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March 2007, Vol. XVII, No. 2

CONTENTS 24 37 43

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Q&A Brian J. Smith Rancho Buena Vista High School, Calif.

Student Corner Your Expert Opinion How to evaluate new treatments and training tools

By Dr. Greg Frounfelter

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Nutrition

and Losing 13 Winning Can athletes win and lose weight at the same time? In this article, we discuss the delicate issue of losing weight in-season.

By Michelle Rockwell Optimum Performance

Better To See 24 The From having Lasik surgery to catching bean bags over their shoulders, athletes are opening their eyes to enhancing their vision.

By R.J. Anderson Treating The Athlete

On the cover: A specialized off-season training program gave Zach Miner the strength, coordination, and stability he needed to secure a spot on the Detroit Tigers’ roster.

Story begins on page 30. Photo ©Getty Images.

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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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Gray Cook, MSPT, OCS, CSCS Clinic Director, Orthopedic & Sports Phys.

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Keith D’Amelio, ATC, PES, CSCS Head Strength & Conditioning Coach/ Assistant Athletic Trainer, Toronto Raptors

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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

Boyd Epley, MEd, CSCS Director of Coaching Performance, National Strength & Conditioning Association 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

Brian Goodstein, MS, ATC, CSCS, Head Athletic Trainer, DC United Gary Gray, PT, President, CEO, Functional Design Systems

March 2007 Vol. XVII, No. 2

Allan Johnson, MS, MSCC, CSCS Coach, Speaker, Consultant

Publisher Mark Goldberg

Maria Hutsick, MS, ATC/L, CSCS Head Athletic Trainer, Boston University

Editorial Staff Eleanor Frankel, Director R.J. Anderson, Kenny Berkowitz, Nate Dougherty, Abigail Funk, Dennis Read, Greg Scholand, Laura Ulrich

Christopher Ingersoll, PhD, ATC, FACSM Director, Graduate Programs in Sports Medicine/Athletic Training University of Virginia Jeff Konin, PhD, ATC, PT Visiting Associate Professor, University of South Florida

Circulation Staff David Dubin, Director John Callaghan

Tim McClellan, MS, CSCS Director of Perf. Enhancement, Makeplays.com Center for Human Performance

Art Direction Message Brand Advertising Production Staff Don Andersen, Director Jonni Campbell, Jim Harper, Miles Worthington

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

IT Manager Julian Cook

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

Business Manager Pennie Small Special Projects Dave Wohlhueter

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

Administrative Assistant Sharon Barbell

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

Advertising Materials Coordinator Mike Townsend

Stephen Perle, DC, CCSP Associate Prof. of Clin. Sciences, University of Bridgeport College of Chiropractic

Marketing Director Sheryl Shaffer

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 Visiting Professor, Athletic Training Education Program, Ohio University Ralph Stephens, LMT, NCTMB Sports Massage Therapist, Ralph Stephens Seminars

Vern Gambetta, MA, President, Gambetta Sports Training Systems

Fred Tedeschi, ATC Head Athletic Trainer, Chicago Bulls

Joe Gieck, EdD, ATR, PT Director of Sports Medicine and Prof., Clinical Orthopaedic Surgery, University of Virginia (retired)

Terrence Todd, PhD, Co-Director, Todd-McLean Physical Culture Collection, Dept. of Kinesiology & Health Ed., University of Texas-Austin

Marketing/Sales Assistant Danielle Catalano Advertising Sales Associate Diedra Harkenrider (607) 257-6970, ext. 24 T&C editorial/business offices: 31 Dutch Mill 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., 31 Dutch Mill 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 $7. Copyright© 2007 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.

Periodicals postage paid at Ithaca, N.Y. and additional mailing offices. POSTMASTER: Send address changes to Training & Conditioning, P.O. Box 4806, Ithaca, NY 14852-4806. Printed in the U.S.A.

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Q&A Brian J. Smith Rancho Buena Vista High School, Calif.

In the five years since graduating from California State University-Chico, Brian J. Smith, MS, ATC, NREMT-B, has rehabbed football athletes at Indiana University, worked with the USA Mogul Ski Team, covered an NCAA Women’s Rowing Championship, treated onthe-job injuries at a shipbuilding factory, and coordinated outreach for 11 high school football teams in and around Chula Vista, Calif. But he’s truly found a home as Head Athletic Trainer and Sports Medicine Teacher at Rancho Buena Vista High School, located about seven miles from the Pacific Ocean in Vista, Calif., near San Diego.

After arriving at Rancho in January 2004, Smith encountered and successfully treated his first near-fatality during football two-a-days that summer, quickly earning the respect of athletes, parents, coaches, administrators, and neighboring athletic trainers. Later, he spearheaded a successful campaign to purchase an automated external defibrillator for the athletic department, and helped lead efforts by the Far West Athletic Trainers Association (FWATA) to publicize the lack of athletic training coverage at area high schools.

Working in one of six states that doesn’t register its certified athletic trainers, Smith has consistently advocated for the profession and was named the 2006 FWATA Secondary School Athletic Trainer of the Year. In this interview, he talks about working in the high school setting, acting quickly during an emergency situation, and promoting athletic training to a wider audience.

T&C: When did you know you wanted to become an athletic trainer?

Smith: Like a lot of athletic trainers, I had an injury playing in high school. Sophomore year I tore my ACL during football, junior year, I came back, and halfway through my senior year I tore my meniscus. We didn’t have an athletic trainer, but I spent a lot of time in the physical therapy setting, and began to think it might be worth pursuing as a career.

My first semester in college at Chico State I declared a major in exercise physiology, but I didn’t really know what I 4

T&C MARCH 2007

For Smith, working at the high school level has turned out to be a great move. “Being able to influence young athletes is a huge advantage to this setting,” he says. wanted to do with it. So my older brother, who was a senior in the athletic training program, took me to see the athletic training room, and everything just clicked right then and there. I realized that by becoming an athletic trainer, even though I couldn’t play football anymore, I could still be part of a team and interact with athletes. It gave me a chance to put my love of sports together with my love of medicine.

How did you wind up at Rancho Buena Vista?

To tell you the truth, the whole time I was studying to be an athletic trainer, I never considered working at the high school level. When I was a graduate assistant at Indiana University, where I worked with the football and women’s rowing teams, I was convinced I wanted to work at the collegiate level. But my first job out of grad school was working at the US Olympic Training Centers in Chula Vista and Lake Placid. After that year, I really wanted to return to the San Diego area, so I took TR AINING-CONDITIONING.COM

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Q&A Brian J. Smith Head Athletic Trainer, Sports Medicine Teacher, Rancho Buena Vista High School, Vista, Calif.

BS, California State University-Chico, 2001; MS, Indiana University, 2002 Previous Positions: Fellowship Athletic Trainer, US Olympic Training Center, Chula Vista, Calif., and Lake Placid, N.Y., August 2002-June 2003 Sports Medicine Director, Sweetwater Union High School Outreach Program/Lead Physical Training Aide, Edward Ayub Physical Therapy Clinic, Chula Vista, Calif., June-December 2003 Athletic Trainer, National Steel and Shipbuilding Company, San Diego, Calif., August-December 2003 Honors: 2006 Far West Athletic Trainers Association Secondary School Athletic Trainer of the Year

a clinical job at a physical therapy clinic, which is where I met my wife, who’s a physical therapist.

Throughout those years, I kept thinking about what my graduate advisor told me: Plan your professional goals around your personal life. So as my relationship grew more serious, high school started to look like a good fit because I’d be able to go home every night, which would be important if we were going to have kids.

I’ve been at Rancho going on three years now, and it’s turned out to be a great move. My athletic director offers nothing but support and my principal backs me on everything I do. When the administration asked if I would be interested in teaching a sports medicine class, I jumped at the chance.

I also have some great kids here, which is very rewarding.

And I have a top-notch athletic training room—it’s a lot like the room I worked in when I was an undergrad. I don’t have all the high-tech equipment we had at the Olympic Training Center, but I have everything I need to do my job efficiently and give the kids the best care possible.

What are the challenges of working at the high school level?

I miss the camaraderie of being around other athletic trainers.

When I was going through school or working at the Olympic Training Center, there were always people I could bounce ideas off. If I needed a second opinion, I could get it immediately. Now, if there’s an injury, everybody turns to me. When I first accepted this job, the athletic director said, “Here’s the key to your athletic training room—it’s all yours.” It was a challenge to come in and hit the ground running, create the program I wanted, and prove myself to all the athletes, parents, coaches, and administrators.

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At the college level, athletic trainers are usually dealing with just one team. At the high school level, I’m one person responsible for 2,000 athletes. So the challenge is to prioritize everything I do, communicate clearly with athletes and coaches, and make sure I don’t favor one sport over another.

Luckily, coaches here recognize I can’t be everywhere at once, so if the athletic training room is full of athletes and I can’t get to their practices on time, they understand.

What have you learned about working with coaches?

The big thing is communication, and to always be up front with them. I don’t sugarcoat anything because at this level coaches are a big part of the sports medicine team. I can’t attend every practice and every game for every team, but if there’s an emergency, they need to know they can call me and trust me to do my best for their athletes.

How about working with athletes’ parents?

I hold a parents’ meeting before the start of every season, where I talk about my approach and emphasize that my highest priority is their children’s safety. If kids get hurt, I’m not going to put them back on the field unless I know they’re ready to return. And every time I say that, I see the parents smile and nod their heads because they know how competitive high school sports can get. I tell them I’m not here for the wins and losses, I’m here for their kids’ safety.

What was your most challenging rehab?

It was a senior starter on the boys’ basketball team, who had a meniscus tear. The doctor was adamant he’d be able to play in a couple of weeks, the coach wanted him back as quickly as possible, and his teammates were all pushing to TR AINING-CONDITIONING.COM

Q&A get him on the court again. It was a relatively simple surgery, so the hard part wasn’t getting him back, it was getting everyone to keep the injury in perspective. I made it a point to keep reminding everyone, “If we can get him back safely in those two weeks, then we will. If we can’t, we won’t. He’s got his whole life ahead of him, and we’re not going to rush this.” If needed, I was prepared to be the bad guy. But in two weeks he was back on the court to finish the season and everybody was happy.

During your first football preseason at Rancho, you helped save an athlete’s life. How did you respond to that situation?

If people think I saved his life, that’s fine, but I don’t really look at it that way. I recognized we were in an emergency situation and I took the necessary steps to get the help he needed.

It was mid-August, we’d just started two-a-days in our new football stadium, and this was the first real emergency situation I was thrown into at Rancho.

This particular athlete, who was a fairly hefty fullback, was walking back from a huddle when he collapsed on the field.

I ran out and when I got to him his eyes were rolled back in his head, his breathing was labored, and he was going in and out of consciousness. I immediately threw my cell phone to the head coach and said, “Call 911.” While we waited for the ambulance to arrive, I monitored his vital signs to make sure

he wasn’t getting any worse and kept his airway clear.

His heart rate was going through the roof. I was trying to take his pulse and couldn’t keep up with it, that’s how fast it was. Once the paramedics got there, they gave him an EKG

“I was thrown into a situation where I needed to act quickly, and it made me really evaluate my program: Did I have everything I needed to save someone’s life?” on the field and saw his heart rate was over 200 beats a minute. They got him to the hospital, stabilized him, and after some tests they diagnosed it as superventricular tachycardia, a pre-existing condition we hadn’t known about and was probably exacerbated by the heat. When it was reported in the newspaper, they made it seem like I’d diagnosed this preexisting condition, which I hadn’t. But I knew it was an emergency and got the ambulance rolling as quickly as I could.

The situation had a happy ending and the athlete made it back to play three or four games that season.

What did that experience teach you?

I learned to always be prepared, because in this profession you never know what’s going to happen next. I was thrown

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Q&A into a situation where I needed to act quickly, and it made me really evaluate my program: Did I have everything I needed to save someone’s life? It took another two and a half years before I convinced the athletic department to get an AED, but I pushed hard, raising funds through my physicals until we were able to purchase one. That incident opened my eyes to see that anything can happen, and we need to have the right equipment on hand, even if we never have to use it.

What was your reaction to winning the FWATA’s Secondary School Athletic Trainer of the Year award?

When I first got the news, I thought someone was playing a joke on me. I like to be involved and get my voice out there, so I’m on the secondary school committee, and I think it’s important to promote the profession. But I really feel I do what any other athletic trainer does.

What are some things you’ve done to promote athletic training?

I did a survey where I called all the schools in the San Diego area and asked the athletic directors, “Do you have an athletic trainer on staff? Why or why not?” I found that of 90 schools, only 21 have a full-time athletic trainer and 41 have no athletic trainer of any kind. The most common reason for not having an athletic trainer was money—the school felt it couldn’t afford one. It’s unfortunate that too often it takes a

catastrophic injury before people realize they can’t afford not to have one.

I don’t believe in promoting the profession by standing on a pedestal and saying, “Athletic training is the best career out there and every high school needs to have an athletic trainer.”

Instead, I try to set an example. When I travel with the football team to a school that doesn’t have an athletic trainer, or when one of those 41 schools comes to play us, I make sure to take care of the athletes on the opposing team as well as our own. I do all I can in the hope that some parent or coach will say, “Why don’t we have an athletic trainer at our school?” I try to act professionally in everything I do, and I always tell my students that whatever career they’re planning to pursue, whether it’s athletic training or anything else, they need to be proactive: “Don’t just punch a time clock—get involved.”

Do you ever think about working at the college level?

I do. My brother is on the athletic training faculty at James Madison University, and sometimes when I hear him talk about it, I miss my days as a graduate assistant at Indiana.

But at the same time, I have to pinch myself because my job here at Rancho is great. Being able to influence young athletes is a huge advantage to this setting, plus I get to go home every night and spend time with my wife. I can live the life of an athletic trainer and still have time to try to be a good husband. ■

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Student

Sponsored by

Corner A special feature for your athletic training students

Your Expert Opinion New treatments and training tools arrive on the market daily. As an athletic trainer, you will need to provide opinions on them.

BY DR. GREG FROUNFELTER

F

or anyone with a computer, an almost unlimited amount of information about training modalities is just a mouse-click away—and that includes your future clients.

Ready or not, you will need to be able to answer their questions about the latest training ideas and equipment.

So how do you assess new training modalities and establish recommendations about them? And how can you incorporate those thoughts into practice as you serve your future clientele?

My strategy is to follow a series of steps when evaluating a new training product. First, I examine content validity by looking over the device and analyzing whether it looks like it can do what it claims to be able to do. I use what I know about anatomy, movement, and rehab to make this assessment.

If the product looks and sounds feasible, I then read any reviews of it that are available. I start by looking for scientific research through Medline, PEDRO, and the Cochrane Library daGreg Frounfelter, DPT, ATC, CSCS, is an Athletic Trainer and Physical Therapist in the Physical Medicine Department at Agnesian Healthcare-Waupun Memorial Hospital in Waupun, Wis. He can be reached at: frounfelterg@agnesian.com.

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T&C MARCH 2007

tabases. If I don’t get many results, I do a standard Web search. I usually use the MSN search engine, playing with search phrases until I find something that looks worthwhile.

Ideally, I would like peer-reviewed articles about the product, which means a panel of academics in kinesiology or sports medicine examined the text before it was approved for publication. It also means the article’s authors must reveal any financial ties with the manufacturer of the product.

I also see if any randomized, controlled trial studies have been performed, although this is less common with newer products. These studies help us develop evidence-based practices that allow us to determine the best treatment and practice patterns with the equipment.

Sometimes, I only find research conducted by the manufacturer of the product. Though these studies can be biased, I don’t automatically assume they are flawed. I look at how the study was performed and how the researchers drew their conclusions. If their methods and analyses are based in science, I will take their conclusions seriously.

If possible, I also take the time to personally try out the equipment. This gives me a hands-on feel for how the product works. It can also help answer any questions I have about content validity and the research I’ve read.

Finally, I will consider whether the product is worthwhile for my clients.

Before purchasing, I ask: Does the equipment fit in my facility? Will my athletes and patients actually be able to use and benefit from it? How much

does the product cost and will my budget allow me to purchase or rent it?

How will staff learn to use the product properly and teach others about it?

Let’s take kettlebells (KBs) as an example. I had heard of KBs through reading about Soviet sports training programs, but I didn’t know their specifics until I saw a presentation about them at the NSCA National Conference and Symposium. As I watched the demonstration, I began to consider their content validity.

Supporters claim KBs are a functional, easy-to-use training modality that can produce resistance training with cardiovascular effects.

The demonstrator showed that there are two basic exercises, the swings and grinds. On the swing motion, the athlete lets the KB swing to the rear between the legs and then uses the leg and back muscles to explosively bring the KB to the front. The weight then falls back to the starting position and the next rep starts. This can be performed with one or two hands holding the KB and there are many variations on the swings. From this basic exercise, cleans and snatches can be performed. As I watched, I found this type of activity very specific to sports performance and felt it could easily be used in late-stage rehab or with relatively lighter KBs to provide a cardio workout.

The second basic exercises are grind motions, which are performed in a controlled manner without the ballistics of the swings, and can be used for general strengthening and conditioning. Exercises include various squats, chest presses, overhead presses, and TR AINING-CONDITIONING.COM

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Corner even Turkish get-ups or windmills. The KB grinds seemed to be perfect for core strengthening, especially when done unilaterally. They also appeared to be very valuable for training trunk stability in patients with back pain.

I was impressed with how many areas the demonstrators were working when using KBs. I also was able to see how the exercises could be incorporated into both training and rehabilitation. The wonderful thing about learning about KBs at a conference was there were vendors at the exhibit hall who sold them. This allowed me to try them first-hand, as well as check out different styles. From the presentation and my own practice with them, at that point, I was confident I had verified the product’s content validity.

After the conference, I searched the Internet and review-based article databases to further investigate the efficacy of KBs. The peer-reviewed articles did not have much information,

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but I did find out more about the use of KBs through various fitness Web sites.

One of the sites also sold KBs, so I was wary of the information. But I kept searching and found two independent Web sites that verified the claims. Although I couldn’t find all the informa-

many patients with back injuries.

■ Because they come in small weights, they would be a good fit with our patients with low strength thresholds.

■ Because they take up very little space, they would work well with our floor plan.

By following a logical progression when assessing new equipment, you too will be able to make solid recommendations based on fact and physiological training principles. tion I wanted about KBs, I had enough to keep thinking about their use.

Next, I determined whether KBs would work with enough of our clientele to make the investment worthwhile.

I concluded that: ■ Because they have many uses, KBs would work well with our diverse clientele.

■ Because they strengthen the core, they would be a good tool for our

We have bought KBs and they have worked well. But I am very glad I took the time to analyze their validity and uses beforehand. By following a logical progression when assessing new equipment, you too will be able to make solid recommendations based on fact and physiological training principles.

In the midst of the information age, our clients will expect nothing less of us as allied health professionals. ■

NUTRITION

NUTRITION

Winning and Losing Can athletes win and lose weight at the same time? In this article, we discuss the delicate issue of losing weight during the competitive season.

BY MICHELLE ROCKWELL he official position of the American College of Sports Medicine, which most sports nutritionists agree with, is that athletes should not try to lose weight during their competitive season. That’s because dieting can very easily jeopardize energy and nutrients critical for training and performance. In addition, the mental stress of restricting calories can become all-encompassing and turn into a performance-distracter.

But what happens when an athlete shows up for preseason physicals with frantic weight-loss goals? The off-season, which is when weight loss was supposed to happen, went by too quickly and the athlete ended up relaxing on their nutrition habits instead of making important changes.

T

PHOTO COMPOSITION: ©MESSAGEPICS, PHOTO: ©GETTY IMAGES

Can athletes lose weight during the season without compromising their training? The answer is yes, but it must be done carefully.

IS IT A GOOD IDEA? Before any talk of dieting or calorie cutting begins, it’s critical to discuss whether a particular athlete who wants to lose weight truly needs to.

It’s easy to say, “No dieting now, let’s write a reminder to focus on it during the off-season.” But the reality is that excessive weight or body fat can impair athletic performance in some cases. The challenge is determining whether the risks of making weight changes in-season outweigh the potential performance benefits.

Therefore, to start, take the time to

talk to the athlete one-on-one about why he or she wants to lose weight. At least half the time, athletes’ weight-loss goals are inappropriate and unrealistic.

Many times athletes want to lose weight for aesthetic reasons, not performanceenhancing reasons. I have worked with professional athletes, both male and female, whose weight goals are based strictly on how they will look in photoMichelle Rockwell, MS, RD, is the former Coordinator of Sports Nutrition at the University of Florida and now serves as a nutrition consultant for several sports teams ranging from youth to collegiate to professional. She has recently helped launch RK Team Nutrition, at: www.rkteamnutrition.net, and can be reached at: michellerock1@aol.com.

NUTRITION

HOW HUNGRY ARE YOU? Below is a log entry in which a gymnast rated her hunger before eating evening meals and snacks.

Time of Day

Food or Drink

Hunger Score

6:45 p.m.

1 grilled chicken sandwich with mustard and pickles, 20 oz. diet soda, 7 baby carrots

7

8:00 p.m.

24 animal crackers

7.5

9:30 p.m.

1 bag Skittles

4

9:45 p.m.

2 chocolate chip cookies

2

graphs and advertisements. Sometimes athletes have competing interests—a college volleyball player who models on the side is a good example.

Others have a “magic number” in mind that they believe is their ideal competition weight, but it’s not based on anything scientific. Take the example of a high school cross country runner I recently worked with. He was convinced that his optimal race weight was 142 pounds since that is how much he weighed when he scored at the state cross country meet his sophomore and junior seasons. At the start of his senior season, he weighed 156 pounds and was tremendously under-confident. His coach grew concerned when he started skipping meals and doing extra runs at night in an attempt to cut weight.

During our initial conversation, the athlete revealed that he had started lifting weights since last season and had grown 2.5 inches taller—both very good reasons for gaining lean mass!

We ultimately created a meal plan that helped him get to 150 pounds, which he was content with, and he raced quite well at the higher weight. But the most important aspect was to get him to understand that 142 was not a magic number.

An intense desire to lose weight may 14

Comments

(10= the hungriest I’ve ever been, 1= not at all hungry)

T&C MARCH 2007

I felt really hungry because it was right after practice

While I was studying

I wasn’t even hungry but couldn’t stop thinking about the cookies in my roommate’s cabinet also be a sign that something else is going on with an athlete. How many times have you heard a young female athlete say, “Everything would be fine if I could just lose 10 pounds.” So much emphasis is placed on weight and body image in our society (and in sports) that athletes may feel losing weight is the cure to all their problems. They could have personal issues or stressors they need to deal with, and may need the help of a mental health professional.

Athletes in sports with weight classifications, such as wrestling and lightweight crew, are clearly in a different category as they typically have no choice but to try to achieve a specified weight.

However, even with these athletes, it must be determined whether they can achieve the desired weight without decreasing performance, or whether they need to move to a higher weight class or heavyweight crew for the season.

Here are six questions to ask athletes who want to lose weight in-season: • What is your weight-loss goal?

• Is this realistic?

• When is the last time you weighed this amount?

• Why do you want to lose weight?

• How will this make you perform better?

• Is there any chance that chang-

ing your diet will detract from your training or performance, both physically and mentally?

A discussion based on the above questions should allow you to get a clear picture of the athlete’s perspective. Then decide if his or her goals are realistic, appropriate, and can be reached without harm. Many times it’s beneficial to involve a sports dietitian or even a team physician in this process. Don’t hesitate to enlist further professional help if you detect signs of disordered eating.

GENERAL GUIDELINES If you decide to help an athlete move forward with an in-season weight-loss plan, it’s important to put some strict guidelines into place. The first is to communicate often. Remind the athlete that there is a reason why the regular season is not the preferred time to focus on weight loss. Low energy levels, poor recovery, and poor concentration may occur on any restricted-calorie diet.

Any physical or mental changes should be consistently communicated with the sports medicine team.

The second guideline is to start immediately. Initiate the weight-loss program as early in the season as possible, ideally in the early preseason when training volume and intensity are high and before competition begins. This will allow more time to space out the weight loss and lessen the chance it will have detrimental effects.

Third, keep it gradual. Athletes should lose no more than one to two pounds per week, and even that may be too fast in-season. Losing weight more rapidly is likely to cause loss of muscle tissue and potentially strength, speed, and power. Emphasize that drastic and rapid weight loss is always a health risk, but it is even riskier during intense training. Watch out for symptoms of inappropriately fast weight loss or excessive calorie-restriction, including increased injury or illness, decreased energy levels, poor recovery, and decreased performance.

Low-calorie diets are also more likely to lead to low intakes of important vitamins and minerals which can affect an athlete. For example, it is well known that iron deficiency impairs performance. Research has also shown a strong relationship between chronically inadequate calories (“energy drain”) and amenorrhea (loss of the regular menstrual cycle). Amenorrhea can TR AINING-CONDITIONING.COM

NUTRITION be a concern in terms of reproductive health, but also in terms of bone health.

Athletes with amenorrhea are more likely to have low bone mineral density, which predisposes them to fractures and eventually osteoporosis.

Even athletes in sports with weight classifications should shed pounds gradually. A wrestler who is 10 pounds over his weight class is much better off losing two pounds per week throughout the beginning of the season than crash dieting to lose it all at the last minute.

The best scenario is when you can convince these athletes to stick to low-fat, but consistent diets.

If you need to make a specific calorie recommendation to the athlete striving to lose weight, I recommend assessing what they currently eat on a typical day (not a “good day” but a “typical day”), and reducing that amount by 10 to 20 percent. For example, a female swimmer who currently eats about 3,200 calories per day should be able to achieve weight loss without jeopardizing training and performance by cutting down to 2,500 to 2,700 calories per day.

DO’S AND DON’TS Once athletes have committed to following the above rules, they’ll want some specifics on how to lose the weight. Simple science says that eating less calories than you expend will lead to weight loss. Friends and popular magazine articles will tell athletes the latest secret to weight loss. But, for an athlete in-season, this advice could be dangerous. They need to limit intake much more carefully.

Since counting calories is foreign to many athletes and can also easily become obsessive, I advise more subtle dietary changes. I’ve found the following do’s and don’ts resonate well for today’s athletes: Don’t Skip Meals …

Skipping meals may seem like an easy strategy to cut calories, but it’s also a sure way to slow metabolism and deplete energy levels. Athletes should eat four to five times per day. The two most important fueling times are breakfast (within one hour of waking up) and refueling (within one-half to one hour of completing hard workouts).

… Do Practice Mindful Eating However, athletes should identify times when they are consuming calories that aren’t contributing to beneficial fuel intake. For example, if snacking on junk food during the evening is the athlete’s biggest issue, they can make a grocery list for healthier items to keep around.

One athlete decided to start studying at study hall where food was not allowed to prevent snacking on her typical potato chips and candy. Another athlete reminded herself to drink water rather than snack at night—she realized she was mistaking thirst for hunger. A third athlete started going to bed one hour earlier—when he got more sleep, he was less hungry. He also stopped keeping coins in his dorm room to prevent visits to the vending machine.

I also try to get athletes in touch with when their bodies are actually hungry and when they’re full. I often start by having them keep a food log that includes a hunger rating, which is a measurement of how hungry they feel when they start eating a particular food or beverage.

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Circle No. 108 TR AINING-CONDITIONING.COM Untitled-1 1

T&C MARCH 2007 1/18/07 11:17:22 AM

15

NUTRITION

BEVERAGE BOARD This table shows how an NFL lineman was able to reduce his caloric consumption significantly by changing his drink choices.

Meal Breakfast

Original Drinks 2 20 oz. bottles orange juice (480 calories)

Substitution 2 20 oz. bottles water and a fresh orange (60 calories)

Throughout the morning

1 can soda (200 calories), 2 large glasses fruit punch (700 calories)

1 can diet soda, 2 bottles water or 2 sugar-free flavored beverages (10 calories)

Lunch

Large lemonade (300 calories)

Large water (0 calories)

During training session

72 oz. sports drink (135 calories), water

72 oz. sports drink (135 calories), water

After training session

Recovery shake (350 calories)

Recovery shake (350 calories)

Dinner

Restaurant soda with free refills (650 calories)

2 restaurant unsweetened teas, water (0 calories)

After dinner

Large glass Kool-aid (400 calories)

Water or sugar-free flavored beverage (10 calories)

Totals

3,215 calories

565 calories

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Rehabilitation & Conditioning Pools

NUTRITION For example, by filling out the log, a gymnast I worked with realized that she was snacking on sweets later in the evening partially because she didn’t find her dinner or 8 p.m. snack very satisfying. (See “How Hungry Are You?” on page 14.) By adding a baked sweet potato at dinner and substituting a high protein snack at 8 p.m. (yogurt), she satisfied her cravings for something sweet and felt full longer. She also recognized that she was bored and lonely at 9:45, the time when she and her boyfriend used to talk on the telephone (they had recently broken up). Instead of snacking at this time, she decided to walk her dog and call a friend on her cell phone.

Don’t Eliminate Favorite Foods …

There is no reason to completely eliminate favorite foods or foods eaten frequently. This will just make the athlete crave them more. … Do Modify Portion Sizes Instead, advise the athlete to modify the portion sizes of favorite foods. Sometimes it even helps to simply use smaller serving dishes. I have them try this experiment: Prepare a cup of pasta and put it on a regular dinner plate—it will look lost in the middle of that big plate.

Put the same cup of pasta on a small plate, and it looks huge. Try the same thing with cereal or ice cream bowls and drink glasses. There is no harm in playing mind-games with yourself! (See “Portion Control,” at right.)

I also caution athletes to beware of “sneaky calories,” those foods that people eat throughout the day almost without realizing it—the bite of a friend’s dessert, the spoonful tastes while cooking dinner, the leftovers eaten as you do dishes. The athlete attempting to lose weight needs to become conscious of these calories, because they really add up. … Do Modify Nutritional Content Others find success by modifying the nutritional composition of favorite foods. That way, they can still eat the foods they like and are used to without the undesired calories. For example, one athlete saved over 400 calories per day just by changing from regular ranch salad dressing to lite salad dressing. Changing from full-fat to lower-fat or fat-free versions of milk, other dairy products, condiments like mayonnaise, and creamy soups can also be very helpTR AINING-CONDITIONING.COM

ful. One athlete liked to have ice cream before bed every night. We determined that between ice cream and fudge sauce, she was getting 800 calories per night.

Imagine how many calories she saved when she switched to a fudge pop (160 calories), low-fat frozen yogurt (180 calories), or an all-fruit popsicle (70 calories), which she ultimately found just as satisfying.

Another trick is to add more water to a diet. High-liquid foods such as fruits, vegetables, and soups (brothbased, not cream-based) can work wonders. They allow an athlete to eat until they’re full without getting a high volume of calories.

Don’t Risk Dehydration …

Some athletes are pleased by the weight they lose during training sessions. But they should not be. Weight lost during exercise is almost exclusively fluid loss that must be replaced to support recovery.

Athletes should also understand that fluid needs are often higher during calorie restriction. Those watching their intake sometimes make the mistake of restricting the amount they drink. But drinking plenty of water is an important part of both weight loss

and athletic performance.

Athletes should also continue to use sports drinks before, during, and after activity. Some athletes who are losing weight worry about the calories in sports drinks, but these should be the last calories they’re concerned about.

Sports drinks provide a small amount of energy in the form of sugar that can help delay fatigue. These are not the calories to cut. … Do Modify Drink Calories However, during the day, it would be wise to substitute sports drinks with water or other calorie-free drinks (unless the athlete has specific problems with dehydration or is in two-a-day practices). Many athletes are surprised to learn how many calories they are getting from beverages. An NFL lineman was able to cut over 2,500 calories from his daily diet and lose two pounds per week just by changing his drink selections. (See “Beverage Board” on page 16.)

Any athlete trying to lose weight should also avoid alcohol. Calories from alcohol are not used as productive fuel and eliminating or reducing them is often very helpful in weight loss. In

PORTION CONTROL Here are some examples of easy portion size changes.

Look at the calorie differences!

McDonald’s Big Mac, large fries, large soda (1,380 calories) VS. McDonald’s Quarter Pounder, medium fries, large diet soda (800 calories) King size Snickers candy bar (510 calories) VS. Regular size Snickers candy bar (275 calories) VS. Fun size Snickers candy bar (110 calories) Regular size bagel (320 calories) VS. Mini bagel (100 calories) Full bag of microwave popcorn (620 calories) VS. Single serving bag light microwave popcorn (100 calories)

T&C MARCH 2007

17

NUTRITION addition, alcohol is an appetite stimulant, which can lead to a larger intake of food calories.

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… Do Eat a Sports Diet A sports diet is one that focuses on carbohydrates, nutrients, and lowering fat. Carbohydrate intake should match the athlete’s training level. As the season progresses, training volume and intensity decrease, meaning the body is likely burning and requiring less carbohydrate foods. For example, a male lacrosse player should reduce his servings of carb-containing foods by about a third from start to end of a season—if he needed 14 servings of carbohydrate in the beginning of the season, he should cut down to nine by the playoffs. The drop isn’t drastic, but it should take place.

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Don’t Follow Fad Diets …

Fad diets, especially low-carbohydrate diets like Atkins, South Beach, and Sugar Busters, are extremely inappropriate for athletes training intensely because carbohydrates are the primary fuel for both exercising muscles and the brain. Any diet or meal plan that is extremely strict or excludes a major food group will wreak havoc on an athlete’s ability to train well.

Protein is also important, and should be included in all meals and snacks. One reason for this is that protein needs are enhanced during weight loss to preserve muscle tissue. Second, including protein in meals helps prolong fullness. Examples of quality protein foods include lean meats, egg whites, low-fat dairy products, beans, nuts/peanut butter, and soy/tofu products.

Fiber, vitamins, and minerals are another focus. Eating more high fiber foods will increase fullness. Good examples are whole grain breads and cereals, beans, nuts, fruits, and vegetables.

Fruits and vegetables, along with meat, will lead to proper vitamin and mineral intake.

High-fat foods are the primary place for the athlete to cut back. Fatty foods are jam-packed with calories. Examples are fried foods, high-fat cuts of meat, meat with skin, whole dairy products, eggs, mayonnaise, cream cheese, sour cream, butter, snack foods, and desserts. Some athletes also get a lot of excess calories through bacon, sausage, and butter at breakfast.

Try ham or Canadian bacon instead of the higher-fat meats and either low-fat margarine, whipped butter, or real-fruit jelly instead of regular butter. Athletes may not even notice if they skip the butter on pancakes, waffles, or French toast.

Athletes should also decrease their intake of foods high in added sugar like candy, desserts, pastries, doughnuts, syrups, and sodas. These are “empty calories” that fail to provide nutrients and long-lasting energy.

Changing one’s diet is difficult, no doubt about it, and athletes interested in losing weight in-season will need a lot of support from the sports medicine staff. Make a special effort to monitor the athlete’s progress without overemphasizing it.

Monitoring should include not only how much weight is lost, but body composition changes, changes in energy level, training capacity, recovery, mood and mental status, menstrual function, quantity and quality of sleep, and general well-being. And remind them that, next season, they need to plan ahead! ■ TR AINING-CONDITIONING.COM

Fueling Athletes All Day

By Ellen Coleman, M.P.H., M.A., R.D.,CSSD Sports Dietitian for The Sport Clinic and consultant to the Los Angeles Lakers, Clippers, Angels and Kings professional sports teams.

M

any athletes have schedules that may require them to play in the evenings and sleep late the next morning resulting in haphazard eating habits, which can impair performance and adversely effect body composition. The key is maintaining an appropriate meal frequency, size, and composition to help keep blood glucose levels even throughout the day. Proper fueling distributes calories, so many players can benefit from eating five times per day – three meals and two snacks.

Start Right Smart fueling starts with breakfast. Regardless of the time of day the player eats, breakfast is defined as the first meal of the day. Breaking the overnight fast can improve exercise performance by as much as 15%1,2, so it’s important for athletes who workout in the morning to replenish energy and fluid stores.

Although some athletes will start practice or workouts without eating, at the very least, they should consume some fluids and carbohydrates to rehydrate and fuel the body. For those athletes who have limited time to eat, they may choose an option like a sports drink or meal replacement shake. With a complete meal being the best choice, those athletes who eat breakfast are also less likely to eat high-calorie meals and snacks throughout the rest of the day, which aids weight control.3,4 In addition to minimizing impulsive snacking, eating breakfast may reduce total fat intake.3

Maintain Energy Continuing to distribute calories evenly throughout the day helps to maintain stable blood glucose levels for training and may prevent overeating.4 An athlete who fasts from lunch through an evening practice or game can get hungry and run out of energy. By the end of the practice or game, the famished athlete may grab whatever food is handy, often a high-calorie fast food meal – generating a “back-loading” of calories. As a result, the athlete may eat more calories in this late meal than if these calories were spread over five or six smaller meals.

Proper meal timing and frequency are critical for optimizing fuel availability to enhance athletic performance.5 The content of these snacks and meals is also important. Eating a meal or snack containing both carbohydrate and protein about every three hours helps maintain the athlete’s blood glucose level.

Carbohydrate-rich foods raise blood glucose, while proteinrich foods help to keep blood glucose from falling and provide satiety.

Maximize Recovery Muscles are most receptive to refueling and rebuilding during the first 30 minutes after exercise. During this window, athletes benefit from both carbohydrate to speed glycogen synthesis and protein to support muscle protein synthesis. A dedicated recovery plan can help this process and bridge athletes to their next meal. Athletes who fail to refuel or rehydrate after these

activities will not have the optimal level of energy for the next day. Athletes can follow these tips for smart recovery: • To rehydrate -- weigh-out at the end of practices and games.

Drink 20 to 24 ounces of fluid for each pound lost.

• To refuel -- choose carbohydrate-rich snacks that are complimented with protein. If solid foods aren’t easily digested, choose a formulated recovery drink.

Recording food intake will help athletes fine-tune when they eat, what they eat, and how much they eat. The key is to follow breakfast, or the first meal of the day, with frequent small meals or snacks so that the athlete isn’t ravenous and inclined to back-load calories later in the day. By distributing calories evenly throughout day, athletes will have energy available when they need it for optimum performance.

Sample meal plan: • Breakfast (600 calories): - 1 poached egg - 1 piece whole grain toast (use added fat or jam sparingly) - ½ cup cooked oatmeal with ½ banana - 1 cup 1% fat milk - 20 oz of Gatorade • Lunch: (600 calories): - Turkey sandwich on whole grain bread - 1 cup salad (lettuce, broccoli, cauliflower, tomatoes) with light salad dressing - 1 apple • Pre-Early Afternoon practice: (350 calories) - 1 oz string cheese - 1 ½ oz pretzels - 20 oz of Gatorade • Recovery Snack (350 calories) - 1 large Graham cracker with peanut butter - 20 oz of Gatorade • Dinner (600 calories) - 1 ½ cups pasta with meat sauce - ½ cup cooked mixed vegetables - 1 cup mixed berries - 1 cup 1% fat milk

References 1

Sherman, W.M., Brodowicz, G., Wright, D.A. et al. Effects of 4 hr pre-exercise carbohydrate feedings on cycling performance. MSSE, 12:598-604, 1989.

Sherman, W.M., Peden, M.C., Wright, D.A. Carbohydrate feedings 1 hour before exercise improves cycling performance. Am J Clin Nutr, 54:866-870, 1991.

3 Schlundt, D.G., Hill, J.O., Sbrocco, T. et al. The role of breakfast in the treatment of obesity: a randomized clinical trial. Am J Clin Nutr, 55:645-51, 1992.

4 De Castro, J. The time of day of food intake influences overall intake in humans. J Nutr, 2004; 134:104-11 5 Hawley, J.A., Burke, L.M. Effect of meal frequency and timing on physical performance. British Journal of Nutrition,77 (Suppl 1):S91-103, 1997.

2

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The Squat Stand adjusts to three height settings, facilitating correct biomechanics for squats, bridges, calf raises and plyometric exercises.

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PowerTower’s Time-efficient Workouts Appeal to Athletes and Non-athletes Alike Athletes aren’t the only ones who can appreciate the effectiveness and efficiency of a PowerTower workout.

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OPTIMUM PERFORMANCE

The Better To See From having Lasik surgery to catching bean bags over their shoulders, athletes are opening their eyes to enhancing their vision.

BY R.J. ANDERSON

E

After undergoing Lasik surgery, Tiger Woods says the ball and cup now look bigger to him. ©GETTY IMAGES

24

T&C MARCH 2007

ight years ago, golfer Tiger Woods was legally blind and frustrated by the contact lenses he wore to correct his severe nearsightedness. So, taking the advice of several other players on the PGA Tour, he underwent Laser Assisted in Situ Keratomileusis (Lasik) surgery.

Before the surgery, Mark Whitten, MD, an ophthalmologist and Regional Medical Director for TLC Laser Eye Centers in greater metropolitan Washington, D.C., says Woods had “counting fingers vision,” meaning he could count the number of fingers someone held up only if they were within a foot of his face. After the 20-minute procedure, performed by Whitten, Woods walked away with 20/15 eyesight— slightly better than what ophthalmologists consider perfect. And coincidence or not, Woods won the next five tournaments he entered. Since the surgery, he has had 55 PGA Tour victories.

Though his post-Lasik eyesight was no better than when he wore contacts before the surgery, Woods told Golf Digest that it has definitely improved his game. Besides not having to deal with dirty, wind-dried contact lenses, Woods said both the golf ball and the cup look bigger now that he is lens-free. He also said it’s easier for him to read his putts.

Because the correction was so sig-

R.J. Anderson is an Assistant Editor at Training & Conditioning. He can be reached at: rja@MomentumMedia.com TR AINING-CONDITIONING.COM

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OPTIMUM PERFORMANCE nificant in Woods’s prescription lenses, Whitten says the cup may have been minified or distorted a bit when he focused on it with contacts. “After his laser correction, his brain perceived the cup as looking bigger,” says Whitten, who has performed the procedure on many PGA players as well as professional football, basketball, and baseball players. “Most golfers tell me that when they putt after having the surgery, they can actually see which way the blades of grass are growing—and they couldn’t see that before.”

As today’s athletes search for any advantage they can get, they are looking more and more to how their vision affects their performance. From correcting how their eyes judge distances to

called a microkeratome or a laser called a femtosecond microkeratome (a femtosecond is one billionth of one millionth of a second). That flap is folded back out of the way and the surgeon uses an excimer laser, which emits an ultraviolet light beam, to remove microscopic bits of corneal tissue, basically reshaping the cornea and removing its flaws.

Reshaping the cornea allows for a more even, more focused dispersal of light into the eye and onto the retina.

When the re-shaping is completed, the flap is laid back in place, covering the area of correction. It heals in a matter of hours.

Lasik surgery was first performed in the U.S. in 1991, and in 2006, more than 1.4 million Americans had the

Another alternative is surgically implanted lenses, called phakic intraocular lenses … Like Lasik surgery, the implants alter the way light rays enter the eye to achieve sharper focus. strengthening their ability to focus, vision enhancement is helping many athletes gain an edge. In this article, we’ll look at the most recent developments in this field.

LASER CRAZE Since Woods’s success with Lasik, a long list of professional athletes have opened their eyes to an ophthalmologist’s laser. Among them are Major League Baseball pitcher Greg Maddux, the NBA’s Amare Stoudemire and Richard Hamilton, and NFL players Ray Buchanan and Tiki Barber. So what exactly is Lasik surgery? And what makes an ideal candidate for the procedure?

A form of refractive surgery, Lasik is relatively painless and known for its quick recovery times. Traditionally used to correct far-sightedness (myopia and hyperopia), Lasik can also improve some forms of near-sightedness and astigmatism. To qualify for Lasik surgery, patients need to be over 18 years old and have demonstrated consistent eyesight for at least a year. If a patient’s prescription changes after having Lasik surgery, he or she will need either a follow-up enhancement surgery or to wear corrective lenses.

To begin the procedure, a surgeon slices a thin, circular flap in the cornea using either a tiny oscillating metal blade 26

T&C MARCH 2007

procedure, according to Market Scope, a St. Louis-based market research company. Over the last eight years the field of refractive surgery has seen many technological innovations, which have led to different approaches to laser eye surgery and have made the procedure more effective.

The most significant advance, says Whitten, is Wavefront-guided software, which guides the excimer based on measurements from a wavefront sensor.

This has made the procedure more accurate than it was 10 years ago, cutting down on flaws caused by irregularities between the lasered and the untouched part of the cornea. As a result, the night vision problems that used to plague some patients after Lasik surgery are largely a thing of the past.

“There’s a misconception that you’re going to end up with night-vision problems, like glare and halos,” says Whitten. “But an FDA study found that with the Wavefront software, many patients actually had improved night vision following the procedure. The software has been out for a few years, and now it’s very unusual for patients to complain of glare and halos.”

Whitten says the Wavefront technology has also dramatically cut down on the number of patients who have to return for follow-up enhancements—once

a common drawback of the procedure.

“I used to have between 15 and 20 percent of people come back for enhancements,” says Whitten. “The last few years it’s down to three percent.”

EYEING OPTIONS Before your athletes jump on the Lasik bandwagon, however, they should understand all their options. Other areas of optometry have advanced along with laser surgery, says William Harrison, OD, an optometrist who works with many college and professional athletes and teams.

“An athlete should not decide on lenses or surgery by only looking at that option,” says Harrison. “There are multiple choices that can be tailored to one’s needs depending on age, eye structure, and sport and position needs.

“A lot of people went to Lasik because they couldn’t stand contacts, but as Lasik has gotten better, so have contact lenses,” continues Harrison. “For instance, there is a new lens called a hybrid. It’s a firm lens with a soft edge so it gives the comfort of a soft outer lens but the vision quality of an aberrationfree firm lens—there’s no diminished vision under the lights or at dusk.”

Another alternative is surgically implanted lenses, called phakic intraocular lenses, which are often a good option if a patient’s corneas are too thin for Lasik surgery. The implants, which resemble contact lenses, are placed between the cornea and the iris or just behind the iris. Like Lasik surgery, the implants alter the way light rays enter the eye to achieve sharper focus.

Whitten says Lasik surgery is also not the best choice for athletes who risk being hit in the eye, such as boxers and martial artists, due to the destructive nature of the corneal-flap creation process. “In general, we try not to do Lasik on patients who might do something to cause the flap to move or be dislodged,” he says. “Although it’s highly unusual for that to happen, it is a minute risk that should be considered.”

For these athletes, Whitten says a better option may be Photorefractive Keratectomy (PRK) surgery, which provides basically the same results as Lasik, but does not involve cutting a permanent flap in the cornea. Instead, with PRK the outer layer of the cornea is removed and discarded before applying the laser to the retina. The drawback is PRK can be more painful, and visual recovery TR AINING-CONDITIONING.COM

OPTIMUM PERFORMANCE takes longer than with Lasik—patients often need three to four weeks before they are 90 percent healed.

For athletes considering Lasik or any other correction, both Whitten and Harrison recommend scheduling a consultation with an experienced physician. “They shouldn’t go to a doctor who does just one thing,” says Harrison. “If a doctor specializes only in contact lenses, they might be biased.

The same can be true for a Lasik surgeon who does nothing else. Athletes need to find someone who can clearly give them all the options and explain the costs of each.”

If an athlete does choose surgery, Whitten strongly discourages basing decisions solely on the price tag.

“Even though a lot of these procedures are technology driven, it’s still the surgeons themselves who make the most difference in a procedure’s success,” says Whitten. “You’ve got to think that somebody who charges $299 for a Lasik procedure is probably not as experienced as those who charge more.”

How much experience is enough? “If a surgeon says they have done 500 to

1,000 eyes, that’s actually not a lot,” says Whitten, who has performed surgery on over 80,000 eyes since 1993.

“Probably 75 to 80 percent of people who have the procedure will turn out well, no matter who does the surgery.

However, you don’t want to be among the 20 to 25 percent who have a problem. If you can lower your problem likelihood down to one percent, which is probably the lowest you can go in even the most experienced of hands, it’s worth spending a little more money.”

FIELD VISION Along with correcting eyesight problems, enhancing an athlete’s ability “to see” also means working on their optical interpretation, also called “sports vision.”

This is what allows a baseball hitter to pick up the spin of the ball more quickly and accurately when it leaves a pitcher’s hand, a volleyball player to judge where a serve will land, or a football wide receiver to snatch a pass amid several defenders. While Lasik and corrective lenses improve visual acuity—what or how far one can see—sports vision training addresses how a person sees. It

is important to note that visual acuity must be addressed before any sports vision training begins.

The premise behind sports vision training is similar to many strengthtraining principles—if an athlete trains and strengthens the tiny muscles in and around the eyes, his or her performance on the field or court will improve. Most vision training devices and programs address the following components: Ocular alignment: the ability to properly fixate the eyes on a target, also known as aiming of the eyes. When a coach says, “keep your eye on the ball,” he or she really means, “work on your ocular alignment.”

Depth perception: the ability of eyes to see objects in three-dimensional space and judge the distance between oneself and the object. It’s how a quarterback judges how far away his receivers are from him.

Ocular flexibility: the ability to move one’s eyes inward (convergence) or outward (divergence) when following a target. For instance, when a batter watches a pitcher’s release, his or her eyes are diverging from the target. Then, as the

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OPTIMUM PERFORMANCE ball approaches, the eyes converge on it. The quicker a player can change his or her focus back and forth between far and near, the better their ocular flexibility will be.

Visual recognition: the ability of eyes to process information regarding the shape and direction of an object and then make correct motor movements to adjust to it. This might be a defensive back’s ability to turn and look for the ball when covering a downfield receiver.

Visual tracking: the ability of eyes to move properly to track objects as they move, and then react accordingly.

One example is a wide receiver tracking a ball that’s thrown to him. It’s also known as “see, think, react.”

At the University of Tennessee, Brian Gearity, MS, CSCS, ATC, an Assistant Strength and Conditioning Coach for the football and baseball teams, uses a wide assortment of vision training methods—both manual and computerbased—when working with his athletes.

Gearity’s favorite is a software-based system that his Volunteer athletes have been using for the last couple of years.

The program addresses each of these

visual components within a 12- to 18minute training session. It’s loaded onto four desktop computers housed in the strength coaches’ offices, and players from Tennessee’s softball, baseball, and football teams typically use it for 20 minutes a day, twice a week, as part of their off-season strength and conditioning programs.

To start, the program tests each athlete on the different skills. From there, Gearity and the computer program’s administrators develop an individualized vision-training program based on the athlete’s weaknesses. The program also assesses each athlete’s progress after every training session.

Staring at a computer, the players wear 3-D glasses while operating a joystick control pad. The on-screen exercises involve identifying and focusing on a series of rapidly moving shapes and arrows. In one exercise to test ocular flexibility, players are directed to hit a control button when they see a diamond appear over a fuzzy background on the screen, then told to follow it and respond to successive commands.

Because the joystick mirrors those

used on mainstream gaming systems, athletes are comfortable with the program and look forward to training with it. “After I show them how to use it, it usually only takes two sessions before they know how to manipulate all the variables and make it harder as they improve,” says Gearity. “After a while, they’re basically administering the program on their own.”

Carlo Alvarez, CSCS, Strength and Conditioning Coordinator at St. Xavier High School in Cincinnati, is also using a computer-based system as a training pilot program with his school’s ice hockey, lacrosse, and baseball teams.

He first became familiar with it while serving as a strength coach with the Cleveland Indians and Cincinnati Reds.

He says the computer program allows him to customize each athlete’s visual workout based on their individual weaknesses and the sport they play.

“We go 15 to 20 minutes, twice a week, in the preseason,” says Alvarez. “We use the data from each session to assess and get them to improve at every workout.

Then every week or two weeks we bump up the intensity of the session.”

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OPTIMUM PERFORMANCE Alvarez says it doesn’t take much prodding to get his athletes to complete their vision training exercises.

“We tell them why they’re using it and the program’s video game-like qualities keep the kids excited about it,” he says. “They love putting the goggles on, picking up the joystick, and competing against each other.”

EYE TOOLS While computer-facilitated vision programs may be the wave of the future, there are lower-priced alternatives.

Thomas Wilson, OD, an optometrist who has served as a sports vision consultant with the U.S. Air Force Academy, USA Shooting, and the University of Colorado ski team, uses a combination of inexpensive hands-on devices constructed of very basic materials.

Co-author of Sportsvision: Training for Better Performance, Wilson says some of his favorite exercises incorporate a balance beam or a two-by-four piece of lumber and bean bags. Balancing on the beam or board, athletes are tossed beanbags from different angles and told to catch them. An advanced step involves having the athlete catch beanbags that are thrown from behind their shoulders. Wilson says these drills are especially beneficial for football receivers and defensive backs.

A similar drill involves tossing an athlete beanbags in a dark room illuminated by a strobe light. The strobe light trains the athlete’s object tracking ability and eye-hand coordination.

To make the exercise more difficult, the strobe’s frequency can be decreased, which increases the amount of time the room is dark while a beanbag is in the air.

Perhaps the most widely used vision training device is called a Brock String. A three to five foot long piece of string that holds three small, multicolored beads set equal distances apart, the Brock String addresses spatial localization and teaches the athlete how to aim his or her eyes together correctly. It also illustrates the difference between convergent and divergent eye aims and indicates to the athlete if they are shutting off or suppressing an eye.

To use the Brock String, an athlete holds one end of the device against the tip of their nose while the other end is tied to a fixed point. When starting

out, the athlete is asked to focus on one bead at a time and name the color. The drill can be made more difficult with gradual adjustments, such as moving the beads closer to the nose.

Along with computer-based training, Tennessee athletes also use manual exercises as part of their off-season program. “For instance, our football wide receivers catch tennis balls that are shot out of a machine at different speeds,” says Gearity. “We also have colored bouncy balls that we throw at the players. We’ll ask them to grab a certain

colored ball and identify the color or catch one color and drop the other.”

When implementing a program, Alvarez recommends starting with only a few teams or athletes. “And it should be sports where the athletes have to focus on and recognize an object coming at them—hockey, lacrosse, baseball, tennis,” he says. “Once you do it with one or two teams, and you can show off their improved test scores, the athletes will talk about how they enjoy the system, and eventually the other coaches will buy in.” ■

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29

TREATING THE ATHLETE

A specialized off-season rehab and strength program gave Zach Miner the power, coordination, and stability he needed to secure a spot on the Detroit Tigers’ roster.

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T&C MARCH 2007

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TREATING THE ATHLETE

Ready for Prime Time When a minor league pitcher sought treatment for some back and shoulder pain, this rehab team helped propel him into the big leagues—and a pennant race.

BY DR. MICHEAL CLARK AND MARTY MILLER

I

n professional baseball, every minor league player is waiting for one phone call: “Are you ready to play in the big leagues?” For Zach Miner of the Detroit Tigers, that call came on June 4, 2006, after starter Mike Maroth was sidelined with an elbow injury. A 24-year-old righthanded pitcher, Miner had played in the minors for five years with limited success, but was pitching better than ever at the start of 2006, with a 6-0 record in Triple A ball.

Although Miner’s call-up was originally for a fill-in stint, he ended up staying—sometimes starting, sometimes relieving—and ultimately helping the Tigers win their first American League pennant in 22 years. On the season, he went 7-6 with a 4.84 ERA, and made the Tigers’ reduced playoff roster in September.

There are many steps in making it to the major leagues, but one that some players neglect is staying healthy. Understanding this dynamic, Miner came to us after his 2005 minor league season, complaining of mild pain in both his right posterior shoulder and lower back. He had never been sidelined with a major injury, but he wondered if his symptoms were slowing him down, and if any underlying problem had the potential to end his career before it ever truly got started.

Overuse and repetitive trauma injuries occur frequently in baseball. A major league season is 162 games long, and there’s also a month of spring training and possible postseason play. Players

TR AINING-CONDITIONING.COM

will perform the same repetitive tasks thousands of times over the season, leaving them at risk for breakdown and injury. However, with a specialized, integrated conditioning program, injuries can be prevented and performance can be improved.

INITIAL EVALUATION Miner began his integrated program with us at the end of the 2005 minor league baseball season. Previously, he had only used traditional strengthening programs that did not take into account any of his movement impairments. He had gone straight from high school into pro baseball.

Before initiating a program for Miner, we performed a comprehensive evaluation. When it comes to assessment, we feel an integrated approach is critical. The combined efforts of the nervous, muscular, and skeletal systems are responsible for even the simplest movements in the human body, and collectively they make up the kinetic chain. If a small dysfunction occurs in any of these systems, the others’ ability to perform their functions will be substantially reduced.

Therefore, we perform goniometric measurements, manual muscle testing, and most importantly, an Integrated Movement Assessment. The movement evaluation includes an overhead squat and single-leg squat. Using our understanding of functional anatomy and biomechanics, we assess structural alignment and the neuromuscular efficiency (coordination) of the ki-

netic chain. If a breakdown or movement compensation occurs at any of the joints that make up the kinetic chain, the structural integrity of the muscles that control those joints will be evaluated. (See “Assessment Chart” on page 32 for check points.)

The purpose of this testing was to discover any pre-existing muscle imbalances, joint dysfunctions, or neuromuscular inefficiencies that could be leading to the discomfort in Miner’s shoulder and lower back. The tests were also chosen to discover any movement dysfunctions that could cause problems in the future.

Whenever there is excessive motion during the assessment, which can be caused by either overactive (short/tight) or underactive (long/weak) muscles, the nervous system will constantly elicit less then ideal firing patterns. A strategic plan can then be created based on these findings. Once the corrective exercise training plan is implemented, the imbalances will be corrected and optimal movement of the kinetic chain will be restored.

Micheal Clark, DPT, MS, PT, CES, PES, CPT, is President and CEO of the National Academy of Sports Medicine and Team Physical Therapist to the NBA’s Phoenix Suns. Marty Miller, MS, ATC, PES, CES, CSCS, is a former athletic trainer for the Montreal Expos and currently Director of Fitness at the BallenIsles Country Club, where he continues to work with professional baseball players during the off-season. Clark and Miller can be reached at: www.nasm.org.

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31

TREATING THE ATHLETE

ASSESSMENT CHART The following findings helped us design Miner’s program. Results are included in bottom two tables.

Overhead Squat Assessment Anterior View Foot Knee

Right Yes Turns Out x Moves Inward x Moves Outward

Left Yes x x

Lateral View (Right Side) Yes LPHC Excessive Forward Lean x Low Back Arches x Low Back Rounds Upper Body Arms Fall Forward x

Posterior View

Right Yes

Foot Heel Rises Flattens LPHC Hip Drops Hip Hikes Hip Shifts

Left Yes

x

x

x

Modified

Heels Elevated

Arms Down

Feet

Improvement

No Improvement

Knees

Improvement

No Improvement

LPHC

No Improvement

Low back arch improvement, excessive forward lean increases

Upper

No Improvement

NA

Single-Leg Squat Assessment Foot Knee LPHC Trunk

Right Leg

Left Leg

x

x

Flattens Moves Inward Moves Outward Lateral Hip Shifts Rotates In Rotates Out

Goniometric Measurements

Ankle Dorsiflexion Hip Extension Hip Internal Rotation Shoulder Flexion Biceps Femoris (short head) *All measurements are in degrees

Pre Right 11 25 10 140 26

Left 12 17 17 146 28

Post Right 17 7 41 162 11

Left 17 7 40 160 11

% Improvement Right Left 55 42 72 59 76 58 16 10 58 61

Manual Muscle Testing Pre Post Right Left Right Left Gluteus Medius 2 2 3 3 Gluteus Maximus 2 2 3 3 Posterior Tibialis 2 3 3 3 Anterior Tibialis 3 3 3 3 Lower Trap 2 3 3 3 *All measurements were graded on a 3 point scale: 1=weak, 2=compensation, 3=strong/optimal

32

T&C MARCH 2007

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TREATING THE ATHLETE Restoring optimal movement is key, because if any segment of the body functions in a less than ideal manner, the altered movement patterns that develop will place increased stress on the tissue around those particular joints. As we condition our athletes, we purposely place stress on their bodies. If there is optimal alignment of the kinetic chain, loads will be handled by the body efficiently and will elicit positive responses. But if the structural integrity of the athlete’s kinetic chain is compromised, the stress we place on them may actually leave them more susceptible to injury.

So how did Miner do on his assessment? During his overhead squat, his feet everted, indicating probable over-activity in his lateral gastrocnemius, peroneal complex, and the short head of his biceps femoris. Underactive muscles that likely contributed to this movement compensation included his medial gastroc, popliteus, and medial hamstring complex.

When Miner squatted, he ran out of available dorsiflexion in his foot and ankle complex in the sagittal plane. To continue descending further into the squat, his body found the path of least resistance. Miner moved his foot and ankle into the frontal and transverse plane (eversion and external rotation) to create the dorsiflexion he was lacking. An everted position of the foot and ankle moves the posterior tibialis, medial gastrocnemius, and medial hamstring into a lengthened position. To correct this movement compensation, those muscles would need to be strengthened.

An everted foot and ankle may also cause the knee to adduct and internally rotate during movement. This indicates weakness in the gluteus medius, which is a key muscle for providing stability to the entire lumbo-pelvic-hip complex in the frontal plane. Along with the gluteus medius, the gluteus maximus is also placed in a lengthened position if the knee adducts and internally rotates.

At Miner’s lumbo-pelvic-hip complex, we noted an excessive arch, along with the movement compensation of arms falling forward, which indicated probable overactivity in the latissimus dorsi, hip flexor complex, and erector spinae.

The anterior-tilted position of his lumbo-pelvic-hip complex placed his latissimus dorsi in a shortened position, which can affect both the origin (thoracolumbar fascia) and insertion (anterior portion of the humerus). This decrease in length and extensibility prevented Miner from fully extending his arms above his head without creating compensation in his glenohumeral joint.

Miner’s normal posture of protraction through the thoracic spine would also mimic the above described movement compensations. These altered positions placed the rhomboids and middle and lower trapezius in a constant state of stretch. As a result, Miner was unable to maintain the proper glenohumeral rhythm necessary during his pitching motion.

When we evaluated Miner’s compensations, we were able to correlate them to his shoulder and lower-back discomfort. His most prominent compensations were the arch in his lower back and the fact that his arms fell forward upon the descent of his squat.

We then explained to Miner that his shoulder and lower back pain were being caused by the movement compensations identified in his assessment, and he took a particular interest in correcting them. Besides obviously wanting to decrease his current pain, he hoped to increase his overall performance and prevent injuries in the future.

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TREATING THE ATHLETE AN INTEGRATED PROGRAM The program we designed for Miner focused on correcting his overactive and underactive muscles, increasing his body’s stability, improving coordination, and furthering strength and stamina to prepare him for the upcoming season. Each phase of his training was broken into three or four weeks, so the whole process fit into his five-month off-season.

Phase One: Our first priority was to address Miner’s movement compensations with an approach we call Corrective

Exercise Training (CET). This phase lasted three weeks. The goals were to inhibit the overactive muscles that were causing movement compensations, lengthen the overactive/short muscles, activate the underactive/weak muscles, and integrate optimal movement into functional movement patterns.

To inhibit the overactive muscles, Miner performed self-myofacial release on the following muscles, doing one set for 30-60 seconds, and following with static stretching on these muscles for 30 seconds:

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• • • •

TFL/IT band Adductor magnus Lateral gastroc Latissimus dorsi.

He activated the following weak muscles for 15 reps and two sets, with a tempo of 4/2/2: • Gluteus medius • Gluteus maximus • Popliteus/posterior tib combo • Medial gastroc.

To integrate these movements into functional movement patterns, he did the following: • Prone iso abs with hip extension, with a five-second hold, 3x each leg, for 10 reps and two sets.

• Standing one-leg reach in the frontal plane, with a five-second hold, for 10 reps and two sets.

• Wall ball squat to scaption, with a tempo of 4/2/2, for 15 reps and two sets.

Phase Two: Upon completion of the CET protocol, Miner moved into a fourweek Integrated Stabilization Training (IST) program. The goals were to increase total body stability, endurance strength, and neuromuscular efficiency while improving inter- and intra-muscular coordination. We also started cardio training three times a week.

For Warmup/Flexibility: • Hold tender spots for 20 to 30 seconds of the: SMR lateral gastroc, IT band, TFL, adductor magnus, latissimus dorsi, and pecs.

• Conduct static stretching, with 30second holds of the: lateral gastroc, TFL, adductor magnus, latissimus dorsi, and pecs.

For Core and Balance: • Ball bridges, 3x15, 4/2/2 tempo, no rest • Prone iso abs, 3x1, 30-second hold, no rest • Cable PNF, 3x12, 4/2/2, maintain neutral spine, arm movement only • Single-leg balance and reach, 3x5, three-second hold, movement in all planes.

For Reactive Work: Jump up to hold, 3x12, three-second hold, rest 15 seconds.

Do one set in each plane of motion.

For Strength Training: The following exercises were done at a 4/2/2 tempo for 15 reps and three sets, with no rest in between except for the step-up, which allows 60 seconds of rest. We added work for the biceps and triceps some days.

• Ball squat w/scaption

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TREATING THE ATHLETE • Standing band chest press, one leg (press until shoulders are fully protracted) • Standing cable row, one leg • Ball combo one (lying prone over a stability ball, the athlete engages the core and lower body while making three distinct movement with his arms) • Step-up sagittal plane to curl.

Post-Workout Flexibility: foam roll and conduct stretching as in the warmup.

Phase Three: With a platform of stability in place from Phase Two, the next phase was designed to build a solid foundation of strength. This program is called Stabilization Equivalent Training (SET) and is a hybrid form of training designed to increase strength endurance.

During this phase of training, the athlete completes one strength-based exercise, then immediately completes a stabilization exercise for the same body part. This helps the body to stabilize itself under heavier loads, handle increased training volume, improve metabolism, and increase motor unit recruitment, frequency of motor unit recruitment, and motor unit synchronization. Phase three lasted four weeks and also included speed, agility, and quickness training, plus cardio work.

For Warmup/Flexibility: • Hold tender spots for 20 to 30 seconds of the: SMR calves, lats, IT band, and adductor magnus.

• Conduct active stretching, with threeto five-second holds, for five reps of the: lateral gastroc, hip flexors, adductors, and lats.

For Core and Balance: Two sets of 12 reps with a 2/0/2 tempo doing the following exercises: • Ball crunch w/rotation • PNF rotations • Ball cobra alt. arm • Single-leg squat For Reactive Work: squat jump multi planar, 2x10, repeating with no rest.

For Strength Training: The following were conducted for 12 reps and two sets, with no rest except for 30 seconds between the squat-to-row sets.

We added work for the biceps and triceps some days.

• Squat to row, two arms, 2/0/2 • Incline DB alt. arm, standing, 2/0/2 • Standing one-leg band chest press, 3/2/1 • Standing cable row, two legs, 2/0/2 TR AINING-CONDITIONING.COM

• Prone call DB row alt. arm, 3/2/1 • Standing scaption, 2/0/2 • Ball combo one, two-second hold each • Ball squats, 2/0/2 • Single-leg Romanian deadlift, 3/2/1.

Post-Workout Flexibility: foam roll and conduct stretching as in the warmup.

Phase Four: Next up was Elastic Equivalent Training (EET). This phase focuses on increasing the body’s ability to produce both force and velocity. A maximum strength exercise is completed, followed immediately by an explosive movement for the same body part using little weight. We also continued to do cardio training and speed, agility, and quickness training.

would complete one IST (stabilization) workout, one SET (strength) workout, and one EET (power) workout in the same week. This form of training is designed to sustain all of the adaptations of stabilization, strength endurance, and power as an athlete goes through a grueling baseball season. This is key, because if any of these adaptations decreases, his ability to perform at the highest level will suffer and the likelihood of injury will increase.

IN THE BIG LEAGUES NOW Miner was a high-rated prospect who was learning how to pitch in professional baseball. Selected by the Atlanta Braves in the fourth round of the 2000 draft, he was traded along with Roman

The final phase of Miner’s training was a hybrid model where he would complete one IST (stabilization) workout, one SET (strength) workout, and one EET (power) workout in the same week. It is designed to sustain all of the adaptations of stabilization, strength endurance, and power.

For Warmup/Flexibility: • Hold tender spots for 20 to 30 seconds of the: SMR lateral gastroc, IT band, adductor magnus, latissimus dorsi.

• Dynamic stretching of 12 reps and two sets by doing MP lunges, prisoner squats, and med ball lift series.

For Core and Balance: Two sets of eight reps of: • Med ball crunch and throw, 15-second rest • Med ball back extension throw, 15second rest • Single leg hop multi planar, 3-10 second hold, 30-second rest For Strength Training: The following circuit was performed three times, with a two-minute rest in between. Work for the biceps and triceps was added some days.

• Squat curl and press, 2x5 • Arm DB snatch, 10x10 • DB press, 2x5 • Med ball rotational pass, 10x10 • Seated cable row, 2x5 • Med ball throw, 10x10 • Step-ups sagittal plane, 2x5 • Power step-ups sagittal plane, 10x10 Post-Workout Flexibility: foam roll and conduct stretching as in the warmup.

Phase Five: The final phase of Miner’s training was a hybrid model where he

Colon to the Detroit Tigers for Kyle Farnsworth in 2005.

Miner’s success in professional baseball was incremental. He did well enough to stay on pace and move up the ranks season after season, but he failed to record a winning season until his 2005 stint with the Tigers’ Triple A club (3-1, 2.36 ERA).

After starting the 2006 season with a perfect 6-0 record (2.82 ERA) at Triple A Toledo, Miner was called up to add support to the Detroit Tigers’ pitching staff. In his first year at the Major League level, Miner finished the season with a winning record (7-6), and helped the team secure the American League pennant and reach the World Series for the first time since 1984.

This off-season he is working with us again, following a very similar program. Some minor movement compensations did return by season’s end, but this is not uncommon after an athlete has played a long season. The good news is that they were much less pronounced than the year before and we were able to clean him up quickly. He won’t be a surprise rookie again this year, but we’re confident he will be strong, with a body ready to endure the challenges of major league baseball. ■ T&C MARCH 2007

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Saving Knocked-Out Teeth During Sports 800,000 teeth are knocked out during sports each year!

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Studies have shown that only 10% of athletes comply with rules that require wearing their mouthguards during all sports activities.

Knocked-out teeth begin to die within 15 minutes, and teeth knocked out during sports events have little chance of being saved unless prompt action is taken.

Why can knocked-out teeth be saved…

Every tooth is connected to its surrounding bone by a ligament, the periodontal ligament (PDL). (See figure on right.) The tooth and surrounding cementum, bone, and gingiva receive nourishment from the blood supply through this ligament. When a tooth is avulsed, this ligament is stretched and splits in half; half stays on the tooth root and half stays on the socket wall. If these two halves can be kept alive, the tooth can be replanted and the halves of the ligament will reattach and the tooth will remain vital.

The half that stays on the socket wall, since it remains connected to the bone blood supply, is naturally kept alive. However, the PDL cells that remain on the tooth root must be artificially maintained. They must be protected from two potentially destructive processes: cell crushing and loss of normal cell metabolism.

Although some dentists advise that the best treatment for an avulsed tooth is immediate replantation, for a variety of reasons this is often difficult. Often multiple teeth are avulsed and an athletic trainer may not know into which socket an individual tooth belongs. The athlete may have other more serious injuries that require more immediate attention such as a severe eye injury or a severely lacerated bleeding lip or gum that prevent easy visualization of the socket. Bone chips or debris may be in the sockets, which will prevent complete reimplantation.

If avulsed teeth are not reimplanted immediately, then all treatment between the time of the accident and the ultimate replantation must be focused on preventing further damage to the teeth and maintaining the PDL cells in the optimal condition.

alveolar bone

PDL

PDL PDL halves

dental pulp

normal tooth

PDL fibers stretch

PDL fibers broken

Save-A-Tooth®…

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According to Henry Rankow, DDS (from Pennsylvania), “SaveA-Tooth overcomes all of the obstacles encountered with avulsed tooth storage. It preserves and protects the tooth for 24 hours successfully.”

A recent study showed that knocked-out teeth stored in Save-ATooth® showed 91% success and another study found that 20% of Save-A-Tooth kits are used within the first year. One of these kits was used by the Director of Health and Athletics for Baldwinsville Central School District, who wrote about his experience: Last year we had an unfortunate incident at one of our boy’s varsity soccer matches where one of our students lost a tooth during play. Luckily, we had one of the Save-ATooth kits in our medical box and the tooth was preserved and successfully implanted back into our player.

Athletic trainers must be prepared to institute the optimum treatment for knocked-out teeth, and this includes having Save-ATooth available. In the case of knocked-out teeth, being prepared and knowing what to do can mean the difference between athlete’s losing knocked-out teeth for life or keeping their own natural smiles.

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SPORT SPECIFIC

A STRONG

SEASON Designing an in-season strength program for basketball is fraught with scheduling challenges. At Wisconsin, the men’s team uses a focused but flexible plan to keep its players strong all season long.

BY SCOTT HETTENBACH

F

or most NCAA Division I men’s basketball teams, inseason strength training is anything but routine. Because each week’s schedule of competitions and travel is unique, not to mention each player’s academic responsibilities, scheduling a performance training program during the season is like trying to hit a moving target.

Here at the University of Wisconsin, our 2006-07 non-conference schedule had the team playing on any given day of the week in November and December. During one stretch, we played seven games in 16 days. After our conference games started, we varied between playing on Tuesday or Wednesday nights and Saturday or Sunday afternoons.

This type of schedule makes it difficult to construct a consistent in-season performance training program for our student-athletes. Communication with coaches and support staff, along with some creative program design, are the keys to keeping the changing schedule “routine.”

BIG PICTURE Before I start designing any strength program, I take time to examine the sport coach’s goals and strategies for the season. For any performance training program to succeed, the strength and conditioning coach, the athletic trainer, and the team’s head coach must work closely together to develop a cohesive plan. They may not always agree entirely, but their level of communication often determines how well a team performs on the court.

Scott Hettenbach, MS, CSCS, is in his 12th year as the Strength and Conditioning Coach for Men’s Basketball at the University of Wisconsin. He has worked with 15 different sports while at Wisconsin, and can be reached at: seh@athletics.wisc.edu.

DAVID STLUKA TR AINING-CONDITIONING.COM

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SPORT SPECIFIC The first thing Head Men’s Coach Bo Ryan and I talk about is the overall philosophy of the men’s basketball program and what his priorities are. From there, I develop a strategy specific to strength and conditioning, focused on making players successful on and off the court. This year, my plan was based on four goals: 1. Reduce the incidence of basketballrelated injuries.

2. Improve performance in the weightroom that transfers to the court.

3. Build self-esteem and confidence in our student-athletes.

4. Ensure that academics are a priority when scheduling workouts.

thusiasm on to others, especially in-season when practices, travel, and academic workloads can wear players down mentally. I think it is extremely important to be early, be organized, and be upbeat. If a workout is scheduled for 6 a.m., I want our athletes to walk into a weightroom that’s full of energy, not a dark building with no one around. Even the best-designed strength programs will fall short if athletes don’t bring a certain level of intensity to their workouts.

A team’s style of play is also part of the big picture and must factor into the performance training program design. We run the swing offense, which requires everyone on the court to be involved in

Coach Ryan and I both believe that intensity and consistency are the keys to great training. He follows a specific routine each day at practice.

The drills he uses change, but the flow of the practice remains very consistent. I try to mimic that philosophy in the weightroom.

Part of the team’s philosophy is to hold student-athletes to a high standard both in the classroom and on the court, and I make sure the same holds true in the weightroom. We expect them to be on time for scheduled workouts, and they are only permitted to wear teamissued practice gear. They are also required to have their shirts tucked in at all times and no jewelry, cell phones, or iPods are allowed. We also demand that they bring a great attitude and a desire to improve, just as they do for a practice or game. These are simple concepts, but it’s amazing what happens when everyone is on the same page and buys into the routine.

Coach Ryan and I both believe that intensity and consistency are the keys to great training, and that’s at the foundation of everything we do on the court and in the weightroom. He follows a specific routine each day at practice. The drills he uses change, but the flow of the practice remains very consistent. Our players know what to expect, but each practice may present a new approach on how to accomplish it. I try to mimic that philosophy in the weightroom.

At the same time, I let my personality come through in our workouts. I really enjoy my job, and I try to pass my en38

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the movement of the ball, whether they are perimeter or post players. This is a patient style of play, meaning that we often use 25 to 30 seconds of each possession before finding the highest percentage shot. Because this style involves

Ryan and I work together closely on developing work capacity and increasing endurance.

IN-SEASON PLAN Every design starts with a yearly plan, and we break ours into four distinct time periods: developmental, pre-competitive, in-season, and regeneration.

The goals of our in-season performance program are to: 1. Have zero starts missed due to injury for the entire season.

2. Maintain body weight, with specific goals for each athlete.

3. Increase lean muscle mass (we use BodPod testing).

4. Increase functional range of motion and flexibility.

5. Maintain approximately 88-94 percent of 1RM strength in our preseason tested lifts (hang clean, front squat, bench). Redshirt athletes are tested in December and March for strength gain goals.

6. Consistently train two to three days each week.

7. Keep the intensity high while reducing the volume accordingly as the season progresses.

8. Enjoy the process, while also making it challenging for our student-athletes.

The trick is to make all of this happen while working around the prac-

I have found it pays to write everything in pencil and stay flexible, because almost every week during the season we end up having some type of change or scheduling conflict. Communication is the key to overcoming these speed bumps, along with understanding my role within the program. continuous movement by our players, it is important for them to have a high level of work capacity.

On the defensive end, we are predominantly a half court man-to-man team, which means very little down time while the players are on the floor. They need to be able to maintain an athletic defensive posture for long stretches, and generate explosive strength even while in a fatigued state. Much like in a hockey game, we substitute frequently, and routinely use 10 or 11 players per half.

Therefore, conditioning our players is a priority in our planning. Coach

tice, academic, travel, and competition schedule of our team. We plan two to three months ahead, and as each week approaches I communicate with the basketball coaching staff to see if any schedule changes or conflicts have arisen. I have found it pays to write everything in pencil and stay flexible, because almost every week during the season we end up having some type of change or scheduling conflict. Communication is the key to overcoming these speed bumps, along with understanding my role within the program.

I am fortunate that Coach Ryan and TR AINING-CONDITIONING.COM

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SPORT SPECIFIC

SAMPLE WEEK The following is an example of our two-day, in-season weightroom workout:

DAY ONE Foam Roll: focus on glute medius, TFL, IT band, and adductors Movement Prep: dynamic movement warmup Prehab: exercise prescription based on athlete imbalances or weaknesses Core: med ball rotational wall throws or functional trainer rotational movement combinations along with static hold exercises Bar Complex: using a 45-pound bar, may include muscle snatch, muscle clean, squat press, straight-leg deadlift (SLD), etc.

Dynamic Effort: Olympic movement or Vertimax, such as snatch, hang clean, rack clean, or push jerk ■ 2-4 sets of 2-3 reps @ 55-70% with 1.5-2 minutes of rest between sets Max Effort: lower-body press, such as squat, front squat, or deadlift ■ 2-4 sets of 2-3 reps @ 80-95% Paired with Repetitive Effort: upper-body pull, such as chin up, one-arm DB row, or bar row ■ 2-4 sets of 6-10 reps @ 60-75% Rest 1-2 minutes between paired exercises Repetitive Effort: DB upper-body press, such as DB standing military, DB incline, or DB bench ■ 2-4 sets of 6-10 reps @ 60-75% Paired with Lower-Body Pull: SLD, one-leg SLD, or glute ham ■ 2-4 sets of 6-10 reps @ 60-75% Rest 1-2 minutes between paired exercises Stretch: may include foam roller, static, PNF, active stretching Nutrition: hydration and nutrient replenishment within 45 minutes post workout

DAY TWO Repeat foam roll, movement prep, prehab, core, and bar complex work from Day One. Dynamic Effort: Olympic DB movement, such as one-arm DB snatch, DB hang clean, or one-arm DB push jerk ■ 2-4 sets of 2-3 reps @ 55-70%, with 1.5-2 minutes of rest between sets Max Effort: upper-body press, bench, or incline ■ 2-4 sets of 2-3 reps @ 85-95% Paired with Repetitive Effort: lower-body pull, such as one-leg SLD, SLD, or glute ham ■ 2-4 sets of 6-10 reps @ 65-80% Rest 1-2 minutes between paired exercises Repetitive Effort: lower-body press, such as one-leg box squat or backward overhead lunge ■ 2-4 sets of 6-10 reps @ 65-80% Paired with Upper Body Pull: such as one-arm DB row, inverted row, or standing row ■ 2-4 sets of 6-10 reps @ 65-80% Rest 1-2 minutes between paired exercises Stretch and Nutrition: same as Day One

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SPORT SPECIFIC his staff fully support my efforts and those of our athletic training staff.

Coach Ryan gives me complete control in designing the team’s weightroom sessions and we combine ideas on the conditioning portion of the workouts. This way, I have better control over the design, timing, and sequencing of exercises in the weightroom, and I’m not worried about a high level of athlete fatigue that might occur if we combined them with practice or conditioning sessions.

In turn, I fully support Coach Ryan’s conditioning plan for the team. During the season, the team practices at a high level every day with a lot of full-court possessions and situational drills. Postpractice sprint sessions are rarely part of our routine as most in-season conditioning work is integrated into practice.

Some coaches I have worked with in the past had me arrive at the end of their practices two or three times each week to “run” athletes who had spent most of the last three hours standing around. This often made me the bad guy, because the only conditioning they received was courtesy of me and my whistle. I believe there is no better agility and conditioning format for basketball athletes than having them compete in high-intensity, high-demand situations and react to the unscripted movements that occur during the flow of the sport. This is difficult to duplicate by setting up some cones or running a series of agility drills at the end of a practice session.

SCHEDULING I prefer to separate our strength training workouts from our practices whenever possible during the competitive portion of the year. Our routine is to train early on Monday mornings when our schedule allows—unless we play that day or the next. Ideally, I prefer to have a 36- to 48-hour break between a strength workout and a competition, and 72 hours between strength sessions. This schedule works well when we have two or fewer competitions in a week and if they are spaced three or four days apart.

For example, if we play on Wednesday and Saturday, our lifting days would be Monday morning and Thursday morning of that week. This is the routine we try to maintain, but we are at the mercy of our game schedule. If we are competing Tuesday and Saturday, we lift on Sunday and Wednesday. If we play TR AINING-CONDITIONING.COM

three games in a given week, it may not be beneficial to do any strength training during that span, especially with those athletes logging the majority of the minutes on the court.

Depending on academic schedules, we will either bring the team in together or in small groups of four to six athletes. There are benefits to both— the team dynamic of having everyone together works well with our Monday early morning workout, while the

of the competitive season, then reduce to approximately 30 minutes once we start the second half of our conference schedule in February.

I like to pair up exercises during this phase, in which we train the upper body immediately after the lower body and vice versa, with little rest in between. With this strategy, we accomplish more in a shorter period of time, at a point in the year when efficiency is a top priority.

During our in-season training, approximately 30 percent of the program is individualized with each student-athlete’s plan based on his position, minutes played, and individual needs (injury rehab, muscle imbalances, redshirt, etc). smaller groups allow the athletes more scheduling flexibility and individualized time with me.

One exception to this setup involves student-athletes who are taking a redshirt year. For them, we treat a home game day as a strength and conditioning day, usually taking them through a weightroom workout immediately following our morning or early afternoon shootaround. Our redshirt athletes continue to train two to three times each week during the entire competitive season, and each one has his own unique goals. For some it may be integration back into strength training along with continued rehabilitation while recovering from an injury, while for others it may be increasing strength and adding lean muscle mass to prepare for next year’s season.

Because most of the team trains only two days per week, we conduct fullbody workouts for both training days and follow a conjugate periodization plan utilizing max effort, dynamic effort, and repetitive effort in varying combinations. We organize the workout around four to six exercises each day, varying them every two to three weeks (depending on our schedule) and then follow with an “unload” week.

We repeat this cycle for most of the competitive season, lifting some of our heaviest weight near the end of the season but with very low volume by that point. The quality and intensity of effort is what we focus on during these workouts, not the quantity of work done.

Most sessions last between 50 and 60 minutes during the first three quarters

AN INDIVIDUAL APPROACH Each of our student-athletes has an individualized card for his week’s workout. They all have nicknames on their cards, along with a weekly quote. This helps players stay focused on the goal for the week while having some fun along the way. We try to educate them on the benefits of becoming internally motivated when practicing, playing, or training, and that we are in this together to succeed as a team.

During our in-season training, approximately 30 percent of the program is individualized with each studentathlete’s plan based on his position, minutes played, and individual needs (injury rehab, muscle imbalances, redshirt, etc). Our style of play dictates that our athletes all perform many different movements while executing our offensive or defensive schemes during practice or competition. But within these movements, each position has greater tendencies while on the court. I observe all of our athletes at every game and practice, and also watch game film each week to break down movement patterns and look for areas where each athlete can improve his performance.

For example, our perimeter players tend to make more rotational chest passes, whereas our post players perform more overhead movements while rebounding or passing. We take this into consideration while designing their individual programs. This might mean that medicine ball work with perimeter players would focus on using rotational throws, while post players focus on overhead throws.

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SPORT SPECIFIC Also, we conduct preseason functional movement screening. Through this process, we may uncover mobility or flexibility issues that require additional attention. These deficiencies are addressed within the workout, with the help of our athletic training staff. For example, we may alter or limit overhead Olympic lifts with a particular athlete if he has mobility restrictions or a history of shoulder injuries. Instead, we may substitute loaded box jumps or squat jumps, along with specific prehab shoulder exercises during that portion

of the program. We still achieve the goal of training the athlete explosively with a ground-based triple-extension movement, while reducing the risk of injury.

THE WORKOUTS We begin each workout with a period of foam rolling to aid in our overall warmup. Then we move into dynamic movement exercises that mimic the movements our athletes do later. The focus is on increasing core body temperature and blood flow to the major muscles.

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From there we perform several prehab exercises specific to each individual athlete’s needs. These could be an extension of protocols the athletic training staff has prescribed to address a specific imbalance or weakness, or it may be based on observations during past weightroom sessions.

We also emphasize ankle strengthening and stabilization exercises, as this accounts for the highest percentage of our injuries. Examples include single-leg MB touches, the use of Airex pads or air disc pillows, and single-leg, eyes-closed drills.

Next, we move into the core exercises, focusing on the rotational and transverse plane movements—from completing a pass to grabbing a rebound to turning to change direction defensively, basketball athletes are continuously making rotational movements. We use the concept of the vertical core, meaning that 90 percent of our core exercises are performed on our feet rather than lying down. We include a wide variety of medicine ball rotational movements and throws, along with functional trainer/Vertimax rotational pull-presses.

The Olympic movements we incorporate include the snatch, clean, rack clean, and push/split jerk. During the second session of the week, we always use a dumbbell variation of these to change the stimulus and reduce the overall load on our athletes following a game.

The body of the program then includes four exercises paired together with a different emphasis every two to three weeks. We usually do a max effort lower-body movement on Day One and a max effort upper-body movement on Day Two. The combinations change depending on each player’s minutes played, position, training objectives, and level of fatigue. Then, following each lift and practice, we spend time static stretching, hydrating, and taking a nutrient recovery supplement.

Our program is always a work in progress. I have borrowed many ideas from others in the field—from Vern Gambetta to Todd Wright to Mike Boyle—and figured out how to make them work in my particular program, and I will continue to do so. Each year the program design evolves in some form or fashion. This is a never-ending process for me, and I am thankful to all the strength and conditioning professionals who have been willing to share their ideas and knowledge with me. ■

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SPECIAL FOCUS: PREVENTING MRSA

You have heard about how MRSA can wreak havoc on an athletic team.

Here’s how to help prevent an outbreak—and also how to deal with one.

Are You Protected?

BY GREG SCHOLAND

A

s Jon Cochran, a senior guard on the Stanford University football team, climbed into bed the night after a game last October, he felt the usual postgame soreness. He also noticed some tenderness in his cheek around what appeared to be a small pimple.

The next morning, he woke up to find half of his face severely swollen.

On the advice of Stanford’s team physician, Cochran was immediately admitted to the hospital for intravenous antibiotics, and he’d miss the next two starts before he was healthy enough to return to action.

TR AINING-CONDITIONING.COM

Cochran is 6-foot-6 and weighs over 300 pounds, but he was sidelined by something smaller than a pinhead: methicillin-resistant Staphylococcus aureus, also known as MRSA. A MRSA outbreak this past season infected a handful of Stanford football players, sending a few to the hospital and causing several to miss playing time. It also gave Head Athletic Trainer for Football Charlie Miller, ATC, a hands-on lesson in managing this infectious disease.

“It was amazing how quickly the infection would hit somebody,” Miller says. “Our doctors would look at a tiny lesion and say, ‘All right, let’s keep an ©GETTY IMAGES

eye on it.’ By the next day, it became something really significant. You could be doing all the right things to protect yourself and still get hit.”

If MRSA isn’t on your radar screen yet, it should be. It can strike anywhere, and if not properly dealt with, the effects can be devastating. Athletic trainers who have faced this microscopic menace agree that vigilance, communication, and common-sense preventive measures are the keys to keeping your athletes and your program safe.

Greg Scholand is an Assistant Editor at Training & Conditioning. He can be reached at: gs@MomentumMedia.com.

T&C MARCH 2007

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SPECIAL FOCUS: PREVENTING MRSA BACTERIAL BACKGROUND It has been almost 10 years since MRSA first appeared in an athletic setting, and in that time, it has cropped up everywhere from elementary school gyms to NFL locker rooms. In 2003, it made national headlines when a football player at Lycoming College died of a bloodstream infection linked to MRSA bacteria. But while more and more team physicians and athletic trainers are aware of the risks, an outbreak still often catches programs by surprise.

What exactly is MRSA, and why is it so dangerous? For years, the antibiotic methicillin (a synthetic form of penicillin) was a standard treatment for staph infections, which were common in hospitals and nursing homes but rarely seen in the general public. Over time, some staph bacteria developed resistance to methicillin, and decades of doctors overprescribing antibiotics made the problem worse. Today, methicillin is no longer prescribed to treat infections, but the term “methicillin-resistant” is still used to describe staph strains that are immune to many common antibiotics.

Because MRSA bacteria are harder to kill, the infections must be treated more carefully than ordinary staph cases (methicillin-susceptible Staphylococcus aureus, or MSSA). If someone with MRSA is prescribed a standard antibiotic, like penicillin or amoxicillin, the bacteria won’t be killed and the infection can spread and grow more serious. Untreated, MRSA can lead to organ damage, bloodstream infections, pneumonia, or, in extreme cases, necrotizing fasciitis (commonly known as flesh eating bacteria). However, if a diagnosis is made quickly, MRSA can be treated fairly easily by debriding and cleaning the infection site and using special antibiotics such as vancomycin and teicoplanin.

“The real key to controlling MRSA is identifying it as quickly as possible,” says Jeff Hageman, MS, an epidemiologist specializing in staph infections at the Centers for Disease Control and Prevention (CDC). “The standard treatment procedures and drugs are very effective, and the severe cases are usually the result of an infection not being recognized early enough.”

A MRSA infection typically begins as a skin lesion containing a pustule, so it is often mistaken for a pimple, ingrown hair, or spider bite. As it devel-

ops, it expands and can present with painful discoloration and swelling, running sores, boils, and sometimes serious tissue damage.

Various forms of Staphylococcus bacteria—and to a lesser extent MRSA— are all around us. The CDC estimates that between 25 and 30 percent of the U.S. population is “colonized” with staph, meaning the bacteria currently live on their skin, in their nasal passages, or elsewhere on their body. Only about one percent of people carry a MRSA strain. The colonized almost never find out they are inhabited with staph, and most show no symptoms.

In athletic settings, infection usually occurs when a colonized person’s bacteria come into contact with a cut, scrape, or other open wound. Sports involving frequent body-to-body contact, such as football and wrestling, pose the greatest risk since any small break in the skin can become an infection site.

But the danger extends to locker rooms as well—MRSA can be spread when athletes share towels, razors, or even bars of soap.

AN OUNCE OF PREVENTION Strategies for warding off MRSA range from the basic, like using the right kind of soap in locker room showers, to the high-tech—one company offers a metal box that attaches to a wall and constantly filters the air in the room. But experts agree a major piece of the puzzle is simply practicing good hygiene and proper wound care.

“Athletes can do a lot to minimize their exposure to MRSA just by following standard cleanliness rules,” says A.J. Duffy III, MS, PT, ATC, Head Athletic Trainer at Widener University and former President of the Pennsylvania Athletic Trainers’ Association.

“That means, for one thing, washing their hands regularly with antibacterial soap. It also means showering immediately after practice—athletes shouldn’t change their clothes and head back to their dorm room to shower, though many prefer to do that.”

Basic hygiene standards should apply to uniforms and equipment as well.

“One thing we know is that bacteria love damp, moist environments, which means protective equipment is a potential danger area,” Duffy says. “How many times do we see athletes finish practice and throw their pads in a bag or locker instead of letting them dry TR AINING-CONDITIONING.COM

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Circle No. 122

SPECIAL FOCUS: PREVENTING MRSA out? It’s a simple step, but it can make a very big difference.”

Almost anything athletes touch on a daily basis—weightroom equipment, towels and washcloths, locker room benches, jerseys—can be a conduit for MRSA bacteria. Since it’s impossible to clean every surface daily, it helps to identify the most frequently contacted spots in your facilities (for instance, locker room doorknobs, treatment tables, and shower areas) and single them out for more frequent cleaning.

No detail is overlooked—not even the athletes’ gloves. “We also provide a spray disinfectant at every practice for anyone who wears gloves on the field,” Miller says. “Bacteria can thrive on players’ sweaty gloves, so as they walk into the locker room we instruct everyone to spray their gloves down.”

Inside the locker room, Stanford installed liquid soap dispensers in all its showers to prevent athletes from sharing bar soap, which provides an ideal growing environment for MRSA bac-

“We also provide a spray disinfectant at every practice for anyone who wears gloves on the field,” says Stanford’s Charlie Miller. “Bacteria can thrive on players’ sweaty gloves, so as they walk into the locker room we instruct everyone to spray their gloves down.”

Of course, even if MRSA is lurking around your department, the bacteria need an open wound to enter an athlete’s body, so keeping skin wounds covered at all times should be a top priority. Some wound care products even have a special antimicrobial treatment that can help prevent infection.

Mike Goforth, MS, ATC, Head Athletic Trainer at Virginia Tech, says his staff’s close attention to cleanliness in the athletic training room sets an example that athletes take home with them. Each treatment table in his facility is outfitted with germicidal wipes, which the athletic trainers use liberally throughout the day. “We’re real sticklers with hand washing procedures,” Goforth says. “All the research says keeping your hands clean is one of the most important things you can do to prevent infection, so we’re extremely diligent about that.”

Hand washing is also now a major focus at Stanford, where Miller brings bottles of an alcohol-based hand sanitizer out to the field for every football practice. “Each athlete does a waterless hand washing as practice ends before they head to the locker room,” Miller explains. “We have keypad locks on our doors, and since athletes will be touching those when they go back inside, we want them to disinfect themselves first. During practice, they touch the ball, wipe sweat off their faces, and make contact with one another, so we want their hands to be clean.”

46

T&C MARCH 2007

teria. “Nothing our athletes use in the locker room is shared—everyone keeps their own razors, towels, nail clippers, and whatever else they need,” says Miller. “We make sure the athletes are following that policy.”

Some programs are also looking to technology to boost their prevention efforts. Last year at Virginia Tech, Goforth’s department hired a company to spray the Hokies’ synthetic turf fields, wrestling mats, saunas, and other areas with a special antimicrobial coating made of spear-shaped molecules that pierce MRSA and other microbes to kill them without chemicals. Other athletic departments have turned to air purifiers that claim to remove harmful bacteria from locker rooms and other common areas, and light therapy devices that kill bateria with therapeutic blue light. In the NFL, the Washington Redskins went high-tech with their MRSA prevention by equipping their whirlpools with a filtering system that uses ultraviolet light, while several other teams use a special sanitizing unit on all player equipment.

“There are many products out there making bold claims, and it’s important to do your homework before investing in any of them,” says the CDC’s Hageman. “Some are backed up by research and registered with the Environmental Protection Agency to prove they’ll do what they say, and others are not as responsible. For teams with very limited resources, the most important thing

they can do is make sure everyone is aware of the dangers and knows how to protect themselves.”

EDUCATION IS KEY Well-informed athletes are the best line of defense against outbreaks, so the most proactive programs place heavy emphasis on MRSA-related education.

The programs’ message is extremely simple: When in doubt, get it checked out. But athletic trainers find this mantra needs to be repeated constantly and in creative ways.

“I’ve learned to not assume athletes will recognize dangers on their own,” says Goforth. “We recently had an athlete with a wound on his knee who didn’t tell anyone for six days—it was ulcerated by the time we treated him.

Here’s a college athlete with a hole in his knee, and he didn’t say anything.

Luckily it wasn’t MRSA, but it could have been. We need to constantly reinforce the message about getting every cut, scrape, pimple, and spider bite checked out and not leaving anything to chance.”

Whether it’s at preseason team meetings, during physicals, or in the athletic training room, Goforth and his staff take every opportunity to talk about MRSA and keep it in the front of athletes’ minds. “The more ways they’re hearing about it, the better,” he says.

“We’re even looking into purchasing a big flat-screen TV to use as a rotating message board for sports medicine topics. If we’re flashing pictures of untreated MRSA cases up there and showing how bad it can get, that will grab their attention.”

Indeed, while they’re not for the squeamish, photos of MRSA infections can make for a very powerful warning.

“We hung up a poster in the football locker room that showed some extreme cases, and it definitely had shock value—which in this case is a good thing,” says Stanford’s Miller. “The guys kept asking us to flip the poster around.

They said, ‘Look, we’ve got it, okay?

We don’t need to see these pictures every time we go in and out!’ But there’s no doubt it raised their awareness.”

Another effective technique is to discuss playing time. At Stafford (Texas) High School, Athletic Trainer David Edell, LAT, ATC, CSCS, talks to athletes about teammates who were sidelined with MRSA. “When I say to a team, ‘See this guy? He didn’t practice TR AINING-CONDITIONING.COM

SPECIAL FOCUS: PREVENTING MRSA yesterday because he’s got an infection, and he won’t be playing this week,’ that hits home for them more than anything else,” Edell says. “When it’s someone they know, a teammate who they can relate to, they’re going to remember it and think to themselves, ‘Could that be me?’

“Above all, athletes want to participate,” Edell continues. “The thought of having their season ended by something that’s preventable means more than any other warning or lecture they’ll get from me, their coaches, or anyone else.”

Athletes’ parents, too, should be part of the education process. The message is still very simple—parents should encourage their children to practice good hygiene, cover all wounds, and report any suspicious skin problem, no matter how minor, to a sports medicine professional. But keep in mind that MRSA is something many parents will be hearing about for the first time.

“We conduct a parents’ meeting at the beginning of our sports seasons, where we explain what MRSA is and talk about how they can help their children protect themselves,” says Tanya Dargusch, ATR, ATC, Head Athletic

Trainer at Washington Township (N.J.) High School, where two football players were infected with MRSA last fall.

“It’s mostly simple things like making sure uniforms get washed, or that kids wear their wrestling shoes only on the mats so they’re not bringing germs and bacteria from outside into the competition area. And we always open it up to questions so parents’ individual concerns can be addressed.”

As an extra benefit, an up-front discussion with parents about a serious subject like MRSA helps build trust, opens lines of communication, and bolsters your credibility as a health care professional. “Parents always tell us how much they appreciate being educated and say they’re glad we are so proactive about their children’s safety,” says Dargusch. “And if they have any concerns during the season, they know they can always come to us.”

HANDLING AN OUTBREAK Even with the best education and prevention programs in place, your athletic department can still get hit with MRSA. If it strikes, there are some

concrete steps athletic trainers can take to minimize the impact and manage the risk.

First, it’s important to tap into outside resources as soon as possible.

When Stanford’s outbreak began last fall, the athletic department called on team physicians and infectious disease specialists from the Stanford Hospital & Clinics to take the lead in developing a plan of action.

“The hospital immediately helped us decide what to do,” says Miller. “Any wound that was even remotely suspicious was cultured and tested, and anyone who came up positive had their wounds treated and received antibiotics that would kill the staph bacteria.”

The next step was decolonizing the infected players to prevent them from re-infecting themselves or others during and after treatment. “We had those players shower using Hibiclenz soap, which specifically targets MRSA and other bacteria on the skin,” Miller explains. “And to decolonize their nasal passages, we gave them Bactroban ointment to coat the inside of their nostrils with.”

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SPECIAL FOCUS: PREVENTING MRSA As a further precaution, the MRSApositive athletes showered away from the rest of the team in a private bathroom, and their uniforms and other laundry were washed separately. According to the CDC’s Hageman, normal washing with hot water and detergent will usually kill any bacteria found on clothing, but with an outbreak already under way, Stanford’s athletic department left nothing to chance.

Another step was eliminating potential MRSA transmission sites, and that meant getting rid of the cloth couches in the locker rooms. “We had no reason to believe the couches were the culprit, but we decided to be safe and replace them with vinyl ones that could be cleaned more easily,” says Miller. “We were just trying to isolate and eliminate anything that could possibly be contributing to the spread of bacteria.”

At Washington Township High, as soon as the first case was confirmed, Dargusch worked with the school’s custodians to find a cleaning product that would be effective in combating MRSA. “We went through the entire school with it, focusing on any area

that athletes regularly come into contact with—door handles, lockers, locks, equipment in the weightroom. We were very thorough,” she says. “Our custodial staff also cleaned and disinfected all the football helmets, shoulder pads, and anything else the athletes used.”

Similar steps were taken at Stafford High when MRSA struck there last fall.

“Before our maintenance staff cleaned the entire locker room, we told the football team, ‘Empty out your lockers—everything goes home, and you can’t bring it back unless it’s clean,’” says Edell.

“Our maintenance director used a cleaning agent that kills microbials, and we went through all the lockers and pads.”

Edell also communicated a lot with athletes’ parents. “One thing that worries me is that not all physicians follow the recommended guidelines for dealing with suspected MRSA cases, so I tell parents exactly what to request when they take their child to the doctor,” he says. “If I think the wound needs to be cultured to perform a type and cross for sensitivity to microbials, which is what Texas Children’s Hospital recommends for any suspicious wound, that’s what

I’ll tell the parents. If they call me back and say, ‘They stuck a Q-tip in it and sent it off to the lab,’ I know we’re on the same page.”

In the broadest sense, when responding to any MRSA outbreak, “better safe than sorry” is the best approach.

“Whenever I send a kid to the doctor, I tell the parents, ‘I hope I’m not wasting your time, but on the other hand, I hope I am wasting your time, because it’s great when I find out I was wrong and it’s not MRSA,’” Edell adds. “One thing I’ve learned from dealing with these cases is that it’s always better to know for sure.”

IN THE LOOP A final piece of advice for keeping one step ahead of MRSA is to stay plugged in to all the resources around you. From maintaining open lines of communication with colleagues in your conference to developing a working relationship with your county health department, there are many ways to be sure you’re in the loop.

“I talk quite often with the emergency room at our local hospital, just to

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SPECIAL FOCUS: PREVENTING MRSA hear what kinds of things they’ve got coming through the door,” says Goforth. “With something like MRSA, it can be a community problem before it’s an athletic department problem, so the hospital is a great source of information. Anytime something comes across their desk, they pick up the phone and call me, and vice-versa. If I hear about something from a colleague or read it in an athletic training publication, I’ll automatically pick up the phone and ask what they know about it. When you’ve built those relationships, you’re much less likely to be caught by surprise.”

At Stanford, Miller’s advice for not being caught by surprise is even simpler.

“You should never assume that it can’t happen to your program,” he warns.

“It’s easy to say, ‘We’ve been careful, it will hit someone else.’ But the truth is, you could always be next.” ■

A version of this article is also appearing in Athletic Management, a sister publication to Training & Conditioning.

RESOURCES www.cdc.gov/mrsa The Centers for Disease Control and Prevention offers extensive Web resources for learning about MRSA, including advice for preventing and controlling outbreaks, information for people who have been diagnosed, and downloadable educational posters. www.nata.org Enter “MRSA infections” into the search window for a link to an official statement on MRSA released by the National Athletic Trainers’ Association in March 2005. It contains recommendations for preventing and managing MRSA outbreaks in an athletic setting. www.ncaa.org/health-safety Click on “Injury Prevention,” then click on “Skin Infection Prevention” for information from the NCAA on MRSA. This includes the association’s own sports medicine guidelines, articles on MRSA in athletic settings, and downloadable educational materials such as posters and slide presentations. www.mrsaresources.com This privately maintained Web site contains multiple pages of MRSA information and a section with links to a variety of MRSA resources on the Internet. www.epa.gov/oppad001/list_g_mrsa_vre.pdf The Environmental Protection Agency has released this list of antimicrobial products that are effective against MRSA bacteria.

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Warning Signs: How to spot the warning signs of MRSA Hand Hygiene: Proper techniques for washing away MRSA Keeping Facilities Safe: Suggestions about MRSA and athletic facilities Equipment Management: Why equipment storage is critical On the Sidelines: Important gametime procedures for ATCs Wound Care: How to treat and cover wounds Tips for Parents: A special poster to educate parents In the Locker Room: Tips for athletes in the locker room Athletic Training Room Procedures: A poster for athletic training rooms

You can also download any of these posters for FREE or you can receive all nine 12” x 18” color posters for $30 per set.

To order, visit: www.Training-Conditioning.com

www.Training-Conditioning.com

Special Focus:

Preventing MRSA

Warning Signs It’s fairly common for athletes to have pimples, cuts, and abrasions on their skin. So how do you know when it might be MRSA and should be referred to a doctor or hospital for a more complete evaluation?

Here are some warning signs to look for and ask about when deciding whether a wound requires medical intervention: ●

Longer than normal healing time

●

Any increase in size

●

Unexplained or unusual pain or sensitivity

●

The presence of pus or a pustule

●

Induration (hardness)

●

The sensation of heat

●

Abnormal swelling or redness

●

Red streaks around the lesion

●

Abnormal coloration

Sponsored by:

To download as a printable poster visit: www.Training-Conditioning.com

Circle No. 126

Special Focus:

Preventing MRSA

Hand Hygiene Every athletic trainer knows the importance of hand cleanliness when treating athletes. However, studies of health care professionals in many different settings have found that proper hand washing procedures are not always followed, and the result may be an increased risk for transmitting infections such as MRSA.

Here are some helpful reminders on proper techniques for hand hygiene: • When using an alcohol-based hand rub, apply the product to the palm of one hand and then rub both hands together, covering all surfaces of the hands and fingers, until hands are dry.

• When washing hands with soap and water, wet both hands first, apply soap, then rub hands together vigorously for at least 15 seconds, covering all surfaces of the hands and fingers. Rinse hands with water.

• Thoroughly dry hands with a disposable towel or one treated with an antimicrobial solution. Use the disposable or treated towel to turn off the faucet.

• Avoid using very hot water, since repeated exposure to it may increase the risk of dermatitis.

• If your sink is equipped with bar soap, only use small bars and make sure your soap rack allows for drainage.

• In between washings, use antimicrobial solutions and products that inhibit the growth of bacteria.

Sponsored by:

To download as a printable poster visit: www.Training-Conditioning.com

Circle No. 127

Special Focus:

Preventing MRSA

Keeping Facilities Safe Everyone wants their athletic facilities to be safe environments. That’s why you make sure gym walls are padded, fields are maintained, and a spotter is always on hand in the weightroom. But some potential hazards are harder to see: At the microscopic level, MRSA and other types of bacteria could put your athletes at risk for infection.

Here are some tips about MRSA and athletic facilities: • Frequently touched surfaces should be cleaned and

disinfected on a regular basis. This includes weightroom equipment, athletic training tables, lockers, benches, and mats.

• Implement a no-sharing rule. Athletes should not

share towels, toiletries, clothing, or athletic equipment.

• Encourage frequent hand washing among all athletes

and staff.

• Pay attention to the storage of athletic equipment. A

dark, moist, warm environment is perfect for bacteria growth, so storage areas for padding and other equipment must be open and well-ventilated.

• Products that prevent MRSA can be applied to many

surfaces, equipment, towels, and athletic apparel.

• The research is inconclusive on whether athletic

fields can harbor MRSA bacteria. Since some studies have shown that the possibility exists, there are companies that offer antimicrobial treatments for athletic fields and other surfaces and substrates.

Sponsored by:

To download as a printable poster visit: www.Training-Conditioning.com

Introducing the

Advanced Antimicrobial Protection of the SportsAide™ System.

Your members may not be the only ones using your health club! On a microscopic level, bacteria, mold, fungi and algae are taking up residence on your equipment, towels or sharing the locker room facilities – potentially threatening your customers and your business.

Find peace of mind from microbial contamination with the 24/7 protection of the SportsAide™ system. Registered with the EPA, the ÆGIS Microbe Shield® technology powering the SportsAide™ system has over 30 years of proven, safe use in medical, athletic and consumer applications. With just one treatment, this powerful and unique antimicrobial system effectively controls the growth of a wide array of bacteria, mold, fungi, algae and yeast; without leaching heavy metals or chemicals onto users, into the water or the environment.

Be the rst to offer your members a Worry Free Workout… with the safe, reliable and consistent performance of the antimicrobial protection in the SportsAide™ system by SportCoatings™. www.csgspor t.com

I

888.510.2847

Circle No. 128

Special Focus:

Preventing MRSA

Equipment Management Athletic equipment is supposed to keep the wearer safe, but if it’s not properly taken care of, it can create a serious health hazard. When sweaty pads and uniforms are thrown into a bag or locker, the result is a warm, dark, moist environment that’s perfect for MRSA bacteria to grow.

The problem can be exacerbated on equipment with large surface areas that are difficult to dry out, such as shoulder pads and gloves.

Take these precautions to help prevent equipment from harboring MRSA bacteria:

Make sure padding and other equipment is stored someplace where it can dry out after each use.

•

• Clean

athletes’ equipment regularly with a product that will kill MRSA and other types of bacteria.

• Don’t

allow athletes to share equipment at practice or during games.

• Whether

your athletic department launders athletes’ uniforms or athletes do it themselves, make sure uniforms get washed after each use.

If one or more athletes in your program are infected with MRSA, launder their uniforms and other washables separately from the rest of the team’s.

•

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Circle No. 129

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Circle No. 130

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Special Focus:

Preventing MRSA

On the Sidelines If you’re an athletic trainer working the sidelines during a contest, you’ve got a lot to think about—treating injuries, massaging out muscle cramps, and making return-to-play decisions. But one thing should always be a priority: limiting athletes’ risk of contracting an infection such as MRSA.

Here are some tips for preventing the spread of infection during athletic events: • Carry a bottle of an alcohol-based hand

sanitizer and perform a waterless hand washing between athlete treatments.

• If possible, use disposable towels. If your

program only has ordinary towels, never use the same one on multiple athletes.

• Follow the same sanitary practices with your

sideline treatment table as you do with your athletic training room tables. Antibacterial wipes can be a convenient, effective cleaning aid.

• Watch for skin wounds that occur during the

game. As soon as the wounded athlete is off the field or court, clean and disinfect the wound site and apply secure bandages.

• Talk to athletes and coaches about these proce-

dures before the season, and make sure everyone on your sideline knows the importance of proactive wound care.

Sponsored by:

ICC Towel™ To download as a printable poster visit: www.Training-Conditioning.com

If MRSA outbreaks are a concern for your team, then

The Infection Control Towel™ created and distributed by SportPharm,™ is designed to help combat MRSA skin infection outbreaks that are common among professional and collegiate sports teams.

Soft, custom inter-woven, cotton-like texture Ultra-absorbing qualities that wipe away sweat that may contain bacteria Disposable and intended for individual usage Easily and quickly discarded Helps reduce the risk of MRSA skin infection outbreaks

Hand Rub™ distributed by SportPharm,™ is formulated with aloe vera and a recognized antimicrobial to provide instant sanitization of hands without the use of soap and water. Helps comply with current OSHA and CDC recommendations.

Kills 99.9% of germs in 15 seconds Evaporates completely; no rinsing required Reduces risk of infection Helps prevent cross contamination Adds moisture to hands with aloe vera Meets OSHA or APIC standards

For more information on the ICC Towel™ and Hand Rub™ Sanitizer, please contact us by e-mail at: orders@sportpharm.com or by phone at 800-272-4767.

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Prescription Management Software | Infection Control Concepts | OTC Unit Dose Medications | Transdermal Compounds Circle No. 131

Special Focus:

Preventing MRSA

Wound Care Staph infections such as MRSA can proliferate in athletic settings. Skinto-skin contact, moist environments, and the potential for scrapes and abrasions make athletes a prime target for infection. A big part of keeping athletes safe is proactive treatment for all skin wounds.

Follow these wound care rules to help protect your athletes: • Make sure athletes know to report all injuries

and open wounds, no matter how minor, to the athletic training staff, the team physician, or a school nurse for treatment.

• Thoroughly clean wounds by washing away

debris and exudate without traumatizing fragile tissue.

• Cover all wounds, even very small ones, during

and after activity and tell athletes to keep them covered at all times. Covered wounds heal faster.

• Use antimicrobial wound dressings to inhibit

the growth and spread of bacteria plus reduce the potential for infection.

• If a wound looks suspicious or isn’t healing

normally, send the athlete to a doctor or to the hospital to have it cultured and tested for MRSA. • Educate athletes and coaches about first aid

for wounds and teach them how to recognize wounds that may be infected. Follow all other MRSA prevention guidelines and recommendations issued by the NATA and the CDC. Sponsored by:

To download as a printable poster visit: www.Training-Conditioning.com

This hurts.

This kills.

Because the playing field is also a battlefield, protect your team from infections like MRSA with TELFA™ AMD dressings.

Infection control your team can’t live without.

For a free 24”x36” training room poster on MRSA Prevention, please call 800-346-7197, x8058

Circle No. 132

15 Hampshire Street Mansfield, MA 02048 1-800-962-9888 508-261-8000 www.kendallhq.com For International locations please see www.tycohealthcare.com 02/07

Special Focus:

Preventing MRSA

Tips for Parents As the parent of a student-athlete, you’d do anything to keep your child safe. When it comes to preventing MRSA, a potentially serious bacterial infection, a few common-sense preventative measures can make a big difference.

Here are some ways to help your child avoid the risks of MRSA: • Launder workout clothing and uniforms after

each use, using hot water and detergent.

• If your child brings his or her equipment home,

designate a place where it can thoroughly dry out after each use. Wet padding and other equipment left in a gym bag creates an ideal environment for MRSA bacteria to grow.

• Encourage frequent hand washing with antibac-

terial soap. Clean hands are a key defense against the spread of infection.

• Tell your child to shower immediately after

practice or competition, especially if he or she participates in a contact sport.

• Any time your child has a skin wound, make

sure it remains covered until it is fully healed.

MRSA usually enters the body through an unprotected break in the skin.

• Make sure your child reports all skin wounds,

no matter how minor, to a coach, athletic trainer, school nurse, or someone else who can decide whether medical attention is warranted. If it’s infected with MRSA, early detection is critical.

Sponsored by:

To download as a printable poster visit: www.Training-Conditioning.com

E•Lete

™

THE #1 DEFENSE AGAINST STAPH/MRSA

For player protection The single source TOTAL SOLUTION family of E•Lete™ disinfecting and deodorizing products specifically formulated to meet all sports hygiene needs.

Sports Turf Disinfectant • Personal Gear Instant Deodorizer Surface and Equipment Disinfectants • Laundry Rinse Disinfectant Environmental Air Fresheners • Hand Protection and Care

Call Toll Free: 800-605-9538 Visit our website at: www.sportshygienics.com Email us at: info@sportshygienics.com CONTACT US FOR A DEALER NEAR YOU Circle No. 133

Special Focus:

Preventing MRSA

In the Locker Room If you’re like most athletes, you enjoy the camaraderie in your team’s locker room. It’s a place to relax, feel safe, and bond with teammates.

But a locker room can also be a harbor for MRSA, a type of staph infection that can be deadly if left untreated.

Here are some precautions for preventing the spread of MRSA in the locker room: • Shower

immediately after practices and competitions. If MRSA bacteria are present on your skin, you can wash them away before they have a chance to cause infection.

• Don’t

share towels, razors, soap, and other personal items and toiletries.

• Get

every skin wound, no matter how minor, checked out by your coach, athletic trainer, or team physician.

• Cover

all wounds to help prevent infection, especially during practice and competition. If a bandage or wrapping falls off, have it replaced immediately.

• Dry

out your equipment and padding after each use. Do not store in a dark, moist, warm environment.

• Wash

your hands often. Frequent hand washing with antibacterial soap is one of the best ways to prevent MRSA. Sponsored by:

To download as a printable poster visit: www.Training-Conditioning.com

Special Focus:

Preventing MRSA

Athletic Training Room Procedures In the athletic training room, preventing the spread of MRSA and other types of infection should always be a top priority. It’s a place athletes pass through frequently, and a few simple precautions can play a big part in keeping them safe.

Implement these rules in your athletic training room: • Make frequent hand washing a standard

practice for everyone who spends time in the room.

• Clean and disinfect treatment tables and other

athletic training room apparatus frequently. Antibacterial wipes are a great choice because they’re convenient for day-to-day use.

• If your room has a waiting area, make it a clean

environment. Any chairs or couches in the waiting area must be easy to clean.

• When an athlete visits the athletic training

room with a skin wound, make sure it gets treated and covered immediately.

• If an athlete has a wound that looks infected,

immediately refer him or her to a team physician, other doctor, or emergency room to have the wound tested.

Sponsored by:

To download as a printable poster visit: www.Training-Conditioning.com

STRAIGHT TALK

Antimicrobial Products Many of the companies that advertise in Training & Conditioning have products which can help prevent MRSA and other microbial diseases. Below is information from several of these companies on a few of their antimicrobial products.

Bac-Shield™, from Adams USA, is a bacteria inhibitor that disrupts the growth of odor-causing bacteria and fungi.

Athletic facilities, equipment, apparel, towels, and playing surfaces can be excellent host environments for odor-causing bacteria, fungi, mold, and mildew. Bac-Shield “fills the gap” and makes your hygiene program more effective by inhibiting the reproduction of harmful microbes between cleanings and disinfections. The active ingredient in Bac-Shield, chitosan, has a long history of safe and effective applications. Use Bac-Shield for laundry, locker rooms, athletic surfaces, mats, and practically any place bacteria can be present. It is available in pint, gallon, and five-gallon sizes.

For more information on Bac-Shield, contact Adams USA at 800-251-6857 or visit them online at www.adamsusa.com.

Circle No. 500 The Sports Antimicrobial System (SAS) from SportCoatings offers antimicrobial protection for synthetic turf, athletic facilities, equipment, and towels. Get antimicrobial protection 24/7 throughout your athletic facilities—from training equipment to the locker room and towels—with the advanced SportsAide™ and SportsAide Fabric Conditioner.

SportsAide combats microbial contamination and odor using the unique AEGIS Microbe Shield®, which creates a colorless, odorless layer of active antimicrobial protection that’s effective against a very broad spectrum of all known bacteria, mold, fungi, and algae. One treatment lasts for years.

To learn more, contact SportCoatings by calling 888-5102847 or by visiting www.csgsport.com.

Circle No. 501 Gear 2000/Z-Cool offers Z-Cool Shoulder Pads with antibacterial foam padding. These patented air- and moisture-transferring shoulder pads feature antibacterial foam padding that 66

T&C MARCH 2007

will not absorb moisture from perspiration. As a result, odor build-up is eliminated and the shoulder pads are 35 percent lighter and cooler for the wearer, which can contribute to enhanced performance on the field.

To find out more, call Gear 2000/Z-Cool at 785-625-6060, or visit their Web site: www.gear2000.com.

Circle No. 502 Kill the Hibigeebies with Hibiclens®. Hibiclens is an antimicrobial, antiseptic skin cleanser that can be an effective defense against the spread of MRSA and other staph infections. Its active ingredient, Chlorhexidine Gluconate (four percent), works in a unique way. It kills germs on contact and bonds with the skin to keep killing microorganisms even after washing. It’s ideal for cleaning skin wounds, general skin cleansing, and personal hand washing. Hibiclens is a product of Molnlycke Health Care.

For more information on Hibiclens® call 800-843-8497 or go to www.hibigeebies.com.

Circle No. 503 Flex Pad™ from Stromgren Supports is a line of antimicrobial, moisture-wicking protective compression garments. The antimicrobial treatment found in Flex Pad provides a “zone of inhibition.” This zone is the area around the treated fabric, where the antimicrobial chemistry kills or inhibits microorganisms. The process attacks bacteria, fungi, mold, mildew, and algae that may cause health problems such as staph infections, and also controls the odor that may result when various microorganisms are present in fabric.

Call Stromgren Supports at 800-527-1988, or visit them on the Web at www.stromgren.com.

Circle No. 504

TR AINING-CONDITIONING.COM

STRAIGHT TALK Tec Laboratories, Inc. has created StaphAseptic First-Aid Antiseptic/Pain Relieving Gel, an antibiotic-free wound care treatment that helps prevent MRSA infections. Some strains of staph, known as MRSA, have become resistant to commonly used antibiotics. MRSA can spread easily from person to person and can enter the body through cuts, scrapes, and abrasions.

To help prevent skin infections caused

by MRSA and other germs, it’s essential to treat cuts and scrapes with StaphAseptic. In-vitro studies show that StaphAseptic kills over 99.9 percent of MRSA bacteria.

For more information, call Tec Laboratories, Inc. at 800-4824464, or visit www.teclabsinc.com.

Circle No. 505 The Infection Control Towel™, created and distributed by SportPharm™, is a disposable towel designed to help fight the battle against MRSA. The Infection Control Towel™ helps to combat MRSA skin infection outbreaks, which pose a threat to professional, college, and high school sports teams. Unlike cotton towels, which can easily spread infection if they are shared or improperly laundered, The Infection Control Towel™ is disposable and intended for individual use only. It’s soft, custom-interwoven, and has a cotton-like texture with ultra-absorbent qualities to wipe away sweat that may contain bacteria. The towels can be discarded quickly and easily, thus helping to decrease the risk of MRSA outbreaks among sports teams and their facilities.

For more information on The Infection Control Towel™ contact SportPharm at orders@sportpharm.com or by phone at 800-272-4767.

Circle No. 506 E-Lete™ Disinfecting and Deodorizing Products from Sports Hygienics are specifically formulated to meet all your sports hygiene needs. The E-Lete family of products offers a comprehensive solution for sports hygiene in your athletic department. For cleaning athletic equipment, weightroom machines, benches, floors, and other surfaces, E-Lete OneStep Concentrate is an EPA-registered disinfectant that kills staph/ MRSA, fungus, and many other pathogens.

For fabrics and padding, E-Lete Scentinel+™ is an instant deodorizer that’s tough on odor but safe for skin and fabric. For waterless hand washing, E-Lete Athletic Hand Sanitizer kills more than 99.9 percent of harmful germs and contains moisturizers and vitamin E. To learn more about these products and the rest of the E-Lete line (including artificial turf disinfectants and laundry sanitizers), call 800-605-9538 or visit www.sportshygienics.com.

Circle No. 507 TR AINING-CONDITIONING.COM

CleenFreek® SportsHygiene® manufactures patented antimicrobial performance products and solutions. CleenFreek SportsHygiene addresses the needs of athletic directors, coaches, athletic trainers, and athletes at all levels by providing protection and prevention against MRSA, staph infections, athlete’s foot, and other infectious diseases. The company’s products and solutions feature patented built-in antimicrobial technology that addresses cross-contamination of germs and offers protection for locker rooms, athletic training rooms, workout rooms, fields, courts, ice surfaces, and mats. CleenFreek SportsHygiene keeps athletes protected and in the game.

To learn more about CleenFreek SportsHygiene, call 800-5913585 or visit www.cleenfreek.com or www.sportshygiene.com.

Circle No. 508 TELFA™ AMD™ antimicrobial wound dressings from Tyco Healthcare/Kendall are effective against MRSA and Staphylococcus aureus. AMD™ dressings contain PHMB (polyhexamethylene biguanide), an antimicrobial component proven to resist bacterial colonization within the dressing and also resist bacterial penetration through the dressing. At just pennies per day, this product offers inexpensive infection control. It is compliant with existing protocols, and clinically proven to kill bacteria, prevent bacteria proliferation, and limit cross-contamination.

Studies have demonstrated AMD’s effectiveness against a host of bacteria, including Staphylococcus aureus and MRSA. For more information, call Tyco Healthcare/Kendall at 800962-9888 or visit www.kendallamd.com Circle No. 509 You know about Staph. But, did you know the percentage of Staph infections caused

by MRSA has almost tripled, from 1995 to 63% in 2004 (CDC)? Today we face the Panton-Valentine Leukocidin from community-acquired S. aureus, Methicillin-resistant and susceptible. What happens tomorrow? An immediate zero-tolerance action plan for combating Staph through sanitation and prevention is no longer an option. See the carefully-chosen products that Silver Leaf Solutions, Inc. offers at www.silverleafsanitation.com or call 800-292-3653 for advice.

Circle No. 510

T&C MARCH 2007

67

ANTIMICROBIAL PRODUCTS

Shopping for Antimicrobial Products?

Training & Conditioning recently sent out an e-mail inquiry to companies in the athletics industry, asking if they offered any products or services related to antimicrobial protection. Each of the companies below either responded to the inquiry, or they prominently feature antimicrobial products on their Web site. This is not a comprehensive list, but it may be a helpful starting point for athletic departments in the market for antimicrobial products or services.

68

Adams USA

www.adamsusa.com

Exclusive distributor of Bac-Shield™ antimicrobial product for textiles and surfaces

American Dryer Corp.

www.amdry.com

AD 50 dryer with drying drawer for helmets and other equipment

Astroturf

www.astroturfusa.com

Synthetic turf with antimicrobial treatment

Clean Gear USA

www.cleangearusa.com

Athletic equipment sanitizing and reconditioning

CleenFreek® SportsHygiene®

www.sportshygiene.com

Antimicrobial towels, hand sanitizers, surface wipes, and equipment

Coatings Specialists Group

www.csgsport.com

Antimicrobial treatments for many applications, including surfaces, equipment, and facilities

Coretection Products Ltd.

www.coretection.com

Antimicrobial and antibacterial compression garments

Cramer Products

www.cramersportsmed.com

A wide selection of antiseptic ointments, antibiotic creams, and wound care products

Esporta Wash Systems, Inc.

www.esporta.ca

Cleaning, sanitizing, and reconditioning services for athletic equipment

Gear 2000

www.gear2000.com

Z-Cool shoulder pads with 3-D Air Flow foam and antibacterial agents

Henry Schein, Inc.

www.henryschein.com

Antimicrobial cleaning products and sanitizers

Impact Protective Equipment

www.impactpads.com

Fully machine-washable athletic pads

Kendall Products

www.dri-dek.com

Self-draining interlocking floor tiles with antimicrobial properties

Kennedy Industries

www.kennedyindustries.com

Kenclean Plus athletic surface disinfectant and cleaner: kills MRSA and many other pathogens

Lonseal

www.lonseal.com

Synthetic flooring products treated with antimicrobial agents

Lyon Workspace Products

www.lyonworkspace.com

Lockers with an antimicrobial finish

Medco Supply Co., Inc.

www.medcosupply.com

Antimicrobial cleaning products and hand sanitizers

Molnlycke Healthcare

www.hibigeebies.com/sports

Hibiclens® antiseptic and antimicrobial skin cleanser

Mondo

www.mondousa.com

Synthetic sports flooring with antimicrobial properties

Mueller Sports Medicine

www.muellersportsmed.com

Whizzer® cleaner and disinfectant: kills MRSA, fungus, viruses, and many other pathogens

Preventec International, LLC

www.germstopper.net

A comprehensive approach to infection control and prevention

Reebok

www.reebok.com

Swimwear featuring an antimicrobial lining

Resilite

www.resilite.com

Mats with built-in antimicrobial technology

RG Medical Diagnostics

www.rgmd.com

Guardian Plus antibacterial hand sanitizer that won’t dry the user’s skin

Safe4Hours

www.safe4hours.com

Safe4Hours sanitizing skin lotion

School Health Corp.

www.schoolhealth.com

CleenFreek® antimicrobial cleaning product: kills MRSA, fungi, mold, and mildew

Shock Doctor

www.shockdoctor.com

Athletic equipment with SmartSilver™ antimicrobial and anti-odor technology

Silver Leaf Solutions

www.silverleafsolutions.com

Antimicrobial cleaning products

Speed Queen

www.speedqueen.com/athletics

Industrial washer and dryer systems

Spike Nashbar

www.spikenashbar.com

Liquid and powder cleansers for mats and other athletic surfaces

Sport Systems Canada

www.sportsystemscanada.com

Mats and wall padding treated with antimicrobial agents

SportPharm Enterprises

www.sportpharm.com

ICC Towel™ and Hand Rub™ antimicrobial products

Sports Hygienics, Inc.

www.sportshygienics.com

Antimicrobial treatment for equipment, facilities, laundry, and skin

Sports-O-Zone

www.sportsozone.com

Treatment for athletic equipment to kill MRSA and other bacteria, viruses, and mold

Stromgren

www.stromgren.com

FlexPad™ football compression girdle made with antimicrobial fabric

Taraflex® Sports Flooring

www.gerflortaraflex.com

Synthetic sports flooring with antimicrobial properties

Tec Laboratories, Inc.

www.staphaseptic.com

StaphAseptic pain relieving antiseptic gel

Tyco Healthcare/Kendall

www.kendallamd.com

Wound care products

UNX, Inc.

www.unxinc.com

Vanguard laundry detergent and Ally athletic equipment wash

T&C MARCH 2007

TR AINING-CONDITIONING.COM

CASE STUDY

Blue Light and the Challenge of MRSA

By J. Stephen Guffey, PT, Ed.D., President of Physical Therapy Plus, Inc.

Dynatron® 405

Dynatronics 7030 Park Centre Drive Salt Lake City, UT 84121 800-874-6251 info@dynatron.com www.dynatronics.com TR AINING-CONDITIONING.COM

Methicillin-resistant strains of Staphylococcus aureus (MRSA) have become a serious clinical challenge.

These community-acquired pathogens are certainly capable of causing quite serious disease (Moellering, 2006). Between 40 and 50 percent of Staphylococcus aureus isolates are resistant to methicillin (Kasper et al., 2006). Athletic trainers, along with all members of the health care community, are experiencing the challenges posed

by MRSA. Like all health care professionals, athletic trainers are evaluating prevention and treatment options to most effectively care for those who make up their practice population.

The challenge is serious.

We have long known that light, and particularly the ultraviolet (UV) spectrum of light, is capable of clearing skin ulcerations of microbial infestations. The use of UV light, however, can be clinically difficult. Improper dosing can lead to ineffectiveness and/or harm to the patient. Realizing the potential value of UV, but fully aware of the clinical problems associated with it, Guffey and Wilborn (2006) examined the bactericidal effect of 405, 470, and 880nm light on Staphylococcus aureus and other organisms. In a lab setting, the 405nm light was found to yield a kill rate as high as 90 percent. Since 405nm light is within the visible spectrum (yet outside the UV spectrum), the clinical risks are minimized. This work strongly suggests that 405nm light has a powerful bactericidal impact for common skin microbes and therefore has significant clinical potential.

At least two studies are currently being undertaken to evaluate 405nm light in terms of its bactericidal effect

on MRSA specifically. This research is extremely important. Based on the Guffey and Wilborn (2006) results, there is reason to anticipate that light in the “blue” range will prove bactericidal against MRSA strains of Staphylococcus aureus. The instrumentation to easily administer this treatment option already exists in the commercial market. We must all carefully follow this research. Many who practice wound care have already begun to use light as a central part of their treatment protocols.

Therapeutic light is an emerging research area. We are beginning to match specific wavelengths of light to specific clinical applications.

Instruments that safely and easily administer specific wavelengths are becoming available. The bactericidal potential of blue light is but one of the clinical applications that may soon be common. The future is bright.

Moellering, RC (2006). The growing menace of community-acquired methicillin-resistant Staphylococcus aureus. Annals of Internal Medicine 144: 368-370.

Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL, Isselbacher KJ [eds.] (2005). Harrison’s Principles of Internal Medicine (16th edition), Chapter 120.

Guffey JS, Wilborn J (2006). Effects of combined 405nm and 880nm light on Staphylococcus aureus and Pseudomonas aeruginosa in vitro. Photomedicine and Laser Surgery 24: 680-683.

Guffey JS, Wilborn J (2006) In vitro bactericidal effects of 405nm and 470nm blue light. Photomedicine and Laser Surgery 24: 684-688.

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AQUATIC EXERCISE AquaJogger 800-922-9544 www.aquajogger.com AquaJogger® has introduced the newest addition to its line of high-quality buoyancy belts. The Shape Pro model was created with weight loss, athletic training, and injury rehabilitation in mind.

It offers immediate vertical posture and lower-back support, as well as greater distribution of buoyancy.

The Shape Pro is made of soft, durable, chlorine-resistant EVA foam. An adjustable 48-inch black elastic belt with a side-release buckle is included. Longer lengths are available upon request.

Circle No. 511 NZ Mfg., LLC 800-886-6621 www.nzmfg.com The StrechCordz line of swim training products was designed by a group of competitive swimmers to improve

stroke, endurance, and strength.

From in-water swimming tethers (the StrechCordz Drag Belt/ Tow Tether is shown), spa tethers, and grudge belts to dry-land resistance training products, these items will meet the needs of both novice and serious swimmers.

Circle No. 512 Power Systems 800-321-6975 www.power-systems.com Power Systems’ newest aquatic exercise equipment is made of non-abrasive closed-cell EVA foam and will not chip or absorb water. The Premium Water Dumbbells are triangular in shape to offer variable resistance, and have textured grips and removable end caps so they can be filled with water for added resistance.

The Premium Water Flotation Belt comfortably contours the body for long-lasting support, buoyan-

Functional Training Solutions • Power • Agility • Cardiovascular FitBALL® Medballs with Strap: • Adjustable Straps • Substitute for Kettlebell training • Made of rubber - will bounce

Conditioning • Proprioception

We’re More Than Just The #1 Exercise Ball!

FitBALL® Balance Trainer: • Holds shape for lunges • Inflatable and adjustable • Combines flat bottom and rounded top

FitBALL® SoftMeds: • Weighted balls with soft shell • Adjustable with needle pump • Easy to grip © 2007 Ball Dynamics International, LLC

Call For FREE Catalog • 800-752-2255 • www.fitball.com

cy, and resistance. The Premium Water Cuffs can be used on the ankles or wrists to add buoyancy—not bulk—to water exercises.

Circle No. 513 Clean up your pool area and protect your equipment investment with the Power Systems Aqua Rack. This threetiered rack can hold and transport most aquatic equipment by securely cradling the gear in mesh hammocks that allow for water run-off and ventilation. End posts can be used for hanging resistance tubing, swim bags, or towels. The Aqua Rack is constructed of sturdy two-inch PVC with swivel casters for smooth mobility.

It measures 57” W x 29” L x 40” H and can easily roll through most doorways.

Circle No. 514 SwimEx, Inc. 800-877-7946 www.swimex.com SwimEx has introduced a new motorized, integrated treadmill. When combined with the SwimEx wall of water, it creates one of the most challenging water conditioning workouts on the market today. Constructed of durable high-traction rubber with a non-corrosive frame, the treadmill is integrated into the SwimEx pool floor and features variable speeds of up to eight miles per hour, a speed indicator, and a removable hand rail for optional support. Athletes enjoy high-intensity aquatic exercise in a lowimpact environment.

Circle No. 515 SwimEx makes the only pool on the market today that combines a patented paddlewheel waterpropulsion system, molded fiberglass composite construction, multiple water depths, and built-in workstations to provide reliable performance and a superior functional aquatic therapy session.

Circle No. 516

Circle No. 134

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TR AINING-CONDITIONING.COM 2/19/07 3:17:45 PM

NEW Product Launch Swing Core Trainer Unique features: • Hollow ball with inserted handles reinforced with PVC • Available in five color-coded sizes Benefits for the user: • Ideal for gripping, throwing, or rotating • PVC inserts prevent the handles from flattening out during upper-body exercises • Ball sizes range from five pounds to 14 pounds with a nine-inch diameter

Perform Better 800-556-7464 www.performbetter.com Circle No. 517

Tred Sled Unique features: • Athlete drives non-motorized tread while braking system resists his movement • Transforms workouts into competition • Allows maximum power on every repetition Benefits for the user: • Players improve ability to recover quickly between plays • Technique becomes second nature • Players grow accustomed to applying large amounts of force in blocking/tackling positions

Rogers Athletic Co. 888-765-3248 www.rogersathletic.com Circle No. 518

Nautilus XPLOAD Racks and Platforms

Crab Sled Unique features: • Aerodynamic design • Aluminum construction • Exclusive lateral handlebar • Powder-coated finish • Five different harness attachments

Unique features: • Designed by athletic trainers, for athletic trainers • Swiveling spotter platforms and other features make this line unique • The first line of its kind from Nautilus

Benefits for the user: • Develops explosive power • Offers two methods of resistive training: Push and pull the sled

Benefits for the user: • Intelligent XPLOAD design allows you to focus effort in the right place—on the workout

Gilman Gear 800-243-0398 www.gilmangear.com

Nautilus 877-657-7762 www.nautilusXPLOAD.com

Circle No. 519

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Circle No. 520

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ADVERTISERS DIRECTORY CIRCLE COMPANY NO.

PAGE NO.

116 . . . Antibody (The BodyGuard) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

CIRCLE NO.

COMPANY

PAGE NO

104 . . . Perform Better . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7

114 . . . AquaJogger . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

135 . . . Perform Better (seminars) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79

126 . . . Bac-Shield (Adams USA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51

119 . . . Power Lift . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

106 . . . Biofreeze . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11

117 . . . Pro-Tec Athletics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

115 . . . California University of Pennsylvania. . . . . . . . . . . . . . . . . . . . . . . . . . . 28

111 . . . Prossage Heat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

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

120 . . . Samson Weight Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42

127 . . . CleenFreek SportsHygiene. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

125 . . . Silver Leaf Solutions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

112 . . . Creative Health Products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

128 . . . SportCoatings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

100 . . . CytoSport . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .IFC

131 . . . SportPharm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

136 . . . Dynatronics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IBC

123 . . . Sports Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .47

134 . . . FitBALL (Ball Dynamics) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70

133 . . . Sports Hygienics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63

102 . . . Gatorade . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3

124 . . . StaphAseptic (Tec Labs) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

129 . . . Gear 2000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

130 . . . Stromgren . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

122 . . . Hibiclens (Molnlycke Health Care). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45

109 . . . SwimEx . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

121 . . . Hibistat (Molnlycke Health Care) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

113 . . . TurfCordz/NZ Mfg. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

107 . . . NASM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12

132 . . . Tyco Healthcare/Kendall . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

103 . . . Nautilus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5

118 . . . WerkSan Sports USA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34

105 . . . NSCA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9

110 . . . Whitehall Manufacturing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

108 . . . OPTP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

137 . . . Wobenzym N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . BC

PRODUCTS DIRECTORY CIRCLE COMPANY NO.

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CIRCLE NO.

COMPANY

PAGE NO

521 . . . Antibody . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73

534 . . . Power Lift . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .74

522 . . . AquaJogger (catalog) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73

514 . . . Power Systems (Aqua Rack) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70

511 . . . AquaJogger (Shape Pro) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70

535 . . . Power Systems (catalog) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .74

500 . . . Bac-Shield (Adams USA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66

513 . . . Power Systems (Water Dumbbells) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70

523 . . . Ball Dynamics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73

536 . . . Pro-Tec Athletics (catalog) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .74

524 . . . Biofreeze/Performance Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73

542 . . . Pro-Tec (Ice-Up) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75

546 . . . California University of Pennsylvania. . . . . . . . . . . . . . . . . . . . . . . . . . . 80

518 . . . Rogers Athletic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71

525 . . . Cho-Pat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73

537 . . . Samson Weight Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .74

508 . . . CleenFreek SportsHygiene. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67

550 . . . Save-A-Tooth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80

526 . . . Creative Health Products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73

510 . . . Silver Leaf Solutions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67

527 . . . Dynatronics (catalog). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73

501 . . . SportCoatings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66

545 . . . Dynatronics (Solaris D709) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80

506 . . . SportPharm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67

539 . . . efi Sports Medicine/Total Gym . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75

538 . . . Sports Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .74

528 . . . Gear 2000 (catalog) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73

507 . . . Sports Hygienics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67

502 . . . Gear 2000 (Z-Cool Shoulder Pads) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66

505 . . . StaphAseptic (Tec Labs) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67

519 . . . Gilman Gear . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71

551 . . . Stromgren (Basketball Girdle) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80

503 . . . Hibiclens (Molnlycke Health Care). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66

504 . . . Stromgren (Flex Pad) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66

530 . . . NASM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .74

516 . . . SwimEx (pool) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70

531 . . . Nautilus (catalog) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .74

515 . . . SwimEx (treadmill) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70

520 . . . Nautilus (product launch) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71

532 . . . TurfCordz/NZ Mfg. (catalog) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .74

512 . . . NZ Mfg. (StrechCordz) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70

509 . . . Tyco Healthcare/Kendall . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67

533 . . . OPTP (catalog) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .74

540 . . . WerkSan Sports USA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75

548 . . . OPTP (Kinesio Tape) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80

541 . . . Whitehall Manufacturing (catalog) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75

549 . . . OPTP (White Foam Roller). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80

544 . . . Whitehall Manufacturing (moist heat) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75

529 . . . Perform Better (catalog) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73

543 . . . Whitehall Manufacturing (ThermaSplint) . . . . . . . . . . . . . . . . . . . . . . . . . . 75

547 . . . Perform Better (PB Disc Pillow) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80

552 . . . Wobenzym N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80

517 . . . Perform Better (product launch) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71

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CATALOG SHOWCASE Antibody, Inc. 401-581-0900 www.antibodywear.com The patented BodyGuard line of compression sportswear has revolutionized how muscle injuries are 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.

AquaJogger 800-922-9544 www.aquajogger.com AquaJogger offers a 12-page color catalog showcasing a full range of aquatic buoyancy belts, barbells, and aquatic footgear to meet all athletic training and rehabilitation needs. All products are shown complete with item numbers and descriptions to assist you in the proper selection of equipment to outfit your program. Call today for more information, or view the products online at the company’s Web site.

Ball Dynamics Int’l, LLC 800-752-2255 www.fitball.com Ball Dynamics’ catalog showcases its newly expanded FitBALL® product line. In addition to the FitBALL exercise ball—an industryleading burst-resistant fitness ball—new FitBALL professional-quality products are available in a full range of training categories, including balance, strength, resistance, massage, mats, education, and more. Call or visit Ball Dynamics’ Web site today to order your free Ball Dynamics catalog.

Circle No. 521 Biofreeze®/Performance Health 800-246-3733 www.biofreeze.com Applied generously, Biofreeze® pain relieving gel and rollon effectively relieves pain from sore muscles, muscle spasms, strains, sprains, tendonitis, backaches, and sore joints. Biofreeze will also help minimize next-day aches and pains, and aid in reducing swelling and inflammation.

Circle No. 522 Cho-Pat 800-221-1601 www.cho-pat.com Cho-Pat designs and manufactures specific, innovative preventive and painreducing sports/ medical devices for the arm, leg, and knee. Incorporating unique design characteristics, excellent craftsmanship, and quality materials, the company’s products are effective, dependable, durable, and highly recommended by medical professionals, physical therapists, athletic trainers, and athletes for their role in preventing or reducing pain and discomfort.

Circle No. 523 Creative Health Products, Inc. 800-742-4478 www.chponline.com Since 1976, Creative Health Products has been 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. Creative Health Products offers heart rate monitors; blood pressure testers; pulse oximeters; body fat calipers; scales; strength testers; flexibility testers; pedometers; exercise bikes; ergometers; fitness books and software; exercise bands; step benches; hand and finger exercisers; heating pads; and more.

Circle No. 526

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Circle No. 525

Dynatronics 800-874-6251 www.dynatronics.com Dynatronics manufactures, markets, and distributes advancedtechnology medical devices, supplies, treatment tables, and rehabilitation equipment. The Dynatronics catalog contains over 2,000 products offering unmatched technology and features at affordable prices. Spring 2007 marks the release of Dynatronics’ new product catalog. Look for new modular taping stations and innovative modalities that are essential for the rehab and athletic training markets.

Gear 2000, Ltd. 785-625-6060 www.gear2000.com Gear 2000 offers a 16page full-color catalog featuring the company’s lightweight Z-Cool line of shoulder pads with antibacterial foam systems. Also included in the catalog are ZCool football accessories, Z-Cool performance apparel, and chin straps. The complete Gear 2000 line of moisturemanagement and air-release shoulder pads is illustrated in the catalog.

Perform Better 800-556-7464 www.performbetter.com The new 2007 Rehabilitation Edition of the Perform Better catalog is a 40-page publication focusing on athletic training products that help speed recovery so that individuals can resume their normal activities. The catalog is neatly organized into 14 different categories, including Flexibility and Recovery, Balance and Stabilization, Strengthening, and Training Room Supplies. For your free copy, call today or visit Perform Better’s Web site.

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CATALOG SHOWCASE NASM 800-460-6276 www.nasm.org The online home of the National Academy of Sports Medicine (NASM) is newly redesigned and now includes an online storefront featuring more than 50 evidence-based educational health and fitness offerings.

Professionals and students can view video samples of the NASM’s advanced specializations, the Performance Enhancement Specialist (PES) and the Corrective Exercise Specialist (CES).

Because they are delivered entirely online, you can now try before you buy when you visit the NASM’s Web site.

Circle No. 530 OPTP 800-367-7393 www.optp.com/ad OPTP is an industry leader, providing quality fitness and rehabilitation products. For more than 30 years, the company has been building a worldwide reputation for offering excellent personal service, cutting-edge tools, and the resources that health and fitness professionals require. OPTP’s Volume 19 catalog features many new pages of Pilates products, foam rollers, and balance, core, and plyometric training tools and resources.

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Nautilus 877-657-7762 www.nautilusxpload.com Nautilus offers a complete line of professionalquality strength and cardio training equipment for high school and collegiate athletic programs.

The company has weight stack machines, plateloaded equipment, and a new line of racks and platforms. Nautilus also offers premium treadmills, bikes, elliptical trainers, the legendary StairMaster StepMill, Schwinn Fitness indoor cycle bikes, and the new Nautilus TreadClimber cardio machine, which provides the cardio benefits of running at a walking pace. For more information, call today or visit the company online.

Circle No. 531 Power Lift 800-872-1543 www.power-lift.com New Products 2007 is a brochure from Power Lift that includes the following new items: Uni/Bi-Lateral Leg Press, Full Body Squat, 4-Way Neck, Belt Squat, Uni-Lateral Bent Over Row, the Performance Training Station, and the new Selectorized line. Featured Selectorized pieces are the seated chest press, incline press, shoulder press, seated bicep, seated tricep, lat pulldown, lateral raise, leg extension, and leg curl. For more information on Power Lift equipment, call the company or visit its Web site.

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Pro-Tec Athletics 800-779-3372 www.injurybegone.com Pro-Tec Athletics is a leading sports medicine company specializing in orthopedic supports and cryotherapy. The company offers unique and effective braces and supports for ligament, tendon, and muscle injuries. Pro-Tec’s newest introduction to the cryotherapy market is the Ice-Up portable ice massager. Find out more at Pro-Tec’s Web site or by calling for a free brochure.

Samson Equipment, Inc. 800-472-6766 www.samsonequipment.com Since 1976, Samson Equipment has designed, manufactured, and sold heavy-duty industrialstrength weightlifting equipment to all five branches of the military, top high schools, colleges, and professional teams, health clubs, and recreational facilities all over North America, Europe, Asia, and the Caribbean. Samson’s equipment line includes a wide variety of freeweight racks and benches as well as selectorized machines and plate-loaded equipment.

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T&C MARCH 2007

TurfCordz by NZ Mfg., LLC 800-886-6621 www.nzmfg.com TurfCordz agility and strength training products allow athletes to perform highly effective resistance exercises.

Used by leading professional football, baseball, hockey, and basketball teams for explosive start drills, power-building footwork exercises, and simulated play action, TurfCordz products offer versatility and performance. Also available are the top-quality MediCordz rehabilitation products and StrechCordz swim training products.

Circle No. 532 Power Systems 800-321-6975 www.power-systems.com Power Systems is advancing physical performance with more catalog choices in 2007. This year, Power Systems introduces three new catalogs in addition to its Fitness Professionals and Sports Performance catalogs. The new 104-page comprehensive catalog combines the Fitness and Sports catalogs into one convenient resource book. For specialized training, Power Systems now offers a soccer catalog and a strength catalog. With more than 1,000 innovative products and programs, Power Systems provides the quality you expect.

Circle No. 535 Sports Health 866-323-5465 www.esportshealth.com Sports Health, a division of School Health Corp., is a leading distributor of medical supplies and equipment to athletic trainers, physical therapists, and other sports medicine professionals. The company offers one-stop shopping for over 8,000 products, including taping supplies, trainers’ kits, defibrillators, quality furniture, and training room supplies. Sports Health invites you to use its Web site to place your order online, access health information, and link to medical sites worldwide.

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CATALOG SHOWCASE efi Sports Medicine/Total Gym® 800-541-4900 www.totalgym.com efi Sports Medicine® is a leader in functional training equipment. Its products are preferred by athletes and athletic trainers who want to enhance power, strength, body composition, endurance, and range of motion. The company’s flagship product, Total Gym, uses body weight as resistance on a rolling incline glideboard and facilitates cable exercises in all planes of motion. With product attachments like the Closed Chain Platform, users can progress from unloaded rehab work to high-performance plyometric exercises.

Circle No. 539 WerkSan Sports USA 877-WerkSan www.werksanusa.com For safety and durability, count on WerkSan. WerkSan has a strong worldwide reputation for high-quality weightlifting equipment. The company’s engineers are devoted to producing safer, better-performing, longer-lasting equipment. WerkSan is the official barbell of USA Weightlifting and is certified by the IWF. The company stands behind its equipment: WerkSan bars are guaranteed for life and its bumper plates are guaranteed for two years from the date of purchase.

Circle No. 540 Whitehall Mfg., Inc. 800-782-7706 www.whitehallmfg.com Whitehall Mfg. provides the health care industry with products of unsurpassed quality, functionality, and durability. The company’s extensive experience in this industry provides great insight into the type of quality care necessary for patient rehabilitation. This experience is reflected in the way Whitehall designs, manufactures, and supplies its products.

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HOT & COLD THERAPY Pro-Tec Athletics 800-779-3372 www.injurybegone.com The Ice-Up portable ice massager by Pro-Tec Athletics stays frozen for up to 12 hours in a portable carrying cooler.

You can take it anywhere to experience the benefits of direct, active, immediate postactivity ice massage. The IceUp is leakproof and offers effective treatment in five to seven minutes, not 15 to 20 minutes like passive ice packs. Enjoy quick deep-tissue relief for ligament, tendon, and muscle injuries. Immediate ice massage increases treatment effectiveness and speeds recovery.

Circle No. 542 Whitehall Mfg., Inc. 800-782-7706 www.whitehallmfg.com The ThermaSplint™ from Whitehall Manufacturing features dual voltage, an illuminated on/off switch, and quick heat-up time.

The unit operates on a solarpowered digital thermometer that allows the temperature to be adjusted with digital readouts for different splinting thermoplastics. The ThermaSplint is constructed of heavy-gauge stainless steel.

Circle No. 543 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.

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COMPANY NEWS

CytoSport’s Nutritional Supplements Offer Time-Tested Quality

CytoSport was founded in 1998 and since that time has grown into a premier manufacturer of sports-oriented nutritional products that address the needs of athletes and active-lifestyle individuals at every level. With every product and every decision, quality, taste, and the athlete are at the forefront.

That’s why the Muscle Milk Collegiate line is rapidly becoming a key addition to many weightrooms across the country, because they work. Taste, quality, and efficacy… what more can you ask for?

The motto at CytoSport is “Driven by Science—Inspired by Performance.”

Thanks to athletes everywhere for the inspiration!

CytoSport, Inc. 4795 Industrial Way Benicia, CA 94510 888-298-6629 performance@cytosport.com www.cytosport.com T&C MARCH 2007

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CEU QUIZ

T&C March 2007 Volume XVII, 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 to MAG, Inc., 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 78) that represents the best answer for each of the questions below.

Complete the form at the bottom of page 78, include a $20 payment to MAG, Inc., and mail it by April 30, 2007 to the following address: MAG, Inc., ATTN: T&C 17.2 Quiz, 31 Dutch Mill 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, 2007.

Winning and Losing (pages 13-18) Objective: To understand how athletes can lose weight safely during their competitive season.

1. What are the guidelines for in-season weight-loss? a) Starting immediately with a goal of losing three pounds per week. b) Communicating often, starting immediately and keeping it gradual. c) Implementing a low-calorie diet and beginning as soon as possible. d) Waiting until the season is over.

2. What are the symptoms of excessive caloric restriction? a) Dry skin and brittle nails. b) Increased injury or illness, poor recovery, and decreased performance. c) Water retention and easy bruising. d) Sunken eyes and decreased blood pressure.

3. Amenorrhea leads to: a) Increased risk of low bone mineral density and increased fractures. b) Increased blood pressure and decreased RBC count. c) Loss of sleep and adequate REM. d) Poor protein absorption.

4. Reducing caloric intake by what percentage is recommended for an athlete trying to lose weight? a) 5-10. b) 10-20. c) 20-30. d) 35.

5. The following may slow metabolism and deplete energy levels: a) Low carbohydrate diets. b) Low fat diets. c) Bingeing. d) Skipping meals.

6. In a) b) c) d)

regard to in-season weight loss, sports drinks: Are the first item that should be eliminated from the diet.

Are high in sugar and considered “empty” calories.

Provide a small amount of energy and help delay fatigue.

Improve weight loss.

7. An a) b) c) d)

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athlete’s diet should: Increase carbohydrates throughout the season.

Encourage weight loss of 3-4 pounds per week.

Have carbohydrate intake match the training level.

Expect some fatigue and energy depletion.

T&C MARCH 2007

The Better to See (pages 24-29) Objective: Learn about the latest developments when it comes to athletes’ vision repair and enhancement.

8. Before Wavefront-guided software, a complication of Lasik surgery was: a) Blindness. b) Detached retina. c) Pain. d) Night vision problems.

9. Why is the hybrid lens beneficial? a) The cost is lower than other lenses. b) There is no diminished vision under the lights or at dusk. c) They may be worn for three weeks at a time. d) They are implanted and remain as long as necessary.

10. When are phalic intraocular lenses a good alternative? a) When Lasik or PRK has previously failed. b) When the patient wants to avoid all risks of surgery. c) When the patient’s corneas are too thin for Lasik surgery. d) When a stigmatism is present.

11. Lasik surgery may not be the best choice for those: a) Requiring highly accurate vision. b) Involved in daytime sports with glare from the sun. c) With risk of being hit in the eye. d) Involved in water sports.

12. How is PRK different from Lasik? a) PRK does not involve cutting a permanent flap in the cornea. b) The long-term results are different. c) There is less pain with PRK than with Lasik. d) Vision corrections are much better with PRK than Lasik.

13. Sports vision training enhances: a) What an athlete can see. b) How far an athlete can see. c) How an athlete sees. d) Visual acuity.

14. Sports vision training may include ocular flexibility, which is defined as the: a) The ability to move one’s eyes inward (convergence) or outward (divergence) when following a target. b) Process of information regarding the shape and direction of an object. c) Ability to judge the distance between themselves and the object. d) Ability to fixate their eyes properly on a target.

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15. Another component of sports vision training may include visual recognition, which is defined as: a) The ability of the eyes to process information regarding the shape and direction of an object and then make correct motor movements to adjust to it. b) Accurately and quickly moving the eyes forward and back in each direction. c) The ability to fixate the eyes properly on a target. d) The ability of the eyes to move properly when tracking objects.

Ready for Prime Time (pages 30-35) Objective: Learn how one baseball pitcher made it from the minors to the major leagues through a specialized rehab and training program.

16. The goal of the Corrective Exercise Training (CET) phase is to do what? a) Improve core stabilization. b) Inhibit overactive muscles that were causing movement compensations. c) Improve muscle firing recovery. d) Improve endurance.

A Strong Season (pages 37-42) Objective: See how the University of Wisconsinâ&#x20AC;&#x2122;s strength and conditioning coach for menâ&#x20AC;&#x2122;s basketball keeps the team in top shape through a season of scheduling hurdles.

17. The University of Wisconsin lifts weights approximately how many minutes per session during the second half of their season? a) 15-20. b) 20-29. c) 30. d) 50.

18. To remain as efficient as possible during the late season, the athletes: a) Lift one day per week. b) Use pairing exercises in which they alternate upper-body lifts with lower body lifts. c) Lift prior to practice. d) Only lift on Sundays and Wednesdays.

19. Which is an example of emphasizing sports specific and position specific activities? a) Post players that perform more overhead passes focusing on overhead throws using a medicine ball. b) Perimeter players dribbling a lot so they will perform resisted knee extensions. c) Lifts involving squatting positions to improve defensive stance. d) Increased repetitions and decreased speed during lateseason lifting.

Are You Protected? (pages 43-49) Objective: Get a comprehensive update on how MRSA is invading locker rooms across the country, and learn what you can do to prevent an outbreak at your school.

20. The key to controlling MRSA is: a) Using Amoxicillin or Penicillin as early intervention. b) Identifying MRSA as quickly as possible. c) Washing the skin thoroughly and on a daily basis. d) Performing cultures of cuts and scrapes one week after they occur.

21. MRSA infection typically begins as: a) An ingrown hair. b) A bug bite. c) A skin lesion containing a pustule. d) A swollen area.

22. The CDC estimates that what percentage of the U.S. population is colonized with staph? a) 10-15. b) 15-25. c) 25-30. d) 30-35.

23. What is one way athletes can minimize their exposure to MRSA? a) Washing regularly with antibacterial soap. b) Only showering once they get back to their dorm room after practice. c) Keeping their pads separated by placing them in lockers or gym bags. d) Washing all fruits and vegetables prior to eating them.

24. Stanford did the following to address the spread of germs and infection: a) Used an alcohol-based hand sanitizer on each athlete after practice before they were able to enter the locker room. b) Provided each athlete with a bar of soap. c) Provided each athlete with a towel. d) Used an antibacterial air spray.

25. When Stanford had a MRSA outbreak last fall, they decolonized the infected players by: a) Using Amoxicillin in high doses. b) Destroying all of their equipment and gear. c) Having those infected shower with Hibiclenz soap and use Bactroban ointment in their nasal passages. d) Having athletes stay home until the infection cleared.

Answer sheet is on page 78

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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 $20 payment to MAG, Inc., and mail it to the following address: MAG, Inc., ATTN: T&C 17.2 Quiz, 31 Dutch Mill Road, Ithaca, NY 14850, no later than April 30, 2007. 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, 2007.

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Last Name ____________________________________ First Name _______________________________ MI______ Title ______________________________________________________________________________________________ Mailing Address ____________________________________________________________________________________ City ________________________________________________ State _________ Zip Code _____________________ Daytime Telephone ( _________ ) ________________________________________ E-Mail Address ____________________________________________________________________________________ Payment Information

❏ $20 check or money order (U.S. Funds only) payable to: MAG, Inc. (please note “T&C 17.2 Quiz” on check) ❏ Visa

❏ Mastercard

❏ Discover

❏ American Express

Account Number _______________________________________________ Expiration Date ____________________ Name on Card _____________________________________ Signature ______________________________________

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T&C MARCH 2007

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ADDITIONAL EDUCATIONAL PROGRAMS

EARN BOC CEUs • Complete quizzes found in the NSCA’s Strength & Conditioning Journal • Complete online quizzes at www.nsca-cc.org Toll-free: 888-746-2378 I Online: www.nsca-cc.org E-mail: commission@nsca-cc.org

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ALL NEW TOPICS Save these dates for the

2007

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ONE DAY SEMINARS February 3, 2007 Los Angeles, CA February 24, 2007 Dallas, TX March 10, 2007 Cincinnati, OH

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TRAINING SUMMITS May 11 - 13, 2007 Chicago, IL June 1 - 3, 2007 Long Beach, CA

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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: performbetter.com Circle No. 135 1 TRUntitled-1 AINING-CONDITIONING.COM

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MORE PRODUCTS Dynatronics 800-874-6251 www.dynatronics.com

OPTP 800-367-7393 www.optp.com/ad

The Solaris D709 offers ultrasound, seven stim waveforms, four optional infrared light probes, and an unattended light pad, making it one of the most powerful and comprehensive devices in the industry. It features a battery-powered option for portability, and it is capable of providing TENS, MENS, NMS, highvoltage, interferential, direct current, biphasic, and Russian treatments. A timer is included, and the product is protected by a two-year warranty.

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Kinesio Tape is specifically designed to be worn for extended periods of time, and during strenuous exercise or hydrotherapy. The adhesive is heat-activated and will not leave residue when the tape is removed.

Kinesio Tape is latex-free and has an elasticity of 140 percent, matching the basic elasticity found in skin. As a result, it works comfortably and effectively with the athlete’s body. Get your free OPTP catalog by calling the company or visiting its Web site.

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California University of Pennsylvania 866-595-6348 www.cup.edu/go

For many years now, OPTP has been a leading supplier of quality foam rollers.

The newest addition to the company’s wide selection is the 18” x 6” Standard White Foam Roller. Made from the same material as other OPTP Standard White Foam Rollers, this new size makes it easier than ever to find the perfect roller for your needs, while still maintaining the same high quality you expect from OPTP foam rollers. Its size makes it ideal for self-massage, balance, and core stability exercises. Larger than the 12” x 6” roller and less cumbersome than the 36” x 6” roller, it is a favorite among runners and other athletes who perform IT band work. OPTP also carries foam roller exercise books, videos, DVDs, and more. Visit www.foam-roller.com to learn more.

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California University of Pennsylvania’s Global Online programs offer an exceptional 100-percent online learning experience with the convenience of an asynchronous format. Complete your coursework from anywhere, at any time that’s convenient for you—all you need is a computer and Internet access. For more information on Cal U’s Global Online programs, call or go online today.

Circle No. 546 Perform Better 800-556-7464 www.performbetter.com Using a PB Disc Pillow can strengthen the muscles that stabilize an athlete’s ankles, knees, core, and shoulders.

This product is a terrific aid for developing joint stabilization and balance. Use one disc for single-leg exercises and sit-ups, or multiple discs for double-leg exercises and push-ups. These soft, unstable discs are 14 inches in diameter and can be found in the 2007 Perform Better catalog. Get your free copy by calling the company or visiting its Web site.

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T&C MARCH 2007

Save-A-Tooth 888-788-6684 www.save-a-tooth.com Every year, 800,000 teeth are knocked out during sports activities, and only 10 percent of athletes consistently wear mouthguards.

Knocked-out teeth begin to die within 15 minutes.

SaveA-Tooth can preserve and nourish knocked-out teeth for up to 24 hours and give athletes a 91-percent chance

of saving their smiles. Save-A-Tooth was developed by a sports dentist and professor at a leading dental school.

Its scientifically proven six-component system includes a cell-preserving solution and a suspension-and-removal basket that protects and saves tooth root cells. Save-A-Tooth is found in every Olympic medical bag. Visit the company’s Web site to learn more about knocked-out teeth and how Save-A-Tooth can help.

Circle No. 550 Stromgren Supports 800-527-1988 www.stromgren.com Stromgren’s Basketball Girdle is a compression short with FlexPad™ protective pads for the hip, tailbone, and thigh areas. FlexPad protective pads are lightweight, closedcell, impact-absorbing EVA foam pads that are laundered into the fabric to provide a unique combination of protection and performance. Also known as the “Bangin’ Machine,” this girdle is designed to help reduce injuries from aggressive play by absorbing impact, while also providing maximum compression and moisture management.

As a new feature for 2007, it now features antimicrobial fabric.

Circle No. 551 Wobenzym 888-766-4406 www.wobenzym.com Let Wobenzym®N, the clinically validated enzyme formula for sports injuries, work for your patients and your reputation. Its proven bio-active enzymes get both elite athletes and weekend warriors back into action more quickly and safely than ordinary non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids.

During the recent world soccer championships in Germany, several teams used Wobenzym®N with their athletes, and it helped get the world’s most elite soccer players back onto the field more quickly.

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Dynatron Solaris

™

You’ve Got Options!

LIGH

T TH ERAP Y 880plus Light Probe (1,000 mW)

• 3 channels (2 pads & 1 probe) • Generating a total of 16,000 mW of light

LIGH

706

T TH ERAP Y&S TIM

XP “Hands-Free” Light Pad (7,500 mW)

• Light therapy • 5 channels of electrotherapy • 7 stim waveforms

LIGH 880plus Light Probe (1,000 mW) T TH ERAP Y, ST IM, & SOUN D • • • •

Light therapy 5 channels of electrotherapy 7 stim waveforms 3 frequency ultrasound 880plus Light Probe (1,000 mW)

No other manufacturer offers so much exibility!

With the revolutionary Dynatron Solaris series, you’ve got options and lots of them!

Dynatronics offers 7 different light therapy units, 4 different light probes and an unattended light pad.

Combine light with electrotherapy, ultrasound, or both!

Regardless of your needs, we have the perfect device for you!

Accessories Choose from a wide variety of optional light accessories ranging in power from 500mW to 7,500 mW.

405 Blue Light Probe (500 mW)

XP “Hands-Free” Light Pad (7,500 mW)

880plus Light Probe (1,000 mW)

Call today for more information (800) 874-6251 Circle No. 136

® Wobenzym N for the winning edge.™

For the short-term, anti-inflammatory drugs may be fine.

(But, in the long-run, NATURAL is better for your patients and your reputation.)

©2006 Naturally Vitamins, a Marlyn Nutraceuticals, Inc., Company. Wobenzym®N is a registered trademark of Mucos Pharma GmbH, Germany.

To learn more about Wobenzym®N, please visit www.wobenzym.com.

To receive a free sample of Wobenzym®N Crème, please call our customer service representative, Sara @ 1-800-899-4499 ext. 427

Let Wobenzym®N, the clinically validated enzyme formula for sports injuries, work for your patients and your reputation. Its proven, bio-active enzymes get both elite athlete and weekend warrior patients back into action more quickly and safely, with less time on the sidelines due to injury, than ordinary non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroids. In Germany, Wobenzym®N is the second leading over-the counter brand, next to aspirin.

Used by professional athletes to: • • • •

shorten recovery time* improve joint movements* reduce muscle pain* reduce swelling, immobility and tenderness*

Recently, during the world soccer championship in Germany, several teams used Wobenzym®N for their participating athletes.

These statements have not been evaluated by the Food and Drug Administration.

This product is not intended to diagnose, treat, cure or prevent any disease.

†

*Wobenzym ®N OTC Pain Relieving Crème: NDC31793-014-60.

Wobenzym ®N Tablets: a dietary supplement.

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