Room 535 Nottingham Athletic Training Center Jeff Perry, MS, LAT, ATC

Room 535 Nottingham Athletic Training Center Jeff Perry, MS, LAT, ATC [email protected] Office: 703-426-6818 Cell: 703-932-1950 Deborah Cassidy, LAT, ATC [email protected]

Sports Medicine Support Staff Team Physician: Dr. Marc Childress, MD Family/Sports Medicine, Fairfax Family Practice, Fair Oaks 3650 Joseph Siewick Dr. Ste. 400 Fairfax, VA 22033 703-391-2020 Team Orthopaedic: Dr. Daniel Thompson, MD Orthopedic Surgeon OrthoVA, 6355 Walker Lane Suite 202 Alexandria, Virginia 22310 Please contact athletic trainer first for expedited appointments

Sports Medicine Support Staff George Mason University ATS: Anna Kurisky (Summer/Fall 2019) The ATS is a University athletic training student studying in the professional educational program at GMU. They spend from 150 to 300 hours outside of their academic classes observing, assisting, and receiving instruction in each semester long clinical rotation. Robinson Secondary ATSA: Lexa R., Bryan A., The ATSA--or high school athletic training student aide—is interested in going to college to study athletic training, physical therapy, medicine, or other allied health care profession. Valuable experience observing and assisting can be obtained in the Athletic Training Center.

Certified Athletic Trainer (ATC) What is an Athletic Trainer? – A 5-6 year Masters degree and successful completion of National Accreditation Exam – Licensed by Virginia’s Board of Medicine to practice athletic training – Use the term “Athletic Trainer” or “AT” to avoid confusion with a “personal trainer” or “sports trainer” at a gym or fitness club – Visit www.nata.org for more information on Athletic Trainers or sports medicine.

AT Responsibilities 1. Prevention of injury 2. Recognition, evaluation, and assessment of injuries and conditions resulting 3. Immediate care of injuries 4. Rehabilitation and reconditioning of injuries 5. Organization and administration of Athletic Training/Sports Medicine Program 6. Professional development and education (for athletes, coaches, community)

Athletic Trainer Coverage Athletic Training Center Room 535 Located upstairs locker room hallway on south side of field house. The Athletic Trainer is available for evaluations, treatments, rehabilitation, and questions from student athletes, parents and physicians each school day afternoon. Office Hours: generally MTHF 12:30 to 5:30 PM, then practice or event coverage to 8, 9 or 10 PM.

Athletic Trainer Event Coverage FALL WINTER Football (all games and equipment/contact practices) Field Hockey Volleyball* Cheer Competition Cross Country Meets* Wrestling Basketball Gymnastics Indoor Track Swim/Dive playoffs* SPRING Lacrosse Soccer Softball* Baseball* Track and Field Tennis* Crew* *ATC on site (May be covering more than one event at a time)

VHSL Sports Physicals (PPE) Tips 1. Before participation, Athletes must have a sports physical completed after May 1st and before sport season. It is valid until June 30th following year. 2. It Must be completed on a current VHSL Pre-Participation Exam form (Revised FEB 2017). Older forms are not acceptable, don’t save to your computer! 3. A Commonwealth School Entrance Exam or BSA forms e.g. are NOT valid for high school sports physical. 4. Find the current form on the athletic training website. Don’t save a copy to your computer as forms are occasionally updated and the VHSL does not accept older versions of their own form. 5. A PPE is needed to join in team related conditioning (“yellow”) and “green day” activity as well.

VHSL Sports Physicals directions 1. Complete page 1 of VHSL form and student signs it. 2. Complete page 2 health questions and use box to explain “Yes” answers. Student and Parent sign p.2 3. The doctor (MD, DO, LNP, or PA) completes page 3, Make sure they have signed, stamped, and dated it 4. Page 4 should be completed by parent including medical insurance company name and requires a parent signature in 2 places at bottom of page 5. SAVE time and missed tryouts—Make sure form is complete! 6. Turn it in as soon as completed! Don’t wait for tryout day. 7. Save time and hassle by getting it done at school in June! 8. Sports Physicals are offered at school each June as a convenience for parents and fundraiser for athletics. Contact the athletic trainer or web site for more information.

Concussion Education Requirement 1. Student-athletes and a parent must complete State mandated concussion education on an annual basis before sport tryouts. 2. This component of compliance can be completed by going to www.fcps.edu/sports and following path for Concussion Education. Please read directions carefully. 3. It is best to complete Concussion Education early to avoid a last minute rush that may cause web or system problems. 4. For this Fall 2019, until further notice, the Temporary fix is to go to web site and read “Concussion Ed Requirement” and print out and sign last page to be turned in with Physical or by itself to Athletic Office. 8. Address any problems or questions to the athletic trainer.

Assumption Of Risk There is inherent risk of injury in all sports Not all injuries can be prevented Even catastrophic injuries can occur in any sport A comprehensive Athletic Training health care program has proven to influence a reduction in the severity of injury and prevalence of re-injury.

When Injury Occurs: 1. Any injury, illness, or medical condition must be reported to Athletic Trainer (AT) regardless of severity, or prior consultations with another Health Care Professional 2. Minor injuries are evaluated and treatment instructions given to the athlete, with daily follow up to full resolution 3. For injuries that MAY be more serious (where a physician evaluation recommended), parents will be contacted and receive a written report as well.

When Injury Occurs: 4. If present at game, please check on your child’s injury status on bench, sideline, or in AT clinic after their initial evaluation. 5. Referral decisions are based on injury type and severity, potential complication, lack of progress with rest and treatment, etc. 6. AT philosophy is to keep injured athletes involved with their team while protecting injured area to allow sufficient healing 7. It is valuable for athlete to do rehabilitation with AT supervision until released.

Immediate Treatment RICES Rest it!! Physician Visits – Please bring in a note* that Ice – 20 minutes max each informs us of diagnosis, hour (if freezer ice-- use wet cloth barrier) Compression – wrap with even pressure towards heart Elevation – Raise Above the Heart Support – Crutches, Cane, Brace, Sling all help to protect injury what rehab or treatment the physician recommends, and participation status. Physical Therapist of Chiropractor PT or DC Intervention should be in conjunction with school based (ATC) treatment and rehab.

Return to: Athletic Trainer School: Robinson Phone #: (703) 426-6818 PHYSICIAN RESPONSE FORM To be completed by the attending physician Patient name: Date of Referral: Reason for referral: Physician name: Date of Consult: Practice Name: Physician address (please use stamp): The “Physician Response Form” can be found on the Athletic Training web page. Physician signature: Diagnosis (please be specific): Please call physician’s office for further instructions Participation Status: No Restrictions No Participation Limited Participation (Please explain): Adaptive Equipment Suggestions: Expected Date for Full Participation: Follow up in office required: Yes No As needed Comments: Treatment: Treat as needed (ATC’s discretion) Rehabilitation to be performed in athletic training room Referred to physical therapy Duration of prescription: Please contact physical therapist to coordinate treatment protocols Special Instructions: Treat as indicated: Range of motion exercises Heat Functional, progressive exercise program Ice Functional testing Strength exercises Electrical Stimulation Ultra Sound Restrictions: Bring it to your MD appointment or Urgent Care visit so we have clear feedback from the treating physician

Treatments conducted by AT may include the use of modalities in the form of cold, heat, manual therapy, electrical stimulation, or ultrasound. Communication between AT, PT, MD, or other health care professional will enhance the overall treatment and recovery of the athlete. The Physical Therapist Response Form found on web page is filled out by PT to help coordinate care or transfer of care

Rehabilitation Rehabilitation and reconditioning is another primary role of Certified Athletic Trainers We have the tools and time to work with your student-athlete on a daily basis to restore, motion, strength, and function Every injured athlete will benefit from some form of rehabilitation

R E H A B Athletes who are compliant with a proper rehabilitation program are less likely to become reinjured or have detrimental long-term consequences to health or athletic performance They must also be evaluated by an AT to determine a schedule for safe return to full participation

Return To Play A Parent, Coach, Treating Physician, Athlete, Administrator, ATC, or Team Physician may exclude an athlete from participation. The Athletic Trainer is to ensure athlete is returned to play in the quickest and SAFEST manner possible to avoid reinjury. The Athletic Trainer gives final medical clearance.

Injury and Tx Summary Fall/Winter 2016 Total Unique Athletes Seen: 464 Injury Treatment Encounters: 3799 Injuries & “Problems”: 1114 Abdomen 3 Hand/Wrist 94 Ankle 109 Head 64 Arm 31 Hip 47 Back 80 Knee 196 Chest 7 Lower Leg 123 Ear 9 Neck 34 Elbow 46 Respiratory 3 Eye/Face /Nose 33 Fingers/Thumb 82 Foot/Toes 62

More Intervention Statistics Fall/Winter 2016 Evaluations and Tests: 2,632 Modalities (ice, heat, ES, US, etc): 3,099 Manual Therapy: 580 Rehab Rx: 4,674 Protection (tape, wrap, pad, brace): 1,502 Wound Care: 407

Some Common Concerns MRSA Personal Hygiene Nutritional Concerns Supplements & “Energy” Drinks Steroids Medications Concussions (Education & Management Issues)

MRSA: What Is It? MRSA is a “Staph” infection. “Methicillin Resistant Staphylococcus Aureus” It does not respond to some antibiotics It is treatable Like other infections, this can become serious if left untreated Severe infections can be prevented by practicing proper hygiene and early detection

MRSA: What Does It Look Like? Mild infections may look like a pimple or boil. Can be red, swollen, painful, have pus or other drainage and are usually easily treated. More serious infections may cause pneumonia or bloodstream infections.

MRSA: What Are We Doing? FCPS Certified Athletic Trainers provide information to athletes specific to MRSA during the athlete meetings at the beginning of each season. Included in this session: View a DVD specific to MRSA – Prevention strategies for staph and other communicable diseases. – Importance of proper personal hygiene and clothes washing. – Importance of bringing all questionable lesions to the attention of the certified athletic trainer and parent immediately.

MRSA: What Are We Doing? The FCPS Athletic Training Program includes the use of a cleansing product for wound care that contains 4% CHG (chlorhexidine gluconate) which specifically targets MRSA and provides a continuous action to kill MRSA on contact for 6 hours. Suspicious lesions will be treated, covered and referred to parents with information to take to family physician. Contact History Inventory and implementation of disinfecting of specific facilities/equipment as needed.

What Can Parents Do? Encouraging good hygiene (i.e. hand washing) and following these tips can minimize the risk of infectious diseases including MRSA: 1. Clean clothes and equipment daily – Wash in warm water and dry completely in hot dryer – Spray equipment with diluted 1-5% bleach solution or commercial product (Lysol, i.e.) 2. Shower right after all practices/competitions 3. Proper use and daily cleaning of water bottles 4. Check with your family physician if suspicious skin lesion is present 5. Read communicable disease info on ATP web site at www.fcps.edu/sports

Nutrition Nutrition is often not a priority for teens Encourage sufficient water intake, proper eating habits—and adequate sleep! Proper Hydration is essential Top choices: WATER! (At least 64 oz./day) Sports Rehydration Drinks Chocolate Milk (after exercise) There is no quick fix real food is far better than any pill or supplement Avoid junk food. Provide a good balanced diet 65-70% carbs, 15-20% pro, 10-15% fats

Nutrition For serious athletes, and those with specific nutritional concerns, consultation with an registered dietician or sports nutritionist at least once in their athletic career is a great idea. Discourage the use of supplements; they are not regulated--may not state all ingredients, and usually are not appropriate for adolescents without consulting a physician or dietician. No FCPS employee may supply, endorse, or encourage the use of supplements.

A B N N D E Using products like these may disqualify a student from participating in contest

Anabolic Steroids Signs and Symptoms: Severe Acne, mood swings, aggression, depression, unusually fast strength/wt. gains, change in physical characteristics, among others. The consequences for being caught using steroids is 2 years disqualification from sports. (Virginia state law) Certified athletic trainers are a resource on negative health effects of Anabolic Steroids For more info visit http://taylorhooton.org/

You r Inhalers, Epi Pens & any other Emergency Meds must be with athlete at all times. If they don’t have it, they should not play or practice until they get it The same authorization form you turn in to Health Room is used for us to hold medicines after school. Avoid giving your child prescribed or OTC pain medication before OR during a Nam e Medications

Concussions Since 2004 and beyond, getting “bell rung” or “just dinged” Concussion It is an injury to the brain Metabolic, physiological, or microscopic as opposed to visible physical damage. Therefore A CT Scan cannot diagnose or rule out a concussion Can be life threatening if ignored Signs & Symptoms include: Headache, confusion, dizziness, change in personality, difficulty sleeping, difficulty concentrating, loss of appetite, loss of memory, “feeling foggy,” among others. Concussions can alter a student’s ability to learn Most are resolved in 2 to 3 weeks although some can take much longer, especially if not getting proper rest.

Concussion Management Concussions are managed on Individual Basis Standardized sideline tests at time of injury ACE Care Plan, Recommendation for rest, no school or partial days for initial period Clinical Evaluation Follow-ups Symptoms scores Vestibular/Balance and Vision Testing Computerized Neuro-cognitive Testing is one web based concussion management tool used to help us identify if the brain has recovered to a point the athlete is safe to begin or continue a progressive return to sport. (Baseline tests are completed on Freshmen and Juniors involved in contact sports).

Concussion Management Academic Instructional Strategies Are given to teachers through Counselor to assist teachers and students with return to full academic workload Step-wise return to play protocol, usually *5 days to full return to play AFTER all symptoms are resolved. *May be much longer if student had a lengthy inactive period. MD referral may be warranted for a prolonged recovery (3 plus weeks w/o expected progress). Proper physical and mental rest, & minimizing academic and social anxiety that athletes often experience during recovery is very important.

What to Expect Following Concussion (1) When a concussion is suspected acutely during an AT covered event, the athlete will be evaluated for a head injury. If signs and symptoms of concussion are present, athlete is removed from play and monitored. If stable with follow-up tests and observation they are released to parent with the ACE Care Plan & recommendations for appropriate rest. Appropriate staff is alerted through the students’ counselor. A Symptom checklist may be provided to help monitor progress at home and help determine readiness to return to school.

What to Expect Following Concussion (2) Student must then follow up with AT until injury is completely resolved. Physical and cognitive activity is modified and recommendations for participation level and supports in the classroom are given to teachers throughout the recovery process. Daily monitoring as student heals ensures that sufficient progress is being made. As the student progresses back to full return to academics and increasing physical activity, neurocognitive testing is administered, monitored cardio and agility workout conducted, and vestibular therapy is provided as needed.

What to Expect Following Concussion (3) Many concussions are self-reported by the studentathlete that has had a recent head trauma and suspect something is not right. They seek care themselves or are referred to us by a parent, teacher or coach. It is wise to assume a concussion regardless of how seemingly minor the trauma to the head has been. If any symptoms linger more than 24 hours it is generally diagnosed as a concussion. While some initial symptoms may be predictors of a longer recovery period, it can be very difficult to determine the severity of injury.

Concussion Management Resources Resources for Parents if AT not available or student having a prolonged recovery: SCORE Fairfax Office, Maegan Sady, PhD www.childrensnational.org/score Fairfax Family Medicine Comprehensive Concussion Center, 703-391-2020 www.ffpc3.com Inova Concussion Centers Pediatric Neuropsychology. www.fnapc.com/neuropsychology (Jillian Schneider, PhD)

Announcements VHSL Sports Physicals at Robinson JUNE, 2019, 5:30 to 8 PM Although a convenience for parents, this is a also Fundraiser, in which proceeds cover about 90% of AT budget for supplies and equipment used for and by all activities, sports, and student-athletes. 50 donation Robinson Secondary Athletics Look for KIT message after spring break for on-line registration details. Medical Professionals: interested in volunteering? Please contact Mr. Perry or Dr. Childress for more information or to register on the volunteer page.

On-Line Resources http://www.robinsonrams.com/ Click on Sports Medicine Find forms, updates, News, etc. Twitter access: https://twitter.com/RamsVATL www.fcps.edu/sports (athletic training, PPE, Concussion Ed » School Accident Insurance, etc.)