The role of athletic trainers in local schools

By Brittany Hively

POSTED ON AUGUST 27, 2021 BY POINT PLEASANT REGISTER

https://www.mydailyregister.com/news/66544/the-role-of-athletic-trainers-in-local-schools

POINT PLEASANT — High temperatures, long practices and a lull in water can be a deadly combination, fortunately, certified athletic trainers are on-site in Mason County Schools to help athletes handle the heat.

Manager of Sports Medicine with Pleasant Valley Hospital and Head Athletic Trainer at Point Pleasant Junior/Senior High School, Gabe Roush, spoke with Ohio Valley Publishing about the importance of certified athletic trainers in schools.

“Athletic trainers are actually allied healthcare professionals that work in conjunction with physicians and therapists and really across the spectrum of healthcare to provide proper healthcare for student athletes, particularly in the high school setting. Which is what I deal with right now,” Roush said.

Certified athletic trainers do more than just focus on practice injuries.

“They really focus on injury prevention, injury maintenance and rehabilitation and have experience in just general illness and everything,” Roush said. “Just to keep an eye on athletes and take care of them through that whole process while they’re participating in sports.”

While athletic trainers are important for student athletes, Roush said not all secondary schools have access to trainers.

“The big thing is, especially in the state of West Virginia, it’s less than half of the secondary schools in West Virginia have access to athletic trainers,” Roush said. “We’re really pushing that because anytime you send a kid to practice in a full-contact sport, obviously they’re at risk of injury. And not really affording that to all kids really across the state, really it’s not fair.”

West Virginia only requires football to have athletic trainers on-site.

“The only sport that requires to have any type of medical coverage in the state of West Virginia is football. So that leaves girl’s soccer just hanging in the wind, when in all reality they have a higher injury rate when it comes to concussions and ACL [injuries],” Roush said.

Roush said athletic trainers are trying to show the importance of having them on-site for all student athletes.

“So, it’s potentially a Title 9 issue in a lot of our eyes, but we’re just trying to show decision makers the relevance and the pertinence of having athletic trainers at all schools, both middle school and high school,” Roush said.

With the increase in temperatures during the start of fall sports, protecting students from the heat is one of the bigger focuses for athletic trainers.

“That’s always a big concern all throughout August and the early part of September,” Roush said. “Of course, ATs [athletic trainers] are highly trained and prepared for the situation if a kid experiences a heat-related illness. That’s something we go through, kind of vigorously through school. Doing continuing education…really trying to put forth the best practice in terms of taking care of a kid that might be overcome by heat, so we’ve helped develop protocols and procedures for our schools to make sure that in the case a student-athlete does develop that we know what to do as quick as possible and then when to send out with EMS.”

While athletic trainers have policies in place and are able to react to a heat-related illness quickly, prevention policies are also practiced.

“Also, since a big role as athletic trainers is injury prevention, we also work in conjunction with the SSAC [West Virginia Secondary Schools Activities Commission] to implement policies and procedures to help prevent that from happening in the first place,” Roush said. “We keep a close eye on the heat index of our venues and make any modifications of our equipment or practice times or the frequency and duration of water breaks as well.”

All Mason County high schools have access to athletic trainers that work together.

“All three of our Mason County Schools are staffed with athletic trainers from Pleasant Valley Hospital,” Roush said. “So, we’re able to implement a consistent procedure across the entire county. It pretty much falls in line with the State of West Virginia and the SSAC, that once it gets up to a certain amount of degrees in the heat index, that’s when we start making adjustments to practice times or like, the equipment, taking off shoulder pads, stuff like that.”

When situations arise and students have been taken over by the heat, Roush said it is important to cool their core temperature. He said studies across the board show this as an effective way to prevent heat stroke and help save a student’s life.

“The biggest one that I think needs to be really taken seriously for other [times] as well, is the fact that if a kid does go down with a heat-related illness, the first thing you do is you cool that student athlete instantly,” Roush said. “There should be a cold tub, regardless of what the container is, a tub of water where you can dump ice on the student-athlete to try and bring that core temperature down before you even transport with the EMS.”

Water intake is the most important thing to fight the heat.

“It almost sounds cliche because this is pounded into every kid’s head in every health class from grade school all the way up, is maintaining proper hydration and a proper diet,” Roush said. “That’s going to be the number one preventative measure.”

Roush recommends avoiding greasy and deep fried foods. He said carbs and higher protein are good for athletes to help rebuild muscle tissue and to not be afraid to use a little bit of salt to replenish what you sweat out.

One thing Roush points out is that the water a student drinks today, is to replenish the body from yesterday.

“If a student-athlete is drinking enough water throughout the day to replenish all the sweat that they’ve excreted from the practice the day before,” Roush said. “Because once their body reaches that level where they are becoming dehydrated their body has kind of reached a stress level already. So you start going out in higher temperatures, exerting yourself at a high level. Your body is already at a disadvantage to try to cool itself anyways, so you’re really working against yourself.”

Roush said there are steps to try to help ensure the athletes are hydrating their bodies.

“We traditionally do weigh-in and weigh-out charts particularly when we know there’s going to be hot weather,” Roush said. “Two-a-days are definitely the time that we really play close attention to that, especially right after summer break. Cause not all kids are out staying conditioned and staying acclimated to the weather. We just monitor that body weight loss, which is essentially water-weight loss, to make sure that they’re staying replenished and get back to that original weight.”

Roush said COVID has made keeping the students hydrated more of a challenge.

“We’ve had to adjust our hydration practices, where we don’t have shared bottles, obviously,” Roush said. “We have to try to rely on student-athletes to bring their own bottles, but then they forget so you try to provide bottled water, it’s just been a challenge for athletic trainers across the nation. It just adds another layer of difficulty in terms of preventing heat illness because it’s hard to get teenagers to drink water anyways.”

With COVID-19 being predominant in everyday life, there are concerns for students who may have had the virus. With the various forms of information out there, Roush said it is always best to discuss concerns and be checked out with the student’s pediatrician.

“We typically leave that in the hands of the pediatrician or the treating physician if a kid does comes down with COVID, especially in the case if a student does come down with more severe symptoms,” Roush said. “I know it’s becoming more recommended for student-athletes to undergo an EKG following a rough bout with COVID.”

Roush said the athletic trainers do not know student vaccine status, but do work to stay prepared and up-to-date on anything else to watch.

“In terms of the vaccine itself, I know those numbers seems to be a little bit lower as well, in terms of a cardiovascular issue,”Roush said. “It’s just something that we’re always keeping a close eye on anyways because a cardiac event is something that we’re prepared to help manage and take care of on the field until EMS arrive. It’s always in the back of our mind anyways.”

Mason County athletic trainers are on-site for all practices — middle and high school — and home games. The high school football games are the only required travel games.

Roush said the athletic trainers in Mason County try to make themselves as available as possible all year long for any sports events.

When it comes to athletic trainers, Roush said not to be afraid to utilize them, he encourages it.

“Athletic trainers have a vast knowledge in orthopedic injuries, a lot of training in concussion diagnosis and management to really help those students along,” Roush said. “I know sometimes a kid twists his ankle, sometimes the parents knee-jerk reaction would be to head to the ER. However, that AT has that background where they can evaluate and if it is something that’s necessary to head to the ER, we’re like ‘yeah go.’ Or if it’s just a routine sprain, we’re like ‘no let’s take a step back, this is something we can treat pretty conservatively’ and that essentially saves them an unnecessary trip to the ER, especially in these times with COVID, we don’t want to overwhelm our ERs any more than they might be.”

Mason County is one of the few counties in the state that have all three junior and senior high school students covered by an athletic trainer. Roush said Pleasant Valley Hospital makes that possible with the restraint on school budgets.

BEATING THE HEAT: High temps demand hydration to avoid cramping

BRIAN KOLLARS, The Sandusky Register

Aug 27, 2021

"Officials timeout for injury."

https://sanduskyregister.com/news/339051/beating-the-heat-high-temps-demand-hydration-to-avoid-cramping/

The referee at last Friday's Port Clinton-Bellevue football game stopped play on the steamy turf at True-Lay Stadium at least a dozen times during the three-hour game, reciting that familiar line as players struggled with leg cramps.

That's August in Ohio, though. It was 82 degrees at kickoff and temperatures again will be in the 80s for Week 2 football games. On Saturday, it's supposed to be even hotter for soccer, tennis, cross country and volleyball matches.

Experts say young athletes need to hydrate days before games in order to best fend off cramps.

"Really, you can't drink enough, especially when it's hot and muggy," said Dr. Matthew Widmer, who specializes in primary care and sports medicine for Firelands Regional Medical Center. "When they're starting to feel it, they're already behind the 8-ball. They need to stay ahead of it. If you're going into the game a quart low, so to speak, it's a recipe for problems."

Widmer said a good warmup and stretch, coupled with electrolyte and hydration replacement, are ways athletes can fend off cramps. But there are no guarantees, even for the fittest competitors.

"Cramps are really tough to deal with, even at the pro and college level, because physiologically you can't pinpoint a specific reason," said certified athletic trainer Bill Gosser, who works for Firelands and has been Sandusky's football trainer for many years. "We think that is has to do with some level of dehydration and possibly missing some of the electrolytes like potassium. The main one is sodium."

Widmer, a member of the Ohio National Guard, has seen cramping issues at the high school level and beyond.

"You might be surprised how many young, physically fit soldiers falls out because of heat and cramps," he said.

Water breaks, diets

Sandusky's football team went through 40 gallons of cold water at Tuesday's practice. The Blue Streaks took seven water breaks.

Junior linebacker/tight end Damarion Westbrook has learned the hard way that hydrating is an important part of game preparation. He regularly suffered from cramps last year, but hasn't had many problems this year.

"Last year I only drank water the day before a game or during a game," he said. "This year I drink water as much as I can through the week."

Westbrook has some incentive. He'd rather not go through the pain of cramps.

"It feels like a needle is being stuck inside your skin and won't go away," he said. "It's very painful, one of the worst feelings I've ever had."

An athlete's diet also can help prevent or make cramps more likely.

"This isn't college football where we can monitor the kids' nutrition," Port Clinton coach Beau Carmon said. "Drinking water alone isn't necessarily going to get it done.

"It's an eye-opener for the kids. They like to eat a lot of junk. They're going to have to make sure they take care of themselves. I always talk about getting off your feet and in the air conditioning when you're not at practice."

Perkins coach Jalen Santoro said the Pirates lost many defenders during the fourth quarter of a hard-hitting game at Bellevue last season. He called that moment "a learning point."

"It's a constant battle with the kids because they don't really know what dehydration is," Santoro said. "We had nice weather for camp (this year) and you play the first game at it's in the 80s. It's always that way in Ohio.

"You gotta stay on them and make sure they're hydrating, and hydrating by themselves when they're not at practice. We don't know if they're drinking three pops a day."

Getting acclimated

High school football games in Ohio were played a week earlier this year to accommodate an extra round of playoffs. The earlier start, the heat and the fact that many games are played on artificial turf may all be contributing factors that lead to cramps.

"Kids are still getting in shape and they're not acclimated to the heat, and they probably haven't been drinking water regularly when they're not here," Gosser said.

Gosser said he keeps a close eye on players who have a history of cramping, as well as the bigger players.

"Some of the big linemen are heat bombs," he said. "Their muscles are creating a lot of heat so you have to keep an eye on them, obviously."

Air conditioning is a modern convenience that makes hot days and nights bearable, but it also can backfire on athletes.

"Since I started (in the 1990s) the practices aren't as rigorous," Gosser said. "But it goes both ways. We didn't have the cold water we have available now. Kids now spend a lot of time in air conditioning so they're not as acclimated when they get out here. That could work against them."

Gosser uses coolers to keep water cold during practice and mixes in sports drinks because some athletes prefer the taste of Gatorade or Pedialyte, which contain electrolytes. Electrolytes are substances in the blood that help cellular function and help to regulate and control muscle contraction, Widmer said.

Sodium, which helps maintain fluid balance, also is important.

"If you do continuous activity for 90 minutes, you lose more of the electrolytes such as potassium, magnesium, calcium, you lose trace amounts," Gosser said. "But the big one is sodium. The days of giving out salt tablets is done. The kids sometimes eat pickles. Saltier foods, nobody's short of sodium in the kids' diets these days."

Pace of play

Another factor that stresses football players is the style of modern the game.

"It's not like back in the day when you huddled up and got a break between every play," said Bellevue coach Ed Nasonti. "It's like a basketball game."

Nasonti said the coaching staffs, trainers and officials all did their best to keep players hydrated during last Friday's game, but several players still missed much of the game with injuries.

"This year is the earliest we've ever had to play a game," he said. "We had 70 snaps on offense; that's a lot of ball to play. The refs were trying to keep everyone watered up. It's always the early games."

Athletes are aware of the importance of hydrating; they hear about it all the time. Especially early in the season.

"I'm staying hydrated now," Westbrook said. "I'm keeping up with it."

Sandusky coach Mike Franklin talked to his players about the importance of drinking water during practice and during the school day. He told the Blue Streaks on Tuesday that it was 87 degrees in his classroom at Sandusky High School.

"I think it's much better when we're at practice because we can somewhat control what they do," Franklin said. "The harder part is when they get into school. Even though they have the water there and you can tell them every time they go past a water fountain to fill up their bottle, the young man has to decide whether he's going to do that.

"A lot of guys don't believe us old coaches when we tell them they can't start drinking just two hours before the game and it'll work. We tell them the game starts Monday, that's when the process begins."

Widmer said many athletes feel "indestructible," but they also benefit from more awareness. Gone are the long practices when players were denied water because it was thought to be a sign of weakness.

"There's a lot of acceptance of medical resources in sports now, more than ever, from the coaching staffs to the refs," Widmer said. "That's been a change over the last couple decades. We can't just run them all to a pulp and expect them to be injury free and perform at a high level."

Hydration tips for athletes

Certified athletic trainer Bill Gosser says "the best thing is to drink 18-20 ounces of water before you go to bed."

Gosser also suggests drinking 18-20 ounces in the morning when you wake up and drink 16-18 ounces a half hour before practice.

Also, parents should consider weighing athletes before and after practices.

"Drink 22 ounces for every pound you lost," Gosser said.