Sports Medicine Department2014-2015

Today’s Goals• Review staffing changes in the department• Concussion education• Management of a concussion• Review drug testing policy and procedure• Sickle Cell Trait education

Sports Medicine Staff

• Director of Sports Medicine/Head Athletic Trainer– Michael Sirois, MS, ATC, PES

• Office: 603-641-7807• Fax: 603-222-4091• msirois@anselm.edu• Sports: Head Football, Golf, Men’s Basketball, Men’s and

Women’s Ski, Softball

• Team Physician – Orthopedic Surgeon– James Vailas, MD – New Hampshire Orthopedic Center

• Team Physician’s Assistant – Orthopedics – Scott Evans, PA-C – New Hampshire Orthopedic Center

Sports Medicine Staff• Assistant Athletic Trainers

– Danny Gay, ATC• Office: 603-222-4089• dgay@anselm.edu• Sports: Assistant Football, Volleyball, Men’s Soccer, Men’s Ice Hockey,

Baseball– Amy Esborn, Med, ATC

• Office: 603-222-4090• aesborn@anselm.edu• Sports: Women’s Soccer, Men’s and Women’s Tennis, Women’s Basketball,

Men’s Lacrosse– Alyssa Van Patten, MS, ATC

• Office: 603-222-4081• avanpatten@anselm.edu• Sports: Field Hockey, Men’s and Women’s Cross Country, Women’s Ice

Hockey, Women’s Lacrosse

Concussion Education

Recognition of Concussion • Classified as a Mild Traumatic Brain Injury

(MTBI)

• Can be caused by:– Direct blow to the head– A hit to another part of the body leading to an

“impulsive” force transmitted to the head

You can have a concussion even if you

are NOT knocked out!

Common signs and symptoms of sports-related concussion

Signs (observed by others):• Athlete appears dazed or stunned

• Confusion (about assignment, plays, etc.)

• Forgets plays

• Unsure about game, score, opponent

• Moves clumsily (altered coordination)

• Balance problems

• Personality change

• Responds slowly to questions

• Forgets events prior to trauma

• Forgets events after the trauma

• Loss of consciousness (any duration)

Symptoms (reported by athlete):• Headache

• Fatigue

• Dizziness, lightheadedness

• Feeling unsteady on feet

• Nausea or vomiting

• Double vision, blurry vision

• Sensitive to light or noise

• Feels sluggish

• Feels “foggy”

• Problems concentrating

• Problems remembering

Not Just Football!• Injury rate per 100,000 athletic exposures

Football 70Boys Ice Hockey54Girls Soccer 33Boys Lacrosse 43Girls Lacrosse 33Field Hockey 23Girls Basketball 20Boys Soccer 19Softball 16

Data from 2 articles in American Journal of Sports Medicine, 2011/2012

Before your season begins…

• You will take a baseline ImPACT test • Freshman year only

• Your athletic trainer may conduct BESS Testing• Baseline balance test

ImPACT Testing• A computerized

neurocognitive test required for all collision/contact sports

• You will do a baseline test before your season starts

• If a concussion happens during the season, this test will be repeated

Sports – 2014-15 Seasons:• Every team this season

will be ImPACT tested.• Each athlete must have a

baseline ImPACT score on file with the department in order to participate.

How Can I Prevent a Concussion?• Do not initiate contact with your head or helmet.

You can still get a concussion while wearing a helmet.

• Avoid striking an opponent in the head.

• Practice and perfect the skills of the sport.

• Practice good sportsmanship at all times.

What should I do if I think I have a concussion?

Don’t Hide It. – Tell someone if you or a teammate has symptoms!

Report Symptoms. – The sooner you get checked out, the soon you may be able to

return to play

Get checked out. – A concussion can affect your ability to perform everyday

activities, your reaction time, balance, sleep, and classroom performance .

Take time to recover. – You are more likely to have a repeat concussion when your brain is still

healing!• These concussions can lead to permanent brain damage or death. • SECOND IMPACT SYNDROME

What to expect if you have a concussion during the season

• You will not be allowed to return to play or drive home the day of your injury.

• Your athletic trainer or coach will decide the safest way for you to get back to campus.

• Your AT will closely monitor your symptoms.– You must follow up every day.

What to expect if you have a concussion during the season

• You will be withheld from all physical activity until you are symptom free

• If needed, accommodations with classes will be made. If you have trouble, speak up!– Director of Health Services, Academic Dean and the

Academic Resource Center

• Once all signs/symptoms have resolved, you will take a follow up ImPACT test and complete a new BESS test

What to expect if you have a concussion during the season

PROGRESSION– Your athletic trainer will gradually progress you

into sport-specific activities following a concussion.

– The AT will decide what activities are appropriate for you during your recovery.

For your own safety!

What to expect if you have a concussion during the season

CLEARANCE• You must have written medical clearance from

our team Orthopedic, be asymptomatic both at rest and during activity, and have returned to full school activities to start the return to play program.

• If your AT has treated you s/he will be responsible for clearing you.

• If you saw a primary care physician or specialist, you must provide written clearance for progression to activity.

Final Points

• Concussions are:– Different for each athlete– Serious medical injury

Questions?

Drug Testing

NCAA Drug Testing

• NCAA banned performance enhancement drugs and street drugs to protect the health of Student Athletes and also to insure fair play. – You are eligible for random year round testing and at

post season events– You are responsible for what goes in your body– Ignorance is no excuse for a positive test

Banned Substances

• Stimulants

• Anabolic Agents

• Peptide Hormones

• Diuretics/Masking Agents

• Anti-Estrogens

• Beta-2 Agonists

• Street Drugs• There is no complete list of banned substance

Medical Exceptions

• “The NCAA recognizes that some banned substances are used for legitimate medical purposes. The NCAA allows exceptions to be made for those student-athletes with a documented medical history demonstrating the needs for treatment with the banned medication”

• All medications should be on record with Sports Medicine staff so if you’re selected you can ask for an exception.

Supplements

• Dietary supplements that are sold over the counter and through the internet are under-regulated by the U.S. FDA.  – We cannot guarantee the product’s purity or safety. 

Impure supplements can cause a positive drug test under the NCAA drug testing program. 

– Athletes are advised that the use of dietary supplements is at the user’s own risk. 

– The list of ingredients and claims made by a manufacturer are not necessarily backed up by reliable, scientific research.

– Before taking any supplement you should ask your AT

NCAA Drug Testing

• Acceptable Banned substances: Asthma medications

ADD/ADHD medications

Only when prescribed by your physician

• Anything else can be searched on:–REC website–http://www.drugfreesport.com/rec/

»Password NCAA2»Ask about dietary supplements

NCAA Drug Testing

• Which vitaminwater products contain impermissible or banned substances? – Currently, vitaminwater has five products that

contain impermissible or banned substances.• power-c• energy• b-relaxed• rescue• vital-t• balance

NCAA Drug Testing

• Supplement Advisory: – Weight loss products or products sold to reduce water

retention, or any masking agents may contain stimulants and diuretics, banned by the NCAA.

– Student-athletes have tested positive for using these products and lost their eligibility.

NCAA Drug Testing

• NCAA have a ban on tobacco use during practice and competition for coaches, athletics personnel, and game officials.

NCAA Drug Testing

• Midol Information:– Midol Cramps Not Banned– Midol Extended Relief Not Banned– Midol Menstral Complete Banned– Midol Teen Formula Banned

Drug Testing process

• If selected you must report at designated time. • Your test will be considered positive if you do not show up.• You must stay until you are able to provide a proper sample.• You will be under constant observation while giving urine specimen

to prevent tampering.• Specimen will be mailed out to testing site. • Results are given directly to AD.• A positive test will affect your eligibility, you will not be able to

participate effective immediately.• A positive test at in the post season can affect your teams place of

finish.

Final Points

• The goals of NCAA Drug Testing are to protect the health of Student Athletes and to provide clean and equitable competition.

• All Student Athletes sign a consent form that you understand the drug testing process.

• You must sign this form in order to participate.

Sickle Cell Trait Education

Sickle Cell Trait Education

• What it is:

– Sickle cell trait is the inheritance of one gene for sickle hemoglobin and one for normal hemoglobin.

– Sickle cell trait will not turn into the disease.

– Sickle cell trait is a life-long condition that will not change over time.

Sickle Cell Trait Education

• During intense exercise, red blood cells containing the sickle hemoglobin can change shape from round to quarter-moon, or “sickle.”

• Sickled red cells may accumulate in the bloodstream during intense exercise, blocking normal blood flow to the tissues and muscles.

• During intense exercise, athletes with sickle cell trait have experienced significant physical distress, collapsed and even died.

Sickle Cell Trait Education

• Heat, dehydration, altitude and asthma can increase the risk for and worsen complications associated with sickle cell trait, even when exercise is not intense.

• Athletes with sickle cell trait should not be excluded from participation as precautions can be put into place.

• People at high risk for having sickle cell trait are those whose ancestors come from Africa, South or Central America, India, Saudi Arabia and Caribbean and Mediterranean countries.

Sickle Cell Trait Education

• How to Prevent a Collapse– Know your sickle cell trait status.– Engage in a slow and gradual preseason conditioning regimen.– Build up your intensity slowly while training.– Beware when adjusting to a change in altitude, e.g., a rise in

altitude of as little as 2,000 feet. Modify your training and request that supplemental oxygen be available to you.

– Use adequate rest and recovery between repetitions, especially during “gassers” and intense drills.

– Avoid pushing with all-out exertion longer than two to three minutes without a rest interval or a breather.

Sickle Cell Trait Education

• How to Prevent a Collapse (cont.)– Stay well hydrated at all times, especially in hot and humid

conditions.– Avoid using high-caffeine energy drinks or supplements, or other

stimulants, as they may contribute to dehydration.– Refrain from extreme exercise during acute illness, if feeling ill,

or while experiencing a fever.– If you experience symptoms such as muscle pain, abnormal

weakness, undue fatigue or breathlessness, stop the activity immediately and notify your athletic trainer and/or coach.

– Seek prompt medical care when experiencing unusual physical distress.

Saint Anselm College Sports Medicine Requirements

• Deadline for paperwork – Returners Only – July 27, 2015– Medical Questionnaire– Sports Physical – Dated within 6 months of the season start date– Acknowledgement of Insurance– Copy of Front & Back of Ins card– Summer Drug Testing Form

• All forms can be found on the athletic website, inside-athletics, student-athlete forms.

• Your athletic trainer will meet with each team in the spring to have this paperwork completed before you leave for the summer.

QUESTIONS??