training & conditioning 14.3

TRAINING CONDITIONING

◆ HIPAA Revisited◆ Educating

Sport Coaches

April 2004Vol. XIV, No. 3$5.00&

Rotation at the ShoulderRotation at the ShoulderExamining Rotator Cuff Injuries

Request No. 1

F EATURES

D EPARTMENTS

C ONTENTS

Training & Conditioning • April 2004 • Vol. XIV, No. 3

P.26

◆ Spec ia l Focus ◆

Honing in on HIPAA........11Forms. Jargon. Red Tape. Lawyers. The Health Insurance Portability andAccountability Act can be a headache—but it can also help you serve your student-athletes better.By David Hill

◆ Management ◆

Head of the Class..........19Teaching your coaches some basics about sports medicine can ensure they are in sync with your procedures. Here are some tips on what to teach them and how.By R.J. Anderson

◆ Nutr i t ion ◆

Confused by Carbs?..........26The low-carb fad has some truth in it, but it’s not for competitive athletes.Our nutrition expert gives the skinny on carbohydrates and performance.By Leslie Bonci

◆ Treat ing The Ath le te ◆

Rotation at the Shoulder.........33“Rotator cuff injury” has become a common treatment term for a sometimes misunderstood condition. Effective treatment starts with a precise diagnosis.By Jodie Humphrey

◆ Sideline ◆

Do Herbal Supplements Work?.........3

◆ ATC Award ◆

This issue’s winner..........4Nomination form..........7

◆ Student Corner ◆

Getting Extra Help.........8

◆ Compet i t ive Edge ◆

Moving Upfield..........39With limited space and resources, NCAA Division III power BridgewaterCollege makes the most of its strength and conditioning program.By Joey Soltis

Advertisers Directory..........58

Nutritional Products.........46

Catalog Showcase..........48

Rehabilitation Products.........49

Injury Prevention Software.........59

Knee Products.........60

Football Conditioning........61

More Products.........63

NEW: CEU Quiz for T&C Readers..........64

P.39

P.19

P.11

Cover Photo by Jonathan Daniel, ©Getty Images

Marjorie Albohm, MS, ATC/LDirector of Sports Medicine andOrthopaedic Research,Orthopaedics Indianapolis

Jon Almquist, ATCSpecialist,Fairfax County (Va.) Pub. SchoolsAthletic Training Program

Brian Awbrey, MDDept. of Orthopaedic Surgery,Massachusetts General Hospital,and Instructor in Orthopaedics,Harvard Medical School

Jim Berry, MEd, ATC,SCAT/EMT-BDirector of Sports Medicineand Head Athletic Trainer,Myrtle Beach (S.C.) High School

Leslie Bonci, MPH, RDDirector, Sports MedicineNutrition Program,University of PittsburghMedical Ctr. Health System

Christine Bonci, MS, ATCAsst. A.D. for Sports Medicine,Women’s Athletics,University of Texas

Cynthia “Sam” Booth, ATC, PhDManager, Outpatient Therapyand Sportsmedicine,MeritCare Health System

Debra Brooks, CNMT, LMT, PhDCEO, Iowa NeuroMuscularTherapy Center

Cindy Chang, MDHead Team Physician,University of California-Berkeley

Dan Cipriani, MEd, PTAssistant Professor,Dept. of Physical Therapy,Medical College of Ohio

Gray Cook, MSPT, OCS, CSCSClinic Director,Orthopedic & Sports Phys. Ther.,Dunn, Cook, and Assoc.

Bernie DePalma, MEd, PT, ATCHead Athl. Trainer/Phys. Therapist,Cornell University

Lori Dewald, EdD, ATC, CHESAthletic Training ProgramDirector and Associate Professorof Health Education, University of Minnesota-Duluth

Jeff DiltsDirector, Business Development& Marketing, National Academyof Sports Medicine

David Ellis, RD, LMNT, CSCSSports Alliance, Inc.

Boyd Epley, MEd, CSCSAsst. A.D. & Dir. of Athletic Perf.,University of Nebraska

Peter Friesen, ATC, NSCA-CPT,CSCS, CAT, Head Ath. Trainer/Cond. Coach, Carolina Hurricanes

Lance Fujiwara, MEd, ATC, EMTDirector of Sports Medicine,Virginia Military Institute

Vern Gambetta, MAPresident, Gambetta SportsTraining Systems

Joe Gieck, EdD, ATC, PTDirector of Sports Medicine andProf., Clinical Orthopaedic Surgery,University of Virginia

Brian Goodstein, MS, ATC,CSCS, Head Athletic Trainer, DC United

Gary Gray, PTPresident, CEO,Functional Design Systems

Maria Hutsick, MS, ATC/L, CSCSHead Athletic Trainer,Boston University

Christopher Ingersoll, PhD,ATC, FACSMDirector,Graduate Programs in SportsMedicine/Athletic TrainingUniversity of Virginia

Jeff Konin, MEd, ATC, MPTAssistant Professor of Athletic Training, James Madison University

Tim McClellan, MS, CSCSDirector of Perf. Enhancement,Makeplays.com Center forHuman Performance

Michael Merk, MEd, CSCSDirector of Health & Fitness,YMCA of Greater Cleveland

Jenny Moshak, MS, ATC, CSCSAsst. A.D. for Sports Medicine,University of Tennessee

Steve Myrland, CSCSOwner, Manager, Perf. Coach,Myrland Sports Training, LLCInstructor and Consultant,University of Wisconsin SportsMedicine

Mike Nitka, MS, CSCSDirector of Human Performance,Muskego (Wisc.) High School

Bruno Pauletto, MS, CSCSPresident,Power Systems, Inc.

Stephen Perle, DC, CCSPAssociate Prof. of Clin. Sciences,University of BridgeportCollege of Chiropractic

Brian Roberts, MS, ATCDirector,Sport Performance & Rehab. Ctr.

Ellyn Robinson, DPE, CSCS, CPTAssistant Professor,Exercise Science Program,Bridgewater State College

Kent Scriber, EdD, ATC, PTProfessor/Supervisor ofAthletic Training,Ithaca College

Chip Sigmon, CSCSStrength and Conditioning Coach,Carolina Medical Center

Bonnie J. Siple, MS, ATCCoordinator, Athletic TrainingEducation Program & Services,Slippery Rock University

Chad Starkey, PhD, ATCAssociate Professor,Athletic Training Educ. Program,Northeastern University

Ralph Stephens, LMT, NCTMBSports Massage Therapist,Ralph Stephens Seminars

Fred Tedeschi, ATCHead Athletic Trainer,Chicago Bulls

Terrence Todd, PhDCo-Director, Todd-McLeanPhysical Culture Collection,Dept. of Kinesiology & Health Ed.,University of Texas-Austin

2 ◆ T&C A P R I L 2 0 0 4 ◆ A T H L E T I C B I D . C O M

Training & Conditioning (ISSN 1058-3548) ispublished monthly except in January andFebruary, May and June, and July andAugust, which are bimonthly issues, for atotal of nine times a year, by MAG, Inc., 2488N. Triphammer Rd., Ithaca, NY 14850. T&Cis distributed without charge to qualifiedprofessionals involved with competitiveathletes. The subscription rate is $24 for oneyear and $48 for two years in the UnitedStates, and $30 for one year and $60 for twoyears in Canada. The single copy price is $5.Copyright© 2004 by MAG, Inc. All rightsreserved. Text may not be reproduced in anymanner, in whole or in part, without thepermission of the publisher. Unsolicitedmaterials will not be returned unlessaccompanied by a self-addressed, stampedenvelope. POSTMASTER: Send addresschanges to Training & Conditioning, P.O.Box 4806, Ithaca, NY 14852-4806.

Printed in the U.S.A.

Publisher Mark Goldberg

Editor-in-ChiefEleanor Frankel

Circulation Director Mark Shea

Associate & Assistant EditorsDennis Read Kenny BerkowitzDavid Hill Laura SmithGuillermo Metz RJ Anderson

Editorial AssistantGreg Scholand

Art DirectorLeslie Carrère

Production ManagerKristin Ayers

Assistant Production ManagerKristi Kempf

Production Assistants Jonni Campbell Hildi Gerhart

Prepress ManagerAdam Berenstain

Prepress Assistant Steve Rokitka

IT ManagerMark Nye

Business ManagerPennie Small

Special ProjectsDave Wohlhueter

Administrative AssistantsSharon Barbell Amy WaltonDaniela Reis

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T&C editorial/business offices: 2488 N. Triphammer RoadIthaca, NY 14850 (607) 257-6970Fax: (607) [email protected]

Editorial BoardTRAINING & CONDITIONING • April 2004 • Vol. XIV, No. 3

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Great Ideas For Athletes...

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By Leslie Bonci, M.P.H., R.D.

It probably comes as no surprise to professionals working withathletes that herbal supplements are one of the fastest growinglines of nutritional products in today’s market. Manufacturers ofthese products have made them readily available to athletes,claiming they improve performance, alter body composition andcure a host of ailments and diseases.

Since herbs are derived from non-woody, seed-producing plants,it’s easy for athletes to believe that they’reall natural and harmless. What athletesoften don’t realize, however, is that takingherbs, on their own or in combination withother medications, can be risky.

Concerns for AthletesPurity and safety risks top the list, asherbal supplements are exempt fromalmost all regulations. There are no man-ufacturing standards that address dosageand quality control or guarantee the activeingredients in these products. Somemanufacturers follow strict self-imposedstandards, while others do not.

Although the Food and DrugAdministration recently banned the stimu-lant ephedra, there are still many over-the-counter products with questionableingredients that may impair performance,contain banned substances, or poseunknown dangers. For example, some“ephedra-free” supplements contain synephrine (also known ascitrus aurantium or bitter orange), an ingredient that is bannedby the National Collegiate Athletic Association.

Things to Know About SupplementsWith that in mind, there are some key things you ought to knowabout supplements so you can help educate athletes.Remember that:� “Natural” and “safe” are not synonymous. � Labels do not always accurately reflect what’s in the bottle. � More is not necessarily better and, in the case of medicines

or herbal supplements, can often be worse!� Potential side effects are rarely, if ever, listed on the

package.� Herbs do not cure diseases.

� Athletes who have medication sensitivities or pre-existing chronic diseases must be extremely careful with herbs.

� There’s little credible research on the ergogenic potential of herbs.

� Herbal supplements can interact with prescription and over-the-counter medications and with vitamin and mineral supplements.

The Best Advice to Give Your AthletesIt’s critical to talk to athletes about thepotential dangers in taking supplementsbefore they begin experimenting. Hereare some guidelines:� Ask them to write down what they take

and how often. If possible, have thembring in the bottle.

� Tell athletes on prescription medica-tions to clear the use of herbal supplements with their physician.

� Encourage them to look for products with the USP designation on the label,which indicates that they’ve been subjected to standards set by the United States Pharmacopeia.*

� Advise athletes to report any unusual side effects immediately!

� Finally, unless athletes are looking to spice up their diets, herbs should be viewed as medications.

Leslie Bonci, M.P.H., R.D., is the Director ofSports Nutrition at the University of Pittsburgh Medical Center and is anutrition consultant to the Pittsburgh Steelers and Pittsburgh Pirates.

Resources* The United States Pharmacopeia (USP) has introduced the ComprehensiveDietary Supplement Verification Program to indicate that products with theUSP seal contain ingredients as stated on the label in the appropriate doseand potency, are effectively absorbed, are within the limits for presence ofcontaminants and have been subjected to quality control.HYPERLINK "http://ods.od.nih.gov/databases/ibids.html"

http://ods.od.nih.gov/databases/ibids.html HYPERLINK "http://www.consumerlab.com" www.consumerlab.comHYPERLINK "http://www.supplementinfo.org" www.supplementinfo.orgHYPERLINK "http://www.herbs.org" www.herbs.orgHYPERLINK "http://www.drugfreesport.org" www.drugfreesport.orgHYPERLINK "http://www.ahpa.org" www.ahpa.org (American Herbal

Products Association)

Do Herbal Supplements Work?

For more information on herbal supplements, please visit the Sports Science Center at www.gssiweb.com.


y his senior year of high school,Chris Mathewson had set hissights on the perfect job. Hewas determined to become

head athletic trainer for the DenverBroncos. And he was committed toovercoming any obstacles that stoodin his way.

At Cheyenne (Wyo.) CentralHigh School, which had no programfor athletic training student aides,Mathewson shadowed his athletictrainer and started studying on hisown. At the University of Wyoming,he completed a pair of internshipswith the SMART Sports MedicineClinic and the Arizona Cardinals, andgraduated in 1994 with a bachelor’sdegree in exercise physiology.

Next, he and his wife—a certi-fied athletic trainer and physical ther-apist—moved to Denver, whereMathewson started looking for anyjob in the field. One call was toPonderosa High School in suburbanParker. As luck would have it, theschool had just lost its athletic traineran hour before, and Mathewson

walked into the job two days beforethe beginning of the fall semester.

At the time, he’d never workedat a high school, and he was set onpursuing his dream of working inthe NFL. Ten years later, it turns outhis high school dream was a littleout of focus. Mathewson got a tasteof the NFL, spending two summersas an Assistant Athletic Trainer withthe Broncos, but he’s still atPonderosa, and there’s nowhere elsehe’d rather be.

“It’s been great to work with pro-fessional athletes, but I’ve decidedthat’s not what I want to do,” saysMathewson, MSS, ATC, CSCS.“Professional athletes know whothey are and what they want to do.But here at Ponderosa, our student-athletes are still developing, and I’veseen the effect I can have. I’d ratherbe here, where I can do more impor-tant work and make more of a differ-

ence in people’s lives.” After working with Mathewson

for a decade, Athletic Director andHead Wrestling Coach Tim Ottmanhas seen the kind of differenceMathewson can make. “Chris has hada huge impact on our program, andwe’re lucky to have him here,”Ottman says. “He’s organized, de-pendable, and thorough—he’s greatin all areas. But more than anythingelse, he’s a true professional. Hisrelationships with our student-ath-letes and his ability to get them backcompeting have been crucial to oursuccess.”

In the past year, Ponderosa’s ath-letic successes have included statechampionships in football andwrestling, and Mathewson has playedimportant parts in both. “Whenever

B

Kenny Berkowitz is an Assistant Editor atTraining & Conditioning.

Chris Mathewson, Athletic Trainer at Ponderosa (Colo.) High School, has found his nicheworking with young people.

By Kenny Berkowitz

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you need him, Chris is always thereto help,” says Patrick McHenry,CSCS, Head Strength and Con-ditioning Coach at Ponderosa. “If it’sa night game, Chris will be there,standing on the sidelines and alwaysbeing upbeat. If it’s a Saturday morn-ing, he’ll be here before I’ve evenopened the weight room, and our ath-letes will be taped and ready to go. Ifit’s summertime and one of our ath-letes is injured, Chris will be here,working on the rehab.”

Taking the job at Ponderosadidn’t initially change Mathewson’sdream of working in pro football. Heearned a Master of Sports Science,Medicine, degree from the UnitedStates Sports Academy, and duringschool vacations, he kept working asan Assistant Athletic Trainer with theBroncos. He was also the HeadAthletic Trainer at the SteadmanHawkins Denver Clinic, which pro-vides sports medicine and orthopedicsurgery to the area’s elite athletes.But as he grew more used to workingwith teenagers, Ponderosa startedfeeling more like home.

“The students have all theseplans, just like I did, and they don’tunderstand yet that life may takethem somewhere else,” says Math-ewson. “They’re impressed by thefact that I’ve worked in the NFL, andthat probably makes it a little morelikely that they’ll listen to me. But Iexplain that the rehabs I do with thepros are the same ones I do here atPonderosa. The pros do quad sets andstraight leg raises, the same as us.They get ice and stim, just like we do.I tell our students that sports medicineis sports medicine, no matter whatlevel you’re at.”

The students at Ponderosa areglad he chose the high school level.“Chris has a very positive impact onhis students’ lives,” says seniorHillary Cotner, a soccer player andathletic training student aide. “Hedemands respect for all of his studentathletic trainers, and makes sure thateveryone in the athletic training room

treats each other well. You can reallytell he enjoys his job and likes to bearound kids. All the kids around theschool know him and really like him.He’s more than an athletic trainer, he’slike a father figure to tons of kids.”

Working with him after her sec-ond ACL injury, Cotner learned thesame lessons that Mathewson tries toteach all his students, balancingpatience, toughness, and encourage-ment. Every day Cotner came into theathletic training room, she found achecklist of exercises to complete,and steady, strong support.

“Between working as a studentaide and going through two rehabs,I’ve spent many hours in the trainingroom,” says Cotner. “He taught me tostay positive throughout my rehab,which can get really frustrating whenit feels like you’re not getting better.He’s taught me a lot about beingtough, and he’s always been reallyencouraging.”

Describing himself as the type ofperson to “give them the tools to fix itthemselves,” Mathewson sees his jobas providing “a shoulder to cry on anda kick in the pants.”

“Some athletic trainers think theyneed to be working hands-on with

their rehabs every day,” he says. “I’mmore likely to tell my athletes, ‘It’syour knee. I can teach you the exer-cises, but you’ve got to do them your-self.’ I’m not a big cheerleader stand-ing over them, saying, ‘Okay, let’s doanother set.’ I give them their chart,tell them what to do, and movealong.”

In his 10 years at Ponderosa, thehardest rehab that Mathewson hasworked on was his first. “A juniorwho was a big part of our footballprogram had torn his ACL,” saysMathewson. “When we first saw him,I knew we could get him back intoshape, but actually doing it was kindof tough. I’d seen plenty of ACLrehabs at college and at the clinic, butI wasn’t making the decisions. So Ilearned about the true flow of how arehab works.

“He came in every single day forthe next four and a half months andworked like nobody I’d ever seenbefore. He never missed a session,”says Mathewson. “When his senioryear came, he scored our openingtouchdown, ran back to the sidelinesand handed me the ball, saying, ‘Thatwas for you.’ That was the toughestrehab, but it was also the best.”

Mathewson’s work at SteadmanHawkins has given him the opportu-nity to work closely with doctors.Plus, for Ponderosa patients at theclinic, Mathewson is a reassuringpresence. “Because Chris knows thedoctors, he’ll go to the surgery,” saysMcHenry. “He gets to see our stu-dents every step of the way, fromright after surgery to the end ofrehab.”

“Chris is very highly regarded asan athletic trainer at the clinic,” saysMeredith King, ATC, who works as anAthletic Trainer at Steadman Hawkinsand the Assistant Athletic Trainer atPonderosa High School. “The doctorsthink the world of him. Wheneverthey see one of our athletes, they’llcall Chris over to ask, ‘What do youthink?’ He works with top-notch peo-ple at the clinic, and I think that adds

Award Winner

Chris MathewsonAthletic Trainer

Ponderosa High School,Steadman Hawkins Denver Clinic

President, Colorado AthleticTrainers’ Association

Above The Call Award

A T H L E T I C B I D . C O M ◆ T&C A P R I L 2 0 0 4 ◆ 7

to his skills as an athletic trainer atPonderosa.”

Every June, Steadman Hawkinsphysicians and physicians assistantscome to Ponderosa, conducting phy-sical examinations of the school’sstudent-athletes. They donate theirfees back to the school to pay forKing’s salary as assistant athletictrainer.

Mathewson’s reach extendsbeyond the Ponderosa community.As President of the Colorado Ath-letic Trainers’ Association (CATA),he has coordinated corporate spon-sorships for the CATA and made pre-sentations on sports medicine both tothe community and his colleagues atCATA. He has also edited the Website of the Rocky Mountain AthleticTrainers’ Association.

After years of building up hisresume, Mathewson is now spendingmore time at home, taking care of hisdaughters—three-year-old Taylorand five-month-old Bailey—beforegoing to Ponderosa at 2 p.m. Heworks only one day a week atSteadman Hawkins, where he’s nowin charge of accounts payable andinventory control.

“Until my first daughter wasborn, the thing I cared most aboutwas my resume and what I was doingprofessionally,” says Mathewson.“When Taylor came along, I decidedI needed to change the way I waslooking at life. Being a dad has real-ly put my priorities right: I want tocontinue working at Ponderosa and Iwant to be the best dad I can.”

As he learned before, dreamscan change. “For years, working inthe NFL was the only job I wanted,”says Mathewson. “But I like work-ing with high school students. I liketheir approach to life, I like theirenergy. On game days, I can feel theexcitement in the locker room andremember what it was like to be inthe same position. Years from now,they’ll still remember being in thesegames. And I get to be a part ofthat.” ◆

he “Above The Call” AwardsProgram serves to honor out-standing athletic trainers forwork not otherwise recog-

nized. This may include someonewho has shown exemplary dedica-tion and devotion to his or her jobor outstanding work outside of theeveryday ATC duties. The goal isto honor those athletic trainers whogo above and beyond the alreadyextraordinary demands placed onanyone in the profession.

Examples include:◆ Someone who is doing some-

thing different and exciting inthe profession.

◆ Someone who serves as a rolemodel and mentor to others.

◆ Someone who has taken on

additional significant duties inthe field.

◆ Someone who gives 110 per-cent in all that he or she does.

◆ Someone who has a specialway with athletes.

TO NOMINATE ANATHLETIC TRAINER:Please fill in the form below, andattach a 500- to 1,000-worddescription of the athletic trainer’sachievements, including:◆ Why you think this athletic

trainer stands out from thecrowd.

◆ Where he or she is currentlyworking and any pertinent aca-demic or work history.

◆ Testimony and/or quotes fromthose he or she works with.

Nomination Criteria and Procedures


T

NOMINATION FORM

Name of Athletic Trainer:___________________________

His or Her Phone No.:______________________________

Your Name:______________________________________

Your Affiliation:___________________________________

_________________________________________________________________

Your Phone No.:___________________________________

Your Address:_____________________________________

________________________________________________

Send nominations to:Above The Call AwardTraining & Conditioning2488 N. Triphammer Road Ithaca, NY 14850

If you have any questions, feel free to call us at (607) 257-6970, xt. 18,or e-mail us at [email protected].

✁



s an athletic training student, you have a lot on yourplate. There are classes, clinic hours, coverage assign-ments, and possibly a part-time job on the side.

While student-athletes are often provided withresources to help them balance their academic andathletic lives—special computer labs, tutors, laptops

to use on away games, seminars on time management—stu-dent athletic trainers rarely have such luxuries. However,some athletic training students are starting to ask for help withtheir busy workloads—and receive it.

The key to gaining access to resources is to join forceswith your fellow classmates. “I suggest forming an athletictraining club, so that you have a voice,” says LeamorKahanov, EdD, ATC, Director of Athletic Training Programsat San Jose State University. “That way, if you have an issue,such as gaining access to the athletes’ computer lab, you canbring it to your program director’s attention as a group.Because a collective voice is always stronger than a singlevoice.

“Sometimes there’s a separation between the educationalside and the athletic side,” she continues, “and the programdirector doesn’t have much pull, but the athletic director does.In that case, you could go as a group to your athletic directorand say, ‘We work very hard and do this and that for your ath-letes, and you have this resource that we want. Please help usgain access to it.’”

“Start by communicating with your advisors, whether itbe your head athletic trainer or academic faculty, about form-ing a club,” agrees Scott Barker, ATC, Head Athletic Trainerat Cal State University Chico. “A number of years ago, ourstudents organized themselves as a student club,” says Barker.“They went through the standard process, from a governancestandpoint, for forming a club and that made them eligible toapply for student funding, which they received.”

Students in the athletic training program at Fresno StateUniversity have also taken advantage of the club model toenhance their access to out-of-classroom resources. “They

A

A Special feature for your athletic training students

Student Corner . . . .

Guillermo Metz is an Associate Editor at Training & Conditioning.

Sponsored by

If you are interested in submitting a column of advice forathletic training students, please send it to: T&C’s StudentCorner, 2488 N. Triphammer Rd., Ithaca, NY 14850.Submissions must be double-spaced, 800-1200 words long,and accompanied by the author’s resume or curriculum vita.

bring in speakers from the community and organize lec-tures,” says Miguel Rueda, MA, ATC, Director of SportsMedicine. “They fund-raise every year to go to the nationalconvention, too.”

Beyond that, his students have gained many of the perksavailable to student-athletes. “Our student athletic trainersare treated very similarly to our athletes, so they have accessto the same resources, the computer labs, study hall, and cer-tain areas that are designated for student-athletes,” saysRueda.

“In addition to that,” he continues, “we have a couple ofextra computers around that students can use. We always putmedical information on there, but we also make sure theyhave word processing, spread sheet, and database capabili-ties, as well as access to a printer. We also stock a library forthem. Some of this my predecessor put in place, and some ofit the students lobbied for and got.”

Athletic trainers also recommend drawing on the expe-riences of athletic training students at other colleges and uni-versities. “One thing I impress on our student athletic train-ers is to talk to other people in the field,” says Rueda. “Meetother student athletic trainers at conventions. Talk with ath-letic trainers at other schools, or other program or sportsmedicine directors. See how they get things done. See whatresources they have for their student athletic trainers.”

There’s another resource that athletic training studentscan tap into: the advice of senior student athletic trainers.They’ve been through all this before and can provide themost sage advice on everything from memorizing the majornerve groups to working with a difficult coach. Manyschools have caught onto this and have made it a formal partof their programs.

“We match up our first-semester students with our sen-iors,” says Kahanov. “It’s important for the newer students tosee how the older students manage their time, including theirschool work, hours in the training room, and their social life.The seniors also give advice on how to survive in this settingin order to attain their goals.” ◆

Extra HelpTips on making the most of the people andresources all around you.

By Guillermo Metz

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◆ S P E C I A L F O C U S ◆

ighteen months ago, the talkof the athletic trainingworld—and much of thehealth care world, for thatmatter—was about the HealthInsurance Portability andAccountability Act. The fed-eral law’s provisions guardingthe confidentiality of individ-uals’ medical records were

about to kick in, triggering a new wayof working for most practitioners, or sothe conventional wisdom had it.

One result: Athletic trainers got intouch with their lawyers.

“How has HIPAA affected me?I’ve probably talked to our legal coun-sel more this year than I ever have

before,” says David Polanski, MS,ATC, Head Athletic Trainer at theUniversity of Tulsa.

A year after the April 14, 2003effective date of the privacy regula-tions, many athletic trainers are still

David Hill is an Assistant Editor at Training& Conditioning. He also wrote on HIPAA inT&C’s March 2003 issue.

Illus

tratio

n: N

aom

i She

a

E BY DAVID HILL

Honing in on HIPAA

Forms. Jargon. Red Tape. Lawyers. The Health InsurancePortability and Accountability Act can be a headache—

but it can also help you serve your student-athletes better.



wrestling with HIPAA. They call it anadministrative burden, a pile of paper-work, and an intimidating morass thathangs the threat of legal action overtheir heads. It’s created confusion, withinterpretations seeming to changeweek to week. A colleague in one set-ting seems to have it figured out, onlyto learn such an interpretation might becritically flawed.

And yet there are athletic trainerswho have conquered HIPAA instead ofthe other way around. They’ve taken itin stride, dealt with whatever changesin policy and procedures it might havedictated, and gotten others they workwith—athletic directors, coaches, stu-dent-athletes, parents—on board withthem. Some even credit the law withimproving their work. In this article,we’ll talk with those members of theprofession who are hip to HIPAA.

CONQUERING THE CONFUSION

For nearly two years, Keith Webster,

MA, ATC, Administrative HeadAthletic Trainer at the University ofKentucky, has been at the forefront ofhelping the profession deal withHIPAA. As Chair of the NationalAthletic Trainers’ Association’s Gov-ernmental Affairs Committee, Websterhas been in frequent contact with theU.S. Department of Health and HumanServices (HHS), the arm ofWashington responsible for adminis-tering the law, which was intended tostandardize electronic managementand sharing of individuals’ medicalinformation, curb abuses of the data,and make health insurance easier toobtain and maintain when workersswitch jobs.

It was Webster who met with HHSofficials in early December 2002 tospeak specifically about the effects ofHIPAA’s privacy rules on athletictrainers, and who came away with themessage that it may not be all that dif-ficult to cope with. Yet early this past

January, Webster was in Philadelphiafor a meeting of the Eastern AthleticTrainers’ Association and found sever-al hundred athletic trainers seekingclarifications.

“One of the reasons it remainsconfusing is because it hasn’t beentried in court to get some legal prece-dent,” says Webster. “Until there issome legal precedent, even lawyerswill vary with their interpretations.Lawyers don’t like working withoutprecedents to hang their hat on. We’restill in that gray area of everyone inter-preting it differently and doing the bestthey can to comply with the way theyread it.”

Webster says HHS reports 3,100complaints filed over HIPAA throughmid-January, mostly under the privacyrules. While HHS has forwarded somecases to the Department of Justice forpossible prosecution, there have yet tobe any fines or penalties imposed. Theleading type of complaint, he adds,

any coaches and athletic administrators com-plain that HIPAA has caused confusion when

relating student-athlete injuries to the media. That’shardly the main concern for athletic trainers, but it cancreate some of the biggest headaches. There are,however, ways to cope, and there may even be a silverlining in the media-release cloud.

At the University of Wisconsin, for example, thesports medicine department’s review of its policiesrelating to HIPAA and FERPA (the privacy law for edu-cational institutions) raised awareness that student-athletes should be in charge of the information abouttheir injuries and rehabilitation, says Dennis Helwig,ATC, Head Athletic Trainer. In the past, student-ath-letes would sometimes read or hear about their condi-tions in the media and complain that they didn’t realizeso much detail would be made public. When toldthey’d signed an authorization for it, many athletessaid they didn’t realize they had given such broad per-mission. Wisconsin has since revisited its media injury-reporting policy.

“I don’t think there was an awareness by coachesand administrators about the privacy of student-ath-letes’ information,” says Helwig. “So there would becasual conversation about how so-and-so is doing, andthings appeared in the newspaper that athletes had noknowledge were going to be there. We have tightened

that up, which has really benefited the athletes.”Badger student-athletes said that the public really

needed to know only the fact that they were injuredand what body part was involved, says Helwig. So now,if journalists want to know more, they’re told to ask thestudent-athletes directly. And sometimes, the athletesthen authorize sports medicine and sports informationstaff to say more so the student-athletes themselvesaren’t inundated with interview requests. “We have aspecific authorization for that, and the athlete knowswhat you’re going to say, and it’s fine—all above-boardand all accounted for,” says Helwig.

The University of Tulsa at first stopped releasinginjury information to the media, but has since askedstudent-athletes what they want and adjusted policyfor specific scenarios, says David Polanski, MS, ATC,Head Athletic Trainer. For example, on the footballteam, about 10 players didn’t sign the release. But thecoaching staff didn’t want to have to keep track ofwhich players had given authorization and who hadn’t,so they decided not to release any injury information.

“A lot of the media members said they’d checkedinto HIPAA and told us we can release injury informa-tion,” says Polanski. “We said it wasn’t because ofHIPAA that we didn’t release it, but because the play-ers don’t want it released. So we had to do a little edu-cation with the media.”

MMedia Concerns



was from patients who don’t have access to their own per-sonal medical records—one of the main reasons the privacyrules were established—and not over mishandling of recordsby health care professionals.

Webster understands the confusion. HIPAA’s privacyrules are complicated, at times arcane, and border on beingcontradictory. At the core, any organization must follow theprivacy rules if it is a covered entity, the term for an organi-zation or person that conducts electronic transactions of med-ical records. Transactions can be billing, payments, authori-zation for services, certification of referrals, benefits coordi-nation, eligibility determination, and checking on the statusof claims. Thus, covered entities include most doctors’offices and group practices, hospitals, health-insurance com-panies, claims clearinghouses, and medical-practice manage-ment companies. But the law doesn’t spell out every sce-nario, and it’s up to each organization to determine whetherit is a covered entity. Most ask their lawyers to decide.

For example, the University of Oklahoma’s athleticdepartment considers itself a covered entity because it hashired an outside company to help with billing. “We reallydon’t do any in-house submitting of claims, per se. But we docontract with a practice-management firm that does submitsome claims on our behalf, and that’s the primary reason wehave to be HIPAA-compliant,” says Scott Anderson, ATC,Head Athletic Trainer at Oklahoma. “We deal with themelectronically. Outside of that, HIPAA would probably haveno bearing on us whatsoever.”

At Tulsa, the question is still open. But to be on the safeside—and because it’s the right thing to do, regardless of fed-eral laws—the sports medicine department has taken someHIPAA-compliance steps anyway, Polanski says. Student-athletes are told what their private health information is andthat they have the right to file complaints over its handling.They’re also asked to fill out release-authorization forms.

“I don’t think we are totally 100-percent positive whichentity we are, covered or non-covered,” Polanski says.“We’re treating ourselves as a covered entity just to be safe.But if the government keeps reviewing things and we findout later that we’re not, then we’re not. Our legal counselthinks maybe things will change.”

GUARDING PHI

Covered entities must take certain steps to guard againstimproper disclosure of personal health information—PHI inHIPAA jargon. Among them are designating an employee asits privacy officer, having staff training on safeguarding iden-tifiable PHI, and making sure that business associates onlyreceive PHI when there is a legitimate reason and do not mis-use that information. That last clause means that coveredentities must take steps to ensure that any non-covered enti-ties they regularly deal with will reasonably safeguard theinformation before PHI is shared. Thus, doctors, hospitals orother providers who are covered will want to be sure sportsmedicine departments with which they work will safeguardpatients’ health information. That means the sports medicine

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department will have to follow manyHIPAA-style safeguards whether it’s acovered entity or not.

The privacy rules allow for PHI tobe disclosed for certain purposes.Billing is an acceptable reason. Moreimportantly for athletic training, so istreatment. Thus, a head team physicianis free to discuss a case with a consult-ing orthopedic surgeon, for instance.Athletic trainers, too, are in the loop, asare coaches, since they have say overpractice and playing time, which are

important to an athlete’s recovery,Webster says.

Others are not so sure aboutincluding coaches, however, and this isa major source of potential confusion.The rule says that release of PHI fortreatment purposes to an authorizedprovider is acceptable, says Webster,but the definition of “authorizedprovider” is left open to interpretation.

“Someone could interpret it tomean that the person providing careneeds to be a licensed provider of

care,” Webster says. “The doctor talksto another doctor—that’s fine becausethey’re both licensed to practice medi-cine. But some people will ask, ‘Can acoach or someone who isn’t a certifiedor licensed provider be considered ahealth care provider?’ I would say yesbecause the coach is a member of thathealth care team at some point intime.”

Another gray-area situation Web-ster has encountered concerns clinic-based athletic trainers who provideoutreach to high schools. “They’realmost wearing two hats,” Webstersays. “When they’re in the clinic, forall intents and purposes, they dobilling, and they fall under the catego-ry of covered entity and they mustabide by HIPAA. When they work atthe school with students, they’re usual-ly not a covered entity, but then theyneed to abide by a different privacypolicy instead of HIPAA.”

The other privacy policy to whichWebster refers is FERPA, the FamilyEducational Rights and Privacy Act,which limits disclosure of students’individual educational records by anyinstitution receiving federal funds—basically all schools, colleges, and uni-versities, though some private highschools aren’t covered. FERPA hasbeen widely interpreted to supercedeHIPAA for public high schools. At col-leges and universities, however, itmight not, because medical recordsmay or may not be considered part ofeach student’s educational record,depending on the practices at a particu-lar institution.

The FERPA-HIPAA boundary is amajor reason Polanski has gotten toknow Tulsa’s legal staff. “They’retelling us that the FERPA laws are ineffect and they already cover studentrecords,” he says. “They’ve told us ourrecords in sports medicine are studentrecords—they’re medical records, yes,but they’re also student records.Basically what that means is that we’regoing to comply with whichever law ismore stringent in whichever facet ofoperations we’re looking at.

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student-athletes to release their PHI. Atboth Tulsa and Oklahoma, for exam-ple, student-athletes sign forms author-izing release of their PHI under certaincircumstances, to certain people, forcertain purposes. This is Webster’s keytake-away advice: Get the okay torelease information when needed, andthen which law governs isn’t really anissue.

“I recommend everyone use awell-worded authorization-to-releaseform,” Webster says. “It’s justinformed consent. Instead of saying,‘It’s education records and underFERPA,’ just spell it out, and makeyour authorization form the key toolthat allows for all the communicationto take place.”

An authorization form must con-tain a few key points, according toElizabeth Squeglia, JD, a HIPAAexpert with the Columbus, Ohio, lawfirm of Bricker & Eckler. First, it needsan expiration date—in college and

high school athletics, this is typicallyone sport season or an academic year.Second, it should state the person orclass of people the information will bereleased to, such as doctors, emer-gency-room personnel, athletic train-ers, coaches, administrators at theschool, and media, if necessary. Third,it should say that no one will be deniedtreatment for not signing—though itcan be made a condition for participa-

tion. Fourth, it should include noticethat authorization to release can berevoked but only in writing. Finally, itshould explain to student-athletes thatif information is disclosed to a non-covered entity, it is no longer protectedunder HIPAA.

MAKING IT WORK

The beauty of a well-written, correctlyexecuted release-authorization formlies not just in the paperwork, but in theact of getting it signed. The processworks internally by reminding athletictrainers and other practitioners of theconfidential nature of personal healthinformation, but it also shows your stu-dent athletes—and others—that you areaware of the need for privacy and willhandle medical information properly.

That’s what happened at theUniversity of Missouri, says RexSharp, ATC, Head Athletic Trainer forTiger sports. Going through theHIPAA education process reiterated

“Awareness of HIPAA has

certainly brought out

the concept that the

student-athlete you deal

with is in charge of their

private information. If

you go from that premise,

everything falls in line

and makes sense.”

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the privacy of student-athletes’ medicalrecords and the importance of sharingthe information only when necessary.

“We already had a general release-of-information form, but we had to bea little bit more specific,” Sharp says.“It’s not our policy to talk aboutinjuries anyway, but it’s made us moreaware of confidentiality.”

Anderson says Oklahoma’s adop-tion of HIPAA rules was relativelypainless, but the process did uncoversome room for improvement. “The

biggest adjustment has been the physi-cal protection of the information,”Anderson says. “We talked about facil-ities and logistics, in terms of protect-ing the files and the records. For exam-ple, we make sure the X-rays aren’t lefthere, files there, those general types ofissues.”

COVERING YOUR BASES

Many people agree that there’s onegood thing that’s come out of the newregulations—it’s forced everyone to

examine how they handle personalhealth information. Then it becomes amatter of finding the guidelines that aremost appropriate for each situation, bethey HIPAA, FERPA, or more of areliance on authorization forms.

Dennis Helwig, ATC, HeadAthletic Trainer at the University ofWisconsin, says he sat in on university-wide meetings about HIPAA compli-ance and learned his departmentwouldn’t be a covered entity and thatFERPA governs student-athletes’ med-ical records on his campus. But theprocess raised his awareness ofFERPA’s requirements and the generalhandling of confidential medical infor-mation, he says.

“Awareness of HIPAA has certain-ly brought out the existence of FERPAand the concept that the student-athleteyou deal with is in charge of their pri-vate information. If you go from thatpremise, everything falls in line andmakes sense,” Helwig says.

The process also helped theWisconsin sports medicine departmentbecome better prepared for sharinginformation with outside medicalproviders who are covered entities.“When our athletes go outside of ouruniversity providers, they now have aset format for authorizations,” Helwigsays. “You don’t just call up the ath-lete’s physician and say, ‘Hey, I’m theathletic trainer at State University and Ineed to know what’s going on withJohnny’s knee.’ That’s not going tohappen, and shouldn’t have happenedbefore. You need to have the properformat to get that information.”

HIPAA’s privacy rules say thatauthorization forms have to specifywhat information is going to bereleased, to whom, and for what pur-poses. It’s much more detailed thanFERPA regulations, Helwig says, butfollowing the HIPAA rules helpsensure that FERPA is followed aswell.

Like Wisconsin, Miami (Fla.)Country Day School also does not con-sider itself a covered entity. However,Athletic Trainer Theresa Belesky, LAT,ATC, still has student-athletes’ parentssign a release-authorization form. Shesays it helps her feel her bases are cov-



Request No. 10

ered, and it serves as a talking pointfor helping to educate coaches—whohave turned out to be a little harder toacclimate to the idea of medical privacy than parents, doctors, and ath-letes themselves.

“I’ve had more flak from thecoaches about the release form thananyone else,” Belesky says. “They’llsay, ‘What does it mean? Are you notgoing to be able to tell me anythingabout an injured student?’ I tell them,‘That’s not the case. It’s just that youneed to know that because the parentshave signed this, they’re allowing meto talk to you. Therefore, you can’t goand talk to some other parent or some-body else.’ It was just a matter of edu-cating my coaches as to how this allworked.”

Belesky adopted the release-must-be-signed policy at the recom-mendation of the NATA and modeledher form after one shown to Floridaathletic trainers by David Jones, ATC,Director of Sports Medicine at Jackson

Hospital in Montgomery, Ala., and theSoutheastern representative to theNATA Governmental Affairs Com-mittee. “I was kind of surprised to hearour lawyer say it wasn’t really neces-sary,” Belesky says. “But to be safe,we’re doing it anyway. My school isvery expensive and we have lawyers’and doctors’ children here. It would bevery easy for someone to misconstruesomething or take something thewrong way.”

Requiring such forms shows anathletic trainer’s professionalism to-ward personal health information,

says Webster, and can put parents andothers at ease—especially importantas more people encounter HIPAAnotices when they visit their ownmedical providers. “If parents thinkproviders aren’t taking the same careto protect the medical information oftheir son or daughter, they’re bound toask more questions,” Webster says. “Itshould make the parents or the adultathletes less leery as to where theirrecords are going and for what pur-pose. Obviously, there’s more toHIPAA than that, but to me, that’s thegist of it.” ◆



SAMPLE FORMS

The following are links to two sample student-athlete authorization forms:

Miami Country Day School:www.miamicountryday.org/athletics/HIPAA_form.htm

University of Oklahoma Department of Intercollegiate Athletics:www.ouhsc.edu/hipaa/docs/HIPAA_AthleticDeptAuthorizationForm_3-10-03.pdf

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unning from school to schooland field to field is nothingnew for Christopher Hobler,ATC, who for 16 years hasprovided athletic trainingservices for high schools inUpstate New York. Based outof the Orthopedic Surgery and

Sports Medicine Group in Ithaca,Hobler facilitates sports medicine cov-erage for three school districts in thearea.

Because of the large number ofathletes he deals with and the distancebetween each school, Hobler can obvi-ously provide only minimal services tohis student-athletes. So to help makethe athletes as safe as possible whenhe’s away, Hobler has taken to educat-ing the coaches.

While teaching the basics of sportsmedicine may not be a major part of an

athletic trainer’s job description, deliv-ering some of your knowledge may bethe key to providing the best possibleservice—especially in a situationwhere an athletic trainer can’t be onevery court or field, all the time. Thechallenge lies in deciding what coach-es should learn and how you will teachthem.

WHAT TO TEACH

Deciding what your coaches need toknow takes some thought. You don’twant to give them the idea that theycan perform your job. In fact, youshould do the opposite. You want toshow coaches that athletic training iscomplicated, but if they are in syncwith you on the basics, they can helpyou perform your job more efficientlyand effectively.

“Coaches may have the most piv-otal role in the sports medicine chain,”says Melinda Flegel, MS, LAT, ATC,CSCS, Head Athletic Trainer at theUniversity of Illinois Sportwell Center,an extension of the school’s studenthealth center. Flegel, author of SportsFirst Aid, a guide for coaches, adds,“It’s a difficult position because theyhave to communicate with athletes,parents, and sports medicine person-nel. And, in most cases, they are theprimary responder. So they have toknow the basics, but at the same time,to be safe, coaches also have to knowtheir limits.”

Most athletic trainers agree thatthe base-level requirement is CPR andfirst aid. Though coaches can attaincertifications from a variety of outlets,Hobler feels that the most effectiveteaching scenario is when he instructshis coaches.

“I prefer it that way because I canget all the coaches together, and I canhandle administrative questions or pol-icy issues,” he says. “I also make sureto hold the training at their respectiveschools—a setting in which the coach-es are relaxed, comfortable, and morelikely to ask questions.”

Dealing with a medical emergency


R.J. Anderson is an Assistant Editor atTraining & Conditioning.

Phot

o: ©

Ded

e Ha

tch

RBY R.J. ANDERSON

HEADHEAD◆ M A N A G E M E N T ◆

Athletic Trainer Christopher Hobler, in front, poses with Lansing (N.Y.) High Schoolcoaches Stuart Dean, Jason Eade, and Ed Redmond.

Teaching your coaches some basics about sports medicinecan ensure they are in sync with your procedures.

Here are some tips on what to teach them and how.

of the Classof the Class

is another must-teach subject. Yourschool probably has written guidelinesfor its emergency plan, but you maywant to supplement that informationwith education on specific life-threat-ening scenarios. “I would make sure toteach coaches how to handle woundcare basics,” says Flegel. “What theyshould do if somebody is bleedingheavily, or if they can’t get the bleed-ing to stop. I would talk about whenathletes should be taken for stitchesand when to call for an ambulance. Iwould also go over splinting andassessing when an injured athleteneeds to be immobilized.”

Hobler worked with athletic direc-tors to revise the emergency guidelinesat two of his schools to include regula-tions for dealing with specific injuriesand situations. The changes includedhow to treat concussions and otherhead injuries, and when to call anambulance. His input also led to mak-ing pre-practice warmups standardprocedure and a mandate for readilyavailable practice-field ice and water.Hobler says this input has made hisservices more effective.

Hobler also finds coaches needsome instruction on assessing an ath-lete’s pain. “They need to be awarethat the ‘no pain-no gain’ philosophy

of years ago is obsolete,” he says.“Coaches need to know that athletesshould not push through pain, and thatthey should encourage an athlete to bein tune with their body and its limits.”

“Lots of coaches want to think,‘He’s just not real tough and that’s whyhe continues to complain about this orthat,’” says Larry Gurchiek, DA, ATC,Professor of Health and PhysicalEducation at the University of SouthAlabama. “But most of the time, kidsare tougher than we give them creditfor—coaches need to understand thatan athlete may not be performing wellbecause he or she is in pain and has aninjury.”

Jerry Whetstone, MEd, ATC,Coordinator of Athletic TrainingServices at Ohio’s Kettering SportsMedicine Center, tells his coaches thata good time to address individualaches and pains is during post-activitystretching sessions. “We encouragethem to watch their athletes closelyand listen to what they are saying dur-ing this time, and maybe have a ques-tion and answer period about eachteam member’s injuries,” he says. “It’salso an opportunity to encourage thoseathletes who are hurting to get atten-tion from the athletic trainer.”

Strength and conditioning is an-


◆ M A N A G E M E N T ◆

t the University of Illinois, Melinda Flegel, MS, LAT, ATC, CSCS, pri-marily treats athletes who are hurt in club sports or intramural-relat-

ed activities. To both help prevent injuries and educate the club coacheson some sports medicine basics, she runs a preseason fitness assessmentprogram for the school’s 50 club teams.

“The point of the preseason screening is to explain what the overuseinjuries are for each sport, then apply a specific test to look for any mus-cle imbalances that can lead to those overuse injuries,” says Flegel. “Thescreening sessions can be very time-consuming. But if you get the coach-es involved, it will go much quicker, and at the same time, you can teachthem basic assessment techniques.”

To replicate her process, Flegel recommends teaching coaches sim-plified techniques. For example, to check any deficiencies in hamstringflexibility, she has athletes lie on the ground with one leg perpendicularto the floor and the other straight ahead.

“You can show the coaches what to look for and give them specificexercises to work on based on what they see,” she says. “And then youhelp the coaches figure out a sport-specific conditioning program to helpthe athletes individually or as a group.”

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other area not to neglect. An athletictrainer should not be expected todevelop a strength program for everyteam, but teaching some basic conceptscan go a long way in preventinginjuries.

The most obvious may be theimportance of flexibility training.Though embraced more and more,stretching remains an area wherecoaches can benefit from more infor-mation and prodding—especially inusing stretching during cool-downperiods.

Whetstone—whose clinic pro-vides athletic training services for 21high schools, two community colleges,and two professional teams—says ath-letic trainers should also stress theimportance of each player keeping apersonal fitness log to record theirtraining. “We tell our coaches to bewary of the repetitions they have eachindividual athlete do,” he says. “Withplyometric training, for instance, youcan’t say, ‘Day one everybody is to do

10 jumps. Day two everybody shoulddo 20.’ In reality, on day two there aregoing to be athletes still struggling todo 10. You have to advance your ath-letes on an individual basis, while atthe same time advancing the group.”

Hobler finds strength training edu-cation especially important for multi-sport coaches. “Most high schoolcoaches tend to generalize too much,”he says. “I’ll see a baseball coach whois also a football coach have all his ath-letes go in the weight room and do aton of bench pressing. That might beokay for football players, but it’s notokay for baseball players.”

To prevent these kinds of errors,Hobler meets with the coaches whoutilize weight training and presentsthem with a basic, sport-specific pro-gram for their athletes. “I’ll sit downwith the baseball coaches and givethem lists of exercises to do in presea-son to prevent shoulder problems, andI do the same thing for soccer coachesto reduce knee injuries,” he says.

HOW TO TEACH

Just as important as figuring out whatto teach your coaches is determininghow to best educate them. Sometimesit’s a balancing act between not step-ping on the toes of the veteran coachwho already knows some of whatyou’re teaching, and reaching the newcoach who may be reluctant to ask anyquestions. Usually a mix of formal andinformal methods works best.

Hobler likes to start each sportseason with a mandatory refreshercourse for all his coaches. Whether it’sto satisfy a first aid certification for thestate or fulfill a staff requirement madeby the athletic director, the courseallows Hobler to impart knowledge tocoaches he will be working withthroughout the year.

By getting all the coaches togeth-er, Hobler is able to keep the entirestaff’s base of knowledge on a some-what even level. It gives him a chanceto find out what each coach knowsabout dealing with injuries. And it

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allows him to go over the specifics ofthe school’s injury treatment protocol.

The courses, which generally lasttwo hours, start with a 15-minute sec-tion on administrative issues like phys-icals and emergency contact informa-tion. Hobler then moves on to a sectionhe calls sprains and strains. Startingwith the shoulder and working his waydown, Hobler describes every joint andthe common injuries associated witheach.

“Instead of showing slides of eachbody part, I like to perform demonstra-tions on somebody from the audience,”he says. “I’ll show the group how Ilook at an ankle and what I’m lookingfor. I also go over what I’m asking theathlete while I examine the ankle interms of trying to assess the injury.”

Hobler says he finds demonstra-tions are more effective than slideswhen discussing anatomy and physiol-ogy, because they keep his audienceinvolved. He also tries to show hiscoaches what type of injuries can be

treated with ice and elevation, andwhich require a visit to the emergencyroom.

Going over sprains and strains isalso a good time for Hobler to talkabout common injuries he’s seen at hisclinic and read about in trade periodi-cals. “For instance, when I talk aboutthe knee, I’m going to cover ACLtears,” says Hobler. “And then I bringup a more current trend: how ACL tearsamong female basketball and volleyball

players are increasing at an alarmingrate. Then I tell the coaches my opin-ions on why that is happening.”

By introducing current events intoa spiel that some coaches have heardfor the last 10 or 15 years, Hobler isable to hold the group’s attention,whether it’s the first or the 10th time acoach has heard him talk about ACLtears. And that’s something he findskey to fostering discussion and provok-ing questions.

“This year I’ll probably talk aboutsteroids and supplements, as well asasthma—which seems to be affectingmore and more high school athletes,”Hobler says. “I’ll give them someinformation about asthma they mightnot know, and ask them questions like,‘If half your team has asthma, howmany inhalers should you have in yourmedical kit?’

“With supplements, I’ll talk aboutthe stuff that’s banned and encouragethe coaches to post that information inthe locker room,” he continues.


“I’ll give them some infor-mation about asthma theymight not know, and ask

them questions like, ‘If halfyour team has asthma, how

many inhalers should youhave in your medical kit?’”

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“Then, I’ll encourage them to take aglance into the kids’ lockers as theywalk around the locker room, and ifthey see something that shouldn’t bethere, to talk to the kid and his or herparents.”

Hobler estimates that he spendsnearly half of a two-hour session dis-cussing emergency preparedness. “Iwant them to be aware of how to han-dle difficult situations before theyarise,” he says. “After they leave mycourse, I want them to think, if some-body gets hurt, ‘Where’s the nearestphone or the nearest AED?’ Or if a kidloses consciousness without havingreceived a head injury, I want them tobe able to recognize immediately thatit’s probably a cardiac problem. Thatway they won’t waste time wonderingwhat to do. I want them to think aboutit beforehand because that’s going tosave lives.”

Kathleen English, MS, LAT, ATC,a Primary Instructor and ClinicalSupervisor at the University of Neb-

raska-Kearney, says role play is aneffective vehicle for delivering infor-mation. “Role play opens some eyes byallowing coaches to anticipate howsomething is going to happen, and howthey will respond,” says English, whouses role play in a class for prospectivecoaches. “Where role play becomesimportant is learning how to deal withvariances. The more times you areexposed to those types of things, thebetter prepared you are to make a pru-

dent decision in regards to the athlete’sneeds.”

To incorporate role playing, Eng-lish, the former Head Athletic Trainerat Nebraska-Kearney, recommends set-ting aside time during the preseason totarget athletic injury management andcare—possibly a half a day.

Another formal way to teach isthrough handout materials. Gurchieksuggests using guidelines put togetherby an accredited organization—espe-cially if you have coaches resistant toyour advice. Flegel backs up her infor-mation with handouts heavy on illus-trations and diagrams. Though ofteninformative and full of great advice,handouts are effective only when thecoaches actually take the time to readthem.

“Let’s say there’s an article inTraining & Conditioning that we maybe able to use,” says Whetstone. “I’llmake a copy for the coach and hand itto him and say, ‘Hey coach, I just cameacross this article and I thought it

“The athletic trainer needsto develop a relationship

that encourages a coach toinvite them in and say,

‘Here’s what we are doing.Do you see anything we are

doing wrong?’”

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might be of interest to you.’ Then, maybe the next day I’ll seethe coach and say, ‘Did you get a chance to read that articleon plyometrics?’ If he hasn’t, I’ll follow up with somethinglike, ‘Why don’t you go ahead and read it, I think it would behelpful, especially as we move forward with our conditioningprogram.’”

Whetstone says he continues to follow up until the coachshows that he has read the article. And, he adds, you can usu-ally tell that they’ve read the article because they’ll havequestions. “The whole point is to stimulate them so that theyopen the door and ask you questions,” he explains.

Don’t forget that all the education does not have to comedirectly from you. Gurchiek suggests setting up workshopsrun by strength and conditioning experts from clinics or localcollege and university athletic programs. By encouraging acoach to tap into that type of expertise, an athletic trainer isable to provide continuing education in a setting that willgrab a coach’s attention in a manner that resonates withoutoffending.

ONE-ON-ONE

As effective as hand outs and mini-clinics can be for educat-ing coaches, don’t forget the importance of old-fashionedinterpersonal communication. That often means visiting eachcoach individually on a regular basis.

“In order to approach every coach at a school, the athlet-ic trainer has to be pretty organized,” says Gurchiek. “Youcan’t go in and try to wing it—you must have a program andplan out what you are going to say to each coach. I would saysomething like, ‘Coach, here are some things you’re going tosee with soccer, here are some things to be aware of in pre-venting knee injuries. Here’s what we’re doing with theseinjuries, and here are some things you can do to give yourathletes better care and help you make better decisions untilwe can get out there and help you.’”

The key, says Gurchiek, is to present yourself as a partnerto the coach, not just an authority figure on sports medicine.“The athletic trainer needs to develop a relationship thatencourages a coach to invite them in and say, ‘Here’s what weare doing. Do you see anything we are doing wrong?’” he says.

Hobler has found this approach effective with hiscoaches. He points to a situation a couple years ago inwhich many of the school’s football players developedshoulder problems. “The coach and I sat down together andsaid, ‘Why are we having all these bad shoulders,’” saysHobler. “We went over their workout routine and found outthat they were overemphasizing the bench press—they weredoing just one push, like it was a competition to see whocould do the most weight.” Hobler says that once they mod-ified the players’ weight lifting habits, the shoulder prob-lems went away.

Whether full-time or part-time, an athletic trainer’s mainconcern is providing care for student-athletes. By settingaside a little bit of time to spend with your coaching staff toshare some of the basics of sports medicine, athletic trainersmight find their jobs become easier and their care more com-prehensive. ◆

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Request No. 18

ust as athletes are start-ing to get the messagethat consuming carbo-hydrates is an importantcomponent of enhancedperformance, the anti-carb movement hasbegun jockeying forposition again. From

Atkins to advertising, the anti-carbmovement has many athletes doubtingthe standard sports nutrition recom-mendations.

Athletes need to be able to sepa-rate fact from fiction. Yes, low-carbdiets can lead to weight loss. Yes, low-carb diets can provide a healthy alter-native for many non-athletes. Butthey’re not right for everyone, and ath-letes who follow low-carb diets willonly compromise their performance.

With a glut of misinformation inthe market, your athletes need toknow the facts about healthy nutri-tion. Fact number one is that carbohy-drates are a necessary part of anyhealthy diet. Fact number two is thatcarbohydrates have always been andwill always be the primary energy

substrate for most exercise. Fact num-ber three is that athletes who cut carbswill pay the price with decreasedspeed, strength, and stamina.

THREE POINTS

Let’s begin this discussion with a defi-nition of carbohydrate. A carbohydrateis a macronutrient composed of carbon(carbo-) and water (-hydrate). Carbo-hydrates are composed of saccharides(sugars) of varying length.

Point No. 1. We eat food, not just

carbohydrates. Some foods are prima-rily carbohydrate, such as carbonatedbeverages. Others, such as skim milk,are a mix of carbohydrate and protein.

Point No. 2. The categorization ofcarbohydrates into two types, simpleand complex, is much too simplisticfor today’s athletes. Using these termsmay persuade people to cut foods fromtheir diet unnecessarily, making theincorrect assumption that simple car-bohydrates are bad and complex carbo-hydrates are good.

The facts are more complicated.Some of the foods that people tradi-tionally classify as simple carbohy-drates—fruit, non-starchy vegetables,honey, maple syrup, grains (rice, corn,oats), and dairy foods such as milk andyogurt—are often a healthier choicethan the foods we think of as complexcarbohydrates.

In addition, some complex carbo-hydrates, such as sweetened cereals,have fiber removed, and may not be asnutrient-dense as simpler carbohy-drates like fruit and non-starchy veg-etables (green beans and broccoli, forexample) which contain fiber, phy-


◆ N U T R I T I O N ◆

The low-carb diet fad

has some truth in it, but

it’s not for competitive

athletes. Our nutrition

expert gives the skinny

on carbohydrates and

performance.

J

ConfusedConfused



tonutrients, vitamins, and minerals.Point No. 3. Contrary to the titles

of today’s top-selling diet books, yourathletes need to eat a balanced diet thatincludes all kinds of carbohydrates.

CUTTING CARBS

Low-carb diets are hot right now as theway to lose weight. According to anumber of popular plans, most carbsare bad and need to be eliminated. Atthe same time, new low-carb productsare flooding the marketplace and “suc-cess stories” abound of people whohave lost weight by severely limitingor eliminating carbs.

Why do people lose weight onlow-carb diets? For one thing, thereare fewer food choices, which makesthe diets easier to follow. Many peopleon low-carb diets also say they aresimply not as hungry, which may bebecause protein makes people feelfuller, and also because low-carb dietstypically allow high fat foods, whichalso contribute to satiety. And decreas-ing carbohydrate intake results in fluidloss, which shows up on the scale asrapid weight loss.

In addition, it’s harder to cheat ona diet that restricts carbohydrates.Many carbohydrate-containing foodsare handheld and ready-to-eat, likebagels or crackers, whereas protein-containing foods tend to requirepreparation, utensils, and sit-downmeals. Carbohydrate-containing foodsare more likely to be eaten as snacksand on the go, which can lead tomindlessly consuming much morethan is healthy.

PERFORMANCE FACTORS

If low-carb diets result in weight loss,why shouldn’t athletes jump on thebandwagon and start cutting carbs?Because carbohydrate, not protein orfat, is stored in the muscles and liver asglycogen, which provides fuel forexercising muscles.

The body cannot manufacture itsown carbohydrate. If carbohydrateneeds are not met, the body will eitherbreak down stored fat to provide fattyacids (which can in part be convertedto glucose through a process known as

ketosis) or break down lean musclemass to yield glucose. Most athleteswould probably rather preserve musclemass, and stored fat should be a fuelsubstrate for exercise, not a substitutefor adequate carbohydrate intake. It isalso important to realize that exerciseitself depletes glycogen stores, whichneed to be replenished with carbohy-drate, not protein or fat.

Consuming carbohydrate beforeexercise can help prevent hunger,delay fatigue, and provide energy dur-ing the workout. Eating carbohydratepost-exercise expedites liver and mus-cle glycogen resynthesis so that ath-letes can recover more quickly.Amazingly, there are low-carb sportbars, no-carb sports drinks, and many“energy” products with water, caffeine,and artificial sweeteners as the primaryingredients. They may taste sweet, butthey are not very healthy for an activebody.

BY LESLIE BONCI

Leslie Bonci, MPH, RD, is Director ofSports Nutrition at the University ofPittsburgh Medical Center and serves as aconsultant to the Pittsburgh Steelers, Pittathletics, and several area high schools.

byCarb

s?

byCarb

s?

How much carbohydrate isenough to fuel optimal performance?The Institute of Medicine’s DietaryGuidelines revisions call for a dietcontaining 45-65 percent of caloriesfrom carbohydrate and not less than130 grams of carbohydrate per day.(By contrast, some of the low-carbdiets recommend an initial carbohy-drate intake of 20 grams a day—theequivalent of six ounces of orangejuice, four gummy candies, or two-thirds of a cereal bar.) Some athletesmay do better with a higher percent ofcalories from carbohydrates, whereas

others may prefer a more moderatecarbohydrate intake, but no athletewill improve performance when thecarbohydrate content of their diet isless than 45 percent of their dailycaloric intake.

To help athletes translate the 45to 65 percent recommendations toinformation they can use to planmeals, have them imagine their platedivided into thirds. The protein shouldfit on one third, while the rest of theplate should be covered with carbohy-drate-containing grains, fruits, andvegetables.

DISCRIMINATE, DON’T ELIMINATE

Better advice for athletes is to dis-criminate, not eliminate, when itcomes to carbohydrates. Portions,timing, and type of carbohydrateschosen are extremely important.Instead of relying on simple and com-plex categories, experts have turnedto a new system for sorting carbs: theglycemic index. The glycemic indexhelps athletes adjust carbohydrateintake by choosing and timing carbo-hydrates according to the glycemicresponse, or effect on blood glucoseand insulin levels.

Basically, eating any carbohy-drate-containing food results in anincrease in blood glucose levels, caus-ing insulin to be secreted from thepancreas. The higher the blood glu-cose, the more insulin is released.Some scientists believe that the extentand rate at which carbohydrate-con-taining foods increase blood glucoseand the insulin response may affectthe risk for obesity, cardiovasculardisease, hypertension, and Type II diabetes.

In the glycemic index system, car-bohydrate-containing foods are classi-fied according to how quickly and howmuch they raise blood glucose levels(i.e., their glycemic index). Foods witha lower glycemic index raise bloodglucose slowly, whereas foods with ahigher glycemic index raise blood glu-cose more rapidly. The glycemic indexof a food is affected by:

Particle size. Larger particlestake longer to digest and slow the riseof blood glucose. That’s why regularoatmeal has less of an effect on bloodglucose than instant oatmeal, whichhas a smaller particle size.

Soluble fiber content. Foods likeoats, barley, and dried beans takelonger to digest and therefore thebody’s glycemic response is moregradual.

Fibrous coverings. Foods such asbeans and seeds take longer to digest,lowering their glycemic index.

Acidity. Acid-containing foodssuch as fruit, vinegar, and pickledfoods take longer to digest.

Fat content. Foods containing fat



igh glycemic index foodsare recommended for rapid

repletion, while moderate and lowglycemic index foods are prefer-able for endurance exercise. Hereare some examples:

HIGH GLYCEMIC INDEX FOODSAngel food cakeSucrosePretzelsSports drinksDoughnuts/croissantsWhite breadRye breadHard candyToaster pastriesBagelsEnglish muffinsWatermelonsCold cerealsRaisinsCouscousIce creamPancakes/wafflesCorn chipsHoney/syrupMolassesBaked/mashed potatoes

MODERATE GLYCEMIC INDEXFOODSSponge cakeMangoes/kiwisBananaTortillasPitaSeven-grain bread

100% whole wheat breadOat bran breadBrown/white riceBasmati ricePastaBarley/bulgurBuckwheatCitrus juicesCornPeasSweet potatoesOatmeal/oat branLow-fat ice creamCandy barsPowerbarsGrapes

LOW GLYCEMIC INDEX FOODSMilkNine-grain breadPlums100% bran cerealYogurtCitrus fruitsBeansNutsRice branApplesApple juiceLentilsRaw peachesTomato soupTomato juiceIronman barsDried apricotsRaw pearsChickpeasHummus

USING THE INDEX

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Request No. 19



take longer to digest. Sugar type. Fructose takes longer

to digest than glucose. From a sports perspective, foods

with a higher glycemic index will pro-duce a greater and more rapid changein insulin, resulting in enhanced glyco-gen replacement in the muscle. Whenthe goal is rapid repletion, there maybe an advantage to consuming higherglycemic index foods. Moderate andlow glycemic index foods take longerto enter the bloodstream and may bepreferred for endurance exercise topromote sustained carbohydrate avail-ability.

I recommend that my athleteschoose carbs based on the duration oftheir events. Athletes who have earlymorning practice and no time forpreparing breakfast beforehand maybenefit from carbs that are processedmore quickly, such as sports drinks.Athletes who have long or back-to-back events may feel better with alonger-lasting grain such as oatmeal,whole grain waffles, or toast beforeexercise. (For lists of other high, mod-erate, and low glycemic index foods,see “Using the Index” on page 28.)

LOW-CARB PRODUCT CRAZE

What about choosing low-carb ver-sions of regular foods as a way to keepcarbohydrate intake at the recom-

mended 45 to 65 percent? New low-carb foods are everywhere, fromhealth clubs to fast food restaurants.Some of the more popular productsinclude low-carb beer, pasta, candy,chips, muffins, pizza crust, bagels,cereal, sports drinks, and milk (the lac-tose is replaced by artificial sweetenerand extra protein).

However, these foods are not thebest choices for athletes. Some low-carb products are actually higher incalories and fat than the regular-carbversions. Others contain sugar alco-hols, which can have a laxative effect.Some have an unpleasant taste andtexture, and most cost significantlymore money! When low-carb foodsare added to a low-carb diet, varietygoes up, but with it go calories, por-tions, and weight.

In addition, there is no industry-accepted definition for low-carb. Evenmore misleading, many productsadvertise on their labels the number of “net carbs” or “net effective carbs”in the food. The manufacturers haveused net carbs as an advertising gim-mick to make people believe that theyare consuming fewer calories. Thisfigure on the label is determined asfollows:

Net carbs = Total Carbohydrates –Fiber – Sugar Alcohols – Glycerine.

The assumption is that fiber, sugar

thletes who make these substitutions at snacks and meals will getfewer carbs from sugar and more carbs from healthy fruits, grains,

and vegetables.

INSTEAD OF CHOOSEPretzels Trail mix with wheat chex, dried fruit,

and some nutsFrozen yogurt Fruit flavored yogurtChips PopcornWhite rice Brown riceLettuce salad Marinated vegetablesPasta with marinara Higher protein or wheat pasta and add

vegetables to the sauceSub on white bread Sub on whole grainTaco salad Chicken or steak fajita with vegetables

or salsa in a whole wheat tortillaCorn flakes Cheerios

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alcohols, and glycerine do not con-tribute significant amounts of caloriesand don’t have to be counted, but this isan oversimplification. There are manyfactors that affect the glycemic responseof a particular food, and lower net carbsdoesn’t necessarily mean a lowerglycemic index.

I caution my athletes to look at allof the nutrition information on the labelof a food that claims to have a low num-ber of “net carbs.” Often, they’ll findthat the product contains the same num-ber of calories as regular versions of thesame food. Also, although fiber is not acalorie source for the body, sugar alco-hols and glycerine are, so the bottomline is that carb-free does not mean calorie free, and low-carb foods stillneed to be accounted for in the dailycaloric intake.

As nutrition sources, low-carbchips and muffins are not equivalent tofruits, dairy foods, and vegetables.Instead of going for low-carb gimmicks,athletes would be wise to meet their car-bohydrate needs through fruit, dairy

products, and grains, while limitingadded sugar in desserts and snacks aswell as high fructose corn syrup in softdrinks and sweets.

PORTIONS MATTER

While it’s essential for athletes to con-sume a diet high in carbohydrates, it ispossible to have too much of a goodthing. One reason it’s easy to overdocarbohydrates is that it’s easy to losesight of what constitutes a portion ofmany carbohydrate-containing foods.There is a disconnect between trueserving size and most student-athletes’definition of a portion. I always tell myathletes, “Never eat anything biggerthan your head,” and as silly as thatadvice sounds, it reminds athletes tothink about portion size.

Controlling portion size is easiersaid than done given the fact that astandard bottle of soda is now 20ounces and contains two-thirds of acup of sugar. A snack serving variesfrom the tiny one-ounce packagesserved on airplanes to the five-ounce

convenience store bag. To help yourstudent-athletes visualize appropriateserving sizes, give them the followingexamples:

• A two-ounce bagel is the size ofa yo-yo, not a Frisbee.

• A cup of cereal is the size of arolled up pair of sports socks, not thesports bag.

• A cup of hot cereal, pasta, or rice is the size of a tennis ball, not abasketball.

• A potato is the size of a comput-er mouse, not the monitor!

FUELING THE BODY

Despite popular diet fads, athletes willstill run faster, lift more, and last longerwith pasta than poultry. The bodyneeds to be fueled, not fooled. It is theresponsibility of the athletic trainingstaff, coaches, and all others involvedin the athlete’s care and well-being toencourage and recommend a variedeating plan with carbohydrate-contain-ing foods and beverages as a majorplayer at every meal and snack. ◆

Request No. 21

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ith baseball seasonupon us, rotator cuffinjuries are on manyathletic trainers’ minds.Last year, in the profes-sional ranks alone, wesaw Ken Griffey Jr.,Troy Glaus, and Mike

Remlinger, to name a few, suffer fromrotator cuff injuries.

Of course, this injury can affectathletes in almost any sport. The term“rotator cuff injury” has evolved to bea blanket term for shoulder injuries.The rotator cuff is actually four mus-cles in the shoulder that hold thehumerus in place. But the public andsome medical practitioners are usingthe term whenever some portion of theshoulder complex is involved in theathlete’s shoulder dysfunction.

Comprised of the supraspinatus,infraspinatus, teres minor, and sub-scapularis, the rotator cuff controlsfine movement at the glenohumeral

joint. It functions primarily to centerthe humeral head in the glenoid fossaby a suction cup process known as thecircle concept. All four of these mus-cles are engaged in a tug-of-war, andin a healthy, normal shoulder there isnet equilibrium to balance these forcesin any movement pattern in space.However, if the balance is disrupted,injury and pain occur.

The athlete’s shoulder complex isattached to the entire body, of course,


Jodie Humphrey, PT, ATC, CSCS, is aPhysical Therapist for Complete P.T., inLos Angeles, and a former SportsMedicine Coordinator for HealthSouthin Warwick, R.I.

Phot

o: ©

Get

ty Im

ages

BY JODIE HUMPHREY

ROTATIONat the Shoulder ROTATIONat the Shoulder“Rotator cuff injury”has become a common term for a sometimes mis-understood condition.Effective treatmentstarts with a precisediagnosis.

◆ T R E A T I N G T H E A T H L E T E ◆

W

Chicago Cubs relief pitcher MikeRemlinger underwent arthroscopic rotator cuff surgery last fall.



hence looking at the entire kineticchain is also important. A rotator cuffinjury is the end result of a failuresomewhere in the kinetic chainthroughout the whole body.

SYMPTOMS & CAUSES

A rotator cuff tear can occur at themuscle belly, the muscle-tendon junc-tion, the tendon, or the insertion of thetendon to one of the bones, scapula, orhumerus. The symptoms that com-monly occur with rotator cuff injuriesare pain, weakness, and loss of motionin the shoulder. Some athletes will feela pop in their shoulder after which theycannot lift their arm very well. Otherswill report a gradual onset of shouldersymptoms, like grinding or clicking,but may not experience any loss ofmotion.

A significant traumatic force isrequired to tear a healthy rotator cuff.Most often, however, rotator cuff tearsresult from a combination of traumaand degenerative changes.

Degeneration causes muscles andtendons which should not normally be

working to assist in producing theequivalent net force and power that theactivity demands. The degenerativeprocess usually starts with swellingand inflammation in the bursa fromrepetitive motion activities at or aboveshoulder level. This process causescompensatory muscles to engage dur-ing the activity to produce the requiredforces for the sport. This process con-tinues until the rotator cuff tendonsfight for space and develop a ten-donitis. Continued overuse due to thetendons’ weakened state leads to fur-ther degeneration.

Think of a rope fraying from fric-tion around a sharp edge, and themovement of the rope causing furtherbreakdown of the rope’s strands.Eventually the fibers tear at the surfacewhere the point of excess friction isapplied.

Of course, not all rotator cuffinjuries occur in isolation. Injury atother muscles, tendons, ligaments,joint surfaces, and other non-contrac-tile supporting soft tissues can occur.

With all these variables assessed

for performance deficiencies, the levelof rotator cuff dysfunction can bedetermined and classified in a moreappropriate categorization of mild,moderate, or severe shoulder complexdysfunction. That’s why the diagnosticprocess is so important.

MUSCLES & TENDONS

All the muscles that act at the shoulderjoint have one of two purposes: either tostabilize or to mobilize. A football line-man’s rotator cuff functions to producea greater stabilizing force than a base-ball pitcher’s. The baseball pitcher’srotator cuff, in turn, functions with agreater endurance and aerobic capacity.

The stabilizer muscles are thosethat primarily hold the joint in place sothe larger muscles can produce powerand strength. The stabilizers are therotator cuff and the musculaturearound the scapula, which keep thescapula anchored to the thoracic wallvia the spine. The scapula is stabilizedto the spine by muscular actions of thelevator scapulae, trapezius, rhomboidmajor, rhomboid minor, and serratusanterior. The stabilizing force couplesat the shoulder complex provide thestable foundation for mobility to occur,particularly at high velocities in theathletic population. The stability is thehinge for all functional strength andpower, since the body inherently limitsmuscle strength gains without a soundfoundation to build upon in an auto-matic self preservation tactic.

The mobilizers generate strength,power, and speed. These are the largermuscles traditionally involved inweight training circuits. Those thatexert force over the shoulder joint arethe rhomboids, levator scapulae, pec-toralis major and minor, and latissimusdorsi, which are trained in the seatedrow, shoulder shrugs, chest press, andlat pull downs, respectively. Othercombined contractile forces to consid-er at the shoulder complex include:

• Deltoid (anterior, middle, andposterior heads)

• Infraspinatus, teres minor, andsubscapularis

• Teres major, coracobrachialis• Biceps brachii and triceps.

he following are some do’s and don’ts for an athlete lifting weightswith shoulder pain:

AVOID• Deltoid work and military press beyond elevation range.• Hyperextension beyond the plane of the body.• Sacrificing proper mechanics to lift heavier weights.• Allowing poor mechanics and asymmetries in posture to follow the

conditioning regime.

DO• Seek medical attention early in the onset of shoulder pain, particularly if

it’s gradual, since the microtrauma has been hiding for some time before pain is felt.

• Perform two sets of pulling exercise for every one set of pushing.• Stabilize the core by blocking: Contract the abdominal and pelvic

muscles so no spinal movement occurs as another adjacent joint performs the exercise.

• Isolate the rotator cuff with exercises at 8-10 percent max bench press weight.

• I’s, T’s, Y’s, external rotation at 90 percent, and serratus punches for scapular stabilization.

• Functional total body patterns to facilitate kinetic chain biomechanics.• Chin ups, chin ups, and more chin ups.

In the Weightroom

T



The shoulder complex muscula-ture needs to be assessed consideringforce production requirements of thesport (strength, endurance, and flexi-bility), and work-rest intervals specificto the shoulder complex.

To assess scapulohumeral rhythm,look for muscular forces that are in linewith the following:

• Upper trapezius should be mostactive in coronal plane, with abductionless than 60 degrees.

• Lower trapezius abductionshould be most active when greaterthan 90 degrees.

• Serratus anterior should be mostactive in forward flexion.

• Middle trapezius should be mostactive during abduction at 90 degrees,and scaption less than 90 degrees.

• Rhomboids should be mostactive at flexion and abduction at endrange.

The process of assessing mobilityin the rotator cuff muscles is depictedwell in Muscle Stretching in Manual

Therapy, by O. Evjenth, MS, and J.Hamberg, MD. They describe the beststretches in these positions:

Supraspinatus: Athlete lies onhis or her side with wedge in axillary,and force is applied while the shoulderis in a slight extension as the arm isadducted across the back.

Subscapularis: Athlete liessupine with elbow flexed 80 degrees,abducted 30 degrees, and force isapplied to externally rotate the shoul-der with forearm supinated.

Teres minor: Athlete sits withshoulder in full flexion with elbowflexed 90 degrees, and force is appliedinto internal rotation.

Infraspinatus: Athlete is supinewith shoulder abducted 80 degrees andelbow flexed 90 degrees, and force isapplied into internal rotation.

When muscles and tendons areinvolved, we need to incorporate agradual progressive resistive exerciseprogram. With injury, the muscle’scellular system is disrupted, partly

due to nerve disruption. Some portionof communication with the tissue istemporarily out of order. It is difficultto speak of muscles’ healing proper-ties without acknowledging this rela-tionship, which is critical in the heal-ing process.

As the axon approaches the mus-cle fiber for innervation, it loses itsmyelin sheath and branches into anarray of terminal fibers, called motorend plates. Essentially, healing of themuscle injury is strongly dependent onthe amount of shearing to these motorend plates and the axon.

The supraspinatus tendon is mostoften involved in rotator cuff injury,because its position makes it mostsusceptible to impingement. For ten-don tears, the connective tissue re-establishes its firm attachment ofmyofiber ends with scars. But exces-sive connective tissue scar formationbetween stumps may impede regener-ation of myofibrils and re-innervationof abjunctional stumps. This means

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the tendon will heal with a lesser per-centage of ROM than normal, and aweak link will occur. The balance atthe tug-of-war will be disrupted, set-ting the stage for further pain anddegeneration.

JOINTS & NON-CONTRACTILE SOFT TISSUES

When diagnosing an athlete withshoulder pain, first examine the tissuesand joints involved. Particular to theshoulder complex, the sternoclavicular(SC), acromioclavicular (AC), gleno-humeral (GH), and scapulothoracic(ST) are the direct articulations thatneed thorough evaluation. Another pri-mary cause of painful arc is the sub-acromial joint (SAJ), which defines thespace between the coracoacromial roofand the humeral head that houses thedeep portion of the subdeltoid bursa.

Sternoclavicular: This intra-articular disk and fibrous capsule pro-vide stability to the shoulder. Theyhold the clavicle in a normal restingposition with a 10-degree upward

angle in the coronal plane. In arthro-kinematic terms, it should have:

• 45 degrees of movement withelevation.

• Five degrees with depression.• 15 to 35 degrees of movement

with protraction/retraction.• 25-50 degrees axial rotation.Note that the sternoclavicular joint

is the foundation of the shoulder com-plex, since it is the last hinge that keepsthe arm in neutral alignment. Oncedysfunction affects this joint, the struc-tural alignment for the whole shouldercomplex and the entire kinetic chainmust be considered.

Acromioclavicular: This intra-articular disk and fibrocartilage is pri-marily stabilized by coracoacromial,coracoclavicular, and acromioclavicu-lar ligaments. It has an inferiormedialoblique orientation. Its arthrokinemat-ics around a vertical axis consist of thefollowing features:

• 15 degrees of scapular wingingby clavicle rotation.

• Flexion/extension tilt is re-stricted by thorax-scapula space.

• Abduction and adduction rotatescapula upward and downward.

Subacromial: This provides afunctional articulation between thecoracoacromial arch and the head ofthe humerus. The costocoracoid fascialies superiomedial to the pectoralisminor muscle and when contractureoccurs, it causes loss of elevation of thearm. Soft tissue is often a culprit in thediagnosis of “subacromial bursitis.”

Glenohumeral: This is a syn-ovial, multiaxial ball-and-socket joint.The glenohumeral index, calculated bydividing the maximal transverse diam-eter of the glenoid by the maximaltransverse diameter of the humeralhead, is 57.5 in normal shoulders.Articular cartilage of the glenoid isthicker peripherally than centrally,whereas the cartilage on the humeralhead is slightly thicker centrally. Theanterior, superior, and posterior aspectsof the capsule are reinforced by the


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tendons of the rotator cuff, coraco-humeral, and superior glenohumeralligaments.

The glenoid labrum is a flexiblestructure allowing adaptation of itsshape to accommodate rotation of thehumeral head. This deepens the gle-noid cavity. If removed, there is a 20percent reduction in resistance to supe-rioinferior and anteroposterior transla-tory forces.

Its arthrokinematics vary in twodifferent research studies. The concave-convex rule says the humeral headslides inferiorly during abduction, ante-riorly during external rotation, and pos-teriorly during internal rotation. Morerecent research has shown that duringthe initial 30-60 degrees of elevation inthe scapular plane, the humeral headmoves superiorly three millimetersthen stays centered within one millime-ter; and during horizontal plane move-ment, the humeral head stays centereduntil maximal extension and externalrotation (such as the cocking phase ofpitching) when four millimeters of pos-

terior translation occurs. These studiessuggest that movement of the humeralhead is related to tightness in the jointcapsule.

Scapulothoracic: This area relieson force couples for orientation andmovement patterns—trapezius, rhom-boid major and minor, and levatorscapulae. It sits 30 to 45 degreesobliquely in the coronal plane with aforward tilt of nine degrees. The medi-al border of the scapula is oriented ver-tically. In a normal position, the gle-noid fossa faces anterior, lateral, andfive degrees downward.

The scapulothoracic allows threerotatory motions (elevation/depres-sion, abduction/adduction, upwardrotation/downward rotation) and twotranslatory motions (protraction/retrac-tion). Fifty degrees of scapular move-ment with protraction arises fromtranslation of the scapula as 35 degreesof anterior clavicle movement occursat the sternoclavicular joint when 15degrees of rotation occurs at theacromioclavicular joint.

In regards to the joint surfaces, theSC, AC, and GH all function as balland socket joints. When joint degener-ation is present, there is low recover-ability, whereas capsular restricted pat-terns mean high recoverability (in thesense of restoring normal joint mec-hanics, not necessarily equating tofunctional restoration).

As for ligaments, they heal withscar similar to scarring elsewhere, butare mechanically inferior to normal tis-sue. During scarring, normal large-diameter collagen fibrils in soft tissuesare replaced with relatively small col-lagen fibrils.

NERVOUS SYSTEM

If the nerve is traumatized, an extend-ed time to fully recover is warranteddue to its slow rate of repairing itself.When a nerve regenerating sprout doesfind an appropriate end organ (musclecell or receptor), these regenerated andre-myelinated fibers have internodaldistances, diameters, and conductionvelocities around 80 percent of normal.

Request No. 25



Involvement of the nerve portion of theneuromuscular connection presents asmuscle weakness, but overloading themuscle with resistance training tostrengthen the muscle is similar toshooting the messenger.

Denervation hypersensitivity is asymptom of nerve injury, and an exam-ple is a brachial plexus injury in whichthe athlete complains of alternatingwarm and cold sensations. At times thearm is warm (no vasomotor tone) andat other times cold and cyanotic(vasospasm), as a result of hypersensi-tivity to circulating epinephrine.

Neuromuscular re-education in-volves working muscles and the nerv-ous system together, with preciseregard to timing, speed, power,strength, and rest-to-work ratio. Thenerves and corresponding muscles thatappear with a dysfunctional scapulo-humeral rhythm include:

Long thoracic ➪ serratus anteriorDorsal scapular ➪ rhomboidsSuprascapular ➪ supraspinatus

and infraspinatus

Axillary ➪ deltoid and teres minor

Another variable is kinesthesia, oreye-hand coordination. Poor coordina-tion results in inefficient movementpatterns, which strain the rotator cuff.The work that the muscles perform inthe arc of movement, considering millimeters of inaccuracy, will cumu-latively affect the rotator strain.

To associate the effects of this toan identifiable situation, considerwalking with a small pebble in yourshoe under the ball of your foot. Thepressure over time will alter the wayyour foot position conforms to theground to maintain the speed of walk-ing. Eventually, pain occurs at stressedpoints that were not designed to bearweight in that fashion. Similarly, thekinesthesia at the shoulder complexadapts until pain sets in upon soft tis-sue destruction. As stated earlier, thebody is designed to be self-guided in allof its systems, so this process of abnor-mal compensatory movement must beconsciously re-trained.

DIAGNOSIS

Obviously, proper prognosis getsthe treatment on the right track. Here isa list of questions to consider whilediagnosing and coming up with a treat-ment plan:

• What is the degree of movementdysfunction?

• What are the diagnostic work-upresults?

• Does the patient need surgery?• Is the athlete willing to allot time

for recovery?• How long has the problem been

present?• Is there a prior injury to this

area?• Is the cervical spine involved? Once damage to the tissue is deter-

mined through an evaluative process,and an understanding of the tissue’shealing capacity is appreciated, thetreatment can be focused at the bull’s-eye. A complete biomechan-ical understanding is necessary for effi-cient implementation of treatmentinterventions. ◆

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C O M P E T I T I V E E D G E

▼

ver the last four years,the Bridgewater Col-lege football team hasbecome one of the topprograms at the NCAADivision III level. This

year’s senior class finished with a com-bined 45-6 record that included fourstraight NCAA playoff appearances,two South Region Championships, andan appearance in the national champi-onship game. One reason for our suc-cess has been the student-athletes’commitment to the strength and condi-tioning program.

Like most Division III schools, wehave limited resources and space avail-able. One of our goals from a strengthand conditioning standpoint is to notlet any of these limitations keep usfrom fully developing our athletes.

We consider ourselves fortunate tohave a strength and conditioning facil-ity dedicated to student-athletes.(There is a new fitness facility for thegeneral student body elsewhere oncampus.) And contributions from ourfootball alumni have helped transformour weightroom from a place with oldUniversal machines and a few benchpresses into a very effective weight-room with no shortage of weights, plat-forms, and power racks.

However, the football team doesshare the weightroom with the otherstudent-athletes at our school, and the

facility is usually pushed to its maxi-mum limits. In addition, we have lessmandatory practice time at theDivision III level, thus less time towork with our players. Therefore,when developing a strength and condi-tioning plan for our football players,we pay close attention to scheduling,constructing efficient workouts, andfiguring out how to motivate playerswithout using a lot of hands-on super-vision.

SCHEDULING & SPACE

We currently have 115 football playersin our off-season program. In order toeffectively deal with such a large num-ber of players, we utilize several strate-gies. First, to keep lifting groups small,we organize hour-long time slots dur-ing the day for athletes to receive

Joey Soltis is the Head Strength andConditioning Coach and Wide ReceiversCoach at Bridgewater College in Virginia.

O

With limited space

and resources, NCAA

Division III power

Bridgewater College

makes the most of

its strength and

conditioning program.

MOVING UPFIELD

MOVING UPFIELD

BY JOEY SOLTIS



▼

supervised instruction. We begin ses-sions at 11 a.m. and go every hourthereafter. If they can’t make any ofthose sessions, they can come in at

6:30 a.m. Either myself or my assistantis always there to supervise the group.

We also try to fully utilize ourweightroom space when designing

training programs. We do this by split-ting our team into Cardinal lifters(beginner level) and Gold lifters(advanced level), with each grouphaving a different emphasis at differ-ent times. For instance, on Monday,the Cardinal group will emphasizeupper-body pushing movements whilethe Gold group will emphasize thelower body and upper-body pullingmovements.

To perform agility and speeddevelopment work during the winter,we utilize our rubberized hallways. Inthis limited space, we perform drillssuch as pro shuttles, tennis ball drops,arm action drills, speed ladder drills,resisted speed drills, and start drills.One of our resisted speed drill adapta-tions is performing belt starts insteadof harness starts. Using practice pantsbelts, we are able to have a resistedstart without the extra expense of pur-chasing harnesses.

Because off-season work is volun-tary in Division III, communicationbetween myself and the head coach isimportant. By maintaining consistentcommunication, the head coach has abetter understanding of who is puttingforth the effort needed to improve.Since the head coach is aware of theirweekly performance, the players see thestrength and conditioning program as ahigh priority. Thus, they are less likelyto miss workouts and more motivated toexert maximum effort each week.

OLYMPIC LIFTS

Here at Bridgewater, we mainly focuson explosive Olympic lifts and theirvariations. Since we started emphasiz-ing these lifts six years ago, our playershave become more explosive and moresuccessful on the field.

As a general rule, we have foundthat athletes in Division III do not havethe same hip mobility as Division I ath-letes. Therefore, we perform about 90percent of the power movements fromthe floor. By performing lifts such aspower cleans instead of hang cleansand adding hip mobility drills such ashurdle drills to the training regimen, we

Table One: Preseason Strength Work

MONDAYJump RopeAbs, 50-100 repsClean & Jerk, 5x3Bench Press (cycle)

WEEKS 1-3:Close Grip Rack Lockout,

6" Lockout, 3x3Lying Triceps Extensions with Curl

Bar, 1x15, 1x12, 1x10Straight Bar Curls, 3x10

WEEKS 4-6:Incline Dumbbell Bench, 3x5Bodyweight Dips, 35 repsIncline Dumbbell Curls, 3x8

Neck Machine, 10 repsBar Hang, 1:00-1:30

TUESDAYSpeed LadderAbs, 50-100 reps Split Squat & Press

WEEKS 1-4: 3x4 (each leg)WEEKS 5-6: 2x3 (each leg)

Power Clean (cycle)Clean Pulls (cycle)

WEEKS 1-3:Lateral Squat, 1x6Speed Squat (50% of Max), 4x5Pull-Ups (vary grip), 3x5-10

WEEKS 4-6:Snatch Squat, 2x5Box Step-Ups, 3x5 (each leg)Barbell Lunges, 2x5

Explosive Dumbbell Core Rows, 3x8

Calf Raises, 20 reps

THURSDAYDot DrillsAbs, 50-100 repsSnatch, 4x3Bench Press (cycle)

WEEKS 1-3:Alternating Dumbbell Bench, 3x5Weighted Dips, 4x6Dumbbell Curls, 3x8

WEEKS 4-6:Plate Raises from Squat Position,

2x10 One-Arm Core Press, 3x6Dumbbell Lying TricepsExtensions, 6x8 (15 sec. rest)Straight Bar Curls, 1x15, 1x12,

1x10

Farmer’s Walk, 1:15-1:30 min.Neck Machine, 10 reps

FRIDAYJump RopeAbs, 50-100 repsPush Jerk Warmup, 3 reps

WEEKS 1-2: 5x3WEEK 3: 3x3, 3x2WEEK 4: 3x3, 1x2, 3x1WEEK 5: 4x3WEEK 6: 3x3, 1x2, 2x1

Squat (cycle)

WEEKS 1-3:Dumbbell Rows, 3x8Stiff-Legged Deadlift, 2x10

WEEKS 4-6:Lat Pulldowns, 3x10Glute Ham Raises, 2x10 ORReverse Hyperextensions, 2x10

Calf Raises, 20 reps

he following plan is for our linemen during their last phase of summer workouts before reporting to training camp.T

Request No. 27


▼

have fewer “stiff hipped” players thanbefore we incorporated these lifts.

We also like Olympic lifts andtheir variations because complexmovements allow us to incorporatemultiple body parts at once. This

allows us to more effectively use ourlimited time and space. For instance,some of the lifts we frequently performare the clean and jerk, snatch squats,split squat and press, and the powerclean-front squat combination. All of

these lifts also enable our players tolearn better body control.

We break our training year intofive phases. The first phase generallyconsists of a six-week cycle that beginsin January when the student-athletesreturn from semester break. During thisphase, the student-athletes lift four daysa week and do agility and accelerationdrills twice a week. After completingthis phase, we test each student-athlete.

The second phase begins after thestudent-athletes return from springbreak. Again, this is generally a six- toseven-week cycle with four days oflifting. However, we begin to incorpo-rate more agility work as well as speeddevelopment work twice a week. Uponthe completion of this phase, we testour athletes before giving them thetwo-week exam period off.

The third phase, consisting of thenext six weeks, marks the start of oursummer workouts. In addition to ourlifting and agility work, we begin to add

Position Level Squat Bench Power Clean TotalLinemen Iron Eagle 500 330 290 1120

Gold 450 315 280 1045Cardinal 420 290 255 965

TE, FB, LB Iron Eagle 465 315 285 1065Gold 410 300 270 980Cardinal 380 270 240 890

S, TB Iron Eagle 415 275 255 945Gold 380 260 240 880Cardinal 355 240 225 820

QB, WR, CB, K Iron Eagle 390 260 250 900Gold 365 235 235 835Cardinal 340 220 215 775

Table Two: Award Levels

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Request No. 28


▼sprint conditioning drills twice a week.

We become more position specificin the workouts during the fourthphase, which covers the last six weeksof summer before our players report.Skill players lift weights three days aweek and perform sprint conditioningand agility drills five days a week.Linemen, tight ends, and linebackersmaintain their previous workout regi-men. We test our players when theyreturn from summer break at the end ofthis phase.

Most of our players do not stay oncampus during the summer, so wedon’t introduce any new lifts duringthe third and fourth phases. Many ofour athletes use the strength trainingfacilities at their former high schoolswhile home for summer. If they can’t,we work with them to find an appro-priate work out venue. We find they areself-motivated to complete the work,since it helps determine whether theywill win a starting spot in the fall.

Tables One and Three provide anexample of how we prepare our linemenfor the final six weeks leading up to thecamp reporting date. We use a variety ofexplosive lifts in addition to our corelifts consisting of the power clean,squat, and bench press to peak our ath-letes’ strength and power for the upcom-ing season. We also work in hand-speeddrills to reinforce hand placements andgenerate punching power and upper

body endurance. Hip mobility drills areanother important area we try to addressthroughout this phase.

The fifth phase is our in-seasonwork. Our top 60 players lift twice aweek, while the other players lift threedays a week. The extra day of lifting isdesigned to help those players developenough strength and power to be effec-tive on the field.

MOTIVATIONAL TOOLS

One of the best motivational tools weuse at Bridgewater College is ouraward level system. We test our playersin three lifts—the squat, bench press,and power clean—then categorizethem by their scores. We break downthe players by position and have fouraward levels for each position (seeTable Two on page 42).

Our first award level is theCardinal level. These numbers repre-sent the minimum amount of weightwe think a player should be able to lift

We test our players in

three lifts, then

categorize them by

their scores. We break

down the players by

position and have

four award levels.

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▼

to be competitive. A player must meetthese requirements in all three lifts toachieve Cardinal status. If they don’treach Cardinal status, we keep workingwith them until they do.

Our next award level is the Goldlevel. This level encompasses playerswho generally are able to make a big-ger contribution to the program. As aplayer approaches the Gold level, hisplaying time usually increases. In orderto achieve Gold level status, a playermust reach Gold level in two exercises

as well as the total. We do this toacknowledge progress and to ensurewe get explosive athletes, not justbench pressers.

The Iron Eagle level is reachedwhen a player meets the Iron Eaglerequirement in one exercise and thetotal. Players who achieve this leveltend to become starters and often reachall-conference status.

And finally, our last award level iscalled Super Iron Eagle. To reach thislevel the athlete must achieve the Iron

Eagle requirements for all three lifts.Players who achieve this award level—almost to a man—are starters and manyreap postseason honors. The playerswho have achieved Super Iron Eaglestatus include numerous all-conferenceplayers and All-Americans as well asschool record holders in passing, rush-ing, receiving, and total yardage. Thus,it is evident our strength and condition-ing strategies have been effective inproducing game results, not justweightroom numbers. ◆

MONDAYPRE-WORKOUTHigh KneesWalking Toe Touches“B” SkipsLow ShuffleForm Starts, 5 sets x 10 yd.Jump Rope Abs

POST-WORKOUTWeeks 1-2:3 x 400s (Rest 2:50 between

sprints)4 x 200s (Rest 1:30 between

sprints & 2:00 after last 200)5 x 110s (Rest 45 sec. between

sprints)6x 40s (Rest 15 sec. between

sprints)

Weeks 3-4:14 x 110s (Rest 45 sec. between

sprints)

Weeks 5-6:16 x 110s (Rest 45 sec. between

sprints)

TUESDAYPRE-WORKOUTWalking Knee HugsButt KicksPower Skips For HeightCariocaPosition Starts, 5 x 10 yd.Speed Ladder, 6 setsAbs

POST-WORKOUTHalf Moons, 5 each wayCircles, Individual & Chase,

4 sets eachFigure Eights, 4 setsTennis Ball Drills, 3 sets Punch Drill (upper body)Hip Mobility - Hurdles (cycle)

THURSDAYPRE-WORKOUTHigh KneesWalking Toe Touches“B” SkipsPower Skips For DistanceForm Starts, 5 sets x 10 yd.Dot Drills, 4 sets x 15 sec.Abs

POST-WORKOUTWeeks 1-2:11 x 110s (Rest 45 sec. between

sets)

Weeks 3-4:Pattern Run Speed PackFour-Quarters (Arm Action Drill)

Week 5:18 x 110s (Rest 45 sec. between

sets)

Week 6:Pattern Run Speed PackFour-Quarters (Arm Action Drill)Hip Mobility-Hurdles (cycle)

FRIDAYPRE-WORKOUTWalking Toe TouchesWalking Knee HugsLow ShufflePosition Starts, 5 x 10 yd.Jump Rope, 1:30Abs

POST-WORKOUTWeeks 1-2:Cone DrillsFour-Corner DrillButterfliesIron CrossFigure Eights90-Degree Power CutGet Up and Sprint, 5 setsPunch Drill (cycle)

Weeks 3-4:Pattern Runs (speed cuts, power

cuts, spins)Circles-Individual & Chase (4 sets

each)Punch Drill (cycle)

Weeks 5-6:Cone DrillsFour-Corner DrillButterfliesIron CrossFigure Eights90-Degree Power CutGet Up and Sprint, 5 setsPunch Drill (cycle)

Table Three: Preseason Conditioning Work

The next generation in sports specific training equipment has arrived! Genetic Potential is proud to unveilthe ultimate in low-load velocity-specific training. The revolutionary V6 represents the perfect combination ofengineering and sports sciences; uniquely designed to optimize lower and upper body reactive power.

The VertiMax Collegiate and Pro models are already well established at the nation's most respected sportsmedicine facilities. The new V6 model now offers unique head-to-toe transfer to all fields of play. If you needa training tool that will make a difference your athletes can feel and their coaches will see, VertiMax is theanswer. Call today and take another step in elevating your programs and distinguishing your facility.

The ultimate way to increase explosive leg power,vertical jump & first step quickness.

Request No. 30

Nutritional Products

COOPER CONCEPTS, INC.877-2-HEALTH (243-2584)WWW.COOPERWELLNESS.COM

Sold direct or through distributors: Directto consumers through the company’s Website and toll-free number. Also available athealth food stores, and sports clubs/gyms.

�COOPER COMPLETE JOINTMAINTENANCE FORMULA

Primary Ingredients: Glucosamine,chondroitin & bromelain ... QuantityDiscounts/Pricing: $29.95-One month sup-

ply. 20 percent discountfor Training &Conditioning readers.Use coupon code “TRAIN-ING” through toll-freenumber or on Web site.... Primary Advantages:Maintain and supporthealthy joints with thisblend of glucosamine,chondroitin and brome-

lain. Glucosamine and chondroitin areamino sugars that occur naturally in thebody and work to lubricate the joints andpromote flexibility. Bromelain, an extractfrom the stem of pineapple, is useful forreducing muscle and tissue inflammation.

Circle No. 50

�COOPER COMPLETE BASIC ONE

Primary Ingredients: Multivitamin andMinerals ... Vitamins and Minerals: E, D,B6, B12, folic acid ... QuantityDiscounts/ Pricing: $16.95-Two month

supply. 20percentdiscount forTraining &Conditioningreaders. Usecoupon code“TRAINING”through toll-free number

or on Web site. ... Primary Advantages:Cooper Complete Basic One is formulatedto meet the needs of those who want tocover their “basic” vitamin and mineralrequirements with just one tablet a day.Basic One includes levels of antioxidantsand “B” vitamins you won’t find in compet-ing “one a day” products, including 400 IUof natural vitamin E, 200 mg of vitamin C,and 800 IU of vitamin D, plus optimumlevels of the key nutrients, B6, B12 andfolic acid. Basic One comes in both anIron Free formulation (suggested for menand post menopausal women) and a WithIron formulation (suggested for women of

child bearing age.)Circle No. 51

GATORADE 877-3-PROPELWWW.PROPELWATER.COM

Sold direct or through distributors:Grocery stores, convenience stores, clubstores, and drug stores.

�PROPEL FITNESS WATER

Primary Ingredients: Filtered water, naturalflavors, sucrose syrup ... Calories PerServing: 10 ... Protein/Carbohydrate/FatContent: 0%/1%/0% ... Vitamins and

Minerals: B6,Niacin,PantothenicAcid, B12, C, E... QuantityDiscounts/Pricing: 700ml$1.19-$1.39 ingrocery, 6-pack$4.49, C-store

$1.39-$1.49, 500ml $.99 ... PrimaryAdvantages: Created by the hydrationexperts at The Gatorade Company, PropelFitness Water is lightly flavored to encour-age improved hydration over plain water.Propel also contains vitamins for an activelifestyle.

Circle No. 52

�GATORADE NUTRITION SHAKE, NEWIMPROVED FORMULA—BETTER TASTE

Calories Per Serving: 370 ...Protein/Carbohydrate/Fat Content:20g/54g/8g ... Vitamins and Minerals: C,

calcium, and iron ... QuantityDiscounts/ Pricing: N/A ...Primary Advantages:Gatorade Nutrition Shake is abalanced nutrition supplementthat is ideal as a nutritioushigh-energy meal replacement,

or a pre-event or between-meal snack.Gatorade Nutrition Shake is for athleteswho want to perform at their best, andoften need to supplement their diet with aconvenient, balanced, and nutritious prod-uct. Gatorade Nutrition Shake is availablein two flavors—chocolate and vanilla.

Circle No. 53

HORMEL HEALTHLABS800-866-7757WWW.HORMELHEALTHLABS.COM

Sold direct or through distributors:Through Distributors.

�PLUS-2™

Primary Ingredients: Milk, milk protein

concentrates, high fructose corn syrup,malto dextrin ... Calories Per Serving: 8oz. = 480 calories ...Protein/Carbohydrate/Fat Content:16g/48g/24g ... Vitamins and Minerals:

Vitamin H20%, VitaminC 26%,Calcium 60%,Riboflavin15%,

Phosphorus 15% ... Quantity Discounts/Pricing: NA ... Primary Advantages: Extraeffort takes extra calories. HormalHealthLabs’ Plus-2 is packed with 960calories and 32 grams of protein in every16 oz. serving—perfect for sustaining orgaining weight. Plus-2 is specially formulat-ed for weight gain.

Circle No. 54

SUN CHLORELLA USA800-605-6556WWW.SUNCHLORELLAUSA.COM

Sold direct or through distributors: Directto consumers through the company’s Website and toll-free number. Also available athealth food stores.

�SUN CHLORELLA GREEN SUPERFOOD

Primary Ingredients: Naturally super-concentrated with vitamins & minerals, pro-

tein, dietaryfiber, beta-carotene, nucle-ic acids (RNAand DNA),ChlorellaGrowth Factor

(CGF), high amounts of chlorophyll, andessential amino acids ... Calories PerServing: 15 calories per 3 gram serving ...Protein/Carbohydrates/Fat: 2g/1g/0g ...Quantity Discounts/Pricing: Discounts andpricing from Sun Chlorella USA vary due tothe many specials that are available ...Primary Advantages: SUN CHLORELLA is afreshwater single-celled green alga.Chlorella may strengthen the immune sys-tem, improve digestion, provide daily detoxi-fication of impurities in the environment,escalate energy levels, maintain healthy tis-sues, and revitalize and fortify the entirebody at the cellular level. With its exclusivepatented pulverization process utilizing theDYNO®-Mill, Sun Chlorella has made thenaturally indigestible chlorella cell 85%digestible. This assures your body optimumassimilation and digestion of all of chlorel-la’s precious and vital nutrients. Contactthe company for a free sample and freehealth journal.

Circle No. 55


N o w i t t a k e s o n l y m i n u t e s .

step oneCreate your account and log in. Thentype in your product specs. Your productrequirements are then e-mailed to allrelevant vendors.

step twoWithin the time period you select,you’ll receive an e-mail response fromsuppliers, with information on theproducts they offer that meet yourspecial needs.

step threeYou contact the suppliers youare interested in by e-mail orphone!

w w w. a t h l e t i c b i d . c o m

I t u s e d t o t a k e h o u r s t o r e s e a r c h p r o d u c t s . . .I t u s e d t o t a k e h o u r s t o r e s e a r c h p r o d u c t s . . .

N o w i t t a k e s o n l y m i n u t e s .

Enabling athletes toplay despite shoulderinjuries"I recently dislocated my shoulder playingbasketball. When I wore the Cadlow withthe black tubes it worked great. I used tohave a MAX shoulder harness, but it took

away almost all ofmy motion. TheCadlow gives me aFULL RANGE ofmotion. It has alsostrengthened myshoulder. I've hurtmy shoulder playingfootball, lacrosse,and basketball butfeel great about

doing all of them with the Cadlow. ICAN'T SAY ENOUGH ABOUT THECADLOW!! I LOVE IT!!”

Rory CooperBoulder, CO

"It worked great. . .The brace was reallyexcellent and we would recommend it toanyone who has shoulderdislocation/subluxation problems. I won-der if my son had had the brace afterrecovery from the first dislocation, if hemight have avoided surgery.”

Susan LutostanskiPediatric Occupational Therapist

Arlington Heights, IL

"My athlete was able to continue as afootball quarterback and defensive back.He said the Cadlow worked well enoughto allow him to finish the last threegames of the season with no major prob-lems. He was able to throw and catchfootball without any apprehension."

John V. Joslin A.T.C/LTulsa, OK

DM Systems, Inc.1316 Sherman Ave., Evanston, IL [email protected]

WWW.DMSYSTEMS.COM

Catalog Showcase

CREATIVE HEALTH PRODUCTS800-742-4478WWW.CHPONLINE.COM

Creative Health Products, in businesssince 1976, is a leading discount suppli-er of rehabilitation, fitness, exercise, and

athleticequipment andalso health, med-ical, fitness test-ing, andmeasuring prod-ucts all atdiscountedprices. Productsinclude heart ratemonitors, blood

pressure testers, pulse oximeters, body-fat calipers, scales, strength testers,flexibility testers, stethoscopes, pedome-ters, exercise bikes, ergometers,stopwatches, fitness books andsoftware, exercise bands, step benches,hand and finger exercisers, heatingpads, and more.

Circle No. 112

POWER SYSTEMS, INC.800-321-6975WWW.POWER-SYSTEMS.COM

Since 1986 Power Systems has been aleading supplier of sport training, healthand fitness products. Power Systems

prides itself inbeing the oneresource for all ofyour trainingneeds. Its new2004 catalog hasa new look withbetter graphics andphotos. Includedareas are corestrength, medicine

balls, speed, plyometrics, agility,strength equipment, strengthaccessories and flooring. You will findthe catalog full of hundreds of new prod-ucts and dozens of products availableexclusively from Power Systems. Thecompany has also lowered some of itsprices to enable the customer to get pre-mium products at great prices. Go on-line or call Power Systems to request afree 2004 catalog today.

Circle No. 113

A versatile tool forimproving flexibilityand strength

”The Flex Band® is the most innovativestrength and conditioning product I’ve seenin the last 15 years. The bands are so ver-satile that they can be used for strength,conditioning, flexibility, and to improve run-ning speed.”

Al Johnson, Strength CoachOhio State University

”We would recommend the Flex Band®to any coach at all levels. With the easy-to-follow stretching routines that are availablewith the Flex Band, it makes it a reliablesource for improving flexibility and strengthof the muscle tissues.”

Rich Tuter, Strength & Conditioning CoachDenver Broncos Football Club

”Band training is a fantastic tool fordeveloping speed strength, speed strengthendurance, starting strength, staticstrength, reversal strength, power, and flexi-bility, and serves as an excellent rehabilita-tion tool. The multi-purpose bands can beused independently, or in conjunction withfree-weight equipment. We have found bothmethods to be very beneficial in the devel-opment of the athletes.”

Joey Batsor, Director of Strength &Speed ConditioningClemson University

Jump Stretch, Inc.1230 N. Meridian Rd., Youngstown, OH 44509800-344-3539

WWW.JUMPSTRETCH.COM

Rehabilitation Products

3-POINT PRODUCTS888-378-7763WWW.3POINTPRODUCTS.COM

Reflex® Putty with Memoryflex®, from 3-Point Products, increases resistance themore it is pulled. Reflex® Putty can be

pulled andstretchedlikeexercisebands but,unlike

bands, it provides consistent resistancethroughout the range of stretch. Musclesreceive resistance throughout theircontraction for a more effective strength-ening regime. Reflex Putty is available inthree resistance levels and in the new ProSeries for athletes and others requiring ahigher resistance level for rehabilitation.

Circle No. 57

BALL DYNAMICS INTERNATIONAL 800-752-2255WWW.BALLDYNAMICS.COM

Achieve deep muscular and fascial

release withthisgroundbreak-ing body thera-py program.The FitBALL®Small BallRelease

Program provides complete step-by-stepinstructions for releasing tension in thepelvic, hip, back, neck, and shoulderareas. Use three balls of decreasing sizefor increasing challenge as you enhanceyour skill level on this self-guided journey.The professional set includes one ball ofeach size, a 45-minute instructional videoand an 80-page manual.

Circle No. 58

CHATTANOOGA GROUP800-592-7329WWW.CHATTGROUP.COM

Chattanooga Group is pleased tointroduce the new Vectra™ Genisys.Vectra Genisys is the first modular therapysystem that consolidates six therapeuticmodalities into one system. The clinician

can access dual channelsEMG, sEMG activated mus-cle stimulation, multiplewaveform electrotherapy,dual frequency ultrasound,and combination electrother-apy. The Genisys also offersthe ability to add two morechannels of electrotherapy,a battery or a future lasermodule.Circle No. 59

Chattanooga Group is offering a new lineof PresSsion Compression TherapySystems, the Multi 6 and the Multi 3.

Both are trulyhighperformancegradientsequentialcompression

systems at an economical price. The Multi6 is the top of the line, offering adjustabletreatment parameters and therapy timecontrol. The economical Multi 3 isdesigned for home therapy or clinical use.

Circle No. 60


The lightweight,

flexible Action

Ultra MP

reduces pain

from Arthritis,

Tendinitis and Ligament

Injuries. Ultra splints can be

custom fit in seconds.

Call for our introductoryoffer and a free catalog:

888-378-7763

Visit our on-line catalog at:www.3pointproducts.com

Also trythe Action

Ultra Spica for thumb and wrist

control.

Stevensville, Maryland

✸newthumb splints

®

ActionUltra MP

Request No. 31

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CONTEMPORARY DESIGNCOMPANY

800-411-1979WWW.SHUTTLESYSTEMS.COM

From acute phase closed chain activitiesto end stage plyometrics, the ShuttleMVP leads the way in progressivefunctional rehabilitation and training. Its

horizontalreboundtechnologyutilizessmooth andpredictable

resistance, perfect for unstable joints, andrapid non-weight bearing rebounding toimprove the eccentric phase necessary forinjury prevention and the development ofpower.

Circle No. 61

The Shuttle Balance functionally trainsthe neuromuscular system of athletes toseniors alike. It’s long been recognized

that the body’sability to negotiateunpredictablechanges in force,direction, andplacement in spaceat the neuromuscu-lar level are criticalbuilding blocks forperformance and

skill development. The Shuttle Balanceprovides a safe platform for individuals todevelop and hone proprioceptive respons-es while performing a variety of activities.

Circle No. 62

CRAMER PRODUCTS, INC.913-856-7511WWW.CRAMERSPORTSMED.COM

Cramer Co-Stretch Non-Adhesive StretchTape is the innovative choice overtraditional stretch and self-adhering tapes.Excellent tensile strength, clean tears, and“no-slip grip” combine for many

advantagesover othertapes. Useas ananchor fortape applica-

tions. It is excellent for use as a compres-sion bandage and it contours to the bodyto allow for effortless wrap of anyappendage.

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DM SYSTEMS, INC.800-254-5438WWW.DMSYSTEMS.COM

Cadlow™ Shoulder Stabilizer, the multi-sport, dynamic shoulder stabilizing brace,is available from DM Systems, producersof wound care and orthopedic rehab prod-ucts. Specifically for chronic subluxationsand sporadic dislocations of the shoulder,Cadlow Shoulder Stabilizer allows the ath-lete to fully function in his or her sportwithout fear of shoulder pain or re-injury. It

Check out www.AthleticBid.com to contact these companies.

The serious athlete relies on the Shuttle Balance for – • Proprioception • Pertubation training • Dynamic core stabilization • Fun and creative

sport-specific activities

As powerful as it is versatile, theShuttle MVP is ideal for – • Skill development • Explosive overspeed plyometrics • Strength training • Aerobic and anaerobic conditioning • Functional rehabilitation

by Contemporary Design Co.

Call or visit on-line www.shuttlesystems.com for more information or to find the authorized dealer nearest you. Call toll-free 800-334-5633

Your Dynamic Duo!Lightning-Fast Plyometrics & Action-Ready

Core Stabilization Make This Duo More

Dynamic Than Any Other System.

Lightning-Fast Plyometrics & Action-Ready

Core Stabilization Make This Duo More

Dynamic Than Any Other System.

Your Dynamic Duo! Shuttle MVP

Shuttle MVP

★★

★★

★

★★

★

★ShuttleBalanceShuttleBalance

★

★

★

★ ★

★

★

★

★

Request No. 33



provides glenohumer-al stability whilemaintaining the ath-lete's full range ofmotion (ROM). Thisstabilizer's uniquepatented pull systemstrengthens theshoulder by providinggraduated resistancethrough the full ROM.

The variable resistance can be increasedas the athlete's strength increases. Cadlowprotects the athlete by helping to preventrecurrent shoulder subluxations and dislo-cations without restrictingmotion/movement. It can also be used forpost-operative protection andstrengthening.

Circle No. 64

In response to requests from rehab profes-sionals, DM Systems, manufacturer of theAnkleTough® Rehab System, hasintroduced low-cost eight-packs for each ofthe four resistive tension straps. The origi-nal system pack, comprised one each ofthe four color-coded resistive tension

straps, will continue to be offered. But forthose rehab professionals who prefer to

purchase alimited resis-tance offeringbased on theirtypical patientprofile, thenew eight-

packs fill the requirement. The eight-packsare offered in a handy, clear pouch with azip lock top. Each package also contains acomplete full-color instruction guide.

Circle No. 65

DONOVAN INDUSTRIES, INC.800-345-3456WWW.DONOVANINDUSTRIES.COM

Donovan™ Fitness Balls help athletesdevelop corestrength in theirabdominal andback regions,which improvesphysical perfor-mance.Donovan™

Professional Burst-Resistant balls will notrapidly deflate like the cheaper balls and allDonovan™ Balls come with a pump andmeasuring device to assure properinflation. Experts strongly recommend usingthe correct size therefore Donovan offerseight sizes to cover all athletic needs.

Circle No. 66

Donovan’s new Multi-Use Shoulder Pulleyincreases range of motion in all planes ofshoulder movement. The design makes therehabilitation process quicker, easier, and

convenientas well ascomfortable.The Multi-UseShoulderPulley

features durable plastic handles, nylonwheel, web door attachment, super strongbut lightweight construction and anexercise manual. Used at home, it allowspatients to increase gains made in the clin-ic and helps speed the recovery process.

Circle No. 67

This ingenious, comfortable deviceprevents plantar flexion during rest

and helps alleviate the pain anddiscomfort associated with plantarfasciitis, leg calf cramps, and otherconditions. Adjustable dorsiflexion

settings at 0°, 5° and 10° withintegrated toe wedge.

Available at Fine Home Medical DealersNationwide, Circle Response Card or Call

FLA ORTHOPEDICS®

1-800-327-4110

©2003FLA Orthopedics, Inc.,Miramar, FL 33025

PLANTAR FASCIITIS

NIGHT SPLINTRESTING COMFORT SLIPPER™

For more information,please visit

www.HealWellinfo.com

Finally, a Plantar Fasciitis Night SplintComfortable Enough to Sleep In!

Request No. 34



FERNO888-206-7802WWW.FERNOPERFORMANCEPOOLS.COM

Ferno Performance Pools now offers thecomplete line of MedZone® topical reliefproducts, which are proven to last longer

thancompetitors tominimizeswelling, scar-ring and scab-bing. With six

formulas available, trainers can treat painimmediately, and continue treatment withother products as the athlete heals. TheMedZone formula line includesPainZone®, BurnZone®, ChafeZone®,DepthZone®, MassageZone®, andDermalZone®. MedZone products targetthe source of the condition quickly to getathletes back in the game faster.

Circle No. 68

Toss the bulky ice bags and never againhave to worry about re-freezing wraps totreat athlete sprains and strains. FernoPerformance Pools now offers Liquid Ice™

non-dyed, non-adhesivebandages totreat athleteinjuries usingcompressioncooling. LiquidIce reduces painfast, and stayscold for two

hours, which is six times longer than thenearest alternative! The bandages arewashable and reusable with a rechargersolution for up to 40 applications.

Circle No. 69

FLA ORTHOPEDICS, INC.800-327-4110WWW.FLAORTHOPEDICS.COM

The Thermal Lumbar Support, from FLAOrthopedics, Inc., is ideal for treatingminor back aches and pains resultingfrom sprains, muscle soreness andstrains, cramping, or contusion (bruising).It features a reusable soft gel pack—ther-mal gel is microwavable for therapeuticheat and freezable for cold therapy. The

ThermalLumbarSupport hasplush, venti-lated elasticpanels—lightweightfor cool,

comfortable compression. The panelsoverlap to give a contouring shape tomost body types. Easy applied, the ther-mal lumbar support is available in blackand beige.

Circle No. 70

FOOT MANAGEMENT800-HOT-FOOTWWW.FOOTMANAGEMENT.COM

Foot Management, Inc., manufactures awide vari-ety offootpadsand otherfoot relat-ed prod-ucts forall your

Request No. 35


athletic needs. For a detailed descriptionon the footpads and their application, visitwww.footmanagement.com. FootManagement also manufactures customorthotics, moleskin, felt, Turf Toe plates,and off-the-shelf insoles. Make FootManagement your distributor and wearwhat the pros wear.

Circle No. 71

GAME READY INC.866-266-5797WWW.GAMEREADY.COM

Trainers for more than 50 pro teams and70 universities turn to the Game ReadyAccelerated Recovery System to help theirinjured athletes heal faster. The portablesystem consists of a control unit, whichdelivers adjustable cold therapy and four

levels of intermit-tent compression,and patentedwraps based onNASA spacesuittechnology. Theeasy-to-administertreatment reducespain and swelling,

resulting in accelerated recovery time andstronger healing.

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THE GEBAUER COMPANY800-321-9348 WWW.GEBAUERCO.COM.

The Gebauer Company has introducedGebauer’s Spray and Stretch, whichreplaces Gebauer’s Fluori-Methane. Non-

ozone depletingGebauer’s Spray andStretch is a nonflam-mable topical skinrefrigerant intendedfor use with theSpray & StretchTechnique in themanagement ofmyofascial pain,

restricted motion, muscle spasms, andthe temporary relief of minor sportsinjuries. Used to reduce or relieve the ini-tial trauma of an injury, Gebauer’s Sprayand Stretch controls the pain of bruises,contusions, swelling, and minor sprains.

Circle No. 73

From the most trusted name in skin refrig-erants for over 100 years comes a new,non-prescription topical skin refrigerant,Gebauer's Instant Ice™. Use it like ice for

the temporary relief ofminor pain and swellingfrom sprains andstrains, minor sportsinjuries, bruising, andcontusions. Instead ofusing ice to treat on-the-scene minor sportsinjuries, high school and

recreational league coaches, high schoolathletic trainers, and others will now beable to use what professional athletictrainers recommend. In fact, Jim Ramsay,head athletic trainer for the New YorkRangers, has been using Gebauer topicalskin refrigerants for years. "Instant Ice isgreat for on-the-scene care," said Ramsay."If a player gets hit on the wrist or takes apuck off the shin, I can easily anesthetizethe area with Instant Ice to reduce thepain, allowing the player to get back in thegame quickly.”

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© 2004 NZ MFG LLC, Tallmadge, OH T&C 0404

This Season be Faster! Quicker!Stronger!

Perfo

rm Be

tterW

ithTu

rfCord

z!

TurfCordz are distributed by M-F Athletic Company

TurfCordz Cuff Tuffshown with

MediCordz Wall Mount(sold separately)

TurfCordz TMCuff Tuff offers...• Outstanding shoulder

rotator strengthening!• Performs both internal and

external rotation exercises! • Available in 5 resistance levels!• Maximum comfort and function

at a reasonable cost!• The safety and reliability

professional athletes demand!• To learn more call us at

800-556-7464 or visit us onlineat www.performbetter.com

Request No. 37

HOW TO REQUEST OR RENEW

A FREE SUBSCRIPTION:The easiest way is to complete the subscrip-tion request card provided in every issue. If arequest card is not available, then on yourinstitution’s letterhead provide us with your:

1. request to receive or renew a free subscription

2. signature and date of request3. title and school name4. mailing address

ARE YOU MOVING?The USPS will not forward your subscription.In order to keep receiving your free subscrip-tion, you must notify us and provide us withyour:

1. new mailing address2. title and school name3. signature and date of request

All subscription requests and changes ofaddress must be in writing, and mailed to:

TRAINING & CONDITIONING,SUBSCRIPTION DEPT.,

PO BOX 4806, ITHACA, NY 14852-4806or faxed to: 607-257-7328

Attn: TRAINING & CONDITIONING, SUBSCRIPTION DEPT.


KEISER CORPORATION800-888-7009WWW.KEISER.COM

Success, 1/10 pound at a time! TheInfinity Series Equipment, from KeiserCorporation, allows for full freedom of

movement.This ultimateequipmentallows individu-als to trainsafely at anyresistance, atany speed and

at any angle without shock-loading thejoints! These pieces allow for an infinitenumber of exercises and are spaceefficient.

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PERFORM BETTER800-556-7464WWW.PERFORMBETTER.COM

Perform Better has introduced SmartHurdle, a lightweight training hurdle youcan easily set up, transport, and store.

The uniquethree-pointbase systemdecreasesthe chanceof steppingon the legwhen the

hurdles are close together. Use for overand under hurdle walks, hops, jumps, andmore. Available in four sizes: 6" and 12"high with carry handle, and adjustable12"-18", and 21"-30" sizes, both of whichfold flat for easy carrying.

Circle No. 76

NATIONAL ACADEMY OF SPORTSMEDICINE (NASM)

800-460-6276WWW.NASM.ORG

The athlete’s ability to consistentlyperform at higher levels while avoiding

injury is essential tohis long-termsuccess in any sport-ing arena. Drawingon the exclusiveOptimumPerformanceTraining™ (OPT™)method—a systemthat has successfullyempowered peakperformance in pro-

fessional, Olympic, college, and high-school athletes—Optimum PerformanceTraining™ for the PerformanceEnhancement Specialist sets the interna-tional pace for athletic training and sportsmedicine professionals.

Circle No. 77

The National Academy of Sports Medicine(NASM) is proud to present Body Map, aunique, state-of-the-art dynamic movement

assessment and pro-gram-design tool thatwill revolutionize theway you train.Whether your goal isto lose fat, gain mus-cle or increase yourperformance in aspecific sport, BodyMap helps you reachyour goals quickly,

safely and effectively. Based on NASM’sexclusive Optimum Performance Training(OPT™) model, Body Map takes less than10 minutes and creates individualizedassessments and corrective strategies,including flexibility, postural control andfunctional strength. If success is your des-tination, let the Body Map be your guide!For more information about where you canget your Body Map, visit www.nasm.org.

Circle No. 78

NZ MFG. LLC800-886-6621WWW.NZMFG.COM

NZ Mfg. LLC's TurfCordz Cuff Tuff is aportable tool designed for shoulder

strengthening. It is usedto perform internal andexternal rotation exercis-es to rehabilitate aninjury or to help preventone. Made with the high-est quality materials forsafety and security, it isavailable in fiveresistance levels. Tolearn more about the full

line of innovative TurfCordz products, callthe company or view its entire catalogonline.

Circle No. 79

OAKWORKS, INC. 800-558-8850WWW.OAKWORKS.COM

The Boss is a great treatment tabledesigned specifically for ATCs. Itslightweight design and protective carrying

case help it traveleasily from trainingrooms to sidelines.The uniquealuminumunderstructure istough enough to

support a 600-lb. UL weight load ratingand the sealed seams and removablefield feet mean the Boss works rain orshine. Easy height adjustments make theBoss the ergonomic answer for every ATC.

Circle No. 80

The ProLuxe™ is an affordable, hardworking, steel framed lift table that willmake your work much easier. With a highperforming super quiet lift motor and extra

wide top, bariatricpatient transfer ofup to 550 lbs iseasy. TheProLuxe isadjustable to alow position of18", enablingwheelchair trans-

fer and helping to qualify for the ADA taxcredit. Plus with five different top optionsand automatic locking wheels the ProLuxecan be easily moved from room to room tosupport a wide variety of modalities andtreatments.

Circle No. 81

OPTP800-367-7393WWW.OPTP.COM

OPTP's newly designed and expanded full-color Volume Sixteen Catalog featuresnew publications from internationally-

renowned physicaltherapy experts,including RickJemmett PT, DianeLee PT, RobinMcKenzie, BrianMulligan PT, andmore. OPTP stilloffers standardssuch as Thera-

Band®, new formulated Rep-Band™,Gymnic® Balls, OPTP Foam Rollers, andthe Original McKenzie® Lumbar Rolls, theStretch Out® Strap, as well as newresources based on Pilates, post-partumhealth, and core stability.

Circle No. 82

OPTP has introduced the versatile, inflat-able exercise roll called the FitBALL®Roller. It is a new exercise roll that com-



bines the best aspects of inflatable exer-cise balls and foam rollers into onedynamic inflatable fitness roll for the

entire body.The FitBALLRoller allowsyou toinflate toyour person-al comfortlevel to opti-

mize exercises that strengthen and tonethe abs, obliques, and core musclegroups. Improve stability and balance,stretch more effectively or use for mobilityexercises. The dynamic, adjustable firm-ness of the FitBALL Roller provides anideal stability challenge for prone andsupine exercises.

Circle No. 83

BIOFREEZE800-246-3733E-MAIL: [email protected]

For pain management programs,Performance Health, Inc., offersBiofreeze®, which can help reduce

swelling, painand stiffness;increase mobil-ity and recov-ery time; andeffectively aidin the overallhealingprocess. ApplyBiofreeze

before, during and after each therapy ses-sion to reduce swelling and stiffness,enabling greater range of motion and flexi-bility for therapeutic exercises. Biofreezecan enhance any situation that wouldrequire the use of ice and breathablewraps and also enhances and prolongsthe benefits of ultrasound, electrical stim-ulation, and massage therapy treatments.

For more information and your no-chargetrial package please contact the company.

Circle No. 84

Biofreeze® is an extremely effective topi-cal pain reliever used in Pain ManagementPrograms to treat athletic injuries, muscleinjuries and strains, stiff joints and

upper/lower backpain and spasm.Biofreeze helps withboth deep triggerand soft tissuework. Prior to mas-sage, it helpsathletes relax for amore effective treat-ment and minimizespost-treatment

swelling when applied after massage.Athletes who rarely bother to use ice canbe counted on to use Biofreeze. Athletescan also use Biofreeze at home to relievepain. Biofreeze is available in a no-touchroll-on, perfect for trainers’ supply bag.

Circle No. 85



Request No. 38


POWERWEB888-823-0310WWW.PWRWEBINTL.COM

PowerWeb is the all-in-one finger, hand,wrist, forearm, and ankle exerciser. Itallows duplication of all joint actions: flex-

ion, extension,opposition andsupination.OriginalPowerWebcomes in sixcolor-coded resis-tance levels, andthe new Power-

Web Combo offers two resistance levels inone. Call the company or visit its Web sitefor a complete brochure.

Circle No. 86

PRO-TEC ATHLETICS800-779-3372WWW.INJURYBEGONE.COM

Iliotibial Band Syndrome, commonlyreferred as ITBS, is a difficult injury totreat. Pro-Tec Athletics does, however,

have an answer. TheIliotibial Band Wrap, byPro-Tec Athletics, stabi-lizes the IT Band andreduces stress to thearea, alleviatingsymptoms of ITBS.Applied above the patel-la, it is designed with a

compression pad that provides direct com-pression on the Iliotibial Band.

Circle No. 87

Unparalleled in comfort and effectiveness,the Shin Splints Compression Wrap, byPro-Tec Athletics, alleviates symptoms of

medial and anteri-or shin splints. Itincludes acompression stripto provide targetedcompression. Thishelps prevent tear-

ing of the soft tissue away from the tibia.In addition, the Shin Splints CompressionWrap absorbs stress to the tibia and helpsstabilize the area. Its contoured designkeeps pressure off the calf area in casesof Medial Tibial Stress Syndrome.

Circle No. 88

RICH-MAR CORPORATION800-762-4665WWW.RICHMARWEB.COM

Rich-Mar’s new AutoSound 7.6 Combouses the patented Hands-Free ultrasounddesign now combined with a two-channel

stimulator for Hands-Free Combo and theAutoPrism Light Therapy attachment. The

AutoSound 7.6Combo designprovides bettertreatments andincredible time-savings forultrasound,combination,and light thera-

py treatments, therefore allowing longer,more effective treatments. And thatmakes for happier patients and staff!

Circle No. 89

Rich-Mar now offers innovative LightTherapy with the AutoPrism unit. Thisdevice has over 600 mW of output thatwill allow you to treat larger areas in short-er amounts of time. It has preset dosages

that allow youto apply 1J/cm2 in 30seconds oryou can applyup to 10J/cm2 in five

minutes. Perfect for a variety of soft-tissueconditions. The AutoPrism’s unique designallows you to use it as a hand-held appli-cator for quick treatments or simply strapit in place for Hands-Free use with longerprotocols. The really nice thing about theAutoPrism is its affordable price. You canget the AutoPrism as an affordable stand-alone product if you just want to add LightTherapy. You do not have to buy a wholeStim/US Combo device or a $15,000“Laser”. It is available as an attachmentfor our AutoSound Hands-Freeultrasounds/stim combos.

Circle No. 90

SPORTS HEALTH800-323-1305WWW.ESPORTSHEALTH.COM

Sports Health offers a variety of rehabilita-tion products used by athletic trainers

everywhere. Fromeveryday productslike exercise balls,stability trainers,hot/cold packs,dumbbells and icebags to the moreextensiveproducts likewhirlpools, TENSand stim units,

ultrasounds and massage therapy - SportsHealth has all the rehabilitation productsyou're looking for.

Circle No. 91

SWEDE-O, INC.800-525-9339WWW.SWEDEO.COM

The Swede-O Tarsal Lok® combines thegreater support of a rigid brace with the

superior comfort ofa lace-up brace.The upgradedFortilene stabilizermaterial will actual-ly form to theshape of yourankle simply frombody heat. The lowprofile design fitsin almost any style

of shoe, not just athletic shoes. Speedlacing system for easy application andremoval.

Circle No. 92

New Thermoskin Thermal Supports, fromSwede-O, may be used for prevention,treatment, and rehabilitation. They are

clinically proven toincrease your subcu-taneoustemperature 2 - 3°F, making muscles,tendons, andligaments moreelastic to reduce therisk of injury whenunder stress. OnlyThermoskin has

Trioxon lining that allows air flow in andwicks moisture out for hours ofcontinuously comfortable wear.

Circle No. 93

EFI SPORTS MEDICINE800-525-6901WWW.EFISPORTSMEDICINE.COM

The new Total Gym 26000 comes with abuilt-in folding wide-base squat stand thatadjusts to three heights and a highly

adaptable fold-ing foot holderthat can beraised or low-ered asrequired fortheperformance

of various lower body and trunk exercises.It also features the new Adjustable PulleyBar accessory that allows clinicians toadjust the height and width of the cablepulley angle for each individual’s size andspecific to each exercise.

Circle No. 94



No longer requiring a patient to get onand off the unit between exercises, thenew, fully electronic Power Tower, by efiSports Medicine, delivers level changes atthe touch of a button. This results in a

morecomfortableexperiencefor thepatient,fewer transi-tions, and amore cohe-sive exercisesession. The

Power Tower features a ground-breakingdynamic pulley system that adjusts to apatient’s girth and height to allow for opti-mum force angles specific to each exer-cise. Other features include a wide base,telescoping squat stand with threeadjustable heights, built in pull-up barsand a fold away foot holder for hamstringand abdominal work.

Circle No. 95

X VEST800-697-5658WWW.THEXVEST.COM

“I have found the X Vest to be an excel-lent tool for providing overloads in bothplyometric and strength training, condition-

ing, and rehabilita-tion programs. Thefit and adaptabilityare excellent. The XVest allows for free-dom of movementand doesn’tinterfere with any ofthe agility, boundingor running programsthat I write for awide variety of ath-

letes, both collegiate and professional.The X Vest has proven itself in myprograms! Thank you for all your effortsand help in improving my capability as astrength & conditioning specialist.” —Donald A. Chu Ph.D., PT, ATC, CSCS and

author of Jumping into Plyometrics. Circle No. 96

Xvest has a new weight configuration andit's heavy, 84 pounds of heavy. The newXvest, known as the Fire Fighter model,

was developedstrictly for the FireFighter and their rig-orous training. Ithas the basicdesign as the origi-nal Xvest but inter-nally it has a newweight configurationallowing for 84pounds. Because ofits ability to adjust

weight like the original Xvest, numerousindividuals from bodybuilders to the mili-tary are buying them.

Circle No. 97



How Exertoolsputs a better spinon foam rollers.

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Visit us today atwww.exertools.comor call 800-235-1559

Request No. 39

POWER•WEBCOMBO!

POWER•WEBCOMBO!

®

Now users canperform all

joint actions!Six individual

color-codedresistance levels

plus two newPower•Web Combos!

Includes fully illustrated manual!For more information, call

888-823-0310, fax 330-630-5091, oronline at www.pwrwebintl.com

POWER•WEB...The #1 Finger,Hand,Wrist, Forearm, Ankle Exerciser!

POWER•WEB...The #1 Finger,Hand,Wrist, Forearm, Ankle Exerciser!

NEW! Features TWO resistancelevels in one, for greater value

and flexibility!

*Patent Pending

*

Request No. 40

57 . . . . 3-Point Products . . . . . . . . . . . . . . . . 49

58 . . . . Ball Dynamics International . . . . . . . . 49

84 . . . . Biofreeze. . . . . . . . . . . . . . . . . . . . . . 55

85 . . . . Biofreeze (no-touch roll-on) . . . . . . . . . . 55

99 . . . . BioSkin (Gladiator) . . . . . . . . . . . . . . . . 60

100 . . . . BioSkin (Q Lok APT) . . . . . . . . . . . . . . . 60

101 . . . . Brace Int’l. (Fluk) . . . . . . . . . . . . . . . . 60

60 . . . . Chattanooga (PresSsion) . . . . . . . . . . . 49

59 . . . . Chattanooga (Vectra Genisys) . . . . . . . . 49

102 . . . . Cho-Pat. . . . . . . . . . . . . . . . . . . . . . . 60

62 . . . . Contemporary Design (Shuttle Balance) 50

61 . . . . Contemporary Design (Shuttle MVP) . . 50

63 . . . . Cramer (Non-Adhesive Stretch Tape) . . . . 50

124 . . . . Cramer (ProShox) . . . . . . . . . . . . . . . . 63

112 . . . . Creative Health Products. . . . . . . . . . 48

65 . . . . DM Systems (Ankle Tough) . . . . . . . . . . 51

64 . . . . DM Systems (Cadlow Shoulder Stabilizer) 50

66 . . . . Donovan (Fitness Balls). . . . . . . . . . . . . 51

67 . . . . Donovan (Shoulder Pulley) . . . . . . . . . . 51

95 . . . . efi Sports Medicine (Power Tower) . . . . 57

94 . . . . efi Sports Medicine (Total Gym 26000) . 56

69 . . . . Ferno (Liquid Ice) . . . . . . . . . . . . . . . . . 52

68 . . . . Ferno (MedZone) . . . . . . . . . . . . . . . . . 52

70 . . . . FLA Orthopedics (Lumbar Support) . . . . 52

103 . . . . FLA Orthopedics (Safe-T-Sport) . . . . . . 60

71 . . . . Foot Management (footpads) . . . . . . . 52

115 . . . . Foot Management (Static Calf Stretcher) 61

72 . . . . Game Ready . . . . . . . . . . . . . . . . . . . 53

74 . . . . Gebauer (Instant Ice) . . . . . . . . . . . . . . 53

73 . . . . Gebauer (Spray and Stretch) . . . . . . . . . 53

109 . . . . Injury Tracker. . . . . . . . . . . . . . . . . . . 59

75 . . . . Keise . . . . . . . . . . . . . . . . . . . . . . . . . 54

104 . . . . Medical Specialties (Dynatrack) . . . . . . 60

105 . . . . Medical Specialties (Gripper). . . . . . . . 60

125 . . . . Mistral Cooling Systems . . . . . . . . . . 63

78 . . . . NASM (Body Map) . . . . . . . . . . . . . . . . 54

77 . . . . NASM (Optimum Performance Training) . . 54

81 . . . . Oakworks (ProLuxe). . . . . . . . . . . . . . . 54

80 . . . . Oakworks (The Boss) . . . . . . . . . . . . . . 54

82 . . . . OPTP (catalog) . . . . . . . . . . . . . . . . . . 54

83 . . . . OPTP (FitBALL Roller) . . . . . . . . . . . . . . 54

116 . . . . Perform Better (plyo boxes) . . . . . . . . . 61

76 . . . . Perform Better (Smart Hurdle) . . . . . . . 54

113 . . . . Power Systems (catalog) . . . . . . . . . . . 48

117 . . . . Power Systems (Power Chute) . . . . . . . 61

118 . . . . Power Systems (Power Toss Football) . . . 61

86 . . . . Power-Web . . . . . . . . . . . . . . . . . . . . 56

110 . . . . Premier Software. . . . . . . . . . . . . . . . 59

87 . . . . Pro-Tec Athletics (Iliotibial Band Wrap). . 56

88 . . . . Pro-Tec Athletics (Shin Splints Wrap) . . . 56

126 . . . . Quest Technologies. . . . . . . . . . . . . . 63

90 . . . . Rich-Mar (AutoPrism) . . . . . . . . . . . . . . 56

89 . . . . Rich-Mar (AutoSound) . . . . . . . . . . . . . 56

91 . . . . Sports Health . . . . . . . . . . . . . . . . . . 56

119 . . . . Sports Imports. . . . . . . . . . . . . . . . . . 62

92 . . . . Swede-O (Tarsal Lok) . . . . . . . . . . . . . . 56

93 . . . . Swede-O (Thermoskin Supports) . . . . . . 56

106 . . . . Townsend Design (Motion Hinges) . . . . 60

107 . . . . Townsend Design (RebelTM5) . . . . . . . 60

120 . . . . Train To Play . . . . . . . . . . . . . . . . . . . 62

79 . . . . TurfCordz/NZ Manufacturing . . . . . . . 54

121 . . . . VertiMax . . . . . . . . . . . . . . . . . . . . . . 62

122 . . . . VertiMax (V6) . . . . . . . . . . . . . . . . . . . 62

96 . . . . Xvest (Don Chu). . . . . . . . . . . . . . . . . . 57

97 . . . . Xvest (Fire Fighter model) . . . . . . . . . . . 57

PRODUCTS D IRECTORYCIRCLE COMPANY PAGE NO. NO.

ADVERT ISERS D IRECTORYCIRCLE COMPANY PAGE NO. NO.

For Quicker Response, Request InformationFrom Advertisers On-Line at

MomentumMedia.com.



ADVERT ISERS D IRECTORY

31 . . . . . 3-Point Products (Action Ultra) . . . . . . . 49

4 . . . . . Biofreeze . . . . . . . . . . . . . . . . . . . . . . 9

5 . . . . . BioSkin Performance Supports . . . . . 10

23 . . . . . Cadlow Shoulder Stabilizer . . . . . . . . 35

12 . . . . . Chattanooga Group . . . . . . . . . . . . . 18

2 . . . . . Cho-Pat . . . . . . . . . . . . . . . . . . . . . . . 2

32 . . . . . Cooper Complete . . . . . . . . . . . . . . . 49

1 . . . . . Cramer. . . . . . . . . . . . . . . . . . . . . . . IFC

17 . . . . . Donovan . . . . . . . . . . . . . . . . . . . . . . 24

3 . . . . . efi Sports Medicine . . . . . . . . . . . . . . 5

8 . . . . . eSimtrak.NET . . . . . . . . . . . . . . . . . . 15

39 . . . . . Exertools . . . . . . . . . . . . . . . . . . . . . . 57

25 . . . . . Ferno Performance Pools . . . . . . . . . 37

42 . . . . . FitBALL USA (Ball Dynamics). . . . . . . . . 62

34 . . . . . FLA Orthopedics/Night Splint . . . . . . 51

35 . . . . . Foot Management. . . . . . . . . . . . . . . 52

20 . . . . . Game Ready . . . . . . . . . . . . . . . . . . . 30

11 . . . . . Gebauer . . . . . . . . . . . . . . . . . . . . . . 17

19 . . . . . GNC . . . . . . . . . . . . . . . . . . . . . . . . . 29

21 . . . . . Hormel HealthLabs (Plus-2) . . . . . . . . . 31

27 . . . . . Keiser . . . . . . . . . . . . . . . . . . . . . . . . 41

41 . . . . . Medical Specialties . . . . . . . . . . . . . . 61

38 . . . . . NASM . . . . . . . . . . . . . . . . . . . . . . . . 55

24 . . . . . Nesar . . . . . . . . . . . . . . . . . . . . . . . . 36

16 . . . . . NSCA Certification Commission . . . . 23

46 . . . . . Oakworks . . . . . . . . . . . . . . . . . . . . BC

29 . . . . . OPTP . . . . . . . . . . . . . . . . . . . . . . . . 43

14 . . . . . Perform Better . . . . . . . . . . . . . . . . . 21

43 . . . . . Perform Better (seminars) . . . . . . . . . . 63

10 . . . . . Power Systems . . . . . . . . . . . . . . . . . 16

40 . . . . . Power-Web . . . . . . . . . . . . . . . . . . . . 57

15 . . . . . PoweringAthletics . . . . . . . . . . . . . . . 22

18 . . . . . Pro-Tec Athletics . . . . . . . . . . . . . . . . 25

7 . . . . . Quest Technologies. . . . . . . . . . . . . . 14

22 . . . . . Rich-Mar . . . . . . . . . . . . . . . . . . . . . . 32

33 . . . . . Shuttle Systems . . . . . . . . . . . . . . . . . 50

9 . . . . . Smart-Hurdle (Train To Play) . . . . . . . . . 15

26 . . . . . Swede-O . . . . . . . . . . . . . . . . . . . . . . 38

45 . . . . . Townsend Design. . . . . . . . . . . . . . . IBC

37 . . . . . TurfCordz/NZ Manufacturing . . . . . . . 53

13 . . . . . Vertec (Sports Imports) . . . . . . . . . . . . . 20

30 . . . . . VertiMax . . . . . . . . . . . . . . . . . . . . . . 45

6 . . . . . Woodway USA . . . . . . . . . . . . . . . . . 13

28 . . . . . Xvest . . . . . . . . . . . . . . . . . . . . . . . . . 42




P R O D U C T S D I R E C T O RY

Injury Prevention Software

INJURY TRACKER888-465-8725WWW.INJURYTRACKER.COM

Sports organizations worldwide are leverag-ing InjuryZone™ to minimize injuries andrelated costs, accelerate medicaltreatment, and ensure athletes return to

play safe-ly andquickly.Designed

to unite the entire organization in a com-mon information network that is HIPAAcompliant, InjuryZone™ delivers revolution-ary templating, internal messaging, andoff-line capabilities as well as state-of-the-art security, complete with audit trail andelectronic signatures, offeringorganizations a web-based facility to easilyreport, track, and manage critical athleteinformation on- and off-line.

Circle No. 109

PREMIER SOFTWARE, INC.630-906-6630WWW.ESIMTRAK.COM

The Web-based eSimtrak.NET injury track-ing and treatment records system providesaccess to your training room records 24

hours a dayfromanywhere.This systemoffers themostadvancedtechnology

at an affordable monthly access feedesigned for low cost of ownership.Scanned documents and digital X-Rays aresupported, bringing together the athletictraining room and physician. Users canenter an unlimited number of athletes atno extra charge. Visit www.eSimtrak.comfor more details and to register for a freedemonstration.

Circle No. 110

IN THE MAY/JUNE 2004 ISSUE:

NATA SHOW PLANNER &EXHIBITOR PRODUCT PREVIEW

NSCA EXHIBITOR PRODUCT PREVIEW

SCOUTING REPORT: CHEST & BACK PRODUCTS

SCOUTING REPORT: CLIMATE CONTROL



More articles, more product information, and moreresources are just a mouse click away, at...

Training & Conditioning has teamed up with its two sister publications,

Athletic Management and Coaching Management, to produce a Web site chock

full of great ideas and advice.

Check out the Bonus Editorial section:� New Ideas in Aquatic Therapy� Curtailing Steroid Use� How One Athletic Department Solved Its Insurance Woes

Use our search engine to access previously published articles:“Heads in the Game” � the latest research on Concussions“Get Ready, Get Set” � Warm Up routines that work“Event Eating” � planning Pregame Meals

TRAINING CONDITIONING

New ideas

in speed and agilityNew ideas

in speed and agility

◆ Staff Diversity

◆ Nutrition News◆ Staff Diversity

◆ Nutrition News

December 2003

Vol. XIII, No. 9

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Balancing work and personal life as an ATC

Balancing work and personal life as an ATC◆ How to Monitor Training

◆ Supervising High School Aides

◆ How to Monitor Training◆ Supervising High School Aides

$5.00October 2003Vol. XIII, No. 7

All in the FamilyAll in the Family

Knee Products


BIO SKIN/CROPPER MEDICAL800-541-2455WWW.BIOSKIN.COM

Bio Skin® introduces the Gladiator XT™and Gladiator DT™ (front closure) limitedrange of motion hinged knee brace. The

Gladiator treats mild tomoderate ACL, PCL, MCL,and LCL instabilities.Outstanding Features:Flexion and Extensionpins are easily accessibleand are attached by“keepers” preventingloss. Struts may beadjusted toaccommodate various

contours of the leg. Unique strappingdesign improves knee stability, minimizingmedial and lateral shift, as well as anteri-or/posterior drawer. The lightweight andlow profile features add comfort to design.

Circle No. 99

Patellofemoral joint dysfunction and painhas a new treatment. The patent pendingQ Lok APT™ (Adjustable Patella Traction),

from BioSkin, diminishespain, increases function, andachieves desired patellatracking. The Q Lok™controls patella pressure inthe trochlear groove toincrease joint surface areacontact. In addition, the QLok allows adjustable medialpatella traction to loosentight lateral connective

tissue, providing successful patellafemoraltreatment when linked with an exercise-strengthening program.

Circle No. 100

BRACE INTERNATIONAL800-545-1161WWW.BRACEINT.COM

Brace International provides informationon its line of bracing andsupport products. TheFLUK™ knee strap isideal for treating suchinjuries as patellar ten-donitis, chondromalaciapatella, and Osgood-Schlatter’s disease. Itapplies compression tothe knee area withoutrestricting circulation.

Circle No. 101

CHO-PAT800-221-1601WWW.CHO-PAT.COM

Cho-Pat’s patented Dual Action KneeStrap provides an extralevel of relief for painfuland weakened knees. Itapplies pressure uponthe tendon below theknee to reduce patellarsubluxation and improvetracking and elevation. Italso places pressure onthe tendon above theknee to give added sup-

port and stability. It allows full mobility. Circle No. 102

FLA ORTHOPEDICS, INC.800-327-4110WWW.FLAORTHOPEDICS.COM

The Safe-T-Sport® Wrap-Around HingedKnee Brace, from FLA Orthopedics, Inc.,is ideal for treating slight to moderate liga-

ment sprains andtears, medial/lateralmeniscal tears, arthri-tis, and knee jointinstability. The brace’sneoprene provides ther-apeutic warmth to theknee. Its wrap arounddesign makes applica-tion easy for swollen orinjured knees. Metal

medial/lateral hinges stabilize the knee,allow for full flexion, and prevent hyperex-tension. An open popliteal eliminatesbunching and irritation behind the knee.Adjustable support straps prevent migra-tion.

Circle No. 103

MEDICAL SPECIALTIES, INC.800-582-4040WWW.MEDSPEC.COM

Med Spec introduces the DynaTrack™patella stabilizer for the treatment ofpatellofemoral dysfunction. The easy-to-

apply design featuresan internal buttresswith Skinloc™ materialand an outer neoprenewrap that can beadjusted to providethe optimum amountof dynamic pressureagainst the patella. Alarge popliteal opening

permits a high degree of flexion with nodiscomfort. Each size fits either the left orright knee.

Circle No. 104

Med Spec introduces the Gripper™Hinged Knee Brace for the treatment of

MCL or LCL sprains. Theneoprene brace may alsobe used post operativelyor during sports to pro-vide medial and lateralstability and to protectagainst hyperextension.The Skinloc™ materialinside the brace grips theproximal end of the gas-trocnemius (calf) muscle

to maintain a proper position on the kneeand resist distal migration.

Circle No. 105

TOWNSEND DESIGN800-840-2722WWW.TOWNSENDDESIGN.COM

Townsend Design has introduced the nextgeneration of its patented TownsendMotion Hinges for functional and

osteoarthritisknee braces. Thenew ultra low pro-file TM5 Hingesare half the sizeof the previousjoint designs, andreduce the medi-al-lateral dimen-

sion of Townsend's braces—at jointline—by nearly one inch. The hinges areavailable in a variety of materials (aircraftaluminum, stainless steel and titanium),and can decrease the overall weight of thebrace by as much as five ounces.

Circle No. 106

Townsend Design has released a newgeneration of custom and pre-sized func-tional knee braces. The 2004 edition of

Townsend's acclaimedPremier graphite shell braceweighs in at just 16 ounces.The new RebelTM5 (fabricat-ed from aircraft aluminum)weighs only 18 ounces.These braces featureTownsend's patented hingemotion and suspension tech-nology and are backed by ano migration guarantee. New

shell options are available to maximizecontrol and prevent injuries.

Circle No. 107

Football Conditioning

FOOT MANAGEMENT, INC.800-HOT-FOOTWWW.FOOTMANAGEMENT.COM

The newest product available from FootManagement is the Static Calf Stretcher.Made from durable, weather resistant

materials,it’sdesignedto helprelievethe painof plantar

fasciitis and to increase calf flexibility.Lightweight and portable, it’s perfect inany setting. Ideal for use with cleats of alltypes. No more slipping when trying tostretch out on the field or court. Use inthe home as well for maximum benefit.

Circle No. 115

PERFORM BETTER800-556-7464WWW.PERFORMBETTER.COM

Part of its First Place® line, Perform Betterhas introduced plyo boxes made of 1",13-gauge tubular welded steel with a large

landing surfacecovered with 1/8" non-skid rubber. The legsare tapered to a sixdegree outward angleto prevent tipping. Soldwith a two-year warran-ty and reasonablypriced. The boxes areavailable in 12", 18",24", and 30" heights.

Contact Perform Better for more informa-tion or a free copy of the 2004 catalog.

Circle No. 116

POWER SYSTEMS, INC.800-321-6975WWW.POWER-SYSTEMS.COM

Some products stand the test of time. ThePower Systems Power Chute is one ofthose products. The best running chute onthe market, you get resistance runningand over-speed training in the same run.The Power Chute enables you to improvetwo key elements of speed—stride lengthand stride frequency. This unique trainingproduct offers diversity and motivation foryou, while improving a key aspect of your

football train-ing program.The PowerChute comesin four sizes toaccommodateall training lev-els. The PowerChute instruc-tional manual

and video are also now available. Circle No. 117

The Power Toss Football, from PowerSystems, is a great training tool for quar-terbacks, centers and receivers at all play-ing levels. The football-shaped weightedball provides greater resistance than astandard football (standard football weighs

1 lb.) forthrowing,optionpitchingand longsnapping. It

improves arm and grip strength. ThePower Toss Football is made of moldedlatex and is available in 2 lb. and 3 lb.

Circle No. 118


Request No. 41

Football Conditioning

SPORTS IMPORTS800-556-3198WWW.SPORTSIMPORTS.COM

Virtually all professional and college sportsteams, including the NFL ScoutingCombine, use the VERTEC jump training

system, distributed bySports Imports. It is thebest way to evaluateand improve jump reachand lower-bodyexplosive power. TheVertec jump trainingsystem challenges ath-letes to improve theirvertical leap throughinstantaneous feedback

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Training & Conditioning is pleased to provide NATA members with the opportunity to earn continuing education units through reading issues of the magazine. The following quiz is based on articlesthat appear in this issue of Training & Conditioning. By satisfactorily completing the quiz and mailing it backto T&C, certified athletic trainers can earn two continuing education units.

INSTRUCTIONS: Fill in the circle on the Answer Form (on page 67) that represents your selection of thebest answer for each of the questions below. Complete the form at the bottom of page 67, include a $15payment to Training & Conditioning, and mail it to the following address: Training & Conditioning, ATTN: 14.3Quiz, 2488 N. Triphammer Road, Ithaca, NY 14850. Athletic trainers who correctly answer 70 percent of thequestions will be notified of their earned credit by mail no later than June 15, 2004.

HEAD OF THE CLASS pages 19-25

Objective: Understanding how best to inform sportcoaches about the basics of treating and assessinginjured athletes, emphasizing the differences between acoach’s limited responsibilities and those of a certifiedathletic trainer

1) According to the “Head of the Class” article, mostATCs agree that a base-level knowledge requirementfor coaches should include:

a) ACL rehabilitationb) Learning CPR and first aidc) Spine boarding techniqued) Taping for MCL instability

2) According to Christopher Hobler, ATC, one way toinitiate coach education is to:

a) Provide the coach with an athletic trainingcurriculum textbook

b) Have coaches attend the NATA annual symposiumc) Have coaches perform an internship with an ATCd) Start each season with a mandatory refresher course

conducted by the ATC

3) Kathleen English, MS, LATC, ATC, says“__________________” opens some eyes by allowingcoaches to anticipate how something is going tohappen and how they will respond.

a) Role playb) Readingc) Watching video d) Listening to tapes

4) The intent of educating coaches is to:

a) Alleviate some of the demands on the ATCb) Allow coaches to be first respondersc) Make the athletes as safe as possible and provide

more comprehensive care when athletic trainingservices are limited

d) Give coaches more responsibility

ROTATION AT THE SHOULDER pages 33-38

Objective: Understanding the causes, diagnosis, andtreatment of rotator cuff injuries by focusing on the rele-vant musculoskeletal and nervous components of theshoulder complex and the kinetic chain as a whole

5) Which of the following is NOT considered to be ascapular stabilizer?

a) Serratus anteriorb) Trapezeusc) Deltoidd) Rhomboids

6) According to Muscle Stretching in Manual Therapy byO. Evjenth, MS and J. Hamberg, MD, the best way tostretch the supraspinatus is:

a) With the athlete lying on his side with an axillarywedge, applying a force with the shoulder in slightextension and adducting across the back

b) In the empty can positionc) Passively abducting the shoulderd) Passively externally rotating the shoulder

7) The healing of a muscle injury is strongly dependenton the:

a) Muscle involvedb) Amount of connective tissue involvedc) ROM deficitd) Amount of shearing to the motor end plates and

the axon

8) The glenohumeral index is calculated by:

a) Measuring the depth of the subacromial spaceb) Dividing the maximal transverse diameter of the

glenoid by the maximal transverse diameter of thehumeral head

c) Dividing the length of the humerus by the length ofthe spine of the scapula

d) Dividing the amount of passive abduction by theamount of active abduction

9) Recent research has shown that during the initial30-60 degrees of elevation in the scapular plane, the:

a) Humeral head depressesb) Humeral head moves anteriorc) Humeral head moves superior 3mm then stays

centered within 1mmd) Humeral head moves posterior 5mm

10) Which of the following is not considered by most tobe a rotator cuff muscle?

a) Teres majorb) Subscapularisc) Infraspinatusd) Teres Minor


NATA CEUQUIZ

T&C April 2004 Vol. XIV, No. 3

HONING IN ON HIPAA pages 11-17

Objective: Understanding the legal and ethical obliga-tions of sports-medicine professionals who have access toprivate medical information, specifically those related tofederal HIPAA legislation

11) For an organization to be a covered entity, theorganization must:

a) Complete a covered entity applicationb) Conduct electronic transactions of medical recordsc) File as a sub-S corporationd) Bill for services rendered

12) HIPAA is an acronym for:

a) Health Insurance Portability and Accountability Actb) Health Insurance Physical Application Actc) Hospital Issuance of Privacy and Accountability Act d) Hospital Insurance Portability Accounts Act

13) To help with tracking of athletes who signedauthorization for release of injury information versusthose that didn’t, the University of Tulsa:

a) Kept a list at all sporting eventsb) Directed all requests for information to the athletic

departmentc) Decided not to release any injury informationd) Is not concerned with this issue

14) The Family Educational Rights and Privacy Act(FERPA) limits:

a) Medical records from becoming student recordsb) The amount of liability the ATC has regarding

documentationc) Family responsibility of medical expensesd) Disclosure of students’ individual educational

records by any institution receiving federal funds

15) According to Elizabeth Sequeglia, JD, an authorizationform must contain all of the following except:

a) An explanation of why sports media has access tomedical records

b) A statement stating no one will be deniedtreatment for not signing the form

c) A list of people the information may be released tod) An expiration date

16) The media may be given the following information:

a) An athlete’s name and injuryb) The expected date of return to full participationc) No information unless a specific authorization to

release information is signedd) An athlete’s prognosis

CONFUSED ABOUT CARBS? pages 26-31

Objective: Learning the biological effects of limiting car-bohydrate intake related to health and athletic perform-ance, and understanding how to communicate with ath-letes about dietary choices and nutritional needs

17) One reason people lose weight quickly on lowcarbohydrate diets is:a) Low carbohydrate diets are usually low in fat and

protein creating satietyb) Decreased carbohydrate intake results in fluid lossc) Increased protein intake results in fluid lossd) Foods high in carbohydrates have more calories

than those high in protein.

18) The body cannot manufacture:

a) Glucoseb) Insulinc) Carbohydratesd) Adrenaline

19) If carbohydrate needs are not met, the body will:

a) Break down stored fat to provide fatty acids or break down lean muscle mass to yield glucose

b) Maintain higher energy levelsc) Retain waterd) Decrease its metabolism

20) The Institute of Medicine’s Dietary Guidelinesrevisions call for a diet containing:

a) 20-40% CHO and not less than 200 grams per dayb) 30-50% CHO and not less than 220 grams per dayc) 35-45% CHO and not less than 180 grams per dayd) 45-65% CHO and not less than 130 grams per day

21) The glycemic index is a system classifyingcarbohydrate-containing foods according to:

a) The amount of total carbohydratesb) How quickly and how much they raise blood

glucose levelsc) The amount of calories certain foods containd) The extent the food may affect high blood pressure,

cardiovascular disease, or obesity

22) Moderate and low glycemic index food may bepreferred for the following athletes:

a) Long jumpersb) Punt returnersc) Sprintersd) Endurance athletes

23) A 64-ounce soda may contain ____________.

a) 6 grams of fiberb) 2 cups of sugarc) Vitamin Dd) The nutrition equivalent of an apple

24) Which of the following is considered to be a high glycemic index food?

a) Pastab) Grapes and citrus juicesc) Cornd) Watermelon, white bread, and pretzels

25) Which of the following is a low glycemic index food?

a) Nine grain bread and applesb) Buckwheatc) Rice and tortillasd) Raisins and ice cream

ANSWER SHEET IS ON PAGE 67

NATA CEUQUIZ


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Biodex offers a full one-day, hands-on course aimed towards those:• Purchasing a new system• Looking to improve application techniques• Retraining staff

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May 8 St. Louis, MO • May 15 Atlanta, GA • May 29 Charlotte, NC

Call 800-224-9339 for complete schedule, course outline and registration.Course is accredited for NATA CEU’s.

Have an upcoming CEU programor event that you’d like to promote?

Call T&C publisher Mark Goldbergat 607-257-6970, ext. 11 to feature it

in the T&C CEU Calendar.

2004 Schedule

Bringing People & Knowledge Together…

Function, Fitness & Feldenkrais with Foam ($169.00)

Stacy Barrows, PT, CFP - 5-22-04 Los Angeles, CA

Core Training Continuum: From Isolation to Function ($195.00)

Chris Sebelski, DPT, OCS, CSCS 5-16-04 Las Vegas, NV • 8-21-04 Seattle, WA

9-11-04 San Francisco, CA • 10-2-04 San Diego, CA (Children's Hospital)

Yoga Mechanics for the Healthcare Professional ($195.00)

Sherry Brourman, RPT 4-24-04 Los Angeles, CA • 6-12-04 Phoenix, AZ • 10-2-04 San Francisco, CA

Gait For Pain Relief ($195.00)

Sherry Brourman, RPT - 5-8-04 San Diego, CA • 7-24-04 San Francisco, CA 10-16-04 Los Angeles, CA • 11-6-04 Las Vegas, NV

Pilates Mat Intensive ($475.00 includes mat)

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6-26 & 27-04 Burbank, CA (Core Conditioning)

7-17 & 18-04 San Ramon, CA (San Ramon Reg Med Ctr)8-14 & 15-04 Phoenix, AZ • 12-4 & 5-04 San Diego, CA

Pregnancy & Pilates (Day 1) • Post-Partum Core Conditioning (Day 2)

4-17 & 18-04 Burbank, CA (Core Conditioning)

10-2 & 3-04 Burbank, CA (Core Conditioning)($195.00 for one-day or $375.00 for two-days)

Pilates for Spinal Stabilization ($195.00)

6-12-04 Burbank, CA (Core Conditioning)

Shoulder Dysfunction & Pilates ($195.00)

6-13-04 Los Angeles, CA (Core Conditioning)

www.californiaeducationconnection.com or call (888) 212-5412for complete info and more courses...

Approved continuing education provider for NATA, NSCA and the NASM.

Confused About Carbs?

NATA CEU Quiz Answer Form

INSTRUCTIONS: Fill in the circle on the Answer Form below that represents your selectionof the best answer for each of the previous questions. Complete the form at the bottom ofthis page, include a $15 payment to Training & Conditioning, and mail it to the followingaddress: Training & Conditioning, ATTN: 14.3 Quiz, 2488 N. Triphammer Road, Ithaca, NY14850, no later than May 28, 2004. Athletic trainers that correctly answer 70 percent ofthe questions will receive two CEUs, and will be notified of their earned credit by mail nolater than June 15, 2004.

1. ❍ ❍ ❍ ❍2. ❍ ❍ ❍ ❍3. ❍ ❍ ❍ ❍4. ❍ ❍ ❍ ❍

Head of the Class

A B C D

5. ❍ ❍ ❍ ❍6. ❍ ❍ ❍ ❍7. ❍ ❍ ❍ ❍8. ❍ ❍ ❍ ❍9. ❍ ❍ ❍ ❍

10. ❍ ❍ ❍ ❍

17. ❍ ❍ ❍ ❍18. ❍ ❍ ❍ ❍19. ❍ ❍ ❍ ❍20. ❍ ❍ ❍ ❍21. ❍ ❍ ❍ ❍22. ❍ ❍ ❍ ❍23. ❍ ❍ ❍ ❍24. ❍ ❍ ❍ ❍25. ❍ ❍ ❍ ❍

11. ❍ ❍ ❍ ❍12. ❍ ❍ ❍ ❍13. ❍ ❍ ❍ ❍14. ❍ ❍ ❍ ❍15. ❍ ❍ ❍ ❍16. ❍ ❍ ❍ ❍

A B C DHoning In On HIPAA


Rotation at the Shoulder

Last Name_______________________________________First Name_________________________________MI______

Mailing Address______________________________________________________________________________________

City___________________________________________________State_________________Zip Code________________

Daytime Telephone_________________________________E-Mail Address____________________________________

Payment Information

__ $15 check or money order (U.S. Funds only) payable to: Training & Conditioning

__ Visa __ Mastercard __ Discover __ American Express

Account Number_______________________________________________Expiration Date________________________

Name on Card_____________________________________Signature__________________________________________

A B C D A B C D

Association CornerThe following associations offer services of interest to our T&C readers.

The Voice of the Doctors who care for the Pros

The PTP provides resources and services for allsports medicine professionals.

Visit www.proteamphysicians.com to find a PTP doctor, ask a question of a PTP doctor, orexplore the educational materials from PTP regarding

prevention, treatment and performance.

SPECIALIST IN SPORTS CONDITIONINGISSA Certification Program

• Be the conditioning coach for your team.• Expand strength & conditioning programs.• Maximize earning potential as a coach.• Learn to enhance athletic performance.

CALL FOR FREE INFO: 1.800.892.4772www.FitnessEducation.com

International Sports Sciences Association

Athletic Therapy. Rapid return to work and play.

Athletic Therapists are dedicated to the promotion and delivery of qualitycare through injury prevention and rehabilitation and emergency services.

In collaboration with other health care professionals, athletic therapistswork to create a healthier environment that encompasses the needs of the

active community, including the high-performance athlete.

For more information please visit us online at www.athletictherapy.org

Take Your Career to New Heights

P E R F O R M A N C E E N H A N C E M E N T

CONTINUING EDUCATION ● CERTIFICATION

• Earn CEUs for NASM, NATA, NSCA

• Live workshops, home-study and online courses

• Flexibility, core, balance, power, speed and strengthtraining

• Clinical applications

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ECA/MIAMI2004 SPORTS TRAINING & FITNESSCONFERENCE, NOV. 12-13-14

1-800-ECA EXPOOR REGISTER ONLINE

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All NATA certified athletictrainers are eligible to receive a

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training & conditioning 14.3

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