Training & Conditioning 19.2 by Momentummedia

March 2009 Vol. XIX, No. 2, $7.00

Managing Celiac Disease Lacrosse Conditioning

Special Focus: Preventing MRSA

Coming Together

Creating partnerships to improve sports medicine access

Circle No. 100

March 2009, Vol. XIX, No. 2

contents

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29 Student Corner 5 Before You Hit Send Communicating effectively online By Dr. Chadron Hazelbaker Q&A 7 Meg Frens Hope College

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56 Advertisers Directory 64 Next Stop: Web Site CEU Quiz 61 For NATA and NSCA Members On the cover: At the University of Northern Iowa, the new Human Performance Center provides a state-ofthe-art workplace for sports medicine professionals from on and off campus. Story begins on page 12. Photo by Randy Darst and Molly Wade TR AINING-CONDITIONING.COM

Sometimes, the best way to improve sports medicine services is to bring physicians’ offices and treatment facilities right onto campus. By Abigail Funk Nutrition

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Before You Hit Send

Are you putting your best face forward when you communicate online?

By dr. Chadron Hazelbaker f you’re under 25 or so, electronic employer, informal and sloppy messagcommunication probably doesn’t es can make you seem careless, unproseem like new technology—you’ve fessional, and even disrespectful. been text messaging, e-mailing, That doesn’t mean every e-mail has and chatting online for years. You to be five paragraphs long. Head athunderstand all the acronyms, have letic trainers often receive tons of emastered the art of conveying meanmail, so it’s also important to get your ing four words at a time, and know point across as efficiently as possible. WHAT YELLING LOOKS LIKE on a If you can say everything in two or computer screen. three well-written, concise sentences, But for those of us from an earlier your recipient will appreciate it. generation, e-communication is still a Use the subject line. Students new frontier. Having grown up relying on sometimes send me e-mails with a face-to-face contact and writing notes subject line of “Hi” or “Re:” This can longhand, we approach this technology be frustrating, since it doesn’t tell me from a different perspective and with whether I need to act on the message different expectations. As you work with immediately or if it can wait until later. professors and others in your ATEP, Clear, informative subject lines help and eventually seek your first job, you’ll people organize their inboxes, espeneed to remember that how you present cially if they receive a lot of e-mail. yourself electronically can leave a lastFor example, a subject line that says ing impression—good or bad. “AT coverage for 6/16 soccer game” Here are some pointers to help make is much better than just “Games” or sure your e-correspondence is effec“Coverage.” tive and trouble-free: Remember your “netiquette.” Consider the recipient. When eRecently, I received an e-mail from mailing your friends, you might not always one of my students after I evaluated a bother with punctuation, capital letters, paper he wrote. He felt the paper had or complete sentences. But when writbeen harshly graded, and sent me a ing to a professor, coach, or potential diatribe criticizing the grading, the textbook, and the way I conducted class discussions. He also called me some Chadron Hazelbaker, PhD, ATC, CSCS, very unprofessional names. Needless NSCA-CPT, is an Assistant Professor to say, it was an inappropriate use of at Eastern Washington University and e-mail and made me question the stuAthletic Trainer at Liberty High School dent’s ability to relate to others. in Spangle, Wash. He is also the NATA It’s easy for electronic communicaDistrict 10 Clinical and Emerging tion to feel anonymous—the person Practice of Athletic Trainers Committee you’re “talking to” isn’t right in front of (CEPAT) representative, and can be you, so if you’re upset about something, reached at: chadronblue@yahoo.com.

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you might be inclined to let your emotions take over. Before sending something you’ll regret, it’s wise to step back for a moment, relax, and re-examine the issue with a cool head. Here’s a good rule of thumb: If you wouldn’t say it to someone’s face, don’t put it in an e-mail or text message. The basic rules of decency and good manners still apply, and perhaps matter even more so, since every message you send leaves a lasting record. Beware of tone. Misunderstandings happen often in electronic communications. Sarcasm, humor, and other conversational nuances get lost without the benefit of body language, facial expressions, and voice inflection. When communicating with friends, you may have found ways around this, but older people and professional contacts might not speak the same language. For example, acronyms like “lol” and “omg” mean nothing to many adults. In addition to confusing your recipient, shorthand like that can make you come off as immature or not serious about what you’re doing. Don’t expect privacy. Nothing is private when it comes to e-mails, text messages, and other electronic communication. Information is backed up on servers, messages can be accidentally forwarded, and text and photos can be posted to places you never intended. Before you e-mail someone that joke, funny picture, or off-handed comment, ask yourself this question: Would I be willing to print this on a T-shirt and wear it to class, the athletic training room, and everywhere else I T&C march 2009

Student

Corner might go today? If the answer is no, it’s probably best to keep it to yourself. You can’t be sure who will end up seeing whatever you send. This rule should extend to your use of social networking sites as well. You

Choose your name wisely. Nothing will cause people to judge you and question your seriousness and professionalism more quickly than a cutesy, offensive, or bizarre user name. For example, resist the urge to send e-

I once had a student e-mail me to ask for a letter of recommendation, and the first thing I noticed was that her address began with crzysxything. I recommended that she use a different e-mail account when sending out her resume. might think you’re just venting to friends about a tough professor or a difficult athlete, but even postings labeled “private” have fallen into the wrong hands. It is now common practice for people in charge of hiring to search the Web for applicants’ MySpace pages, Facebook accounts, and other social networking presences. Compromising photos and unflattering posts have plagued many a job seeker, and the problem will only worsen as searching tools get more and more advanced.

mails to professors or potential employers using an address that identifies you as beerchugger22, soccerhottie21, or pongstud56. I once had a student email me to ask for a letter of recommendation, and the first thing I noticed was that her address began with crzysxything. I recommended that she use a different e-mail account when sending out her resume. Follow up in person. Nothing beats old-fashioned conversation for clearing up misunderstandings or explaining

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something complicated. Don’t get so caught up in the convenience of texting and e-mailing that you forget it may be simpler to stop by someone’s office or call them on the phone. Besides cutting down the chances of miscommunication, there’s another important benefit to not overusing e-communication: People are much more likely to remember a friendly face and a short, pleasant conversation than an e-mail they received along with 25 others. You can make a positive impression that will pay off the next time you ask for a recommendation, or when you hope your resume makes its way to the top of the pile. There’s no doubt about it: Technology has changed the way we communicate, and brought with it a lot of positives. But to take advantage of the benefits while avoiding the pitfalls, you have to be careful and use common sense. By keeping these rules in mind, you can eliminate the fear of “sender’s remorse” and make sure your voice is heard just the way you want. n

Q&A Meg Frens Hope College

As a teenager in Osseo, Mich., Meg Frens, MS, ATC, dreamed of becoming a veterinarian. But after meeting Rich Ray, EdD, ATC, while attending a science camp at Hope College in the summer of 1991, she changed her mind. Frens matriculated at Hope the next year, and after earning her bachelor’s degree in 1996, she went on to obtain a master’s degree from Indiana University. She spent a year as Assistant Athletic Trainer at Slippery Rock University before returning to Hope as an Athletic Trainer and Visiting Instructor of Kinesiology. In August 2000, she left to become an Assistant Professor of Athletic Training at the University of New England, only to rejoin the Hope staff in the summer of 2002 as Assistant Athletic Trainer and Assistant Professor of Kinesiology. In the six and a half years since, she’s taught in the school’s athletic training education program, supervised clinical rotations, and provided care for the NCAA Division III school’s 18 men’s and women’s varsity teams. She’s also learned to balance work and home, where she and her husband are raising a five-year-old son and a twoyear-old daughter. Last fall, when Head Athletic Trainer Kirk Brumels went on sabbatical, Frens added Interim Head Athletic Trainer to her title—just weeks before Hope experienced the largest norovirus outbreak in state history. In this interview, Frens talks about her different roles on campus, her advice for today’s students, and the challenges of juggling career and family. T&C: What was the athletic training education program like when you arrived at Hope as an undergraduate? Frens: I think there were 16 of us in the program, with one athletic trainer. It was still an internship program, and I only had two formal athletic training classes before my senior year, when the department added an administration class. A lot has changed since then, all for the better. The number of academic courses has grown substantially. It has become a fully accredited program, and there are 11 required classes for the athletic training major, plus required courses in the kinesiology department. What was the most important component of your TR AINING-CONDITIONING.COM

Shortly after Meg Frens stepped in as Interim Head Athletic Trainer at Hope College last fall, she faced a serious test: A norovirus outbreak sickened over 500 people on campus. undergraduate education? The clinical part, which is what I emphasize to my students now. I think 80 percent of what you actually retain in an athletic training education program comes from the clinical experience—something you did with your hands or witnessed with your eyes during a rotation. What was it like to come back to work at your alma mater? When I first came to Hope in the summer after my junior year of high school, I didn’t even know what an athletic trainer was. But I thought sports medicine sounded cool, so I signed up for an intensive class, which is how I met [Dean of Social Studies and former Kinesiology Department Chair] Rich Ray. All these years later, having Rich as a mentor and working with him on a chapter in a textbook has been an incredible privilege. I always knew I wanted to come back to this type of setting, so to end up at Hope has been very special. This is where I grew up, figured out who I wanted to be, and really began to establish myself. It’s also a wonderful place to work. Hope College has been very good to me by making this job as flexible as possible. After just one year, I was allowed to start working three-quarter time to spend more time with my family. T&C MARCH 2009

Q&A How did you make the transition to Interim Head Athletic Trainer? I’ve always been a team player, so I talked frequently with my co-workers and we made decisions together. I also wanted them to know I felt responsible for everything in the athletic training room and that it was my job to make sure athletes were taken care of.

“That Thursday, athletes started coming to see us, and at first we thought it might be food poisoning. When I called the health clinic, we realized a lot of people on campus were getting sick. So we immediately went into anti-infection mode.” On some level, taking charge was very stressful, and I got a little intense at times. Given the opportunity to do it again, I’d delegate more, which would take away some of the pressure. What was the biggest challenge of the role? There are many administrative duties, and they take time to figure out. Before Kirk left, he instructed me on some of the details and my colleagues were very helpful, as were the

T&C MARCH 2009

coaches. Everyone understood I was still learning the ropes. The life-work balance was probably an even bigger challenge. I had to take a lot of work home—after my kids went to bed, I was often grading papers, writing tests, and preparing for class. What have you learned about balancing work and family? I’ve learned that my family has to come first. But I know they sacrifice a lot—when I have to be at work for six or seven hours on a Saturday, that’s hard for them. So I try to balance things as best I can, because I really enjoy what I do here. Everyone at Hope understands that my children are my priority, and when I need time to take care of them, I have to take it. Striking a balance is especially hard during the fall, when I’m here at least 50 hours a week, even though I’m working three-quarter time. My family understands fall is not an easy time for mommy, and thankfully, my husband has always been absolutely fabulous about it. We have excellent childcare, and we prioritize like crazy, which is how we make it work. And when I’m home on the weekends, we make the most of our time together. The norovirus typically results in 48 hours of fever, nausea, vomiting, and diarrhea. At Hope, it infected more than 500 people last fall, causing

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Q&A Meg Frens Hope College Assistant Athletic Trainer Assistant Professor of Kinesiology Education: MS, Kinesiology, Indiana University, 1997 BA, Kinesiology/Athletic Training, Hope College, 1996 Previous Positions Assistant Professor of Athletic Training, University of New England, 2000-02 Athletic Trainer/Visiting Instructor of Kinesiology, Hope College, 1998-2000 Assistant Athletic Trainer, Slippery Rock University, 1997-98

administrators to shut down the school for five days and cancel Parents Weekend. What was it like to deal with that? Given the intensity of the outbreak, I think we did well. That Thursday, athletes started coming to see us, and at first we thought it might be food poisoning. When I called the health clinic, we realized a lot of people on campus were getting sick. So we immediately went into anti-infection mode, being extra vigilant about hand washing, proper hygiene, and sending anyone home who was feeling ill. By Friday, we knew there might be close to 500 people infected, and closing school was clearly the best way to stop the spread. Did you change anything in your protocols? We’ve always followed good hygiene in the athletic training room, cleaning the whirlpool after each treatment, washing our hands between patients, and disinfecting our equipment daily. As long as you’re taking those measures, you can limit the spread of disease. But this was one of those viruses that if you came into contact with it, it was going to get you. What types of rehabs are the hardest? A difficult rehab is like a good puzzle. You have to pick the problem apart and look at it from a lot of different angles. The most challenging situations are when student-athletes come in with chronic conditions. It’s hard to know how, when, or why the trouble started. Those cases take a little more effort, and you have to spend more time talking, measuring, and observing before you can make a good clinical assessment. How do you intertwine your teaching with hands-on athletic training? As a teacher, I get to have the athletic training room as my own daily case study. In the clinical setting, I can tell my students, “Here’s an example of what we talked about in class two days TR AINING-CONDITIONING.COM

ago.” And in the classroom, I can use everything we’ve done in the athletic training room as a teaching opportunity. You never know what kind of case is going to walk through the door. Just today, an athlete had a latissimus dorsi strain with swelling in the shoulder, which is rare unless there’s been a direct contusion. I talked about the injury with my students in class.

“Athletic training students need to be aware of the challenges of balancing work and life. If raising a family is important, you need to find a work environment that allows you that flexibility. If you don’t, you’re going to have to choose between the two.” What do you tell athletic training students about the future of the profession? That it’s strong. That there will always be physically active people who need the kind of care we’re uniquely qualified to provide. That our training allows us to adapt to a lot of different environments. I tell them, “You need to figure out where you want to be and work hard to get there.” That’s what I did. I knew I wanted to teach in a college setting and I looked for those opportunities every time I did a job search. Athletic training students also need to be aware of the challenges of balancing work and life. If raising a family is important, you need to find a work environment that allows you that flexibility. If you don’t, you’re going to have to choose between the two. I have lots of friends from my undergraduate and graduate days who decided not to become athletic trainers or are no longer in the profession, and I can’t blame them. It’s not easy to find the kind of situation I have here at Hope. I have my dream job, and I’m lucky I can say that. T&C MARCH 2009

Q&A Are you involved in any professional organizations? I’m a member of the NATA, the Michigan Athletic Trainers’ Society (MATS), and the Great Lakes Athletic Trainers Association (GLATA). I’ve presented at MATS and GLATA meetings, and I’m currently on the GLATA Education Committee.

“It has been a lot of work, but it’s good work ... Every athletic trainer should do something for either the local, state, regional, or national organization, because the people you meet and the things you learn are enormously helpful.” It’s essential for networking. The number of people you meet by getting involved in an organization like GLATA is amazing. I really enjoy being part of the committee and discussing topics of interest to bring to our membership. It has been a lot of work, but it’s good work, and I’m happy to contribute to our profession. Every athletic trainer should do something for either the local, state, regional, or national organization, because the people you meet and the things you learn are enormously helpful. What’s the biggest issue Michigan athletic trainers

are working on right now? We’ve had some incredible people working very hard to get licensure passed in this state, and it’s expected to be enacted in 2010. I am so thankful for those people, and every athletic trainer in the state of Michigan owes them a huge debt of gratitude for what they’ve done for the profession of athletic training—not just in our state, but nationally as well. What’s the hardest part of your job? Working with people. Every day, there’s a challenge on an interpersonal level. But at the same time, having those conversations is probably the best part of the job. A lack of communication is often the biggest hurdle in interpersonal relationships, so if you can create open lines of communication that foster understanding, the problems go away. What are your goals? I want to be a good role model for our students, which means balancing life and work, keeping my skills current, and enjoying what I’m doing all the time. It also means grabbing every opportunity I have to learn something new, which I do by reading, going to conferences, and talking to other athletic trainers. I’m always trying to find out more, because when you stop asking questions, you stop learning. And that’s not my intention—ever. n

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T&C MARCH 2009

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LEADERSHIP

At the University of Northern Iowa (UNI), the new Human Performance Center provides a state-of-the-art workplace for sports medicine professionals from on and off campus. From left to right: Sean Schulte, Cedar Valley Medical Specialists (CVMS) Physical Therapist/Athletic Trainer; Dr. Jeffrey Clark, CVMS Orthopedic Surgeon and UNI Team Orthopedic Surgeon; Don Bishop, UNI Head Athletic Trainer; and Dr. Todd Evans, Chair of the Division of Athletic Training.

Randy Darst and Molly Wade

LEADERSHIP

Coming Together Sometimes, the best way to improve sports medicine services is to bring physicians’ offices and treatment facilities right onto campus. Three innovative programs discuss the partnerships they’ve formed to do just that, and more. By Abigail Funk

wenty minutes into a high school soccer game, one of your players rolls his ankle and falls to the ground in obvious pain. After you and an assistant coach help him off the field, you see that his ankle is extremely swollen and he can’t put any weight on it. You’re afraid he may have a broken bone. Here’s where the story takes an unexpected turn. Instead of helping the athlete into the nearby ambulance for a trip to the emergency room, you help him onto a golf cart and drive two minutes to a nearby campus building, where you meet the team physician for further evaluation and an x-ray. The EMS crew remains at the game in case of another injury, the ambulance doesn’t have to be deployed, and the athlete’s parents don’t have to make a trip to the hospital. While it may seem far-fetched to have almost instant access to an x-ray machine, a radiologist, and a physician right on campus, David Baker, Superintendent of the Springboro (Ohio) Community School District, fully expects a scenario like this one to play out at Springboro High School next school year. The district is working hard to finish a new campus buildTR AINING-CONDITIONING.COM

ing in which nearby Premier Health Partners’ Miami Valley Hospital has agreed to lease two floors for the next 22 years. In essence, Springboro will be bringing sports medicine services right to its student-athletes. At the University of Northern Iowa, a similar partnership with several nearby medical groups put a state-of-theart facility on campus and is benefiting Panther athletes immensely. And at Boise State University, the Idaho Sports Medicine Institute, located next door to the football field, has been helping the campus athletic training staff rehab student-athletes for the past 25 years. Through innovative sports medicine partnerships, these three schools are helping their athletes receive convenient access to the best possible care. GOLDEN OPPORTUNITY Springboro, like many high schools facing the tough economic climate, was having trouble securing money for its athletic program. Its football field was in desperate need of renovation, there were no coaches’ offices or a weightroom to speak of, and while community members were proud of the growing district’s academic prowess, they were frustrated with the sports teams’ lack of success.

Nearby Miami Valley Hospital (MVH), which already provided Springboro with athletic training coverage for a minimal fee, knew the area was rapidly growing—the district welcomes over 200 new students each year—and wanted a stronger presence in the Springboro community. So a deal was struck. In exchange for naming rights, MVH paid for a brand new synthetic turf field and other stadium improvements. Then, as part of Springboro’s plan to construct a 40,000 square-foot building on campus with new locker rooms and a weightroom on the first floor, MVH signed a 22-year lease for the top two floors. The hospital will bring in its sports medicine physicians and the latest treatment and rehab equipment, and plans to sublease some of the space to a local family medicine practice and other specialists, like an orthodontist or dermatologist. All of Springboro’s students, faculty, staff, and community members will have access to services in the new campus building, which should be completed by the start of school this fall. And the athletic trainers who provide coverAbigail Funk is an Assistant Editor at Training & Conditioning. She can be reached at: afunk@MomentumMedia.com. T&C MARCH 2009

LEADERSHIP age at Springboro will be able to work closely with other healthcare professionals in the building. “Here’s a way that we can provide medical services to the athletes, stu-

building loan. In the end, it costs the school district nothing.” For MVH, there was no better way to become ingrained in the Springboro community. “The physicians who oc-

“With a general practice in the building, instead of parents having to pull their kids out of school for a doctor’s appointment downtown, the kids can just walk across the street to the medical building and not lose as much time from class.” dents, and the rest of the community right at the school,” says Tom Daskalakis, Vice President for Business Development at MVH. “They won’t have to drive to the hospital for our services thanks to this partnership. It truly is a win-win relationship.” The lease is structured so that after 22 years, MVH will have paid for the cost of construction, and whatever lease money Springboro brings in after that is essentially profit. “For Miami Valley Hospital, there are no development costs, just the lease payment,” Baker says. “The hospital writes us a check and we use that money to pay back the

cupy the new building will be forever linked to the school, and we expect positive relationships to form over time,” Daskalakis says. “We’re building trust and goodwill with the school and community. Not only are we developing partnerships that benefit us as healthcare providers, but we are also promoting health education and creating an interest in healthcare careers among students.” Baker hopes that a family practice will sublease space from MVH soon. “With a general practice in the building, instead of parents having to pull their kids out of school for a doctor’s

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appointment downtown, the kids can just walk across the street to the medical building and not lose as much time from class,” he says. As Springboro gets ready to open the doors of the new building, Baker is fielding a lot of calls from other school districts interested in learning more about the partnership. “We presented this concept at our state school boards convention, and all of a sudden I had people asking, ‘How can we do something like this?’” he says. “A group of superintendents from Marion, Ohio, came to look at the building, and another school district is seriously thinking about doing this exact same thing. I think this is the future for high school athletics and sports medicine.” COMMON INTEREST When the University of Northern Iowa’s Human Performance Center opened last May, it wasn’t just the UNI community that was smiling. Several area medical groups, a U.S. Senator, and even a team of federal grant workers in Washington, D.C., all felt a sense of accomplishment. They had come together to build

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LEADERSHIP a state-of-the-art sports medicine facility that is benefiting thousands of people, both on and off the UNI campus. The $7.8 million, 50,000 square-foot building houses the athletic training education program and the Sports and Performance Center on the first floor, and the Davis Center for Healthy Youth Development upstairs. The first floor caters to Panther athletes, other UNI students, faculty, staff, and community members, providing healthcare services like x-ray, MRI, and hydrotherapy, in addition to substantial classroom and research space. The second floor is geared toward youth health and safety, and houses groups like UNI’s Camp Adventure Youth Services. “We’ve built a pretty unique complex,” says Gil Irey, Chief Executive Officer of Cedar Valley Medical Specialists, which oversees much of the ground floor. “We have UNI’s team physician, who is our own orthopedic surgeon, and a physical therapy department that sees 45 to 50 patients a day. There’s also full-service diagnostic imaging that does 10 to 12 MRIs a day. There really is a little of everything.” Years ago, discussions about a one-stop

healthcare center on UNI’s campus began. Richard “Biff” Williams, PhD, LAT, ATC, then the Athletic Training Program Director, approached Cedar Valley Medical Specialists about constructing a build-

local philanthropist. State Representative Jim Nussle and U.S. Senator Tom Harkin also took special interest, helping secure a federal grant of $1.8 million. With so many groups sharing one

The Human Performance Center isn’t just a plus for the athletes and other patients who use it. “Our grad students work as high school athletic trainers through graduate assistantships with our partners.” ing together. Irey loved the idea, especially since Cedar Valley was just then looking for office space near UNI. “It was perfect timing,” Irey says. “We had already been working with UNI on a sports acceleration program for their athletes, so it was a natural partnership. We could even design the building together.” Cedar Valley Medical Specialists brought local Allen Hospital on board, and together, the two entities raised enough capital to outfit the space with new rehab equipment. For the building itself, UNI began fundraising in 2001, with a jumpstart $500,000 donation from a

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building, collaboration is frequent and student-athletes are reaping the benefits. “It has made life a lot easier for my staff here on campus,” says Don Bishop, MA, LAT, ATC, Head Athletic Trainer and Director of Athletic Training Services at UNI. “Having our team orthopedic surgeon right across the hall is a huge advantage. If an athlete comes into the athletic training room and has a problem we want the orthopedic surgeon to see, they just walk on over for an x-ray, MRI, or whatever else they need. “The physical therapy clinic is right across the hall, too,” Bishop continues. “Our physical therapist used to be here

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LEADERSHIP only in the morning. Now we have access to him full-time, which is especially helpful for long-term and specialty rehabs. The situation has really enhanced our entire sports medicine team.” The new facility also includes a hydrotherapy rehab area, which had been a dream of UNI’s athletic training staff for years. “Now we have a hydrotherapy pool and hot and cold plunge tanks,” Bishop says. “We have a hydraulic floor with a treadmill, cameras, and jets. It’s as stateof-the-art as you can get, and something we couldn’t have afforded on our own.” The Human Performance Center isn’t just a plus for the athletes and other patients who use it. UNI athletic training students have seen their clinical horizons expanded dramatically through the partnerships with Cedar Valley Medical Specialists and Allen Hospital. “Our grad students work as high school athletic trainers through graduate assistantships with our partners,” Bishop says. “Their off-campus locations also serve as clinical sites for our undergrads. Our relationships with the different constituents have really blossomed into many positive opportunities for our campus.”

NEW

PRACTICE MAKES PERFECT For a tried and true example of a successful partnership between a school and an outside medical practice, look no further than Boise State and the Idaho Sports Medicine Institute (ISMI). ISMI employees and the Boise State athletic training and strength and conditioning staffs have been teaming up to provide outstanding sports medicine services to Bronco athletes since 1984. “We all work together here,” says Korene Mayo, LAT, ATC, Athletic Trainer at the ISMI. “Ultimately, it comes down to this: How are we going to get these athletes the best care and get them back onto the field or court as quickly and safely as possible? We have a great concept here on campus, and the athletes definitely benefit from it.” Though the ISMI—which also sees private non-student patients—has been working with Boise State athletes since its inception, it was located off campus for its first four years of existence. Founder George Wade, MD, a physician at the ISMI, says it took a forward-thinking athletic director and university president to invite his prac-

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tice onto campus. “The president was very interested in athletics, so that was a big help,” he says. “And because our setup has been this way for so long, everyone in the different departments—athletic trainers, strength and conditioning coaches, and us at the ISMI—gets along very well. It’s a total team approach.” The ISMI staff includes five orthopedic surgeons, a sports medicine doctor, a family medicine doctor, an athletic trainer, four physical therapists (two of whom are also athletic trainers), and an exercise physiologist. Having them all work in concert with the Boise State athletic training staff requires clear communication, something the parties involved have learned through experience. “There are a few things we do to make sure we’re all on the same page,” Mayo says. “Once a week, I meet with Boise State’s head athletic trainer and strength and conditioning coach and we review all the athletes who are doing rehab at the ISMI. When there isn’t great communication among everybody involved in an athlete’s care, their recovery isn’t as smooth and successful as it could be.”

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T&C MARCH 2009

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Circle No. 112

LEADERSHIP The ISMI is located next to the football field in Bronco Stadium, and the convenience of its location has been one of its greatest advantages. “If the physical therapist, one of Boise State’s athletic trainers, or anyone else has a question about a rehabbing athlete, we all have direct access to the physician,” Mayo says. “There’s an immediate answer to our inquiry. “This setup has also improved our compliance rate,” Mayo continues. “It’s much easier for the athletes to follow their rehab instructions when they know we’re checking up on them through the athletic trainers and strength coaches.” Most often, Boise State athletes seen at the ISMI have recently undergone surgery. Once the ISMI professionals feel an athlete is ready for sport-specific exercises and drills, they connect with the school’s athletic trainers and strength and conditioning coaches next door. But the information flows in both directions. “Our physicians make regular training room visits,” Mayo says. “If a Boise State athletic trainer has an athlete who isn’t progressing after an ankle sprain and the athletic trainer isn’t sure what to do, they can have a physician evaluate the ankle. From there, if something else is wrong—maybe the athlete needs x-rays—we have x-ray capabilities right on site, so that’s immediately taken care of.” Though athletes don’t have to travel far for an ISMI visit, its location does pose one unique challenge. “We have to close early when there are home contests during the week,” Wade says. “For example, the Humanitarian Bowl was here on a Tuesday, so we couldn’t see our usual patients that day.” ISMI doctors and rehab specialists care for local community members as well, or “weekend warriors” as Mayo and Wade call them. And of course, Boise State athletes are free to go off campus to another orthopedic surgeon or sports medicine specialist if they choose, though it’s a rare occurrence. “We have an understanding with the university that we will make sure an athlete gets back to good health, even if insurance stops covering their care,” Mayo says. “We don’t just dump them. But that means we have to work very closely with the athletic trainers next door, so when it’s time to return to play, that athlete has a smooth transition. Communication really is the key to a better recovery.” While it’s clear to the Boise State ath-

letic training staff and ISMI employees that the ISMI is a private group, Wade says he has always felt a part of Boise State. “I like that I can see the athletes outside the office,” he says. “It’s nice to say hi to people walking around campus, and I think it makes us feel more like family.” Boise State athletes are not the only students who benefit from the ISMI’s proximity. The school’s biomechanics lab and kinesiology department have also formed partnerships with ISMI doctors interested in research projects. “There

are countless learning opportunities,” Wade says. “We have athletic training students and physical therapy students rotate through. Right now, some biomechanics students are using our facility for a study on turf and shoes.” Mayo says she’s seeing more and more schools interested in partnerships similar to Boise State’s with the ISMI. “It’s not uncommon for outside physicians to come by with athletic trainers to see how we operate,” she says. “I won’t be surprised when facilities like ours start popping up all over the place.” n

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Circle No. 114

Against the Grain

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nutrition

Athletes who have celiac disease face a special challenge: fueling themselves for performance while avoiding all foods made with wheat. By understanding the condition and guiding them toward the best dietary options, you can help them thrive. By Dr. James Leone

eanne had always been a solid performer on her soccer team, valued by coaches and teammates for her skill, athleticism, and commitment. So when her performance during practices and games started to decline for no apparent reason, her coach pulled her aside to ask if anything was wrong. “I just feel fatigued, achy, and sore,” she replied. “And lately I’ve had trouble keeping food down. I’m sure it will pass soon.” But the symptoms didn’t pass, so the following week, Deanne talked to the team’s athletic trainer. He suspected a gastrointestinal virus, food poisoning, or maybe even mononucleosis, and made her an appointment with the team physician. When asked about her food intake, Deanne said she was becoming “afraid to eat” because it made her feel terrible,

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with bloating, diarrhea, and stomach pain. She had lost several pounds in a matter of weeks. At first, the physician thought it was an eating disorder, but Deanne didn’t show the psychological signs—she wasn’t obsessing about food, and had a generally healthy sense of body image. However, she was growing distraught as her condition worsened and no one seemed to know what was causing it. Deanne, her athletic trainer, and her team physician would soon find out that she suffered from celiac disease (CD), an illness that affects the body’s ability to digest and process food. Often undiagnosed or misdiagnosed, CD affects athletes of all ages, and can wreak havoc on athletic performance and overall health. But once identified, the condition can be managed successfully and doesn’t have to spell the end of an athletic career.

WHAT IS IT? In a healthy digestive tract, food is broken down so that macronutrients (carbohydrates, protein, and fat) and micronutrients (vitamins and minerals) can be absorbed through the intestines and delivered throughout the body. But for those with CD, also known as celiac sprue, non-tropical sprue, or gluten-sensitive enteropathy, ingesting a protein called gluten irritates the intestine, causing an autoimmune response that’s similar to an allergic reaction. When someone with CD is exposed to gluten, usually through food, it trigJames Leone, PhD, ATC, CSCS,*D, CHES, is Assistant Professor of Health Education in the Department of Movement Arts, Health Promotion, and Leisure Studies at Bridgewater State College. He can be reached at: james.leone@bridgew.edu. T&C MARCH 2009

nutrition gers a cascade of physiological events. As the gluten cells reach the stomach and eventually the small intestine, there is a marked increase in white blood cells (macrophages) and other inflammatory chemical mediators. Acute inflammation ensues, which leads to swelling and even bleeding, and the individual may experience bloating, gas, diarrhea, and localized pain. Over time, this response to gluten exposure can lead to scarring and changes in the structure of the small intestine, especially the tiny finger-like projections in the intestinal wall called villi. Abnormal intestinal cells begin to develop and reduce the overall absorptive surface area for nutrients. This condition, called crypt hyperplasia, is a primary cause of nutrient malabsorption in people with CD. Due to crypt hyperplasia, fewer nutrients are absorbed during digestion, so an individual must eat more food to meet their nutritional needs. But if the additional food contains gluten, the problem only grows worse, creating a vicious circle. If the condition is not identified and gluten isn’t eliminated from the diet, CD can cause long-term health problems, including ulcers, intestinal bleeding, lymphoma, adenocarcinoma (cancer) of the intestine, osteoporosis, and shorter stature in developing chil-

dren (mainly due to malnutrition). In rare cases, people can even die from nutrient imbalances caused by CD that affect heart function. Gluten is a very common protein found in countless food items, including virtually all foods containing wheat, many types of candy, and some condiments. It’s also sometimes present in non-food products, such as lipstick and the adhesive on envelopes. This is one reason why CD often goes undiagnosed—because so many things can trigger symptoms, narrowing down the cause is a difficult process. Once the disease is suspected, however, a physician can use tests to confirm the diagnosis fairly quickly. Who gets CD and why? Many researchers agree there is a strong genetic component to the disease, as it often runs in families. People of Scandinavian and Northern European descent have especially high incidence, so international athletes from these areas may warrant extra concern, especially if they’re adjusting to an American diet for the first time. For reasons not yet fully known, CD can remain dormant for years, during which time an individual displays no symptoms, before it suddenly manifests. Adding to the mystery, many CD patients report first noticing a change in

digestive function after a surgery, major trauma, pregnancy, or period of severe emotional distress or sickness. In the U.S., recent studies suggest that around one in 133 people likely have CD, which represents between two and three million cases nationwide. However, the condition is severely underdiagnosed—one estimate says that 97 percent of all CD sufferers in the country don’t know they have the disease, largely due to unfamiliarity with it among U.S. physicians. RAISING AWARENESS Sufferers of severe CD are most likely to be diagnosed, and they usually learn to eliminate gluten from their diet. But those who are only moderately affected—with some intestinal inflammation, but perhaps not enough discomfort to seek treatment—may be compromising their health and athletic performance without knowing it. In fact, athletes may be less likely than other people to complain about mild CD symptoms, because they sometimes attribute intestinal distress to the demands of training for their sport. But for athletes, CD can pose serious problems. The higher carbohydrate and protein demands of active people means that any drop in nutrient absorption can create serious deficiencies,

GLUTEN CHALLENGE The gluten dietary challenge is a method of testing the body’s natural reaction to foods containing the protein gluten. This is often among the first steps recommended if an athlete’s gastrointestinal symptoms—such as gas, bloating, stomachaches, and diarrhea—suggest that they may have celiac disease (CD). To conduct a gluten challenge, an athlete avoids all foods containing gluten for a set period, usually one to two weeks. Some food labels now provide a specific warning if the product contains or may contain gluten, but this is far from universal, so careful reading of ingredient labels is necessary. The athlete should also avoid contact with potential non-food gluten sources, such as envelope adhesive, lickable stamps, and lipstick. During the challenge, the athlete should keep a detailed

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food journal of everything they ingest, in order to track which foods provoke or ameliorate symptoms. Even if CD isn’t the problem, this can help narrow down the real source. Close communication with a physician or gastroenterologist is also highly recommended during the challenge, since he or she can help interpret the results and determine as quickly as possible whether other tests should be performed. If eliminating gluten causes the athlete’s condition to improve or makes their symptoms disappear entirely, that doesn’t guarantee they have CD. A logical next step is for a physician to order blood panel testing and/or a small intestine endoscopy to determine a diagnosis. If CD is in fact present, the physician will most likely recommend permanently eliminating gluten from the diet.

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nutrition

ON THE LABEL Some food labels now include a specific warning if the product contains gluten, but most do not. Following a glutenfree diet (GFD) means checking ingredient lists for any substances that may trigger symptoms. If the label mentions any of the ingredients listed below, that product probably contains gluten. As a general rule, the more processed a food item is (often evidenced by a long ingredient list), the greater the odds it contains at least some gluten. Abyssinian hard (wheat triticum durum)

Groats (barley, wheat)

Strong flour

Hard wheat

Suet

Amp-isostearoyl hydrolyzed wheat protein

Hydrolyzed wheat gluten

Tabbouleh

Barley grass

Hydrolyzed wheat protein (pg-propyl silanetriol)

Teriyaki sauce

Barley hordeum vulgare

Hydrolyzed wheat starch

Barley malt

Hydroxypropyltrimonium

Timopheevi wheat (triticum timopheevii)

Bleached flour

Kamut (pasta wheat)

Triticale X triticosecale

Blue cheese (often made with bread)

Malt

Triticum vulgare (wheat) flour lipids

Bran

Malt extract

Triticum vulgare (wheat) germ extract

Bread flour

Malt syrup

Triticum vulgare (wheat) germ oil

Brewers yeast

Malt flavoring

Udon (wheat noodles)

Brown flour

Malt vinegar

Unbleached flour

Bulgur/bulgur wheat

Macha wheat (triticum aestivum)

Vavilovi wheat (triticum aestivum)

Cereal binding

Matzo semolina

Vegetable starch

Chilton

Mir

Wheat amino acids

Club wheat (triticum aestivum subspecies compactum)

Oriental wheat (triticum turanicum)

Wheat bran extract

Pasta

Wheat durum triticum

Pearl barley

Wheat germ extract

Persian wheat (triticum carthlicum)

Wheat germ glycerides

Poulard wheat (triticum turgidum)

Wheat germ oil

Polish wheat (triticum polonicum)

Common wheat (triticum aestivum) Couscous Dextrimaltose Disodium wheatgermamido peg-2 sulfosuccinate

足 4 2

Textured vegetable protein/TVP

Durum wheat (triticum durum)

Rice malt (if barley or Koji are used)

Wheat germamidopropyldimonium hydroxypropyl

Edible starch

Rye

Wheat grass

Einkorn (triticum monococcum)

Seitan

Wheat nuts

Emmer (triticum dicoccon)

Semolina

Wheat protein

Farina

Semolina triticum

Wheat triticum aestivum

Farina graham

Shot wheat (triticum aestivum)

Wheat triticum monococcum

Filler

Small spelt

Wheat (triticum vulgare) bran extract

Flour (normally this is wheat)

Soy sauce

Whole-meal flour

Fu (dried wheat gluten)

Spirits (some types)

Wild einkorn (triticum boeotictim)

Germ

Spelt (triticum spelta)

Wild emmer (triticum dicoccoides)

Graham flour

Sprouted wheat or barley

Granary flour

Stearyldimoniumhydroxypropyl

T&C MARCH 2009

Source: www.celiac.com

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nutrition limit muscle growth, and slow recovery. Compromised vitamin and mineral absorption also presents major trouble, since athletes rely on balanced micronutrient levels for everything from bone growth to blood clotting. That’s why it’s critical to be on the lookout for even minor symptoms. When an athlete complains of persistent gastrointestinal distress, how can you tell if CD could be the cause? For reasons already described, arriving at a diagnosis can be tricky, but there are a few red flags which, if present, warrant referring the athlete to a physician for evaluation: Weight loss. Of course, many gastrointestinal illnesses are accompanied by the loss of a few pounds. But with CD, the weight loss occurs even though the athlete is following normal eating patterns— unlike with stomach flu, for instance, which often results in loss of appetite and some degree of dehydration. Skin reaction. An itchy skin rash called dermatitis herpetiformis is another distinct sign commonly found with CD. It typically presents in clusters of red bumps, sometimes with tiny water

blisters. A burning sensation is usually felt locally before the bumps appear. Unexplained anemia. If an athlete shows signs of anemia, or if it’s revealed by a blood test, and their diet doesn’t explain the cause, CD may be to blame. Iron is one of the key minerals that the body fails to absorb efficiently in CD sufferers.

If CD is suspected, an important first step is to temporarily eliminate gluten from the athlete’s diet, a method commonly called a “gluten challenge.” If symptoms begin to resolve soon after, that’s a good indicator CD may be present. (For specifics on how to conduct this test, see “Gluten Challenge” on page 22).

People with the disease often have low levels of iron, potassium, calcium, and sodium, and many also experience electrolyte imbalances. Specific nutrients needed to repair tissue, including certain proteins and collagens, may be under-absorbed as well. Other common symptoms include gas, abdominal pain and bloating, chronic diarrhea, bone or joint pain, low bone density, behavioral changes, cramping, seizures, mouth sores, and the production of pale, fatty stools. Various combinations of these symptoms can indicate other illnesses as well, but CD should at least be part of the discussion with a physician when trying to pin down the cause of an athlete’s unexplained illness.

A blood test is often used for a firmer diagnosis, and the athlete will need to consume some gluten beforehand so the test reveals a reaction in the form of elevated antibody levels. If the initial blood test is positive, a physician may order another, more specific panel test—usually looking for levels of immunoglobulin A (IgA), anti-tissue transglutaminase (tTGA), and IgA antiendomysium antibodies (AEA). If dietary changes and blood testing

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nutrition suggest the presence of active CD, gastroenterologists consider a jejunal mucosal biopsy to be the “gold standard” of diagnosis. In this procedure, a sample of tissue is removed from the jejunum (a section of the small intestine) using a guided endoscope inserted orally. Lab testing evaluates the intestinal villi for inflammatory markers, scarring, and other damage—the telltale signs of CD. COPING & THRIVING If one of your athletes has been diagnosed with CD, it’s important to reassure them their athletic career isn’t over. While there is no cure for the disease, fueling the body for optimum performance is still possible if they take a careful approach to planning their diet. One primary challenge for anyone with CD—and athletes especially—is getting enough carbohydrates on a daily basis while avoiding gluten. Some very popular complex carb sources, such as whole-grain breads and pastas, are rich in gluten and will cause an inflammatory response. Athletes may be tempted to “tough it out” because they feel the need to eat these foods, figuring they’ll mask the CD symptoms with over-thecounter drugs for indigestion, gas, or diarrhea. But this must be discouraged: The cumulative damage to the small intestine is serious, and in the long run they’ll be less able to absorb carbohydrates and other nutrients. Adapting to a gluten-free diet (GFD) takes effort, but it is the best way to successfully manage the disease. Thankfully, labeling practices and heightened awareness to gluten sensitivity have made this task much easier in recent years. Also, several excellent resources are now available to help people with CD achieve a diverse, healthy diet while avoiding gluten. (See the “Resources” box at right for some examples.) Many traditional pastas, breads, cereals, and snack foods such as crackers are obviously off-limits to those on a GFD. However, there are now ricebased varieties of these foods that can provide quality carbs and closely simulate the texture and taste of the wheatbased versions. While more and more supermarkets are stocking these items, they’re still scarce in some areas, so the Internet is a great resource. Gluten-free versions of almost anything can now be found online with a little searching, 26

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and mail-order bulk purchasing of staple foods is a great way for athletes to stock up on healthy choices they can eat without worry. Eating out during team meals and on road trips is another challenge, and this is one area where an athletic trainer’s assistance can be critical. Many restaurants have pre-planned menu adjustments for patrons with various dietary restrictions, so it’s important to call ahead and find out what gluten-free options will be available before a team books its meals, or what other special arrangements can be made. A physician may recommend certain dietary supplements to address nutrient deficiencies in athletes with CD. People with the disease often have low levels of iron, potassium, calcium, and sodium, and many also experience electrolyte imbalances. Specific nutrients needed to repair tissue, including certain proteins and collagens, may be under-absorbed as well. Blood tests can reveal which substances require supplementation, and a registered dietitian or nutritionist can also help athletes find nutrient-rich foods that can meet their needs. SUPPORT MATTERS Not surprisingly, all these changes often carry a psychological impact. Losing a sense of personal food choice can be likened to any other grieving process. An athlete with CD may experience shock and denial after first being diagnosed, then anger at the prospect of having to change their diet and eliminate some foods. They may go through a “bargaining” phase, where they tell themselves they can occasionally cheat on the GFD—a slice of pizza here, a sandwich there, a couple of beers on the weekend—but they’ll end up feeling even worse when those lapses lead to physical distress. Like athletes with diabetes, severe food allergies, or other medical conditions, they will need to accept that successfully managing CD means a lifestyle change and a more proactive, careful, educated approach to fueling the body. Beyond assisting with the nutritional changes, you can provide emotional support as an athlete adjusts, and if needed, also refer them to a counselor or other professional who can help them through any psychological issues associated with CD. Members of the “support team” for

an athlete with CD can include the athletic trainer, a dietitian, the team physician or another doctor, a counselor, coaches, and virtually anyone else in a position to help them manage the disease. It’s important for these people to communicate on a regular basis, to ensure that the athlete receives consistent reinforcement, any needed intervention and treatment, and access to all the education and assistance they can use. The most important message to give athletes with CD is that they can continue to be successful in their sport and lead an active, normal, healthy life. The growth of gluten-free food options in recent years has been a giant leap forward in making CD easier to manage, and medical research continues to improve our understanding of the disease and its effects. Armed with the right knowledge, support, and resources, CD can be just another obstacle that athletes overcome on the road to optimal health and performance. n

RESOURCES The following Web sites can educate athletes about celiac disease and help them develop strategies to manage it by adjusting their diet and lifestyle. Celiac Disease Awareness Campaign www.celiac.nih.gov American Celiac Society www.americanceliacsociety.org Celiac Disease Foundation www.celiac.org Celiac Disease and Gluten-Free Diet Information www.celiac.com Celiac Sprue Association www.csaceliacs.org Gluten Intolerance Group of North America www.gluten.net National Foundation for Celiac Awareness www.celiaccentral.org American Dietetic Association www.eatright.org TR AINING-CONDITIONING.COM

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optimum performance

Ahead of the Curve

Ontario Hockey Academy

By R.J. Anderson

hey are names you’ve likely heard: Athletes’ Per for m a nc e , At h le t ic Republic, Velocity Sports Performance, Nike Sparq Training, and Tom Shaw. They’re the specialists and gurus who prepare football players for the NFL Scouting Combine, put Major Leaguers through their off-season paces, and train Olympians, professionals, and gifted high school athletes on a daily basis. Because of their years of experience and resource-rich environments, the methods and philosophies of these well-respected experts and their training facilities push the envelope and help drive innovation in athlete development. In many cases, their ideas are eventually incorporated by the broader strength and fitness world. TR AINING-CONDITIONING.COM

Insiders at elite private training centers discuss the present and future of athlete development. From treadmills you can skate on to weight machines that record the details of each user’s workout, they say new technology is helping revolutionize the way athletes train. We picked the brains of several of these professionals for insights into the latest trends and technology advances in strength and conditioning. In this article, they share their methods and reveal some of the most innovative and state-of-the-art

tools currently lining their training arsenals. PLAN PROGRESSION These days, top strength and conditioning specialists know that training an athlete is like preparing for battle: It’s imperative to have a plan before striking the first blow. While it’s no secret that a conditioning program should address an athlete’s deficiencies, Rett Larson, Program Coordinator for Velocity Sports Performance, says more and more strength coaches are learning the value of corrective exercise and designing workouts that train movement instead of just building muscles. R.J. Anderson is an Assistant Editor at Training & Conditioning. He can be reached at: rja@MomentumMedia.com. T&C MARCH 2009

optimum performance “Modern sports performance is more about focusing on movement mechanics, and from there, backing up to find which muscles need to get stronger, which are dominating others, and what imbalances may exist,” Larson says. “By correcting movement imbalances instead of just building strength, we’re creating a better athlete. “It’s pointless to train an athlete to have a bigger engine if his alignment is off,” continues Larson, who relies on the principles of Gray Cook’s Functional Movement Screen to guide him. “So we train each of our coaches to develop an eye for picking out poor movement patterns, then utilize the right exercises to correct those deficiencies. And there are no magic exercises—everything is individualized based on an athlete’s needs.” Assessing movement patterns and identifying deficiencies also helps reduce injury risk. “Movement screens aren’t new, but they mark another contribution to our profession from the physical therapy world,” Larson says. “It’s the type of information that makes strength coaches smarter and helps us better grasp what’s happening in the body and what causes injuries.” In the same vein, Larson says there has also been an enhanced focus on building recovery into a workout plan. “Instead of just worrying about building an athlete’s muscles, strength coaches need to teach their athletes about the role of

“With pneumatics there is no inertia, and unlike lifting a traditional load, there’s no deceleration at the end of the lift. It’s basically the same idea behind using chains and bands ... The air machines teach athletes to produce power through the entire range of motion.” rest and recovery between workouts, and how that will make them stronger,” he says. “For example, we are seeing more and more studies on the role of sleep in tissue regeneration and how ice baths, massage, and other active rest techniques ultimately make athletes stronger and faster.” Larson, who also helps design the education and training programs for Nike Sparq-certified training centers and coaches, is working to develop programs that cater to the needs of both elite and younger athletes. “We only have an hour and a half twice a week with most of our athletes, so in that short time we need to be mentors and teach them about the things that will help them improve every day,” he says. “We design recovery programs they can do on their own and talk to each athlete about proper nutrition and the dangers of overtraining.” AIRING IT OUT When putting athletes through weightroom workouts, coaches at Athletes’ Performance’s three training centers rely heavily on the air-based resistance of pneumatic Keiser equipment. The theory behind pneumatics is that by removing momentum and the inertia generated when an athlete accelerates mass and replacing it with air pressure, more constant resistance is provided throughout the entire range of movement. “Once we’ve developed an athlete’s lifting and movement fundamentals, we’ll put them under the air, working with rep schemes of less than five and focusing on velocity of TR AINING-CONDITIONING.COM

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optimum performance movement,” says Nick Winkelman, Education Manager for Athletes’ Performance. “With pneumatics there is no inertia, and unlike lifting a traditional load, there’s no deceleration at the end of the lift. It’s basically the same idea behind using chains and bands, but with more dynamic effects. “For example, if I’m doing a front squat with a Keiser air machine for three reps with max power output, I have to go all the way through triple extension and finish hard for that last little bit,” Winkelman continues. “We really emphasize pneumatics when we get closer to an athlete’s preseason, when speed of movement and power become the dominant training factors—the air machines teach athletes to produce power through the entire range of motion.” Pneumatic equipment is also improving the way Athletes’ Performance measures strength and evaluates progress. As part of a baseline athlete evaluation program, coaches incorporate pneumatic-based exercises to help them collect in-depth data for each athlete. For instance, when measuring power levels using pneumatic machines, athletes

perform upper-body chest presses and lower-body leg presses. The air-driven technology allows a coach to seamlessly modulate the amount of weight during each test. “We start by having them do a single rep with a light weight to see how quickly they can move it,” says Winkelman. “Over the course of 10 reps, we go from very light to very heavy to get an idea of their upper- and lower-body power levels. Not too many facilities have this equipment yet, but it’s a major advantage because it allows us to get that full-spectrum power curve reaction time and then look at any power asymmetries.” INFORMATION OVERLOAD For Athletic Republic, a chain of 160 athletic development facilities based in Park City, Utah, recent years have seen a strong emphasis on developing and integrating new measurement tools to more accurately assess each athlete’s progress. With more precise, individualized information, the strength coaches can dial in highly efficient and effective training programs for their nearly

80,000 clients, who range from Olympic athletes and players training for the NFL Scouting Combine to athletes in high school and younger. One of their favorite tools is a proprietary instrumented leg press featuring a high-tech force plate. Used both for diagnostics and as an everyday training device, it can be applied in both performance development and rehab settings. “The leg press is basically a sled that moves horizontally and has a footplate at one end,” says Steve Swanson, Chief Officer of Science and Technology at Athletic Republic. “The athlete lies down with a set amount of weight on the stack, and they press or jump on the force plate. It provides us with a safe environment where we can overload the body without risk of injury. “For example, during weighted jumps, it allows for force output beyond that of a standard squat or body weight jump,” continues Swanson, adding that the machine can be used for one- and two-leg presses. “By measuring the force the athlete applies, we can gauge power output precisely, evaluate their progress based on that data, and

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optimum performance adjust their training regimen accordingly. It allows our coaches to push the envelope for what the athlete can do in terms of raw power output.” Complementing that piece of equipment is a portable force platform utiliz-

he can’t properly execute the landing from a body weight jump or if he isn’t able to consistently stabilize his center of mass. These tools help us decide when they’re ready to progress.” Athletic Republic is on the cutting

“If we can capture and analyze this mound of information effectively, our new coaches and those with less experience will have access to planning strategies rooted in the successes and failures of a large population. They hit the ground running, and benefit from the collective wisdom of others.” ing similar technology. Athletes use it for a variety of closed-chain exercises, including body weight jumps. Swanson says the platform measures force in three directions, which adds a balance component to many exercises, giving him and his staff the ability to assess stability levels during push-offs and landings. “For us, the focus is on training movements, and everything we do is rooted in developing sound movement skills before progressing to the next phase,” he says. “For example, an athlete shouldn’t be doing depth jumps if

edge in other areas as well, including information management. Traditionally, collecting and analyzing data has been a chore not many strength and conditioning coaches look forward to—if they do it at all. At Athletic Republic’s flagship facility in Salt Lake City, an official sport science provider for the U.S. Olympic Committee, the oncetedious process of collecting and processing data is quickly becoming part of a system-wide automated solution. Using radio-frequency identification (RFID) technology like that found in retail stores for theft prevention, some

of Athletic Republic’s training and testing equipment contains a prototype data entry system that instantly records the athlete’s workout information and enters it into a database. Before stepping on a treadmill or using the instrumented leg press, athletes scan an RFID wristband and the details of their lift, run, or sprint test are tracked by computer software. “If I test somebody on the leg press or treadmill, their performance is automatically uploaded to our database and the athlete can immediately log on to see it and get feedback,” Swanson says. “It helps us more efficiently manage the information and allows athletes to get more out of their time with our coaches.” Swanson says the future of strength training lies in taking an evidencebased approach to improving program design, and bringing less experienced coaches up to speed more quickly. He says data management and analysis are major keys to this trend. “If we can capture and analyze this mound of information effectively, our new coaches and those with less experience will have access to planning strategies rooted in the successes and failures of a large population,” Swan-

VIBRATION TRAINING One innovative tool that’s quickly growing in popular-

“Vibration plays a large role in our training programs,”

ity is vibration training. Using Power Plate platforms

says Nick Winkelman, Education Manager for Athletes’

from Power Plate North America, coaches at Athletes’

Performance. “It’s primarily for neuromuscular

Performance’s three training centers utilize vibration as

activation, corrective exercise, and movement aware-

a stimulus during prehab and movement prep, and as

ness—we’ll ask the athlete to perform a movement

part of movement and strength training sessions.

pattern on the plate, then repeat it on the ground.

The idea behind vibration training is simple: Repetitive

“We’re also using it more and more as a preactivation

impulses from the platform excite muscles’ motor

tool,” Winkelman adds. “Vibration is great for enhanc-

neurons, causing the fibers to contract. Vibration has

ing power movements, whether it’s with plyometrics or

been shown to affect the sensory, neuroendocrine,

in the weightroom.”

and cardiovascular systems. For athletes, benefits are thought to include increased flexibility, increased

bone density, synchronization of motor units,

To read an article about vibration training previously

increased hormonal secretion, and preactivation of

published in T&C, visit: www.Training-Conditioning.com

the musculoskeletal system.

and type “Vibration Training” into the search window.

T&C MARCH 2009

TR AINING-CONDITIONING.COM

optimum performance son says. “They hit the ground running, and benefit from the collective wisdom of others.” TREAD AHEAD Long a staple of training facilities, treadmills have undergone some impressive upgrades in recent years. Currently, Athletes’ Performance is testing a new treadmill from Woodway called the Speed Board. It has no motor, and its free-motion deck lends itself to speed training. Because the Speed Board slows with the athlete’s pace and doesn’t force the user to step off when they can’t run fast enough to keep up with the machine, it allows athletes to train at top-end speed in a safe, low-impact environment. “We typically use it in short intervals,” Winkelman says. “For max velocity work, it will be for less than 10 seconds. Once we see posture break down, a typical indicator of fatigue, we have the athlete step off.” Winkelman says it also helps him advance a concept called potentiation, which he defines as using high-velocity or high-force movement to increase neu-

ral drive to the muscles during unloaded repetitions. “With our advanced athletes who are more confident in their running mechanics, we use it as a short-term potentiator by keeping them on it for a fivesecond burst,” he says. “They feel like they’re moving faster than they would be on the ground, but none of the speed is artificial because it’s not created by a

over 16 miles per hour. A handful of elite college hockey programs, including Cornell University and the University of Minnesota, also use this technology. “The Hockey Treadmill allows skaters to work on their movement mechanics while watching themselves in a mirror or in front of a coach,” Swanson says. “The athletes can work on getting

Shaw has trained over 117 NFL first-round draft picks ... His philosophy on linear speed development is simple. “We try to increase each athlete’s vertical jump, standing long jump, stride length, and stride frequency.” motor. When they get back on the track, the potentiation from that short burst translates into real speed gains.” Athletic Republic has integrated its treadmills with technology that could be described as a slippery slope. The Hockey Treadmill contains a synthetic ice-like surface designed to train skaters to move more efficiently. Capable of tilting to a 32-percent grade, it uses two-inch slabs of fake ice implanted on the foot bed and can operate at speeds

down in the proper stance and use hip muscles that are really tough to train in the weightroom. It also offers the potential for video feedback after each session.” NEED FOR SPEED When a top NFL prospect wants to lower his 40-yard dash time and elevate his draft stock, he is often referred to Tom Shaw. A longtime strength and conditioning guru and former speed and con-

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T&C MARCH 2009

optimum performance ditioning coach for the New England Patriots during their recent Super Bowl runs, Shaw has trained over 117 NFL first-round draft picks and coached five of the six top 40-yard performers in Scouting Combine history. His calling card is speed development, and though he claims his methods aren’t sexy, his results are off the charts. Shaw’s philosophy on linear speed development is simple. “We try to increase each athlete’s vertical jump, standing long jump, stride length, and stride frequency,” says Shaw, who is also one of

six Nike Sparq Master Trainers. Among Shaw’s favorite tools for increasing stride length are stride checkers—50-yard patterns of ropes or sticks laid out on grass or a track that athletes try to strike with their feet. “The first 10 markers are 18 inches apart, and then the distances are progressively lengthened by four inches every two targets until there is a distance of eight feet between the last two sticks,” says Shaw, whose training facility is located inside Walt Disney World’s multi-million dollar

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Wide World of Sports Complex. “The runner’s goal is to stay in a forwardleaning position while keeping their elbows pumping at the same rate of speed even as the strides lengthen. You want to maintain that frequency while improving stride length.” For most athletes navigating the course, which is run at top speed, one pass takes six to eight seconds. “We’ll start off running it two or three times, and depending on how tired their legs are after that, we’ll do up to five,” Shaw says. “It’s the most important part of our training sessions.” Shaw also utilizes both assisted and resistance running with bungee cords and a launch belt. For assisted running, he hooks a bungee cord to the athlete’s waist and attaches the other end to a partner, who then pulls the athlete forward as they run at top speed, creating an effect similar to sprinting downhill. The resistance drills operate in reverse, with the partner pulling backward on the bungee cord. In other resistance drills, the athlete pushes against the resistance of a cart driven by Shaw. “I try to get them in a power position with their legs driving straight ahead and their feet pushing into the ground.” Shaw says. “The weight of the cart provides resistance on their first step, which is very important in a 40.” A typical speed workout with Shaw might start with three 30-yard resisted runs. “Then I may have them do three more 20-yard sprints, but I’ll release the launch belt after 10 yards so they run the last 10 with no resistance,” he says. “Then, they might do three 30-yarders with no resistance. At that point, they usually feel a lot faster—and eventually, they are.” n

RESOURCES More information on the ideas and equipment detailed in this article can be found at the following Web sites: AthletesPerformance.com AthleticRepublic.com

ACSM, AFAA, NATA/BOC Total Training Seminars are approved for continuing education courses by the above organizations.

visit totaltrainingseminars.com or call 1.800.321.6975

3 4

SparqTraining.com CoachTomShaw.com VelocitySP.com

Circle No. 124 T&C MARCH 2009

TR AINING-CONDITIONING.COM

Saving Knocked-Out Teeth During Sports 800,000 teeth are knocked out during sports each year! These teeth can be saved, but do you know what to do? Now you can have Save-A-Tooth® as a vital first aid component Each year approximately eight hundred thousand teeth are knocked out (avulsed) during sports activities in the U.S. alone. 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.

Save-A-Tooth®… In order to be prepared for these incidents, athletic trainers should have Save-A-Tooth , emergency tooth preserving systems, available with their first aid supplies. Save-A-Tooth® contains a pH-balanced cell preserving solution, called Hank’s Balanced Salt Solution, and a removable basket and net that suspends knocked-out teeth in the solution preventing cell crushing. 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.

Be Prepared! Order Save-A-Tooth® Today

www.Save-A-Tooth.com

(888) 788-6684 Circle No. 125

Circle No. 126

special focus: preventing mrsa

Searching for Answers From locker rooms to hospital rooms, MRSA continues to threaten athletes’ health and safety. In this Q&A, an infectious disease expert sorts fact from fiction and explains how to minimize the risk. With Jeff Hageman

f you keep up on the news about methicillin-resistant Staphylococcus aureus (MRSA), it’s a good bet you’ve seen at least a few quotes from Jeff Hageman, MS, Assistant Director for Antimicrobial Resistance at the Centers for Disease Control and Prevention (CDC). With over 10 years at the CDC, Hageman, an epidemiologist, is one of the world’s foremost experts on MRSA and other staph infections. Hageman’s duties include directing lab research, conducting outbreakcontrol measures, and evaluating and

TR AINING-CONDITIONING.COM

implementing prevention and intervention strategies. He’s done field investigations and technical consultations with high schools, NCAA institutions, and pro sports teams and associations, as well as the U.S. military and state and federal prisons. The work Hageman does at the CDC leads directly to guidelines and recommendations for the prevention and containment of MRSA, staph, and other types of infection. In this conversation with Training & Conditioning, Hageman explains how MRSA poses a threat in many different settings, and

shares his expertise and advice on how to keep athletes safe. T&C: MRSA in healthcare facilities, especially hospitals, has been in the news lately. Why do so many hospitals struggle with MRSA? Hageman: Hospitals have been battling MRSA for several years, so it’s not exactly a recent development, but now there’s heightened attention to it and there has been a greater focus on prevention. Ten years ago, most people thought certain infections were inevitable—no matter what we did, some hosT&C MARCH 2009

special focus: preventing mrsa pital patients were going to get staph and MRSA. But there’s been a paradigm shift, and people now realize that we can control MRSA and prevent new infections. How are MRSA infections typically transmitted in hospitals? For one thing, people aren’t usually hospitalized unless they are very sick, so they’re often at higher risk for infections in the first place because their immune systems are weakened. And one out of every three people carry staph bacteria on their skin (though that doesn’t mean they’re infected), so over 30 percent of

cedures that athletes typically undergo, the infection rate is even lower. What can someone do to limit the risk of contracting MRSA or another infection when visiting a hospital? Patients undergoing surgery should receive instructions on staph prevention prior to their procedure. They’ll often be prescribed an antibiotic before the surgery, which they should always take according to the doctor’s instructions. Another control practice is using an antimicrobial or antiseptic agent on the surgical site for several days before the procedure, which will

“Any break in the skin can become an infection site, whether it’s a visible abrasion or a micro-abrasion caused by something like shaving or putting in a catheter. All that needs to happen is for bacteria to get into the skin opening.” patients and visitors bring staph into the hospital on any given day. Any break in the skin can become an infection site, whether it’s a visible abrasion or a micro-abrasion caused by something like shaving or putting in a catheter. All that needs to happen is for bacteria to get into the skin opening. Staph and MRSA are usually transmitted in hospitals by nurses, doctors, and others picking it up on their hands while working with someone, then having a lapse in hand hygiene and passing the bacteria to another patient. Athletes often worry about the risk of infection after surgery. How does MRSA typically get into a surgical wound? For joint surgeries, which are common among athletes, staph doesn’t have to get in at the time of the surgery, particularly if foreign material is implanted. If you have pins or plates put into a knee or hip, for instance, staph can get in some time later through a break in the skin, and once it enters the bloodstream, it typically finds those pieces of foreign material. It can then bind to them and cause infection after the fact. Overall, the risk of surgical infection is quite low. Everyone sees the headlines when a high-profile athlete gets infected after surgery, but there are roughly 27 to 30 million surgical procedures in the U.S. each year, and only 300,000 surgery-related infections—that’s only about one percent. For orthopedic pro 8 3

T&C march 2009

decrease the amount of bacteria on the surface of the skin. The most important advice is to closely follow all pre-op instructions. What happens when MRSA gets into a surgical wound? Surgical-site infections are broken down into several categories. Some are very superficial and don’t go beyond the skin surface, and others involve deep organ and tissue infection. The superficial in-

aren’t taken, the impact can be devastating. Once staph and MRSA are inside the body and reach the bloodstream, they can travel anywhere, leading to complications like pneumonia. If the bacteria get into the bone, they’re very difficult to remove. Though it’s rare, in advanced cases, limb loss and death are possible. What are the early signs of an infection? Usually, the signs of a MRSA infection include fever, pain at the site, redness or other discoloration, and increased drainage or production of pus from the area. After surgery, discharge instructions should include a complete list of symptoms to watch out for. If a patient doesn’t receive that information, they should ask their physician about it. Once an infection is identified, how is it treated? The first step is usually draining and cleaning the infection site. Sometimes this can clear all the bacteria out of the area. Then the patient will often receive a special type of antibiotic that MRSA is not resistant to. Depending on the type of infection, its location, and how early it’s caught, it may take a long course of antibiotics to completely get rid of it. But the good news is that we’re not running out of

“Everyone sees the headlines when a high-profile athlete gets infected after surgery, but there are roughly 27 to 30 million surgical procedures in the U.S. each year, and only 300,000 surgery-related infections—that’s only about one percent.” fections tend to be less severe, while the deep infections that get into a joint can be more traumatic and damaging, especially when foreign material is involved. It can often result in having to redo the surgery, taking out the original material and putting in new material. MRSA infections cause a heightened inflammatory response, which leads to tissue destruction. In joints, where white blood cells don’t penetrate the area well, the destruction can be severe. Many bacteria, including staph and MRSA, secrete toxins that can further break down tissue and bone. If the symptoms of an infection aren’t recognized early and appropriate steps

antibiotics that kill MRSA bacteria. It’s just a matter of a physician identifying the infection as drug-resistant and writing an appropriate prescription. What other settings outside of athletic facilities pose the greatest risk to athletes? People can get infections virtually anywhere—it’s difficult to pinpoint high-risk areas. Institutional and closed-group settings, such as prisons, have a lot of problems with MRSA, but hopefully athletes don’t find themselves there. Any place where a lot of people are present, a lot of bacteria will be there as well. TRAINING-CONDITIONING.COM

(in vitro)

To learn how to prevent MRSA call or visit Circle No. 127

special focus: preventing mrsa Athletic trainers should understand that when an athlete gets a staph infection, they might not have picked it up in the athletic setting. So while it’s important to raise awareness and make sure there are no other active infections on the team, they also need to ask

If I had to choose one thing, it would be signs and symptoms: what MRSA looks like and how to recognize a possible infection. Without that knowledge, treatment of infections will be delayed and there’s increased likelihood of transmission within the team environment.

“Even if someone comes into contact with MRSA or staph and gets it on their skin, it doesn’t cause an infection instantly. If they wash it off the skin surface, it doesn’t have a chance to infect tissue.” the athlete about personal contacts— roommates, girlfriends, boyfriends, family members, and close friends. If one of those people has an active infection, they might be continually introducing it to the athlete, so it won’t go away. And with each subsequent infection, there is always the risk of spreading it among the team. What should all athletes know about protecting themselves from MRSA and staph infections in their daily lives?

Some teams distribute fact sheets to their athletes listing symptoms to watch out for and stressing the importance of seeking medical help immediately. We’ve worked with several national sports associations, like the NCAA, to create educational posters and other materials that are disseminated to schools. It’s important for athletes to understand that MRSA can take several forms—there’s quite a spectrum of how these infections can look. It’s also extremely important for athletes to learn about and practice good

TTENTION ATHL TIC TRAINERS

Circle No. 128

hygiene habits. They should wash their hands after touching frequently used items in the weightroom and at practice. They should never share towels, razors, soap, or other toiletries. And showering is important after practices, workouts, and games. Even if someone comes into contact with MRSA or staph and gets it on their skin, it doesn’t cause an infection instantly. If they wash it off the skin surface, it doesn’t have a chance to infect tissue. Another step is to prevent skin abrasions, since these are common entryways for MRSA bacteria. Many sports carry an inherent risk of abrasions, particularly contact sports like football and wrestling. Using equipment and apparel to protect exposed areas of the body helps prevent breaks in the skin. If an athlete does have a skin abrasion, they should make sure to keep it clean and cover it with a bandage right away. Athletic trainers should have wound care supplies and anti-infection wound dressings on hand. And in all cases, athletes should keep the wound covered until it has healed completely. In addition to limiting person-to-

special focus: preventing mrsa person transmission, keeping a wound covered prevents staph from spreading to other body parts. What specific cleaning products are most effective against MRSA and other bacteria? The CDC has put fact sheets on our Web site to address this question. [See the “Resources” box on page 43 for a link.] We recently posted one about environmental management of MRSA, with information on laundry and surface cleaning and disinfection. In many cases, basic cleaning with soap, water, and detergent are sufficient to remove MRSA and staph from a surface. But with any product, it’s important to follow the instructions on the label. If you’re using a disinfectant, it should be registered with the Environmental Protection Agency (EPA)—there should be an EPA number listed on the label. That label ensures there is data to support the effectiveness of the product. For most cleaning applications, it’s not so much what you use, but using it properly and following a regular cleaning routine. For example, athletic train-

ing room equipment should be cleaned after each use. You can never create a completely sterile environment because bacteria spreads whenever people touch surfaces, but good cleaning habits can go a long way in reducing risk. Should an athlete with a MRSA infection be kept from participating in their sport? If the infection site can be kept covered, the athlete might be allowed to participate, especially in non-contact sports. It depends on where the infection is

clude the athlete from participation. Wound coverage in contact sports is a major challenge. In football, for instance, an infection on an athlete’s arm might be bandaged before a game, but between sweat, contact with the ground, and contact with other players, that bandage might come loose or fall off during play. That can even happen in sports with limited person-to-person contact like soccer. If a wound has the potential to become uncovered, that athlete should sit out until it has completely healed.

“We also recommend that athletes with active infections not use whirlpools or other therapy pools. In fact, that goes for anyone with a skin abrasion, because staph can survive in water.” and whether there’s a risk of spreading MRSA bacteria to others. If it’s on a body area that’s hard to keep covered and there’s potential for drainage or other matter from the wound to get on surfaces or other people, it’s best to ex-

We also recommend that athletes with active infections not use whirlpools or other therapy pools. In fact, that goes for anyone with a skin abrasion, because staph can survive in water. People with abrasions open themselves

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special focus: preventing mrsa up to infection by getting into a common-use pool.

why that team was more susceptible to a MRSA outbreak.

A few college teams that have struggled with MRSA have considered using antibiotics preventatively. Is that a good idea? For MRSA prevention, there’s no evidence to support that practice. Fur-

What misconceptions persist about MRSA and the risk of transmission? One is the idea that MRSA isn’t treatable. People call it a “superbug,” and the only cases that make news are the tragic ones, and that creates a sense of

“Another misconception is that good prevention is just about having the best resources—that’s not the case. In the NFL, they have the best physicians, great athletic training facilities, and all the latest technology, but athletes still get infections.” thermore, we know that overuse of antibiotics leads to new bacteria that are drug-resistant, so you could actually do a lot of harm by using antibiotics indiscriminately. When the CDC investigated an outbreak among the St. Louis Rams in 2003, we found that the players received 10 times the amount of antibiotics that the general population in the same age group received. Heavy antibiotic use could have been one reason

alarm about MRSA. But in reality, an infection isn’t cause for panic—just a fast response. It is treatable, especially when it’s only a skin infection, which most cases are. The earlier it’s treated, the better the outcome, so the key is being well-educated. Another misconception is that good prevention is just about having the best resources—that’s not the case. In the NFL, for instance, they have the best physicians, great athletic training facili-

What common mistakes might an athlete or athletic trainer make regarding infection control? When someone receives antibiotics, it’s common for them to stop taking the medication when their symptoms resolve. Antibiotics control bacteria so the body can catch up and eliminate it, but if you stop taking them too soon, your body won’t kill the bacteria. Unless a physician tells the athlete to stop taking the antibiotics, he or she should always complete the course. For athletic trainers, a common error might be not taking a proactive approach to identifying infections. Any time a skin problem looks suspicious, the athlete should be referred to a physician who can perform any needed tests and make a diagnosis. Athletic trainers also need to follow up with athletes

For For a a Free Free skin skin * infection ID infection ID card card*

According to a recent study performed by the College of According to a recent study performed by the College of Pharmacy at Oregon State University, StaphAseptic was Pharmacy at Oregon State University, StaphAseptic was found to be substantially more effective at killing MRSA found to be substantially more effective at killing MRSA than other OTC minor wound care products.* The ointmentthan other OTC minor wound care products.* The ointmentlike gel, made with Benzethonium chloride, tea tree oil and like gel, made with Benzethonium chloride, tea tree oil and white thyme oil, killed MRSA quicker and more effectively white thyme oil, killed MRSA quicker and more effectively than the other compounds tested, and had a sustained than the other compounds tested, and had a sustained killing effect for 24 hours. Also included in the testing were killing effect for 24 hours. Also included in the testing were products made with neomycin and polymyxin; and another products made with neomycin and polymyxin; and another made with polymyxin and gramicidin. These other made with polymyxin and gramicidin. These other compounds are commonly found in “maximum strength” compounds are commonly found in “maximum strength” or “triple anitibiotics”. or “triple anitibiotics”. Breaks in the skin are the most common entry points for Breaks in the skin are the most common entry points for staph bacteria. Apply StaphAseptic to cuts, scrapes and staph bacteria. Apply StaphAseptic to cuts, scrapes and abrasions to kill MRSA, staph, strep and other germs to abrasions to kill MRSA, staph, strep and other germs to help prevent skin infections. help prevent skin infections. *Bearden, D.T. (2007, Dec.). Poster presented at the ASHP Midyear Clinical Meeting, Las Vegas, NV. *Bearden, D.T. (2007, Dec.). Poster presented at the ASHP Midyear Clinical Meeting, Las Vegas, NV.

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What is the latest news in the fight against MRSA? Things are pretty much as they’ve always been. Methods for preventing skin infections today are no different than they were 10 years ago, but we need to be more vigilant about following them. It’s up to the athletes to follow through with proper precautions, and it’s up to athletic trainers and coaches to promote good hygiene and awareness. At one college I consulted with, athletes weren’t showering after practice, and when we talked to some of them, we figured out the reason: They didn’t think the shower room floor was sanitary, and they didn’t want to go in with bare feet. So the school included shower shoes as part of its uniform handout. Sometimes, it’s just a matter of taking simple steps to create a culture of awareness about the risk. n

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sport specific

Syracuse University won the 2008 NCAA Division I men’s lacrosse championship last May.

John Mecionis

Staying on Top To defend its 2008 men’s lacrosse title, the Syracuse Orange is working hard, but also working smart. A four-phase training approach ensures that players address all areas of conditioning and optimize performance when it matters most. By Hal Luther

istorically, only a few teams have had a real shot at the NCAA Division I men’s lacrosse national title each season. In the past 15 years, the Division I crown has rotated between just four schools— Syracuse University, the University of Virginia, Princeton University, and Johns Hopkins University. Syracuse has claimed six titles in that span, and we enter 2009 as the reigning champs. But the landscape of college lacrosse is changing fast, and those changes are exciting. The sport has grown much more competitive in recent years, and

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this season, at least a dozen teams have legitimate title hopes. I expect that number will only grow, as more high school athletes take up the sport and it spreads beyond the traditional lacrosse hotbeds. More and more programs are assembling teams of highly skilled, highly conditioned athletes hungry to join the elite ranks of college lacrosse. At Syracuse, we know this is no time to rest on our laurels. To keep our place at the top, we’re working harder than ever on building and conditioning our players with an approach aimed at making steady progress every week, every month, and every season.

ESTABLISHING A PHILOSOPHY To lay the foundation for everything we do in strength and conditioning, we start with this philosophy: We want each individual to become a highly conditioned, more explosive, mentally tough, balanced athlete. To achieve this, we follow three specific rules at all times. Trust. The athletes must trust the strength coach and vice-versa. To enHal Luther, MS, CSCS, is Director of Strength & Conditioning at Syracuse University, where he works with the football and men’s lacrosse teams. He can be reached at: hcluther@syr.edu. T&C march 2009

sport specific sure that the athletes believe in me, I explain the rationale behind everything we do and outline in specific terms how each activity will enhance their athletic potential. I never leave them thinking, “Is this really the best way for me to train right now?” or “I’m really wearing myself out—is this worth it?” I have to trust them as well, believing they’ll tell me the truth about work they’ve done on their own over breaks and during the summer, even when they haven’t made the progress we hoped for. That’s the only way I can identify and correct problems, and make necessary adjustments to their individual strength and conditioning plans. If an

pared to their teammates, but by the way their numbers stack up against what they did yesterday, last week, or last semester. We constantly encourage our players to win the little battles as they train: five more pounds, one more rep, one second faster. If they can do that every week over four or five years, it really doesn’t matter where they start—they will maximize their performance on the field. MULTI-PHASE APPROACH For most athletes, it’s not enough just to be talented at the college level, even if raw talent made them stars in high school. As I explain to our new players,

Lacrosse players need to perform short bursts of maximum power output ... They constantly switch back and forth between the anaerobic and aerobic energy systems during a game. This leads to rapid buildup of lactic acid and debilitating fatigue if the body hasn’t been trained properly. athlete isn’t making progress with a specific lift, he might be doing it incorrectly or we may need to adjust the activity. Accountability. In order to manage a large number of athletes (our team has around 50), a disciplined approach is necessary. Our players treat training sessions the same as practice: They’re required to show up early, dressed and ready to perform. A disciplinary system is in place for missed workouts, just like with practices, classes, and study table sessions. An athlete who misses a workout might find himself making it up at 6 a.m. in a one-on-one session with me, or doing extra running under the supervision of our captains. Sometimes the entire team shares in the punishment, under the “one fails, all fail” principle. Technical Proficiency. We make proficiency a part of our core philosophy because we know that performing each activity correctly is a key to our success. If body position is compromised during a lift, we don’t have adequate spotting, or agility movements are allowed to get sloppy, our entire conditioning program will be watered down, and even worse, we’ll put our athletes at risk for injury. Those outcomes are not acceptable. Following these three rules, we strive for improvement in every session. I measure an athlete’s progress not by the numbers they generate com46

T&C march 2009

“In high school you were on a team— in college you are part of a program.” That means college lacrosse is a 365day yearly commitment, with scheduled time off. Our program’s calendar is built around four phases, or mesocycles. Each has specific goals, following a logical progression that puts the players in peak physical condition for the season. I see my role as providing our coaching staff with the best conditioned athletes possible, and the coaches take that “raw material” I’ve provided and create outstanding lacrosse players. The better I do my job, the faster, more intense, and ultimately more productive practices will be. Phase I begins in the second week of July and continues until the first week of September, when athletes report for the fall semester. The month prior, our players don’t follow any formal conditioning plan, taking time to recharge after the previous season (which typically ends on Memorial Day weekend). Phase II runs from the first week in September to the first week in December, and includes six weeks of fall practices. Phase III goes from the second week in December until the first week in January, when players report after winter break. Phase IV is our preseasonseason-postseason training regimen. Phase I. At this time, we focus primar-

ily on muscle endurance, core strength, establishing technique, and overall fitness. The bulk of serious weightlifting will come later. First, we want our athletes’ neuromuscular systems, tendons, ligaments, and joint structures to be conditioned for hard work. Our strength base program is the same for each athlete, built around the “big three” movements: bench, squat, and hang clean. Lacrosse is classified as a contact sport, not a collision sport like football and hockey, but it does involve very intense collisions and I want our athletes equipped with the pure strength needed to be on the “giving end” of these hits more often than the “receiving end.” Our workout schedule in Phase I uses four-day splits with two days of rest built in. The first two days of the week are the heavier, more intense days, with one focusing on the upper body and one on the lower body. On the third and fourth days, we decrease intensity and increase volume or speed of movement, again breaking the work into upperand lower-body sessions. This way, we can focus on nailing down proper lift technique, improving general fitness, and recruiting the fast-twitch muscle fibers needed to perform an exercise with speed while not sacrificing control. It also gives us a jump-start on the muscle building that will be our top priority later on. Phase II. Next, we focus on developing size, strength, and power. We cut back from four days a week to three, and the structure also changes: All three days—a heavy day, a speed day, and a work day—consist of full-body workouts, with no more division between upper- and lower-body exercises. The heavy day focuses on the bench press, squat, and hang clean, along with a few assistance movements, such as shoulder circuits, dips, pull-ups, and push-ups. The weight loads are high to deliver maximum hypertrophy, so I generally keep the number of reps low (under six per set), especially when the athletes are first getting used to a lift or an increased weight load. This limits muscle fatigue and helps prevent mechanics from breaking down near the end of a set. The speed day is designed to enhance speed of movement during certain lifts. We’ll focus on exercises that can be performed with speed, such as DB rips (DB hang cleans), DB rip and press, TRAINING-CONDITIONING.COM

sport specific jump squats, split squats, squat holds, high pulls, and power shrugs—these activities will translate into power gains. This is also a time when we pay close attention to technique. Once the athlete can perform a movement with proper technique slowly, we’ll gradually increase their speed. The work day is just what it sounds like. The athletes come into the weightroom on Friday mornings at 7 a.m. and just work for 45 minutes. They can get in extra reps on an exercise they struggled with earlier, work on a specific type of strength they’d like to improve, or perform remedial work in any areas where they’re deficient. On a typical work day, you can look around our weightroom and see athletes doing core exercises, push-ups, manual squats, jump squats, split squats, squat holds for time, and plate work. There’s a psychological element to this day as well, as everyone understands that it’s a time to bear down and work hard. The players use a concept called “holding the rope” to reinforce this idea. Anytime a teammate feels like giving in or taking a break, the others will pull him through by shouting “Hold the rope!” The message is that we’re all in this together, and everyone is expected to hold up their personal end of that bargain. Phase III. This phase is dedicated primarily to conditioning. With most size and strength gains completed, our goal is to make sure newly built strength shows up in the fourth quarter of games just as it did in the first. Lacrosse players need to perform short bursts of maximum power output involving both the upper and lower body, then “reload” while moving, over the course of a two- to three-hour period. If they’re not in shape for that level of work capacity, their sport-specific technique will break down and mental fatigue will compound the problems. Fatigue can make a coward of anyone: An exhausted player doesn’t want the ball on his stick in the fourth quarter of a tie game. A lacrosse player constantly switches back and forth between the anaerobic and aerobic energy systems during a game. This leads to rapid buildup of lactic acid and debilitating fatigue if the body hasn’t been trained properly. In Phases I and II, our conditioning efforts consist mainly of running, with some emphasis on speed development TR AINING-CONDITIONING.COM

and change-of-direction drills. When Phase III begins, the volume of conditioning work increases and we follow a progression schedule that allows each athlete to maximize personal progress. Each day of the week in the conditioning phase has a different emphasis. Monday is our stride program: The athletes complete sets of 20-, 40-, 60-, and 80-yard strides and finish with a 440-yard gasser. On Tuesday, we perform a program with the jump rope, the simplest form of plyometrics and in my opinion a lost art. On Wednesday,

we do half-gasser training (220 yards), with the number of reps, time goals, and length of rest periods changing on an individualized basis throughout the phase. Thursday is spent on a variety of running and movement drills that develop speed, agility, and quickness. Friday is the conditioning self-test, which I’ll describe later on. I want all our athletes to make progress in these conditioning cycles each week. For example, if we ran Monday’s strides as 4x20, 4x40, 4x60, and 4x80 yards this week, next week we’ll add

Circle No. 134 T&C MARCH 2009

sport specific two more reps at each distance. We make similar gradual increases to every conditioning activity throughout the conditioning phase. I talk to the players frequently to get their feedback on conditioning work. I want them to push themselves and each other to improve, but I don’t want to beat them into the ground to the point where the work becomes counterproductive or interferes with their other activities. If I feel we’ve “maxed out” the benefits of our progression in a particular activity, I’ll recalibrate the sets and reps or switch to a different exercise to keep things fresh. I want them coming back for more every day—not feeling overwhelmed and discouraged by a daunting workload. Our Friday self-test is one of the most challenging sessions on the calendar. It consists of three 440-yard gassers with five minutes of recovery time between each one. The lacrosse field is 110 yards long from end line to end line, so each gasser involves two round trips. We keep track of players’ individual performance from week to

week, and the desire to finish a second or two faster each time is a great motivator. The conditioning self-test is useful at other times during the year as well. We conduct it when athletes first report in the fall, with these time goals: 65 seconds for the first gasser, 70 for the second, and 75 for the third. If someone took the whole summer off from conditioning work, that will be easy to see— he might complete the first gasser in the allotted time, but probably not the second, and he may not even line up for the third. On the flip side, athletes who took conditioning seriously are proud to show they can complete the test with time to spare. Phase IV. Once the preseason begins, all of our strength and conditioning activities shift into maintenance mode. We decrease work volume and frequency, and our workout schedule is built around preseason practice, then the regular season and postseason calendar. I still vary the activities to keep the athletes challenged, and I’m always cognizant of the team’s practice and game demands to avoid overuse injuries.

FINER POINTS When planning workouts within the four-phase framework, we have a few philosophies that go against the grain. The first involves order of exercises. Virtually all of our plyometric movement patterns are interspersed among our strength training sessions, instead of being reserved for a specific time or session, which is common practice in many strength programs. I feel this is important because it places demands on the body that imitate those of an actual lacrosse game. For instance, in one of our typical strength workouts, each pure strength move (such as the bench or squat) is followed by a plyometric or speed move (such as the plyo push-up or jump squat). This approach, sometimes called “contrast training,” also helps keep the athletes engaged by challenging different body systems in close succession. Another important aspect of our workout planning involves weight load selection. I don’t believe in using percentages based on an athlete’s maxout performance in the first session of the year. Over time, I’ve recognized the

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sport specific simple truth that some athletes adapt to exercises and build muscle more quickly than others. So rather than setting percentage-based long-term schedules for individual strength training, I’ll set new goals for a workout based on each athlete’s previous workout performance, making incremental increases that ensure consistent progress without risking overload. I usually set a base weight for everyone in the first training session (135 pounds on the bench, 185 on the squat, 155 on the hang clean) and evaluate each athlete’s performance. In subsequent workouts, I might increase the load by five to 10 pounds per set, with personalized attention to see who can handle more and who is reaching their max. It all goes back to our philosophy of winning the little battles: five more pounds, one more rep, constantly moving forward. Another key aspect of our workout planning involves the use of a dynamic warmup that focuses on the core. The core is the power source for what I call the athlete’s engine. Everyone wants to run faster, jump higher, and throw fur-

ther, and the core is an integral part of all those skills. After traditional dynamic warmup activities, which might include jumping rope, hurdles, form running, and functional hip mobility drills, we turn to core work. The athletes’ functional core strength begins at the waist line and goes south, so our core regimen includes movements such as big leg kicks, riding the bike, both legs up and down, feet straight up, and reaching for the toes—there are literally thousands of variations. I usually pick 10 to 12 exercises and we do 10 to 25 reps of each, with no rest period in between. PLAYING THE SALESMAN A final element of our training program involves knowing how to get all the athletes on board with strength work. Unlike football players, lacrosse players often are not experienced in the weightroom when they begin college. In fact, some have consciously avoided it, not wanting to upset the physical routines that obviously worked well for them in high school. This is where the salesman in the strength coach has to come out.

For me, the key is finding a way to make my “product” appealing on an individual basis. Once I’ve gotten to know the athletes, I can hone in on what will appeal to their needs—a smaller athlete might be most interested in strength gains, a slower one might want to improve running proficiency or changeof-direction mechanics, and one who has struggled with injury might be sold on the prehab benefits of a strength program. One aspect I know I can sell all the athletes on is mental toughness. This is the quality that separates good players from great ones, and our strength program strives to instill it in everyone. Whether it’s seniors pushing freshmen and sophomores to run their hardest during the gassers, teammates training together on the field through rain, wind, and snow, or players at early morning workouts urging each other to “hold the rope,” we build team chemistry by lifting together, sweating together, and hurting together. It’s hard work, but as our 2008 team proved to themselves and their successors, the rewards are great. n

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Battling Bacteria 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. TELFA™ AMD antimicrobial wound dressings from Covidien 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 proven to prevent bacterial 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 Covidien at 800962-9888 or visit www.covidien.com. Circle No. 500 Z-Cool shoulder pads from Gear 2000 are patented air- and moisture-transferring shoulder pads with antibacterial foam padding. The foam used to make Z-Cool shoulder pads will not absorb moisture from perspiration. As a result, odor buildup is eliminated and the pads are 35 percent lighter and cooler for the wearer, which can contribute to enhanced performance on the field. These pads are used by pro athletes, NCAA Division I college programs, and high school state champions. To find out more, call 785625-6060 or go to www.gear2000.com. Circle No. 501 GymWipes antibacterial formulas provide full-spectrum sanitation for all equipment surfaces. They will safely sanitize fitness equipment and kill germs that can cause illness. Full-spectrum disinfecting is fast and easy, as the EPA-registered formulas will kill a variety of harmful bacteria such as Staphylococcus and MRSA, along with HIV. The wipes are pre-moistened, disposable, alcohol-free, phenol-free, and bleach-free. The new Megaroll 1200 adds an economical option to the GymWipes line. A variety of dispensers and stands are TR AINING-CONDITIONING.COM

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Battling Bacteria

Stromgren compression and protective performance garments are treated with an antimicrobial agent that may assist in protecting the wearer from MRSA bacteria. The antimicrobial agent has been developed to attack and hopefully kill MRSA. To find out more, call 800-527-1988 or go to www.stromgren.com. Circle No. 506 In a recent study performed by Oregon State University, StaphAseptic was tested against four strains of MRSA compared to compounds made with neomycin and polymyxin, and polymyxin and gramicidin. StaphAseptic was the only compound to have genuine bactericidal effects against all four MRSA strains. Use StaphAseptic on cuts, scrapes, and abrasions to help prevent skin infections from MRSA, staph, strep, and other germs. StaphAseptic also contains lidocaine for pain relief. To find out more, Call Tec Laboratories at 800482-4464 or visit www.staphaseptic.com. Circle No. 507

GymValet is a holder for disinfectant spray bottles and towels. Achieve and maintain a clean and sanitary environment for your athletes by providing convenient access to your sanitizing system for conditioning equipment, the athletic training room, and hard surfaces. GymValet is easy to install, as it attaches to both equipment and walls. It’s also economical—the durable holders last for years, and a sanitizing system based on spray bottles and towels saves countless dollars versus disposable wipes. With the GymValet holder, the disinfectant solution/system is always right at hand. For more information, call 866-435-2009 or visit www.gymvalet.com. Circle No. 508

The Most Innovative On-Line Buyer’s Guide for Athletic Organizations

AthleticBid.com is a free service to help buyers at schools and athletic organizations contact many companies in the most efficient fashion to request product specs and pricing information. It used to take hours to contact dozens of companies to research products and plan purchases. But by using AthleticBid.com it now only takes minutes.

l View the complete product lines of companies listed. l View catalog pages or spec sheets from many of the top companies. l Read a profile or description of select companies. l Send an e-mail directly to a supplier or make a request to be contacted by a company representative. l Request catalog and sales literature from companies.

See for yourself why more than 13,000 unique users each month rely on

Athleticbid.com 52

T&C march 2009

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New ProductS

China-Gel Unique features: • New slim-line bottle allows for easy storage in equipment bags • Seven herbal ingredients • Pleasant scent and smooth texture • Can be used with ultrasound Benefits for the user: • Fast, convenient, and effective pain relief

The M5 Strider Unique features: • An exciting and innovative magnetic group elliptical • Comfortably adjusts to accommodate a wide array of users • Designed, engineered, and manufactured in the U.S. to strict quality standards Benefits for the user: • Powerful computer system tracks power output and offers workout feedback • Works both the upper and lower body, increasing muscle activation and caloric output

China-Gel, Inc. www.chinagel.com 800-898-4435 Circle No. 510

Keiser Corp. www.keiser.com 800-888-7009 Circle No. 511

N e w

P r o d u c t s Matguard® Blood Spot & Body Fluid Cleaner

The Elevation Series Unique features: • All products in the Elevation Series are offered with three unique console options: the Engage™, Inspire™, or Achieve™ • The Engage and Inspire consoles feature iPod integration, USB connectivity, a Virtual Trainer, and Workout Landscape™ perspectives Benefits for the user: • The multiple entertainment options available on the Elevation Series products keep users entertained, motivated, and engaged Life Fitness www.lifefitness.com 800-634-8637 Circle No. 512 TR AINING-CONDITIONING.COM

Unique features: • The safest way to handle blood spills • Kills MRSA bacteria and blood-borne pathogens like HIV and hepatitis • Professional-grade extra-large wipes are safe on all surfaces • EPA-registered and bleach-free Benefits for the user: • Protects athletes and people responsible for blood and bodily fluid cleanup • Throw-away wipes combine safety, efficacy, and convenience Matguard USA www.matguardusa.com 877-628-9473 Circle No. 513

T&C march 2009

Aquatic Facilities

Water Works

“Strech” Your Limits StrechCordz dry-side and in-water resistance swim training tools by NZ Mfg. improve stamina, power, stroke, and individual medley times for international Olympians and novice swimmers alike. StrechCordz products provide resistance training for triceps extensions, rowing, overhead raises, chest flys, proper hip rotation, stroke efficiency, and more. Stretch your limits to enhance performance through resistance. (Dry-land StrechCordz with paddles are shown.) NZ Mfg., LLC • 800-886-6621 • www.nzmfg.com • Circle No. 514

Built for Water Enhance aquatic workouts with waterspecific tubing from Power Systems. The Aqua Versa-Tube is powder-free and has a specialty coating to resist the damaging effects of chlorine. With plugs at each end of the 48-inch tube, water stays out. Its contoured, pliable handles provide a secure grip in the water and do not absorb water. The Aqua Versa-Tube is available in three resistance levels: light, medium, and heavy. Power Systems • 800-321-6975 • www.power-systems.com • Circle No. 515

Add Many Options The 900T pool from SwimEx offers the ultimate in flexibility. With an overall depth of 5’ 6”, it can be adapted with a second floor to offer a second water level anywhere from 3’ 6” to 4’ 6”, with or without

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T&C march 2009

an integrated treadmill. Athletes gain the benefit of shallow workstations, an optional integrated motorized treadmill, and deep-water exercise all in the same pool. For more information on all of SwimEx’s pools, call the company or visit its Web site. SwimEx, Inc. • 800-877-7946 • www.swimex.com • Circle No. 516

Webbing that Works Add resistance during aquatic exercise with Spandex Water Gloves from Power Systems. These form-fitting, soft Spandex jersey gloves fully enclose the fingers and thumb while providing smooth resistance through the full range of motion. They are webbed to provide up to 30 percent more resistance than water alone. Use them to tone muscle and increase the heart rate. Three sizes are available: small, medium, and large. Power Systems • 800-3216975 • www.power-systems.com • Circle No. 517

A Current Below The 800T pool from SwimEx offers the freedom of an open workspace. It has an overall depth of 5’ 6” throughout, with a 30-inch deep current flow. This model allows for a variety of non-weight bearing exercises, such as deep-water running and of course swimming. It can also be configured with an integrated treadmill and multiple open depths. Contact SwimEx for more information. SwimEx, Inc. • 800-877-7946 • www.swimex.com • Circle No. 518

At Your Fingertips

Monitor Everything

Help for Healing

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; stethoscopes; pedometers; exercise bikes; ergometers; stopwatches; fitness books and software; exercise bands; step benches; hand and finger exercisers; heating pads; and more. Creative Health Products, Inc. • 800742-4478 • www.chponline.com • Circle No. 520

Knees, legs, ankles, elbows, and arms take a beating. Cho-Pat’s innovative preventive and pain-reducing sports/medical devices incorporate unique design characteristics, excellent craftsmanship, and quality materials to help reduce pain and discomfort and assist in healing. Each of the company’s American-made products is highly recommended, easy to use, comfortable to wear, allows full mobility, and is available in multiple sizes for more specific and effective results. Cho-Pat • 800-221-1601 • www.cho-pat.com • Circle No. 521

TRAINING-CONDITIONING.COM

At Your Fingertips See What’s New The new Dynatronics 2009-2010 product catalog has more than 8,000 products, hundreds of new items, and greater product diversity than ever before. Expanded sports medicine and taping sections feature tables manufactured exclusively for the sports medicine professional. Look for exercise equipment and supplies to meet your every need, and take advantage of competitive pricing. Call the company today for more information. Dynatronics • 800-874-6251 • www.dynatronics.com • Circle No. 522

Many Athletes, Many Configurations Fitness Anywhere, the pioneers of Suspension Training, deliver the TRX Suspension Training Zone, the ultimate functional training solution for teams and personal training. A Zone requires minimal space and no expensive equipment or electricity, and it is configurable for up to 24 simultaneous TRX users. With attractive leasing and financing options as well as marketing and educational support, a TRX Suspension Training Zone is the ideal group training solution. Fitness Anywhere • 888-878-5348 • www.fitnessanywhere.com • Circle No. 523

Enhancing Explosiveness TurfCordz resistance products are engineered for high-level athletic agility and strength training. Leading professional sports teams and international Olympians train with TurfCordz for explosive start drills, power-building footwork, and simulated play action to enhance performance through resistance. Stamina, power, strength, speed, and flexibility are achieved with TurfCordz. Also available from NZ Mfg. are the top-quality MediCordz rehabilitation products and StrechCordz swim training products. TurfCordz by NZ Mfg., LLC • 800-8866621 • www.nzmfg.com • Circle No. 524

Tested for Quality The 2009 Perform Better catalog is now available. It has 78 pages chock full of training and rehab specialties, all pre-tested for function, quality, and value by the Perform Better staff. Included are products for balance and stabilization, body weight and dumbbell training, flexibility, and recovery specialties. There are also TR AINING-CONDITIONING.COM

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in-demand products such as kettlebells, plyometric specialties, speed and agility training aids, and more. Request your 2009 Perform Better catalog by phone or online. Perform Better • 800-556-7464 • www.performbetter.com • Circle No. 525

Still Going Strong The 2009 Cramer Products catalog supplement highlights all new products introduced for the upcoming sport seasons. These products include new athletic training kits, ankle braces, and sports hygiene products. The supplement also focuses on hydration products, Cramer’s full line of sports medicine kits, and tape products. A leading supplier of sports medicine products for more than 90 years, Cramer is known for reliability, authenticity, and innovation. Cramer Products, Inc. • 800345-2231 • www.cramersportsmed.com • Circle No. 526

In a New Category McDavid is one of the most widely used and recommended brands of braces among sports medical professionals, and is an industry leader in sports medical products and technical performance athletic apparel. Its most recent innovation, HexPad technology, is changing the way athletes wear compression garments and base layers by fusing padding to performance fabrics and defining an entirely new category of protective apparel. McDavid’s goal is to develop innovative products and technologies to help prevent injury and enhance the performance of athletes and active people of all ages. McDavid • 800-237-8254 • www.mcdavidusa.com • Circle No. 527

Tapes and Much More The 2009-2010 Mueller Sports Medicine catalog features Mueller’s extensive line of sports medicine products. The catalog boasts more than 80 pages of full-color photographs and comprehensive product descriptions. Mueller’s complete line of athletic tapes and taping supplies is featured in the catalog, including TapeWrap, Mueller’s revolutionary alternative to prewrap. Available in March, the catalog showcases Mueller’s newest products for 2009. Call, go online, or e-mail sportcare@muellersportsmed.com to request your copy. Mueller Sports Medicine • 800-356-9522 • www.muellersportsmed.com • Circle No. 528 T&C march 2009

Director ies Circle Company No.

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116. . . California University of Pennsylvania . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

136. . . OPTP. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

119. . . China-Gel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

110. . . Perform Better . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

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

135. . . Perform Better (seminars). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

114. . . Covidien. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

103. . . Performance Health, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

112. . . Creative Health Products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

133. . . Power Lift . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

138. . . CytoSport . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . BC

124. . . Power Systems. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34

137. . . Dynatronics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IBC

120. . . PRO Orthopedic Devices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

118. . . Egg Whites. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

134. . . Samson Equipment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47

128. . . Gear 2000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

125. . . Save-A-Tooth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

109. . . GymValet. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

130. . . StaphAseptic by Tec Labs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42

131. . . GymWipes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43

129. . . Stromgren Athletics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41

127. . . Hibiclens (Molnlycke Health Care). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

104. . . SwimEx . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

113. . . HQ, Inc. (CorTemp). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

111. . . Texas Orthopedic Products & Services. . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

106. . . Indiana Athletic Trainers Association. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

117. . . The PolarPool. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

126. . . Matguard. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

123. . . TRX/Fitness Anywhere. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

102. . . Mueller Sports Medicine. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

132. . . TurfCordz/NZ Mfg.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43

105. . . NASM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

108. . . Ultimate Ice Wraps. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

115. . . New York Barbell of Elmira . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

121. . . WerkSan Barbells. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

100. . . NUCAP Medical (SpiderTech) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IFC

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546. . . California University of Pennsylvania . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58

505. . . Mueller (Whizzer). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

542. . . Chattanooga Group. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58

514. . . NZ Mfg. (StrechCordz). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54

547. . . China-Gel (herbal formulation) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58

524. . . NZ Mfg. (TurfCordz) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

510. . . China-Gel (new product). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

530. . . OPTP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

521. . . Cho-Pat (catalog). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54

525. . . Perform Better (catalog) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

548. . . Cho-Pat (Compression Sleeve). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

553. . . Perform Better (First Place Elite Kettlebells) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

500. . . Covidien. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

539. . . Performance Health, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58

526. . . Cramer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

531. . . Performance Health, Inc. (catalog). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

520. . . Creative Health Products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54

532. . . Power Lift . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

549. . . CytoSport (Cytomax Collegiate). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

515. . . Power Systems (Aqua Versa-Tube) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54

557. . . CytoSport (Muscle Milk Collegiate RTD). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

533. . . Power Systems (catalog). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

522. . . Dynatronics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

517. . . Power Systems (Spandex Water Gloves) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54

551. . . Egg Whites. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

534. . . PRO Orthopedic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

501. . . Gear 2000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

535. . . Rogers Athletic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

538. . . Gebauer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58

536. . . Samson Equipment (catalog) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

554. . . Gladiator Mouthguards. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

550. . . Samson Equipment (Power Thrust) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

508. . . Gym Valet. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52

556. . . Samson Equipment (Sprinter). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

502. . . GymWipes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

555. . . Save-A-Tooth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

504. . . Hibiclens (Molnlycke Health Care). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

507. . . StaphAseptic by Tec Labs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52

552. . . HQ, Inc. (CorTemp). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

506. . . Stromgren Athletics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52

511. . . Keiser. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

518. . . SwimEx (800T). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54

529. . . Life Fitness (catalog) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

516. . . SwimEx (900T). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54

512. . . Life Fitness (The Elevation Series). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

537. . . The PolarPool (catalog) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

503. . . Matguard. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

540. . . The PolarPool (cryotherapy spa). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58

513. . . Matguard (new product). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

523. . . TRX/Fitness Anywhere. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

527. . . McDavid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

541. . . Ultimate Ice Wraps. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58

528. . . Mueller (catalog). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

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At Your Fingertips

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Lots of Choices

Innovative Support

Life Fitness is a global leader in designing and manufacturing a full line of reliable, high-quality fitness equipment. As one of the largest commercial fitness equipment providers in the world, the company has been offering premium fitness equipment for more than 30 years. Its comprehensive catalog features an extensive line of cardiovascular, strength training, and group exercise products. Life Fitness • 800-634-8637 • www.lifefitness.com • Circle No. 529

Offering more than 20 patented products, PRO Orthopedic is constantly upgrading designs and materials to give you the best support possible. The fourway stretch properties of neoprene, combined with therapeutic heat retention, make neoprene so effective in controlling edema. Compression alone cannot produce the same results, and all PRO neoprene products are latex-free. PRO Orthopedic Devices, Inc. • 800-5235611 • www.proorthopedic.com • Circle No. 534

Classics and New Options OPTP has released volume 22 of its product catalog, complete with a new design, images, and prices printed right in the catalog for your convenience. The company has added new products, but still carries all your favorites, including the Stretch Out Strap, foam rollers, and other products for your fitness needs. To request a copy of volume 22, call or go online today. OPTP • 800-367-7393 • www.optp.com • Circle No. 530

Trusted Relief Biofreeze pain reliever is a brand most trusted and recommended to treat a wide variety of pains, including backaches, sore joints, arthritis, sore muscles, strains, sprains, muscle spasms, and joint discomfort. Biofreeze pain reliever is formulated for hands-on health professionals to use or sell to the patients, clients, or athletes under their care. Performance Health • 800-246-3733 • www.biofreeze.com • Circle No. 531

Strong Selection The Power Lift catalog contains all of the company’s products. Equipment in this catalog includes patented products, racks, Olympic lifting platforms, benches, pulley units, wood products, and accessories. Also included in the catalog are items from Mastiff and Uesaka. For more information on Power Lift equipment, call the company or visit its Web site. Power Lift • 800-872-1543 • www.power-lift.com • Circle No. 532

Performance for Everyone Power Systems aims to advance health, fitness, and physical performance for everyone by offering a large selection of innovative products, first-class training solutions, and superior customer service. The company’s award-winning product line includes more than 2,000 items geared toward both elite and beginner athletes. Power Systems • 800321-6975 • www.power-systems.com • Circle No. 533 TR AINING-CONDITIONING.COM

Superior Technique Rogers Athletic is committed to manufacturing strength training equipment that promotes proper technique and is designed with safety in mind. The company’s revolutionary line of plate-loaded, biomechanically correct machines and innovative Brute Rack system allow athletes to work out more safely and with greater results. Request your free Rogers Athletic strength training catalog to begin building your champions. Rogers Athletic Co. • 800-457-5337 • www.rogersathletic.com • Circle No. 535

The Selectorized Difference Since 1976, Samson Equipment has designed, manufactured, and sold heavyduty industrial-strength 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. Samson Equipment, Inc. • 800-472-6766 • www.samsonequipment.com • Circle No. 536

Smart Aquatics The PolarPool is a clean, safe, compact, portable alternative for cold-water therapy. It’s small enough to fit through a standard door and can be incorporated into an existing environment without the need for additional construction or building renovations. The bench seat around the inside and open footwell provide the perfect platform for four to six athletes to sit or kneel. Isn’t it about time for an affordable upgrade? The PolarPool • 617-480-7683 • www.thepolarpool.com • Circle No. 537

T&C march 2009

hot & cold ther apies

Targeted Relief

Cooling Relief Gebauer’s Spray and Stretch topical anesthetic skin refrigerant provides a fine stream of spray with a cooling effect. It’s designed to be used in conjunction with the spray and stretch technique and trigger-point therapy to help manage myofascial pain syndromes (MPS) in the head (like TMJ/ TMD), neck, shoulders, extremities, and lower back. The product is non-flammable and non-ozone depleting. It can be purchased through your medical supplier or wholesaler, or directly from Gebauer, by prescription only. Gebauer Co. • 800-3219348 • www.gebauer.com • Circle No. 538

All-Natural Effectiveness Biofreeze pain relieving spray complements Biofreeze gel and roll-on, delivering a blend of science and nature. Using 100-percent natural menthol and 100-percent natural essential oils and natural extracts, the spray provides strong pain relief without a prescription and is easy to apply. The spray can be used at any angle and penetrates the skin immediately for pain relief. Performance Health, Inc. • 800-246-3733 • www.biofreeze.com • Circle No. 539

Cold Therapy and More The Polar Pool cryotherapy spa offers cold water therapy, hot water therapy, and saltwater therapy—all in one. It’s completely portable, so you can provide athletes with state-of-the-art treatment and pain relief without installing new plumbing or redesign-

More products

T&C march 2009

ing your entire facility. Users can sit or kneel in the pool, and the purification and sanitization systems keep the water clean while the solid-state cooling system maintains the temperature you want. The Polar Pool • 617-480-7683 • www.thepolarpool.com • Circle No. 540

Cold Under Clothing Ultimate Ice Wraps offer a patented design that incorporates 100-percent natural Igloo ice products. Ultimate Ice targets eight specific muscle groups with a washable wrap design and reusable Igloo ice inserts. Ultimate Ice stays cold two times longer than gel. Ultimate Ice Wraps are designed to be worn under clothing and allow freedom of movement while being used. Ultimate Ice Wraps, Inc. • 888-678-8494 • www.ultimateicewraps.com • Circle No. 541

A Cool Solution The economical Opti-Ice helps reduce athlete pain and swelling and speed rehabilitation. Its motorized, eight-quartcapacity system provides continuous, consistent cold therapy for up to seven hours through the patented semi-closed loop system. Opti-Ice has an easy-to-use external console and thermometer to help maintain an accurate, safe water temperature. Instructions are printed on the lid for easy referral, and the fill line is molded inside the cooler for accurate filling. Chattanooga Group • 800-592-7329 • www.chattgroup.com • Circle No. 542

Great Ideas, Great Value

Never Stop Learning

Sweet-Smelling Comfort

California University of Pennsylvania has helped build the character and careers of its students for more than 150 years. Cal U’s dedication to providing high-quality, in-demand programs to its students continues through the University’s Global Online 100-percent online programs of study. Through an asynchronous format, Global Online allows students the opportunity to complete coursework anytime, anywhere. All that’s required is a computer with Internet access. Go online for more information. California University of Pennsylvania • 866-595-6348 • www.cup.edu/go • Circle No. 546

China-Gel’s herbal formulation helps to relieve pain associated with sore muscles, aching joints, and sports injuries. Seven herbal ingredients utilize the body’s natural ability to relieve pain. It has a refreshing mint and lavender fragrance that is not medicinal and a texture that resembles a hand cream, absorbing completely without staining or leaving a greasy residue. The result is fast and effective pain relief. China-Gel, Inc. • 800-898-4GEL • www.china-gel.com • Circle No. 547

TRAINING-CONDITIONING.COM

Great Ideas, Great Value

more products

Just the Right Fit

Essential Information

Cho-Pat’s Compression Sleeve combines warmth, compression, and reinforcement to help reduce pain and discomfort in the calf and enhance healing. The four-way stretch knit material contours anatomically for maximum fit, comfort, and effectiveness. The material is breathable and facilitates the movement of moisture away from the skin. This American-made sleeve does not contain neoprene or latex and is available in three sizes to provide more specific and effectual results. It’s available in white and black. Cho-Pat • 800-221-1601 • www.cho-pat.com • Circle No. 548

Early intervention to rapidly and accurately assess core body temperature on the field is necessary for the proper prevention, evaluation, treatment, and management of exertional heat stroke. Research indicates that external methods of monitoring core temperature have not been proven valid under conditions of intense exercise in the heat. The CorTemp™ system, featuring the CorTemp ingestible temperature pill, provides an easy, affordable approach to monitoring core temperature on the field and gauging the effectiveness of cooling methods on the sidelines. This FDA-cleared product is used by professional and collegiate teams nationwide. HQ, Inc. • 941-723-4197 • www.hqinc.net • Circle No. 552

Prolonged Peaks Cytomax Collegiate Performance Drink is a blend of complex carbohydrates and electrolytes that optimizes hydration during exercise and keeps energy at peak levels longer to help improve stamina. Alpha L-polylactate acts to prevent acid buildup and minimizes post-exercise muscle soreness. Cytomax is available in convenient ready-to-drink or powder formulas. CytoSport, Inc. • 888-298-6629 • www.cytosport.com • Circle No. 549

Extend and Rotate The Samson Power Thrust is a dynamic piece of equipment that allows athletes to develop hip explosion, upper-arm strength, and shoulder strength. Each handle operates independently on linear ball bearings to allow for an amazingly smooth movement, and resistance is easily added by the weight horns already attached to the handle apparatus itself. A variety of exercises, including extensions and rotations, can easily be performed using this unique piece of equipment. Samson Equipment • 800-4726766 • www.samsonequipment.com • Circle No. 550

Goes Down Like Milk Egg Whites International’s 100-percent pure liquid egg whites are heat-pasteurized and tested for salmonella, making them “liquid” but not “raw.” They are double-filtered to achieve the smooth consistency of milk, and they’re completely tasteless and odorless for making the perfect protein drink. An eight-ounce serving supplies 26 grams of protein with no fat, no cholesterol, two grams of carbs, 120 calories, and all the essential amino acids. Egg Whites International • 877-EGG-WHITES • www.eggwhitesint.com • Circle No. 551

TR AINING-CONDITIONING.COM

Updating a Classic Designed to make increasing weight an easier transition, Perform Better has introduced its First Place Elite Kettlebells, made from a smooth steel shell (not iron) with a smooth-as-glass handle. These are deluxe competition-style kettlebells, color-coded for easy identification. Order them in 12, 16, 20, or 24 kilograms in green, red, silver, or black. They’re new in the 2009 Perform Better catalog. Perform Better • 800-556-7464 • www.performbetter.com • Circle No. 553

Built Like a Gladiator When Sports Guard International wanted a name for its new top-quality mouthguard, the company surveyed athletes to find out what word they associated with the product’s main features: toughness, reliability, and strength. The leading choice was “gladiator,” and today, athletes nationwide rely on Gladiator mouthguards for optimum protection and performance. Made of multi-layer EVA material, the Gladiator is designed to prevent injury while not interfering with breathing or communication. Gladiator Mouthguards • 877-848-2737 • www.customguards.com • Circle No. 554

Because Time Matters Without proper care, a knocked-out tooth begins to die in 15 minutes. The Save-ATooth emergency tooth preserving system utilizes Hank’s Balanced Salt Solution (HBSS) to not only preserve, but also reconstitute many of the degenerated cells. The patented basket and net container are designed to protect tooth root cells. This is the only system that keeps tooth cells alive for up to 24 hours. Save-A-Tooth® • 888-788-6684 • www.save-a-tooth.com • Circle No. 555 T&C march 2009

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Great Ideas, Great Value

Sprinting with Resistance

Multi-Source Protein

The new Samson Sprinter is yet another way Samson Equipment is leading the way in heavy-duty custom equipment. This unique piece allows your athletes to perform a sprint motion while in a biomechanically sound running position. Adding resistance is made easy with the plate-loaded weight horns that are designed to prevent any plate movement. Designed with comfort, durability, and adjustability in mind, the new Samson Sprinter will fit every athlete comfortably, and just like any other Samson piece, it will last a lifetime. Go online today to see a video demonstration. Samson Equipment • 800-472-6766 • www.samsonequipment.com • Circle No. 556

Muscle Milk Collegiate RTD (ready-todrink) formula from CytoSport provides a high-quality protein blend that helps promote recovery from exercise and is permissible under collegiate bylaw 16.5.2.2 for nutritional supplements. Due to its unique multi-source protein, maltodextrin carbohydrate, and healthy fat structure, this product is second to none for collegiate athletic programs. It is available in convenient ready-to-drink chocolate and vanilla flavors, and strawberry is coming soon. Visit CytoSport online to learn more. CytoSport, Inc. • 888-298-6629 • www.cytosport.com • Circle No. 557

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T&C march 2009

TRAINING-CONDITIONING.COM

CEU QUIZ

T&C March 2009 Volume XIX, No. 2

Training & Conditioning is pleased to provide NATA and NSCA members with the

icke You c a and g n now tak r & E a et yo e our ur C CEU q sier! uizze Click EU results s on www o a .train n “CEUs & C nd credit in line... s ourse ing-c s” at: tantly. ondi tio ning

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, readers can earn 2.0 BOC Athletic Training and 0.2 NSCA (two hours) continuing education units.

.com

Instructions: Go to www.training-conditioning.com and click on “CEUs & Courses” to take the quiz online. You may also mail your quiz to us: Fill in the circle on the answer form (on page 63) that represents the best answer for each of the questions below. Complete the form at the bottom of page 63, include a $25 payment to MAG, Inc., and mail it to the following address: MAG, Inc., ATTN: T&C 19.2 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 within 30 days. Before You Hit Send (pages 5-6)

Objective: Get advice on how to make a positive impression and avoid pitfalls when communicating online with others in the field.

1. The author says that one good way for students to make a positive impression on professors and potential employers is to: a) Use a catchy or funny name in an e-mail address. b) Make a point to talk to them face-to-face. c) Try to find them on social networking sites like Facebook or MySpace. d) Send lengthy e-mails. 2. One good rule of thumb for electronic communication is: a) Shorthand is common, so use it often. b) If you wouldn’t say something to someone’s face, don’t say it in an e-mail or text message. c) A casual tone is always acceptable in e-mail. d) Text messages are generally more appreciated than phone calls. 3. It is now common for people in charge of hiring to search online for job applicants’: a) E-mail histories. b) Employment histories. c) Facebook accounts and MySpace pages. d) College transcripts.

Against the Grain (pages 21-26)

Objective: Understand celiac disease, how it poses a unique challenge for athletes, and how you can help them manage the condition.

4. Typical symptoms of celiac disease include: a) Headaches and muscle stiffness. b) Disorientation and dizzy spells. c) Bloating, gas, and diarrhea. d) Loss of muscle control and frequent bruising. 5. According to the article, two non-food products that may contain gluten are: a) Lipstick and envelope adhesive. b) Gum and lotion. c) Breath mints and throat spray. d) Teeth whitener and breath spray.

6. People of ______ descent may be more likely than others to have celiac disease. a) Australian and Japanese b) Korean and North African c) Mexican and South American d) Northern European and Scandinavian 7. Why might athletes be less likely than others to complain about celiac disease symptoms? a) Athletes often try to avoid doctor’s visits. b) Athletes may desire to “play hurt.” c) Athletes often attribute intestinal discomfort to the demands of training for their sport. d) Athletes fear losing playing time. 8. Celiac disease may damage the finger-like projections called ______ found in the intestinal wall. a) Ganglions b) Villi c) Alveoli d) Gastrons 9. Recent studies suggest that around ______ people in the U.S. likely have celiac disease. a) One in 25 b) One in 88 c) One in 133 d) One in 198 10. What do gastroenterologists consider to be the “gold standard” for diagnosing celiac disease? a) A series of four weekly blood pressure tests. b) A jejunal mucosal biopsy. c) A body composition analysis. d) An MRI.

Ahead of the Curve (pages 29-34)

Objective: Learn about the methods and strategies used by coaches at elite training centers to help athletes optimize performance.

11. Nick Winkelman says that with pneumatic exercise equipment, there is no: a) Overstress. b) Inertia. c) Movement. d) Risk of injury.

Answer sheet is on page 63...or take this quiz online and get instant results: www.training-conditioning.com click on CEUs & Courses TR AINING-CONDITIONING.COM

T&C MARCH 2009

CEU QUIZ

12. Some training and testing equipment at Athletic Republic facilities instantly records athletes’ workout information with the help of: a) Barcode scanners. b) Built-in clipboards. c) RFID wristbands. d) An e-mail interface. 13. One of Tom Shaw’s favorite tools for increasing stride length is the use of: a) Water striders. b) Sprint-assists. c) Overstriders. d) Stride checkers.

Searching for Answers (pages 37-43)

Objective: Get the latest information on methicillinresistant Staphylococcus aureus (MRSA) and how to help your athletes avoid infection.

14. Surgery-related infection in the U.S. occurs in roughly ______ percent of cases. a) One b) Five c) Eight d) Nine 15. If an athlete has a MRSA-infected wound, they should be careful to: a) Visit a physician daily. b) Keep the wound covered until it has healed completely. c) Use a whirlpool frequently. d) Take herbal supplements that fight infection. 16. Jeff Hageman says the most important thing for athletes to know about MRSA is: a) That it’s a type of staph infection. b) Which specific antibiotics can treat it. c) How many cases there are in the U.S. each year. d) How to recognize a possible infection. 17. In hospitals, MRSA is usually transmitted due to: a) Dirty surgical instruments. b) Inadequate floor cleaning. c) Lapses in hand hygiene by nurses, doctors, and others. d) Soiled bed linens being re-used. 18. The first step in treating a MRSA infection is usually: a) Draining and cleaning the infection site. b) Applying anti-viral medication. c) Applying a pain-relieving topical ointment. d) Testing the wound with several different antibiotics.

T&C MARCH 2009

19. On average, one out of every ______ people carry staph bacteria on their skin. a) Two b) Three c) Five d) Nine 20. If an athlete is taking an antibiotic and their symptoms go away, they should: a) Stop taking the medication immediately. b) Save the rest of the medication in case of a relapse. c) Complete the course as prescribed. d) Start taking half-doses.

Staying on Top (pages 45-49)

Objective: Learn about the strength training and conditioning regimen followed by the Syracuse University men’s lacrosse team.

21. The Syracuse lacrosse team’s training calendar is broken into ______ phases. a) Three b) Four c) Five d) Seven 22. For this author, “contrast training” means: a) First working one side of the body, then the other. b) Alternating strength work with plyometrics. c) Following heavy work days with days off. d) Working the upper body and lower body on separate days. 23. During the lacrosse season, the author is careful to: a) Work players harder to keep them in shape. b) Maintain the same workout schedule used in the off-season. c) Monitor practice and game demands to avoid overuse injuries. d) Introduce extra strength work. 24. The conditioning self-test for players consists of three: a) 440-yard gassers. b) 100-yard dashes. c) Hang clean movements. d) Treadmill tests. 25. The team’s dynamic warmup focuses on the: a) Ankles. b) Shoulder musculature. c) Core. d) Metatarsals.

TR AINING-CONDITIONING.COM

CEU QUIZ Answer Form Instructions: Go to www.training-conditioning.com and click on “CEUs & Courses” to take the quiz online. You may also mail your quiz to us: Fill in the circle on the answer form below that represents your selection of the best answer for each question. Complete the form at the bottom of this page, include a $25 payment to MAG, Inc., and mail it to the following address: MAG, Inc., ATTN: T&C 19.2 Quiz, 31 Dutch Mill Road, Ithaca, NY 14850. 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 within 30 days. Questions? Problems? E-mail: CEU@MomentumMedia.com.

Before You Hit Send

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Ahead of the Curve

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Searching for Answers

Against the Grain

14. 15. 16. 17. 18. 19. 20.

Staying on Top

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T&C MARCH 2009

Next Stop: Web Site Our editorial continues on Here is a sampling of what’s posted right now:

Chicago Cubs Head Athletic Trainer Mark O’Neal checks on umpire Gerry Davis after he was hit in the throat by a pitch during a game last season. O’Neal and his staff were honored as baseball’s best in 2008. O’Neal recently talked with Training-Conditioning.com about life as an athletic trainer in Major League Baseball.

MONTHLY FEATURES Since the conclusion of Super Bowl XLIII, stories about Pittsburgh wideout Hines Ward’s accelerated return from a knee injury have been grabbing headlines across the country. Check out our in-depth feature on the new platelet-rich plasma therapy he used and how it could improve the treatment of chronic injuries like tennis elbow and knee tendonitis. With Major League Baseball spring training in full swing, Chicago Cubs Head Athletic Trainer Mark O’Neal, LAT, ATC, is a busy man. In this interview, O’Neal—who recently accepted the 2008 Major League Baseball Athletic Training Staff of the Year award—shares his thoughts on the daily challenges of working in the big leagues. Is talent in the genes? A new genetic test may be able to identify at a young age whether someone has more innate potential as a power athlete or an endurance athlete. However, many people are debating whether this type of science does young athletes and our youth sports culture any favors.

www.training-conditioning.com/features.php

SolariS “The Solaris 709 has been extremely helpful and beneficial to me.... My wrist injury several months ago healed perfectly and much faster than expected. For years, I have had problems with the muscles in my forearms and after several treatments with the Solaris device the pain is gone.... I highly recommend the Solaris 709.... I am healthy and enjoying life to the fullest.” Bernhard Langer Two-Time Masters Champion

TIMING IS EVERYTHING.

When it comes to sport nutrition, timing is crucial. Getting enough fuel to make it through another day of training, class, practice and studying can be difficult for today’s time-constrained student-athlete. That’s where Collegiate branded products from CytoSport can help. TM

PRE -FUEL with CYTOMAX ®

Providing a combination of glucose, fructose, Polylactate , and electrolytes – Cytomax fuels and hydrates like no other sport drink today. TM

RE-FUEL

with MUSCLE MILK

Complex carbohydrates • Multi-source proteins • Advanced lipid complex

Muscle Milk® Collegiate nutritional shakes, powders and bars help athletes re-fuel after grueling workouts, practices and games. Muscle Milk Collegiate taken immediately post-workout helps stimulate glycogen replenishment along with muscle recovery and repair.

GET SOME. 707-747-3377 performance@cytosport.com

Circle No. 138