Backboarding the injured athlete is an ever-evolving skill. Dr. Matt Camarillo discusses it live at the Memorial Hermann Sports Medicine Update

How common are spinal cord injuries?

-9-10% of injuries are spinal. About 12,000 nationally.

Looking at physicals I have a couple of athletes with previous spinal cord injuries. What are some of the things that I should be more aware of when taking care of these athletes?

-Usually due to trauma or born with cervical stenosis.

-Should have a spine surgeon associated with the athletic population

We talk about spinal cord injuries, and the first thing we think about is football. We think that it is equipment-heavy and collision-based and talk about equipment removal for that. But what is the instance in other sports?

-Happens in lacrosse, gymnastics, hockey, soccer, baseball, and basketball.

-Helmet and shoulder pads keep them in alignment then leave it on.

-If only a helmet probably needs to come off.

These spinal cord injuries, I believe you mentioned there are about 12,000 injuries per year. Are these spinal injuries with awareness in education are we increasing these or decreasing these?

-Since 1975 they have gone down.

-A lot of spinal injuries come from automobile accidents.

Is there a reason for that?

-Awareness, and if it goes away the numbers will go up again.

Moving back into narrowing down into more of an athletic training setting when working with sport athletes for example what would be our initial assessment and what would be some red flags to actually move the person onto a spine board?

-Big trauma like a head-on hit you want to be careful.

-Clinical judgment.

-numbness bilaterally

The athlete just has a lot of pain.

-Trust your gut

So once you decide to stabilize someone, I know you talked about two methods to stabilize, but what is your preferred method?

-6 man lift

-If you don’t have enough hands, nobody will fault you for doing a log roll.

When is it appropriate to move the neck into neutral?

-It is always ok as long as you do the head or trap squeeze.

-You want to make sure you have access to the airway.

Can you talk a little bit about the difference between a head or trap squeeze?

– head squeeze is more about putting you hands around the athletes head or helmet

-trap squeeze where you are putting your thumbs and finger around someone’s traps and gives you more stability because you also have to add in the fatigue factor.

-Trap squeeze is more stable

Be aware that clothing could cause you to slip while holding a helmet.

I think it comes down to practice and figuring out how everything works. Because once you get it down, then when all that emotion going, if you practice over and over again it just becomes a routine.

What are some tips you have for someone who is working with an equipment-intensive sport, like hockey, that they are not familiar with the equipment?

-Practice

-Use equipment managers to become familiar with equipment.

What does it look like once they are at the hospital?

-equipment removal and go into a cervical collar.

-Then straight to a CT scan is #1.

-Transport to a level 1 hospital because you don’t want to have to move to multiple locations.

Can you talk about differences between places that have stopped using spine boarding techniques like in motorcycle accidents?

-Two different mechanisms and two different thoughts.

-Make sure everyone is on the same page

-You can always ask to talk to a supervisor because these are generally big EMS areas and you can’t control what everyone does.

Can you talk about the order you take the piece off of the helmet?

-Side pieces off first. Allows to flip and gives access to the airway

CPR with shoulder pads. With a spinal cord injury and you are having to do CPR and you are removing the equipment, you would leave the shoulder pads in place as long as you open them up?

-Open them

-If getting into CPR take them off because it has become life-threatening.

Do you have any recommendations for an AT who does not have a lot of volunteers or staff and might be working alone?

You have coaches. Train the coaches. ...

Turf Toe is ever-changing. Dr. Paul Shupe and Joseph Eberhardt discuss some of the facts and history of turf toe at the Memorial Hermann sports medicine update.

What can I do to benefit my athlete since turf is here to stay?

Making sure the field is well maintained, and proper personal protective equipment is significantly important. A lot of football players like to wear narrow cleats which can contribute to lower extremity injuries based on the cleat pattern, length, and width of the shoe. The time of day we practice is important as well.

Is there any data or research done about laces and appropriately tying the shoe with appropriate arch support?

Great question, I’d have to look into that. I’m sure there are studies – I didn’t delve into that. These are very important questions, I think that core strengthening is a very pertinent point as well.

You spoke about an increase in PCL injuries. From my education, the mechanism of injury for PCL is that dashboard injury, coming from direct force on the anterior tibia. Is there any research, or from your background and knowledge, why is it that we’re seeing more prominence from that mechanism on that turf?

When it’s not a dashboard injury, the common mechanism is that you onto your knee bent at 90 degrees, your toe has interacted and your cleat is stuck in the turf so it’s not giving away.

Your foot is in this dorsiflexed position and you land on that knee with all of the force going back through, as opposed to if the shoe gives out allowing you to land on less of a 90-degree angle.

Is there any correlation to gastrocnemius weakness regarding those Turf Toe injuries?

I think that’s a valid argument, I don’t have enough science or background to say but I do think that would be an interesting thing to study.

We talked about the history of turf in your presentation, would you say we’ve moved in a safer direction? Are we moving to a safer surface?

I think we are, I think we’re moving to a safer surface for our lower-level athletes. I think our higher-level athletes have different muscle builds and different muscle types that may lead to some of those injury at a higher level.

I do think the technology that’s going into it is moving towards a safer playing surface, I don’t think there’s much we can do about the heat and some of the other things, and they are looking into that. I think we are moving there, the important thing here is that turf isn’t going away, I don’t think that we’ll ever go back to grass.

With technology moving forward, I do think it’s becoming safer. I don’t think it’ll ever be 100% safe but with education, and proper maintenance, I think we can make it as safe as we can.

You mentioned the coconut or the cork, those things are natural materials that would rot, and putting turf in is a lengthy and expensive process. How does it make sense for a high school field to put something that might rot underneath there?

So part of it is just the turnover of it, so it’s got to be properly maintained. So when we use the proper equipment and the proper rakes just to shift it around that’s a valid question, especially in a wet and humid environment like it is here. It’s not being used a ton yet, and I think that’s yet to come. We may determine years from now that it’s a bad idea.

Rice uses wood instead of rubber on their field, I found that interesting when we played there last year.

Did you notice any difference?

Thinking back, I think your point about feet being sore on these fields; is a major problem. Your feet hurt at the end of the day on the rubber. There’s less of that impact.

We did have in our Rice game, but I don’t think it makes a difference in injury, we had an ankle fracture that game, we had a significant hamstring rupture, and a couple of other things so I don’t think it makes a difference as far as the interaction of the cleat but it may make it as far as the softness.

You mentioned your time in the military where you would sweep and make sure there was no foreign debris as part of the turfing. Can you speak briefly about your time serving our country?

I served in the Navy for 12 years and loved it. I trained as an intern, and then I was 3 years as a flight surgeon with the Marines, serving in an F-18 squadron. I had the opportunity to go all over the world with that, then finished my ortho training in San Diego.

Then I spent 4 years as an orthopedic surgeon in Japan and Florida, and loved it.

They were not allowing me to ...

Mitigating Secondary Loss is something that hits home for me. Bubba Wilson has taken his role with ATsCare to another level. We recap the summer and one of the best CEU talks I have ever heard.

Where has AT taken you?

JJ:

Thibodeaux, LA

Dallas, Texas

Arlington

Fort Davis

South Padre

Lansing Michigan

Hot Springs

Las Vegas

New Orleans

San Antonio

JJ Road trip

5 weeks

One van

7 people

Chad from Candid AT

Michigan AT Society Meeting

Meeting Cookie Tuesday in Detroit

Megan Smith at the University of Delaware.

Favorite tourist thing:

Niagara Falls

Least favorite tourist thing

Statue of Liberty

Bubba

All this travel means you need to have your stuff in order...

I teach and followed the DaveRamsey plan to get out of debt, budget, and have my financial house in order

Talk about secondary loss

Nok box

I Am Dead, Now What

Bubba’s Quick Start Guide

Video from Trinity Sports Medicine Update

Call to action:

Contact:

Bubba Wilson –@ATCLATBubba – on X

Jeremy – @MrJeremyJackson on socials

These people LOVE Athletic Trainers and help support the podcast:

Frio Hydration – Superior Hydration products.

Donate and get some swag (like Patreon but for the school)

HOIST – No matter your reason for dehydration DRINK HOIST

MedBridge Education – Use “TheSMB” to save some money, be entered in a drawing for a second year free, and support the podcast.

Marc Pro – Use “THESMB” to recover better.

Athletic Dry Needling – Save up to $100 when registering through our link.

AI Motion Capture can be a game-changer for orthopedics. Dr. Adam Whitman of Medbridge discusses how we can benefit and what we have to be careful of when using AI Motion Capture.

Everything has AI now, what does motion capture with AI mean?

AI has been around since the internet started.

As hardware improves so can the calculations the computers can do.

Self-driving cars example – cows falling from abridge...what would you do vs what would a computer do?

AI does really well in processing huge amounts of data rapidly and consistently.

The physics problems in movement patterns allow for AI to be used for growth and improvement.

The machine has to be fed.

ROM is easy to capture and accurately measure.

The computer is limited in cases like spinal movement.

Theoretical AI Motion Capture concepts

Look at the FMS – they are built to be read against functional norms. It has been confirmed against many hundreds of thousands of instances.

We are looking for the potential for injury.

Think about scapular winging...it is like building a house on a concrete foundation vs building on a swamp...which one is built to last.

Some algorithms are being fed based on info so they begin looking for biased outcomes.

One AI model determining which patients should be prioritized from an insurance standpoint became racist because it was being fed biased information.

The algorithmic process can remove the bias when it is fed comprehensive data.

ChatGPT is now its own prompt engineer that allows you to ask average questions and get really good answers.

I look forward to when we can feed the movement into the machine and let it run its analysis without our input.

Think about re-captcha...computers are still bad at identifying objects in pictures. Humans are still needed.

Your movement analysis is your movement fingerprint. That can become a movement profile with each new recording.

What does that look like for the Athletic Trainer?

Emphasis on prevention of injury to the athlete as opposed to reaction-based interventions – reduce the likelihood of an ankle sprain or ACL tear by catching fault movement patterns before the injury occurs

Contact Us:

Dr. Adam Whitman – [email protected]

Jeremy Jackson – @SportsMedicineBroadcast on IG

These people LOVE Athletic Trainers and help support the podcast:

Frio Hydration – Superior Hydration products.

Donate and get some swag (like Patreon but for the school)

HOIST – No matter your reason for dehydration DRINK HOIST

MedBridge Education – Use “TheSMB” to save some money, be entered in a drawing for a second year free, and support the podcast.

Marc Pro – Use “THESMB” to recover better.

Athletic Dry Needling – Save up to $100 when registering through our link.