Athletic training encompasses the prevention, examination, diagnosis, treatment and rehabilitation of emergent, acute or chronic injuries and medical conditions. Athletic training is recognized by the American Medical Association (AMA), Health Resources Services Administration (HRSA) and the Department of Health and Human Services (HHS) as an allied healthcare profession. Athletic trainers work under the direction of a physician as prescribed by state licensure statutes.
(National Athletic Trainers’ Association)
Therapeutic exercise refers to a wide range of physical activities that focus on restoring and maintaining strength, endurance, flexibility, stability and balance. The goal of the therapeutic exercise is to return the athlete to a fully functioning, pain-free state.
Electric stimulation therapy is a therapeutic treatment that applies electrical stimulation in treating pain. It is used by athletic trainers and other healthcare professionals for the purpose of decreasing inflammation and swelling of affected tissues. Electrical Stimulation can also be used to treat muscle spasm and can be a key component post-surgical for muscle re-education.
Therapeutic ultrasound is applied using the head of an ultrasound probe that is placed in direct contact with your skin via a transmission coupling gel. Therapeutic ultrasound has been shown to cause increases in healing rates, tissue relaxation, tissue heating, local blood flow, and scar tissue breakdown.
Moist heat is a modality used to treat chronic pain and to relax the body. In the athletic training room, this is used most often in conjunction with electrical stimulation.
Ice is used to treat acute injuries. It is very beneficial in preventing further swelling and reducing pain. Like moist heat, ice will commonly be used in conjunction with electrical stimulation.
Manual therapy is delivered with the hands as opposed to a device or machine. In manual therapy, practitioners use their hands to put pressure on muscle tissue in an attempt to decrease pain caused by muscle spasm, muscle tension, and joint dysfunction.
Lauren Brown joined Habersham Medical Center as the athletic trainer for the Tallulah Falls School Indians. A native of Rabun County, Lauren graduated from Rabun County High School before attending Western Carolina University and earning her bachelor’s degree in Athletic Training. At WCU, Brown had the opportunity to take part in many clinical experiences including military, collegiate, and fine arts. Brown is also certified in mental health first aid.
Lauren H. Brown LAT, ATC
Habersham Medical Center
Tallulah Falls School
Office: (706) 754-0400 (ext: 2099)
What is a concussion?
A concussion is a type of traumatic brain injury—or TBI—caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells.
Concussions Are Serious
Medical providers may describe a concussion as a “mild” brain injury because concussions are usually not life-threatening. Even so, the effects of a concussion can be serious. (taken from CDC)
Click here to access the GHSA concussion form.
Recovery Techniques to Improve Fitness, Drill Execution, Focus, and Contest Performance
The research and anecdotal evidence is overwhelming that simple recovery techniques help overall training and performance (and may be good for injury prevention and heat-related issues). Coaches are challenged this year to observe with a purpose of how an individual and the team is recovering w/n the practice segments, between practices, and the within the cumulative effect of training.
Methods BEFORE/BEGINNING Practice/Contest
- Have a cue/purpose/statement/quote/focal point/emphasis set for that practice
- Keeps the mind off of extraneous factors that can increase fatigue
- Remind athletes to snack toward the end of the school day or immediately after school
- Fruit, Cliff Bar, preferably
- Warm up complementary to the purpose of that practice
- Pre-practice static stretching may actually be detrimental to power related activities
- Utilize various multi-joint, “dynamic” or movement oriented exercises that increase core temperature, go through a full range of motion, and progressively mimic the segments of the workout or contest.
- Massage rollers
- Foam Rollers
- Skips, gallop, shuffle, crossover, carioca, bear crawl, crab walk, hop, bound, jump, jump rope going forward, backward, sideways, or at angles progressively for motor control, height, distance, speed, or rhythm. Can progressively be done barefoot
- Add movements like multi-directional lunges with an upper body movement (reach), various bodyweight squats, or yoga type movements or stabilization exercises
- Accelerate and/or running progression appropriate for the next practice activity
Recovery Methods DURING Practice/Contest
- Fluids: Water, Electrolyte/Sports drinks (NEVER energy drinks)
- PowerAde (cold and diluted), Hammer HEED, Shaklee Performance, Ultima Replenisher, VegaSport Electrolyte Hydrator
- Ice towels/mist-spray bottle/head in cold water/cold water on face or head or ice in hand(s)
- Massage rollers
- Foam Rollers
- Change shirts or socks ½ way through practice
- Introduce a cue, a visual, a word/phrase/concept/feeling for the athlete to focus
- “Feel the breeze” is a good cue when hot (when an athlete keeps walking/moving, it is easier to “feel” a breeze which cools them
- Take off shoes…walk barefoot…or put feet in an ice bucket
- Feet up above head (allows blood flow back to the heart and may help reduce waste product buildup)
- Rest, whether active (walking) or sedentary (standing, feet up, in front of a fan, etc)
Recovery Methods AFTER practice/contest
- Massage rollers
- Foam Rollers
- Stretching (Achilles, calves, hams, glutes, low back, groin, IT band, hip flexors, quads, shoulders, upper back)
- Take off shoes…walk barefoot
- Cryotherapy/ice water baths – temperature 50-60 degrees
- Water and/or sports drink
- Simple 4:1 carb:protein type recovery drinks such as chocolate milk w/n 30 minutes after practice
- Snacks – nutrient bars
- Those with truly whole or natural or non-process or fewer ingredients
- Summary of Recovery Techniques
- Active Rest/work another energy system/skill
- Introduce a Cue
- Mobility – improving range of motion through movement pre- and w/n practice; Stretching – post practice
- Hydration – cold, water and electrolyte sports drink
- Cryotherapy – cold/ice towels, water, bucket, spray, immersion
- Nutrition – chocolate milk or protein shake
Various research related notes/summaries
During exercise, glycogen is broken down to adenosine triphosphate (ATP) and used to supply energy to the body. Hypoglycemia, or low blood sugar, can result if glycogen uptake exceeds the body’s glycogen production. Beverages are the quickest and easiest way to aid in the resynthesis of glycogen as well as rehydrate the athlete.
Summary of research referenced in the review:
- Athletes can maximize glycogen resynthesis during the 30-60 minutes following a workout when the body can do so independently of insulin.
- Glycogen resynthesis is highest when post workout carbohydrate intake is 1.0-1.5g per kilogram of body weight.
- Carbohydrates with a higher glycemic index increased glycogen storage in the muscles, compared to lower glycemic carbohydrates.
- Glucose and sucrose enable a higher rate of muscle glycogen storage than fructose.
- Branched-chain amino acids may have an anabolic effect during recovery.
- A combination of protein and carbohydrates post workout is more effective at restoring glycogen than a carbohydrate-only drink.
- The addition of antioxidants to post-workout beverages could reduce muscle soreness by lessening oxidative stress and muscle damage.
- Low-fat chocolate milk was found to be more effective than a standard carbohydrate-protein drink as a post-workout recovery drink, possibly due to the combination of proteins, carbohydrates, and the antioxidant properties of cocoa.
- Cyclists consuming low-fat milk after training were found to retain more fluid and be better hydrated than those drinking a standard carbohydrate-electrolyte drink.
In summary, the review determined that in order to maximize restoration of glycogen stores endurance and team athletes should consume 0.8 grams of carbohydrates per 1 kilogram of body weight and .04 grams of amino acids or proteins per 1 kilogram of body weight every hour for 4-6 hours following a workout. In addition, post workout beverages should include potassium, chloride, and 0.3-0.7 grams of sodium per liter of fluid to restore electrolytes.
According to a Runner’s World article lauding the benefits of ice baths:
“Cryotherapy ("cold therapy") constricts blood vessels and decreases metabolic activity, which reduces swelling and tissue breakdown. Once the skin is no longer in contact with the cold source, the underlying tissues warm up, causing a return of faster blood flow, which helps return the byproducts of cellular breakdown to the lymph system for efficient recycling by the body. "Ice baths don’t only suppress inflammation, but help to flush harmful metabolic debris out of your muscles," says David Terry, M.D., an ultrarunner who has finished both the Western States 100-Mile Endurance Run and the Wasatch Front 100-Mile Endurance Run 10 consecutive times.”
Click here to read more.
Click here to read more about the recommendation of “cool first, transport second”: from NATA June 27 new position statement:
The current document now states that a patient suspected of having exertion-related heat stroke must be cooled via cold water immersion for the full treatment time prior to being transported to a hospital; and that this must be stated in the school’s emergency action plan.
Always follow the required heat/humidity/hydration policy!