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Healthy Roster provides patient engagement, care coordination, telemedicine and outreach tools for Sports Medicine, Orthopedics and other medical specialties. We enable patients to communicate with providers, reducing communication gaps, phone tag, and readmissions. Use with Home Health & SNF’s to manage CJR and Cardiac bundled payments.

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Filtering by Category: Sports Medicine News

Understanding Sudden Cardiac Arrest

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Understanding Sudden Cardiac Arrest

#HeartMonth

It’s hard to believe that February is almost over. It seems like just yesterday we were reviewing winter safety tips, and now schools are gearing up for the spring season! But before we trade in the hockey skates and wrestling mats for tennis rackets and lacrosse sticks, we thought we’d take a moment to think about American Heart Month.

One of the most serious cardiac issues facing athletes today is Sudden Cardiac Arrest (SCA). Though SCA technically has its own awareness month, it’s never a bad time to review the warning signs and prevention measures — after all, being properly prepared just might save a life.

A little background

SCA is a condition in which the heart “suddenly and unexpectedly stops beating.” When this happens, blood flow to the brain and other vital organs stops, which can lead to unconsciousness, permanent brain damage, and death all within a matter of minutes. Almost 300,000 sudden cardiac arrests occur outside of hospitals in the U.S. each year, including the 2,000 patients under the age of 25 who die of SCA annually.

It’s important to understand that SCA is not a heart attack. A heart attack, or a myocardial infarction (MI), occurs when blockage within a blood vessel prevents oxygen from reaching the heart tissue. SCA, on the other hand, is a cessation of the heart’s pumping caused by arrhythmia, an irregular heartbeat prompted by issues within the heart’s electrical system. While some MIs can additionally cause cardiac arrest, there are numerous other conditions that can trigger an SCA-inducing arrhythmia.

Because intense physical activity is one of the stresses that can cause the heart’s electrical system to fail, SCA is a serious concern for athletes. (In fact, one of the first reported cases was Pheidippides, the Greek soldier who collapsed after running 24 miles from Marathon to Athens to announce victory over the Persians.) Another common cause is Commotio Cordis. Caused by a “blunt, non-penetrating blow to the chest,” Commotio Cordis accounts for 20 percent of sudden cardiac deaths in young athletes.

While athletes with underlying heart issues are at a higher risk, as many as 80 percent are asymptomatic until SCA occurs, and some causes won’t be detected through pre-participation screening. Furthermore, SCA can occur in athletes who exhibit no risk factors and appear otherwise healthy. It’s thus imperative that athletic trainers understand how to recognize and react to SCA as quickly as possible.

Signs and symptoms

Just one in 10 students who suffer SCA survive, but survival rates improve drastically when proper steps are taken within three to five minutes of collapse. In fact, the greatest factor affecting survival is the time from arrest to defibrillation. If an athletic trainer can recognize the symptoms of SCA within a quick window, they can optimize the chances of saving the athlete’s life.

While any unexpected collapse should warrant consideration of SCA, additional symptoms in male athletes include chest, ear, or neck pain; severe headache; excessive breathlessness; vague discomfort; dizziness and palpitations; abnormal fatigue; and indigestion or heartburn. In female athletes, symptoms include center chest pain that comes and goes; lightheadedness; shortness of breath; pressure, squeezing or fullness; nausea or vomiting; cold sweats; and pain or discomfort in the arms, neck, back jaw, or stomach. Additionally, seizure-like activity occurs in half of young athletes with SCA, so seizures should be perceived as SCA until proven otherwise.

Prevention and preparedness

All athletes should undergo cardiovascular screenings before participating in competitive sports. This should, at minimum, include a comprehensive review of medical and family histories, as well as a physical exam. If possible, an electrocardiogram (ECG) should also be used to identify underlying heart issues that may put an athlete at risk for arrhythmia.

However, as we mentioned above, SCA can occur in athletes who exhibit no risk factors, so it’s essential that schools, clubs, and sports facilities develop an emergency action plan to respond immediately to suspected SCA. This should include recognition of SCA (see above), calling 9-1-1, initiating early CPR beginning with chest compressions, using an AED (see below), and transporting the athlete to a hospital capable of advanced cardiac care. Remember that once the heart stops beating, death is imminent within minutes, so the emergency plan should be activated as soon as possible. It should incorporate an effective communication system, ensure that first responders are trained in CPR and AED use, and be coordinated with the local EMS agency.

AEDs

Perhaps the most important aspect of a facility’s emergency action plan is its access to an automatic external defibrillator (AED). Studies have shown that the survival rate from SCA drops 10 percent for every minute that passes without defibrillation, and in cases where CPR is provided and defibrillation occurs within three to five minutes, survival rates have been reported as high as 74 percent. It’s therefore recommended that all facilities have an AED on-site and readily available within three minutes, though one minute is ideal. Additionally, all athletic trainers, medical professionals, coaches, parents, and athletes should be educated annually on their location and use so that an AED shock can be administered swiftly and properly in the event of SCA.

Have a great final week of American Heart Month!


Sports Specialization vs. Multiple Sports: What's Better?

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With more and more club teams and elite camps popping up in youth sports and pressure for success coming from many directions, it’s no surprise that young athletes and their families are choosing to “specialize” in one sport year-round instead of participating in multiple sports throughout the school year. Is one option better for young athletes or do both have an equal chance of helping athletes stay healthy and (for a few athletes) make it to the collegiate and professional levels?

Children who play one sport exclusively (single sport-specialization) have not only increased in number over the years, but they’re doing so at younger and younger ages. The American Academy of Physicians has emphasized that even if a child is focused on professional play (or even a college scholarship), participation in multiple sports still improves both the health of the child and even their overall performance. They recommend that children should have at least three months off from intensive sports and at least one day of rest a week.

There is also evidence that encouraging athletes to not specialize too young can lead to fewer overuse injuries, less emotional and physical burn-out, more exposure to different roles and accumulate more skills in a variety of environments. Plus, different sports require different mental mindsets and physical skills, which allows athletes to develop a more diverse skillset.

What about those who do make it to the pros?  Did specialization help them or not? A study released late in 2017 may provide answers to that.  It looked at 237 professional athletes in the NBA and compared those who were specializing in a single sport by high school versus those who spent high school playing a variety of sports.  36 were multi-sport athletes; 201 were single sport. The 37 who did not specialize in high school played in an average 78.4 percent of games, vs. 72.8 percent for single sport athletes. The multi-sport athletes were also less likely to sustain a major injury; 25 percent had one as opposed to 43 percent of single sport. Interestingly, 94 percent of multi-sport athletes were still active in the league, as opposed to 81.1 percent of the single sport ones.

Despite encouraging young athletes to not specialize in one sport too early, sports medicine experts still agree that some degree of specialization is paramount for gaining elite skills. For some individual sports (such as gymnastics or diving), this could occur when children are still in their early adolescence, whereas intense training for many sports (including team sports and endurance events) should be delayed as long as possible in order to decrease psychological stress and/or overuse injuries. Similarly, specializing might help athletes achieve the 10,000-hour rule to reach peak performance or provide kids the opportunity to be a part of experiences only available to the most elite athletes.

So, what does this mean for parents, coaches and athletic trainers involved in a child’s athletic journey? Here are a few recommendations:

  1. Make sure athletes have multiple avenues for development. For some athletes, this might involve running track in the football offseason as a way to stay physically active without the full body contact that comes with football. For others, it might be playing more casual backyard soccer with friends in the summer instead of only participating in elite travel teams.

  2. Recognize what goals a child actually has and at what age those goals are generally attained. For example, a child who dreams of being the next Simone Biles would most likely specialize in gymnastics at an earlier age than a kid who wants to play basketball at the collegiate level.

  3. Encourage athletes to take time to rest and explore non-athletic interests to lower emotional burnout.

  4. Create a care circle of athletic trainers, parents, coaches, mentors, and physicians for an athlete who is hoping to compete at an elite level to monitor best practices and the athlete’s physical and mental well-being.

  5. Remember that organized sports are supposed to be fun and to always put the athlete’s well-being and choices at the forefront of any decisions on specialization.

Concussion Awareness 101

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Concussion Awareness 101

Concussions are one of the most discussed sports injuries in the world. In 2015, 615,000 people visited hospitals and emergency rooms for head injuries. From the NFL to high school girls soccer, concussions and other traumatic brain injuries can have life-changing effects on athletes of all levels and ages.

What is a concussion? It’s an injury to the brain after a blow to the head. The brain is smaller than the skull and floats in cerebrospinal fluid. When the head is hit or shaken, the brain will move around inside the skull, sometimes hitting against the hard bone. This can cause temporary or permanent damage to the brain itself.

Symptoms of a concussion can include dizziness, headaches, confusion, and nausea or vomiting. If the effects of the concussion continue for some time after the initial injury, this is called post-concussion syndrome.

Repeated concussions can lead to the devastating condition known as chronic traumatic encephalopathy (CTE) – around thirty percent of those with repeated concussions will develop it. The condition starts with behavioral and mood abnormalities and can lead to dementia and eventual early death.

Clearly, concussions are incredibly serious, so what can be done and how can they be prevented? These resources will give you a look at various aspects of concussions and how to prevent and treat them:

  • Concussions in Children: How to Protect Their Health (OhioHealth)

    Children are more vulnerable to concussions than adults. This blog post from our friends at OhioHealth gives some ways to prevent them and, if they do occur, how to minimize their effect.

  • New Advice for Treating Young Athletes with Concussions (Orlando Health)

    Lots of what we consider common knowledge about concussions are actually out of date. Orlando Health shares some of the new research and treatment methods.

  • A Blood Test for Concussions? (Dayton Children’s)

    After an article came out about using blood tests for concussions, Dayton Children’s published this article about outlining what we do and don’t know about this potentially promising innovation.

  • Concussions in the Workplace (University Hospitals)

    Not everyone who gets a concussion is an athlete. In this article, University Hospitals shares tips on preventing concussions in the workplace.

  • What is a Concussion Clinic and How Does It Help Local Athletes? (Lake Health)

    Some healthcare systems, including our friends at Lake Health, have concussion clinics at their facilities. This article explains basic concussion information and what a concussion clinic is.

  • After a Concussion (University of Colorado Health)

    What do you do after a concussion? Here are some answers from University of Colorado Health.

  • HEADS UP Resource Center (Centers for Disease Control and Prevention)

    The CDC has a whole library of research and statistics about concussions.

  • Concussion Resources (Concussion.org)

    The International Concussion Society also has statistics, symptoms, and personal stories.

  • What is CTE? (Concussion Legacy Foundation)

    Finally, the Concussion Legacy Foundation has multiple resources about CTE, or Chronic Traumatic Encephalopathy.

At Healthy Roster, we want to do whatever we can to help encourage concussion prevention and provide tools for proper documentation when Traumatic Brain Injuries do occur. That’s why every Healthy Roster profile comes with a preloaded SCAT5 (Sport Concussion Assessment Tool 5) you can fill out online or in our app in a HIPAA compliant environment, and we can help you create or add Concussion Symptom Checklists or other documentation tools to our platform. You can also add your own resources to a Resource Library accessible by all of your athletes, coaches and parents. To learn more, click this link and schedule a demo.

Sports Medicine Licensure Clarity Act 101

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Becoming the Sports Medicine Licensure Clarity Act

The Sports Medicine Licensure Clarity Act was signed into law on October 5 after being introduced in January of 2017.  It was summarized on the Congress website as “This bill extends the liability insurance coverage of a state-licensed medical professional to another state when the professional provides medical services to an athlete, athletic team, or team staff member pursuant to a written agreement. Prior to providing such services, the medical professional must disclose to the insurer the nature and extent of the services.”

So what does that mean in plain English?

Health insurance for an individual is typically confined to one state.  Most healthcare professionals are therefore licensed in the state they live in, and no others.  Treating someone out of state is practicing without a license. Besides potential fines and loss of license, healthcare professionals had no liability insurance in case something went wrong.  For most healthcare professionals, particularly doctors, this is rarely an issue, but for athletic trainers, team physicians and other medical professionals who travel with sports teams, this could be a big problem, especially when treating a patient might lead to a loss of your job and financial consequences?

This bill protects that. It says that if a sports medicine provider is working across state lines, they will be protected by the law, and all of the practice will be treated as if it was in their home state.  So a doctor can treat an athlete on a team they travel with without fear they will be prosecuted for practicing without a license or that they will be financially accountable without the coverage of liability insurance. Much of the advocacy behind the bill came from the National Athletic Trainers’ Association, who supported the bill through its passing through Congress and into the White House.

“At Healthy Roster, we're all about giving athletic trainers the best tools on the market to not only keep athletes active and healthy, but to also help validate the role they play in our communities,” Dan Fronczak, President of Healthy Roster said. “This Act allows our healthcare providers to do what they do best - treat patients - wherever their role takes them, and since Healthy Roster is web and app-based, our platform can go with them."

As a result of the Sports Medicine Licensure Clarity Act, athletes can be cared for by the same healthcare professional as always, and that provider will be covered risk-wise for whatever they get treated for. That’s a win regardless of who you’re rooting for.