Athletic Therapist in an Occupational Setting

We would like to thank Mat Bonneau, Certified Athletic Therapist for giving us this insight as to what it is like to work in an occupational setting. 

So I’ve been working in occupational testing for 2 years now, and it’s something I never thought that I’d be working in coming out of school. The opportunity has been good thus far although the job definitely comes with its own set of challenges.

As an athletic therapist, I am responsible for assessing a person’s medical history to help make a determination if they are able to complete our lifting test. We hold our clients to pretty strict standards to help ensure that they do not injure themselves while doing the test or something that could be potentially harmful on the job site. Occasionally we also run the physical portion of the test depending on how busily our day gets booked up. We see everybody from the lean 18 year old heading out for his first job on the rigs who’s never had so much as a cold to the overweight 55 year old type 2 diabetic, hypertensive operator who’s looking for a job to take them to retirement. We get quite a range of characters coming through. For the most part things run smoothly but occasionally we run into people who are more difficult to deal with. Like any service type job, how our day goes depends a large part on who companies send us each day.

Typically, a client goes through a brief pre-medical screen before coming to see us. We take a few measurements such as height, weight and blood-pressure to make sure there are no concerns with a client taking the test. We then go over their medical history with them, making sure to highlight and talk more in depth about any health conditions that may be red flags. Every once in a while I’ll come across a condition which I’m not as familiar with. We have a medical review team of medical doctors, chiropractors, physiotherapists and athletic therapists that help us to discern what may need to be looked at by another health professional or can continue through our testing without any restrictions. All of our files are reviewed by this team to make sure that everything is covered. Any type of medical clearances or restrictions are take care of by this department.

After going through a client’s medical history, we typically review their injury history looking for dislocations, fractures, sprains and strains. This can be challenging because clients may try to hide or not disclose information that they feel may hinder their opportunity to find a job. We check a client’s joint range of motion, muscle strength and ligament laxity to determine if a candidate is fit enough to not only complete the test, but also safely work at the job site without putting them at risk of further injury. We tend to focus on problem areas such as shoulders, low backs, knees and ankles throughout our assessment, while also keeping in mind common workplace injuries such as medial/lateral epicondylitis or carpal tunnel syndrome. The most difficult part of the job comes when you have to stop somebody from performing the lifting portion of the exam. Sometimes a person understands why we have a concern about the injury or medical condition in question and sometimes they don’t. We see people who have had a rotator cuff tendonitis for years but feel it is just part of getting old and don’t ever seek treatment for it. Other times they've had surgery and we just want proof that a surgeon feels that they are safe to go back to work without any restrictions. It can be a very touchy subject because a person feels if they don’t get through all their testing on the first day that they won’t get the job. It does put us in an awkward situation sometimes but we do our best to try and explain everything to our clients to the best of our ability.

Each physical test is set for a company based on a site analysis done by one of our assessors. The test doesn't change much from company to company but we vary the weight of the test based on what the person will be doing on the job site. The test is always run by a person with an exercise background, whether it’s a PFT, Kinesiologist or one of our assessors to ensure client safety. The test takes about 30 min to run for each group. We start with a brief cardiovascular test and proceed to a lifting test. Throughout the physical test, we are looking for a person’s ability to safely perform the lifting portion of the test using proper lifting technique for each lift. Clients are closely monitored to ensure that we are not putting them in danger throughout the testing. People will try and push themselves past their limits sometimes in order to attempt to secure a position within a particular company, so we do our best to prevent them from causing any injuries throughout our testing.

Overall it’s been an enjoyable experience working in occupational testing. It’s a really good chance to be exposed to different medical conditions and it’s a good chance to work on your assessment skills. On a busy day you can assess 25-30 people so it’s a good opportunity to be hands on with your muscle testing and special tests. I’m grateful for the opportunity to work in this field and appreciate being stretched outside the box of a typical athletic therapy setting.

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

Working with High Performance Minor Athletes - Part 2

Please check out part one of Working with High Performance Minor Athletes

It does not matter if the athletes are male or females, hormones are going to effect your interactions with them each and every day.  They effect their moods, their body, how they recover from injuries both physically and emotionally, how they react to their teammates, training partners and coaches.  I will break the myth right now, it is not only girls who cry and not only boys who want to hit things.  If you are dealing with young elementary aged children, they are still learning how to deal with disappointment, loss and success.  As the athletes grow older they are starting to discover who they are, and are having more expectations put on them.  Their role in sport can start to define them, if this role is suddenly changed, they may find it hard to cope.  You typically become their ally or enemy. If this role change occurs due to an injury, they see you as an enemy because you are what is holding them back.  If it is a coaching choice that changes their role you become the ally, they see you as someone to turn to who understands what is going on.  Typically at this age their relationships with their parents are changing and they may not feel they can go to them, you become their constant who they can trust.  It is this trust that will help you get through the enemy stage.  If you have built the trust when the time comes for you to remove them from play you remain their ally.  When removing an athlete from activity be prepared for anything.  As I said earlier girls hit and boys cry, you are messing with their identity in their minds, and they each have their own way of showing it.

At times you feel like a glorified babysitter.  You are the first one there, the last to leave, you pick up after the athletes, find out who's parents are always late, and do the room checks because the coaches are having strategy sessions.  Due to all this you become the gate keeper, you learn which athletes like to toe the line, which ones like to step over the edge a little and the ones who will ask you later "what line?"  Many coaches like to think they have their finger on the pulse of their athletes, but truly it is the Athletic Therapist.  We see all, here all and usually end up cleaning up the mess.  With minor aged athletes you try to help them keep the messes to a minimum, you become the teacher again in guiding them as to right and wrong.  You would be amazed at what these young minds can come up with to do on road trips.

For everyone involved in minor sports at a high level, we all must remember that these athletes are still kids.  Even as an Athletic Therapist it is hard.  We are trying to give them the structure and guidance they need to succeed.  Nutrition plans, treatment schedules, and expectations of how to act in the clinic or treatment room.  Let the kids be kids.  They will try to eat poutine before a game, use your athletic tape for their sticks and you will go through about ten sets of nail clippers each season.  It all becomes worth it though when they do something to show they have been listening, or when the truly show they care by carrying the treatment table and medical kit.  No matter the age of your athletes it is important to treat them all with respect and have their long term health and wellness in mind, because at times you will be the only one worrying about that.

Please follow us on Twitter @EliteInjuryMgmt  and our webpage at www.eliteinjury.com

Exercise - What is the Perfect One?

I would like to thank Freakonomics for the inspiration for this article and for Dr. David Geier for introducing me to the Three I's.

For many the desire to improve their health via exercise can be a long, tiresome journey.  One of the reasons is the need to try and find the perfect exercise.  Walk into any gym and you will see line ups for treadmills, ellipticals and bikes, yet not everyone is seeing the same results.

Intensity High intensity work outs are all the rage right now and for good reason.  By increasing the intensity of each individual work out you can decrease the time needed to work out and lets face it the majority of us do not have the time or desire to spend hours of each day in the gym.  A good example of intensity training would be to run for a minute as hard as you can, then rest (key here is active) for a minute.  You complete more work in 15 minutes than you would in double that time by doing continual exercise.

Indvidualized We all move in our own way.  Not everyone is a runner or a swimmer.  Some people have the ability to move gracefully in dance or yoga, were others feel more comfortable hitting a heavy bag.  Due to injury, physiology, anatomy or access to equipment can effect how well an activity works for you.  High intensity training works great for those who do not have access to much more than their running shoes and a pair of shorts.  Exercises such as high knees, bear crawls and jumping jacks can all be done in your living room.  Even those who enjoy running can employ the principals of intensity.  For some traditional exercises such as running, swimming and biking work well for them and produce ideal fitness gains.

I Like to Do It The best exercise for anybody is the one they will do.  If you don't like to run, don't.  Sink like a rock, don't enter the pool.  I quite enjoy Zumba, while my husband has recently discovered DDP Yoga.  Within a 30 minute Zumba session I work more muscles, burn more calories  than I do in a 30 minute jog.

I am adding Inspire even if you love the exercise if it does not inspire you to get off the coach, push your chair away from your desk then it still won't do you any good.  I love swimming but I have no desire to find a babysitter just to go workout for an hour, plus it's hard to get inspired to go into a cold pool during our Alberta winters.  A good test as to whether an activity is inspiring would be this.  If you see someone doing it, and you want to join, I suggest you do.

Not everyone has to start competing in triathlons once they start their journey to better health like TriFattyTri but you may enjoy it.  If you are starting your own journey to better health and incorporating exercise follow the Three I's, remembering that the most important is do you like it.

Please visit our website at www.eliteinjury.con and follow us on Twitter @EliteInjuryMgmt

MRSA in Sport

It used to be said that cleanliness is next to godliness.  In the case of athletes and the locker room that holds true.  Methicillin resistant staphylococcus aureus (MRSA) comes in two forms HA-MRSA which is health facility based and CA-MRSA which is community based.  In the world of sport we need to pay attention to the community based MRSA.

The main cause of all MRSA is the over prescribing of antibiotics.  Even the proper use of antibiotics has lead to the increased resistance of bacteria.  In sport settings there are five C's of risk.  Contamination, lack of cleanliness, compromised skin, crowding and contact.  30% of all individuals are carriers of CA-MRSA which is why dealing with the 5C's is so important in the prevention of MRSA.  Cleanliness of both the athletes, their equipment and the facility is pivotal in the early stages of prevention.  Athletes should shower immediately after participation, soap and towels should never be shared.  Paying attention to any type of open wound is imperative.  All wounds must be cleaned properly and covered to avoid the chance of infection entering the body.  Crowded locker rooms or dormitories increases the chance of infection spreading. If you are in charge of the locker room, use a cleaning solution of 1:100 bleach to water. The use of antimicrobial cleaners can also reduce the amount of bacteria on surfaces.  Main areas that you need to be concerned with are the locker room, shower facilities, weight room, and any adjoining areas to the locker room.   Contact of an infected person onto either training surfaces or other athletes either by direct or indirect contact start the transmission process.  By having your athletes maintain proper levels of hygiene, cleaning their gear, and maintaining clean facilities will help decrease the chance of CA-MRSA being transmitted.

As a coach, parent, trainer or athlete it is key to pay attention to skin condition.  If a wound is present it must be cleaned and covered before the athlete returns to participation in sport.  If a wound does go untreated look for the following signs of infection.  Hot, red and raised area around the wound is the standard signs for any infection.  CA-MRSA will start as small red bumps similar to pimples and will develop into painful abscesses.  Early intervention and treatment is essential to the athlete returning safely from CA-MRSA.  If any athlete does have CA-MRSA the whole locker room must be thoroughly sanitized, this includes all hard and soft surfaces and all clothing.

Prevention of all injuries is important however the prevention of MRSA is even more important due to the long term dangerous health effects.

References:
Rogers, Sharon. A Practical Approach to Preventing CA-MRSA Infections in the Athletic Setting, 2008 Human Kinetics - ATT 13(4), pp. 37-41
www.cdc.gov
http://www.phats-sphem.com/newsletter/Newsletter_spring13.pdf
www.mayoclinic.org/mrsa