Bilateral Sideline Coverage

A few weeks ago, during smokepocalypse 2017, football games at highschools across our region were rescheduled to be played in an indoor facility. Unlike wonderful natural grass fields, sprinturf is a wound care enthusiasts best friend, and bleeding is something that must be handled per rules and regulations to minimize the potential for exposure to blood born pathogens, MRSA, etc. This tends to up the workload for Athletic Trainers. You might not believe this, but most high schools with a student body of less than 100, serving a town or city with a population of under 1000 do not have Athletic Trainers. As such, I am often asked to cover both sidelines for significant issues.

In one particular game, the team opposite mine was lacking even basic first aid supplies. Seeing someone from the opposing team jogging around the endzone and onto my sideline, I met them and they asked if I would clean up a fairly significant wound to a member of their teams elbow. I quickly ran around the field to their sideline and began patching up the injured player when I heard my name being shouted. The calls were coming from a position essentially as far away on the field as possible. What I saw there was a member of my team flat on his back. Thinking a bit too quickly, I closed my hand around the remaining supplies for wound care that I should have left with the opposition and, being quite quick on my feet, arrived swiftly to evaluate the situation with my student athlete. On the way I began lamenting not leaving those supplies with the other sideline though I was sure they would understand my priorities given the situation. Later in the game, while dealing with a knee injury and half my roster suffering from bilateral lower leg cramps, I witnessed one of their players being carried off the field by their coaches with his leg extended and a heavy dose of tape on his ankle. I logged this somewhere in my mind for some reason and went about my evening sorting out the low level yet persistent carnage.

After the game had concluded and I had made sure that my patients were all accounted for, I went back on to the field to look for the young man with the ankle tape feeling a bit sorry for teasing them with my med kit full of wound care supplies and then swiftly sprinting away leaving them with nothing but a blood soaked 4x4 gauze stuffed into my inside out glove. As luck would have it he was being piggybacked off the field by an assistant coach with a plaster cast level ankle tape application half torn off of his leg. I walked over and asked them if they would like me to cut the remainder of the tape off and do a quick evaluation of his ankle, they graciously accepted telling me that he had 'rolled' his ankle in practice at the beginning of the week and had done it again, painfully, during the game. After removing the tape application I found a classically sprained left ankle presenting as a fairly perfect Mulligan Concept candidate. I asked the patient and the coach if they minded if I tried to 'sort out his ankle', they both rather skeptically said 'sure'. After 3x10 mobilizations with movement including clinician over-pressure into plantar flexion/inversion followed by a series of grade 2/3 anterior to posterior talar joint mobilization with passive dorsiflexion, and some minor hand placement adjustments, I asked the patient to stand and take a short walk. He obliged and walked away with no antalgic gait and no complaints of pain or stiffness in the ankle. Both the coach and patient had a difficult time thanking me through their confused smiles.

I returned to our locker room for one more check in, then went back to the field to find some of my student athletes mingling with their friends and family. As I entered the field, I found the entire staff of the opposing team standing in a circle with the coach mentioned above attempting to explain what I had done to his players previously injured ankle. He saw me as I walked by, pointed and said "him, he fixed his ankle". The response form the rest of the coaching staff were good natured cries of "hey I have this pain in my back from bulging disks" and "hey can you fix my old knees" etc. It was oddly satisfying to profoundly help a patient from the opposition, who had just beaten us fairly badly. I'm not sure why experiences like these have been some of the high points for me, but I think it has something to do with the relative lack of Athletic Trainers in secondary school settings in my area. If I can demonstrate value at every opportunity, perhaps I accomplish something small in the way of advocacy for athletic training services in rural communities and secondary school environments.