September spts newsletter by SPTS

RETURNING TO JROTC RAIDERS COMPETITION AFTER MPFL RECONSTRUCTION: A “BOOTS ON THE GROUND” EXPERIENCE! By Chris Alford NOTE: The purpose of this article is not to present an exhaustive case report, but rather to highlight the demands of RAIDER competitions along with the return to sports after a medial patellofemoral ligament (MPFL) reconstruction and Tibial Tuberosity Transfer (TTT) surgery. The MPFL has been called the “most important ligamentous stabilizer preventing lateral dislocation.”1 It has been reported that 94 percent of patients who suffer a patellar dislocation also tear the MPFL.2 MPFL reconstruction and TTT surgeries are both usually performed to treat patellar instability. These are typically lastresort surgeries to address patellar instability which has otherwise failed traditional conservative treatment. Return to play after an MPFL reconstruction and a concurrent tibial tuberosity transfer (TTT) can be quite a daunting task and require plenty of patience by both the patient and the sports physical therapist.

The post-operative rehabilitation, time frames for return to play and criteria for return to competitive sports have not been clearly established for MPFL reconstructive surgeries.3 In addition, when an MPFL reconstruction surgery is combined with a TTT surgery, the standards for return to play become more complicated.

of the United States. A similar “Ranger” competition is held for Army ROTC college programs throughout the nation annually. These competitions and programs are becoming very popular in high school JROTC programs and are quite challenging for even the elite of athletes. The particular competitions can differ depending who is hosting the event. Usually the events are comprised of the following 1. Personal fitness /individual strength test (push-ups, curl-ups, tire drag, obstacle course) 2. Distance team running event (3-5K with 25-35 pound backpacks) 3. Obstacle course through the woods 4. Rescue /first aid event

What is RAIDER competition? RAIDERS are athletic competitions held between U.S. Army High School Junior Reserve Officer Training Corps (JROTC) programs from many areas

5. Rope bridge construction / transport component All of the competitions require significant mental aptitude, physical strength, endurance, determination,

and dedication to the team. Preparation for these events, like many other athletic competitions, require months of hard training and development of teamwork skills to compete at a high level. The Raider competitions require an athlete to be physically able to run, jump, climb, crawl, hang, carry, and function without restrictions, while wearing military boots and often donning backpacks weighing 25-35 pounds. Making sure an athlete, recovering from a major MPFL, can adequately and safely perform these activities can be quite challenging for the physical therapist. Case Description The patient is a sixteen year old female who had two previous patellar dislocations and had failed conservative treatment. She suffered the dislocations while competing in high school soccer, but also participates in basketball and Raiders competitions. She attends a military high school (U.S. Army JROTC) and is required to march, stand in formation, and participate in physical training tests every nine weeks. She elects to participate in the strenuous RAIDER competitions and desires to return to these events as soon as possible. She was referred to physical therapy fifteen days after an MPFL reconstruction and TTT surgical procedure. She desires to return to certain components of the RAIDER competitions in less than three months after MPFL reconstruction (tibialis anterior allograft) and TTT surgical procedure. The patient was limited to 90 degrees flexion for the first four weeks postoperatively and locked at 0 degrees extension in a knee brace during ambulation. Her weight-bearing status was weight bearing as tolerated, as long as the brace was locked in full extension due to quadriceps weakness. Currently, there is no established standard of care in literature for the appropriate progression of ROM, strengthening, weight bearing, or return to sport after an MPFL recon-

struction and TTT surgical procedure. Even published case reports regarding the rehabilitation component of MPFL reconstructions are very limited but are certainly helpful to establish current approaches to post-operative care for this type of surgery.2 At 12 weeks post-op, she was evaluated by the surgeon and was cleared to return to marching at school on a daily basis, along with participation in the Rope Bridge component of an upcoming RAIDER competition. The patient’s physical therapy status, prior to the visit to the surgeon, included the following: knee active range of motion from +10 – 0 – 145 degrees, quadriceps strength at 4-/5, hip abductor /adductor strength at 4/5, significant remaining circumference deficits of 3 cm compared to the uninvolved knee at 10 cm above the patella, Lower Extremity Functional Scale at 60/80, and unrestricted ambulation

Rope bridge component of RAIDER competition. Photo courtesy of Major Rick Coles.

with a patellar stabilizing knee brace donned. At this time, the physical therapist continues to restrict her involvement in the RAIDER competitions to only the Rope Bridge component. She remains with enough quadriceps weakness and agility deficits to justify the current restrictions, despite her motivation and prodding to the therapist. The distance running component alone in the

RAIDER competition is usually performed with 25-35 pound backpacks donned and are on courses similar to cross country events. The unpredictable running environment and added weight are currently problematic for this particular patient. She is on schedule to return to unrestricted participation in high school basketball at around five months post-operatively and a return to high school soccer around eight months post-operatively, as long as she meets establish criteria. Her recovery has been without any serious complications. The remaining issues are full restoration of quadriceps strength, normalization of quadriceps circumference, and demonstration of ability to participate in agility training. The surgeons that typically refer to this physical therapy practice have a wide range of approaches regarding the return to play after an MPFL reconstruction and TTT surgery. For example, one surgeon allows the return to full activity as soon as the patient is ready, regardless of the post-operative time frame. Another surgeon allows return to fairly aggressive strengthening at three months, and return to sports as soon as possible after three months from the surgery. A third surgeon allows the return to running at ten to twelve weeks and a return to sports at four to five months. The verdict is still out on which approach is best, and, most likely, there will never be a simple answer due to so many variables that affect such a decision. Many factors influence the decisions regarding time frames for return to play after an MPFL reconstruction and TTT surgery including 1. Adequate healing time for reconstructive graft tissue (MPFL) 2. Adequate healing time for osseous structures (TTT) 3. Full knee knee range of motion 4. Restoration of quadriceps strength, circumference, and power

5. Restoration of hip abductor and hip flexor strength

- Strength and Conditioning Specialist (CSCS)

transparency! Please feel free to contact me.

6. Respecting the particular surgeon’s philosophy, fixation, and quality of the reconstruction

- School Nurse(RN)

Chris Alford, PT, DPT, SCS, ATC, CSCS SPTS – Website Content Committee Member calfordpt@gmail.com

7. Demonstrated patellar stability 8. Absence of pain, swelling, or any complications after activity 9. Pre-surgical fitness level and competitive sports level 10. Motivation of the athlete to return to sports 11. Physical demands of the particular sport(s) of the athlete 12. Demonstrated success with agility training, running, and sports-specific testing 13. Coordination with other health care professionals who may be involved in the athlete’s care: - Orthopaedic Surgeon (MD or DO) - Certified Athletic Trainer (ATC)

Author Notes This article is intended to start a discussion among SPTS Knee Special Interest Group members about the return to play after a MPFL reconstruction in a young athlete. If you have any input or feedback about how you or your center handle the return to play in patients with MPFL reconstructions, please contact me. If this starts a discussion, we will share the information with the SPTS Knee SIG members. Some of my favorite memories from CSM over the years were highly respected colleagues sharing cases and experiences during the “Difficult Case Problems” component of the Sports Section’s CSM programming. It’s easy to share our successes, but we all come across challenges in the clinic. We can learn so much from each other with healthy

1. Panagopoulous A, vanNiekerk L, Triantafillopoulous IK. MPFL reconstruction for recurrent patella dislocation: a new surgical technique and review of the literature. Int J Sports Med. 2008 May;29(5):359-365. 2. Carmont M, Maffulli N. Medial patellofemoral ligament reconstruction: a new technique. BMC Musculoskelet Disord. 2007;8:22. 3. Cheatham S, Kolber MJ, Hanney WJ. Rehabilitation of a 23-year-old male after right knee arthroscopy and open reconstruction of the medial patellofemoral ligament with a tibialis anterior allograft: a case report. Int J Sports Phys Ther. 2014; 9(2):208-221.

ATTENDING NSC? WE NEED YOU!

If you’re attending National Student Conclave in Omaha, Nebraska this October, the SPTS needs your help! SPTS will have a full booth in the expo hall at NSC, and we need volunteers to represent us in our booth. The job is easy and fun! Simply greet those who stop by to learn more about the SPTS, and share Section information as well as your experiences with SPTS. One-hour slots are available only during unopposed hours on Friday and Saturday, so you work when you have the time, without missing a thing. Gather up your fellow students and work the booth together! You’ll have the opportunity to network with other students and support your Section at the same time. Signing up is easy, too...follow this link to VolunteerSpot and choose your time. Friday: 10:30 am to 12:30 pm 3:15 pm to 5:30 pm

Saturday: 11:00 am to 1:30 pm

HOW DO YOU KEEP 30,000 RUNNERS SAFE AND HEALTHY? ASK SHELLY WEINSTEIN. By Sylvia Czuppon

Captain Michele “Shelly” Weinstein, MSC, USN PT, MS, SCS, ATC has been practicing physical therapy for 29 years and has been an active Sports Section member for many years. She graduated in 1989 with a BS in Physical Therapy from Temple University, and then completed her MS in Human Movement Science and Athletic Training internship in 1995 at University of North Carolina, Chapel Hill. She has been a leading physical therapist in the Navy for the last 27.5 years. Her name is wellknown in the Sports Physical Therapy and Emergency Medical Response (EMR) communities. She was the Chief Athletic Trainer at the 1996 Centennial Olympic Games in the Georgia World Congress Center Venue and has served as the Medical Operations Planner of the Marine Corps Marathon (MCM) for the last

11 years – this year’s October 25, 2015 race will mark her 12th year.

Captain Shelly Weinstein is shown here with her son Sam. Shelly is not only a military veteran, founder of her own company, EMR instructor and trainer, and the medical operations planner for the Marine Corps Marathon, she is also married and the mother of five.

How did Shelly get so involved in emergency medical response? Her path started in 2003, when she completed her second MCM. At the time, she was working as the Department Head of Physical Therapy at the Naval Health Clinic in Quantico, VA, which included heading the clinic’s 250 person team to provide medical support for the 15,000 runners participating in MCM that year. In 2004, race-day temperatures were the hottest ever, with over 1,500 runners seen for medical attention and 75 hospitalized for heat-related injuries, including severe heat stroke. Shelly admits at the time, “I didn’t really know what I was doing – I was just acting on instinct.” She talked to the EMR responders on site and learned how Incident Command Systems op-

However, she is quick to point out that the teams she works with makes her job much simpler. Because many volunteers do not arrive until the day of the race, every first aid station team is trained electronically (via email, PowerPoint presentations, etc.) through race day and then prepped and trained further the morning of the race. Even with all the training, Shelly says, “It’s always amazing to see when people are given the chance, they step up and do a fantastic job.”

Physical therapy volunteers at MCM 2014 pose in front of the iconic Iwo Jima statue. SPTS members will recognize some familiar faces.

erated, and has since worked with the American Red Cross and Arlington County EMS to gain a better understanding of the breadth of the EMR world. Having been involved with EMR for over a decade, Shelly notes that EMR has become increasingly important in sporting events – it’s not just as simple as where to put first aid tents, but rather much more complex, including how to transport people safely, and how to have the right staff, equipment and supplies available. When events are being planned

MCM 10K hardware awaits runners at the finish line.

– big or small – the medical aspect is critical and cannot be overlooked. The Marine Corps Marathon, which is fondly known as “The People’s Marathon,” will be celebrating its 40th anniversary this year. For about one third of the runners, or 10,000 individuals, this will be their first (and possibly only “bucket list”) marathon. Volunteers are essential for the success of the event. The MCM medical team consists of approximately 1,000 people from across the country, half of whom are military and half of whom are volunteers. Not all volunteers have medical training, though nurses, physicians, PTs, PTAs, and students are crucial. As the Medical Operations Planner, Shelly determines first aid station locations, coordinates teams staffing first aid tents, determines equipment needs, and works with law enforcement and the professional EMS system staff in both Arlington and DC. Though this seems like a daunting task for an event that now boasts 30,000 runners, Shelly loves her leadership role. “I like being the person who people turn to and say, ‘We’ve got this problem, what do we do?’ The problem solving and critical thinking skills that we have as PTs come into play.”

Examples of some of the various situations Shelly and the MCM medical teams have had to work through include transporting a disabled bilateral amputee whose bike had a flat tire; dealing with critically ill runners with exertional heat stroke and temperatures of 108-109 degrees; finding lost children or parents; talking a lost, out-of-town ice truck driver, carrying massive amounts of ice needed for the medical tents, into town before race day; getting Tylenol, a vital medication on race day, to an aid station which had forgotten to bring it before the race started. In particular, Shelly remembers working through the 2012 MCM because of the snow. The Kids Run occurs every year the day before race day, and that particular year,

An attendee at a recent EMR course gets the “full immersion” treatment serving as the patient...in full football gear.

Friends and family celebrate with Shelly at the Marine Corps Museum following her retirement ceremony.

with 4,000 kids scheduled to run in the snow, sleet, and freezing rain, Shelly and her team had to develop plans for possible medical injuries. 1,500 kids safely raced that year. While she notes she has recently retired from the Navy, Shelly is far from actual retirement. In addition to her volunteer work with MCM, Shelly has been an EMR course instructor for SPTS for the last 18 years.

She is also a partner and founder of Cogent Steps, LLC, which serves as the official EMR provider for SPTS. As she had already been doing consulting work related to event planning, Shelly wanted to provide more education on the medical/safety piece of large events and teach people how to be more prepared at sporting events, regardless of the size of the event (from the sideline of a soccer game to the Olympics) or magnitude of the injury (from bandaids to weather-related emergencies). In addition to being the SPTS’s approved provider

for the EMR course, Cogent Steps provides consultation services for event management, and has also begun to add continuing education courses to its portfolio. Look for the upcoming course on the post concussion syndrome athlete. I asked Shelly what advice she had for new PT graduates and young or new SPTS members. First and foremost, Shelly said that new graduates need to practice, practice, practice. Therapists cannot be proficient in skills learned in the classroom without a lot of hands-on practice. Next, she says, learn to “listen to patients. Often, they will tell you what’s wrong in the first 5 minutes. Be patient when they talk to you.” Third, get patient buy-in – this is critical for compliance and a solid patient-therapist relationship. What about advice for SPTS members who want to get involved? Shelly says that they just need to “get out and volunteer!” She is always looking for more student PTs, licensed PTs and PTAs to work at MCM because musculoskeletal injuries are always the most prevalent. However, local agencies and events are often looking for volunteers. Even if you don’t know what to do, she says, observe – experience is key. She encourages them to

connect with other SPTS members; Shelly credits the mentorship of William “Sandy” Quillen PT, PhD, SCS, FACSM and Gail “Cookie” Freidhoff-Bohman MA.T, PT, SCS, ATC-L as her biggest influences on her road to becoming a sports physical therapist and her involvement with the Sports Section. The Marine Corps Marathon is still seeking qualified volunteers for this year’s race. If you are interested in volunteering, contact Shelly at mlweinstein4@verizon.net and let her know. If you’re interested in connecting with Shelly, she will be presenting EMR courses before Team Concept Conference 2015 in Las Vegas and will be attending TCC for the first time this year. Stop by and say hello! If you can’t make TCC this year, she will also be teaching EMR courses as well as presenting an education session discussing triathlons and event preparation at CSM 2016 in Anaheim. For more information, visit: http://www.cogentsteps.net/ http://www.marinemarathon.com/

SPORTS PHYSICAL THERAPISTS AND TACTICAL ATHLETES By MAJ Rich Westrick, PT, DPT, DSc, OCS, SCS, Chair, SPTS Tactical Athlete Special Interest Group This edition of the newsletter includes two feature articles relevant to the recently established SPTS Tactical Athlete Special Interest Group. Dr. Chris Alford’s description of the unique factors influencing “return to play” for an injured U.S. Army High School Junior Reserve Officer Training Corps (JROTC) athlete and “Raider” competitor reveals some of the unique considerations often experienced by PTs working with tactical athletes. The article describing Michele “Shelly” Wienstein (who recently retired from the U.S. Navy as a Captain – if you’re unfamiliar, this is the highest rank PTs hold in the Navy) and her experience coordinating medical coverage for runners participating in the Marine Corps Marathon highlights the Emergency Medical Response aspect of sports physical therapy, an often essential skill set required of physical therapists working with tactical athletes. The term “tactical athlete” has been used for nearly a decade to acknowledge the athleticism required of individuals working in tactical occupations and is commonly used within sports medicine to describe

military, law enforcement, firefighter, and rescue personnel (Schwartz 2008). The SPTS Tactical Athlete SIG was established this year to support and expand the knowledge and understanding of SPTS members working with (or interested in working with) these athletes. SPTS Tactical Athlete SIG member & U.S. Army Officer, Major Joe Kardouni, recently co-authored an article discussing the many similarities and differences between traditional and tactical athletes (Scofield and Kardouni, J Strength Cond Res. 2015). The typical injuries suffered by tactical athletes aren’t often unique from those of traditional athletes . . . however, the similarities end when we reflect on the specific tasks and challenges these athletes are required to return to and the potential consequences of returning unprepared. Rehabilitation professionals routinely include activities which simulate the unique aspects of an athlete’s sport and position when developing return-to-sport programs. Similarly, Physical Therapists must consider the physical and occupational requirements of tactical athletes when

designing later stages of rehabilitation programs and when proposing return-to-duty recommendations. Consider that tactical athletes don’t have the luxury of an off-season, and at a moment’s notice, firefighters may be called on to respond to structural fires, climb stairs, and carry injured people over unpredictable debris and obstacles, all while wearing or carrying a significant amount of gear. If you’re interested in joining the Tactical Athlete Special Interest Group contact the SIG Chair, Rich Westrick at rbwestrick@gmail.com, follow the SIG on Twitter at @SPTSTactical, and like us on Facebook. To learn more about working with tactical athletes look for the upcoming presentation by SIG members at the 2016 Combined Sections Meeting in Anaheim titled “Tactical Athlete Symposium: Physical Therapists Working with Firefighters, Law Enforcement, and Military Personnel.” The views expressed in this article are those of the author and do not reflect official policy of the Department of the Army, Department of Defense, or the U.S. Government.

Climb Higher in Your Career! Join SPTS as we rock Las Vegas at the stunning Red Rock Resort and Casino. We're taking the tradition of TCC higher this year! Special Pre-conference Day Included in Registration Fee! The conference will include a pre-conference day on Thursday, December 3, featuring the topic of running injury, prevention and rehabilitation. Welcome Event Sponsored by TheraBand TheraBand returns as the sponsor of our welcome cocktail event on Thursday evening. Attendees will participate in a special educational session, followed by refreshments in the exhibit hall. Friday and Saturday Line Up: December 4-5 Two additional days of head-to-toe programming for sports physical therapists and the entire sports medicine team follow the kickoff. Friday and Saturday topics include • Current Concepts in Treatment of Shoulder Instability • Posterior and Multidirectional Glenohumeral Joint Instability • Elbow Injuries in Throwing Athletes • The Kevin Wilk Traveling Fellowship Presentations • Manual Techniques for the Shoulder Complex • Performance Enhancement for the Athlete • Special Considerations for the Female Athlete • Patellofemoral Joint • Multi-ligament Injured Knee • Spine in Sport

P.O. Box 431 | Zionsville, Indiana 46077-0431

The entire agenda may be found at www.spts.org/education/team-concept-conference Take the Lead with our Keynote Speaker Dr. Kevin Plancher earned his Doctorate in Medicine from Georgetown University in Washington, DC, completing his residency at Harvard University’s Combined Orthopaedic program. He then went on to complete two post-graduate fellowships, the first at The Indiana Hand Center, focusing on hand and microvascular surgery, and the second was at the world-renowned Steadman-Hawkins Clinic, focusing on sports medicine and reconstruction of the shoulder and knee. About Base Camp Red Rock is situated across from the entrance to the famous Red Rock Canyons. This five-diamond resort features free WiFi, access to the fitness center and spa, shuttle service to the airport and Strip and more! Enjoy luxurious accommodations at a special price. The Jump Off Point Register today at www.spts.org. Click on store and navigate to Team Concept Conference 2015. Special discounts are available for SPTS, APTA and IFSPT members as well as students. For more information, go to www.spts.org/education/team-concept-conference Are you ready to rock? SPTS is! Claim your seat now for the only conference dedicated to sports physical therapy!

877.732.5009 | www.spts.org | Fax 317.669.8276

The Events

OUR SPONSORS

TeamMates TCC 2015 Thursday, December 3 Noon to 1:00 PM Pavilion Ballroom Conference Level Free, but pre-registration is required Strictly limited to 50 attendees Register as a "rookie" (first time attendee or student or early career member) or a "captain" (an experienced SPTS member) and network for mentoring and fun!

TeamMates>

Silver Sponsor SPTS Supporter for over 20 years

Thursday, December 3: Bryan Heiderscheit, PT, PhD Mark Reinking, PT, PhD, SCS, ATC Blaise Williams, PT, PhD

Silver Sponsor

Friday, December 4 and Saturday December 5: TheraBand® Welcome Event at TCC Thursday, December 3 4:00 to 6:00 PM 4:10 to 4:45 PM Main Conference Hall Educational session Question and answer session 4:45 to 6:30 PM Refreshments in Exhibit Hall TheraBand will once again sponsor the evening educational and welcome event at TCC immediately following the pre-conference course! Join us in the conference hall for an educational session and prizes, then step into the exhibit halls for refreshments (food and alcoholic and non-alcoholic drinks) and networking with your fellow attendees and our exhibitors.

Registration Fees

Non-APTA and non-IFSPT attendees: $545 APTA and IFSPT members: $500 APTA and IFSPT bring a friend: $450 SPTS Members: $425 SPTS Members bring a friend: $375 each Students: $275 (must provide proof of student status upon registration at site) Those who attend all three days earn 21 CEUs. CEUs are approved by the BOC.

LINKS

Kevin Plancher, MD (Keynote) Matt Provencher, MD Eric McCarty, MD Lindsay Becker, PT, DPT, SCS, CSCS, CGFI-M3 Bart Bishop, DPT, SCS Gary Calabrese, PT, DPT Teresa Chiaia, PT, DPT Mark DeCarlo. PT, DPT, MHA, SCS, ATC Heidi Edwards, PT, MPT, OCS, SCS, COMT, CSCS Sue Falsone, PT, ATC, SCS Bryan Heiderscheit, PT, PhD Walt Jenkins, PT, DHS, L-ATC, ATC Andre Labbe, PT Dan Lorenz, PT, DPT, L-ATC, CSCS Rob Manske, PT, DPT, Med, SCS, ATC Phil Page, PT, PhD, ATC Stacey Pagorek, PT, DPT, SCS, ATC Russ Paine, PT Rob Panariello, PT, MS, ATC, CSCS Mark Reinking, PT, PhD, SCS, ATC Teresa Schuemann, PT, DPT, SCS, ATC, CSCS Tim Tyler, PT, MS, ATC Kevin Wilk, PT, FAPTA Blaise Williams, PT, PhD

Bronze Sponsor

OUR EXHIBITORS Biodex CDM Sport (sponsor) Cedaron College of St. Scholastica Dynamic Tape FAKTR Gawenda Consulting and Seminars (sponsor) Graston Technique (sponsor) IJSPT JOSPT Lightspeed Running and Rehabilitation LiteCure

MedBridge MeyerPT™ North Coast Medical Pro Orthopedic RockTape SpineDok Systemic Dry Needling Tekscan The Quick Board TheraBand (sponsor and welcome event sponsor) WebExercises (sponsor) WebPT (sponsor)

SPOTLIGHT ON CRAIG GARRISON PHD, PT, ATC, SCS Craig Garrison is the Director of Research and Post-Professional Residencies at Texas Health Ben Hogan Sports Medicine. He oversees the development and management of day-to-day operations of clinical research and post-professional residency programs. This includes two clinical research coordinators, one clinical biomechanist, four sports physical therapy residents, and two athletic training residents. The clinical research program also includes two motion capture labs, one for upper extremity throwing biomechanical analysis and the other for lower extremity biomechanical analysis. At any one time, the Ben Hogan Sports Medicine team may have up to thirteen ongoing clinical research studies that include clinical outcome studies of ACL and UCL injuries, throwing-related injuries to the shoulder, sport-related concussion, and prospective studies of upper and lower extremity injuries. Craig also leads in the development and maintenance of physician relationships through research and education. Craig offered to share some brief reflections on his role as a clinician researcher, residency director, and member of the SPTS. What inspired you to be a physical therapist and pursue a career in clinical research? I always enjoyed the analytical side of physical therapy and how the body moves and functions. The intrigue with clinical research came about as I began practicing as a young clinician and had so many questions arise about how one thing in the body influenced another. I wanted to continue to challenge myself, so I decided to return to school

to pursue my PhD in order to gain the skills I was lacking to answer some of my questions. Describe your motivation to start a new ABPTS Sports Physical Therapy Residency Program? I appreciate the opportunity to continue to learn and grow as a clinician, and one of the ways this occurs for me is through teaching and mentoring sports physical therapy professionals. Each year I am able to surround myself with young, bright, and highly-driven sports physical therapy residents who challenge me to be a better clinician and researcher. What is the most unique part of your position as a clinical research scientist? With each research study in which I am involved, one of the underlying goals is to answer a clinical question. Being able to take that new information and then use it to transform the way I practice is very meaningful. Identifying new clinical evidence and then implementing it into practice on a regular basis is one way to ensure we are providing the best possible care to our patients. This raises the expectation level across our sports medicine team. How would you advise a young therapist interested in pursuing a careering in sports physical therapy? I am probably biased on this topic, but I believe that sports physical therapy residencies are a terrific way for a young PT to work their way into a career in sports physical therapy. Not only are the residents exposed to invaluable mentoring during the residency, but they also

Craig Garrison PhD, PT, ATC, SCS develop their networking skills that can help shape the future of their career in sports physical therapy. How has the Sports Physical Therapy Section impacted your career? The Sports Physical Therapy Section has provided critical resources that are needed to grow as a professional. From mentorship opportunities to access to leading sports physical therapy journals, the Sports Physical Therapy Section has provided me with a platform to enhance my career. In addition, many of the leaders in the Sports Section were kind enough to offer guidance and advice early in my career that has helped in my development along the way. For more information on the Texas Health Ben Hogan Sports Medicine clinics and residency programs, please visit Texas Health Ben Hogan Sports Physical Therapy and Rehabilitation.

GRASTON TECHNIQUE® JOINS SPTS AS A SPONSOR! injured tissues, which can result in restricted range of motion, pain and functional limitations.

We all know how important our sponosrs are to furthering the mission of the SPTS. Graston Technique® is our newest sponsor. We’ve invited Julianna Patterson, PTA, Graston Technique’s Exhibits & University Outreach Coordinator, to give our members a little more information about their company. Graston Technique® is a unique, evidence-based form of instrumentassisted soft tissue mobilization that enables clinicians to effectively and efficiently address soft tissue lesions and fascial restrictions. GT is used as an injury prevention method and as a treatment post injury, helping to get your patients back in the game better, faster and stronger. GT uses specially-designed stainless steel instruments with unique treatment edges and angles to deliver an effective means of manual therapy. The instruments are not meant to replace a clinician's hands, but to complement them, amplifying what the clinician can feel. By combining Graston Technique with appropriate therapeutic exercise, restoration of pain-free movement and function can be achieved. Historically, this combination has led to increaseWe all kod positive outcomes in 75-90 percent of all conditions treated. The technique is used during the evaluation process as a diagnostic instrument. It is also used during the treatment phase and used extensively as an injury prevention method in maintenance programs. During the Graston Technique training courses, clinicians are taught to use the instruments along the kinetic chain, identifying the source of pain and dysfunction more readily, rather than treating only the localized area of dysfunction or pain. “Where our hands may not be able to identify restrictions, the instruments will amplify the root of the dysfunction quickly and effectively, allowing us to treat or prevent injury based on the concept of regional interdepend-

“By incorporating GT into the treatment of these damaged tissues, we are able to remodel the tissue allowing for increased cellular activity in the region, including fibroblasts and mast cell activity, as well as increased blood flow,” Ploski added.

ence,” said Mike Ploski, MS, MEd, PT, ATC, OCS, and Director of Strategic Planning for Graston Technique, LLC. Graston Technique helps to paint a detailed and specific picture of what is happening underneath the skin in the soft tissue. When viewed under a microscope, normal tissue can be organized as dense, regular elongated fibers running in the same direction, such as in tendons and ligaments; or dense and loose, irregular fibers running in multiple directions, found in connective tissue. In both types of tissue, it will often heal in a fibrotic, haphazard manner and may appear radio-dense under diagnostic ultrasound. The tissue may show thickening, irregular organization or less precise margins as compared to non-

A Graston Technique® training course in progress.

Research also has shown that Graston Technique increases histamine response secondary to mast cell activity, initiating the healing response. Evidence shows that GT facilitates reflex changes in the chronic muscle holding pattern and can alter and inhibit spinal reflex activity, proving that GT is equally effective in restoring function to acute and chronic injuries as well as pre- and post-surgical patients. Since 1994, GT has set the standard for instrument-assisted soft tissue mobilization, continually working to raise that standard and support clinicians with new research and educational opportunities. GT provides exceptional hands-on training with CE credits for licensed clinicians and has recently introduced three online courses through a partnership with MedBridge, which are BOC-approved Evidence-Based Practice (EBP) programs. “We are proud to be a sponsor of the Sports Physical Therapy Section of the APTA and look forward to being a continued resource for its members,” said Todd R. Lugar, President and CEO of Graston Technique, LLC. “We are dedicated to providing our clinicians with the best evidencebased information to more effectively treat their patients and productive resources to help grow their practice.” Graston Technique currently has more than 22,000 trained clinicians worldwide, and remains the most respected and requested form of IASTM by patients and clinicians.

LEGACY FUND RFPs DUE OCTOBER 11 Don’t miss the opportunity to earn funding for your research project through the SPTS Legacy Fund. Up to $10,000 will be awarded for a two year project in 2016. Priority for funding will be given to applications that meet the following criteria. • Projects that are clinically relevant to sports physical therapy. • Scientific merit of the project as determined by the reviewers. • Feasibility of the project to be successfully completed within the proposed time period and budget. • Institutional support and mentorship. • Likelihood that the project will lead to publication, larger clinical projects and/or future grant support.

DEADLINE: SEPTEMBER 30 We each have a reason for being a member of the Sports Physical Therapy Section of the APTA. But why are you part of the Sports Section? We want to know! If you are a member and physical therapist or PTA in your first five years of practice, tell us why! Videotape your thoughts and submit your creation to the #teammember competition. The prize? We will pay your registration to the 2015 Team Concept Conference in Las Vegas! Here is your topic: “I am an SPTS member because... AND I want to get other SPTS members involved by…”

Submit the registration form (available at http://www.spts.org/studentsearlycareer/teammember) to Jim Tyndall, Membership Team Committee Coordinator, at jt@osogood.com. Copy Mary Wilkinson, Director of Marketing at mwilkinson@spts.org. Mary will send you an invitation to submit to the #teammember DropBox. Just upload your video file, and you are done! If you win, you will be required to attend TCC (travel and expenses are on you, but registration is free...a $450 value) and make a short presentation at TCC to show your work! Show us your best stuff! See you at TCC!

Applications should be sent electronically in PDF format to the Chair of the Sports Physical Therapy Section’s Research Committee to the email address below. Applications and supporting materials must be received by 5 PM EDT, October 11, 2015. Paper or faxed copies will not be accepted. Ready to Submit? Please address all applications and questions to Chuck Thigpen, PhD, PT, ATC Chair, Research Committee Sports Physical Therapy Section Proaxis Therapy 200 Patewood Drive Suite C150 Greenville SC 29615 Phone: (864) 454-0904 Email: Chuck.Thigpen@proaxistherapy.com Grant Application

JOSPT September, 2015 The Role of Physical Therapists in the Medical Response Team Following a Natural Disaster: Our Experience in Nepal Effects of Weight-Bearing Biofeedback Training on Functional Movement Patterns Following Total Knee Arthroplasty: A Randomized Controlled Trial Higher Knee Flexion Moment During the Second Half of the Stance Phase of Gait Is Associated With the Progression of Osteoarthritis of the Patellofemoral Joint on Magnetic Resonance Imaging Manual Physical Therapy Following Immobilization for Stable Ankle Fracture: A Case Series The Development and Psychometric Properties of the Patient Self-Report Neck Functional Status Questionnaire (NFSQ) Detecting Meniscal Tears in Primary Care: Reproducibility and Accuracy of 2 Weight-Bearing Tests and 1 Nonâ&#x20AC;&#x201C;WeightBearing Test Resisted Side Stepping: The Effect of Posture on Hip Abductor Muscle Activation Validation of a Clinical Test of Thoracolumbar Dissociation in Chronic Low Back Pain

IJSPT Volume 10, Number 4, August 2015

September/October 2015, Vol. 7; Issue 5

The Efficacy of Taping for Rotator Cuff Tendinopathy: A Systematic Review and MetaAnalysis.

The September/October issue of Sports Health is available and focuses on the lower extremity. Original articles include

The Relationship Between Passive Glenohumeral Total Rotation and the Strength of the Internal and External Rotator Muscles: A Preliminary Study. Comparison of Eccentric and Concentric Exercise Interventions in Adults with Subacromial Impingement Syndrome. Clinical Reliability and Diagnostic Accuracy of Visual Scapulohumeral Movement Evaluation in Detecting Patients with Shoulder Impairment. Knowledge of Injury Prevention and Prevalence of Risk Factors for Throwing Injuries in a Sample of Youth Baseball Players. Baseball Players with Ulnar Collateral Ligament Tears Demonstrate Decreased Rotator Cuff Strength Compared to Healthy Controls. Observer Rating Versus Three-Dimensional Motion Analysis of Lower Extremity Kinematics During Functional Screening Tests: A Systematic Review.

Reference Values for the Marx Activity Rating Scale in a Young Athletic Population: History of Knee Ligament Injury Is Associated With Higher Scores Treatment of Popliteal (Baker) Cysts With Ultrasound-Guided Aspiration, Fenestration, and Injection: Long-term Follow-up Patellar Tendinopathy A Unique Incidental Finding in Two Young Dancers: A Case Series

Changes in Hip Range of Motion and Strength in Collegiate Baseball Pitchers Over the Course of a Competitive Season: A Pilot Study.

Impact of Femoroacetabular Impingement Morphology on Gait Assessment in Symptomatic Patients

Evidence for Isokinetic Knee Torque Asymmetries in Male Long Distance Trained Runners.

Sport Specialization, Part I: Does Early Sports Specialization Increase Negative Outcomes and Reduce the Opportunity for Success in Young Athletes?

Neuromuscular Control During Performance of a Dynamic Balance Task in Subjects With and Without Ankle Instability.

Pain and Giving Way Following Total Knee Arthroplasty

Effectiveness of Dry Needling, Stretching, and Strengthening to Reduce Pain and Improve Function in Subjects with Chronic Lateral Hip and Thigh Pain: A Retrospective Case Series.

Student members receive JOSPT and IJSPT online.

Weightbearing Versus Nonweightbearing After Meniscus Repair

Pattern of Fascicular Involvement in Midportion Achilles Tendinopathy at Ultrasound

Rehabilitation after Hip Arthroscopy and Labral Repair in a High School Football Athlete: A 3.6 Year Follow- Up with Insight into Potential Risk Factors.

These three journals are SPTS member benefits. Members receive JOSPT and Sports Health as both online and print publications; IJSPT is an online only journal.

Prevention of Lower Extremity Injuries in Basketball: A Systematic Review and MetaAnalysis

The Use of Functional Tests to Predict Sagittal Plane Knee Kinematics in NCAA-D1 Female Athletes.

Ultrasound Imaging in Postpartum Women With Diastasis Recti: Intrarater Between-Session Reliability

Link here

Sports Health

Why are Eccentric Exercises Effective for Achilles Tendinopathy? The Female Athlete Triad: What Every Physical Therapist Should Know. Link here >

Test-Retest Reliability of a Computerized Concussion Test: CNS Vital Signs Review of Lacrosse- Related Musculoskeletal Injuries in High School and Collegiate Players Suicide in National Collegiate Athletic Association (NCAA) Athletes: A 9-Year Analysis of the NCAA Resolutions Database Omohyoid Muscle Syndrome in a Mixed Martial Arts Athlete: A Case Report

Click here to view this issue online>

AWARD THOSE WHO ARE DESERVING: NOMINATE AN EXCELLENT SPT TODAY! 2016 Awards Nominations Now Being Accepted! Know someone who has made a difference in Sports Physical Therapy? If so, recognize their efforts by nominating them for a Sports Section Award. Each year, the Section highlights the accomplishments of those who have made significant contributions in the area of Sports Physical Therapy. If you know a clinician, educator, researcher and/or student worthy of an award, let their achievements be known and submit an electronic nomination. Nominations must be received by October 31, 2015. Instructions and application forms may be found on the SPTS website. No submissions will be considered after this date. Submit nominations electronically to Drew Jenk, Awards Committee Chair and Mark De Carlo, Executive Director.

Awards nominations are open for • Outstanding Student Award • New Horizon Award • Excellence in Education Award • Lifetime Excellence in Education Award • Lynn Wallace Clinical Education and Professional Development Award

• Outstanding Service Award • Jack C. Hughston Sports Physician Award • Ron Peyton Award • Outstanding Special Interest Group Chair Award • The Turner A. Blackburn Hall of Fame/Lifetime Achievement Award

NEED INFORMATION ON THE SCS EXAM? HERE’S WHERE TO FIND IT! Each year, many of our members register to take the Sports Certified Specialist (SCS) examination. As anyone who has taken this exam knows, it is a rigorous test, requiring many hours of preparation. The American Board of Physical Therapy Specialties (ABPTS) has certified more than 16,000 individuals who have demonstrated advanced clinical knowledge and skills in physical therapy specialty areas. However, as this is a changing process, the ABPTS has requested that we refer those interested in taking the examiination to their site for more information. Here are some links you may find helpful in your pursuit of the SCS: Sports Certification Site Examination Outline Preparation Resources Examination Tutorial Frequently Asked Questions What Constitutes Direct Patient Care? Specialty Council

SPTS also offers opportunities for preparation for the SPTS at an additional cost. SPTS Prep Course Upcoming EMR Courses

EDUCATIONAL OPPORTUNITIES FROM SPTS AND OUR PARTNERS AND SPONSORS SPTS Educational Partners

Evidence in Motion Online and Live Courses Residency and Fellowship Practice Management Information and Registration

Gawenda Seminars and Consulting Information and Registration

Information and links

Training Opportunities and Schedule

Medbridge Education Online Courses and Home Exercise Programs Information and links to registration

Information and Registration

October APTA National Student Conclave | October 22-24 | Omaha, Nebraska | Learn more, reserve your hotel room and register NOW! Emergency Medical Responder Course | In conjunction with the Marine Corps Marathon | Participants encouraged to work the Marine Corps Marathon on October 25 to gain experience; contact Shelly Weinstein for more information | See Calendar of Events for information on location | October 22-24 | Recertification course will be held on October 23 | Challenge course will be held on October 24 Advances in Examination and Treatment of Patients with Selected Musculoskeletal Conditions (Shoulder, Knee): Advances in Evidence-Based Practice | October 24-25 | Presented by George Davies, DPT, MED, PT, SCS, ATC, LAT, CSCS, PES, FAPTA | Hosted by Los Gatos Orthopedic Sports Therapy | DoubleTree by Hilton Campbell - Pruneyard Plaza, Campbell, CA | Registration November Emergency Medical Responder Course | Palo Alto, CA | November 68 | Sunnyvale Center, Palo Alto Medical Foundation, 401 Old San Francisco Road, Sunnyvale, California 94086 | Full course November 6-8 Register here | Challenge course November 8 Register here IFSPT First World Sports Physical Therapy Congress | November 20-21 | International faculty | English language conference | Held in conjunction with the IFSPT general meeting | Registration The Science of Running | Chicago Marriott O'Hare | November 21-22 | Faculty: Irene Sprague-Davis, Bryan Heiderscheit and Chris Powers | Special hotel rates available | Registration