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Keyword: athletic-trainer

By Kathleen Choate, ATC, CSCS, CEAS
Athletic Trainer
MUSC Health Sports Medicine

Most of us have seen it or felt it. We see an athlete go down on the field with an injury during a game. The athletic trainer runs out, lifts the leg, pushes the toes back, and starts massaging the calf. This athlete is likely a victim of exercise associated muscle cramps (EAMC) and can cost players valuable playing time. Many players swear by treatments to prevent it such as bananas, pickle juice, Pedialyte, or sports drinks. For some they work, for others they don’t. My goal is to help you learn what strategies are most likely to effectively prevent and treat EAMC.

Causes and Prevention

The currently accepted theory for EAMC is called the “altered neuromuscular control theory.”1  In a nutshell, this theory means that the muscles cramp up because of muscle fatigue.

The strategies for preventing EAMC that have been backed by scientific evidence include the following:
• Training for competition by addressing neuromuscular endurance and muscle imbalances. Plyometrics could be helpful in this area.1
• Tapering workouts in the days leading up to competition.1
• Warm-up prior to exercise. I always recommend a dynamic warm-up.1
• Rest breaks during or in between competitions.1
• Start the competition in a controlled effort.1

While hydration and electrolytes are not currently accepted ways of preventing EAMC, they could help prevent a variety of heat related illnesses. For that reason, you should still plan to hydrate with water or sports drinks prior, during, and after physical activities.

Treatment

The strategies for treating EAMC that have been backed by scientific evidence includes stretching and ice.1  Please don't force the stretch since being too aggressive can cause a strain in the muscle. While ice is effective and a less painful treatment, I’ve noticed that this method usually takes the longest to relieve the cramp.

While still an unproven hypothesis, I personally believe massage or use of a foam roller or stick roller on the affected muscle are also extremely effective. Brace yourself for the pain, because this is also the most painful treatment.

In extreme cases where the cramps do not resolve, especially if multiple body parts are involved, they may have to be treated by a physician in the Emergency Room. If you have muscle cramps frequently, and nothing you’ve tried seems to prevent them, discuss this with your physician to identify any other potential causes and treatments.

References

Edouard, P. (2014). Exercise associated muscle cramps: Discussion on causes, prevention and treatment. Science & Sports, 29(6), 299-305. doi:10.1016/j.scispo.2014.06.004
 

By Amberle Phillips, MA, ATC, SCAT
Athletic Trainer
MUSC Health Sports Medicine

Adequate amounts of sleep are vital for athletic performance and mental function. This is especially true for younger athletes. Sleep deprivation among college-aged athletes can be attributed to travel for sport, stress, balancing academics, athletics, and social life. The National Athletic Trainers’ Association recommends eight hours of sleep for individuals aged 17-22 years.

Sleep deprivation may impact mental health. The body’s ability to deal with stress and emotions depends on sleep to regulate proper functionality. Without sleep the mind is unable to process situations effectively and may cause emotional instability and inability to process stressful situations. Mood and depression are also affected by lack of sleep. Sleep deprivation may cause increased depression and other mood swings. The mind is not the only thing that is impacted by lack of sleep; the body’s cells are also affected.

During sleep is when the cells in the body grow, repair and rebuild helping injuries heal and preventing further injury from occurring. Cells need the rest that sleep provides to catch up on the days’ work that the body did. The cells will repair themselves and create new cells to assist in growth, and repair. The healing of cells that takes place during sleep is also the time when muscle cells and tissue can grow. Poor sleep and shortened sleep may also lead to weight gain and obesity. This is especially true in adolescents whom require more sleep than adults.

Here are a few tips and tricks that can be done to help fall asleep and to stay asleep:

  • Turn off all devices 1 hour prior to bedtime
  • Create a bedtime routine
  • Exercise daily
  • Meditation or total muscle relaxation techniques
  • Avoid caffeine late in the day
  • Stick to a schedule, even on the weekends

By Stephanie Davey, MEd, ATC, PES
Athletic Trainer
MUSC Health Sports Medicine
www.MUSCHealth.org/Sports

The middle of July means that high school football is just a couple of weeks away. In South Carolina, most of our high schools start around July 27th. If your son is planning to play football and go through preseason, there are a few things they need to focus on off the field in order to be safe and productive on the field.

Hopefully, your son has already been working on his conditioning. This will go a long way to him being able to acclimate to the South Carolina heat. South Carolina High School League mandates an acclimatization practice plans that all high schools must follow. If you have questions about that plan you can find it on the South Carolina High School League website

Hydration is always the first thing that comes to mind when we think of preseason football. Your son must be hydrated prior to reporting to practice each day. There is no way to catch up if they are already dehydrated when they arrive. Two ways to tell if they are hydrated is monitoring the color and volume of their urine and making sure they weigh in and out of practices. Their urine should be a light yellow color and high in volume before they go to bed each night. Secondly, they should be weighing in prior to practice and out after practice. They can do this at home or with their athletic trainer. For every pound that they lost during practice, they need to drink 20-24 oz of fluid. If they do not regain the weight they’ve lost during the previous practice, they may need to be held out of practice until they’ve rehydrated. To rehydrate, they should consume water and a sports drink. Soda and beverages with a high caffeine content should be avoided. Energy drinks should not be consumed at all.

The next thing to focus on is proper nutrition. The body is just like a car, the better fuel you put in it the better it performs. Your son needs quality food that is high in nutrition volume with a good balance of carbohydrates, proteins, and fats. Your son needs 40 – 50 kcals/kg of body weight. They should consume 4-8g/kg of carbohydrates and 2-3 g/kg of proteins.  Foods to focus on are lean meats, eggs, nut butters, protein shakes, pastas, and fruits and vegetables. Fruit and vegetables with a high water content can also help to hydrate. Your son needs to eat prior to practice, even if it is an early morning practice. It shouldn’t be a big heavy meal, but they need to have some source of energy before practice.

The last thing to focus on is sleep. The National Institute of Health recommends that high school athletes get an average of 9-10 hours of sleep each night.  Proper sleeping habits with allow your son’s body the time it needs to recover after each practice.  It allows him to stay focused and think clearly during practice. Better recovery and better focus leads to better performance.

Taking these steps will go a long way towards protecting your son during preseason football, ensuring that he has a fun, productive and safe football season.

By Alecia Good, MEd, ATC
Athletic Trainer
MUSC Health Sports Medicine

A young athlete collapses to the ground in front of you. No trained emergency personnel are present on the scene. Would you know what to do?

As the athletic trainer at Pinewood Preparatory School, I have posted Emergency Action Plans in every sports venue. The plans include what to do, who to call, and exact locations for dispatch if there is a need to call for emergency personnel. The hope is that if an emergency should ever occur and I am not there the first responders (usually coaches), will know how to respond. Two weeks ago, these plans were put into place and the first responders were able to save a young man’s life.

One evening a few weeks ago, several alumni gathered to play pick up basketball in our gym. Around 8 pm one of the players crashed to the ground and was unresponsive with sudden cardiac arrest. The other players quickly acted to find two coaches that were in the other gym, send someone for an automated external defibrillator (AED), and call 911. Within minutes, one coach performed hands-only CPR while the other quickly attached and turned on the AED. They continued their rescue efforts until the paramedics arrived. 

Once at the ER it was reported that emergency personnel were able to regain a pulse after at least 10 to 20 minutes of the young man’s heart being stopped. The question the doctors then began to ask was what the brain function would be like because his heart was stopped for such a long duration. The doctors were comforted by the fact that early CPR and defibrillation was performed. 

After only 2 minutes without oxygen-rich blood from the heart, brain cells can start to die. After 6 minutes, brain death occurs. According to the American Heart Association, “Sudden Cardiac Arrest is a leading cause of death in the U.S.—but when ordinary people, not just doctors and EMTs, are equipped with the skills to perform CPR, the survival rate can double, or even triple.”

The young man was placed in a medically-induced coma with a cooling therapy for a few days. After his body was brought back up to temperature and the paralytic drugs were discontinued, the young man woke and returned to normal function. He was talking and moving around and has since been discharged from the hospital. 

Early CPR to manually pump the blood to the brain and early defibrillation to shock the heart back into rhythm is without a doubt what saved this young man’s life. Had the coaches and students not acted quickly to enact the emergency action plan, this story would not have had the same happy ending. To reiterate my colleague’s blog on the importance of knowing CPR, please take the time to learn CPR and how to use an AED. Here is a link for hands-only CPR from the American Heart Association. Even if you don’t have time to take a full course, this compression only technique can save a life as it did in this situation. More importantly, know your surroundings and be willing to act in the event of an emergency. Take note of where there may be emergency equipment (AED, first aid kit) and know your location to be able to give accurate directions. Any delay in action can be the difference in the outcome of the emergency.

 

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