Athletic Therapist as Coach Educator

As much as we all would like to live in a perfect world where every team, school, and club carried or hired an Athletic Therapist, we haven't reached that point and unfortunately never will.  After participating in the #sportssafety chat this past week, it came to my attention that no matter how hard we try to have ATs at all levels of sport it seems that there are obstacles that will never be removed.  So what do we do?  We need to work on educating the coaches on injury prevention, recognition and basic management.

When working with a team or not one of the roles an AT takes on is educating coaches on the above topics.  Injury prevention must be something that all participants buy into.  The coaching staff are the ones that run practices, make tactical plans for competitions and are the overall guardian of what goes on with the athletes. Coaches need to learn about topics such as proper warm up, nutrition, hydration, rest and equipment as they can be a major influence if not the key influence as to athlete safety.

When it comes to injury recognition and management, by no means do I think coaches should know the difference between the laxity of a grade 1 sprain vs a grade 2 nor should they learn how to place players on spine boards.  What coaches do need to know though are basic first aid, CPR and have an understanding of basic injuries.  ATs need to share some of their knowledge with coaches.  Coaches do need to understand the difference between sprains and strains and understand the severity of each.  This knowledge will help them become a better coach, as they will understand why their athletes are out of sport while injured.  Everyone involved in sport should have first aid and CPR, so they can deal with emergent situations and have basic splinting skills.  Where ATs come into the education role is to help coaches take that first aid knowledge and apply it to sport.  

We know that at some point in their coaching career a coach will have to deal with an injured athlete, by educating them as to how to prevent injuries, we can help them decrease the number they will see.  By expanding their skill set when it comes to injury recognition and management, they will feel more comfortable when an injury does occur.  Athletic Therapists have a wide knowledge base, and by no means should coaches be expected to have the same one.  What we as ATs need to do is help the coaches expand their knowledge base, take the fear and uncertainty away when it comes to injuries.  Give coaches the ability to handle an injury until the athlete can receive more advanced care and ensure that the injury is not made worse.  If we as ATs work to empower coaches then coaches will learn that we are an integral part of the sporting community.

Please follow us on Twitter @EliteInjuryMgmt and check out our website at www.eliteinjury.com 

The Life of an Athletic Therapist in Junior A Hockey

Thank you to Mat Bonneau, CAT(C) for sharing what it is like to work with in the AJHL. 

I’ve had the pleasure of working this past year for a Junior A hockey team as their athletic therapist/equipment manager. It’s been a lot of fun and I love being able to go to the rink every day and get paid to be there. I have a variety of different tasks but all focusing on keeping our guys on the ice and in the best condition to play that I safely can. On the equipment side, my major duties include ordering and picking up equipment, keeping inventory and sharpening/repairing skates. There’s a lot of long days and a many hours logged on bus trips but nothing beats the feeling of being at the rink on game day. Typically I’m at the rink six days a week, training camp was 2-3 weeks of being there every day so it’s nice to get that out of the way and get a bit of a break once the season starts.

Our boys practice from 2:45-4:00pm each day, so I typically arrive at the arena around 1:00pm. From there I may have a few pairs of skates to sharpen or put rivets in if I didn’t get to it the night before. I try and get water bottles filled and put out sock and stick tape for the guys. I do any brief treating and assessing before practice to see where injured guys are at and to help determine what they are doing at practice that day. This is also usually the time that guys find broken sticks or any other repairs that need to be done before they head out on the ice.

During practice I usually try and keep the water bottles filled and assess anyone that gets injured during practice. Also if we have guys that are out, I try and get them to do some exercises while they are at the rink. This is usually a good time to assess anyone that may be out with a concussion because everyone is out of the room so they can focus on their SCAT without any distractions. We have some bikes in the room as well so guys can ride when they reach that part of their return to play.  After practice I typically get ice ready for anyone that needs it. Also I usually try and the guys to put their skates out and I’ll finish them that night.

Game days run a little different. I’m usually at the rink pretty early. I’ll hang all the boy’s jerseys in their stalls to start. Then usually I’ll fill water bottles for our bench and the penalty boxes. I have to make sure the game day pucks are on ice so that they don’t bounce around too much during the game. Again I’ll set out sock and stick tape for the game and make sure that guys that are playing have their game socks in their stalls. There’s usually a couple guys that need skates done because they didn’t check them or didn’t put them out the night before so I try and get those done while the players are having their pre-game meeting. I also mix the Gatorade and make sure that the visiting team has the game sheet. It’s also a good time to check in with the other therapist and see if they need help with anything or forgot something. After the meeting the guys go for their run and after the run I’ll do any extra stretching or taping/supportive techniques that need to be done. After that’s done I set up the bench with the water bottles, towels, my medical bag and set up the pucks for warm-up as well as make sure the nets are on for both sides. After warm-up I try and help pick up pucks and do any last minute things that need to get done before the game.

The routine for road games looks fairly similar but I also have to make sure that the bus is packed and ready to go. This means making sure we have all our jerseys, socks, extra equipment, tape, skate sharpener,  medical equipment and extra sticks all packed and ready to go the night before so when I get the rink the next day its ready for the guys to load.

During the games I like to run one of the doors to keep me involved and it’s fun to do. I try and look after myself but I’ve still been hit with the odd puck or stick during games. I’ll look after any injuries that happen and deal with equipment issues like broken sticks or skates that lose their edges. Between the periods I’ll refill the water bottles and put nets on if I have time to do it. The odd time I’ll have to sharpen a pair of skates or two if someone stepped on something or slid into a post.

After games I’ll get ice ready and I’m responsible for getting the game socks and jerseys washed. If I’m at a home game I’ll usually do it the same night. After getting back from the road it’s usually pretty late by the time we get back and unpack the bus so I’ll do them the next day we have practice.

It’s been a great year so far and I really hope that I get to continue and maybe move up someday to a major junior or professional team. We have a great staff and team so it’s fun to go to work each day. Like I said there are a lot of long days and weeks but it’s still great to be able to do it at the rink.

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.

Please follow us on Twitter @EliteInjuryMgmt and check out our website www.eliteinjury.com