By Dr. William Vranos
Classes start next Wednesday at Brattleboro Union High School, but the student athletes have already been on the practice fields and in the weight room for a couple of weeks preparing for the Fall 2011 season. It’s an exciting time of year to be an athlete or a coach. It is also when our sports medicine department has an influx of young patients suffering from various sports-related injuries.
Football is the obvious number one cause. There are so many things that go on in football that lead to the boys getting bumps, bruises and traumatic injuries that are minor but require treatment. The girls need to be careful as well. Whether it’s a contact sport like soccer or a non-contact sport like cross-country running, it’s well-established that knee injuries are more common in female athletes. Over seventy percent of the sports-related knee surgeries we do here are on females.
This time of year we see a lot of heat-related injuries that are preventable. Many athletes come to the first practices of the year out of shape and maybe a step slow. They haven’t been active and suddenly they’re thrust into training for their sport. The heat and sudden increase in activity level leads to dehydration or sprains or stress fractures. It is a sad fact that every year at this time, across the country high school football players die from heat-related problems. These are almost always preventable.
Six years ago, BMH and BUHS developed a formal Sports Medicine Program in the interest of helping make sports safer for students. It serves as a resource for local school sports, providing local athletes a physician in attendance at games, and a Certified Athletic Trainer (ATC) to consult with the various teams. We’re happy to welcome Josh Underwood as the new ATC for the 2011 school year. Josh is a graduate of BUHS and has been the trainer at Bellows Falls High School the past few years. He’ll provide injury prevention information for the student athletes and serve as a liaison between the school and BMH’s orthopedic and rehabilitation services.
The trainer is really on the front lines for injury prevention. He’ll be doing pre-season evaluations, checking on how well each player is stretching, setting their weights for workouts, making sure they’re hydrated and just knowing what to look for in each individual. Again, you’ve got a lot of different athletes with different body types and levels of conditioning working out in harsh conditions. If you have 50 football players and 49 are going through the drills without a problem, the coach may not notice the one kid who isn’t looking right. It’s the trainer’s job to look out for that one kid.
During games, a trainer is good at not always looking at the point of action, but seeing the whole field. The athlete who needs help might not always be involved in the major collision and may be injured on another part of the field. It’s the trainers job to identify these athletes and bring it to the attention of the coaches or the referee.
We’ve also become very alert for concussions and other things that really weren’t on the radar ten years ago. The trainer plays a critical role in the education of the public now as well. Last year, our trainer joined the BMH staff for a public talk about what the current standard of care is for concussions. A lot of coaches and emergency personnel attended to learn how it’s changing. We’ve implemented IMPACT testing of all student athletes at risk for concussion. Both pre-season and post-injury testing will be performed. This is the current gold standard of care and we are fortunate to have a program on site at BHS.
With teenagers, the trainer also needs to be able to educate athletes about diet and nutrition. Body image disorders like anorexia are a concern, but it’s also very discouraging how many athletes, both male and female, have a body mass index well above what is acceptable for their age group. That leads not only to injuries and problems with heat but it also doesn’t bode well for later in life. So if the trainer can combine his efforts with our office and the athletes’ primary care physicians, hopefully we can promote healthier lifestyles and eating habits.
When there is a serious injury that requires rehabilitation, the trainer is important for communication and continuity of care. There are mechanisms in place to make sure athletes are seen in a timely manner, even with games taking place on evenings or weekends. The trainer is invited over to BMH for a patient’s appointment because generally he or she will oversee the athlete’s physical therapy in the training room. The trainer will also interact more with coaches and parents on a regular basis than we can.
The good news is that teenagers heal quickly due to their age. They are also, with few exceptions, compliant patients who do their therapy and exercises and see the trainer when they’re supposed to. It’s a very gratifying population to take care of.
Larger high schools and prep schools have always had trainers in their athletic departments. It’s been very gratifying that the athletes at BUHS now have that same level of care. It’s unfortunate but athletes are going to get hurt sometimes. We are putting someone in place where we know there are going to be patients. For a town the size of Brattleboro, it’s a win-win for everybody.
Dr. William Vranos is an orthopedic surgeon and the medical director for the Sports Medicine Program at Brattleboro Memorial Hospital.