCE DATA AS WELL AS GENERATING DIET AND ACTIVITY SUGGESTIONS AIMED AT IMPROVING FITNESS AND REDUCING HEALTH RISKS

&EATURES "ENEFITS OF THE &542%8

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30%.#%2 -%$)#!,

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A T H L E T I C B I D . C O M â&#x2014;&#x2020; T & C M A R C H 2 0 0 5 â&#x2014;&#x2020; 53

Athlete Monitoring Systems HQ, Inc. 941-721-7588 WWW.HQINC.NET Product Name: CorTemp® Monitors: Core Body Temperature Application: The CorTemp® Monitoring System, featuring the CorTemp ingestible temperature pill, has been on the market for over 15 years. It wirelessly monitors athletes’ core body temperature in a stationary or mobile environment with the highest degree of accuracy, ease, and convenience. It monitors up to 99 athletes and is cleared by the FDA. Advantages: The ability to rapidly and accurately assess core body temperature on the field is critical to the proper

evaluation and treatment of exertional heat stroke. Other methods of assessing core temperature are not as convenient or appropriate for individuals exercising in hot environments. The CorTemp monitor offers a new, affordable approach to recognizing elevated core temperature on the field. It’s the perfect tool to optimize performance and keep your athletes in the game, where they belong. Circle No. 550

tool that stores data for analysis after games and practices. Advantages: Actiheart allows the collection of heart rate and physical activity data without cumbersome wires or chest belts. It combines heart rate and physical activity tracking in a single instrument to provide a more accurate estimate of energy expenditure than either measure can on its own.

Mini Mitter Co., Inc.

Circle No. 551

800-685-2999 WWW.MINIMITTER.COM

Product Name: VitalSense® Monitors: Core Body Temperature and Skin Temperature

Product Name: Actiheart™ Monitors: Heart Rate, Physical Activity, and Energy Expenditure Application: The Actiheart™ monitors heart rate, physical activity, and energy expenditure without using wires. It’s a lightweight “wear-and-forget” monitor which snaps onto two electrodes placed on the chest. Actiheart is a research

Application: VitalSense® is a physiological monitoring system for use during training or competition. Athletes swallow vitamin-sized Jonah™ temperature capsules, and each capsule transmits core body temperature and a specific ID number as the athlete comes within range of the monitor.

“LET THE BODYGUARD PROTECT YOUR TEAM” BodyGuards are designed for the prevention and treatment of upper and lower-body soft tissue injuries using the theory of Stored Elastic Energy Transfer (“SEET”). BodyGuards: used by 17 of 32 NFL teams and numerous collegiate programs during the 2004-2005 season in a wide variety of sports. “The BodyGuard made me feel like I had an extra layer of muscle that gave me the ability and the conÀdence to perform. I recommend The BodyGuard for any athlete that has suffered an injury similar to mine.” Triple H - World Wrestling Entertainment

“The BodyGuard worked perfectly for me...I wouldn·t have played without it.” Troy Vincent - Philadelphia Eagles/ Buffalo Bills

INJURY

ANSWER

Groin strain: Hamstring: Quadricep: Hip Flexor: Shoulder subluxation: Shoulder dislocation: Shoulder separation:

The BodyGuard The BodyGuard The BodyGuard The BodyGuard The BodyGuard The BodyGuard The BodyGuard

Antibody, Inc. phone (301) 782-3700 fax (301) 782-3701

Antibody·s goal is to improve the Athletic Quality of life of all athletes. To purchase and learn more visit us at www.antibodywear.com Circle No. 129

54 ◆ T & C M A R C H 2 0 0 5 ◆ A T H L E T I C B I D . C O M

Athlete Monitoring Systems Advantages: VitalSense’s Jonah ingestible capsules monitor core body temperature but don’t interfere with performance. Hot or cold, these “swallow-and-forget” capsules provide critical physiological feedback. Circle No. 552

Premier Software, Inc. 630-906-6630 WWW.SIMTRAK.NET Product Name: Simtrak™ Monitors: Health, Injury, and Treatment Data Application: Simtrak™ systems provide a PC- and Web-based way to maintain data on athlete health, injury treatment, drug dispensing, document filing and management, team and personal

Relief.

MedZone™ includes a full line of topical relief products formulated specifically for athletes to enhance saturation and deep penetration through high performance ingredients. • Relieves minor aches and pains of muscles and joints • Relieves pain from minor burns and skin irritations • Minimizes scarring and scabbing • Reduces swelling • Accelerates healing

real-time alerts and time-stamped history profiles of measured data that directly affect an athlete’s safety and performance.

administration, and group and individual health and injury statistics. Advantages: Simtrak systems give athletic trainers a low-cost way to readily manage athlete information and reports from training rooms, hotels, homes, and even wireless connections. Premier Software is a progressive leader in data systems innovation, offering customers the most up-to-date technology in the industry.

Advantages: Exertional heat illness can inhibit an athlete’s ability to perform at his or her best. It can also threaten athetes’ safety, and expose an organization to significant liability. Quest’s environmental monitors enable athletic trainers, coaches, and sports-medicine professionals to obtain accurate and comprehensive information that can be used to keep athletes safe.

Circle No. 553

Quest Technologies, Inc. 800-245-0779 WWW.QUEST-TECHNOLOGIES.COM Product Name: QUESTemp

Circle No. 554

Monitors: Core Body Temperature and Heart Rate Application: QUESTemp Series monitors can display and record core temperature and heart rate, and provide

PlyoBacks from Exertools. Enjoyable. Effective. Affordable. Get an intense strength and aerobic workout using weighted medicine balls and the time-tested Exertools PlyoBack.™ PlyoBack Pro

왘

New PlyoBack Light Institutional

Both models are fully adjustable for a clinically proven upper body and cardio workouts Professional and Light Institutional models available separately, and as packages All heavy-duty construction with powdercoated steel Proven choice of NFL, Major League Baseball, NHL, college and high schools internationally

Visit us at www.exertools.com or call 800-235-1559 for packages and pricing. Ask about our our Trade-in Program for your old rebounder in any condition!

888-206-7802 www.fernoperformancepools.com Circle No. 130

Circle No. 131 A T H L E T I C B I D . C O M ◆ T & C M A R C H 2 0 0 5 ◆ 55

w le No ilab a Av

New 2005 Professional Product Catalog

ADVERTISERS DIRECTORY CIRCLE NO.

Our Complete 80-Page Catalog, Including: • Orthopedic Bracing & Supports • Night Splints / Multi AFOs • Graduated Compression Hosiery • Sports Medicine Supports... and More!

COMPANY

PAGE NO.

CIRCLE NO.

COMPANY

PAGE NO.

112 . . . . .Aircast . . . . . . . . . . . . . . . . . . . . . . 23

113 . . . . .HQ . . . . . . . . . . . . . . . . . . . . . . . . . 25

129. . . . .Antibody (BodyGuards) . . . . . . . . . . 54

127. . . . .ImPACT Applications . . . . . . . . . . 49

137 . . . . .Athletes.com . . . . . . . . . . . . . . . . IBC

100 . . . .MET-Rx . . . . . . . . . . . . . . . . . . . . IFC

102. . . . .Biofreeze . . . . . . . . . . . . . . . . . . . . . 5

119 . . . . .Mini Mitter . . . . . . . . . . . . . . . . . . . 39

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

122. . . . .North American Assn. for Laser Therapy . 41

104 . . . .Concussion Sentinel . . . . . . . . . . . 11

138. . . . .Oakworks . . . . . . . . . . . . . . . . . . . BC

133. . . . .Creative Health Products . . . . . . . 56

115 . . . . .OPTP . . . . . . . . . . . . . . . . . . . . . . . 29

103. . . . .efi Sports Medicine. . . . . . . . . . . . . 7

105 . . . .Perform Better . . . . . . . . . . . . . . . 13

121 . . . . .Simtrak (Premier Software) . . . . . . . . . 40

136. . . . .Perform Better (seminars) . . . . . . . . 63

131 . . . . .Exertools . . . . . . . . . . . . . . . . . . . . 55

108 . . . .Pro-Tec Athletics . . . . . . . . . . . . . . 16

130. . . . .Ferno (MedZone) . . . . . . . . . . . . . . . 55

114 . . . . .Prossage Heat . . . . . . . . . . . . . . . . 26

117 . . . . .Ferno Performance Pools . . . . . . . 33

118 . . . . .ProThermo (ThermoTek) . . . . . . . . . . 37

134. . . . .FitBALL USA . . . . . . . . . . . . . . . . . 57

124 . . . . .Quest Technologies . . . . . . . . . . . 46

126 . . . . .Fitness First . . . . . . . . . . . . . . . . . . 49

135. . . . .Spencer Medical . . . . . . . . . . . . . . 57

When Made in America Quality Counts.

132 . . . . .FLA Orthopedics. . . . . . . . . . . . . . 56

125. . . . .Sports Health . . . . . . . . . . . . . . . . 48

116 . . . . .Game Ready . . . . . . . . . . . . . . . . . 31

123. . . . .Thera-Band/Hygenic Corporation . 44

Call 800-327-4110

110 . . . . .Gatorade . . . . . . . . . . . . . . . . . .18-19

128. . . . .TurfCordz/NZ Manufacturing . . . . 50

107. . . . .Gebauer (Instant Ice) . . . . . . . . . . . . 15

120. . . . .Uridynamics . . . . . . . . . . . . . . . . . . 40

106 . . . .Gebauer (Spray & Stretch) . . . . . . . . . 14

109 . . . .Whitehall Manufacturing . . . . . . . 17

www.flaorthopedics.com FLA Orthopedics, Inc.

Circle No. 132

DISCOUNT PRICES FITNESS TESTING PRODUCTS & EXERCISE EQUIPMENT

CREATIVE HEALTH PRODUCTS

PRODUCTS DIRECTORY CIRCLE NO.

COMPANY

PAGE NO.

CIRCLE NO.

COMPANY

PAGE NO

508 . . . .Aircast (Hand & Wrist Cryo/Cuff) . . . . . 48

552 . . . .Mini Mitter (VitalSense) . . . . . . . . . . 54

509 . . . .Aircast (Shoulder Cryo/Cuff). . . . . . . . 48

535 . . . .NZ Mfg., LLC . . . . . . . . . . . . . . . . . 53

525 . . . .Antibody . . . . . . . . . . . . . . . . . . . . 52

536 . . . .Oakworks . . . . . . . . . . . . . . . . . . . . 53

500 . . . .Aquatics by Sprint . . . . . . . . . . . . . 47

505 . . . .OPTP (AquaBodyCiser) . . . . . . . . . . . 47

BIG SAVINGS ON

526 . . . .Ball Dynamics International . . . . . 52

537 . . . .OPTP (catalog) . . . . . . . . . . . . . . . . . 53

538 . . . .Biofreeze (catalog) . . . . . . . . . . . . . . 53

504 . . . .OPTP (Fin & Flipper Exercise Logs)

• HEART RATE • BREATHING MONITORS EXERCISERS • BODYFAT • FLEXIBILITY CALIPERS TESTERS • BLOOD PRESSURE • LUNG CAPACITY TESTERS TESTERS • STRENGTH TESTERS • SCALES • STETHOSCOPES • GONIOMETERS • ERGOMETERS • METRONOMES • EXERCISE BANDS • STOPWATCHES • FITNESS APPRAISAL KITS • ANTHROPOMETRIC CALIPERS • BLOOD CHEMISTRY ANALYZERS

514 . . . . .Biofreeze (pain relieving products) . . . 49

534 . . . .Perform Better . . . . . . . . . . . . . . . 53

We stock popular brand name instruments for Fitness Measuring and Testing at the lowest prices.

QUALITY PRODUCTS GUARANTEED LOWEST PRICES PROMPT FRIENDLY SERVICE

CREATIVE HEALTH PRODUCTS 5148 Saddle Ridge, Plymouth MI 48170

800-742-4478

WWW.CHPONLINE.COM e-mail: sales@chponline.com

....

527 . . . .Cho-Pat . . . . . . . . . . . . . . . . . . . . . 52

507 . . . .Power Systems (Aqua VersaTubes) . . . 47

528 . . . .Concussion Sentinel . . . . . . . . . . . 52

539 . . . .Power Systems (catalog) . . . . . . . . . 53

529 . . . .Creative Health Products . . . . . . 52

506 . . . .Power Systems (Water Cuffs) . . . . . . 47

542 . . . .efi Sports Medicine . . . . . . . . . . . 53

553 . . . .Simtrak (Premier Software) . . . . . . . . . 55

530 . . . .Exertools . . . . . . . . . . . . . . . . . . . 52

516 . . . . .Pro-Tec Athletics . . . . . . . . . . . . . 50

501 . . . .Ferno (AquaGaiter) . . . . . . . . . . . . . . 47

515 . . . . .Prossage Heat . . . . . . . . . . . . . . . . 50

502 . . . .Ferno (custom pools) . . . . . . . . . . . . . 47

554 . . . .Quest Technologies . . . . . . . . . . . 55

503 . . . .Fitness First (Aqua Cuffs) . . . . . . . . . 47

540 . . . .Spencer Medical (catalog) . . . . . . . . 53

531. . . . .Fitness First (catalog). . . . . . . . . . . . 52

555 . . . .Spencer Medical (Futrex) . . . . . . . . 57

532 . . . .FLA Orthopedics (catalog) . . . . . . . 52

541. . . . .Sports Health . . . . . . . . . . . . . . . . 53

510 . . . . .FLA Orthopedics (Thermal Lumbar Support) 48

560 . . . .The Hygenic Corp. . . . . . . . . . . . . 58

511 . . . . .Game Ready . . . . . . . . . . . . . . . . . 48

517 . . . . .ThermoTek (ProThermo) . . . . . . . . . . 50

513 . . . . .Gebauer (Instant Ice) . . . . . . . . . . . . 49

561 . . . . .THOR Laser . . . . . . . . . . . . . . . . . . 58

512 . . . . .Gebauer (Spray and Stretch) . . . . . . . 49

556 . . . .Uridynamics . . . . . . . . . . . . . . . . . . 57

550 . . . .HQ . . . . . . . . . . . . . . . . . . . . . . . . . 54

518 . . . . .Whitehall Manufacturing (moist heat) .50

800-287-5901

533 . . . .Life Fitness . . . . . . . . . . . . . . . . . . 52

519 . . . . .Whitehall Manufacturing (ThermaSplint) 50

WWW.POLARSERVICECENTER.COM

551 . . . . .Mini Mitter (Actiheart) . . . . . . . . . . . 54

AUTHORIZED

SERVICE CENTER

Circle No. 133 56 ◆ T & C M A R C H 2 0 0 5 ◆ A T H L E T I C B I D . C O M

Athlete Monitoring Systems

Why choose FitBALL Products? ÂŽ

Spencer Medical, Inc. 877-348-6692 WWW.SPENCERMEDICAL.COM Product Name: Futrex

Application: Futrex body composition analyzers give athletes the competitive edge they need. To be at their best, athletes need to know their physical condition. Futrex analyzers help athletes move to the elite level by providing accurate bodyfat measurement for maximum performance. Advantages: There are multiple ways to determine lean body mass and bodyfat. Futrex is the only instrument that can guarantee accuracy and reliability while being non-invasive, reproducible, and easy to useâ&#x20AC;&#x201D;anytime, anywhere. Circle No. 555

Uridynamics, Inc. 866-748-7463 WWW.URIDYNAMICS.COM

T&C 0501

Monitors: Body Composition and Resting Metabolic Rate

Quality,Service,Choice! â&#x20AC;˘ All of our products, regardless of their price, are of the highest quality! â&#x20AC;˘ FitBALL dealers give their customers the finest, friendliest service! â&#x20AC;˘ FitBALL offers a choice of products to meet their customers exact needs!

800-752-2255

www.fitball.com Circle No. 134

"ENEFIT FROM !CCURATE Â¤ 2ESULTS WITH THE &542%8 "ODY #OMPOSITION !NALYZER

Product Name: HydraTrendâ&#x201E;˘ Monitors: Hydration Status Application: HydraTrendâ&#x201E;˘ urine test strips provide feedback about an athleteâ&#x20AC;&#x2122;s hydration level. They can be used to adjust fluid intake to ensure that athletes stay properly hydrated, allowing them to perform at their best and remain safe from dehydration and exertional illness. This is extremely important in weight certification for wrestlers. Advantages: HydraTrend test strip kits are convenient and easy to use, and provide results in just 30 to 60 seconds. Testing requires only a small urine sample. Each kit includes 50 test strips, a sample collection cup, complete instructions, a color chart for interpreting results, quality controls, and a card for recording test results over time. Circle No. 556

s 2EPRODUCIBLE 4EST 2ESULTS s 'OLD 3TANDARD !CCURACY s 3IMPLIFIED 4ESTING 0ROTOCOLS s &ITNESS !NALYSIS 2EPORTS )MAGINE HAVING THE BEST ASSESS MENT TOOL IN THE ATHLETIC TRAINING INDUSTRY !THLETIC TRAINERS AND STRENGTH COACHES HAVE LONG RECOGNIZED THE IMPORTANCE OF ACCURATELY MEASURING THE BODY FAT OF THEIR ATHLETES 4HE MOST SUCCESSFUL OF THEM KNOW HOW BODY FAT ANALYSIS CAN HELP THEIR ATHLETES REACH THEIR OPTIMAL POTENTIAL &542%8 S PATENTED NEAR INFRARED BODY COMPOSITION ANALYZERS HAVE HELPED THOUSANDS OF TRAINERS AND COACHES DO EXACTLY THAT "EST OF ALL &542%8 IS ACCURATE AND PORTABLE ENABLING YOU TO MEASURE YOUR ATHLETES ANYTIME ANYWHERE

&OR &2%% )NFORMATION #ONTACT 5S 4ODAY

)NTERNATIONALLY

WWW 3PENCER-EDICAL COM !SK !BOUT /UR 3PECIAL /FFERS Circle No. 135 A T H L E T I C B I D . C O M â&#x2014;&#x2020; T & C M A R C H 2 0 0 5 â&#x2014;&#x2020; 57

Concussion Management

Concussion Sentinel’s Innovative Tests Measure Brain Function Concussion Sentinel’s innovative use of playing cards to measure reaction time, memory, processing speed, and accuracy ensures that athletes are engaged in the protection of their own health. An athlete takes a preseason ‘baseline’ test. If the athlete is concussed, he or she takes another test. The results are compared to the baseline score and provide an objective measurement of whether the athlete’s brain has returned to its normal pre-injury level of function. What sets Concussion Sentinel apart is that the program was specifically designed with athletic trainers in mind, for use in high school and college settings. It’s easy to administer, no pretraining is required, and specialized medical training is not necessary for report analysis. “The physicians at the University of Notre Dame have been using this test for four years to help in making returnto-play decisions. We have found it to be an indispensable tool.” Dr. James Moriarity Head Team Physician University of Notre Dame Date Founded: 1999 Company Background: Concussion Sentinel is an easy-to-use, computerbased cognitive testing system for the management of concussions in athletes. Concussion Sentinel takes the guesswork out of concussion management by providing a tool for athletic trainers and physicians to use in making confident return-toplay decisions.

Concussion Sentinel INFO@CONCUSSIONSENTINEL.COM WWW.CONCUSSIONSENTINEL.COM

More Products The Hygenic Corp. 800-321-2135 WWW.THERA-BAND.COM The new Thera-Band® Exercise Station combines strength, balance, and flexibility exercises into one convenient system. With three levels of customdesigned resistance tubing, users can progressively increase their workout challenge level. The Exercise Station is also designed to integrate the use of resistance tubing with exercise balls, Thera-Band Stability Trainers, rocker boards, and wobble boards (sold separately). It includes 18 pieces of tubing with clips, two handles, two Assist™ straps, an exercise bar, and a color poster with 24 exercises. Circle No. 560

Thor Laser 866-251-7743 WWW.THORLASER.COM Thor has broken new ground with FDA clearance of the LX2. Thor’s expanded product line now includes the DDII—the Z world’s most powerful portable laser, lasers and LEDs for treating a wide variety of specific conditions—and eight different probes. The addition of the LX2 gives Thor the largest selection of powerful FDA-cleared performance lasers and probes in the United States. Circle No. 561

Web News SEE EXERCISES AND PRODUCT INFORMATION ON JUMP STRETCH’S SITE The Jump Stretch Web site features background information on owner/inventor Dick Hartzell. It also lists band sizes and widths, as well as resistances. If you click on “Flexibility Routine,” you will see the start and finish of each exercise in a moving-picture format. By clicking on the “Order Now” icon, you can check out the various combinations of bands the company sells, as well as running stations, home gym packages, and instructional videos. For additional information, residents of the continental U.S. can call 800-344-3539, and anyone can e-mail from the link within the site.

www.jumpstretch.com

PRODUCTS, PROGRAMS, INFORMATION, AND GREAT DEALS: POWER SYSTEMS OFFERS YOU MORE The Power Systems’ Web site continues to grow. It now showcases over 700 products and programs to improve strength, speed, agility, balance, and flexibility. The new site has been completely redesigned and is now easier to navigate and more informative, to help you make the right training equipment decisions. Hundreds of new training products and programs have been added, as well as a new sport-specific Sports Training section for six different sports. The site includes an increased number of specials, discounts, and links to related products, which can be found on most shopping cart screens and product information pages. Go online today to order your free catalog.

www.power-systems.com

ELEVATE YOUR LIFTING PROGRAM TO THE NEXT LEVEL WITH MONSTER ARMS Go beyond power lifting by adding the Monster Arms to Rogers’ Brute Racks. You’ll experience a whole new environment of closed-chain free weight training. See details in the catalog section of Rogers’ Web site. With the adjustable Monster incline, horizontal, and decline arms on your Brute Rack, perform free weight exercises with the added safety of pre-determined starting and stopping points. With an unrestricted range of motion, the arms help athletes develop more of the muscles used in football and other sports. Increase both power and sport-specific skill with the benefits of power racks and dedicated machines combined into one system.

www.rogersathletic.com

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Testimonial

The Smart Way To Build Strength “I have lived by the theory that there are two kinds of athletes in the world: Those who sit on the sidelines and watch life happen, and those who jump in feet first and make life happen. Guess which one I am. “After 13 years in the NFL, I’ve had my share of aches and pains. I built myself into one of the strongest NFL players, and I did it by being smart. “I began using ‘electromuscle stimulation’ to enhance my muscle performance. E-Stim, as it is called, provided me with four big advantages: 1. Injury Prevention: E-Stim helped me build and maintain strength during a rigorous in-season schedule. Many times, I couldn’t work out in the gym because of nagging soreness or injuries, and EStim helped me keep going. 2. Injury Maintenance: E-Stim allowed me to work around injuries to continue my strength training program, because I could work out the body parts that were healthy, unlike in traditional weight training. 3. Targeting Specific Muscles: There were many times when I couldn’t get a muscle or group of muscles to respond to training, and E-Stim targeted those muscles and stimulated increases in strength beyond what I was getting from traditional weight training. 4. Rapid Muscle Recovery: E-Stim has been clinically proven to speed muscle recovery, and I personally experienced that every time I used E-Stim. When I had tight or sore muscles, I didn’t head for the ‘ice bath’... I headed for E-Stim.” Mike Morris Host of the Power Trip Morning Show KFAN, Minneapolis, MN

Testimonial

The Best Teams Choose VertiMax for Vertical Jump Conditioning

OPTP’s Foam Rollers Are Athletic Trainers’ First Choice

Sports teams all over the country are turning to the VertiMax to improve their athletes’ vertical jump, and the results speak for themselves.

“I use NASM’s Body Map to prescribe integrated and individualized corrective exercise training. Self-myofascial release exercises using OPTP foam rollers play an important part in Body Map exercise programming, to correct muscular imbalances, improve neuromuscular efficiency, and prevent injury. OPTP has been my source for the best foam rollers and other cutting edge products for over seven years.” Mark Neumann, A.C.E.-Master Trainer; NASM-PES, CGT, IFS; ACSM-HFI Director of Programming and Education www.AthleticArchitect.com

“After implementing VertiMax in our off-season strength and conditioning program, our basketball team’s cumulative vertical jump capability in sheer inches increased by a magnitude that I have not seen in my 26-year coaching career. The VertiMax has made every player on my team a more dominant athlete, and has provided me a more competitive team to work with. After seeing what VertiMax has done for my program in three short months, I can’t imagine any coach not making VertiMax an integral part of their team’s strength and conditioning program.” Bruce Weber, Head Coach University of Illinois Men’s Basketball “Vertimax has taken our program to another level. In three years, we have helped 21 athletes become first-round NFL draft picks. In our profession, it’s all about results, and we’ve had great results improving speed and quickness. I believe it is a direct result of the increase in explosive leg power derived from VertiMax training.” Tom Shaw, Owner Speed Incorporated, Kenner, LA Speed Coach for the New England Patriots

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Testimonial

“I’m often asked to evaluate athletes who are having difficulty progressing in rehabilitation. I generally start them on three or four foam roller exercises, and about 80 percent of the time I can improve pain-free functional performance using simple retraining techniques which focus on core stability and neuromuscular rebalancing.” Marjorie A. King, Ph.D., ATC, PT Director of Graduate Athletic Training Education Plymouth State University “When taping our latest DVD, ‘The Complete Guide to Foam Roller Exercises for Improved Performance,’ we used OPTP’s foam rollers because of their quality and high resistance against compression. I advise my clients to buy foam rollers and other rehabilitation products from OPTP because I know they will get a high-quality product, delivered on time, and at a good price.” Staffan Elgelid, PT, Ph.D., CFT Associate Professor of Physical Therapy Nazareth College of Rochester

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CEU QUIZ

T&C March 2005 Vol. XV, No. 2

Training & Conditioning is pleased to provide NATA and NSCA members with the opportunity to earn continuing education units through reading issues of the magazine. The following quiz is based on articles that appear in this issue of Training & Conditioning. By satisfactorily completing the quiz and mailing it back to T&C, readers can earn 2.0 BOC Athletic Training and 0.2 NSCA (two hours) continuing education units. INSTRUCTIONS: Fill in the circle on the answer form (on page 62) that represents the best answer for each of the questions below. Complete the form at the bottom of page 62, include a $15 payment to Training & Conditioning, and mail it by April 30, 2005 to the following address: Training & Conditioning, ATTN: 15.2 Quiz, 2488 N. Triphammer Road, Ithaca, NY 14850. Readers who correctly answer 70 percent of the questions will be notified of their earned credit by mail no later than May 15, 2005.

FROM HANDS TO HEAD (pages 10-17)

NOT PRETTY (pages 21-25)

Objective: To understand the steps one should take to update their school’s concussion assessment protocol.

Objective: To learn how to turn non-agile players into more graceful and faster-moving athletes.

1. According to Richard Ray, each institution should have a return-to-play policy that states: a) How an athlete will be tested prior to return to play. b) When an athlete will be tested prior to return to play. c) Who has the final authority over participation when medical issues are involved. d) Any medical professional may clear an athlete to play at or for the institution.

6. Agility is defined as the ability to: a) Accelerate on a straight plane. b) Change direction rapidly and under control. c) Decelerate in a controlled manner. d) Change speeds rapidly.

2. One helpful tool in assessing concussions is: a) The length of time since the concussion. b) The use of baseline testing prior to participation in sports and before an injury occurs. c) Memory testing. d) Assessing for any personality changes. 3. The two tests Utah State utilizes that are fairly inexpensive and well-respected are: a) The Proprioceptive and Cognitive Scoring Tests. b) The Standard Assessment of Concussion and the Balance Error Scoring System. c) The Concentration Test and the Speed Assessment Scoring System. d) The Variable and Assessment Test and the Agility and Scoring System. 4. The following is mentioned in the NATA’s position statement on Management of Sport-Related Concussions: a) Focus attention on the athlete’s symptoms, neurocognitive testing, and postural-stability testing. b) Allow an athlete to return to play when symptoms at rest have subsided. c) Focus on how many concussions the athlete has sustained in the past seven years. d) Allow an athlete to fully participate when headaches resolve. 5. The one message that remains consistent when dealing with concussions is: a) Once an athlete is functional, they are safe to return to play. b) Concussions are not as serious as once thought. c) Athletes are safe to return to play when they are 75% healed. d) No athlete should return to play unless they are 100% healed and completely symptom-free. 60 ◆ T & C M A R C H 2 0 0 5 ◆

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7. The following statement is the result from the National Strength and Conditioning Association, asking its research committee to issue a position paper on speed and agility: a) Speed and agility are best improved with a standardized training program. b) Speed and agility must be trained independently of each other and for two-week increments. c) The research committee found that the available information on the topic did not provide a basis for a position statement. d) The research committee documented a specific methodology for speed and agility. 8. The body’s ability to change direction rapidly and under control begins with: a) The central nervous system as it receives commands from the brain. b) The peripheral nervous system. c) The autonomic nervous system. d) Feet as they are in a closed-chain position to begin. 9. According to the author, the most successful agility programs include the following two components: a) Pre-testing and post-testing. b) Core stabilization and flexibility training. c) Cross training and flexibility training. d) Thorough testing and making the entire program very sport-specific. 10. When planning your program, an issue that may be beneficial to address is: a) Player motivation. b) Body weight problems. c) Player knowledge of the sport. d) Areas of testing that the players excelled in.

THE LATEST BUZZ (pages 27-33) Objective: To understand how caffeine affects an athlete’s body and performance as well as how to safely reduce use.

11. Adenosine inhibits: a) Neuronal firing and neurotransmitter release, leading to the feeling of sleepiness. b) Fast twitch fibers. c) Relaxation. d) The onset of fatigue. 12. Caffeine makes one feel more alert by: a) Stimulating the production of endorphins. b) Binding with adenosine receptors and blocking them from causing their normal affect. c) Stimulating the production of glucose. d) Inhibiting neuronal firing. 13. Recent research indicates caffeine is so addictive in part because: a) Of psychological reasons. b) It creates a chemical imbalance. c) It releases dopamine in the nucleus accumbens. d) People have many reasons to be more alert and strive to excel in their area. 14. According to Laura Juliano, a Starbuck’s 16 ounce coffee contains _____ milligrams of caffeine, the same amount that researchers have shown can induce anxiety. a) 300 b) 400 c) 500 d) 550 15. According to Juliano, if a student-athlete does not want to be physically addicted to caffeine, he or she needs to keep intake well below _____ milligrams. a) 25 b) 50 c) 75 d) 100 16. According to Lawrence Spriet, there is information to suggest that caffeine: a) Aides performance by allowing the body to tap into fatty acid stores more quickly. b) Allows people to exercise harder and longer in aerobic events lasting 20 minutes or longer. c) May have a physiologic effect on athletes participating in sprinting events of 90 seconds or less and throwing events. d) Help student-athletes score better on academic tests. 17. Research indicates that caffeine doses of _____ milligrams per kilogram of body weight will provide a performance effect without health risks. a) 3-5 b) 4-6 c) 5-7 d) 6-8 18. The blood level of caffeine is maximized _____ minutes after it is consumed. a) 15 b) 15-30 c) 60 d) 90

19. Athletes considering using caffeine to boost performance should first consider their current: a) Stress levels. b) Performance levels. c) Nutrition, hydration, training, and rest. d) Anaerobic sport requirements.

ON THE RECORD (pages 34-40) Objective: To understand the changing responsibility athletic trainers have concerning record-keeping and how to properly document. 20. One way to assess the quality of your record keeping is to: a) Review records from last month and see how complete they are. b) Review records from one to two years ago and see if the full story is documented and complete or if there are still unanswered questions. c) Assign students to write case studies from previous records. d) Require each entry to fill one entire page. 21. The following include types of records that should be kept by the sports medicine staff: a) Medications issued and a signed clearance to play form. b) The athlete’s classroom attendance and grades. c) Documentation of an athlete’s demeanor and attitude. d) A log of each athlete’s nutritional intake.

BIG JUMPS (pages 42-46) Objective: To learn how to safely and effectively include plyometrics in training volleyball players. 22. The goal of training with plyometrics is to: a) Increase the rate of the stretch-shortening cycle. b) Increase static strength. c) Decrease the amount of stored energy. d) Decrease the amount of time in the air. 23. Power is defined as: a) The rate of muscle recruitment. b) The time it takes to move over a distance. c) The amount of force an athlete can apply over a distance in the amount of time it takes to do so. d) The amount of force an athlete can apply over a distance. 24. Strength does not have a _____ component. a) Time b) Distance c) Force d) Weight 25. The NSCA position statement guidelines include that: a) Athletes of all ages may engage in plyometric training safely. b) Athletes at lower levels of strength training should engage in plyometric training. c) Less demanding drills should be mastered prior to attempting more complex and intense drills. d) There is a specified amount of strength necessary prior to initiating plyometric training.

ANSWER SHEET IS ON PAGE 62 ATHLETICBID.COM ◆

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CEU QUIZ

ANSWER FORM

INSTRUCTIONS: Fill in the circle on the answer form below that represents your selection of the best answer for each of the previous questions. Complete the form at the bottom of this page, include a $15 payment to Training & Conditioning, and mail it to the following address: Training & Conditioning, ATTN: 15.2 Quiz, 2488 N. Triphammer Road, Ithaca, NY 14850, no later than April 30, 2005. Readers who correctly answer 70 percent of the questions will receive 2.0 BOC Athletic Training and 0.2 NSCA (two hours) CEU’s, and will be notified of their earned credit by mail no later than May 15, 2005.

FROM HANDS TO HEAD A B C D 1. 2. 3. 4. 5.

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13. 14. 15. 16. 17. 18. 19.

NOT PRETTY A B C D 6. 7. 8. 9. 10.

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❍ ❍ ❍ ❍ ❍ ❍ ❍

ON THE RECORD

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20. 21.

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BIG JUMPS A B C D

THE LATEST BUZZ A B C D 11. 12.

22. 23. 24. 25.

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Last Name_____________________________________First Name________________________________MI_______ Mailing Address_____________________________________________________________________________________ City___________________________________________________State______________Zip Code__________________ Daytime Telephone________________________________E-Mail Address__________________________________

Payment Information __ $15 check or money order (U.S. Funds only) payable to: Training & Conditioning __ Visa

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__ Discover

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ATHLETICBID.COM

ADDITIONAL EDUCATIONAL PROGRAMS

EARN BOC CEUs • Complete quizzes found in the Strength & Conditioning Journal • Complete online quizzes at www.nsca-cc.org Phone

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888-746-2378

commission@nsca-cc.org

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Call for Our 2005 Perform Better Catalog

Write, Fax – PERFORM BETTER, 11 Amflex Drive, P.O. Box 8090, Cranston, RI 02920-0090 • Toll-Free Fax 800-682-6950 • See Our Web Site www.performbetter.com Untitled-9 1

Request No. 136 ATHLETICBID.COM ◆

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Association Corner The following associations offer services of interest to our T&C readers. Keep your career in motion… NSCA Educational Events for 2005 • NSCA National Conference and Exhibition • NSCA’s Performance Series Symposia

(Essentials of Weight Training,Youth Fitness, Advanced Periodization, Strength and Conditioning Methods, Endurance Training)

For dates, locations, and session information call 800-815-6826, or visit www.nsca-lift.org

National Strength and Conditioning Association ECA/MIAMI2005

SPORTS TRAINING & FITNESS CONFERENCE, NOV. 11-12-13 1-888-MI A M I- E C A

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

Visit www.proteamphysicians.com

516-432-6877 OR REGISTER ONLINE

www.ecaworldfitness.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.

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• Clinical applications • Proven methods

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Athletic Therapy. Rapid return to work and play.

Athletic Therapists are dedicated to the promotion and delivery of quality care through injury prevention and rehabilitation and emergency services. In collaboration with other health care professionals, athletic therapists work to create a healthier environment that encompasses the needs of the active community, including the high-performance athlete.

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

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

Circle No. 137

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