Hand hygiene and shots can help athletes win against swine flu

This season, the star players on many football teams may not be on the offense, defense or specialty teams. Instead, it may be up to the medical team to execute a successful game plan.

The H1N1 influenza virus has proven to be a formidable opponent for even the toughest teams. Over recent weeks, legions of players throughout the southeast have been relegated to isolation, causing some games to be canceled. H1N1 is now heading north.

Viruses are not susceptible to antibiotics and the best way to limit spread is by immunization. Unfortunately, that requires forewarning and preparation. H1N1 is particularly virulent and a large scale immunization program has yet to be initiated.

Symptoms include high fever, chills, fatigue, nausea and coughing. College athletes are more vulnerable because dormitories and other close living quarters are breeding grounds for any virus. Universities have instituted strict isolation policies but the virus can be spread for approximately 24 hours before and after the onset of fever.

This attack has actually changed how sports-related injuries are treated.

“The H1N1 outbreak has caused us to refrain from using any medications that might even remotely suppress the immune system when treating injuries,” said Dr. Jeffrey Anderson, medical director for the University of Connecticut Department of Athletics.

He hopes the H1N1 vaccine will be available for winter sport athletes.

The best way to limit the spread of any virus is by practicing good hygiene:
• Wash hands with soap and water or alcohol-based antimicrobial hand cleaner, especially after sneezing or coughing.
• Avoid unnecessary human contact.
• Do not share utensils.

Instituting some basic precautions may prepare athletes to limit the spread of this virus and chalk up some extra victories.

Young athletes need good role models

Athletes making poor decisions both personally and professionally are now a common occurrence. Sports fans read about these indiscretions so often that they are almost expected behavior.

Although many of these choices have legal implications including time in prison, they also can have serious health consequences. Young athletes are now using unprescribed supplements purchased on the internet in astonishing numbers. Peer pressure to drink alcohol and use illicit drugs continues to rise.

No one will argue that things have changed for the worse over the past several decades. Recently publicized events raise many questions:
• What has changed in sports and in society that has resulted in a “leadership void?”
• How can parents, coaches and teachers help correct this and hopefully protect athletes?
• What is the role of the media?

Football has traditionally been the team sport serving as a model for leadership in the United States. No other sport is so similar to battle and requires careful coordination of many skills for success. The quarterback position is analogous to that of a field general leading troops. Bad behavior is more dramatic in football because of the team implications.

“Thirty years ago, the technology to broadcast every college football game wasn’t available,” said Tim Prendergast, director of football operations at the University of Connecticut. “The internet, 24-hour sports television and U-Tube now dramatically increase the exposure of athletes.”

This exposure also influences the behavior of young athletes who imitate their heroes’ poor sportsmanship in the end zone and at times bad health decisions. Prendergast believes that good leaders are able to identify a goal, remove any obstacles to achieving that goal and thank others for their help.

Coaches and administrators agree that leadership is best taught by example. Youth organizations and church activities provide good opportunities other than athletic events to influence young adults.

“The community now also serves as the extended family for many athletes. Many people serve a role in raising a leader,” said Jamal Davis, head coach of the Norwich Free Academy football team. This year Coach Davis is emphasizing the importance of commitment, character and courage both on and off the field with his players. He repeatedly drives home the point that after football, it is these characteristics that will be their legacy.

Dr. Michael Joyce, an orthopedist and highly-regarded team physician, along with his wife, Pam, are embarking on a large-scale effort to provide the necessary skills for athletes to become leaders. The KJ Life Foundation (www.KJLife.org) was established in 2009 in memory of their son, Kenneth, who died tragically in a ski accident.

The foundation has begun a series of seminars for athletes to serve as peer role models by setting good examples and developing character.

“There are moment-to-moment examples of good character. We need to capture those moments and use them as teaching tools,” said Dr. Joyce.

The recurring theme is that personal responsibility is crucial to getting the most out of any athletic experience and making the right decisions to stay healthy.

Athletes require a team of physicians

At one time, sports medicine solely consisted of orthopedic surgeons and athletic trainers. There is now a myriad of physicians associated with professional sports teams and scholastic athletic programs. While each contributes something different, it is important for an athlete to understand how various physicians approach sports-related injuries.

Primary Care Physicians: These are medical doctors (MDs) or doctors of osteopathic medicine (DOs) who have completed a residency program in either family medicine, pediatrics or internal medicine. They then enter a one-year fellowship program in sports medicine and complete an examination to attain added qualifications in sports medicine (AQSM). Most major sports programs now have one or more primary care physicians who treat non-operative sports injuries.

Orthopedic Surgeons: Many orthopedic surgeons who specialize in sports medicine complete an additional year of fellowship training after residency. This year is exclusively devoted to sports-related orthopedic injuries and working with a variety of sports teams.

Sports Neurologists: While there is currently no formal fellowship in sports neurology, these are MDs or DOs who complete a neurology residency and treat athletes with neurologic injuries. Concussions, spinal injuries and injuries to peripheral nerves are typical.

Sports Psychologists: Sports psychologists have PhD degrees in clinical psychology. They help athletes deal with the mental aspects of their sport to improve performance.

Other physicians who are commonly utilized as part of the sports medicine team include chiropractors, podiatrists and dentists.

In the case of a sports-related injury, the approach and goals of treatment center around how to get an athlete back to sports participation safely. When seeking care it is wise to investigate what experience that physician has in sports.

Sports medicine involves a wide range of specialists

“The advice you receive is only as good as the source.” This adage is especially true when seeking medical advice for a sports-related injury.

As sports medicine has become more inclusive of various disciplines, it is sometimes hard for athletes to determine where they should be going for consultation and treatment. Here is a rundown:

Certified Athletic Trainers (ATCs): These professionals are the quarterbacks when it comes to evaluating and treating sports injuries. They are often employed by a school or team to oversee medical care. Their role includes obtaining consultation with appropriate medical specialists. Athletic trainers serve as the intermediaries between physicians and administrative staff.

Physical Therapists (PTs): Physical therapists specialize in rehabilitating medical conditions. These can be musculoskeletal, cardiac or neurologic in nature. A variety of modalities can be used including ultrasound, traction and stretching exercises. Many physical therapists specialize in rehabilitating sports-related injuries.

Certified Strength and Conditioning Specialists (CSCSs): This group typically works with teams or individuals to put together a workout regimen that will avoid injury and improve athletic performance. They accomplish this through exercise and nutrition.

Personal Trainers: Personal trainers are usually employed at gyms and by individuals to provide advice and instruction on proper ways to exercise. They emphasize putting together an effective workout routine and avoiding injury.

The most important difference between these groups is that athletic trainers and physical therapists are medically-based disciplines. They are trained to diagnose and treat sports injuries while working closely with a physician. Strength and conditioning specialists and personal trainers are performance-based and emphasize reaching athletic goals.

Many sports medicine professionals are certified in multiple disciplines. Deborah Gardiner of Procare Physical Therapy in Willimantic has both a Master’s degree in physical therapy and certification as an athletic trainer.

Scott Di Francesco is a certified athletic trainer and certified strength and conditioning specialist. Along with his brother, Tim, a physical therapist, they own TD Athletes Edge in Salem, Mass. They work with many professional athletes to rehabilitate injuries and help them exceed previous accomplishments.

Sport-specific programs for rehabilitation and training are now growing in popularity. These consist of various medical and performance professionals who specialize in a specific athletic activity. They often work with athletes beginning in their teens during the off season to develop strength in muscles needed for their sport and a diet that will help them succeed during the season. Surprisingly, these programs are very different and can be designed for any sport.

Sports medicine physicians have also become a diverse group. Next week, Healthy Sports will clarify some of the confusion surrounding how different physicians approach sports injuries.