Building Culture to Mitigate Injury Risk

Since becoming an Athletic Trainer I have also resumed my roll as a Strength and Conditioning Coach. This dual role was a natural progression for a variety of reasons. Professionally and academically I am both an Athletic Trainer and a Strength and Conditioning Coach. Philosophically and functionally it is impossible to separate these roles and still provide the best patient care that I am able to. I also have excellent weight room facilities directly attached to my athletic training facility. I have written about this in past blogs referencing my utilization of the FMS as part of my RTP decision making while noticing increases in FMS scores after rehabilitation from orthopedic injury, the development of a loaded movement skills hierarchy with basic patterns of hip hinge,  squat, push, pull, and carry with the addition of low amplitude high frequency to high amplitude low frequency plyometrics in the saggital, frontal, and transverse planes, and how I utilize these principles not only in strength and conditioning but equally in rehabilitation.

Midway through the Fall Sports Season I was seeing what I imagined was a normal amount of injuries for a football/volleyball/cross country season between grades 7/8 and Junior Varsity/Varsity. I was however troubled by the dusty, unused training equipment in the weight room while at the same time seeing low aggregate and individual task scores on the FMS and injuries that appeared to based in a lack of stability and motor control and athletic readiness. What I had yet to discover at the time of previous writings was whether or not the implementation of this type of rehabilitation philosophy along with comprehensive strength and conditioning programming would alter the culture of the school from those who seem to passively engaged in athletics into one that would prepare to compete, or if my assumption that I may be in a position to prevent injury through proper training, based on a few data points produced by comparing pre and post injury FMS scores, would prove fruitful in my overall patient care. It appears that on both accounts my patient population has benefited.

At the conclusion of the fall sports season I had:

Football:
4 patients missing practice and competition with concussions.
1 patient with an on going manageable orthopedic injury that required no lost practice or competition time.
0 patients missing practice or competition with orthopedic injury.

Volleyball:
4 patients with on going manageable orthopedic injuries, all sustained prior to my arrival, that required no lost practice or competition time.
0 patients missing practice or competition with orthopedic injury.

Cross Country:
1 patient, who after the state cross country meet took time off to recover from a potential stress injury to a tibia.

At the conclusion of the winter sports season I had:

Boys Basketball:
1 patient with on going manageable orthopedic injury that required no loss of practice or competition.
0 patients missing practice or competition with orthopedic injury.

Girls Basketball:
1 patient missing practice and competition with concussion.
0 patients missing practice or competition with orthopedic injury.

It should be noted that due to the use of the Mulligan Concept LAS technique and fibular repositioning tape applications five patients among the Boys Basketball team were treated at various times during the season for sprained ankles without prophylactic tape applications and with no loss of practice days or competition. Moving into the spring sport season I will have Junior High Girls and Boys Basketball and High School Baseball, Softball, and Track and Field. Not only am I going into this season with only two minor active patient cases on my rosters but the strength and conditioning program is showing signs of a cultural shift. Student athletes from 8th to 12 grade are now able to teach their peers much of the loaded movement hierarchy and plyometric progressions with an eye to proper form and seem to understand the purpose of moving well, moving often, then moving with load. They are not only buying into some of the principles I teach, they seem to be understanding them well enough to mentor their peers. I am excited.