The Job of the Athletic Trainer

I can hear it now.  After the last four columns (where I wrote about various life lessons, maybe with a sports twist) my wife will have said somewhere along the way “those are all nice, but you need to write about sports and injuries and that sort of thing.”

Of course she’s right.  I guess when you get to a certain age, you want to philosophize a bit—share the lessons you’ve learned in a long life.  I most surely qualify.

I do believe there was meaning in those stories, maybe not so much about dealing with injuries but about life lessons that apply to sports.  I also believe the other side of that coin, that sports teach us life lessons as well.

But back to what I know best:  Dealing with your injuries.  Here’s what I know—to deal most successfully with injuries, you’ve got to know what you’re dealing with.  That’s where the importance of athletic trainers comes in.

When I came here in 1981 and put out my own shingle, I know I wanted to be in the arena of athletic health care.  I wanted to build my practice around it.  Other than the legendary Dr. Bob Haralson, there wasn’t much going on in the way of sports medicine around here.

That has most assuredly changed and the athletes of this area have benefitted from that.  There are athletic trainers and sports physical therapists everywhere around here.  I know that because I work with them.

Dedicated professionals who love kids and love sports.  Caring individuals who sacrifice huge amounts of time to take care of their athletes. 

So, if you don’t know what your injury is, seek professional help.  Don’t “walk it off.”  Don’t “shake it off.”  Don’t “toughen up.”  Get answers.  Get checked out.  You will get better quicker that way.  Athletic trainers take no joy in keeping you from playing your game.  Our job is to get you back out there as quickly as possible.

And we will do it within the framework of making sure that it is safe for you to return to play, that there are no short term or long term ramifications to your return.  We do not compromise on that. 

It used to be that we put ice on an injury for 24 hours and then switched to heat.  We now know better.  There really isn’t a place for heat in sports medicine.

Don’t be afraid of braces.  I’ve heard a thousand times that somebody didn’t want to wear an ankle brace because it made the ankle “weak.”  Huh-uh.  It doesn’t.  It just protects the ankle, maybe gives it a chance to heal.

I tape a lot of ankles but not much else.  A few wrists and fingers.  Tape on a knee or a shoulder is worthless.  Those colorful stripes that you see on shoulders and knees?  Mostly decoration.  Hardly worth the cost or effort.

Common sense also goes a long way in dealing with sports injuries.  If it doesn’t make sense, get it checked out.  If it lingers too long, find out why.

The job of the athletic trainer is to help you get exactly what you need, when you need, and get you back to your sport.

What I do Best

OK, so what’s the most common injury that we see? That’s easy. Ankle sprains.

You know the injury. The foot turns in and you hurt on the outside of the ankle. It happens all the time, either when you suddenly change directions or when you jump up and land on somebody’s foot. 

The treatment is the same—Rest, Ice, Compression, Elevation (RICE). The sooner the better. Remember, you never “walk it off.”

              We see a lot of shoulder problems too. Those can be simple and can be complicated.  I spoke last week about the need to get a proper evaluation of injuries. That is never more true than when dealing with shoulder problems. 

              There are a lot of knee problems out there in athletics as well. Most of them, when treated correctly, won’t need surgery or months of rehab. Everyone is afraid of ACL injuries but fortunately they don’t happen that often. Younger athletes, particularly girls, are prone to problems with their kneecap (patella).  Most often it is a biomechanical issue and if those issues aren’t dealt with, relief will be temporary.

What’s the most difficult injury we deal with? That’s easy too. Concussions.

Concussions are also the scariest thing that we deal with on a regular basis. During our sports seasons, there is rarely a day that one of our athletic trainers doesn’t deal with a possible concussion.

And a concussion is something that we can’t be wrong about. Make a mistake and there is the potential to negatively impact someone’s life. That’s why we’re ultra-conservative when we suspect a concussion. That’s why if there’s any doubt about it, the game is over for that athlete.

That’s also why an athlete has to go through a whole battery of tests before returning to sports after a concussion. We simply cannot make a mistake.

It’s definitely frustrating for an athlete that has had a concussion who feels fine and cannot understand why they still can’t return to their sport. We have to make sure that the brain is fully healed before allowing sports participation. 

If the brain is still healing, it is far more fragile. The 2^nd Concussion Syndrome is very real. Have a concussion on top of a concussion and the impact can be much, much more severe.

I know concussions on a first name basis. Not only do I deal with them professionally, I had what I now know was a pretty serious concussion in high school football. 

It was 1970 and I remember arriving at our opponent’s field and I remember lining up across from their best player. And that’s it. That’s all I remember. The next thing I know, we’re back home in our own locker room.

I played the entire game, on both sides of the ball, and remember nothing about it. On film, it looks like that all-state player slapped me in the head one time and maybe that was it but I have no memory of any of it.

It turned out OK.  I don’t think I suffered any long term effects from it, but in hindsight, it is a bit scary. My brain was injured and yet I continued to play. 

I don’t want to let a fear of injury and especially of concussions keep you from allowing your child to play sports. I think that’s a huge mistake. I honestly believe that some of our best life lessons come from our playing fields. 

But I do believe that we owe it to ourselves and to our children to be smart about it.  And that means seeking trained professionals to make those decisions with you.

I Had a Dream

I Had A Dream

With all due to respect to one of the greatest speeches ever given (Dr. Martin Luther King’s “I have a dream” speech), I want to offer a glimpse of my dreams. Maybe it’s selfish. Maybe it’s bragging. Maybe you can learn something from it.

My story is humble. I probably had no right to dream but that didn’t stop me. I dreamed of a life and a world that was very different from how and where I grew up. From an early age, I dreamed of changing the world.

The first thing I can remember is the dream of being a Boy Scout. That started with my Den Mother Mrs. Patton and was fostered by really great Boy Scout leaders. I loved everything about it and grew leadership skills there that are still with me.

I dreamed of playing football. I loved everything about it. The teammates, the practices, the games, the helmets, the hitting. My high school football coach remains one of the greatest influences ever on who I became as a man.

I always wanted to have good friends that I could depend on. I’ve had a bunch of them. Even though we don’t talk often, I remain somehow cosmically connected to my best friend from childhood, Ronnie McNabb.

I dreamed of being married. It hasn’t always been easy and anybody that tells you that it will always be easy is lying but it has been worth it and now it is both easy and perfect.

I dreamed of finding a job where I was of value, a career that I enjoyed. Growing up, very few from my hometown went to college. Dreaming big was not really part of the culture. I remember all too well being told by a high school teacher that “people like you don’t go to college.”

But I was always going to college. My parents didn’t allow me to even consider anything else. They both worked in local factories, which was what most of my high school classmates did after graduation.

How I stumbled into this one must be the result of divine intervention. Nobody could be so lucky. Every time someone turns to me for help with their physical well-being, I know I’m doing what I’m supposed to be doing. And when a parent tells me that they feel better because their child is in my hands, well…it doesn’t get any better than that.

I dreamed of having children. I dreamed that those children would become successful adults. I really hit the jackpot on that. And then they brought me grandchildren which may be the greatest blessing a senior citizen could ever have. 

I dreamed of staying healthy and being healthy into old age. You’ve heard that story many times, as it relates to my dad’s heart problems. From an early age, I took ownership on that one. A lot of what I do today is my effort to sustain that dream.

I never wanted fancy cars or expensive clothes.  Jeans and t-shirts have always been more my style. I never dreamed that I would write a newspaper column for 33 years that people would actually read.  I know every English teach I ever had would find that thought pretty funny (or ridiculous…or both). 

I never dreamed that I would get to walk on the sidelines of championship football teams year after year. I never dreamed that I would be embraced by a community like I have by this one, where I have lived my dreams for 40 years. Thank you.

Purpose in Life

What is your purpose in life?  What were you put on earth to do?  I’ve seen young folks that seem to have figured that out.  I’ve seen old folks still looking for it. 

I believe we have a responsibility to change the world.  We have an obligation to make the world a better place, to leave it better than we found it.

We adopted two kittens not long ago.  I’m not a cat person.  Never have been.  Not too long ago, I wrote about that “one great dog” that everyone should have.  But my wife wanted a couple of cats and I really like to make my wife happy so we headed to the Animal Shelter with all six grandkids in tow. 

We wanted cat siblings.  And girls.  So we made our choices and left with Ariel and Batman (yeah…I know…not the name for a female cat—such is the influence of grandchildren). Well folks, I fell in love with them immediately.  It didn’t take long until they had wrapped me around their little paws. 

Last week, I came across a meme with a photo of a kitten sitting alone by a curb with the caption “he will never change the world but he will change the people who find him.”  An abandoned kitten, changing somebody’s world.  Imagine that.

Maybe that’s what our life should be about.  Maybe that’s what I’m talking about.  I was one of those people that wanted to change the world.  You know the list.  Feed the hungry.  Heal the sick.  Rescue the lost.

I had big dreams about being the greatest physical therapist ever and the greatest dad that ever lived.  We would live an active life and be responsible to the planet.  I would be an upstanding guy, a role model, and would treat everyone with respect and dignity. 

I would make the world a better place to live and grow my own vegetables and raise my babies in love and harmony, gently molding them into good people.  Maybe I’ve done some of that but at times I’ve failed miserably in all of that.  I’ve had some great opportunities and have led an interesting life but the world I’ve been able to change has never gone much beyond my reach.

As we get older, our world shrinks.  Our family grows and there are bills to pay and our priorities change.  Oh, for some of us, those lofty dreams stay alive and some do go on and change the big huge worlds.

But at some point, we all have to decide what world it is that we want to change.  Maybe your world is your family.  You want them to have things that you didn’t.  Or at least have the life that you always wanted.

Maybe your world is your job.  You want to make a difference through your work.  I get that.  Maybe your world is your town.  You want to make a difference so you run for local political office.  I admire that.  Maybe you continue to pursue those huge dreams and hopefully no one told you that you couldn’t do that.  

If you can’t change the whole world, you can always change your world.  From the governor’s mansion to the changing table, all our worlds are important.  And like that lost kitten on the curb, you can always change somebody’s world.  Isn’t that what it’s all about?

Chronic Pain & The Opioid Crisis

I just found out I was one of “those people.” You might know one of them. Those people with chronic pain. People who may have fallen into opioid addiction because of that chronic pain.

I never thought that I was someone that had chronic pain until listening to my friend Karen Litzy’s podcast on the subject. Let me back up. From the time I was a teenager until about the time I turned 45, I had migraines.

Throbbing, unremitting migraines. Keep you up all night migraines. When I ask patients what their pain level is on a scale of 0 to 10, I sometimes think about those nights when I was a 10 out of 10.

I tried everything to try and control my headaches. Nothing much worked. I saw a neurologist. I had all kinds of tests. I tried a lot of different treatments. Nothing. I had no choice but to keep going. I had responsibilities. I finally found a formula that seemed to keep my headaches somewhat manageable—hot showers and lots of Excedrin.

Most of my headaches arrived in the middle of the night. My routine was to eat something (with all the Excedrin I was taking, my stomach was always irritated), take two Excedrin, and jump in the shower, turning the water on as hot as I could stand. There were many nights when my wife would hear me in the shower at maybe 2 AM. There were lots of nights when I would empty the hot water heater. The hot shower was my best relief. After the shower I would take two more and try to go back to sleep.

Through the years, I tried all kinds of medications. One seemed to work but then I discovered it was based on a barbiturate and so I quit taking it. Excedrin became my drug of choice. I always had several Excedrin in the pocket of my pants. Always. When I was having the worst of those headaches, I remember thinking that I would do or take anything to get away from that pain. Anything.

Those around me didn’t understand. Chronic pain is largely invisible. I would look fine but my head would be pounding. I was told just to suck it up and keep going. Mostly I did. There were days when I would sit in a dark office until someone on my staff came to get me to see a patient. Then it was right back in the dark room.

At 45, something happened. Maybe it was male menopause. I have no idea. For the next 10 years, I rarely had a headache. At 55, they came back but not nearly as bad or as frequent. I still occasionally have to take an Excedrin but I don’t have to carry them in my pocket all the time. I can live with what I’ve got now.

But here’s my point: Pain can get so bad that you will take anything to make it go away. You’ve got a problem and there’s a pill that takes it away? You will take that pill. You may continue to take that pill if the pain continues.

Our country is in the midst of an opioid epidemic. We must do something. We must take ownership of our chronic pain. We must actively pursue control of our own condition.

Addiction is real and requires long term intervention. For many chronic pain conditions, my profession, physical therapy, is an effective non-pharmaceutical option but with copays and deductibles PT can be quite expensive. It’s a whole lot easier to simply take a pill than to exercise and work to get better.

I managed to escape that trap with my headaches but I’ll never know if I was lucky or strong. Just remember this—it can happen to anybody. Those opioid addicts can be your neighbors, your friends, your family.