With a snowstorm hitting across the eastern US brings up the issue of practicing when school is closed. Standard practice at many schools is to hold practice, even though the school has deemed it too dangerous for students and staff to travel. Of course, the athletic trainer must now be there to cover the activity. Other situations arise when a school closes early and the athletic practices continue on normal schedule. This flies in the face of common sense.
If a educational institution has deemed it too dangerous to have students and staff traveling because of weather conditions why are athletes somehow exempt from those dangers. While some students may live on campus, and be able to walk to athletic facilities, many do not. While it may be nice for the coach to say attendance is contingent upon an athlete being able to safely travel, the reality is usually different. Many athletes will first make the effort to travel to determine if the conditions are safe enough. There is also the pressure from the coach. If they can make it into the facility then why can't the athlete.
Along with the athletes you have many support people that are needed. This will include student coaches, managers, equipment people, and of course the athletic trainer. Athletic Trainers best approach to this dilemma is to look at it from a student safety issue. Do we really want to put the athlete in this potentially dangerous situation. The person on campus that will be an ally is the school's legal counsel. If you put the question to them regarding the best policy I am sure they will be on your side. Set up the policy in advance so that all parties are well aware the guidelines and there are no complaints when school is cancelled. This is a situation that in the middle of summer does not seem all that important until it is upon you and there is no time establish meaningful guidelines.
Friday, February 12, 2010
Friday, February 5, 2010
Athletes and Casts
Oftentimes, in the course of a year athletic trainers are faced with an athlete who has a fracture. Sometimes it is season ending, sometimes there is enough time for recovery and return. Other times the athlete may continue, provided they meet certain criteria. In the case of an athlete with a cast, the continued participation is usually dependent on the rules of that sport. Being able to protect opposing players from harm is usually the number one consideration. Athletes who can continue to participate present their own set of problems for the athletic trainer.
While fiberglass casts where a great innovation, the underlying cotton padding and stockinette is the same system used for the old plaster casts. While the actual fiberglass casting material is impervious to water the cotton padding cannot become saturated with water. Doing so leads to the deterioration of the skin and possible infection. An athlete practicing with a cast accumulates sweat and dirt over time, increasing the potential for a harmful outcome. Over time the cast will become a petri dish for bacteria. I had one athlete tell me that his cast smelled so bad that it woke him while he was asleep.
There are a couple of options that the athletic trainer can pursue to deal with this scenrio. In both cases it takes a cooperative physician to accomplish.
The Bivalve - After an athlete has been fitted for a cast and it begins to deteriorate ecologically, you send them back to the doctor for a new cast. The doctor then bivalves the cast and a new one is applied. The new cast is also immediately bivalved. The athlete now has two removable casts. The original and now smelly cast for practice and competition, and a new one which is now presentable in mixed company.
This procedure requires a physician comfortable doing this and a fracture that is far enough along in its healing. You also need a responsible athlete who will continue to wear the cast since they can now remove on their own. The athletic trainer only needs to apply the casts at the beginning and conclusion of activity. Tape is all that is usually required to join the two pieces for a stable device.
Cast Liner - The other option is to use some new products that make the underlying cast padding also water proof. These products are applied just like the traditional cotton padding but are now water proof. The athlete can practice in them and then go into the shower without any protective cover. In fact that is preferably as the shower will help rinse out any accumulated dirt and sweat. Many doctors do not carry this product because of reimbursement issues with insurance companies. I have used the Gore Tex PROCEL cast Liner for a number of years. I purchase this myself and when I have an athlete who is to be casted I send along some rolls of the material for my doc to use. It works out well.
Besides PROCEL there are a couple of other products now on the market. PROCEL. Here are the links:
Gore Tex PROCEL
BSN Deltra Dry
While fiberglass casts where a great innovation, the underlying cotton padding and stockinette is the same system used for the old plaster casts. While the actual fiberglass casting material is impervious to water the cotton padding cannot become saturated with water. Doing so leads to the deterioration of the skin and possible infection. An athlete practicing with a cast accumulates sweat and dirt over time, increasing the potential for a harmful outcome. Over time the cast will become a petri dish for bacteria. I had one athlete tell me that his cast smelled so bad that it woke him while he was asleep.
There are a couple of options that the athletic trainer can pursue to deal with this scenrio. In both cases it takes a cooperative physician to accomplish.
The Bivalve - After an athlete has been fitted for a cast and it begins to deteriorate ecologically, you send them back to the doctor for a new cast. The doctor then bivalves the cast and a new one is applied. The new cast is also immediately bivalved. The athlete now has two removable casts. The original and now smelly cast for practice and competition, and a new one which is now presentable in mixed company.
This procedure requires a physician comfortable doing this and a fracture that is far enough along in its healing. You also need a responsible athlete who will continue to wear the cast since they can now remove on their own. The athletic trainer only needs to apply the casts at the beginning and conclusion of activity. Tape is all that is usually required to join the two pieces for a stable device.
Cast Liner - The other option is to use some new products that make the underlying cast padding also water proof. These products are applied just like the traditional cotton padding but are now water proof. The athlete can practice in them and then go into the shower without any protective cover. In fact that is preferably as the shower will help rinse out any accumulated dirt and sweat. Many doctors do not carry this product because of reimbursement issues with insurance companies. I have used the Gore Tex PROCEL cast Liner for a number of years. I purchase this myself and when I have an athlete who is to be casted I send along some rolls of the material for my doc to use. It works out well.
Besides PROCEL there are a couple of other products now on the market. PROCEL. Here are the links:
Gore Tex PROCEL
3M™ Scotchcast™ Wet or Dry Cast Padding
BSN Deltra Dry
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