My greatest strengths after this semester now would treatment and rehab because I have been doing a lot of both with my CASE project recently. I have learned a lot about ultrasound and the proper parameters to be used in different situations. At the beginning of the semester I said modalities was one of my weaknesses, so I have come a long way since then. I have learned a lot about the different muscle groups and how important it is to strengthen and gain flexibility in all surrounding muscle groups when doing rehab for stabilization. When putting a rehab together, I know athletes like it to be fun instead of just a workout, so I have been trying to think outside of the box for exercises while still challenging different groups of muscles.
My weaknesses now I would say are my diagnoses and some taping techniques. During my evaluation process I have been able to narrow it down what I think is a possibility during the history portion of the evaluation. After I palpate and test for strength and flexibility, I can rule out several other injuries depending on the injured site. By the time I get to special tests, I have a pretty good idea of what the injury is, but I still end up choosing a differential diagnosis. I have been trying to keep a more open mind lately to think of all the injuries I know and narrow it down to key points I found in the rehab. I have also talked to my preceptors after the evaluation to see what I could have done better and what I missed to make the correct diagnosis. When it comes to taping I have down very well at making it comfortable for the athlete, but I feel like I can do better when it comes to the looks and maybe saving tape from extra/unneeded strips. I have been focusing on how I have been laying the tape especially on the ankle and thumb. In spring football, I have been getting a lot of practice and I plan on focusing on doing it faster to get the athlete to meetings or practice earlier.
0 Comments
In the future I plan on working with college or professional athletes at any sport but primarily football or baseball. I want to be around the sports I know best because I feel like I will be more helpful to those athletes. Although, I am always willing to learn and am prepared for anyone who approaches me or goes down on the field with an injury. As an athlete, I know how to talk to them and I know their mentality. In my future I see myself getting out of bed excited to go to a field/stadium/campus that I have always dreamed of playing on growing up. I always wanted to play in the NFL or MLB growing up and since that is not an option, it would be a dream to wake up and go to one of those stadiums or facilities everyday to work. Being able to help those athletes maintain what they have worked for their whole life and take care of them during the week or on Sunday nights would be what I am trying to work forward to my whole life.
This semester I have applied for PBATS and talked to Athletic Trainers in the Cleveland Indians organization about working there over the summer or in the future. I plan on keeping in contact with them in the future as I gain more experience throughout my college career. I also have talked to the University of Virginia about working as a first aider over the summer for their camps that the athletic department puts together. This will give me a lot of experience in many different sports if I plan to stay there over the summer. I am still waiting to hear back from them, if that is not an option I plan on staying on campus to take extra credits and start looking for master’s programs that I can further my education. I also, plan on trying to help at the school to keep up on what I have learned so far as an Athletic Training student and become more proficient in my skills. Every athlete has a different mentality. It is important to know who the athlete is and what kind of person they are. I handle challenging conversations by trying to comfort the athlete. Letting them know it may be hard now but if they have the right mindset and work hard, they can come back to full strength. I have not had to have many challenging conversations because I like to talk to athletes as if I was on the team with them. For example, I was at a JV football game when one of the star players sprained his ankle. The way he reacted you would think his ankle was broken but we carried him off the field to further evaluate once a fracture was ruled out. He was upset because it was at the end of the game and they lost. Tears rolling down his eyes and barely able to talk to us, I was able to calm him down by letting him know that his team had his back. Soon his mother showed up and we all kept positive mindsets and tried to stay happy because the season was over and he will be able to take a break until he is able to start strengthening for his next sport. By the time he got off the bench, the athlete was still in pain but we was able to cope with what happened.
I believe that if an AT can keep a positive mentality and reassure the athlete that we can help them, they will have a willingness to work with us. I have learned from talking to preceptors and others that if evaluations, rehab, and treatments are done specifically for the athlete and kept interesting, the athlete will want to come back. Going down with an injury is always tough but the mentality is always what drives an athlete. Keeping an athlete to believe they can come back no matter how long it takes, if they do what is right and listen to the people that are trying to help them. Also, as an AT you want to help them by doing what they want so asking them what they would like to do for the injury or rehab is always reassuring them. I think a lot of people over look what an athletic trainer really is until they see what we do behind closed doors. There are a lot of rules and regulations health care providers must follow in which people know in the hospital setting because everyone has been there. In athletic training, since we focus primarily on athletes and not the general population, many people don’t see the importance of us because many people in the government did not play sports at a high level. They do not see the importance and how we play a big affect on some teams and school’s success because many people did not have a relationship with an athletic trainer like they did with there doctor. A doctor is someone they make an appointment with at least once a year and talk to about all their problems and many people know there doctor outside of the hospital because their child may go to school with there’s or they have been seeing them for years. Many people do not know that some athlete’s see their athletic trainer every day for weeks to months out of the year.
This message promotes the athletic trainers really are health care because we can do and have done most of what many doctors do inside other clinics or hospitals. We are just specific to a team, athlete, or school and it is up to the athlete to come and see us when there is a problem or injury. People need to know this because athletic trainers can help many people prevent injuries and save some family’s money if they know they can come to us and receive proper care if we are given the attention. My little clinical question is:
For athletes that have had ACLR, does the use of hip strengthening directly after surgery have better outcomes compared to athletes that waited several weeks to start hip strengthening? My committee is: Beth Funkhouser, Cole Ross, and Matt Harris I chose to do this topic this semester because I have been focusing a lot on ACL rehab. I have learned that it is very important to focus on strengthening and stabilization of not just the knee itself but the joint distal and proximal to it as well. The kinetic chain plays a huge role in stabilization and proper mechanics. I wanted to look even more into why this is and how important it is to begin stabilization of the hip post-op during the acute phase to prevent reinjury. Especially, when I have seen the different mindsets of athletes during the rehab process. Even talking to other athletic trainers, teachers, and doctors about how the hip and ankle play a role in preventing a contralateral or ipsilateral ACL tear when the athlete returns to play. I hope to find valid statistics on the hip and if when the athlete begins hip strengthening if it affects the athletes return to play or if at the end of the process, the athlete is still at full strength on each side. I am curious to see if there is any other information I will find that causes athletes to have a greater risk of re-injury or contralateral tears due to failure of strengthening the kinetic chain during the rehabilitation process. One skill I have worked on a lot this semester is the rehabilitation process which was one of my goals this semester. My goal was: I want to become more familiar with the rehabilitation process and knowing what the best exercises are for specific injuries. Throughout the semester I have worked with the football and basketball team which both teams have had athletes with ACL reconstruction. I have been focused on two athletes which I have put together daily rehabs and set short term and long-term goals for both. What made the process and the exercises different was one athlete had surgery in January, so my rehab had to focus on more of the acute and proliferation stages. He also had a meniscal repair with his reconstruction as well. The football player had surgery last fall when he tore his ACL during the season. Now he is about six months post-operative and has been cleared to begin some plyometric training. I have been able to through in jump squats, jump rope, and burpees in his rehabilitation so far and hope to get to more functional exercises by the end of the school year. He is very discipline in coming to rehab and the team’s practices. Also, he gives me good feedback when I talk to him and making sure he has the proper mechanics when squatting during chain pulls and monster walks.
In contrast, the other athlete that was about a month post-op began to feel to comfortable with movements and stopped showing up to rehab. I was just able to focus on glute, hamstring, and quad group strengthening before he stopped showing. This is when I focused on bridges, total knee extensions, clam shells, step-ups and step-downs. We were still using compression and other modalities as needed to keep moving the excess swelling out. Once he got too comfortable with moving and full weight-bearing he has been missing or not responding to scheduling. Primarily, ACL reconstruction rehab is what I have been working with lately. Although there has been some athletes with shoulder or foot rehabs, I have not worked with them much. I have picked up on many exercises and have talked to my preceptor and doctors about what are good exercises overall for those extremities. Luckily, there has not been many severe injuries so far this spring on either the basketball or football team so far. When I need help is when I have come to an injury that I have not seen yet. I can not always think of the simple special tests to rule out other injuries that I may think are possible. For example, I ran into a patient that had localized pain on the dorsum of his foot and none at the ankle. I knee it was the intermediate cuneiform, but he had no signs of a fracture, so I needed help determining what the diagnosis should be. I knew it was not Morton’s neuroma because it happened suddenly when he was coming out of a break instead of chronically. We came to a conclusion that is was a sprain of the ligaments surrounding that cuneiform. I turned to get help from my preceptor which I usually do if I have a question about something I had seen or read about. Also, when I do not understand something that I had been over in class, I will turn to my professors or preceptor and talk about the topic when we have time in the clinic or on Friday’s when I meet with my professor. It is always really helpful to talk to several people about topics I have trouble with such as the lumbar, pelvic, and hip region because I get to hear how different everyone’s evaluation and treatment process is. This lets me see what has worked and not worked for some patients and also rule out anything else that may be involved with certain injuries. My support system has assisted me in gaining a better understanding of what an athletic trainer needs to do during phases of rehab and how to really get involved with my patient to educate them on their injury.
The role of an athletic trainer during rehabilitation is very important because we can determine how fast or slow a patient returns to play. An AT will be by the patient as much as possible to make sure they are getting proper treatment, doing the exercises properly with correct form, and keep the patient interested in rehabilitation process. As important it is to keep the patient physically in the rehabilitation process, it is crucial to make sure the patient is mentally there. They need to know they can do it but it will take time because it is often you see patients that do not show up to rehab or do not believe it is worth playing again. Then others believe they are okay to begin activities they are not cleared to do. For example, my patient believed he did not need crutches a week before the physician cleared him to fully weight bear. Even after he was cleared the patient wanted him to still be cautious and use crutches as needed to gain proper gait. When progressing the patient, they need to be comfortable with exercises that you have done before and notice the patient can do proper reps and sets of several exercises in that phase. This tells the AT they have proper strength and endurance to progress and set new short-term goals to continue to slowly progress to the long-term goals set at the beginning. For example, when the athlete can do 3 sets of 10 with moderate weight and 5 sets of 5 with a heavy weight with ease and the patient is not fatigue by the end of the session. This is when the AT should know it is time to progress and move onto harder, more strenuous exercises. Knowing when to progress comes from experience, also staying in contact with your patient and physician. The AT needs to make sure the patient does not go pass any limitations that are given or known in that stage of the process.
My Case Study for this semester is an ACL injury that is about a month post-op. He is a basketball player and plans on returning to play next season. I think this will be a little bit of a challenge because he only does minimum of what he needs to be doing and I have to make sure he did enough reps or sets after every exercise, so he does not cheat himself. Although, he is responding very well to the treatment and gives us feedback on how things feel even though he usually just says everything is good. I believe I will have to push him a little harder when we get further in the rehab process because he needs to build a lot of strength in the next couple months if he wants to return in 6-7 months.
I am excited to work with both the athlete and my preceptor on this process because Cole has had to do a lot of ACL rehab over the past year so he has a lot of experience with this specific injury. I am excited to work with the athlete to because I can relate to him since we are at the same age and he listens to what I have to say. The only thing I am worried about is if he has the power to stick with us through this whole process so there are no set-backs or increased risks for injury. I hope he continues to get a better understanding of the situation so that we can get him back to the court and he has time to prepare for next season. I think he knows how important the rehab is and has accepted the fact that he must go through it but I am worried that he does not care for it as much as he should. Overall, I am excited to have the opportunity to rehabilitate this injury and work with this athlete. I hope I can change his attitude a little bit to get him into the process more and make his senior season one of his best. |