Erika Myers
The Sports Medicine Center, Susquehanna Health
Outreach Athletic Trainer
Canton Area High School
509 E. Main St.
Canton, PA 17724
(570) 673-5134, ext. 345 (athletic training room)
(570) 673-5566 (fax)
myersem2@upmc.edu
A reminder to parents that all athletes must have a physical before being able to participate in any practice or game. The PIAA physical form available in the high school office, nurse's office, athletic trainer's office, and on this website is the only acceptable form. If you have questions about filling out the forms, please contact the athletic trainer
Location of Athletic Training room and working sites:
The athletic training room is located in the high school between the boys and girls locker rooms.
For events outside, the trainer will be set up on the home sideline or home dugout. For track meets, She will be set up all the way to the left when entering the track (on the unused corner of the track). During events in the high school, she will work out of the training room, but will sit either on the home side or between the bleachers with first aid supplies. At events in the elementary school gym (volleyball and basketball games), the location will be set up outside the girls locker room. For wrestling matches held in the elementary gym, it will be set up outside the boys locker room.
Hours of operation for the Spring Season : In at 11am every day. Athletic Training room closes at 6:30pm on days of practices and approximately 15-30 minutes after baseball/softball games end.
On days of only practices: will be primarily in the Athletic Training Room. At approximately 4pm, I will be checking in with coaches at each respective practice site.
On days of baseball/softball games: will be in the Athletic Training Room until 1/2 hour prior to games starting...once games begin, will be at baseball game through 2 innings, then at softball game through duration of game, then back to baseball.
On days of track meets: will be in Athletic Training Room until 3:45pm, then will be at the track near the start/finish line.
On days of baseball/softball games + track meets: will cover baseball/softball games as listed above. Will have radio at all sites in case of emergency.
These hours are subject to change per athletic season. Please check the boards on the Athletic Training Room door or calendar frequently for the most up-to-date schedule. If your child needs rehabilitation or other services, please contact or meet with me to set up a convenient and appropriate time.
PIAA PAPERWORK
All athletes are required to have an annual physical to participate in any sport. Re-certifications are required for each season, after the initial physical. The necessary paperwork can be printed here, completed, and turned in to the Athletic Trainer. All physicals and paperwork must be completed and turned in, prior to the start of each sport season. (The above paperwork is also available in the CHS office.)
For initial physical for the school year, fill out, making sure you and your child sign and date in all appropriate places, Sections 1-5. Section 6 must be filled out by the physician conducting the physical.
For all subsequent sports played in a school year, fill out Section 7. Only if an injury or illness occurred that required a physician's car, does Section 8 need to be filled out for subsequent sports.
CONCUSSIONS
This experience was shared with me by an athletic trainer I used to work with. It occured on the week of April 21, 2008 at a school in southern PA. I share this with you to stress the severity of even the slightest symptoms of a concussion, and the importance of monitoring the symptoms at home (especially at night while the injured athlete is sleeping). It also demonstrates that concussions can occur in sports other than football. The name of the athletic trainer and email address have been deleted to protect the privacy of the school and athletes.
"I arrived at work on Monday to be told that one of my athletes was in the hospital b/c they 'needed brain surgery for a concussion'. Of course my initial response was that these students were pulling my leg. But, as more and more students started asking about this athlete I became curious and asked my AD if he knew anything. And sure enough I had an athlete recovering from surgery to stop a bleed that occurred after receiving a head injury during a game on Sat. So, I contacted the ATC at the school where they played and the athlete's parents to get all of the information. And of course followed up with my coach as to why we didnt get a phone call.
Now, fast forward 24 hours. One of my student trainers approaches me regarding a rumor she heard about another athlete in the hospital after being hit in the head with a baseball. After Monday's situation I called the coach to find out that yes indeed we had an athlete in the ICU recovering from surgery to repair a bleed caused by a head injury.
I'm sure you're asking yourself why I am bothering you with this info. Here's why...after following up with all parties involved with the evaluation and treatment I found an interesting item. Neither of these athlete's had any symptom worse than a headache. They tested negative for all of the symptoms and signs we would ask when checking for a concussion. My second kid I'm told even finished practice without any complaints or change in performance. Thankfully both parents involved felt that this headache was too severe and went in search of professional treatment. Imagine how many student athletes we send home thinking a headache will just resolve itself or we will see them the next day. Both of these athletes could very well have been that 'athlete that died in their sleep' that we use as an example to scare home the severity of a concussion."
Why do we take extra precautions with concussions??
Concussions occur as the result of a head injury. We treat them with extra precaution, especially when they occur in adolescents. Young athletes who experience a head injury are often kept out of participation and competition for a minimum of 7-10 days. Why do health care providers do this? Mostly for the simple fact that the human brain does not stop growing and developing until around the age of 17 or 18, sometimes later. For this reason, it takes longer for the brain of an adolescent to recover from injury, especially if the injury occurs during the school year. Think about it--the brain is trying to heal from injury, learn and store new information being learned in school, and perform normal development. If an athlete returns to play too soon (that is, while still experiencing symptoms), Second Impact Syndrome can occur. Second Impact Syndrome is almost always fatal. If the athlete does survive, permanent dysfunction occurs. Second Impact Syndrome causes a catastrophic increase in intracranial pressure, causing massive swelling, paralysis, and/or herniation of blood vessels. The scariest thing about Second Impact Syndrome: it only occurs in kids!! Almost all cases have occured in athletes <21 years old. You will almost never see a college or professional athlete experience this because his/her brain is fully developed. Second Impact Syndrome often occurs as the result of a routine hit or minor contact. It has been shown to occur up to 14 days after the initial injury occurs. Also, if multiple concussions occur, the effects are like a waterfall, just adding onto each other. This is one of the reasons we are seeing many retired NFL athletes experiencing depression or vision and motor problems now. Concussions are extremely important to manage correctly so that a more severe injury does not occur.
Signs and Symptoms of a concussion:
Headache
Nausea/Vomiting
Balance problems/Dizziness
Ringing in the ears
Double vision, fuzzy vision, misty vision, seeing spots, blind spots
Sensitivity to light and/or noise (tends to increase symptoms)
Feeling sluggish or slowed down (like everything is moving in slow motion)
Feeling foggy or groggy
Concentration problems (increase in symptoms with reading, classwork, homework, watching TV, working on the computer)
Trouble remembering things that happened before or after the head injury
Confusion
Loss of the sense of taste or smell
Changes in personality/acting out of character
Trouble sleeping: sleeping too little or too much compared to normal sleeping patterns
**In order to have a concussion, a blow to the head must have occurred.**
Many people experience one or any combination of these symptoms in a day, but a mechanism of injury must occur to have a concussion. These mechanisms of injury include: a blow to the head (from an object or another athletes body), falling and hitting the head (usually on a wall or the ground or hard floor), and spearing (tackling with the head down, falling straight down on the head, etc.). While helmets help to reduce the risk of injury, they do not prevent injury. The best prevention of a head injury is proper technique.
Home management of a concussion:
Monitor signs and symptoms.
When athlete sleeps, wake every 2 hours to monitor symptoms.
If symptoms worsen, or new symptoms occur, take him/her to the emergency room immediatly! If you cannot wake your child, call 911 immediately!!
Do not give any medication to decrease symptoms until instructed by a physician. This may mask symptom severity, and make it impossible for health care personnel to accurately monitor symptoms and severity of the injury.
**If you have any questions during the home management of your child after he/she suffers a concussion, please do not hesitate to contact me, no matter what time of day or night.
Canton uses the ImPACT computer program as a management tool for concussions. This program monitors symptoms we are not able to see or get accurate feedback on otherwise. These symptoms include: changes in reaction time, changes in impulse control, visual motor speed, and visual and verbal memory. It also tracks the symptoms the athlete reports, which may or may not be reported to the athletic trainer or coach. All athletes participating in collision, contact, and certain non-contact sports are baseline tested so that if an injury occurs, the results can be compared to the normal functioning of that particular athlete. If a baseline test was not taken, there are normative ranges that the athlete can be compared to to generate results. More information on the ImPACT program and concussions can be obtained at www.impacttest.com.
Concussions in the News:
CA-MRSA
Community-Acquired Methicillin Resistant Staphylococcus Aureus (CA-MRSA)
What is it: A bacterial infection that is resistent to the most common antibiotic treatment (penicillin, amoxicillin, methicillin, etc.)--no longer used for treatment. This is a rapidly progressing bacteria that attacks the soft tissue areas of the skin and can become systemic by entering the blood stream, endagering joints and vital organs.
Transmission: Direct contact with the infected area, contact with a surface that contacted the infected area. It can live for MONTHS on surfaces and fabrics (lives in dead skin cells)!
Signs/symptoms: Looks like a spider bite; area becomes red and hot, pustule (DO NOT POP!), may see red streaking around lesion, longer than normal healing time, unusual or unexplained pain or sensitivity, hardness in area.
Treatment: Must see physician (may become very dangerous if it gets into the bloodstream)--culture area. Keep all suspected areas covered with a dry, clean bandage, use an antimicrobial proven to kill MRSA (may use a bleach mixure with a ration of 9:1), evaluate vitals and inspect infected area daily.
Prevention: GOOD HYGIENE is the best prevention!
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Frequent handwashing or use of an alcohol-based hand sanitizer
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Cover all cuts, scrapes, rashes, skin disruptions, etc. prior to participation
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Shower after every practice and competition BEFORE leaving the facility
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Do not share personal items (razors, towels, clothing, bars of soap, etc.)
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Wash all workout gear after each pratice in HOT water and detergent, dry on HOT
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Let all equipment dry thoroughly before next use (DO NOT LET IT SIT IN YOUR GYM BAG--dark and damp area perfect for breeding bacteria!)
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Wipe down all equipment after each practice/competition (head gear, shoulder pads, etc.)
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Clean all practice surfaces with a bleach mixture or antimicrobial proven to kill MRSA
SKIN LESIONS
Impetigo
What is it: A bacterial infection, usually caused by streptococcus or staphylococcus aureus. It is the most common skin condition among kids.
Transmission: Easily spread via contact with the infected area, contact with items that contacted the infected area (towels, clothing, etc.), scratching the infected area and touching other parts of the body or other people. More easily contracted if the skin has been irritated or injured by other skin problems, such as eczema, poison ivy, insect bites, or a skin allergy to soap or makeup.
Signs/symptoms: Most commonly affects areas around the nose and mouth, hands, and forearms. Blisters or sores that may eventually burst and leave small wet patches of red skin that may ooze. May see a honey-colored crust cover the affected area.
Treatment: See physician, will prescribe antibiotics--either topical or oral (complete entire prescription!); non-contact for 48-72 hours, as directed by physician.
Prevention: Good hygiene (regular hand washing), do not share personal items (towels, clothing, etc.), keep cuts, rashes, etc. (any break in the skin) clean and covered during practice/competition.
What does impetigo look like?
Ringworm (Tinea Corporis)
What is it: Fungal infection. May occur all over the body. Some infected areas have specific names:
Tinea pedis = athlete's foot
Tinea cruris = jock itch
Tinea unguum = ringwom in nails
Tinea capitis = ringworm in scalp and hair
Transmission: Can get it from people, animals (cows), and the soil. Direct skin-to-skin contact with infected person or animal, contact with objects that contacted the infected area. **INFECTED INDIVIDUALS ARE CONTAGIOUS EVEN BEFORE SYMPTOMS APPEAR!**
Signs/symptoms: Lesion that is clear in the center with a rough, scaly, circular border. May vary in size. Symptoms usually appear 10-14 days after contact.
Treatment: See physician, will prescribe antifungal medication, usually topical (Lamisil, Tinactin, Lotrimin). If severe infection, may need oral medication. Non-contact for 48-72 hours as directed by physician. May take 4-6 weeks for lesions to completely resolve. Continue the medication for 1 week after the lesions have cleared because the fungus may be living under the skin.
Prevention: Very difficult to prevent. Good hygiene and do not share personal items. Shower with antibacterial soap and a medicated shampoo with selenium (Selson Blue) may help to prevent in the scalp and hair. Wash all workout gear daily, and wash knee pads and head gear twice/week.
What does it look like?
Herpes
What is it: Viral infection. Kinds: Herpes Simplex I (cold sores) or herpes gladiatorum (generally occurs on the face)--herpes gladiatorum known as mat herpes; herpes zoster (shingles)
Transmission: Direct contact with the infected area; contact with mat that contacted the infected area; dirty clothing. **Must have a disruption in the skin to contract!**
**Herpes zoster (shingles) is not contagious. It usually follows the specific path of the nerve it lays dormant in, and generally occurs on the trunk.
Signs/symptoms: cluster of honey-colored bumps with a red base; may feel a tingling or irritation of affected area just prior to outbreaks; fever and general sickness a few days before outbreak. Looks similar to impetigo or folliculitis.
Symptoms occur within 2-7 days of exposure.
Reccurent outbreaks will usually occur in the same place and are generally less severe; fever, sun exposure, and stress can trigger recurrent outreak. Often feel a burning or tingling in area prior to outbreak.
Treatment: Must see physician, will prescribe oral medications, like Valtrex, help to increase healing time, and may prevent recurrent outbreak (start taking a few days before a large tournament or camp). Non-contact until all active lesions are dried up, or as directed by physician. May use a drying agent or astringent to accelerate crusting and drying of lesions. Never completely get rid of the virus (lays dormant in the nerves).
Prevention: Good hygiene. Keep all cuts, rashes, skin disruptions clean and covered during practice/competition. Keep all infected areas covered to prevent transmission to other athletes, even after active sites have dried up. Clean all mats and common areas.
For non-infected athletes wanting to prevent transmission from an infected teammate, take Valtrex as directed by physician (generally 500mg twice/day for 3 days).
Prior to large tournament or camp, take Valtrex, as directed by physician (generally 500mg daily beginning 3 days prior to the starting day and concluding 1 day after).
What does it look like?
Herpes gladiatorum (mat herpes)
Herpes Simplex 1 (cold sores)
Herpes zoster (shingles)STEROIDS AND SPORTS
Steroids in professional sports has been plastered all over the media recently, especially in baseball with Jose Canseco's accusations, the Barry Bonds controversy, and the A-Rod list. But how much do you actually know or understand about steroids, other than that they give you a competitive edge? For example, did you know that steroids are prescribed every day by physicians for therapeutic use? The Taylor Hooton Foundation has reported that 84{20edc72a9c42ebfff7738c7ec536f09b71b72722c3d5965a3e8cef387d5f556b} of high school students have never had a coach, parent, or teacher talk with them about the dangers of performance enhancing drugs. The National Athletic Trainers' Association (NATA) wants to help educate students, parents, and coaches about steroid abuse. Check out the following list to see how many of points you already know! If you have questions about any of the others, don't hesitate to ask Sarah Watson, Canton High School's athletic trainer!
1. Anabolic steroids and other performance enhancing drugs are not regulated or quality-controlled and provide danger from a health and eligibility standpoint.
2. Steroids do not replace proper nutrition. Without the right balance of nutrient-rich foods, your body cannot be fueled at its best. Talk to your ahtletic trainer, school nurse, health teacher, or doctor for more information.
3. Taking steroids can have physical and emotional consequences and can be life threatening. You can suffer from short and long term health issues.
- Steroid use can lead to a shortened life. The cardiovascular system comes under heavy attack from steroids. Good cholesterol levels go down, bad cholesterol levels go up, increased water and salt retention can result in high blood pressure. All of this leads to increased chances of strokes and heart attacks.
- Other physical dangers include: hypertension, liver cysts and/or cancer, increased chance of injury to tendons, ligaments and muscle, jaundice, trembling, aching joints, and bad breath.
- Behavior can be affected. Effects include mood swings, aggression, severe depression, paranoia, extreme irritability, delusions, impaired judgement, and a sense of invincibility. Many of these feelings are even worse when a user stops using these drugs. Some of these feelings can last for a year after you stop using steroids.
4. A male using steroids has additional risks and is prone to sexual problems including impotence. The user can develop male breasts (gynecomastia) and experience testicular atrophy. Additionally, they are at risk of prostate growth and cancer.
5. A female using steroids has additional risks and is prone to development of facial hair, male pattern baldness, loss of menstrual cycle, reduction in the size of her breasts, inflammation of sexual body parts and deepened voice. There is even a potential for birth defects when she has children.
6. Possession of anabolic steroids without a legitimate prescription is illegal, and all preformance enhancing drugs are banned in high school, college, and professional sports. Use of these substances can result in loss of eligibility and potential legal consequences.
7. How we think about our bodies is vitally important. Having a good body image is an integral part of a healthy lifestyle and a sense of self. If you're taking care of the outside, but not the inside (through proper exercise and diet), you're putting yourself at risk of injury, fatigue, and compromised performance.
The Taylor Hooton Foundation is a 501c3 non-profit organization dedicated to educating young people and their adult influencers about the dangers of performance enhancing drugs. The organization was formed in memory of Taylor Hooton, a young man who died after using anabolic steroids. He was a pitcher on his high school baseball team.
MODALITIES
Therapeutic modalities
are treatments that cause some change to the body. They assist in the healing process of an injury. The most common modality is ice, but there are many other modalities. This page will help to briefly explain different modality types and why they are used.
Electrical Stimulation (E-stim)
E-stim is used to treat muscle strains, break muscle spasms, and after surgery. It helps to relieve pain, and help to retrain muscles to fire correctly following surgery. Electrical impulses from the unit stimulate the muscle to contract. Different wave forms help to achieve different rehabilitative goals.
Ultrasound
Therapeutic ultrasound is used as a deep-heating agent. It helps to facilitate healing in severe muscle strains, contusions (bruises), injuries to ligaments, joint capsules, and treat scar tissue.
How it works: electrical energy from the outlet travels to the ultrasound head and causes a crystal in the sound head to vibrate. The vibrations travel through the skin, and when they meet scar tissue, adhesions, or injured tissue, causes friction, resulting in heating of deep tissues.
Hydrocollator
Hydrocollator packs are more commonly referred to as heat packs. They are used to help relax muscles, in preparation for stretching or physical activity. Unlike ultrasound, the heat from hydrocollator packs do not penetrate deep into the tissue, but create more of a superficial heating sensation.*Always wrap a heat pack in a towel to avoid burning the skin!
Ice
Ice is the most commonly used modality. Its greatest benefit is pain relief. Different ice applications include: ice bag, ice massage, and commercial ice packs. Ice massage is rubbing ice (usually frozen in dixie cups) directly on the painful area until area is numb. This application is most commonly used with shin splints.*When using a commercial ice pack (anything other than an ice bag), always make sure there is a layer of towel or clothes between the pack and the skin to avoid frostbite.
**Typical ice application: 20 minutes on, 2 hours off (this allows proper rewarming of the tissue and ensures frostbite will not occur).
Whirlpools
Cold whirlpools are beneficial for those with ankle sprains more than 2 or 3 days old. Whirlpool treatment allows movement of the ankle, helping to restore full range of motion faster, while still receiving the benefit of the cold. Cold Whirlpools are also beneficial for muscle strains and shin splints because they allow a greater area to be treated. Warm whirlpools are beneficial in relieving sore muscles, and aid in relaxation following practice or competition.
NUTRITION
Nutrients important for the body: proteins, carbohydrates, fats, vitamins, minterals, and water.
- Each nutrient performs specific functions in the body. A lack of one is a disadvantage to the body!
- By eating the recommended amounts of food from each food group daily (from the Food Guide Pyramid), you can greatly increase your ability to get all the nutrients the body needs, which will improve your ability on the playing field!
- Carbohydrates are the most efficient fuel for the body during strenuous activity.
| Food Group | Nutrients | Recommended amount for teenagers (bullets are 1 serving) |
| Milk, Yogurt, and Cheese | Calcium, proteins, Vitamin A, and riboflavin (Vitamin B2) | 3 servings daily minimum
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| Meat, Poultry, Fish, Dry Beans, Eggs, and Nuts (included peanut butter) | Good source of protein. Contains thiamin (Vitamin B1), riboflavin (Vitamin B2), niacin, iron, and zinc | 2-3 servings daily minimum
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| Vegetables (the brighter the color, the more nutritous) | Vitamins and minerals that complement other food sources. Good sources of Vitamin C include tomatoes, broccoli, and brussel sprouts. Good sources of Vitamin A include carrots, broccoli, spinach, greens, pumpkin, and sweet potatoes | 3-5 servings daily minimum
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| Fruit | Good source of many vitamins and minerals. Good sources of Vitamin C include citrus fruits and their juices, melons, and strawberries. Apricots are a good source of Vitamin A | 2-4 servings daily minimum
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| Bread, cereal, rice, and pasta | Contributes complex carbohydrates (starch and fiber) and significant amounts of protein, B vitamns, and iron | 6-11 servings minimum
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| Butter, margarine, sweets, and jellies (deserts and candy) | Provides energy and some nutrients | Use sparingly |
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**To meet higher energy needs, most teen athletes require more than the minimum amount of servings listed. In some cases, teen ahtletes may need more than the recommended number of servings. For most athletes, the increase in energy should come from the vegetable group and bread, cereal, rice, and pasta group. These groups contain a lot of starch, an excellent source of food energy.
High school athletes should not need to use vitamin or mineral supplements (unless otherwise prescribed by a physician). They also should not need protein supplementation or high-protein diets. Eating high-protein diets or protein supplements may prove harmful and may lead to a loss of appetite, diarrhea, dehydration, and undue stress on the kidneys.
My Pyramid (http://www.MyPyramid.gov) is an excellent guide for young athletes:
- Helps to select a variety of nutritious foods
- Emphasizes starch foods like grain and vegetables needed to build glycogen stores
- Guides your selection of a lower fat diet
- Offers a variety of foods within each food group so that meals can be built around the foods you like
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What to eat before a game:
- Eat meals high in starch (pasta, baked or sweet potatoes, rice, etc.) 24-48 hours before competition. Select foods from all 5 food groups...our bodies use nutrients more efficiently when consumed together.
- Eat breakfast the morning of competition
- nShould eat an easily-digested meal (higher in starch) no later than 3 hours before competitionavoid foods that contain lots of fats and oils (harder to digest)
- nAvoid candy or honeycause rapid swings in blood sugar, resulting in lower energy levels
- Drink plenty of fluids to ensure full hydration
At all day events (tournaments/track meets)
- nBreakfast is especially important!!
- Consume several high-starch mini-meals or snacks, along with lots of fluids
- nEat snacks high in carbohydrates, and dont forget to snack before bedtime (keeps energy levels up) » Choose snacks that contain more than just calories!
- Select meals containing all 5 food groupsour bodies use the nutrients better when consumed together
- When eating out, choose something nutritionally sound, like a cheeseburger with lettuce and tomato
Try to choose starchy vegetables and whole grain and enriched breads, cereals, and pasta over fatty foods (for example, a baked potato over french fries)
To refuel after a workout:
- Consume high carbohydrate, nutritious foods » The body replaces lost glycogen rapidly and normal synthesis of new proteins can resume
- Should eat within 2 hours after the event/workout
- Drink plenty of fluids, even if you aren't thirsty.
wBasic guidelines for altering body composition
For fat loss:
- Distribute protein, carbohydrates, and fats throughout the day and at each meal
- Choose whole grains and fresh vegetables
- Should eat NO FEWER than 4 meals per day (no more than 6)
- Avoid empty calories and highly processed foods
- Drink 8-12 cups of water per day
For lean body mass gain (muscle):
- Eat 4-6 meals per day
- Spread protein intake throughout the day
- Consume post-workout meal/drink of protein and carbohydrate within 90 minutes of finishing exercise
- Do not neglect the importance of carbohydrates and fats in a balanced diet
For more information on Sports Nutrition:
American Academy of Orthopedic Surgeons - Sports Nutrition: http://orthoinfo.aaos.org/topic.cfm?topic=A00370
Gatorade Sports Science Institute: http://www.gssiweb.com/
NWCA Optimal Performance Calculator: http://www.nwcaonline.com/nwcaonline/default.aspx
University of Illinois Extension, Sports, and Nutrition: The Winning Connection: http://www.urbanext.uiuc.edu/hsnut/
Colorado State University Cooperative Extension - Nutrition for Athletes: http://www.ext.colostate.edu/PUBS/FOODNUT/09362.html