Training & Conditioning 23.5 by Momentummedia

Learning From Boston

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July/August 2013, Vol. XXIII, No. 5

contents

25 Bulletin Board 4 Concussion education not enough … New guidelines for EIB … Notching a national championship … Uncovering shoulder injury risk through motion measurement. Comeback Athlete 8 Steven Bennett New Castle (Ind.) Chrysler High School Product News

56 Ankle & Footcare 59 Heat Stress Products 60 More Products 63 Web Site Directory 67 Product Launch 45

Sponsored Pages HI Trainers

66 Advertisers Directory CEU Quiz 53 For NATA and NSCA Members

Leadership

Prepared for the Worst

From veteran athletic trainers to students, the sports medicine team at the Boston Marathon responded heroically to the bombings on April 15. What lessons can we learn about medical coordination from the tragic event? By R.J. Anderson Optimum Performance

the Foot 25 Freeing As running barefoot and with minimalist shoes has taken off,

new research is uncovering the pros and cons of the practice, as well as how to shed shoes safely. By Dr. Daniel Cipriani Treating the Athlete

the Line 33 Behind Preventing heat illness in football players is a behind-the-

scenes team effort. Getting coaches on board requires good communication and persistence. By Patrick Bohn Nutrition

ATC Diet 41 The If you’re like many athletic trainers, following a nutritious meal plan during a typical hectic day doesn’t easily happen. In response, we offer the ATC Diet. By Dr. Jackie Buell Sport Specific

On the cover: LSU football players stay safe in the heat thanks to the work of Jack Marucci, one of several athletic trainers providing advice in our cover story, starting on page 33. Photo by APImages/ Patrick Green TR AINING-CONDITIONING.COM

Waves 47 Making By going against the current of traditional thinking, the author of this article has developed a unique and effective strength and conditioning regimen for the Auburn University swim teams. By Bryan “PK” Karkoska

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Editorial Board Marjorie Albohm, MS, LAT, ATC Director, Ossur Americas Past President, NATA

Maria Hutsick, MS, LAT, ATC, CSCS Head Athletic Trainer Medfield (Mass.) High School

Jon Almquist, ATC Athletic Training Program Administrator Fairfax County (Va.) Public Schools

Christopher Ingersoll, PhD, ATC, FACSM Director of Graduate Programs in Sports Medicine/Athletic Training University of Virginia

Jim Berry, EdD, ATC, SCAT, NREMT Head Athletic Trainer Conway (S.C.) High School Christine Bonci, MS, LAT, ATC Associate Athletics Director Sports Medicine/Athletic Training University of Texas

Tim McClellan, MS, CSCS Owner and Strength and Conditioning Coach StrengthAndPeace.com

Leslie Bonci, MPH, RD, CSSD, LDN Director of Sports Medicine Nutrition Center for Sports Medicine University of Pittsburgh Medical Center

Timothy Morgan, DC, CCSP Professor of Exercise and Health Sciences University of Massachusetts

Cynthia “Sam” Booth, PhD, ATC Visiting Assistant Professor SUNY Brockport

Jenny Moshak, MS, ATC, CSCS Assistant AD for Sports Medicine University of Tennessee

Debra Brooks, CNMT, LMT, PhD CEO, Iowa NeuroMuscular Therapy Center

Steve Myrland, CSCS Owner, Manager Myrland Sports Training, LLC Director of Coaching, Train-To-Play

Cindy Chang, MD President, American Medical Society for Sports Medicine Dan Cipriani, PhD, PT Associate Professor Deptartment of Physical Therapy Chapman University Gray Cook, MSPT, OCS, CSCS, RKC Clinic Director Orthopedic and Sports Physical Therapy Dunn, Cook and Associates Keith D’Amelio, ATC, PES, CSCS Nike Sparq Training Bernie DePalma, MEd, PT, ATC Assistant Athletic Director Head Athletic Trainer/Physical Therapist Cornell University Lori Dewald, EdD, ATC, CHES, F-AAHE School of Public Safety and Health American Public University David Ellis, RD, LMNT, CSCS Sports Alliance, Inc. Boyd Epley, MEd, CSCS Director of Coaching Performance National Strength & Conditioning Association Peter Friesen, ATC, NSCA-CPT, CSCS, CAT Head Athletic Trainer/Conditioning Coach Carolina Hurricanes Lance Fujiwara, MEd, ATC, EMT Director of Sports Medicine Virginia Military Institute Vern Gambetta, MA President, Gambetta Sports Training Systems P.J. Gardner, MS, ATC, CSCS, PES Athletic Trainer, Liberty High School, Colo. Joe Gieck, EdD, ATR, PT Director of Sports Medicine Professor, Clinical Orthopaedic Surgery University of Virginia (retired) Brian Goodstein, MS, ATC, CSCS, Head Athletic Trainer, DC United Gary Gray, PT President, CEO Functional Design Systems

Allan Johnson, MS, MSCC, CSCS Sports Performance Director Velocity Sports Performance

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Tim Neal, MS, ATC Assistant Director of Athletics for Sports Medicine Syracuse University

July/August 2013 Vol. XXIII, No. 5 Publisher Mark Goldberg Editorial Staff Eleanor Frankel, Director R.J. Anderson, Patrick Bohn, Kristin Maki, Mary Kate Murphy, Dennis Read Circulation Director David Dubin Art Direction Message Brand Advertising Production Staff Maria Bise, Director Neal Betts, Trish Landsparger Business Manager Pennie Small

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

Special Projects Natalie Couch Dave Wohlhueter

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

Administrative Assistant Sharon Barbell

Stephen M. Perle, DC, MS Professor of Clinical Sciences University of Bridgeport College of Chiropractic

Marketing Director Sheryl Shaffer

Brian Roberts, MS, ATC Director of Sports Medicine and Business Operations, Xcelerate Physical Therapy Ellyn Robinson, DPE, CSCS, CPT Assistant Professor of Exercise Science Bridgewater State College Kent Scriber, EdD, ATC, PT Professor/Clinical Education Coordinator Ithaca College Chip Sigmon, CSCS*D Speed and Agility Coach OrthoCarolina Sports Performance Bonnie J. Siple, EdD, ATC Assistant Professor, Department of Exercise and Rehabilitative Sciences Slippery Rock University Chad Starkey, PhD, ATC, FNATA Division Coordinator, Athletic Training Program, Ohio University Ralph Stephens, LMT, NCTMB Sports Massage Therapist, Ralph Stephens Seminars Jeff Stone, MEd, LAT, ATC Head Athletic Trainer, Suffolk University Fred Tedeschi, ATC Head Athletic Trainer, Chicago Bulls Terence Todd, PhD Lecturer, Kinesiology and Health Education University of Texas

Advertising Sales Associate Diedra Harkenrider (607) 257-6970, ext. 24 Advertising Materials Coordinator/Sales Mike Townsend (607) 257-6970, ext. 13 T&C editorial/business offices: 20 Eastlake Road Ithaca, NY 14850 (607) 257-6970 Fax: (607) 257-7328 info@MomentumMedia.com Training & Conditioning (ISSN 1058-3548) is published monthly except in January and February, May and June, and July and August, which are bimonthly issues, for a total of nine times a year, by MAG, Inc., 20 Eastlake Road, Ithaca, NY 14850. T&C is distributed without charge to qualified professionals involved with competitive athletes. The subscription rate is $24 for one year and $48 for two years in the United States, and $30 for one year and $60 for two years in Canada. The single copy price is $7. Copyright© 2013 by MAG, Inc. All rights reserved. Text may not be reproduced in any manner, in whole or in part, without the permission of the publisher. Unsolicited materials will not be returned unless accompanied by a self-addressed, stamped envelope. Periodicals postage paid at Ithaca, N.Y. and additional mailing offices. POSTMASTER: Send address changes to Training & Conditioning, P.O. Box 4806, Ithaca, NY 14852-4806. Printed in the U.S.A.

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Concussion Education Not Enough Most high school athletic departments take numerous steps to educate their student-athletes about the dangers of concussions. Changing student-athlete behavior continues to be elusive, however, according to a study presented at the Pediatrics Academic Societies annual meeting in May. In the summer of 2012, researchers from Cincinnati Children’s Hospital Medical Center gave surveys to 120 Cincinnati-area high school football players. The questions asked about their knowledge of concussion symptoms and gauged their attitudes regarding return to play. The respondents scored well on symptom recognition, especially headaches (93.3 percent), dizziness (89.2 percent), difficulty remembering (78.3 percent), sensitivity to light and sound (78.3 percent), and difficulty concentrating (75.8 percent). Over 90 percent understood that they risked serious injury by returning to play too soon following a head injury. Despite this knowledge, 91.4 percent of players surveyed said they believed it was acceptable for athletes to play with a concussion. In addition, only 40.6 percent said they would immediately tell their coach if they had experienced concussion symptoms. Some players felt that concussed athletes have a responsibility to take part in important games. “It is possible that concussion education alone may not be enough to promote safe concussion behaviors in high school football players,” Brit Anderson, MD, Pediatric Emergency Medicine Fellow at Cincinnati Children’s Hospital Medical Center and one of the study’s co-authors, said in a news release. “These attitudes could leave young athletes vulnerable to injury from sports-related concussions.” To view an abstract of the study, “‘I Can’t Miss the Big Game’: High School Football Players’ Knowledge and Attitudes about Concussions,” go to www.aap.org and search “High School Athletes Say Concussions Won’t Sideline Them.” The link to the abstract will be in the article.

New Guidelines for EIB In an effort to provide sports medicine professionals with accurate, up-to-date information on exercise-induced bronchoconstriction (EIB), the American Thoracic Society recently released a new set of clinical practice guidelines. Published in the May issue of the American Journal of Respiratory and Critical Care Medicine, the recommendations cover both diagnosing and managing the syndrome. EIB is an acute airway narrowing that can occur during or after exercise. Compounding factors include cold or dry air, ambient ozone, and airborne particles. Up to 20 percent of the general population is expected to experience EIB at some point during their lifetime, with a prevalence rate of up 4

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to 70 percent for Olympic and elite athletes and 90 percent for individuals with asthma. The new guidelines advise basing a diagnosis of EIB on post-exercise lung function rather than peak expiratory flow rate or symptoms of coughing, wheezing, and chest tightness. Lung function can be determined by measuring the forced expiratory volume (FEV1)—the maximum amount of air that can be exhaled in one second—before and after five, 10, 15, and 30 minutes of exercise. The percentage difference between the pre-exercise FEV1 value and the lowest level recorded within 30 minutes of exercise should be used to determine the level of EIB severity. Mild EIB is diagnosed when the FEV1 drops by more than 10 percent but less than 25. When the decline is between 25 and 50 percent, EIB is considered moderate, and any reduction exceeding 50 percent signifies severe EIB. The newly released guidelines also outline appropriate treatment options. These include a thorough warm-up and use of an inhaled short-acting beta-agonist 15 minutes prior to exercising. Athletes requiring additional care should add a daily dose of an inhaled corticosteroid or a leukotriene receptor antagonist. In addition, a long-acting beta-agonist (LABA) may be used provided it is limited to no more than three times per week since one study found that those taking LABAs build up a tolerance.

Sink or Swim Not many athletic trainers have a collegiate coaching victory, let alone a championship win, on their resume. However, in April, Daniel Siopa, MS, ATC, a first-year Assistant Athletic Trainer at Connecticut College, pulled off just such a feat. With 5:44 left in the Collegiate Water Polo Association (CWPA) Division III women’s championship game, Siopa found himself summoned to the pool deck after Connecticut Head Coach JJ Addison was issued a red card and ejected from the game with his team leading 4-1. Because Assistant Coach Ryan Pryor was serving a one-game suspension for being ejected from the team’s previous game, the Camels were left without a coach. This presented a problem as NCAA rules, which govern the CWPA, dictate that if a declared coach is not present on the bench once the clock restarts, the team must forfeit. “I was sitting in the stands and the PA announcer said that our team needed an administrator present to continue the game,” Siopa says. “A few seconds later, one of the officials asked me if I was an administrator, and I told him I was an athletic trainer for the school. He said that satisfied the criteria and pulled me down to the pool deck where I stood until the match was over.” Siopa had attended only one or two water polo matches previously. “I really don’t know anything about water polo, so I relied on the athletes to guide me,” he says. “But I wasn’t nervous. They were playing so well to that point, I was confident that no matter what I did, the team would pull it out.” TR AINING-CONDITIONING.COM

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Board During his time on the sideline, Siopa called a timeout and at his team’s request inserted a senior reserve goalie into the line-up so she could finish out her career in style. He also watched the squad net two more goals to ice the championship—the program’s first. Per NCAA and CWPA standards, Siopa was the coach of record for the game. When the final buzzer sounded, Siopa found himself in yet one more unusual situation. “The girls told me that if I had a cell phone in my pocket, I should take it out because I was about to go for a swim,” Siopa says. “Luckily, JJ came running out before that could happen and they threw him in the pool instead.”

Revealing Suspect Shoulders A new motion measurement system can help identify baseball pitchers who are at greatest risk for shoulders injuries, according to a study published in a supplement to the April 2013 issue of Musculoskeletal Surgery. Using a portable 3-D-motion measurement machine, researchers were able to detect small changes in the pitchers’ scapulo-humeral rhythm (SHR), which may indicate a deterioration in the coordinated movement of the upper arm and shoulder. The study’s authors attached sensors to 13 college-age pitchers’ bodies (at the thorax, scapula, humerus, and fore-

arm), including 3-D gyroscopes, magnetometers, and accelerometers. Using the Xbus kit from Xsens, this allowed them to track the motion of both the shoulder and upper arm in greater detail than is possible through video. The researchers evaluated flexion-extension and abduction-adduction movements before pitching, immediately after throwing 60 pitches, and 24 hours after throwing the 60 pitches. Three of the pitchers (23 percent) showed deterioration in their SHR after pitching that did not improve in the following 24 hours. Three other pitchers with reduced SHR results immediately after pitching showed some improvement after 24 hours, but had not completely recovered. Five pitchers showed complete recovery of their deteriorated SHR scores after 24 hours and two pitchers showed no change in their SHR through all three measurement stages. Since deterioration of the SHR can lead to shoulder injuries, the study’s authors recommend that pitchers flagged with sustained deteriorated SHR measurements should consider shoulder strengthening exercises and physical therapy. An abstract for the study, “Motion Analysis Assessment of Alterations in the Scapulo-Humeral Rhythm After Throwing in Baseball Pitchers,” can be found by typing the title in the search window at: www.springer.com.

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ComebackAthlete

Steven Bennett New Castle (Ind.) Chrysler High School By R.J. Anderson

When New Castle (Ind.) Chrysler High School boys’ basketball star Steven Bennett went down with an ACL tear halfway through his junior season, everyone was confident he would return to full strength in time for his senior year. Though the road to recovery would not be easy, New Castle veteran Athletic Trainer Matt Matanich, ATC, LAT, had every reason to believe it would be routine. However, thanks to a crutches-related accident, that was not the case. Playing in the country’s largest high school fieldhouse, which holds more than 9,000 basketball-crazy fans, the New Castle program is steeped in tradition, boasting alumni such as former Indiana University stars Steve Alford and Kent Benson. Bennett, a 6’4” sharp shooter coming off a first-team North Central Conference All-League selection as a sophomore, was receiving attention from a number of NCAA Division I programs, and had New Castle entering the 2011-12 campaign with high expectations. That November, Bennett got out of the gates quickly, averaging nearly 20 points a game while leading the team to a winning record. Then, on Jan. 20, 2012, during the team’s first league home game, everything changed in an instant. “As I planted my right foot to jump into the defender and try to draw a foul, I heard a loud pop,” recalls Bennett. “I fell to the ground and immediately knew something was wrong. There were two doctors at the game who looked me over along with Matt. They all thought my ACL was torn.” An MRI revealed a complete tear of his right ACL and a partial tear of his medial meniscus in the same knee. New Castle’s best player was done for the season. Surgery entailed using a graft from his right patellar tendon to repair his ACL, and all went well. However, the reality of his situation soon set in and Bennett went through a range of emotions—from anger and despair to self-pity. “But once I started my rehab, that all went away and I started focusing on improving and getting better,” he says. “Right away, my goal was to come back an even better player for my senior year. I wasn’t going to use the injury as an excuse for not performing at a high level.” Matanich says the program Bennett began following was R.J. Anderson is an Assistant Editor at Training & Conditioning. He can be reached at: rja@MomentumMedia.com. 8

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Bennett led New Castle in scoring, as well as rebounds, assists, and steals, last season after spending nine months off the court rehabbing. typical of other ACL rehabs he had overseen. “The protocol was given to me by Steven’s surgeon, and it was very easy to follow,” says Matanich, who is contracted out to New Castle by the Henry County Center for Orthopedic Surgery and Sports Medicine, located across the street from the school. “We put in a lot of work.” Just two weeks after the rehab began, though, that work came to an abrupt and painful halt. Feeling confident on his crutches, Bennett was at school descending a short set of steps when he lost his balance. Falling forward, he landed at the bottom of the staircase with his injured leg bent underneath him. Unbeknownst to him, the awkward landing had caused his right patellar tendon to snap. “As I was sitting at the bottom of the stairs, I tried to lift my right leg and I couldn’t,” Bennett says. “I had no strength in it whatsoever, and it wouldn’t move. That’s when I knew it was serious, and I started getting scared. Later that day I had another MRI, which showed that my patellar tendon was torn.” Because a graft from that patellar tendon had been used to repair Bennett’s ACL, Matanich says it stands to reason the first injury may have contributed to the second. Days later, on Feb. 15, Bennett was back under the knife having his second procedure in nearly as many weeks. With his patellar tendon reattached, Bennett entered a sixTR AINING-CONDITIONING.COM

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ComebackAthlete

Steven Bennett New Castle (Ind.) Chrysler High School Injury: Torn ACL and patellar tendon. Rehab Outcome: Returned from two separate injuries and three surgeries to lead his team to the Indiana High School Section 4A championship game. Will attend Butler University in the fall and attempt to make the basketball team as a non-scholarship walk-on.

week immobilization period with his leg locked in a straightleg brace. “There’s not a whole lot we were allowed to do rehab-wise because the patellar tendon reattachment needed time in order to heal,” says Matanich. At that point, Bennett says his frustrations reached a whole new level. “I couldn’t do anything on my own,” he says. “My leg always had to be straight, and I couldn’t lift it by myself. It would take me an hour just to take a shower, and I needed help getting in and out. Many of the daily activities I took for granted were taken away.” By early March, the six weeks had finally come to an end and Bennett’s surgeon gave Matanich the okay to begin the recovery protocol. This time around, however, the process would not be as predictable as the original ACL rehab. “I have done hundreds of ACL rehabs, but I have never had one that was set back by a patellar tendon tear,” says Matanich. “Because Steven could not bend his knee for six weeks, there was significant quad atrophy, and both his quad and patellar tendon had become very tight. Right away, our main focus was to regain flexion in that leg, which proved to be a very slow, tortuous process. “We worked two to three hours a day sometimes, and we pulled out all the stops to try to bend his knee—from me cranking on him manually to putting him on a Cybex machine,” Matanich adds. “The surgeon said we could push as hard as Steven’s pain threshold would allow, and 10

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we certainly did. But if the kid is sitting there in tears, writhing with pain, you can only go so far.” Through March, April, and May, regaining even a degree of flexion a week was considered successful. “We had to focus on maintaining a positive mindset and keeping the athletic training room high energy and lively,” Matanich says. “We wanted Steven to look forward to coming in, even when he wasn’t seeing improvement, which is not an easy thing to do.” The uniqueness of the situation did not go unnoticed. “Our facility serves as a clinical site for the Ball State University athletic training program and Steven became a case study for them,” Matanich says. “They saw that every day was a battle and the starting point was so difficult. With a typical ACL rehab, you see improvement almost daily. Because of Steven’s patellar tendon repair, there were days and weeks with very little to no progress. But the students also saw how we all stayed with it and never got discouraged.” With the rehab at such a glacial pace, Bennett was given the option of undergoing a surgical manipulation. A 30-minute procedure, he would be under anesthesia while the surgeon bent his leg without the hindrance of pain. Though Bennett was reluctant to go through another surgery for fear of even more setbacks, Matanich persuaded him to give it a try. He went in for the procedure on June 7. “It was a complete success,” says Matanich. “Basically, the surgeon opened up the knee, removed the wire that had pinned the damaged tendon down, then started bending the knee five degrees every couple of minutes. By the time he was done, he had obtained full flexion— which he took pictures of to show us that it could indeed bend all the way.” The next day, Bennett and Matanich went back to work. “There was a big difference right away,” says Matanich. “That first week alone, we regained 15 to 20 degrees, and his progress just took off from there.

“With a typical ACL rehab, you see improvement almost daily. Because of Steven’s patellar tendon repair, there were weeks with very little to no progress.” “Once we got close to full flexion in early September, we were able to really advance his rehab and ramp up the traditional ACL elements like strengthening and proprioception while transitioning to more sport-related activities,” Matanich adds. “His comfort level is on the basketball court, so whenever we could put a basketball in his hands for various drills, we would.” The expedited pace reinvigorated Bennett. “I was finally making the gains that I was expected to,” he says. “Instead of seeing minute improvements every two to three weeks, I was progressing every day. I was so relieved.” Bennett continued doing rehab activities with Matanich through the summer and into the fall. Throughout the proTR AINING-CONDITIONING.COM

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ComebackAthlete cess, there was one date circled on everybody’s calendar: Nov. 20—New Castle’s first game of the 2012-13 season. With the rehab finally on a more typical timeline, Bennett began doing running and jumping exercises in October and was cleared for half-court two-on-two and three-on-three competition. By November, he was released to fully participate in five-on-five drills and scrimmages.

“It was a complete success ... The surgeon opened up the knee, removed the wire that had pinned the damaged tendon down, then started bending the knee five degrees every couple of minutes.” When New Castle’s first game arrived, 10 months after his first surgery, Bennett was ready. Wearing a brace that would be a part of his uniform for the entire season, Bennett announced his return by lighting up Blue River High School to the tune of 23 points, 13 assists, and nine rebounds while leading the Trojans to an 89-38 victory. Despite his production not having missed a beat, Bennett admits that his quickness and jumping ability were somewhat compromised. “When I first came back from my injury, I really had to focus on the little things a lot more,” he says. “I couldn’t drive as well as I used to, so I had to figure out

more ways to score from the perimeter. That meant improving my touch, incorporating more shot fakes, and getting better at using screens to free myself for open looks.” As the season progressed, so did Bennett’s athleticism and court skills. Finishing the regular season with an 11-9 record, the young, undersized Trojans entered the first round of the Class 4A sectionals with a game against higher seeded Anderson High School, which had defeated New Castle by six points just 11 days earlier. Seeking the program’s first sectional victory since 2008, Bennett poured in 30 points as New Castle won by 15. Along the way, he eclipsed 1,000 points for his career. “That’s the game that sticks out as far as signaling that he was pretty much all the way back,” says Matanich. “He was on fire and just willed his team to victory. He was knocking down almost every shot he took and it seemed like everything was finally normal with him.” New Castle continued its run into the sectional championship game, where it was defeated by Pendleton High School. Calling it a “satisfying season,” Bennett ended the year leading the team in scoring, rebounds, assists, three pointers made, and steals. Bennett’s 1,047 career points put him 12th all-time in the New Castle record books. He also became the seventh player in school history to earn three first team allNorth Central Conference selections (he was honored after his junior season, despite only playing a couple of league

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ComebackAthlete games), and along with teammate Korey Ryan, was named a New Castle Courier Times All-Area Co-Player of the Year. His postseason included appearances in a number of high school all-star games featuring the state’s top seniors. Despite Bennett’s impressive season, offers from the Division I teams that expressed interest in him prior to his junior season never materialized. “Before I got hurt, I was getting some looks from Ohio University, Miami University of Ohio, and Davidson University,” Bennett says. “Those went away after my injury, and there were times I got frustrated and mad about what could have been. But eventually I just accepted that life isn’t always fair. Besides, there are a lot worse things that happen to people than what I went through.” Still, Bennett’s dreams of playing Division I basketball weren’t completely dashed by his injuries. In the fall, he will attend nearby Butler University, where he will have an opportunity to make the team as a non-scholarship preferred walk-on. “Although I got offers from some Division II and NAIA schools, I ultimately decided that since I had the skills to play Division I before I got hurt, I was going to work hard to get back to that level again,” says Bennett. “We’ve had six or seven players from New Castle play at Butler and I think the program and the school are a good fit for me. I’m excited to see what I can do.” Matanich says Bennett’s rehab is one that will stick with

him for the rest of his career. “Seeing him back out on the court after all the time we’d spent together was one of the more rewarding experiences I’ve had as an athletic trainer,” Matanich says. “Steven and I developed a bond, and what he went through is something we’ll probably talk about for a long time. That’s why athletic trainers do this job—to have an impact on a kid’s life.” Bennett says it was Matanich’s attitude and personal-

“Before I got hurt, I was getting some looks from [Division I schools]. Those went away after my injury, and there were times I got frustrated and mad about what could have been.” ity that helped him turn a difficult rehab into a successful return. “I give so much credit to Matt,” says Bennett, who is considering going pre-med at Butler. “He was extremely patient and understanding of what I was going through and always positive, even when we weren’t making much improvement those first few months. “Despite the pain and frustrations, I looked forward to working with him every single day,” Bennett adds. “I know it wasn’t easy on him either, yet he constantly went the extra mile for me.” n

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LEADERSHIP

Finish Line Co-Captain Larry Venis (in red hat) and Finish Line Physician Team Captain Lyle Micheli (in yellow hat, who originated medical coverage at the finish line 36 years ago) work with others to break down the barriers and attend to the injured.

Prepared © GETTY IMAGES

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LEADERSHIP

From veteran athletic trainers to students, the sports medicine team at the Boston Marathon responded heroically to the bombings on April 15. What preplanning enabled everyone to act with such calm efficiency? And what lessons can we learn about medical coordination from the tragic event? By R.J. Anderson

for the worst TR AINING-CONDITIONING.COM

s he has done on the third Monday in April for 35 years, Brian FitzGerald, LAT, ATC, was at the 2013 Boston Marathon finish line tending to exhausted and dehydrated runners. When the first explosion went off at 2:49 p.m., he immediately thought the worst. “That’s got to be a bomb,” FitzGerald said to himself. After a second boom 12 seconds later, the Finish Line Coordinator/Athletic Trainer Coordinator for the Boston Marathon was sure he was hearing a violent detonation. As unthinkable as it seemed, two bombs had gone off in crowded spectator areas near the finish line at the Boston Marathon. As smoke filled the air, pandemonium ensued and FitzGerald did what athletic trainers do when a situation turns difficult: He responded. Running toward the smoke a few yards away, FitzGerald, along with his team of white-jacketed, red-hat-wearing athletic trainers, quickly reached the area where the first of the two bombs had gone off. They tore down the fencing separating the viewing area from the racecourse and encountered what FitzGerald describes as “another world.” “It was eerily quiet once I stepped over the fence. A fire alarm was the only real sound,” says FitzGerald, whose full-time job is Community Outreach Coordinator at Boston Children’s Hospital. “The smell of the smoke was powerful and everywhere I looked there was blood and severely injured people. Those of us who came upon that scene started trying to help the injured any way we could. We didn’t believe what we were seeing at that point.” Finish Line Co-Captain Jon Dana, ATC, Director of Sports Medicine at the University of New Hampshire, arrived at the area the same time FitzGerald did. “Noth-

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

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LEADERSHIP ing in my career prepared me for what I saw when I got there,” says Dana. “When I stepped over that fence and looked at all that blood on the ground, I remember thinking, ‘This is going to be unbelievably difficult.’ But like all of the other people wearing white jackets [indicating they were medical providers], I knew I had to go in and help—it was my job and my duty as a medical professional.”

I think how I reacted was more a function of my training than instinct. “During an injury situation, the athletic trainer is the one with the calm head,” Dana continues. “That’s how all of us reacted in those moments at the marathon.” As the athletic trainers and other medical personnel tended to the victims, applying pressure to bleeding wounds and using belts, T-shirts, and

“I was astonished when the Boston EMS Special Operations Captain told me we evacuated that many victims from the scene and out into ambulances in 22 minutes. He looked at me and replied, ‘That is because all your people ran in the right direction.’” Dana says his focus immediately narrowed and the calm-amid-thestorm mentality that he’d developed during his three decades as an athletic trainer kicked in. “The stuff I saw was so far beyond what I’m experienced in dealing with, but when you’re in a situation like that, you don’t have time to think about the pain and suffering the same way as if you were an outside observer—you have to react and do what you can to help,” he says. “I’ve been an athletic trainer for a long time and

ID card lanyards to tie impromptu tourniquets, athletic training student volunteers who had been transporting tired and dehydrated runners with wheelchairs from the finish line just minutes earlier came rushing to the scene. They quickly used the wheelchairs to bring the severely injured to nearby ambulances and a finish line medical tent that had been transformed into a triage area. “The kids reacted perfectly and I’m telling you we really needed those

NEW AWARENESS In the aftermath of the Boston Marathon bombings, many administrators are re-visiting their event planning as it relates to security and trauma response. At the University of New Hampshire, Head Athletic Trainer Jon Dana, ATC, who was a Finish Line Co-Captain at the 2013 Boston Marathon, has already been part of such a discussion. Just months after the Boston bombings, Dana and other university officials met with a local police officer who also works with the U.S. Department of Homeland Security to talk about the university’s response during a mass trauma scene such as a bleacher collapse, bombing, or shooting. Still, he’s not sure if there is anything more an athletic trainer can do to be ready for such situations. “I’m really not sure how you can prepare for the devastation we saw,” Dana says. Brian FitzGerald, LAT, ATC, Athletic Trainer Coordinator for the Boston Marathon, agrees. “I think any training would entail awareness more than anything medical,” he says. “One good thing we have nowadays is more former military doctors and nurses who have been in war situations volunteering at these events. We had that at the marathon finish line and it was really an asset in treating the severely injured.”

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wheelchairs to get people to the tents and the ambulances as fast as possible,” FitzGerald says. “Those without wheelchairs helped where they could. I had one athletic training student from Bridgewater State University who is a Marine Corp veteran pick up a woman and carry her to the medical tent in his arms.” There were 97 injured people who had to be evacuated from the first bombing site. Ambulances transported the victims to nine different area hospitals in a process that took just 22 minutes. Some were in emergency rooms in as little as eight to 10 minutes after the first explosion. “I was astonished when the Boston EMS Special Operations Captain told me we evacuated that many victims from the scene and out into ambulances in 22 minutes,” says FitzGerald. “He looked at me and replied, ‘That is because all your people ran in the right direction.’” How did the sports medical team respond in such an efficient, orderly— and heroic—way? While FitzGerald says there is no specific training that could have prepared him and his colleagues for that day, he believes that the medical response plan and protocols in place were key in helping bring the victims to safety. The plan for rushing a heat-stroked runner to an on-site medical tent or hospital was applicable for evacuating a spectator with shrapnel damaged legs. And following the chain of command, as displayed by the athletic training students, was also crucial. We talked to FitzGerald and Dana about the planning that goes into the medical response for the Boston Marathon and how athletic trainers fit into that picture. They also share their experiences from that difficult April afternoon and how they and others who were there are helping each other cope in the aftermath. MORE THAN A RACE Commemorating the first battles of the American Revolutionary War, Patriots’ Day is a state holiday in Massachusetts and a major source of pride for the people of Boston. Held the third Monday in April, schools and businesses close and the city comes together in celebration. Athletics play a big part in the day’s festivities with the Red Sox hosting a late-morning game and more than a half million people comTR AINING-CONDITIONING.COM

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LEADERSHIP ing out to appreciate and participate in the city’s crown jewel—the Boston Marathon. For many athletic trainers in the area, the marathon is also an opportunity to give back and re-connect with one another. Each year, 130 or so volunteer their time providing medical coverage for more than 27,000 runners. Working the marathon is a prestigious opportunity and volunteer slots fill quickly. Many, including FitzGerald, Dana, and long-time Boston Marathon Medical Coordinator Chris Troyanos, ATC, (who was under media blackout at the time of publication) have each provided over 30 years of service to the 116-year-old race. As one of the largest single-day sporting events in the world, the marathon also provides elite-level learning opportunities for students in athletic training programs from around the country. This year between 70 and 80 athletic training students from 15 colleges and universities came to Boston to learn the ins and outs of covering a very large sporting event. The majority of athletic trainers working the marathon are located on and behind the finish line. Their job is to observe the health condition of the runners who have just completed their 26.2-mile goal. Usually, that means identifying signs of hyponatremia, heat illness, and dehydration, then escorting afflicted runners to nearby medical tents, which are manned by physicians, nurses, physical therapists, and other athletic trainers. In addition to highly trained medical personnel, the two finish line tents contain each runner’s medical records, cooling tubs, IVs, cardiac testing equipment, and a host of other cutting-edge medical tools. “I don’t think there’s anything like it in the world,” says FitzGerald of the event’s on-site medical facilities. “There are 15 to 20 sections in each tent. Each section has a physician, an athletic trainer, a physical therapist, a nurse, an IV nurse, and a medical records person who all work together to treat runners as they are brought in. Each tent also has an intensive care section as well as an area manned by Boston EMS.” The person responsible for putting everything together is Troyanos, Head Athletic Trainer at Lasell College and Medical Coordinator for the Boston Athletic Association, which puts on TR AINING-CONDITIONING.COM

the marathon. “Chris has been with the marathon for 36 years, the last 19 as the medical coordinator, and he works year-round to organize everything medical-related from the start to the finish,” says FitzGerald. “Since he’s taken over, the medical coverage has evolved immensely, adding things like ice water immersion and temperature recording techniques. Before that, we weren’t using all of the evidencebased protocols as we do now. “And the education component that Chris has added is phenomenal,” con-

tinues FitzGerald. “He has put together a 43-page medical manual for the event that is updated every year. Chris is constantly sharing signs, symptoms, and treatment specifics of the conditions the medical volunteers could see during the event so that they’ll have an understanding of what they’ll be dealing with before race day arrives. Along with that, he creates a safety video that is e-mailed to all of the runners and volunteers.” Coordinating coverage for a 26mile stretch of road is no easy task.

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LEADERSHIP To create a larger blanket of medical oversight that extends beyond his volunteer work force, Troyanos works with officials from every town along the course, ensuring all of the various

EMS’s responsibility in a catastrophic situation, such as a collapse in the stands or something of that nature,” he says. “They’re trained to handle those types of situations. We’re there

“The education component Chris had added is phenomenal. He has put together a 43-page medical manual that is updated every year ... And he creates a safety video that is e-mailed to all of the runners and volunteers.” fire departments, ambulance services, and emergency responders are on the same page. “He also meets with all of the hospitals on the route and educates them on what they might see and what they should have on hand, such as an ice water immersion tub,” FitzGerald says. “Chris’s communication with all of these entities is the key to making the event’s coverage consistent from one town to another.” Although there wasn’t a specific plan in place for dealing with a catastrophic mass trauma situation, FitzGerald says the chain of command was very clear. “We’re taught that it’s really Boston

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to assist and be good Samaritans and do what we can, but when they arrive on the scene, it’s our job to move aside and let them do what they do.” Dana says effective coordination of an event—no matter the size—comes down to the execution of a few key principles. “It requires organizing everything in your head, then projecting that to the people who facilitate your plan—the hospital emergency rooms, the EMS services, and other entities,” he says. “It’s also about getting them to buy into your system.” “There needs to be foresight and an awareness of the logistical challenges

of the area where the event is being hosted,” FitzGerald says. “You also need to think about the type of athletes you’re dealing with, common injuries to consider, and the assets you’ll need to have on hand should something happen. Then it comes down to asset management and delegating responsibilities to make sure you have everything covered.” MARATHON MEN & WOMEN With great on-site facilities and a detailed plan, the medical coverage of the Boston Marathon is recognized as top notch. But what makes it world class are the volunteers who comprise the medical staff. That is especially true of the athletic trainer contingent, which relies on both experience and familiarity to provide efficient care and leadership. “The marathon is a prestigious event and it’s not hard to get people to volunteer,” says Dana, who has done so since 1977 when he was an undergraduate at Northeastern University taking classes alongside Troyanos. “The New England athletic training community is a fairly small, close-knit group.

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LEADERSHIP When we have downtime before the race, it’s a nice opportunity to catch up with old friends, make new contacts, and hang out and tell stories. Then once the race starts, we do what we’re trained to do.” Joining Dana, 26-year marathon veteran Larry Venis, MEd, ATC, Head Athletic Trainer at Boston University, works as a Finish Line Co-Captain under FitzGerald. Dana and Venis each have 25 athletic trainers and 10 athletic training students working for them. Dana points to volunteer retention along with the group’s interpersonal relationships as a big reason things run so smoothly at the finish line area. “Because Chris, Brian, Larry, and I have been doing this for so long, there is an understanding among all of us about our roles and positioning during the race,” Dana says. “For Chris, that means he doesn’t have to worry about the finish line, which is one less thing he has to monitor during the race. “That trickles down to each of our teams as well,” Dana adds. “This year I only had two or three athletic trainers who were doing this for the first time, two or three in their second year, and the rest had five, 10, 15, or 20 years of experience working the marathon.” Although they don’t have the years of experience, athletic training students are also critical. In 2013, no group played a bigger role in marathon bombing victim evacuation than these athletic trainers of the future. That day, there were 20 students at the finish line operating wheelchairs under Dana and Venis and a few others shadowing certified athletic trainers. Meanwhile, 50 or so other students worked with the race sweep team, walking various parts of the course to cover everything happening between the start and the finish. When the first bomb went off, like the athletic trainers they were following, the students made the critical decision to run toward the chaos, not away from it. “And there really wasn’t a whole lot of direction from the athletic trainers,” says FitzGerald. “The students just followed our lead and figured out that you put an injured person in the wheelchair and take them to the tent—the same as they would if it was an injured runner. “Our student program has always been a big part of our success,” FitzGerald adds. “I get requests from new schools every year that want to get involved. For TR AINING-CONDITIONING.COM

example, this was the first year for LSU and James Madison University. We want these kids to have the opportunity to come and be a part of the most prestigious race in the world.” ROAD TO RECOVERY Once all the victims had been transported to hospitals and the bomb site transformed into a crime scene, there was one more important thing to be done. FitzGerald turned his attention to making sure his team was okay. With everyone healthy and accounted

for, the volunteers’ day was finished, but the gravity of the situation was just starting to sink in. “It was so fresh and just looping through my mind continuously after I left the site,” says FitzGerald. “I kept wondering if there was more that I could have done and if we could have handled anything differently. I wish I could have done more and gotten to more people and helped them. I also knew there would be others who would have regrets and trouble processing.” The next morning, FitzGerald woke

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LEADERSHIP up early. Back to work at Boston Children’s Hospital, he immediately called members of his team. “I didn’t e-mail them because I wanted to hear voices and connect with each person. I wanted to feel what they were saying and make sure they would have another person with them in the days that would follow,” he says. “I also talked to athletic training faculty leaders who were with their students on the way back to their campuses and made sure there were support networks set up for all of them.” And there were. “Everybody at those institutions were wonderful in opening their arms up to those kids,” FitzGerald says. “They made sure there were people the students could talk to about the experience.” Over the next few days, he and Troyanos followed up with each group of athletic training students. In one meeting they joined students from Boston University in a group Skype with those from LSU and the University of South Carolina. “They were happy to see us and we were happy to see them,” FitzGerald says. “Whenever we’ve met or talked with the students who were at this year’s marathon it’s been

“Talking about it with different people gives me various ways to look at the experience and I’m okay with that. That’s how I have to process it.” great. We’re bound with all of these people for life. We need to keep in touch and continue talking about what we’ve seen, how we’re feeling, and how we’ve been affected. I’ve come to realize how important it is to stay engaged, communicate, and not withdraw when things like this happen.” That’s the exact advice Dana received from counselors at New Hampshire. “I was told the best way to deal with post traumatic stress disorder is to keep talking about what happened,” he says. “So that’s what I’ve done. Anytime anybody has asked a question, I answer it. Anytime it comes up, I discuss it, whether that person was there that day or not. “I look at it as therapy,” Dana adds. “Talking about it with different people gives me various ways to look at the experience and I’m okay with that. That’s how I have to process it.”

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BOSTON STRONGER Despite all of the challenges and despair created by bombings at the Boston Marathon, both Dana and FitzGerald acknowledge that it could have been much, much worse. “The bombers actually picked a spot where there was probably the highest concentration of medical personnel in Boston at any time of the year,” Dana says. “You could not have asked for a more prepared location with better medical staffing to handle that type of situation.” “And all of the emergency room physicians told us the same thing,” says FitzGerald. “They said if we hadn’t gotten the victims to them as quickly as we did, there would have been a lot more deaths.” And if there are any questions about whether the impact of the 2013 attacks will dissuade medical volunteers from returning next year, FitzGerald can quickly put those doubts to rest. “Every single athletic trainer I’ve spoken with told me to make sure his or her name is on the list for next year,” he says. “We’ll definitely be back bigger and stronger.” n TR AINING-CONDITIONING.COM

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FREEING THE FOOT

CHARLIE RIEDEL/AP PHOTOS

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As running barefoot and with minimalist shoes has taken off, new research is uncovering the pros and cons of the practice, as well as how to shed shoes safely. by Dr. Daniel cipriani

he popularity of barefoot running has once again reared its dirty foot. From competitive track and field athletes to weekend warriors, more and more runners want to feel the earth underneath them while they train. This “trend” actually has a long history. When the running fitness craze took off in the 1960s, a small but very dedicated group opted to run without shoes. This practice gained international attention after the barefoot running success of athletes such as Abebe Bikila (1960 Olympic gold medalist in the marathon) and Bruce Tulloh (1962 European Championships gold medalist in the 5000 meters). Two decades later, the world was captivated by Zola Budd (1985 and 1986 World Cross-Country champion) who mainly ran barefoot. Her success revitalized the notion that running shoeless might have performance benefits, and many gave it a try in the mid to late 1980s. In recent years, there has been another push to trade running sneakers for bare soles thanks in part to the book Born to Run by Christopher McDougall, published in 2009. McDougall argues that the human species is engineered for long distance running (hunters would run their faster prey Daniel Cipriani, PhD, PT, is an Associate Professor in the Department of Physical Therapy at Schmid College of Science and Technology at Chapman University, where he teaches courses in biomechanics and kinesiology. He can be reached at: cipriani@chapman.edu or follow him on Twitter @danielcip3. T&C JULY/AUGUST 2013

optimum performance into a fatigued state to allow capture without the use of weaponry) and compares the incredible distance running performances of today’s athletes to current-day tribes in Mexico and Africa who run either barefoot or in nothing more than a sandal. Mc-

the mechanics of barefoot running, but may be more efficient. Thus the big question arises: Is barefoot and minimalist running better than shod running (with shoes)? Is it more efficient? Is it safer? Thanks to the research of epidemiologists, biomecha-

Running barefoot and in minimalist shoes involves a different technique than running with traditional shoes. This results in differences in foot position at initial landing, stride length, cadence, knee flexion, and ground reaction forces. Dougall likens barefoot running to a sense of freedom and liberation from modern-day constraints. Another significant factor contributing to the growth in popularity of barefoot running is the development of “minimalist” style shoes (such as Vibram’s FiveFinger, New Balance’s Minimus, and Sockwa’s G2/G3). These have allowed runners to try near-barefoot training without risking injury to the plantar surface of the foot. Current research suggests that running in a minimalist shoe not only replicates

nists, and sports medicine specialists, we are much closer to answering these questions—although there is still more research to be done. LANDING PATTERNS Before we can even begin to compare the pros and cons of each style, it is important to understand the mechanics of running with shoes vs. without. Running barefoot and in minimalist shoes involves a different technique than running with traditional shoes. This results in differences in foot position at initial

landing, stride length, cadence, knee flexion, and ground reaction forces. All barefoot runners and most minimalist shoe runners land using the midfoot or forefoot portion as the primary contact area on initial impact. Unlike shod runners, the heel touches the ground barely, rarely, or not all. Landing this way, the athlete’s ankle begins contact with the ground in a position of slight plantarflexion. The vast majority of shod runners, on the other hand, land with the ankle neutral or slightly dorsiflexed and with the heel as the first point of contact. Mid/forefoot landing requires the use of a shorter stride and a higher cadence compared with the traditional heel-strike runner. This leads to slightly greater knee flexion of mid/forefoot strikers, particularly during the stance component of running. In looking at ground reaction forces, it has been demonstrated that the mid/ forefoot striker experiences a reduced impact force at initial contact. This is due to the action of the ankle joint, which undergoes a rapid dorsiflexion motion to absorb the impact with the ground. The heel-strike runner absorbs this force

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optimum performance through very limited subtalar joint eversion and knee flexion, resulting in a higher and more rapid impact force. However, it is important to note that the overall peak ground reaction forces are very similar between a heel-strike runner and a forefoot-strike runner. The slight difference is that the forefoot runner does not have an initial spike in ground reaction force. INJURY RISK It’s no secret that injury risk for runners is high and many who have parted with their traditional shoes are seeking a way to lower their chances of injury. Research on injury rates for shod runners is bountiful, showing that 75 percent of these athletes will sustain some form of injury. Because mid/forefoot strikers experience less impact on initial contact with the ground, it seems to follow that this should reduce the prevalence of injury. A recent survey study performed on military personnel examined this idea and suggests that midfoot and forefoot striking might be a way to protect against injuries. In a sample of 900 runners, the authors found that those who self-reported to be mid/forefoot strikers (69 percent) had less injuries than those who self-reported as heel strikers (31 percent). Unfortunately, self-report of striking style is highly unreliable, with other research showing that nearly 70 percent of runners who claim to be mid/forefoot strikers are actually heel-strike runners. Another study examining more than 1,000 marathon runners, which

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Consider the dancer, who performs highly dynamic activities in minimal footwear. These athletes complete demanding foot-to-ground movements including jumping, landing, twisting, and spinning. Interestingly, they demonstrate a significantly lower incidence of injuries to the knee, particularly the ACL, when compared with court sport athletes. It could be argued that because dancers choreograph their movements, they are well prepared for every jump and landing. However, research has demonstrated that the difference in landing styles between men and women basketball players (leading to higher rates of ACL injuries in females) does not exist between dancers. Female and male dancers exhibit similar hip and knee movement when landing, which protects the knee from injury. Could it be that training in a minimalist shoe or barefoot provides athletes with improved proprioception and footknee-hip interactions compared with athletes who train and compete in standard athletic shoes? Research on this hypothesis would be interesting.

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optimum performance videotaped their running form at a midpoint location in the race, noted that over 90 percent landed on their heels. A smaller study looking at a sample of very select competitive runners (36 heel strikers and 16 forefoot strikers) found a two to three times greater incidence of injury in the heel-strike runners compared with mid/forefoot strikers. While these results are certainly promising, the small number of subjects and highly specific sample makes it difficult to apply these findings to all runners. One theory to explain the possible reduction in injury risk relates to the differences in ground reaction forces. As mentioned earlier, mid/forefoot landing eliminates the initial spike in ground reaction force that is seen with heel-strike runners. Advocates of barefoot running postulate that this initial impact is a cause of injury in shod runners. However, research has not found any relationship between ground reaction forces and injury risk (primarily stress fractures) in runners. A study examining the correlation between these forces and the incidence of stress fractures in runners found no substantial differenc-

es. In addition, the bulk of the ground reaction forces (shod or barefoot) occur during the full loading and propulsive aspects of running, which are similar between the running styles. Unfortunately, there have not been any studies to date examining ground reaction forces and the multitude of injuries observed in runners, including tendonitis around the foot, ankle, and knee, as well as anterior knee pain. Barefoot enthusiasts have also speculated that running shoes impede foot proprioception and reduce foot strength, which could leave the athlete more susceptible to injury. However, there is no research to support or refute these anecdotal claims. Nor is there any research to support the notion that greater foot strength contributes to injury prevention. Overall, running shoes have not yet been shown to increase or decrease injury risk. In fact, the rate of running injuries reported in the literature has not changed over the past 40 years, despite all of the advances made to sneakers. There are a few biomechanics studies that suggest a modern running shoe

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might contribute to the pronation motion at the foot, rather than control for this motion. And since excessive relative pronation is associated with injury risk, there is certainly a need for further research to test this theory. Although we know a great deal about the injury prevalence in shod runners, we do not know the rates or types of injuries of barefoot runners, due to the lack of research on the topic. Beyond the obvious plantar foot skin injuries, anecdotal evidence reports an increased risk for metatarsal stress fractures and Achilles tendonitis. However, it is not clear if the incidence rate of these injuries is less or greater than that of shod runners. The good news is that research is starting to pick up on barefoot running. In March, a team of researchers reported they found that running on the ball of the foot places greater stress on the metatarsals and could potentially lead to stress fracture development. MRIs revealed that runners transitioning to minimalist shoes had greater increases in bone marrow edema in their feet and more stress injuries than those in sneakers.

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optimum performance PERFORMANCE QUESTIONS Beyond injury risk, many athletes want to know if there are any training or performance benefits to going minimal or barefoot. Those who have made the switch often say they feel they are running faster and getting a better workout. Many also report feeling less “beat up” after a run. However, research has yet to find anything to back this up. In terms of energy cost, limited research on this topic has found no significant differences between barefoot and shod running. The benefit of less mass (no weight of the shoe) during barefoot running is lost because of greater muscle work from using the ankle plantarflexor muscles (the gastrocnemius and soleus) to absorb the initial impact and produce propulsion.

Instead of suddenly tossing away traditional running shoes, athletes should slowly introduce barefoot or minimalist running to their training. This allows the athlete time to develop different movement skills associated with midfoot and/or forefoot striking. Running in a minimalist shoe, however, does provide a slight energy advantage. The same research that examined energy cost between shod and barefoot runners also included a group with minimalist shoes, which were found to be the most efficient, albeit by only a slight amount. It is possible that the shoe material, along with the running mechanics, contributed to this advantage. Still, the energy advantage did not translate into improved performance. Another area to examine is temporal and spatial differences, since the mid/forefoot landing results in a shorter stride and a higher cadence compared with the traditional heel-strike runner. Barefoot/minimalist shoe runners often report feeling less stressed while training by taking shorter, faster strides. But we do not know if this translates into improved performance. One possible advantage is the fact that, as speed of running increases, the tendency to run on the midfoot or forefoot also increases. At speeds approaching sprinting, the runner will use an entirely forefoot landing style. Thus, training in a minimalist shoe would likely help prepare a runner to develop faster running form. A recently published study refuted the notion that all barefoot runners land on the ball of the foot, finding that increased speed leads to adopting a forefoot running style, while runners landed on their heels while going slowly. This supports the notion that faster running is facilitated by forefoot landing mechanics, but that barefoot running does not always translate to forefoot landings. MAKING THE TRANSITION If your athletes want to make the switch to barefoot running or minimalist shoes, how can you help? First, figure out if the move is right for them. Although there is a lack of research to indicate who is best suited for barefoot running, it is safe to suggest that any current runner likely has the potential to train in a minimalist shoe or even barefoot. With that said, individuals who have extremely flat feet (exTR AINING-CONDITIONING.COM

optimum performance cessive pronators) should pay particular care with progression to a barefoot style of running. An individual with a “high arch,” however, is already somewhat programmed to the stress of forefoot landing and might make this transition a bit more readily. Regardless, the best plan is a gradual, careful progression from a heel-strike to a forefoot-strike running form. To begin, instead of suddenly tossing away traditional running shoes, athletes should slowly introduce barefoot or minimalist running to their training. This allows the athlete time to develop different movement skills associated with midfoot and/or forefoot striking while running. It also gives the skin on the bottom of the foot the time necessary to adapt to these new forces. Frequent barefoot walking before beginning barefoot running is a great place to start. It is also important to explain the changes in running form. The athlete will need to adopt a short stride and high cadence while remaining in a more upright running posture. This will require slightly greater knee flexion prior to initial contact. The athlete will need to consciously avoid heel strike, attempting to land with the foot flat on the ground or biased toward the forefoot. These form changes will place a much greater mechanical demand on the metatarsals and metatarsal heads, as well as the Achilles tendon and calf musculature. Preparatory activities to condition the foot and calf musculature can include backward running and uphill running. Backward running has been shown to improve function of the calf muscles, and it requires a forefoot landing pattern and greater knee flexion at initial contact. Training on a treadmill or track are the safest environments for this form of running. Running and walking briskly uphill requires a forefoot strike pattern, greater knee flexion, shorter stride, and greater muscle effort of the calf musculature, as well. Before the athlete takes off with no shoes, he or she should try wearing true minimalist shoes such as the Vibram FiveFinger sock or Sockwa’s G2/G3 shoe-socks for a period of time. Beginning with some form of foot protection, while avoiding the feel of traditional shoes, might improve the athlete’s transition to a forefoot striker and eventually barefoot runner. The final step is to condition the skin on the bottom of the foot to withstand TR AINING-CONDITIONING.COM

the abrasive forces encountered with ground contact. This will likely require several months of gradual dosage of fully barefoot running. Again, barefoot walking is a sensible place to start. Recommendations range from 10 to 15 minutes of barefoot running three days a week, to exposure of five to 10 minutes a day, gradually increasing barefoot running time at a rate of 10 percent per week. And of course, selecting the safest terrain for barefoot running, which is free of any litter or other debris, as well as training with

sufficient daylight to see the running surface are critical. Most important to remember is that, regardless of footwear, the predominant risk factors for injury remain excess mileage and training errors. Too many miles puts athletes at greater risk for injury, and any runner (particularly a novice) is at increased risk when training is not conducted properly. In fact, any major change, whether it is an increase in distance or speed work or running on new terrain, ups the chance of injury. n

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treating the athlete

Behind the Line Preventing heat illness in football players is a behind-the-scenes team effort. Getting coaches on board requires good communication and persistence. By Patrick Bohn

hen Joe Iezzi walked onto the field for his first preseason football practice as Head Athletic Trainer at Downingtown (Pa.) High School West in 1988, he was shocked at what he saw. It was a scorching hot day in August, and all the players were wearing full gear. “I asked the head coach, ‘What are they doing in pads and helmets in this heat?’ and he responded, ‘Joe, there are no rules governing what they can or cannot wear,’” says Iezzi, MS, ATC, LAT, PES, who retired in June. “That blew my mind. I spoke with him about how having all that gear on wasn’t good for the players and got them out of the pads immediately.” Twenty-five years later, policies and attitudes regarding football practices in the heat have changed significantly thanks to ongoing research and educational efforts. But challenges remain, particularly at the high school level, where some coaches accept measures like sideline fans, but push back against acclimatization best practices and frequent water breaks, worried they will interfere with the team’s practice regimen. For an athletic trainer, working with their football coach to keep players safe in the heat can be difficult. In this article, we talk with experienced athletic trainers about how they’ve brought coaches up to speed on hydration, heat illness prevention, and acclimatization, and helped them adjust to legislation recently put in place in several states. Patrick Bohn is an Assistant Editor at Training & Conditioning. He can be reached at: pb@MomentumMedia.com. TR AINING-CONDITIONING.COM

Thanks to the collaboration of Director of Athletic Training Jack Marucci and Head Football Coach Les Miles, LSU football players receive the most up-to-date techniques in heat-illness prevention. AP PHOTOS/PATRICK GREEN T&C JULY/AUGUST 2013

treating the athlete Turning the tide One of the biggest moves to prevent heat-related illnesses at football practices in the last decade has been the adoption of heat acclimatization guidelines at all levels of the game. In 2003, the NCAA implemented preseason acclimatization rules, and in 2009, the NATA released a consensus statement titled, “Preseason Heat-Acclimatization Guidelines for Secondary School Athletics,” hoping every high school state association would adopt it. The guidelines cover everything from practice lengths, to time required between practices, to rules for introducing shoulder pads, full contact, and two-aday practices. But many have been slow enacting these policies. As of this writing, only 10 states have fully adopted the NATA’s guidelines, with Missouri being the most recent to do so in May of 2013. While several other states have some rules in place to address acclimatization, they fall short of the NATA’s recommendations. What’s preventing universal acceptance? “State associations are listen-

ing to the football coaches who cling to old ideas and not the medical professionals,” says David Csillan, MS, ACT, LAT, Head Athletic Trainer at Ewing (N.J.) High School and co-chair of the task force that drafted the NATA guidelines. “The coaches say, ‘The more hours players work and the harder they work, the tougher they’ll be.’ That gets the associations’ ears, while our voices get drowned out.” When Csillan tried to get the NATA guidelines passed in New Jersey in 2009, the biggest road block was the addition of football coaches to a subcommittee of the state’s Sports Medicine Advisory Committee that was charged with studying the idea. “Once that happened, the conversation shifted completely,” he says. “Instead of the discussion focusing on player safety, it turned to coaches saying they would lose practice time and as a result, not be as prepared for games. “To get any of the guidelines in place, we had to give and take,” continues Csillan. “For example, rather than waiting five days before allowing full pads and hitting, we settled on three. It

was tough for the medical professionals to accept, but in order to get some of the other guidelines passed, we had to compromise with the coaches.” Csillan’s advice to others working on getting the NATA’s recommendations in place is to come armed with a lot of information. “Make sure you have plenty of research to present to your state association,” he says. “Then, go beyond the data. For example, you can find the number of student-athletes who were taken to a hospital after suffering from heat illness, but be sure to remind your audience that the actual total is higher and includes athletes whose parents took care of them at home.” If providing research doesn’t work, explaining liability realities can be effective. “While our committee was discussing how to get the full guidelines passed, we had a meeting with area lawyers,” Csillan says. “They told us, ‘If a student-athlete goes to the hospital or dies because of heat-related illness, the first thing we’re going to do is ask the state association why they’re not using the guidelines suggested by the national association. Then, we’ll ask

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treating the athlete

SCHOOL RULES While heat guidelines developed by governing bodies are important to put in place, some athletic departments also construct their own school-specific policies. Jeff Pounds, MS, ATC, NASM-PES, Director of Athletic Training at Coastal Carolina University, helped put protocols in place for the athletic program when the school started a football team in 2002.

same guidelines the Marine Corps did because they had done the most research on working in heat while wearing gear,” Pounds says. “But we’re constantly evaluating the policy and looking for ways to improve it. We recently switched to the guidelines used by the Georgia High School Association, because we felt they were more relevant to athletics, especially football.”

“At that time, there wasn’t as much information out there, but we based a lot of our guidelines on the research done by Douglas Casa on heat illness,” Pounds says. “Any policy you create needs to have a foundation in existing research because that will give it legitimacy.”

The final piece of the policy covers fluid replacement and hydration guidelines. Overall, Pounds says it has been accepted by the coaching staff, but there are things you can do to make it go over easier.

Pounds adds that a policy shouldn’t simply be a list of restrictions. It should also educate those who read it. “The first half of our protocol consists of the definition, prevention and treatment of, and recovery from heat illness,” he says. “We wanted to make sure that was explained in enough detail that the coaches understood its importance.” Another component is a chart detailing Wet Bulb Globe Temperatures (WBGT) and the activities permitted when each threshold is reached. “For a long time, we used the

“We didn’t give coaches a lot of input into the creation of our guidelines, largely because they trusted us,” Pounds says. “But we kept their concerns in mind. For example, we make sure to take the WBGT readings early enough in the day so the coaches can put a backup plan in place if the temperature is too high to practice. They appreciate that.” To view Coastal Carolina’s heat illness guidelines, which is in its Sports Performance Policy and Procedures manual, click on the “Policy and Procedures” link at: www.coastal.edu/sportsperformance/training.

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treating the athlete the school district the same question.’ Once administrators and coaches start worrying about being held liable, opinions can change quickly.” Finally, Csillan says, patience is critical. “Take things in small steps,” he advises. “Our coaches went nuts in 2009 when we tried to pass all the guidelines at once. But we got several of them in place, and in

relationship. When Georgia adopted the guidelines in March of 2012, William Utsey, ATC, Head Athletic Trainer at Wheeler High School in Marietta, Ga., sat down with his coach and made sure they understood each other. “Before we even talked about the specific rules, I told him that we are all on the same team when it comes to both

“You have to point out that heat illness is not instantaneous, but a cascade, and is therefore 100 percent preventable ... If coaches understand the entire process, they can keep problems from developing.” 2011, we were able to say, ‘Look, we already have most of them. All it takes now is a couple more changes.’ They bought in quickly, and the full guidelines were adopted in May of that year.” A Joint Effort For athletic trainers in states that have embraced the NATA guidelines, the challenge can be getting your coach to understand and implement the new rules while still maintaining a positive

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practices and player health,” Utsey says. “I relayed that I knew what he wanted his team to accomplish on the field, and I didn’t want to get in the way of that. But I did want to help him by keeping his players healthy. “With that mutual agreement in place, addressing his concerns was easier, because he knew I respected what he was trying to do,” he continues. “We took a look at the rules, and he wanted to know exactly what was al-

lowed during the walkthroughs on days one through five. I told him the players should be in shorts, T-shirts, and tennis shoes, and the practice should entail discussing schemes and plays. Because we’d established a good relationship, he knew I wasn’t trying to take away from what he could do.” Mary Cardarelli, MS, ATC, LAT, Head Athletic Trainer at Manchester (Conn.) High School, talked with her football coach not long after her state adopted the guidelines in March of 2013 and has been revisiting that conversation ever since. “Don’t just talk about the rules one time and then leave the coach on his own,” she says. “Coaches have a lot to keep track of, and they may forget what’s allowed on certain days. You wind up taking him by surprise if you tell him that the players can’t wear full pads just as they are getting ready for practice. “Instead, talk to the coach ahead of time about what he’s got planned for the next few days,” Cardarelli continues. “That way, if there’s an issue, you can discuss modifying the plan—maybe having a chalk talk instead. If you’re

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treating the athlete direct about these issues, most coaches will be receptive to you.” When it comes to implementing the guidelines, Utsey stresses one critical point: documentation. “Write down exactly what time practices start and end,” he says. “That allows you to go up to a coach and tell him, ‘We’ve only got a few more minutes.’ Also, if the coach has the players stay in pads for too long, and you need to talk to your athletic director about it, you’re able to show exactly what happened.” Some of the rules might force coaches to change the way they normally do business, so a little advice may be helpful. “One of the things coaches don’t like about the guidelines is the three-hour rest period between practices,” Csillan says. “They feel like they have to babysit the players during that time. Discuss ways they can fill that time productively, such as going over film with the team.” Finally, remember to not just focus on the varsity head coach. “When I spoke to our football coaches about the new guidelines, I made sure every one of them was present,” Csillan says. “This information isn’t just pertinent

to the varsity team, and it’s crucial to make sure the message stays consistent from the head coach to the assistants.” ON THE BALL Whether or not your state has the NATA guidelines in place or your institution follows NCAA rules, every athletic trainer still needs to educate their football coach about the importance of preventing heat illness and heat acclimatization. Jeff Pounds, MS, ATC, NASM-PES, Director of Athletic Training at Coastal Carolina University, starts by explaining what players’ bodies go through in the heat. “You have to point out that heat illness is not instantaneous, but a cascade, and is therefore 100 percent preventable,” he says. “It starts with dehydration, then heat exhaustion, then heat stroke. If coaches understand the entire process, they can keep problems from developing. “Sometimes, coaches are skeptical of health and safety rules because they feel it’s impossible to prevent every injury,” Pounds continues. “But that’s not the case with heat-related issues, so we stress that.”

Iezzi points out how heat illness can affect a player long-term. “I talk to my coaches in terms they understand, and that’s usually performance,” he says. “For example, I’ll tell them, ‘If we push our guys too hard in August and one of them gets heat exhaustion, he’s going to get worn out by that and be more at risk for an injury later in the season.” “Let’s say a player’s been pushed too hard in the heat, and he’s got a deer-inheadlights look,” Utsey says. “I’ll point him out to the coach so he can see how much it affects that athlete’s play.” Another of Utsey’s strategies is to remind coaches about heat illness constantly. “I post information on the dangers and symptoms of heat illness on the bulletin boards of the field house,” he says. “That way, our coach sees it each day as he walks to and from his office. I also post articles on players who get heat illness so he understands what exactly it is we’re trying to avoid.” Jack Marucci, MS, ATC, Director of Athletic Training at Louisiana State University, says high school athletic trainers can also point to the next level for backup. “If you’ve got a coach who talks

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treating the athlete about wanting to run his program the same way a top college does, make sure he knows that we’re already doing all of these things,” he says. “At LSU, our top concern is trying to prevent heat illness. You can tell your coach, ‘The elite schools make this a priority, and you should too.’ “You can even go a step further and talk about how the military takes things like WBGT [Wet Bulb Globe Temperatures] into account when training soldiers,” Marucci continues. “If a coach understands guidelines are in place at other institutions, especially ones that

he and his players respect, he won’t hesitate to implement them at his school.” Equipment can be another critical component to stress. “We’ve taken temperature readings of players’ shirts, and the difference between a black shirt and a white shirt can be as much as 17 degrees,” Marucci says. “Coaches don’t often know how much effect dark colors can have, so point it out to them and request that the players wear light colors when possible.” Coaches may also not be aware of how certain playing surfaces react to

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heat. “Lots of schools are using synthetic turf,” Marucci says. “We’ve taken readings and found that the on-field temperature can be 40 degrees higher on a synthetic turf field compared to a grass one. Show a coach that, and it really makes an impact. Then, they’re more likely to move practice to a grass field if they have the option.” If all else fails, you can discuss worstcase scenarios. “I tell coaches that we don’t ever want to be on the front page of the newspaper because a football player died as a result of the heat,” Utsey says. “If such a tragedy happens, every one of us is going to be out of a job, and it’s possible that we’re going to have to defend our actions to a jury.” WATER, Water EVERYWHERE No plan to protect student-athletes from heat illness would be complete without a component focusing on hydration. It’s crucial that athletic trainers work with football coaches to keep players hydrated both before and during practice. “When I see situations where football players aren’t adequately hydrated, it’s usually not an intentional move by the coach,” Iezzi says. “I think coaches can completely lose track of time during practice. I’ve told my football coach the players need to take a water break, and he’s responded, ‘Really? I thought we just had one.’ Because I write down the time of each break, it’s easy to show him one is needed again.” If your coach constantly takes too long between hydration periods, you have to assert yourself. “This can be difficult, especially if the coach is a respected veteran and you’re inexperienced,” Cardarelli says. “But you have to have the confidence to go out on the field and confront the coach if necessary. Ask yourself: do you want to prevent or treat? “If you get resistance, there are a couple of strategies you can try,” she continues. “The first is asking them what they are hoping to accomplish in practice and point out that denying the players water won’t help. If that doesn’t work, turn it around and ask if they would be okay with their son or daughter practicing in the heat with no water. I’ve found that to be effective.” It’s also important to have coolers and hydration stations set up all around the practice field, so players can drink and cool off even if the team isn’t taking a break. “It’s all about providing resources,” Pounds says. “We have water TR AINING-CONDITIONING.COM

treating the athlete anywhere players group together on the field, so if they’re watching teammates do a drill, they can get a quick drink.” Hydration can be accomplished through food as well, something Marucci says LSU has done for years. “Water is critical, and we have coolers everywhere,” he says. “But inside our cooling tents, we also have plates of fruit, like grapes, which players can eat to effectively re-hydrate.” While keeping athletes hydrated on the field gets most of the attention, Pounds reminds his players and coaches to drink water all day long. “We give each person a water bottle and point out the places to get water in our facility,” he says. “With the football and strength and conditioning coaches on board, we’re able to ensure that players have their water bottles with them in team meetings and when lifting. We challenge the players to be hydrated all the time.” Like many athletic trainers, Csillan uses weight charts to make sure players are drinking enough. “If a player has lost too much weight, he is held out of practice,” he says. “And because the coaches know we’ve talked to the kids about hydrating, the coaching staff will get mad at them for not doing what they need to do, not at us for holding a kid out.” Whenever you talk to coaches or players about hydration, it’s important to speak on their terms. “When a player doesn’t adequately hydrate and says he feels sick, I walk him and the coach though it like it’s an injury evaluation and point out what he could have done to prevent it,” Pounds says. “Rather than getting into numbers, I say ‘With what you weigh, you need to drink a bottle and a half of a sports drink before practice.’ That’s something they can grasp. “Another thing our strength and conditioning coach does, which works really well, is show players a picture of a juicy steak next to beef jerky,” Pounds continues. “He asks them which one looks better and more pliable. Everyone points to the steak. Well, that’s the piece that’s hydrated.” Getting your coaching staff on board with hydration, ultimately, means a better functioning team. “It’s my job as athletic trainer to make sure everything is set up properly,” Utsey says. “Do we have enough coolers? Are they in shaded areas? Are there cold towels soaking? If I make sure I have these things in place, my coach can concentrate on the X’s and O’s during practice.” n TR AINING-CONDITIONING.COM

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Younger athletes’ developing brains are more susceptible to long-term effects of a concussion, so it is critical to be confident in your return-to-play decisions. Concussion Vital Signs (CVS), a reliable and valid online neurocognitive concussion test, when used with a medical evaluation, is designed to help facilitate confident decision-making. • Baseline results highlight raw scores, percentile ranks, and test validity indicators • Post-injury reports indicate whether the scores have returned to baseline, or are within 5% of baseline • Easy-to-view color-coded, longitudinal bar graphs show your student’s progress For more information on CVS, visit ConcussionVitalSigns.com to view free training webinars, and find out how you can help protect the future of student athletes in sports, academics, and life.

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NUTRITION

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If you’re like many athletic trainers, following a nutritious meal plan during a typical hectic day doesn’t easily happen. In response, we offer the ATC Diet. By Dr. Jackie Buell

Author Jackie Buell (right) talks to Ohio State Assistant Athletic Trainer Katie Kneisel about how to incorporate healthy snacking into her day.

long with evaluating injuries and doing rehab, athletic trainers often engage in a little parenting of the students they interact with. That can be a great thing, of course, for young people who need some mentoring. The downside is that athletic trainers can become so busy taking care of “their kids,” they don’t take equal care of themselves. This is especially true when it comes to nutrition. Despite all the education athletic trainers provide to athletes on the topic, that knowledge seems to be forgotten when it comes to meeting their own needs. However, to be at your best throughout the day, you need a nutritious diet as much as athletes do. A donut at 11 a.m. followed by a bottle of Gatorade two hours later can leave you hungry and may prevent you from making good decisions. It can also lead to unhealthy eating patterns. DAILY GAME PLAN The most frequent nutrition mistake athletic trainers make is going for long periJackie Buell, PhD, RD, CSSD, ATC, is a Sports Dietitian for the Ohio State University athletic department and Director of Sports Nutrition in the Medical Dietetics division of the School of Health and Rehabilitative Sciences. She is also an athletic trainer and can be reached at: buell.7@osu.edu.

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NUTRITION ods of time without eating. Due to the hands-on work of athletic training and the lack of downtime during a typical day, there are not natural breaks for meals. Sometimes we don’t eat for six to eight hours, convincing ourselves we are not hungry, or even falling out of touch with hunger cues. We don’t really miss eating until late in the day, and at that point, it’s tough to not pig out. When we get too hungry, it is more difficult to make healthy food choices and exercise portion control. So after finishing a long day of tending to everyone’s needs, hunger starts to surface in a big way without us even realizing it. When we finally get home, that frozen pizza looks good and easy to make, so we throw it in the oven. While it cooks, a bag of potato chips gets opened and one handful leads to another. However, that doesn’t diminish our appetite. The entire pizza is devoured soon after it’s cooked. Even if you eat a healthy dinner, bigtime hunger can lead to consuming large portions. As a result, you may grab three dinner rolls instead of one and have an additional helping of pasta that you don’t need. Not only does this pattern promote unhealthy choices, but it wreaks havoc on our metabolism. Nutritionists call it backloading—being somewhat restrictive all day and consuming most of our calories in the evening hours. Studies have shown that this behavior leads to being less sensitive to insulin and having less ability to manage weight. While our bodies are undernourished during the morning and afternoon, our metabolism slows down, and we will not burn as many calories. Instead, we want our

metabolism to work well all day so our body uses calories as it should. The best way to stop this pattern is to eat small, frequent meals throughout the day and include enough fat and protein among the carbs. People who eat every two to four hours throughout the day can usually control dinner portion sizes better. If you chronically overeat at dinner, evaluate your eating habits earlier in the day. Do you eat breakfast? Do you take time to eat a healthy and balanced

There is now quite a bit of research showing that people who eat a mixed breakfast of protein, fat, and carbohydrate are more likely to be less hungry throughout the day. lunch? Do your snacks satisfy your hunger? Getting on track with a solid meal plan is an important step to managing consumption. OFF TO A GOOD START Breakfast is still considered the most important meal of the day. There is now quite a bit of research showing that people who eat a mixed breakfast of protein, fat, and carbohydrate are more likely to manage their weight, do better at school or work, have fewer behavioral issues, and be less hungry throughout the day. When we eat primarily carbohydrate in the morning with nothing to slow gastric emptying, we end up hungry again in a shorter period of time. Including two to three ounces of protein at breakfast and a little bit of healthy fat will help us avoid that rebound hunger. The problem is that busy people—like athletic trainers—often hit the ground running in the morning instead of priori-

IN AN EMERGENCY Even if you plan out your eating for the day, it’s good to have some emergency snacks. They can be a lifesaver for those days you end up working later than planned or have to take an injured athlete to the hospital. This is where a box of granola/energy bars can be helpful, stashed in your car or office. However, it’s important to read labels and choose bars that provide a good mixture of carbs/protein/fat with some vitamins and minerals. Here are some brands that fit the bill:

• Pure Protein

• EAS Lean 15

• Luna Bars

• Simple Truth

• Balance

• Special K

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tizing this meal. They say they don’t feel hungry and would rather spend the time sleeping in or getting to work early. So how can you make breakfast a priority? If you have a routine in the morning, examine where you might fit in a meal. If you hop on your computer firstthing, why not eat while checking your e-mail? If you are a news watcher, associate breakfast with this morning habit. Eating in the morning does not have to be time-consuming, and it does not

have to involve typical foods like cereal or pancakes. Here are some ideas for quick and easy recipes that have a good carb/protein/fat mix: Blend It: Smoothies are a great way to get all of your breakfast nutrition quickly and easily. Invest in a single serving smoothie blender and throw a little yogurt, milk, fruit, and some veggies into it. Sandwich Lovers: How about a sandwich where you scramble an egg, throw it in the microwave, place it on a toasted English muffin, and add a slice of cheese? Pour yourself a glass of milk and breakfast is ready. Going Greek: Add a handful of granola to a Greek yogurt, and this is a super easy breakfast that can be enjoyed quickly. No Time: If nothing else, make yourself a peanut butter and jelly sandwich the night before, leave it in the fridge, and eat it with a glass of milk the next morning. SUCCESSFUL SNACKING With a solid breakfast getting you going, the next step is fueling throughout the day. The key to implementing the “small, frequent meals” plan is controlling food availability. It stands to reason that if no food is available, you can’t eat. If only junk food is available, you are likely to eat it when you get hungry enough. Learning to make the snacks you want to consume available is the strongest habit you can form. Plan ahead to have healthy foods on-hand when you get hungry. Packing a wide variety of snacks allows you to follow your mood with the right foods. Just like you plan for what to have in your sideline kit to take care of injured athletes, you should plan to have the foods you want to consume with you. Of course, it’s up to you to make the TR AINING-CONDITIONING.COM

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NUTRITION right food choices. You can fill up your bag with apples, bananas, and string cheese, or you can fill it with Snickers bars. An incentive to choose healthy snacks is that your student-athletes will be watching you. Think of the message you send to them when you snack on an apple and string cheese while the team is warming up instead of a candy bar.

falls for most of us is fending off cravings. Food cravings are likely the body and brain talking to us about our nutritional balance and habits. Evaluating your frequency of eating and the variety of foods you consume can lead you to fewer cravings. In other words, our diet needs to include foods that taste good and help us

One of the biggest stumbling blocks for athletic trainers can be eating too many carbohydrates. We see our athletes consuming carbs and follow suit. But while many athletes need those carbs for training, we don’t. Time your snacks so that you are eating every three hours or so. It can be a good idea to plan this out ahead of time, so you don’t suddenly realize you haven’t eaten in five hours. For example, you might plan a late morning snack while looking over rehab paperwork, an early afternoon snack just before you start pre-practice taping, and a late afternoon snack while watching practices on the sidelines. Like your breakfast, each snack should be balanced in terms of carbohydrate, protein, and fat. I also find that folks who crave sweets will have fewer cravings if the protein in their diet is high (around 1.7 g/kg). The most desirable balance for a snack would be: Fat: less than 2 exchanges of fat (<10 grams) Carb: no more than 1-2 exchanges of carb (15-30 grams) Protein: 1-3 ounce equivalents of protein (7-21 grams) Vitamin and mineral nutrient density: 25 percent daily value of most vitamins and minerals. Here are some suggestions for good snacks that meet these criteria: • Small banana with 1 tablespoon of peanut butter • Greek style yogurt with 1/4 cup granola • Trail mix with 2 tablespoons of soy nuts, 2 tablespoons of raisins, and 6 to 8 almonds or walnuts • Pita bread or baby carrots with 1/3 cup of hummus • An apple with one cheese stick. CRAVINGS Changing eating patterns can be difficult. Following the above suggestions is easier said than done. One of the biggest down4 4

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avoid feeling punished by our choices. The daily menu also must provide protein to help us feel satiated and stave off hunger. When we eat simple carbs in solo, we get a little sugar rush that lights up our brain and is somewhat addicting, which is why it’s important to eat some protein and fat at the same time to slow it down. Of course, this likely means the amount of carb needs to be small to prevent the snack from becoming a meal. Anytime you deprive yourself of something you like to eat, you risk “falling off the train” and bingeing on the very foods you eliminated. This binge-deprive cycle can be tough to break. Letting yourself have a small, sweet snack to satisfy a craving can sometimes work well. Eating a couple of cookies during the day might save you from consuming a whole bag of Oreos later. Another way to fight off cravings is by asking yourself why you want certain foods. Often, it is the simple fact that they give us pleasure. What other activities do you do that light up the pleasure centers in your brain? Are you craving a reward? Life balance and psychological health are instrumental in helping us deal with other people as we go through the day. Sometimes food serves as an antidote to the negative aspects of our day. Recognizing this is an important step in changing one’s diet. Exercise is also an important tool. The “runner’s high” you can get from proper exercise stimulates your brain and is much better for your waistline. You know you should prioritize exercise into your day. If you are not, what is holding you back? For some individuals, cravings are even an addiction. If you consistently find yourself craving sweets, consider that addictive brains are addictive brains

regardless of the desire. If you need help with depression or eating addiction, seek professional counseling, just like you would suggest for your athletes. COUNTING CALORIES Any eating plan works only if the overall calorie consumption equals your body’s needs. The Harris-Benedict equation is a good way to estimate your resting metabolic rate and daily calorie requirements and can easily be found with a Google search. Listening to your body also works well. If we eat small, balanced meals all day long, we usually know when we are satiated. If you want to lose weight, that can take a little more focus on the numbers since you need to be in energy deficit. Many dieters make the mistake of eating too few calories and running a larger deficit than what is necessary to promote loss. This will actually decrease metabolic rate and increase loss of lean body mass as your body tries to accommodate the starvation with energy efficiency. A healthier way to lose weight is to eat 300 to 500 calories less than what is needed per day, and to remain at your current energy level. That can be as simple as taking a smaller portion at dinner or changing your snacks from caloriedense packaged food to fruit and yogurt. One of the biggest stumbling blocks for athletic trainers can be eating too many carbohydrates. We see our athletes consuming carbs and follow suit. But while many athletes need those carbs for training, our manual work throughout the day does not come close to the calorie requirements or intensity level of a young athlete (who also may still be growing). For example, if your body requires around 1800 calories per day, you only need 6 to 8 ounces of carbohydrate per day. Having a four-ounce bagel at breakfast covers half of your daily requirement. Having a plate of pasta (2 cups) and a breadstick with the team would likely ring up a full day’s supply of carbs. One last point: Be careful when eating with your athletes. It can be positive to eat with them for the camaraderie and knowledge of their habits but can lead to overeating, especially of carbs. I often say to athletes, “Just because food is free, does not mean you have to eat it.” Not eating those French fries that come with your meal can be an investment in your health. n TR AINING-CONDITIONING.COM

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Rapid Recovery Rapid recovery after maximum power output is arguably one of the most important factors in sport performance. It should be regarded as a cornerstone of performance ranking with strength, speed, and agility. In the heat of a game, athletes need to be fresh, alert and ready as soon as the moment calls. Fatigue is a performance killer; still trying to catch your breath when going into the next play means you cannot be ready to repeat your best possible effort. As a cornerstone of performance, conditioning anaerobic and aerobic recovery should be practiced as such— by being developed and improved with dedicated training time and performance measurements. With such a high focus on developing strength and speed, too many conditioning professionals have moved their attention away from proper conditioning, believing that it occurs as a result of the other trainings and practices they have their athletes do. But this approach creates a huge risk of weakness. Despite their athletes being faster and stronger, if they can only sustain that performance for a short period then it is only a matter of time before the other team will be able to wear down these “better” athletes and take over the game. Athletes need to be 100% ready throughout a game in order to win; victory comes at the end, not the beginning. The 49ers went to the 2013 Super Bowl recognized as the most conditioned team in the NFL. They demonstrated superior performance later in the game (just not enough to win). Likewise, the 2013 Cotton Bowl was a showcase of no-huddle offense. The Texas A&M Aggies were

41-13 winners, keeping the defense anaerobically exhausted. What does the body have to do to improve rapid recovery? High intensity sports rely heavily on the anaerobic energy systems for strength and power, and then the aerobic system is what helps the body recover between bouts of intense exercise. This means improving muscle energy cell (mitochondria) performance and cardiovascular fitness are what help an athlete improve anaerobic recovery and endurance. Better mitochondria performance is a product of greater oxygen demand over longer periods. More intense workouts, sustained for as long as possible are what help athletes improve their fitness. So how can conditioning professionals improve their athlete’s fitness efficiently, without taxing their bodies further or wasting valuable time?

EntER thE hItRaInER PRo The HiTrainer Pro is designed for unbeatable conditioning in a minimal amount of time. By positioning the user in a constant drive phase position (leaning forward to accelerate) during high intensity sprint intervals on a self-propelled running surface, the HiTrainer engages very large amounts of muscle tissue at once. When worked at very high intensity, this

muscle mass creates a high demand for oxygen, forcing the cardiovascular system to peak very quickly. The muscle’s high demand for oxygen is still beyond what can be delivered, so the energy cells are forced to adapt and improve efficiency. Due to the rapid increase in blood flow, the body also gets a jump start on flushing out toxins from the muscles. The result: the anaerobic system is pushed to its limit, near maximum heart rate is achieved faster and longer than any other conditioning method, and the energy system’s performance is improved within as little as a 3-minute protocol—meaning fast, efficient conditioning with less impact on an athlete’s already beaten body. The HiTrainer Pro has already demonstrated significant performance improvements among athletes in professional sports teams and Division I Universities. Long gone are the days of the treadmill; it is just a matter of time before this equipment becomes a standard feature in the gym.

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sport specific A six-time All-American in 2013, Marcelo Chierighini helped the Tiger men’s squad to its 21st consecutive top-10 finish at the NCAA Division I championships.

making waves W By going against the current of traditional thinking, this author has developed a unique and effective strength and conditioning regimen for the Auburn University men’s and women’s swimming teams. By Bryan Karkoska

hen I first started training the swimmers at Auburn University in 1994, I felt like I was working with fish out of water. As powerful and skilled as they are in the water, swimmers are generally less adroit out of it. While there certainly are exceptions, these aquatic athletes are not always comfortable with the exercises common to today’s strength and conditioning regimens—especially when compared to other college athletes. I also felt like a fish out of water myself as I had little knowledge of or experience with the sport. But I was young and full of enthusiasm for training anyone who was willing to give me a chance. At that time, David Marsh was Head Coach of the men’s and women’s teams, and no one had ever been assigned to handle strength and conditioning for his athletes before. Working with Coach Marsh, I developed a training approach that can be summed up by the well-known acronym: K.I.S.S (Keep It Simple, Stupid). I train swimmers the same way I train other athletes, using basic bodyweight exercises and Olympic lifts to develop strength while adding sport-specific exercises where appropriate. But keeping it simple does not mean making it easy. We challenge our athletes inside and outside the weightroom to develop both their own individual strength and team bonds. We have even created special training circuits to drive home the imporBryan “PK” Karkoska, MEd, CSCS, SCCC, is the Head Strength & Conditioning Coach of Olympic Sports at Auburn University, where he has worked with the men’s and women’s swimming and diving teams for the past 19 years. He can be reached at: pk@auburn.edu.

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A FLOATING MAX Rather than assign a specific amount of weight for our swimmers to use in each exercise, we use “floating maxes” for all of our major strength work. Due to the volume of work they do in the pool, some athletes may not be able to hit what I would normally assign as a prescribed weight for a particular workout. Instead, I specify a percentage range of their max, and they choose the exact weight. The ranges are determined by the type of exercise, number of sets and reps, and intensity needed to reach our training goals. As long as they stay within the proper range, which I can quantify through logged progressions, the athletes will continue to progress within the training block. This floating max also gives them the freedom to go beyond what would be their prescribed weights on days they may be feeling strong. This will help them handle higher loads and intensities as the block progresses. With auxiliary movements, which are typically not major strength movements, I allow the athletes to self-prescribe their training load based on how they feel. This has little impact on the accumulation of training effect, because most of the exercises lack the intensity of the major strength exercises.

tance of team in a sport that focuses on individual performance. Our goal is to maximize results when our athletes toe the starting blocks in championship meets at the end of the year, and the results speak for themselves. Auburn’s 13 total NCAA Division I team championships—eight for the men and five for the women—is the third best in NCAA history, and all have come since 1997. BUILDING BLOCKS My philosophy for training swimmers developed out of the work I was already doing with the other sports I worked with at the time, mostly basketball, volleyball, tennis, cross country, and gym-

minous pull-ups, push-ups, sit-ups, and medicine ball activities. Instead, he had a vision that if I could make them better athletes, he would make them better swimmers. We began with fundamental movements centered on the Olympic lifts— cleans, snatches, and jerks. We also included basic strength movements that complimented these exercises, such as squats and pulls, basic bodyweight movements, and plyometrics. This approach helped develop athletic ability and body awareness in swimmers who lacked athleticism, which usually translated into more productive water training. From there, we followed a standard linear progression model—as the

The activities are intended to create duress and push our swimmers. Failure is accepted because if the athletes don’t learn to push beyond their preconceived limits, we will have problems getting them to achieve their full potential. nastics. My ignorance of swimming actually served me well when I began working with the team. Coach Marsh was not a big fan of the traditional swimming training methods of volu48

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athletes became proficient in a movement or gained strength, they graduated to the next exercise in the series. This sequence followed my basic understanding of the collegiate season’s pro-

gression. However, once the swimmers began their championship tapers, I let the coaches call the training shots, as I do to this day. The more time I spent around swimmers, the more I appreciated their work ethic. I watched a lot of practices, asked a lot of questions, and even attempted to learn some of the strokes. This helped me to create some stroke-specific exercises that I use today as part of our supplemental work. These starting points formed the core of our training regimens. I have certainly made some adjustments through the years based both on my increased knowledge of the sport and input from the team’s coaches, including current Head Coach Brett Hawke. But the underlying structure is the same now as it was when I first began nearly 20 years ago. THE PLAN Our training calendar runs from the start of classes in August until the end of the competitive season in March and is composed of seven blocks lasting four to six weeks each. The first three blocks comprise our training phase and focus on work capacity (Block 1), strength (Block 2), and power (Block 3). The second and third blocks overlap with the early part of the team’s competitive schedule, which typically begins in mid-October. During this time, we do not reduce intensity in the weightroom for these competitions, but there may be a drop in total volume and frequency due to travel and meet days. Our competition phase starts in December with Block 4, which consists of individualized work around the end of the fall semester and finals followed by limited strength work during the team’s annual Christmas training trip. After the swimmers return to campus, we focus on power and stroke-specific work (Block 5) followed by separate taper blocks for the Southeastern Conference championships (Block 6) and NCAA championships (Block 7). During the competition phase, we taper athletes’ work individually based on the instruction of the swimming coaching staff. Block 1—Work Capacity: We employ a mix of training modalities in this block, including strength training in the weightroom and speed, agility, and conditioning work outside it—which is known in the swimming world as dryland training. The highlight of our dryland training is our circuits. TR AINING-CONDITIONING.COM

sport specific These circuit sessions are not about developing strength or endurance, they are about building a team. Despite the logistical challenges of accommodating 80 or more athletes at once, the whole team—both men and women—perform circuit sessions at the same time. We regularly divide the team into smaller groups for competitive circuit sessions where they have to work together to succeed. We deliberately avoid using our usual groupings by event. This way, a male sprinter, for example, gets to see how hard a female distance swimmer is working, as they may rarely see each other while training in the pool. During these circuits, we use every type of activity in our training toolbox, including bodyweight exercises, weight and cardio machines, med balls, barbells, dumbbells, and more. The exercise lineup varies from year to year depending on the makeup of the team and the specific goals of the coaching staff. The activities are intended to create duress and push our swimmers to test their limits. Failure is accepted because if the athletes don’t learn to push beyond their preconceived limits, we will have problems getting them to achieve their full potential. We also get to see how the athletes handle failure, both in themselves and others. It’s important to know who will respond by trying harder and who will shirk from the challenge. We want to find out who will rally behind a struggling teammate and who will leave them on their own. In an attempt to push our athletes out of their usual routines and into uncomfortable, challenging situations, the structure of these circuit sessions differs from the standard arrangement of sets and reps with prescribed work-to-rest ratios. Throughout the years, we have employed a myriad of methods, such as no-clock circuits, multiple-set circuits, no communication sets, reverse-order sets, and memorization sets. Another unique aspect of these circuit sessions is that many carry a special theme to set a different atmosphere. For example, we sometimes use an intrinsic theme, where the athletes are expected to motivate themselves. The strength coaches will only communicate with the athletes as needed for safety and even wear sunglasses to avoid eye contact with them. One year, we used a Tour de France theme, where swimmers competed for our own versions TR AINING-CONDITIONING.COM

of yellow and green jerseys and other awards. Never before or since have I seen athletes compete so hard for a 50cent T-shirt. Other common sources for themes include video games, television shows, and movies. From the outside, these themed circuits may seem hokey, but I believe our athletes buy into them because they understand the purpose behind them. They are willing to put the work in and embrace an otherwise silly idea because they know it will help them get better in the pool, just as it has for the athletes

who have gone before them. In addition to dryland circuits, our team lifts twice a week during the first block. Although the whole team works out at the same time, we do split the athletes into groups. We have all of our newcomers, both incoming freshmen and transfer students, lift as one group so they learn how we train and compete. This also gives us an opportunity to teach them proper lifting techniques before advancing them to higher loads. Block 2—Strength: This block builds on the work capacity gains established

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Block Work Below is a list of the blocks one through five workouts used by the sprinters on the Auburn University swimming team. Each workout also includes two or three sets of 10 reps of auxiliary movements (such as overhead DB presses, lat pulldowns, or stroke-specific exercises) and bodyweight movements (vertical and horizontal presses, pulls, and plyometrics).

Barbell complex: General Javorek complex (timed and broken) or Olympic movements

Olympic movements: Clean & snatch catch & pulls (mid-thigh & below knee)

Strength movements: Squat series and push presses

Block 1

3-6 sets of 5-6 reps at 25-40% of clean or snatch max

4-6 sets of 5-8 reps at 70-85% of max

4-6 sets of 10 reps at 70-85% of max

Block 2

2-4 sets of 3-5 reps at 25-40% of clean or snatch max

3-5 sets of 3-5 reps at 70-90% of max

3-6 sets of 5 reps at 70-90% of max

Block 3

2-3 sets of 3-5 reps at 25-40% of clean or snatch max

3-5 sets of 2-5 reps at 70-95% of max

3-6 sets of 2-5 reps at 70-95% of max

Block 4

Individual lifts and dryland as needed during training trip

Block 5

2-3 sets of 3-5 reps at 25-40% of clean or snatch max

3-5 sets of 2-5 reps at 70-95% of max

Presses only, 2-4 sets of 2-4 reps at 70-95% of max

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sport specific in the first block. We eliminate our high-intensity dryland work, including our circuits, and limit strength-training activities outside the weightroom so we can focus on building strength in it. Another change in Block 2 is the frequency of lifts for certain groups. At this time, we establish group assignments based on each swimmer’s event distance. Our sprinters do two days of major movements and one day of bodyweight training using suspension modalities. We used to have sprinters lift weights four days a week before going to three days a few years ago to accommodate the type of training the swimming coaching staff does with these swimmers in the water. Last season, we reduced it even further to two lifting days. Our distance swimmers train three times a week during Block 2, with one day of lifting, a second day of dryland training, and a third day of competitive dryland training and med ball exercises. This routine balances the need to maximize strength training gains without compromising their water training, which is based more on endurance than strength.

Workouts in Block 2 are designed around a constant reinforcement of the Olympic movements progressions. During this time, we start including endurance sets of back squats into the squat routine for the day. We also add plyometric movements into dryland workouts, such as box

ments, such as squats and presses. Our middle-distance swimmers lift two times a week prior to afternoon practice while our sprinters lift three mornings a week before their power swims. The distance swimmers do one morning of dryland training. At this point, we also begin integrat-

My understanding of swimming has allowed me to bolster the athlete’s belief that their taper is going in the correct direction and that the plans will prepare them to achieve their maximum ability. jumps, squat jumps, and bounds, both non-loaded and weighted. Additionally, we use several types of horizontal and vertical medicine ball throws. Block 3—Power: The third block culminates our training phase and features the highest intensities of the schedule. We are coming off several weeks of hard weight training, so our athletes are well prepared to make gains. During this block, the focus remains on Olympic lifts and strength move-

ing our freshmen and transfer students into their event groups, although we may still alter their programs somewhat based on their ability and training levels. For example, we may use a smaller set of exercises and emphasize technique over intensity until these newcomers have caught up to their teammates. Block 4—Transition: With the endof-semester academic demands during this block, we pull back on the athletes

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Circle No. 140

and give them a chance to recover. They do enough lifting to maintain the gains they made in the previous blocks, but most work is done on an individual basis when the athletes are available instead of in groups. This block also includes our annual Christmas training trip, where the focus is on high intensity and high volume work in the water, so we ask little else of the athletes at this time. In addition, the quality of the facilities on the road varies greatly from year to year, so it is often difficult to do much more than limited dryland sessions. Block 5—Power and Stroke-Specific: Once the swimmers are back on campus, we pick up right where we left off in Block 3. The emphasis returns to building power, especially for the sprinters, who lift three afternoons a week. The middle-distance swimmers lift two times each week while the distance swimmers will hit the weightroom two or three times a week based on the water training loads set by their coach. Since we are nearing the heart of the competitive season, we focus more on Olympic lifts and plyometrics as opposed to strength-building movements. This past season marked the first time that we did not do any squats during the competitive phase of the training schedule. The change was made at the request of Coach Hawke, who wanted to “freshen” the athletes’ legs and increase their ability to do quality training in the water. This is also the time of year where we introduce some of our stroke-specific movements. Among the athletes’ favorites are medicine ball throw-downs that replicate each stroke’s hand entry in the water. For example, we will have a freestyle swimmer stand on a box and catch the ball at the height at which their hand enters the water. Then, keeping the elbow high, they throw the ball back down. For the backstroke, the swimmer reaches to catch the ball to their side and throws it using an S-type movement. Blocks 6 & 7—Taper: We set aside this time beginning in February for two different taper blocks, one leading up to the Southeastern Conference championships in late February and another leading to the NCAA championships in late March. The taper blocks are highly individualized to each athlete, and the swim coaches determine who will do strength work, when they will do it, and the specific exercises they will perform. The decisions are based on their performance in the water, practices, and the likelihood of success at the championship meets. These blocks require a lot of adjusting on our part as we move away from a structured training model to a highly changeable plan that reflects the needs of individual athletes. At this time of the year the psychological often outweighs the physiological. My understanding of swimming has allowed me to bolster the athlete’s belief that their taper is going in the correct direction and that the plans will prepare them to achieve their maximum ability. Many times I also act as a sounding board for the younger athletes and allay their concerns by telling them about past athletes who have followed the same path and accomplished great things. Our long tradition of success provides plenty of examples for our swimmers to follow. Of course, our plan is only as good as the athletes who follow it. We spend a great amount of time educating the athletes about our workout regimen so they understand it and believe in it. With the talented swimmers and outstanding coaches we have at here Auburn, a little belief can go a long way toward upholding our tradition and achieving our lofty objectives. n TR AINING-CONDITIONING.COM

CEU QUIZ

T&C July/August 2013 Volume XXIII No. 5

uicke You c an no r&E w tak and g asi e our et yo ur CE CEU q er! U res ults a uizzes on www li C .train lick on “CEU nd credit ins ne... tantly s” at: ing-c . o nditi o

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

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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.

Instructions: Go to www.training-conditioning.com and click on “CEUs” to take the quiz online. You may also

mail your quiz to us: Fill in the circle on the answer sheet (on page 55) that represents the best answer for each of the questions below. Include a $25 payment to MAG, Inc., and mail it to the following address: MAG, Inc., ATTN: T&C 23.5 Quiz, 20 Eastlake Road, Ithaca, NY 14850. Readers who correctly answer at least 70 percent of the questions will be notified of their earned credit by mail within 30 days.

Bulletin Board (pages 4-6)

Objective: Learn about recently published or presented research. 1. According to researchers from Cincinnati Children’s Hospital Medical Center, what percentage of high school football players surveyed believed it was acceptable for athletes to play with a concussion? a) 91.4 percent b) 50.3 percent c) 10.4 percent d) 0 percent 2. What percentage of those players surveyed would immediately tell their coach if they had experienced concussion symptoms? a) 100 percent b) 82.3 percent c) 51.4 percent d) 40.6 percent 3. According to recently released American Thoracic Society clinical practice guidelines on exerciseinduced bronchoconstriction (EIB), diagnosis should be based on: a) Peak expiratory flow rate b) Post-exercise lung function c) Symptoms such as coughing, wheezing, and chest tightness d) Family history 4. Appropriate treatment options for EIB as outlined by the guidelines include: a) A thorough warm-up before physical activity b) Use of an inhaled short-acting beta-agonist two hours before exercising c) Taking a long-acting beta-agonist seven times per week d) None of the above TR AINING-CONDITIONING.COM

5. In helping to identify baseball pitchers who are at greatest risk for shoulder injuries, researchers used a portable 3D-motion measurement machine to detect small changes in a pitcher’s: a) Stride length b) Ulnar torque c) Biceps laxity d) Scapulo-humeral rhythm

Freeing the Foot (pages 25-31)

Objective: Find out about the differences between training barefoot or in a minimalist shoe, compared to a traditional running sneaker. 6. What is the primary cause for the different running forms between barefoot and shod runners? a) Shod runners land on their mid- or forefoot while barefoot/minimalist runners land on their heel b) Barefoot/minimalist runners land on their mid- or forefoot while shod runners land on their heel c) The extra weight of the sneaker used by shod runners d) Shod runners take shorter strides 7. What did a study discover about injury risks associated with barefoot/ minimalist running? a) Barefoot/minimalist runners report more anterior knee pain b) There are no increased risks with barefoot/minimalist running c) Barefoot/minimalist running places greater stress on the metatarsals d) The risk for tendonitis increases when running barefoot or in a minimalist shoe

8. What is a possible performance benefit to training in minimalist shoes or running barefoot? a) Development of a faster running form b) Increased lower body strength c) Boosted endurance d) Elevated agility 9. Which of the following is a recommended way to transition from shod running to barefoot/minimalist running? a) Backward running b) Uphill running c) Conditioning the skin on the bottom of the foot d) All of the above 10. What is the recommended rate for transitioning from shod running to barefoot/minimalist running? a) 20 minutes of daily barefoot/ minimalist running, increasing 10 minutes every week b) Barefoot/minimalist running one day a week, increasing one additional day each week c) 10 to 15 minutes of barefoot/ minimalist running three days a week, increasing 10 percent each week d) Complete 25 percent of workout barefoot or in minimalist shoe the first week, increasing 25 percent each week

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T&C july/august 2013

CEU QUIZ Behind the Line (pages 33-39)

Objective: Learn about effective ways to prevent heat-illness in football players by working collaboratively with your football coaching staff. 11. As of July, how many states had fully adopted the NATA’s “Preseason Heat Acclimatization Guidelines for Secondary School Athletics”? a) 15 b) 10 c) 20 d) 25 12. Which of the following does David Csillan not recommend doing to help get the NATA’s heat acclimatization guidelines passed in your state? a) Threaten to boycott covering games if the guidelines aren’t passed b) Present research on heat illness to state associations c) Discuss potential liability if a player were to be hospitalized due to heat-related illness d) Compromise with coaches if needed

15. Which of the following are suggested in the article as ways to help keep football players hydrated? a) Encourage them to drink throughout the day b) Have coolers and hydration stations set up around the practice field c) Have fruit, such as grapes, available to players inside cooling tents d) All of the above

The ATC Diet (pages 41-44)

Objective: Re-evaluate your diet and eating habits as an athletic trainer in order to follow a nutritious meal plan. 16. Studies have shown that “backloading” can lead to what? a) Boosted metabolism b) Under-eating c) Less sensitivity to insulin d) Eating too much during the day 17. How often does the author suggest eating throughout the day? a) Every one to two hours b) Every two to four hours c) Every four to six hours d) Every six to eight hours

13. According to the article, how much higher can the temperature be on a synthetic turf field compared to a grass field? a) 10 degrees b) 20 degrees c) 30 degrees d) 40 degrees

18. Rather than running a large calorie deficit, a healthier way of losing weight is to eat how many fewer calories while remaining at your current energy level? a) 100 to 200 b) 200 to 300 c) 300 to 500 d) 400 to 600

14. What is not mentioned as a way to educate high school coaches about the importance of preventing heat illness? a) Having parents discuss their experiences as athletes b) Illustrating that elite colleges and the military have heat illness guidelines in place c) Pointing out that heat illness can have a long-term effect on a player’s health and performance d) Telling them that heat illness is 100-percent preventable

19. According to the article, what is one of the biggest stumbling blocks for athletic trainers? a) Eating too many carbohydrates b) Eating too much fat c) Eating too much protein d) Not getting enough vitamins and minerals

T&C july/august 2013

20. If your body requires 1,800 calories a day, how many ounces of carbohydrates do you need as an athletic trainer? a) Four to six b) Six to eight c) Eight to 10 d) 10 to 12

Making Waves (pages 47-52)

Objective: Learn about the strength training program used by Auburn University’s swimming teams. 21. According to the author, what is the main purpose of Auburn University swimming’s “circuit” sessions? a) To increase athletes’ size and strength b) To punish athletes who miss other workout sessions c) To build team bonds d) To intimidate opponents 22. What is the basic approach behind the Auburn strength training program? a) Train swimmers the same way other athletes are trained b) Keep swimmers out of the weight room c) Focus on conditioning instead of strength d) Produce swimmers who can lift as much weight as possible 23. Who determines the strength training protocols during taper periods at Auburn? a) The swimmers b) The strength coach c) The athletic trainer d) The swimming coaches 24. Why doesn’t the Auburn swimming strength program call for much weight lifting during the team’s annual holiday training trip? a) It would violate NCAA rules b) The swimmers are doing a lot of work in the pool c) The swimmers are distracted by the holidays d) The weightroom would get too crowded 25. Why were squats recently removed from the competitive phase of the Auburn swimming strength training program? a) The swimmers didn’t like them b) They took too much time to perform c) The swimming coach wanted to keep the swimmers’ legs fresh d) They were causing too many injuries

TR AINING-CONDITIONING.COM

CEU QUIZ Answer Form Instructions: Go to www.training-conditioning.com and click on “CEUs” to take the quiz online. You may also

mail your quiz to us: Fill in the circle on the answer sheet below that represents your selection of the best answer for each question. Include a $25 payment to MAG, Inc., and mail it to the following address: MAG, Inc., Attn: T&C 23.5 Quiz, 20 Eastlake Road, Ithaca, NY 14850. Readers who correctly answer at least 70 percent of the questions will receive 2.0 BOC Athletic Training and 0.2 NSCA (two hours) CEUs, and will be notified of their earned credit by mail within 30 days. Questions? Problems? E-mail: CEU@MomentumMedia.com.

A B C D

Bulletin Board

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The ATC Diet

Making Waves

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T&C july/august 2013

Ankle & Foot Care Unwinds Consistently

Every roll of Cramer 100-percent cotton porous tape is like the next, which means you can count on it to unwind consistently, conform better, and adhere longer. Cramer 950, constructed with a latex-free adhesive, is perfect for athletic trainers or athletic programs looking for a highquality, economically priced porous tape alternative. Cramer Products has been an industry leader in sports medicine and athletic training room supplies for more than 85 years.

Cramer Products, Inc. • 800-345-2231 www.cramersportsmed.com

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Supportive Bracing

Starting with the popular and very effective 610 Arizona Ankle Brace, PRO has taken ankle support to a new level. By combining the ankle brace with a non-elastic strapping system that anchors on the calf, PRO has created a very supportive inversionresistant bracing system. Ideal for chronic ankle conditions and high ankle sprains, the Ankle Anchor System is lightweight and machine washable. For more information, please contact PRO. PRO Orthopedic Devices, Inc. • 800-523-5611 www.proorthopedic.com Circle No. 502

The Multi Challenge Board™ can be used for active and reactive rehabilitation of ankle injuries and/ or ROM and strength conditioning for the lower kinetic chain. This versatile balance board is a useful tool for core muscle strengthening and stabilization, stretching, improved proprioception and balance, and motor skill training. An insert demonstrating a variety of easy, intermediate, and advanced exercises is included with the Multi Challenge Board.

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The Arch Pro-Tec Arch Supports provide targeted compression, alleviating conditions of plantar fasciitis and heel pain. They support the plantar fascia by wrapping around the foot and providing upward compression to the arch region. The Arch Supports are extremely comfortable within the shoe and allow the user to control the amount of support they deem necessary. Each includes a medial pad for additional support to the inside arch, helping prevent excessive pronation. Pro-Tec Athletics • 800-779-3372 www.injurybegone.com

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Reduces Injury Risk

Ankle injuries are a pain—they are all too frequent and difficult to come back from. A University of Wisconsin-Madison Sports Medicine study, involving more than 1,400 high school basketball players, showed the McDavid 195’s effectiveness. The study found that student-athletes wearing the brace were three times less likely to experience ankle injuries compared to those who didn’t use the 195™. This brace simulates a perfectly executed athletic tape wrap, but unlike a taping, the fully adjustable figure-six straps can be tightened quickly and easily without shoe removal. McDavid • 800-237-8254 www.mcdavidusa.com

Useful Tool

Active Ankle Systems, Inc. • 800-800-2896 www.activeankle.com

Targeted Compression

Game Ready® is a best-in-class sports medicine device to help athletes have a speed recovery from injury or orthopedic surgery. The system uses ACCEL™ technology to set a new standard in recovery, combining active compression and cold therapies, that gives healthcare providers the power to accelerate the body’s natural repair mechanisms. Game Ready can be found in the training rooms of virtually every professional sports team in the U.S.

OPTP • 800-367-7393 www.optp.com

The Dorsal Night Splint is designed for athletes who suffer from Plantar Fasciitis. The stretchresistant straps hold the foot in a neutral position, providing the necessary stretch to relieve the tension in the underside of the heel and arch of the foot. Designed with lightweight padding, this brace is breathable and comfortable, making it easy to wear for a prolonged period of stretching and a better night of sleep.

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Accelerate Healing

Game Ready • 888-426-3732 www.gameready.com

Easy to Wear

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Support and Comfort

The Tarsal Lok® ankle brace combines the support of a rigid brace with the comfort of a lace-up. The patented built-in stabilizer design molds to the ankle’s shape, due to body heat, for a more conforming, custom fit. This low-profile, comfortable, and easyto-apply brace is readily accepted by the most demanding athletes to maintain their peak performance level. Swede-O, Inc. • 800-525-9339 www.swedeo.com

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Ankle & Foot Care Enhanced Fit

The ASO EVO® ankle stabilizer is making an evolutionary step forward in ankle bracing technology with its unique stirrup and stabilizing straps, and its dynamic cuff. The EVO provides exceptional support and stability in the treatment of syndesmotic or inversion ankle sprains, and reduces the severity and frequency of future ankle injuries. The boot and dynamic cuff of the EVO have been redesigned to enhance the fit and compression around the malleoli. Medical Specialties, Inc. • 800-582-4040 www.medspec.com

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Dome Industries, Inc. • 800-432-4352 www.selfgrip.com

Simple Solution

The Thera-Band® First Step to Foot Relief combines stretching, massage, and cold therapy to effectively provide relief from foot pain associated with excessive activity and common conditions such as plantar fasciitis and heel spurs. The package includes a Thera-Band Foot Roller, a Red Thera-Band Professional Resistance Band, instruction booklet, and Biofreeze® Pain Relieving RollOn. The instruction booklet illustrates stretches, massage techniques, and step-by-step band exercises that guide athletes through an effective treatment plan. Performance Health • 800-321-2135 www.thera-band.com

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Get relief from arthritis, bursitis, and tendonitis with the 5115 Ankle Sleeve with four-way elastic and a gel buttress. This sleeve is ideal for those with neoprene allergies, and the four-way stretch elastic material increases compression and fit without heat retention. The gel insert buttress applies compression for soft tissue support. This sleeve fits left or right ankles. Circle No. 517

One-Stop Source

Dr. Jill’s is the complete one-stop source for all your foot pads and padding needs at the guaranteed lowest prices. The company offers more than 120 pre-cut pad shapes and rolls of felts, foams, and moleskin, along with tapes, gel pads, and shoe accessories. If you are buying these items elsewhere, you are paying too much. Dr. Jill’s is the manufacturer, so no matter what discounts you may get from other vendors, they can’t beat the prices. Dr. Jill’s products are made in the USA.

Dr. Jill’s Foot Pads, Inc. • 866-366-8723 www.drjillsfootpads.com TR AINING-CONDITIONING.COM

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Facilitates Healing

The Plantar F3 Foot Roller™ relieves heel and foot pain in three ways—stretching, cold therapy, and heat therapy. To stretch, roll it under your foot to gently stretch and massage the affected area. For cold therapy, the freezer-safe roller helps relieve pain and reduce inflammation. And when used for heat therapy, the roller increases elasticity of plantar fascia tissue and facilitates healing. Its patented design isolates the plantar fascia for optimal treatment and stretching. Portable and antimicrobial, this roller is one-size-fits-all. Swede-O, Inc. • 866-317-5678 www.swedeo.com

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Sustains Stretches

Supportive Relief

McDavid • 800-237-8254 www.mcdavidusa.com

Sticks to Itself, Not You

SelfGrip® helps active people and athletes perform at their best by providing firm compression and maximum support to ligaments, tendons, and muscles. The unique cotton/latex woven process allows SelfGrip to stick to itself without pins or clips— without sticking to hair or skin. SelfGrip is reusable, tears easily, wicks away moisture and perspiration, and even maintains grip under water. Recommended by doctors and athletic trainers, SelfGrip is available in two-, three-, and four-inch widths and assorted colors.

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The DARCO Body Armor Dorsal Night Splint is the only night splint that engages the windlass mechanism of the foot, resulting in a sustained stretch of the Plantar Fascia, flexor tendons, and Achilles tendon. The Body Armor Dorsal Night Splint is an excellent product for runners and active athletes who experience symptoms of Plantar Fasciitis or Achilles Tendonitis. This splint comes in one size and fits all athletes. For more information, visit DARCO online. DARCO International • 304-522-4883 www.darcointernational.com

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Reduce Ankle Injuries

Designed to meet the needs of demanding athletes, the Stabilizing Pro and Stabilizing Speed Pro ankle braces reduce the chances of ankle injury by 61 percent. Made of rugged ballistic nylon and featuring a circumferential 3-inch elastic strap and removable articulated stays, the Stabilizing Pro braces give athletic trainers confidence that the vulnerable ankles of their athletes are protected. In addition to all the benefits of the Stabilizing Pro, the new Stabilizing Speed Pro brace has the added benefit of a “speed-lacing” system that makes applying the brace exceptionally fast and easy. DJO Global • 760-727-1280 www.djoglobal.com/donjoy

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Ankle & Foot Care New and Improved

A major re-engineering on the 610 Arizona Ankle Brace design emphasizes quality points of the original brace while stepping up durability, function, and performance with some game-changing improvements. The addition of a new breathable mesh/foam tongue provides improved comfort and durability. A stretchable Achilles accommodation panel is integrated for a more comfortable fit, and the bottom seam reduces irritation points to provide a more comfortable fit. This brace is lightweight, low profile, and machine washable. PRO Orthopedic Devices, Inc. • 800-523-5611 www.proorthopedic.com Circle No. 508

The Excel ankle brace features an innovative lacing style that tightens all the way around the ankle and conforms much tighter than other braces. The nylon eyelets reduce pressure points and allow for better comfort without losing support. This brace provides athletes the support needed by utilizing the figure-eight straps commonly used in taping techniques, and reduces the risk of lateral ankle sprains. Circle No. 509

Ultimate Skin Protection

The advanced liquid technology in LiquiCell® Blister Bands protects skin from rubbing and friction, protecting against blisters, hot spots, abrasions, and bunions. LiquiCell® is a created blister so you don’t have to go through the pain of having your body make one, and the bandage’s liquid circulates and moves in all directions so your skin doesn’t. With easy-to-use and completely safe peel-and-stick application, LiquiCell® Blister Bands provide the ultimate skin protection. Pro-Tec Athletics • 800-779-3372 www.injurybegone.com

The ASO ankle stabilizer now has the bottom shoelace attached to its tongue. This keeps the lace centered—even after multiple applications. In addition, by attaching it to the tongue, the shoelace will never become separated from the ASO when it is washed. Finally, this upgrade reduces the possibility of improperly applying the ASO by putting the tongue under their foot. The ASO fits either the left or right ankle.

T&C july/august 2013

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Medically designed, athlete-proven Medi-Dyne products are easy-to-use tools that relieve tight muscles, stretch important muscle groups, and prevent pain and injury. With patented stretching, strengthening, foot, knee, and blister products, the Medi-Dyne family of brands includes: Cho-Pat ®, Tuli’s®, ProStretch®, StretchRite®, CoreStretch®, Skin-on-Skin®, and RangeRoller®. These products are known for both their effectiveness and ease of use. Medi-Dyne is dedicated to providing innovations in pain relief and prevention. Medi-Dyne Healthcare Products, Ltd. • 800-810-1740 www.medi-dyne.com Circle No. 513

Unrestricted Movement The ESS Ankle Compression Sleeve’s patented articulated ankle joint allows for unrestricted movement while providing mild compression and support to the joint. Compression provides a performanceenhancement benefit as well as mild muscular support. The unique knitted design allows for lightweight fit and exceptional stretch and comfort. Cramer Products, Inc. • 800-345-2231 www.cramersportsmed.com

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High-Quality Orthotics

Dr. Jill’s Foot Pads, Inc. • 866-366-8723 www.drjillsfootpads.com

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Center Lacing

Medical Specialties, Inc. • 800-582-4040 www.medspec.com

ECOGEL is the number-one gel with fabric choice for more than 9,000 foot care professionals, pro and college teams, and athletic trainers. If you are using any gel padding besides ECOGEL or Premier Gels, you are spending too much. Dr. Jill’s Foot Pads manufactures gels with the highest-quality materials to get you what you need and save you money. From toe caps to corn pads, the company has it all—and don’t forget about Dr. Jill’s complete line of felt, foam, and moleskin. And it’s made in the USA.

Effective Relief

Innovative System

Active Ankle Systems, Inc. • 800-800-2896 www.activeankle.com

Low Cost, High Quality

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The Action Arch® insole is perfect for everyday use and can provide the needed arch support for athletes. Combining superior comfort with maximum support, the Action Arch is an excellent option for those seeking a high-quality, over-the-counter orthotic. These insoles provide tremendous value that is unrivaled by other over-the-counter orthotics. All Foot Management prefab devices offer a quality alternative to custom orthotics. Foot Management, Inc. • 800-HOT-FOOT www.footmanagement.com

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Heat Stress Prevention Built to Last

The Hydration Station brand of portable drinking fountains is one of the most durable and rugged brands on the market. Constructed with welded aluminum carts with galvanized industrial casters and no-flat foam tires, the Hydration Station is built to last for years to come. Now with the new bend water valve there are no valve, handles and no moving parts to break or lose. Make the Hydration Station your choice.

WissTech Enterprises • 800-809-8184 www.wisstechenterprises.com

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Designed for Athletics

Waterboy Sports’ Hydration Systems are designed with the needs of the athletes, coaches, and athletic trainers in mind. These units are constructed of sturdy aluminum components and have 10” x 3” rubber tires on metal casters—they’re strong, yet lightweight and easy to move. The double-sleeved manifolds are durable, and Waterboy Sports’ patented Safety-Spouts protect against bacterial transfer. Vertical or horizontal, Chiller or Power Model, Waterboy Sports has you covered. Waterboy Sports, Inc. • 888-442-6269 www.waterboysports.com

All-In-One System

PowerFlo Portable Misting Accessories provide a unique, all-in-one system that requires no additional water or power hook-ups. PowerMisters run off your chilled water for more effective temperature drop and are collapsible yet sturdy with minimal maintenance and upkeep.

Cramer Products, Inc. • 800-345-2231 www.cramersportsmed.com

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Beat The Heat

Heat Guard® can be your first line of defense in the prevention of heatinduced fatigue and performance loss. In addition to sodium and chloride, Heat Guard contains potassium, and the unique wax tablet provides slow release—up to five hours—of the active ingredients to prevent “salt sickness” and provide a continuous, gradual flow of vital electrolytes throughout a workout or competition. Heat Guard is convenient, easy to use, and cost-effective.

Mission Pharmacal Co. • 210-696-8400 www.missionpharmacal.com

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Serious Hydration

The Right Stuff ® is a NASA-developed, zero-carb, electrolyte drink additive. High schools, colleges, pro teams, and Olympians use The Right Stuff ® for training/game day regimens. NASApublished studies show it is far superior for fighting dehydration symptoms (cramps, muscle fatigue, light-headedness, headaches, etc.); increasing endurance by 20 percent more than any other formula; improving core thermoregulation; and protecting from overheating in times of high exertion/high heat settings. Not just another sports drink, The Right Stuff ® is Serious Hydration for Serious Athletes™. The Right Stuff • 720-684-6584 www.therightstuff-usa.com

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Fuel They Need

Give it everything you’ve got. Gatorade is dedicated to providing high school athletes with the fuel they need to achieve their best during practice and competition. That’s why Gatorade offers G Series performance packages to high school coaches and athletic trainers at a significant discount. To get the most out of every play and every player, visit the Web site to learn more and place your order. Gatorade • 800-88-GATOR www.gatorade.com/coaches

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Rugged and Accurate

Stay Cool

Kestrel Heat Stress Trackers by NK • 800-784-4221 www.nkhome.com Circle No. 524

Aquality Water Systems, Inc. • 210-493-4545 www.aqualitywater.com

Prevent heat stress injuries in athletes with the Kestrel Heat Stress Tracker. Recommended by the Korey Stringer Institute, the Kestrel Heat Stress Tracker is waterless, lightweight, and easy to use. It measures temperature, humidity, heat index, wet bulb, and wet bulb globe temperature—the most recommended composite measure for predicting heat stress. Waterproof, rugged and accurate, its capabilities also include in-depth data storage, charting, and wireless Bluetooth® data transfer. This product has a five-year warranty, and is designed and manufactured in the USA.

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Aquality’s misting fans, ventilation fans, and personal and evaporative cooling units are designed to cool athletes on the sidelines, in locker rooms, at practice, and on the field to create a safer and more comfortable environment. With median temperatures rising every year, keeping athletes cool is more important than ever. Evaporative cooling and misting systems can create a space that’s typically 15 to 35 degrees cooler than the ambient air. It can protect your athletes from dangerous heat stress, protect your program from liability, and help keep athletes performing at their best in any climate. Circle No. 549

T&C july/august 2013

More Products Allows Consistent Movement

Create School Pride

PB Extreme Soft Toss Medicine Balls are new at Perform Better. These medicine balls have a soft outer shell, which makes them easy to catch, throw, and slam. They are strong enough to withstand even the most intense workouts. Each ball is 14 inches in diameter, which allows for consistent exercise movement at all intensities. These PB Extreme Soft Toss Medicine Balls are only available through Perform Better. Request your free copy of the Perform Better catalog today.

Perform Better • 800-556-7464 www.performbetter.com

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Top Industry Professionals

The National Strength and Conditioning Association (NSCA) is an international educational association. The NSCA develops the most advanced information regarding strength training and conditioning practices, injury prevention, and research findings. Unlike any other organization, the NSCA brings together a diverse group of professionals from personal trainers, strength coaches, researchers and educators. These individuals are all in pursuit of achieving a common goal—improving athletic performance and fitness.

NSCA • 800-815-6826 www.nsca.com

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Versatile Resistance

Dynatronics • 800-874-6251 www.dynatronics.com

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Angle Adjustment

The new Glute-Ham Assist is just another example of how Samson Equipment is leading the way in innovation. This unique design allows the athlete to adjust the angle of the knee shelf and foot carriage from 0 to 30 degrees, on six different settings. Now for the first time, a glute-ham bench can be adjusted to fit the needs of the athlete. As the athlete becomes more advanced in the exercise, they can adjust accordingly. Put this innovation, along with the new upgrades available on every unit in Samson’s arsenal, and you will have some of the best equipment on the market today. Samson Equipment • 800-472-6766 www.samsonequipment.com

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Drops of Energy

Tougher and more versatile than resistance tubes or bands, Sport Cord® is constructed of bungeetype cord with a high-strength nylon jacket for increased lifespan and no sudden breakage. Steel snap links on each end quick-connect to handles, accessories or any sturdy anchor point. The Sport Cord Kit includes four Sport Cords of increasing resistance, two handles, a door anchor, a waist belt, and an adjustable strap for the wrist or ankle.

Cytomax Energy Drops™ are a portable and chewable means to deliver a precise blend of carbohydrates and essential electrolytes. Cytomax Energy Drops™ may be used before and during training. Each portable pouch provides 10 individual chews. Cytomax Energy Drops™ are available in two great-tasting flavor options: Tropical Fruit + Pomegranate Berry (non-caffeinated), and Orange + Tangerine (50 mg of caffeine per pouch). Tropical Fruit + Pomegranate Berry is collegiate compliant.

OPTP • 800-367-7393 www.optp.com

CytoSport, Inc. • 888-298-6629 www.cytosport.com

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Fits Your Schedule

American Public University offers more than 170 undergraduate and graduate degree and certificate programs designed for sports and health science professionals, coaches, athletic directors, and working adults like you—completely online. APU has been nationally recognized by the Sloan Consortium for effective practice in online education. Classes start monthly with eight- and 16-week courses. For more information, visit APU online. American Public University • 877-777-9081 www.studyatapu.com/sports

Dynatronics designs and customizes athletic training rooms for professional teams, high schools, colleges, and universities nationwide. The company furnishes facilities with individual taping stations that feature cabinets in beautiful, durable hardwoods; wood carving; and team logos that are color-screened or debossed in long-lasting Naugahyde. Plus, they offer all the advantages of buying direct from the manufacturer. The professional image of a well-branded training room creates school pride—a great recruiting tool for the athletic department.

T&C july/august 2013

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Top-Notch Heating

Rich-Mar debuted a state-of-the-art composite heating unit at the 2013 NATA Convention. With no metal, this unit does not rust. It also features a low-voltage control digital thermostat, digital low water sensor, isolated heating element, and five composite slide-out dividers for packs—no tongs are necessary. The deluxe model features a dual-purpose circulation/drain pump, and a folding shelf. This product is available in 12-pack, six-pack, and four-pack models. Rich-Mar • 423-648-7730 www.richmarweb.com

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More Products Elite Knee Care

The Elite Seat ® is a portable knee-extension device designed for the non-operative treatment of degenerative knee conditions. By evenly distributing force across the leg, the Elite Seat provides effective full-knee hyperextension and reduces pain in bent knees caused by any of these conditions: acute ACL injury, inadequate post-operative rehabilitation after ACL reconstruction, total-knee arthroplasty, arthrofibrosis, deconditioned knee with a flexion contracture, and arthritis. Elite Seat ® • 866-756-3706 www.eliteseat.com

Circle No. 541

The Future is Here

Dynatronics is introducing its Dynatron® ThermoStim™ Probe. The first of its kind, this probe combines cold or heat with electrical stimulation and soft-tissue mobilization. ThermoStim represents the future of therapeutic modalities and is the newest accessory for the Dynatron Solaris® Plus. It has seven-stim waveforms, a Tri-Wave Light, and enough power to generate eight separate treatments simultaneously. Call for a demonstration or more information. Circle No. 540

Stands Up to Abuse

Infinity Max 1.25-inch-thick tile stands up to the constant abuse of heavy weights being dropped directly on the weight room floor without denting, tearing, or splitting. This tile is backed by the company’s exclusive 10-year warranty—and you can even use the floor itself as an Olympic Lifting Platform. The tile is available in 10 standard colors and an unlimited number of custom colors, with custom logos also available. This product contains up to 95 percent recycled content and may qualify for up to eight LEED Points.

Infinity Performance, Inc. • 888-479-1017 www.infinityflooring.com TR AINING-CONDITIONING.COM

MilkPEP • 202-737-0153 www.gotchocolatemilk.com

Circle No. 542

Flexible Schedules

Samson Equipment is now offering custom weight stack shield graphics on all machines. This is a great way to add any client’s custom school/team/organization branding. Each graphic image is custom-designed by Samson’s graphic team and is approved by the customer prior to implementation. Add a major “wow” factor to your weight room with custom graphics.

Dynatronics • 800-874-6251 www.dynatronics.com

Science supports what elite athletes have known for years: low-fat chocolate milk has what it takes to help recover after a hard workout. High-quality protein helps rebuild, the right mix of protein and carbohydrates refuels, while fluids and electrolytes help replace what’s lost in sweat. It’s a simple, effective, and delicious way to help your body recover so you can perform at your next race, game, practice, or workout.

Circle No. 552

Custom Graphics

Samson Equipment • 800-472-6766 www.samsonequipment.com

Simple and Delicious

Circle No. 553

The 12-month, 36-credit Master of Science in Exercise Science and Health Promotion at California University of Pennsylvania is 100-percent Web-based. The flexibility of the online program allows professionals or military personnel, who would be precluded from attending graduate school in the traditional sense, to complete the M.S. program while still maintaining their full-time positions. For more information and a list of degree programs, contact Cal-U. California University of Pennsylvania • 866-595-6348 www.calu.edu/go Circle No. 543

Versatile Workout

Create more effective workouts with the Resist Assist, a TurfCordz® product featuring a 10-foot nylon strap that connects two belts for two-person resistance drills. Athletes improve core strength and agility by pulling against the resistance provided by the strap, which is held by—or secured around the waist of—the other athlete. Resist Assist improves acceleration and explosiveness through quick-start drills and power-building footwork exercises. TurfCordz resistance products provide a versatile, safer, and more comfortable workout. NZ Manufacturing • 800-886-6621 www.turfcordz.com

Circle No. 544

Enhanced Healing

DARCO Elastic Tape is a sport and therapy product used for kinesiology taping—a technique used on athletes, as well as patients in a physiotherapeutic setting. This tape is used in treatment of muscle and tendon symptoms and assists in performance by way of continuous receptor stimulation. The healing process is enhanced via improved circulation in the taped areas. The suggested retail price for DARCO Elastic Tape is $9.95 per roll. DARCO International • 304-522-4883 www.darcointernational.com

Circle No. 546

T&C July/august 2013

More Products Best of Both Worlds

The 1.25-inch-thick Infinity iTurf is the perfect companion for the Infinity Max tiles. Both have the same thickness, which allows you to have the best of both worlds in your weight room in a flush installation. The Infinity iTurf is perfect for running, jumping, and agility drills. This product does not have rubber infill. It is available in 16 colors, with an option of customizing with your layouts and logos.

Infinity Performance, Inc. • 888-479-1017 www.infinityflooring.com

Circle No. 554

The new Biofreeze® 360-Degree Spray delivers the number-one clinically recommended topical analgesic using superior spray technology. This spray works from any angle, making it ideal for hard-to-reach areas. It even works upside down. The can’s design ensures a continuous flow of product—no pumping required—and a uniform spray pattern for better coverage. Like all Biofreeze products, this spray is paraben and propylene glycol free. All Biofreeze spray products are also colorless and use 10-percent menthol. Circle No. 534

The First Place Fitness Mats are quality mats at an affordable price. These commercial-grade, soft-foam mats are perfect for stretching and low-impact exercises. Each mat has eyelets, allowing you to hang it on a wall to save floor space. The First Place Fitness Mats are easy to clean and will not absorb water, making them a great solution for club use. The mats are available in four different colors and three different sizes to allow for more variety in group classes. Check out Perform Better’s 2013 catalog for more information. Circle No. 535

Revitalizing Programs

CytoSport, parent company to Muscle Milk®, is sponsoring the Muscle Milk Recovery Grant Program. This program will provide up to $250,000 in grants to high school athletic programs in need. Nominations will be accepted on the Muscle Milk Facebook page (www.facebook.com/musclemilk) or at MuscleMilkRecoveryGrant.com through Nov. 30, 2013. Applicants must submit a written statement outlining their program’s needs and provide supporting photos. They will also have the option to upload a video to help tell their story.

CytoSport, Inc. • 888-298-6629 www.cytosport.com

T&C july/august 2013

Helps Protect Futures

Concussion Vital Signs® (CVS), designed for studentathletes’ developing brains, aligns to current sports concussion management guidelines. This scientifically based system, used as part of a medical evaluation, enables confident return-toplay decisions while helping to protect the future of your athletes in sports, academics, and life. Pearson • 800-627-7271 www.concussionvitalsigns.com

Save Floor Space

Perform Better • 800-556-7464 www.performbetter.com

Mission Competition Fitness Equipment launched The Halo at the CSCCa Convention in May 2012, and the company marked its oneyear anniversary by introducing the product’s new name: The Iron Neck—a dynamic rotary neck strengthening cable attachment. The Iron Neck works out the neck by applying horizontal resistance during neck rotation. Mission Competition’s goal is to help prevent concussions and neck injuries by increasing the athlete’s neck strength. For more information, please e-mail info@ironneck.net. Mission Competition Fitness Equipment • 310-776-0621 www.ironneck.net Circle No. 537

Superior Technology

Performance Health • 800-321-2135 www.biofreeze.com

NEW NAME, SAME Concussion Prevention

Circle No. 536

Circle No. 538

Good Vibrations

Exervibe is a whole-body vibration stepper that provides athletic enhancement when used in either the static (standing) or dynamic (stepping) position. Vibration stimulation is applied simultaneously to the feet, hands, arms, and core. The Exervibe has a step range from one to 18 inches, an adjustable seat, and a control module with four settings. It is an extremely versatile device that efficiently and effectively implements the benefits of vibration. VersaClimber/HeartRate, Inc. • 800-237-2271 www.versaclimber.com Circle No. 539

No-Mess Solution

Gel-SHOT is the next generation of patented ultrasound technology from Rich-Mar. Gel-SHOT provides a no-mess, high-outcome solution to treatments. It features no freight cost, lower application cost, sterility, no mess, superior coupling, dosage control, extended treatment area, and better efficiency and outcomes. Rich-Mar • 423-648-7730 www.richmarweb.com

Circle No. 557 TR AINING-CONDITIONING.COM

2013 SUPPLIER WEBSITE

Active Ankle Systems, Inc. Ankle Braces and Supports

Read injury treatment guidelines, evidencebased research, and testimonials on bracing.

www.activeankle.com

Athletix Products by Contec Cleaning Products for Gyms

Visit Athletix Products by Contec, Inc. online for links to literature, trade shows, product information, finding a sales representative, getting a sample, and more.

www.athletixproducts.com

California University of Pennsylvania Web-Based Degree Programs

Cal U offers 100-percent online degree programs, which allow professionals the flexibility to attend school while maintaining their full-time positions.

www.calu.edu/go

Dynatronics

Advanced Technology Equipment

Build your own favorite products list, and then place orders from your list or reorder from a previous order.

www.dynatronics.com

Game Ready

Cold and Active Compression Device

Game Ready combines the circulation of ice water and pneumatic progressive compression through anatomically specific wraps to help speed recovery.

www.gameready.com

HiTrainer

High-Intensity Fitness Training Equipment

See how we achieve an unbeatable conditioning workout with instant performance feedback, and advanced performance analysis features.

www.hitrainer.com

TR AINING-CONDITIONING.COM

American Public University

American Sport Education Program

This Web site features a list of degrees and certificates, live chat with a representative, and a downloadable informational eKit.

ASEP Coaching Principles is an online course that meets coaching education requirements of more than 30 state high school associations.

Balanced Body

Biofreeze/Performance Health

Online Programs for Sports Professionals

www.studyatapu.com/tc

Pilates, Mind-Body Equipment/Education

Balanced Body offers an online space planner that lets athletic trainers figure out what kind of equipment can fit into their current floor space footprint.

www.pilates.com

Cramer Products, Inc. Sports Medicine Products

Read information about the company and its products online.

www.cramersportsmed.com

Elite Seat®

Portable Knee Extension Device

Go online to see our instructional video and learn why athletic trainers should use and prescribe the Elite Seat.

www.eliteseat.com

Global Bodyweight Training

Bodyweight Training Equipment, Videos, Apparel

Global Bodyweight Training is the ultimate source for the bodyweight athletes with exercise instruction, equipment, apparel, videos, and inspiration.

www.globalbodyweighttraining.com

Human Kinetics

Strength & Conditioning Resources

Human Kinetics publishes authoritative training and conditioning resources, offers approved courses for continuing education, and hosts free Webinars.

www.humankinetics.com

Online Course for Coaching Certification

www.asep.com

Topical Pain Reliever

Biofreeze Pain Reliever is one of the top clinically used and recommended topical analgesics in the U.S.

www.biofreeze.com

CytoSport, Inc.

Sport-Oriented Nutritional Products

During the 2013-14 school year, Muscle Milk® will donate up to $250,000 to selected high school sports programs.

www.cytosport.com

Ferris Mfg. Corp

Wound Dressings & Injury Wraps

The site shows examples of how PolyMem and Sports-Wrap improve injury recovery, which leads to quicker return to play.

www.polymem.com

Hibiclens®/Hibistat® Wipes

Infection Prevention for the Skin Hibiclens® and Hibistat® wipes provide con-

tinuous killing action for up to six hours to help prevent skin infections in contact sports.

www.hibiclens.com

Infinity Performance, Inc.

Rubber Flooring for Weightrooms

View photo galleries of the company’s work, learn about products, and see a list of clients.

www.infinityflooring.com T&C July/august 2013

2013 SUPPLIER WEBSITE

Kestrel Heat Stress Trackers by NK Measure Real-Time Temperature, Humidity & WBGT

McDavid, Inc.

SportMed™, Sports Protection and Performance Apparel

MilkPEP

Research the Science Behind Lowfat Chocolate Milk

The site features the science, latest news, webinars, and workout/training information from athletes.

Learn more about the Kestrel Heat Stress Tracker and view a printable PDF product brochure.

Read about independent research that supports the efficacy of McDavid’s 195™ ankle brace.

www.nkhome.com

www.mcdavidusa.com

Med Spec

Mission Competition Fitness Equipment

National Strength and Conditioning Association

The Iron Neck is a dynamic neck strengthening rotary cable attachment that will help prevent neck injuries and concussions.

Find help for bridging the gap between science and application.

ASO® and EVO® Ankle Stabilizers

Product information on ASO and EVO ankle stabilizers.

www.medspec.com

New York Barbells of Elmira, Inc. Strength Training & Weight Equipment

Read testimonials, see frequently asked questions, and read about the company’s products.

www.newyorkbarbells.com

Perform Better

Functional Training & Rehabilitation Equipment

An online, interactive catalog with favorable pricing based on Perform Better’s growth and buying power.

www.performbetter.com

PRO Orthopedic Devices, Inc

Sports Medicine Supports and Braces

Custom product information is available online, and an e-shop that is enabled for secure order check out.

www.proorthopedic.com

SPRI Products, Inc.

Professional Quality Portable Training Products

The totally redesigned site now offers more than just a new look. Keep an eye on the site for new features that are being added all the time.

www.spri.com

T&C july/august 2013

Neck Strengthening Cable Attachment

www.ironneck.com

NZ Manufacturing

Athletic Resistance Training Tools

NZ Manufacturing’s Web site provides ease in ordering by allowing guests to click through by product—and order without logging in.

www.nzmfg.com

Pivotal Health Solutions

Health/Wellness and Athletic Training Products

See the company’s line of inversion therapy, treatment tables, and more online.

www.pivotalhealthsolutions.com

Pro-Tec Athletics

Sports Medicine Braces, Hot/Cold, & Massage

View the company’s complete line of braces, hot/cold, and massage therapy products.

www.injurybegone.com

Swede-O, Inc.

Orthopedic Soft-Goods & Bracing

Swede-O’s Web site features an Injury and Indications section along with educational YouTube videos.

www.swedeo.com

www.gotchocolatemilk.com

Authority on Strength and Conditioning

www.nsca.com

OPTP

Functional Rehab/Fitness Catalog

www.optp.com

Power Lift

Heavy-Duty Strength Training Equipment

Power Lift’s Web site features a gallery of facility photos and videos. Viewers can also learn more about the company’s newest product innovations.

www.power-lift.com

Samson Equipment

Heavy-Duty Weight Training Equipment

See the “Samson Difference” and read about the “Built for Strength” warranty.

www.samsonequipment.com

SwimEx, Inc.

Aquatic Therapy Pools & Plunge Tanks

View exercise riders showing you how versatile the SwimEx pools are.

www.swimex.com TR AINING-CONDITIONING.COM

2013 SUPPLIER WEBSITE

Total Strength and Speed

Thera-Band/Performance Health

Professional Progressive Resistance Products

Thera-Band is a world-leading brand of progressive exercise systems for athletic training.

Customized Weight Equipment

Total Strength and Speed offers its products for sale on its Web site. Visit online to see the catalog, product specs, and more.

VersaClimber/Heart Rate, Inc.

Strength Training & Rehabilitation Equipment

Read product information and testimonials.

www.versaclimber.com

www.totalstrengthandspeed.com

www.thera-band.com

Waterboy Sports, Inc.

WissTech Enterprises

Wellness Brands - The Right Stuff®

Hydration Systems

NASA-developed Electrolyte Drink Additive

Portable Drinking Fountains

Learn about the horizontal power model with a 40-gallon tank.

Read hydration basics, get product information, and order online.

Find company, product, and dealer information.

www.waterboysports.com

www.therightstuff-usa.com

www.wisstechenterprises.com

Rich-Mar

Electrotherapy, Light Technology and Thermal Therapy

The Web site includes user application information, downloadable manuals, video on Hands-Free Ultrasound and dealer locator.

www.richmarweb.com ORDER FORM

In the Fight Against Concussions: Reliable Resources zx Symptoms to watch for post-concussion

zx Questions to ask your physician

Code TC2305

Name: Street Address: City: State: Zip: Daytime Phone:

(To be used if there’s a problem with your order)

Email address:

zx What you need to know about neurocognitive testing, and whether to seek additional testing zx Understanding return-to-play guidelines

PLEASE PRINT INFO.

MAG, Inc. • 20 Eastlake Rd. Ithaca, NY 14850

PAYMENT METHOD

SHIPPING PRICES

q U.S. check made payable to MAG, Inc. enclosed (sorry, only US orders)

q VISA

0-$49.99 50-$99.99 $ 100-$149.99 $ 150-and up $

q MasterCard

q Discover

q AmerEx

Credit card #: ________/________/________/________

= $7.00 = $9.00 = $10.00 = $12.00

Expiration date: _____/_____ 3 or 4 digit code: _______

zx Information on choosing the right helmet

TEAM DISCOUNT Special bulk

pricing for orders of 20 or more books

Cardholder Name PRINTED: Cardholder Signature: ITEM QUANTITY

TITLE

PRICE

Parents’ Guide to Sports Concussions Fax this order to 607-257-7328 or Mail this order to MAG, Inc., 20 Eastlake Rd., Ithaca, NY 14850

Subtotal $ + Shipping $ NY residents add sales tax $ = TOTAL $ Please allow 2-3 weeks for delivery.

Ca l l 877.422 . 55 48 E x t.1 1 fo r m o re i nfo r m a t i o n . TR AINING-CONDITIONING.COM

Circle No. 141

T&C July/august 2013

Heat Stress Prevention Directory

Advertisers Directory Circle #. Company. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page #

Circle #. Company. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page #

110. Active Ankle. . . . . . . . . . . . . . . . . . . . . . 17

103. Gatorade . . . . . . . . . . . . . . . . . . . . . . . . . 5

116. Pro-Tec Athletics . . . . . . . . . . . . . . . . . . 22

109. American Public University. . . . . . . . . . . 13

106. HiTrainer. . . . . . . . . . . . . . . . . . . . . . . . . . 9

101. Rich-Mar . . . . . . . . . . . . . . . . . . . . . . . . . 2

133. Aquality Water Systems . . . . . . . . . . . . . 39

139. Infinity Flooring . . . . . . . . . . . . . . . . . . . 51

137. Samson Equipment . . . . . . . . . . . . . . . . 49

113. California University of Pennsylvania. . . . 20

127. Kestrel Heat Stress Trackers by NK. . . . 34

125. SelfGrip® . . . . . . . . . . . . . . . . . . . . . . . . 31

121. Concordia University Chicago. . . . . . . . . 28

118. McDavid. . . . . . . . . . . . . . . . . . . . . . . . . 24

126. Swede-O . . . . . . . . . . . . . . . . . . . . . . . . 32

134. Concussion Vital Signs® - Pearson . . . . . 40

132. Medi-Dyne . . . . . . . . . . . . . . . . . . . . . . 39

122. T&C Online CEUs . . . . . . . . . . . . . . . . . . 28

105. Cramer. . . . . . . . . . . . . . . . . . . . . . . . . . . 7

108. Medical Specialties. . . . . . . . . . . . . . . . 12

112. The Iron Neck (Mission Competition). . . . 19

124. DARCO . . . . . . . . . . . . . . . . . . . . . . . . . 30

107. MilkPEP. . . . . . . . . . . . . . . . . . . . . . . . . 11

131. The Right Stuff®. . . . . . . . . . . . . . . . . . . 38

111. DJO Global (Donjoy® UltraSling IV) . . . . . 18

114. Mission Pharmacal. . . . . . . . . . . . . . . . . 20

120. Thera-Band® Roller Massager+ . . . . . . . 27

135. DJO Global (Fast Freeze). . . . . . . . . . . . . 43

143. Muscle Milk® (CytoSport™). . . . . . . . . . . BC

102. TurfCordz®/NZ Manufacturing. . . . . . . . . . 3

117. Dr. Jill’s Foot Pads . . . . . . . . . . . . . . . . . 23

138. NSCA. . . . . . . . . . . . . . . . . . . . . . . . . . . 50

123. VersaPulley & VersaClimber . . . . . . . . . . 29

100. Dynatronics . . . . . . . . . . . . . . . . . . . . . IFC

130. OPTP. . . . . . . . . . . . . . . . . . . . . . . . . . . 37

136. Vicore Fitness. . . . . . . . . . . . . . . . . . . . . 46

142. Elite Seat . . . . . . . . . . . . . . . . . . . . . . IBC

141. Parents’ Guide to Sports Concussions. . . 65

128. Waterboy Sports. . . . . . . . . . . . . . . . . . . 35

119. Foot Management, Inc.®. . . . . . . . . . . . . 26

115. Perform Better. . . . . . . . . . . . . . . . . . . . 21

129. WissTech Enterprises. . . . . . . . . . . . . . . 36

104. Game Ready . . . . . . . . . . . . . . . . . . . . . . 6

140. PRO Orthopedic . . . . . . . . . . . . . . . . . . . 52

Circle #. Company. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page #

504. Active Ankle (Dorsal Night Splint) . . . . . . 56

501. Game Ready® . . . . . . . . . . . . . . . . . . . . 56

545. Performance Health (product launch) . . . 67

509. Active Ankle (Excel lace-up brace) . . . . . 58

533. Gatorade . . . . . . . . . . . . . . . . . . . . . . . . 59

516. Performance Health (Thera-Band®). . . . . 57

Products Directory

530. American Public University. . . . . . . . . . . 60

554. Infinity Flooring (iTurf). . . . . . . . . . . . . . . 62

508. PRO Orthopedic (610 Arizona Ankle Brace). . 58

549. Aquality Water Systems . . . . . . . . . . . . . 59

553. Infinity Flooring (Max tile). . . . . . . . . . . . 61

502. PRO Orthopedic (Ankle Anchor System). 56

543. California University of Pennsylvania. . . . 61

524. Kestrel® Heat Stress Trackers by NK. . . 59

505. Pro-Tec Athletics (Arch Supports). . . . . . 56

538. Concussion Vital Signs - Pearson . . . . . 62

506. McDavid (195 Ankle Brace) . . . . . . . . . 56

510. Pro-Tec Athletics (LiquiCell® Blister Bands). . 58

500. Cramer (950 tape) . . . . . . . . . . . . . . . . . 56

517. McDavid (5115 Ankle Sleeve). . . . . . . . . 57

557. Rich-Mar (Gel-SHOT) . . . . . . . . . . . . . . . 62

514. Cramer (ESS Ankle Compression Sleeve). . 58

513. Medi-Dyne. . . . . . . . . . . . . . . . . . . . . . . 58

556. Rich-Mar (heating unit). . . . . . . . . . . . . . 60

522. Cramer (PowerFlo) . . . . . . . . . . . . . . . . . 59

511. Medical Specialties (ASO ankle stabilizer). . 58

532. Samson (Glute-Ham Assist) . . . . . . . . . . 60

551. CytoSport (Cytomax Energy Drops ). . . . 60

515. Medical Specialties (ASO EVO ). . . . . . . 57

541. Samson (graphics). . . . . . . . . . . . . . . . . 61

536. CytoSport (Muscle Milk Recovery Grant). . . 62

542. MilkPEP. . . . . . . . . . . . . . . . . . . . . . . . . 61

519. SelfGrip®/Dome Industries . . . . . . . . . . . 57

547. DARCO (Body Armor Dorsal Night Splint). . 57

537. Mission Competition (The Iron Neck). . . . 62

520. Swede-O (Plantar F3 Foot Roller™). . . . . 57

546. DARCO (Elastic Tape) . . . . . . . . . . . . . . . 61

523. Mission Pharmacal. . . . . . . . . . . . . . . . . 59

507. Swede-O (Tarsal Lok®). . . . . . . . . . . . . . 56

548. DJO Global . . . . . . . . . . . . . . . . . . . . . . 57

528. NSCA. . . . . . . . . . . . . . . . . . . . . . . . . . . 60

526. The Right Stuff® . . . . . . . . . . . . . . . . . . 59

518. Dr. Jill’s Foot Pads . . . . . . . . . . . . . . . . . 57

503. OPTP (Multi Challenge Board™). . . . . . . . 56

544. TurfCordz®/NZ Manufacturing . . . . . . . . 61

512. Dr. Jill’s Foot Pads (ECOGEL) . . . . . . . . . 58

550. OPTP (product launch) . . . . . . . . . . . . . . 67

539. VersaClimber/HeartRate. . . . . . . . . . . . . 62

531. Dynatronics (athletic training rooms) . . . 60

529. OPTP (Sport Cord ). . . . . . . . . . . . . . . . . 60

525. Waterboy Sports. . . . . . . . . . . . . . . . . . . 59

540. Dynatronics (Dynatron ThermoStim Probe). 61

535. Perform Better (First Place Fitness Mats). . 62

521. WissTech . . . . . . . . . . . . . . . . . . . . . . . . 59

552. Elite Seat . . . . . . . . . . . . . . . . . . . . . . . 61

527. Perform Better (Soft Toss Medicine Balls). 60

555. Foot Management . . . . . . . . . . . . . . . . . 58

534. Performance Health (Biofreeze®). . . . . . 62

™

T&C july/august 2013

™

TR AINING-CONDITIONING.COM

Testimonial

Product More Products Launch

Products That Ease Athletes’ Pain

Portable Roller Massager+

Performance Health www.performancehealth.com 800-321-2135 Circle No. 545

“I’ve found Pro-Tec products to be a great addition to my patient care, as they are very patient-compatible.” —Jim Whitesel, MS, ATC, Former Seattle Seahawks Head Athletic Trainer

“I have found the Iliotibial Band Wrap to offer unmatched effectiveness in alleviating conditions of iliotibial band syndrome. We are recommending it for our patients.” —Dr. Shintaro Ohtake, Aim Treatment Center

“Finally, because of the Shin Splints Compression Wrap, I feel no pain in my shins during strenuous activity.”

Unique features:

• Helps increase blood flow and circulation in targeted areas • Helps to increase muscle flexibility and range of motion • Easy to pack for use at athletic events—home or away

Benefits for the user:

• Unique, patent-pending ridged design supports both superficial and deep tissue mobilization • Provides a massage-like experience • Available in a portable version with retractable handles

—Lisa Duke, ballerina and runner

“Thanks to the Arch Pro-Tec, the plantar fasciitis in my foot has completely disappeared.”

The Rotational Trainer™

—Christina Cambra, Ironman Austria third-place finisher

OPTP www.optp.com 800-367-7393 Circle No. 550

“Pro-Tec’s Y Roller is by far the most effective Foam Roller I’ve ever used!” —Scott Jurek, PT, seven-time champion, Western States Ultra 100-Mile Marathon

“I use the Pro-Tec Foam Roller and the Pro-Tec Roller Massager to help me get stretched out and to loosen up before practice. They’re great because I have them at home, so anytime I’m sore or feeling a little tight, I break out my foam roller.” —Roman Harper, pro football player

Pro-Tec Athletics 800-779-3372 www.injurybegone.com

TR AINING-CONDITIONING.COM

Unique features:

• Converts centripetal force into a powerful rehabilitation and strength training tool • Challenges users to constantly stabilize engaged muscle groups, strengthening their core, shoulder, and girdle areas

Benefits for the user:

• Versatile and easy-to-use • Designed by a physical therapist

T&C july/august 2013

Heat Stress Case Study Prevention

Teaching Strength and Conditioning Online

by Dr. Amy Ashmore

To teach these real world skills, we use a variety of interactive and applied learning activities, which include traditional text reading and journal article review along with peer and instructor forum discussions and applied fitness/exercise program design projects. We also use outside Web sources for program design examples and videos for the demonstration of exercise mechanics.

e are often asked how we teach fitness trainers to go into a gym, fitness center, athletic training facility, or rehab center to train people. There is a misconception that in order to become a fitness instructor you must learn your trade only in a gym settingâ&#x20AC;&#x201D;or in a lab. Preparing future fitness trainers for hands-on strength and conditioning work online is not very different from a traditional classroom. Although gym experience is required at some point, all trainers must first learn the content or science behind strength and conditioning program design. Regardless of the learning environment, the fundamentals of exercise science are the same.

Exercise analysis (determining which muscles are used for which exercises) demonstrates how online learning is superior to traditional learning for strength and conditioning program design. This is an absolutely critical skill for practitioners, and it is best taught in an online setting because there are an abundance of sources for student use. We post videos in our forums to view and discuss.

At American Public University, we teach the foundations of strength and conditioning in our online classrooms, providing students with basic principles and how to use them for building effective programs for the real world. For example, the key to building any effective strength and conditioning program is knowledge of how to manipulate the four training variables that make up any programâ&#x20AC;&#x201D; frequency, duration, volume, and intensity.

The online learning environment provides us with unique tools and resources. These novel online experiences along with traditional learning aids enable us to best prepare future trainers for the workforce.

The use of these variables will change based on the specific client and his or her goals and fitness level, along with such factors as health and motor coordination. However, without a strong academic background in these basics, which APU programs provide, it is very difficult to go into the field and simply whip up a custom strength and conditioning training program for anyoneâ&#x20AC;&#x201D;regardless of time spent in the gym.

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This is not practical in a live classroom as it is typically time and resource prohibitive. In a live classroom, only one video may be viewed and discussed at any given time. Online, students may view and discuss multiple videos with no time limits. Feedback has shown that this is both an enjoyable and valuable lesson structure exclusive to the online classroom.

Amy Ashmore, PhD, earned a doctorate in Kinesiology from the University of Texas at Austin. She is an Associate Professor in Sports and Health Sciences at APU.

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