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Monday, 10 March 2014

So Your the One who Runs Onto the Ice?

First of all I don't run onto the ice, that isn't safe, I walk quickly.  You may be thinking that all our concentration is on not falling, even though that may be part of what is going on in our head, we are already starting assessing the scene.

When you are working on the bench or the sideline as an Athletic Therapist you are always at the ready.  I have heard coaches say it is like we have eyes in the back of our heads we can know something is wrong even if we are not looking at the playing surface.  Adam Oates commented that when he started as a coach in the NHL he noticed one of his players was hurt and turned to Athletic Trainer Greg Smith to point it out and Smith was already moving down towards the end of the bench the player was coming off at.  This is a typical reaction for any AT working with a team.

I have been asked what we do while on the bench.  When working lacrosse and hockey I did work the gate but for me that just helped me see the ice and floor better, it also helped me get to know my athletes.  You could tell what they were like coming off from each shift, what was normal and what wasn't.  You would also be amazed at what they will tell you while you are both standing there.

So a player goes down.  You get an initial shot of adrenaline, I have told coaches who do not have access to ATs on their bench that the first thing you need to do when entering the playing surface is to take a deep breath and calm down, it is because that is what I do. As I am on my way to the injured athlete, many things are running through my head.  I am assessing what position they are in, are they lying still or rolling around in apparent agony?  I am going over what I saw the last few seconds of the play, based on this I already have an idea of what body part might be injured.  I quickly run through their medical history, was that the same knee that they had surgery on two seasons ago?  I may talk to another player or official to see if the noticed anything.

Once I arrive at the athletes side, the hands on work begins.  Always start with A, B, C - Airway, Breathing, Circulation.  Hopefully the athlete is talking to you and that solves A & B, you still need to check their heart rate.  Have them take some deep breaths before you start to assess, what is wrong, what hurts, what happened?  What I saw might not be what they are complaining of, however when I start my physical assessment I am going to make sure we both aren't right.  As long as it is not a suspected spinal injury, a quick physical assessment occurs and once the athlete is ready we move the athlete safely.

The pressure that is on during the on field assessment is huge.  Deciding if it is safe to move the athlete and how to do so.  Officials, other players are over your shoulder trying to help and wanting to get the game moving.  The coaches are wanting you to find out what is wrong so they know if they have lost a player or not.  Then there is the fans.  Parents, grandparents, family, friends, scouts, everyone is watching your every move, at times if feels like they are waiting for you to mess up.

I may not have eyes in the back of my head, but I do use my senses during injury assessment.  Initial injury assessment begins on the sideline, by watching and listening to the game or sport.  Once the physical assessment begins we add the sense of touch but always continue with my eyes and ears.  The use of the 6th sense is almost the most important, however that is a whole other post in itself.

So yes I am the one that goes onto the ice or field, but my job doesn't start or end there.  I've been watching to make sure if anything happens, making sure any of the prevention techniques used are doing their job, checking in with athletes as to their status of a healing injury.  When an athlete does get hurt, getting them off to the sidelines safely is just the start, a further assessment and decision about care must occur prior to anything else.  No matter what the safety of the athlete is key.  Getting them back to play is the goal, that is why we do what we do.

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