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Athletic Trainer:

Enrique Ochoa, MSEd, LAT, ATC

Phone: 1-505-890-0343 Ext. 37085

Email: enrioque.ochoa@aps.edu

4/16/18 12:18 PM
4/16/18 12:18 PM
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6/13/18 11:05 AM
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Athletic Training

Sports Medicine

What is a Athletic Trainer:

Athletic Trainers (ATs) are health care professionals who collaborate with physicians to provide preventative services, emergency care, clinical diagnosis, therapeutic intervention and rehabilitation of injuries and medical conditions. Students who want to become certified athletic trainers must earn a degree from an accredited athletic training curriculum. Accredited programs include formal instruction in areas such as injury/illness prevention, first aid and emergency care, assessment of injury/illness, human anatomy and physiology, therapeutic modalities, and nutrition. Classroom learning is enhanced through clinical education experiences. More than 70 percent of certified athletic trainers hold at least a master’s degree.

What do athletic trainers do?

Athletic Training & Personal Training

Athletic training is often confused with personal training. There is, however, a large difference in the education, skillset, job duties and patients of an athletic trainer and a personal trainer. Athletic trainers provide physical medicine, rehabilitative and preventative services. Athletic trainers treat a breadth of patients, including but not limited to: professional, college, secondary school and youth athletes, dancers, musicians and military personnel. Athletic trainers can work in a variety of locations including schools, physician clinics, hospitals and manufacturing plants.

Athletic Trainers vs Personal Trainers

To become certified athletic trainer, a student must graduate with bachelors or masters degree from an accredited professional athletic training education program and pass a comprehensive test administered by the Board of Certification. Once certified, they must meet ongoing continuing education requirements in order to remain certified. Athletic trainers must also work under the direction of a physician and within their state practice act.

Return to Play Criteria

If a diagnosis of a concussion or concussion like symptoms are made by the Athletic Trainer or your Medical Provider, Once they are cleared, either by the Athletic Trainer or your medical provider, your athlete will then will have to go through the Return to Play Criteria once they are ASYMPTOMATIC for 24 hours.  The return to play criteria does not start at the onset of the injury. This process takes a week to perform and it is a gradual physical exertion test to see if the symptoms or signs of a concussion come back. For a further explanation please do not hesitate to ask me about the Return to Play Criteria or click on the link in the concussion guidelines for the NFHS box below.

National Federation of High School Sports Concussion Management Guidelines

Heat and Hydration Guidelines:

Athletes are at risk for heat-related illness when their bodies are unable to properly cool themselves during physical activity.  The risk of heat illness increases with rising temperatures and rising humidity.   The body normally cools itself by sweating. But under some conditions, sweating just isn't enough, causing an athlete’s body temperature to rise rapidly.

Several factors affect the body's ability to cool itself, such as:

  • Weather: when the humidity is high, sweat will not evaporate as quickly, preventing the body from releasing heat quickly.
  • Age: children have lower sweat rates, higher heat production, and require more time to acclimate to heat.
  • Larger athletes:  more mass means more energy production and body heat. Fewer sweat glands per surface area, along with additional fat, insulates the body and keep heat internalized.
  • Restrictive clothes and gear limits heat evaporation and increases insulation.
  • History of heat illness


Other conditions related to risk include obesity, fever, dehydration, heart disease, poor circulation, sunburn, and prescription drug and alcohol use.

Because heat-related deaths are preventable, it is vital coaches are aware of who is at the greatest risk and what actions can be taken to prevent a heat-related illness or death.

General Guidelines for Heat Illness

Dehydration

Dehydration occurs when the body looses too much fluid.  Dehydration impairs athletic performance whenever body fluid level falls below 98% of normal. The primary cause of dehydration is sweat loss, an essential body process which facilitates the release of body heat into the environment. When athletes don’t replace what they lose in sweat, the physiological function of the body’s heat management system is compromised, placing both the athletes’ performance and physical well-being at risk.

Heat Exhaustion

The inability to continue exercise associated with any combination of heavy sweating, dehydration, sodium loss, and energy depletion. Occurs most frequently in hot, humid conditions.

Heat Stroke

Occurs when the temperature regulation system shuts down due to excessive heat production and/or inhibited heat loss.  This life threatening situation occurs during activity and effects organ tissues resulting in systemic organ failures.

Signs, Symptoms, and Actions to Take

Signs and Symptom Symptoms Actions to Take

Dehydration

  • Fatigue  
  • Irritability 
  • Nausea
  • Vomiting 
  • Muscle Cramps
  • Loss of Performance
  • Re-hydrate     
  • Stop activity

Heat Exhaustion      

  • Dizziness   
  • Headache  
  • Nausea   
  • Vomiting  
  • Weakness  
  • Rapid Pulse  
  • Cold, clammy skin
  • Replace fluids (re-hydration is critical)
  • Rest in a cool, shaded area until all symptoms have passed.
    • If dizziness continues, lie the athlete down, elevate their legs, and seek medical attention.
Heat Stroke 
  • * Medical Emergency  
  • Irrational Behavior 
  • Drowsiness
  • Nausea   
  • Hot, dry skin   
  • Confused or disoriented 
  • Dangerously high temperature
  • Get out of sun and seek immediate medial attention. If this is an emergency, call 911.
  • Cool immediately using ice baths, ice bags, or whatever is available for you to use.

REMEMBER:  Athletes can still be experiencing heat stroke even if most symptoms are absent. 

Seek medical attention immediately at the first sign of serious or unusual symptoms.

Steps to Preventing Dehydration

  • Acclimate to the heat over a period of 10 -14 days by beginning to exercise during the hot parts of the day for 10 -20 minutes and gradually increase your exercise time working up to 1 – 2 hours.
  • Be sure to drink plenty of proper fluids during the acclimatization period.
  • Drink fluids containing sodium to keep your urine clear to light yellow
  • If you sweat a lot, or heat conditions worsen, be sure to take in extra sodium during the day with your meals and/or or rehydration beverages containing sodium.
  • When exercising in the heat, cloths should be breathable and allow for proper sweating and evaporation. Clothes that get wet and hold on to the sweat need to be changed regularly.
  • Alter intensity and frequency if exercising in the heat. Always make adjustments as the heat and/or humidity increase.

Hydration breaks should be more frequent and longer as the heat and/or humidity increase.


Nutrition Guidelines for Practice and Pregame:

Nutrition is often overlooked as a potential competitive edge possibly because it is poorly understood.  It has been shown that proper eating before exercise improves performance. It is also important to be well hydrated before the exercise session. Too many high school athletes head off to school without eating breakfast, lunch may be a slice of pizza.  At this point they, with very little fuel in their system, they are not prepared to be their best at game time or even practice.  

Some signs that an athlete may not be eating enough to fuel their performance are:

  • Difficulty paying attention in practice or in a game.
  • Weight loss
  • Fatigue before the practice or games have been completed.
  • Injury or frequent illness.


Nutrition Tips

To help athletes achieve peak performance it is important to promote healthy eating and adequate fluid intake. Encourage athletes to take time to eat breakfast everyday. Remind your athletes that lunch for many of them will be their pre-game meal and to eat accordingly. And for some athletes, lunch may be as early as 10:30 in the morning and they may not be eating again until after practice or after the game. The size of the meal or snack eaten before exercise is important because adequate time is needed for digestion.  A meal or snack that is high in protein and/or fat will take longer to digest. Years ago a typical pre-game meal was steak and eggs which is mostly protein and fat. Many studies have confirmed an ideal pre-game meal should be predominantly carbohydrate.  Eating foods high in carbohydrate can maintain blood glucose levels during exercise and provide fuel for the exercise session. The closer it gets to game time or practice, the smaller the meal or snack should be.

The body must have the proper fuel for peak performance; there are no substitutes for good nutrition.  Some athletes may be tempted to try an energy drink as a quick pick me up before they compete. There are no quick fixes, including energy drinks, for not eating and drinking adequately during the day.  Keep in mind some of these energy drinks may be too high in caffeine to be considered a healthy choice (have your athletes read the label).  They should not take the place of healthy meals and adequate fluids during the day.

Pre-Game Nutrition Guidelines:

4 or more hours before game:

  • Sandwich with lean meat such as turkey or ham, fresh fruit or juice, lowfat milk or lowfat yogurt.


3 hours before game:

  • Fruit or juice, bagel or toast with a little peanut butter, light cream cheese or margarine or cereal with lowfat milk and fruit.


1-2 hours before game:

  • Fresh fruit or fruit juice or a sports beverage.


Foods higher in fat and protein such as steak and eggs, pizza, nachos, and hot dogs will leave the stomach very slowly and be unavailable for fuel during exercise and should be avoided immediately before exercise.

To help keep athletes well hydrated, encourage them to:

  • Stop at the drinking fountain between classes.
  • Bring a water bottle to school and to practice so that they may take frequent water breaks.
  • Drink fluids with their breakfast and lunch.

During practice and in game situations to drink during time outs or breaks in play, and to drink even in they claim they are not thirsty (since thirst is not a good indicator of hydration)

Lightning Protocol for Practices and Games:

Lightning is the most frequent weather hazard affecting athletic events. Advance planning is the single most important means to achieve lightning safety. Removing individuals from activity in the event of inclement weather is a shared responsibility of the athletic director, athletic trainer and coaching staff. The following steps are recommended:

  1. It is the athletic training/coaching/athletic staff’s responsibility to be aware of current weather conditions within the area and potential threats. Staff will then be aware of the possibility of a storm forming or moving into the area during the day.
  2. The athletic training/coaching/athletic staff should be aware of the signs of a nearby thunderstorm. It is important to understand that thunderstorms can become threatening in the matter of half an hour. In addition, lightning can occur even with the absence of rain.
  3. The athletic training/coaching/ athletic staff should also be aware of the closest safe shelter to their practice or game site and the amount of time it takes to reach the safe shelter. (Safe shelter is defined as: any sturdy building that has metal plumbing or wiring to electrically ground the structure, and in the absence of a sturdy building or any vehicle with a hard metal roof (not a golf cart or convertible) with the windows rolled up.)
  4. The flash-to-bang method should be used to monitor how close lightning is occurring. (Count the seconds between seeing the lightning flash and hearing the clap of thunder bang. Divide this number by 5 to determine how far away (in miles) the lightning is occurring. For example, 15 seconds is 3 miles away.)
  5. APS Has determined that lightning within 8 miles of games or practices requires them to be halted until such time that the all-clear has been given by the ATC/GameOfficials/Athletic Director.
  6. If the flash-to-bang count is decreasing rapidly and the storm is approaching your location or if the flash-to-bang count approaches 30 seconds (6miles), all outdoor activity must cease. All persons must immediately leave the athletic field and report to the closest safe shelter.
  7. Stay away from tall or individual tree, poles, metal objects, standing pools of water, and open fields. Avoid being the tallest object in a field.If there is no safe shelter within a reasonable distance, crouch in a dry ditch. You should crouch with only your feet touching the ground, keeping your feet close together. Wrap your arms around your legs and tuck your head. DO NOT LIE FLAT.
  8. If you feel your hair stand on end, your skin tingle, or hear crackling noises, immediately crouch as described above.
  9. Allow 30 minutes to pass after the last sound of thunder and/or flash of lightning before resuming any activity. Lightning can still flash even after the rain stops.
  10. Do not use landline telephones unless an emergency arises.

Lightning strike victims do not carry an electrical charge. CPR/AED is safe and should be utilized immediately if warranted.