USA TODAY High School Sports and the National Athletic Trainers’ Association have partnered on a monthly column to address injuries, prevention and related issues to help schools, coaches and student-athletes. Here is the latest column from Scott Sailor, the president of NATA.

Does this scenario sound familiar? A high school athlete complains to her parents, coach or athletic trainer about chronic fatigue, headaches, poor performance on the field and lack of focus in the classroom. She thought the symptoms would pass in time, but finds that her health and schoolwork are suffering. She does not appear ill, nor has she sustained an injury that would bring on these types of symptoms. After undergoing a thorough exam including medical history to rule out an illness or injury, perhaps the adage, “sometimes the simplest answer is the correct one” applies: This athlete may be experiencing sleep issues.

Sleep is vital to health and function for everyone. For student athletes, the stress of physical performance and schoolwork may create an environment that affects their sleep. Here are three areas that are influenced by the lack of restful sleep; all play a role in sports performance:

Physical Health

• The lack of sleep interferes with healing and recovery of injuries and physical conditioning. Cells grow, repair and rebuild during sleep, making it essential to athletic performance, as well as injury recovery and prevention.
• Any disruption in sleep affects metabolism. Sleep controls insulin and glucose functioning, secretion of metabolic hormones and the way fat and muscle cells use energy.
• Healing that takes place during muscle growth occurs during sleep. In order for the student athlete to recover and build muscle during weight training, proper amounts of sleep are required to allow hormonal secretion to take place.
• Poor sleep quality and short sleep durations can lead to weight gain and obesity, especially in adolescents and young adults. Proper sleep helps stave off unwanted fat gain.

Mental Health

• The body’s ability to control stress and emotions depends on sleep to maintain proper function, and without it, the body has a hard time processing mentally stressful events, resulting in a possible increase in anxiety and depression.

Cognitive Health

• During sleep, the mind sorts, filters, evaluates, consolidates and integrates information taken in during the day, especially in class. A lack of effective sleep interrupts the brain’s ability to learn.
• Poor sleep negatively affects decision-making and clouds one’s judgment.
• Not getting enough sleep negatively affects the ability to focus and maintain attention, which are important components to learning in the classroom or in sports.

Here are some simple suggestions to enhance your sleep. Reach out to your athletic trainer for additional assistance:

• Create a “sleep friendly” environment. This includes a room that is dark, cool and comfortable.
• Get on a sleep schedule. Try for seven to eight hours of sleep per night, including weekends.
• Put away electronic devices at least an hour before bedtime, if possible. The blue light of a cell phone can stimulate the brain and prevent it from going into a sleep cycle.
• Manage stress. Everyone experiences stress, but how you manage it is important. If you feel that you handle stress in a negative way or very differently than other students, speak with a mental health professional to learn coping skills. Developing effective stress management skills and establishing healthy sleep habits will help you live a happier life.

If you continue to experience sleeping problems, contact your physician for further evaluation and care. The National Athletic Trainers’ Association has created a resource that provides tips on the power of sleep. Also, visit atyourownrisk.org for additional sports safety tips for athletes and parents.

USA TODAY High School Sports and the National Athletic Trainers’ Association have partnered on a monthly column to address injuries, prevention and related issues to help schools, coaches and student-athletes. Here is the latest column from Scott Sailor, the president of NATA.

One of the great concerns that parents have is for their child’s health. If a child experiences a sports-related injury or an illness that impairs health, well-being or performance on the field or classroom, a parent would seek the assistance of a health care professional such as a physician or athletic trainer. However, parents should be just as vigilant about the mental health and wellness of their child.

Studies show that one in every four to five adolescents and adults met the criteria for a mental health disorder within the past year. These disorders are across the spectrum of mental health challenges, but primarily anxiety and depression. Certainly, adolescence is a challenging time for a teenager for many reasons, and being a student athlete does not make one immune to experiencing the stressors or exposure to being that one in four to five who is affected by a mental health issue.

The thought of suicide is one area of mental health that has many people concerned. Suicide is the second leading cause of death for youths age 10-24, with approximately 4,700 young people dying of suicide annually in the United States. Unfortunately, secondary school student athletes are among these statistics. Adding to this concern is the stigma that is still somewhat attached to those experiencing a mental health challenge. So, how do we address the public health issue that has many parents of all walks of life concerned?

One of the first places to start is acknowledging that there is a problem and trying to address mental health issues early in the disorder. If you notice signs and symptoms, it is important to encourage intervention early so that depression or anxiety can be managed and does not progress to a more advanced stage where the student athlete may be contemplating or acting on suicide thoughts. In other words, do not let a mental health disorder progress and worsen when early detection and care could make a positive difference. What indicators might signal that an adolescent may be experiencing a mental health challenge? Part of the answer lies in observing the student athlete for behaviors that may indicate any thoughts of suicide.

The teenage years are challenging. Add in the stress of competitive athletics, and a student athlete may be at increased risk for developing a mental health disorder or exacerbating an existing condition. Being injured, demoted from the first-team, pressure from a well-meaning coach or parent or simply not living up to unrealistic personal athletic expectations can all be triggers for a mental health concern, including suicidal thoughts. Athletic trainers, coaches, school nurses, team physicians, guidance counselors and parents are in positions to observe and interact with students on a regular basis. It is important to ensure a team approach – the athletic trainer, school nurse, school counselor and team physician should collaboratively identify a potential psychological concern and refer the athlete to the appropriate mental health professional (clinical psychologist, psychiatrist or licensed social worker).

The pre-participation physical examination is an optimal time to ask about a history of mental health problems and to screen for related conditions.

Here are some of the behaviors to monitor when there is a concern for someone’s mental health and well-being:

• Anger
• Purposelessness
• Hopelessness
• Anxiety
• Depressed mood
• Withdrawal
• Recklessness, including alcohol and substance use
• Anorexia, over-exercising, or over-concern with weight
• Forgetfulness, poor grades
• Insomnia
• In extreme conditions, self-harm such as cutting oneself, or harming others through assaults on family members, teammates, friends or classmates
• Talking of death or suicide.

If these behaviors are observed, the next step would be to approach the student athlete, especially if he or she has expressed such thoughts. Simply asking, “How are you doing today” is an effective open-ended question to get the conversation started. You can also follow up with questions regarding your concern based on the behaviors observed. If the student expresses concerning thoughts, know how to access mental health referrals through the school or primary care physician.

While seeking assistance, here are three important points when having a discussion with someone who has thoughts of suicide:

1. Ask the student athlete if he or she is having thoughts of committing suicide.
2. If the person expresses these thoughts, ask about “TIPA”: Thoughts of suicide; Intention of harming themselves; Plan of self-harm; and Access to things to harm themselves. Someone who has these “TIPA” items in place is at greater risk of self-harm.
3. Do not leave the person alone. Stay with him or her until an ambulance, security or police arrives, or take the person to the hospital or mental health care facility. Know the mental health care emergency plan at your school.

Talking openly and honestly with student athletes and adolescents about mental health and wellness is an important step in preventing suicide or thoughts of it. While approaching the student athlete with a concern may be uncomfortable, remember that the health and wellness of that individual is critical. Be sure to have accurate facts before meeting with the student, and remain empathetic when the meeting occurs. Encourage the student to talk about his or her situation and to have a mental health evaluation. Discussing that stress is a normal expectation in life, and developing effective coping mechanisms to deal with it are important.

Sports participation is a great avenue to develop positive characteristics in an adolescent. Athletic trainers, among other sports medicine team members, are on the front lines of this public health problem, working daily to educate and refer student athletes with mental health issues. They help them work towards identifying and preventing events that threaten the athlete’s life and well-being.

The National Athletic Trainers’ Association has created a resource that offers additional information on suicide awareness. Also, visit atyourownrisk.org for additional sports safety tips for athletes and parents.

Scott Sailor, president of National Athletic Trainers’ Association (NATA).

USA TODAY High School Sports and the National Athletic Trainers’ Association have partnered on a monthly column to address injuries, prevention and related issues to help schools, coaches and student-athletes. Here is the latest column from Scott Sailor, the president of NATA.

Throughout March Madness, staying injury-free was likely on the minds of many of the players and coaches as their teams moved closer to championship games. Teams capitalize on peak performance during the postseason, but unfortunately, injuries, especially those to the knee, can be devastating.

The knee is the most commonly injured joint in sports, and the anterior cruciate ligament (ACL) is one of the most frequently injured knee ligaments. Damage to the ACL can happen to athletes in any sport, but basketball, soccer and football players are particularly susceptible. The injury can occur when an athlete suddenly pivots or stops, quickly changes direction or lands after jumping. Half of ACL injuries are accompanied by damage to other ligaments or cartilage in the knee, and surgery is generally recommended when dealing with a combination of knee injuries.

An ACL injury is painful and can be detrimental due to the loss of time away from play, a lengthy rehabilitation process and potential long-term health consequences such as osteoarthritis. Half of those diagnosed with an ACL injury will develop osteoarthritis within 10 to 20 years after the injury.

What can be done to help prevent an ACL injury? An injury prevention training program can help reduce the risk of ACL and other knee injuries as well as improve performance. This type of program is ideal for all athletes and those who are physically active. It is highly recommended for anyone participating in sports that involve landing, jumping and cutting tasks (e.g., basketball, soccer, team handball) and those with a previous ACL injury. Because numerous research studies suggest that female athletes are at greater risk of an ACL injury, those involved in sports that involve a lot of jumping or sudden changes of direction should strongly consider a prevention training program.

The school’s athletic trainer can help develop an injury prevention training program tailored to each individual athlete’s needs. Here are some guidelines:

Exercise Selection and Training Intensity

• The program should comprise at least three of the following exercise categories: strength, plyometrics, agility, balance and flexibility. The athletic trainer will provide feedback on movement techniques.
• Injury prevention training exercises should be performed at progressive intensity levels that are challenging and allow for excellent movement, quality and technique.

Frequency and Duration

• The program should be performed year-round at least two to three times a week.
• To maintain the benefits of reduced injury rates and improved neuromuscular function and performance over time, multicomponent training programs (preseason, in season and offseason) should be performed each year. This should not be discontinued after a single season.

Program Adoption and Maintenance

• The program should be regularly supervised by athletic trainers, physicians or other sports medicine professionals.
• Multicomponent training programs are effective when implemented as a dynamic warmup or as part of a comprehensive strength and conditioning program. If time constraints are a concern, evidence shows they can be performed 10 to 15 minutes before the start of practices or games.

Research suggests that when done correctly, injury prevention training programs help reduce the risk of ACL and other traumatic knee injuries by more than 50 percent. The National Athletic Trainers’ Association has created a resource on 10 things to know about ACL injuries. Also, visit atyourownrisk.org for additional sports safety tips for athletes and parents.

Scott Sailor, president of National Athletic Trainers’ Association (NATA).

USA TODAY High School Sports and the National Athletic Trainers’ Association have partnered on a monthly column to address injuries, prevention and related issues to help schools, coaches and student-athletes. Here is the latest column from Scott Sailor, the president of NATA.

With preparation for summer activities around the corner, there is good news for those with sickle cell trait. Although being involved in sports poses some risk, those carrying the sickle cell trait are often able to participate with proper education and precautions. Athletes with questions about how this blood disorder may affect them should check with the school’s athletic trainer.

Sickle cell trait and sickle cell anemia: What’s the difference:

Sickle cell anemia and sickle cell trait are both blood disorders that can be harmful for athletes. Here is the difference:

• Sickle cell trait is the inheritance of one abnormal gene for sickle hemoglobin and one gene for normal hemoglobin. During intense or extensive exercise, the sickle hemoglobin can change the shape of red blood cells from round to quarter-moon, or “sickle.” This change, known as exertional sickling, can pose a grave danger for some athletes. The abnormal blood cells can “logjam” blood vessels, blocking proper oxygen flow to the heart and other muscles, which can cause serious complications.
• Sickle cell anemia is when the body produces abnormal hemoglobin, causing an inherited form of anemia. This means that the body’s red blood cells tend to break apart and die, causing a lack of oxygen being carried in the blood. Periodic episodes of pain and fatigue are common. Athletes with sickle cell anemia are often discouraged from participating in sports due to the serious health risks.

Sickle cell status should be confirmed during a pre-participation physical exam since every child is screened at birth. All athletes with sickle cell trait should know their status. It is important that their coaches, other players and parents be educated and aware of exertional sickling and the potential for collapse. Athletes who are unaware of their status should ask their pediatrician for their newborn screen results.

To help prevent a sickling collapse, athletes with the sickle cell trait should follow these recommendations:

• Follow a pace-progression training program with longer periods of rest and recovery between repetitions
• Set their own pace
• Avoid performance tests such as mile runs, serial sprints, etc.
• Stop activity at the onset of symptoms and report immediately to the athletic trainer or coach, in case no athletic trainer is on site.
• Adjust work-rest cycles to accommodate environmental factors such as heat or change in altitude
• Check with the athletic trainer about the availability of oxygen in the event of an emergency 

Exertional sickling symptoms:

Because a collapse from sickling can be mistaken for cardiac or heat collapse, it is important to know the symptoms that are specific to exertional sickling. They include:

• Possible collapse during the first 30 minutes of exertion
• Fatigue
• Difficulty breathing
• Leg or lower back pain
• Sudden weakness in the muscles causing the athlete to slump to the ground
• Core temperature is not greatly elevated

Additionally, environmental heat, dehydration, uncontrolled asthma, acute illness and newness to altitude can predispose athletes with sickle cell trait to potentially traumatic conditions.

What to do if a sickling collapse occurs:

An emergency action plan and appropriate emergency equipment should already be in place for all practices and competitions. A sickling collapse should be treated as a medical emergency, and the athletic trainer or other medical professional will do the following:

• Check vital signs
• Administer high-flow oxygen, if available, with a non-rebreather facemask
• Cool the athlete, if necessary
• If the athlete appears to have slowed mental responses, or as vital signs decline, call 911, attach an AED and transport the athlete to the hospital fast
• Tell the physicians to expect serious complications due to muscle breakdown and byproducts in the bloodstream and kidneys

Knowledge, education and simple precautions may help athletes with sickle cell trait thrive in their favorite sports. The National Athletic Trainers’ Association has created an infographic handout on sickle cell and athletes. Also, visit atyourownrisk.org for additional sports safety tips for athletes and parents.

According to new research published by the National Athletic Trainers’ Association (NATA), high school baseball pitchers who also play catcher suffer three times more upper-body injuries than pitchers who play other secondary positions.

The study was published in the NATA’s scientific publication, the Journal of Athletic Training.

The NATA reports that pitchers account for 73 percent of injuries in high school baseball players, approximately 10 percent of which require surgery.

“Clinicians, coaches and parents can use this information to determine secondary positions for pitchers to decrease injury risk,” NATA member and lead author Elizabeth E. Hibberd, PhD, ATC, an assistant professor in the University of Alabama Department of Health Science, says in the study. “Our findings suggest that pitchers should consider not playing catcher as their secondary position in order to allow adequate time for recovery and to decrease their overall throwing load.”

RELATED: Study: 50 percent of high school pitchers report pain in throwing arm

While pitch counts are enforced state to state, and informally on a team-by-team basis, the results of this new study indicate that a 2.9 times greater injury risk may result from cumulative throwing load between both pitching and non-pitching activities. On each play, the pitch and catcher is involved, adding to strain on the arms of each.

Per the NATA report, the objective of the study was to compare the rate of throwing-related upper extremity injuries between high school baseball pitchers who also play catcher as a secondary position (pitcher/catcher) and those who do not play catcher (pitcher/other). Researchers studied 384 male high school baseball pitchers from 51 high school teams over three years. Of those athletes, 352 (97 percent) played a position in addition to pitcher, and 32 (8.3 percent) of them played catcher as their secondary position.

While the researchers reported 24 throwing-related shoulder or elbow injuries among pitchers during the study period, five occurred in the pitcher/catcher group, resulting in an injury rate of 15.6 percent. Meanwhile, 19 injuries occurred in the pitcher/other group spread among seven other positions, resulting in an injury rate of 5.4 percent.

As the study found, the proportion of pitchers who developed a shoulder or elbow injury during the three-year study period was 2.9 times greater in pitchers who also served as catchers versus those who did not.

“Players and adults monitoring their play should use the results of our study and previous research and work with athletic trainers to determine the injury prevention techniques to keep athletes in the game,” Hibberd said in the study.

According to the NATA, Pitch Smart (an initiative of USA Baseball and Major League Baseball) recommends not playing catcher as a secondary position. Also, Little League baseball prevents pitchers who throw more than 41 pitches in a game from entering as catchers.

As athletes prepare for summer sports camp, here are a number of safety tips that parents should consider to ensure a great experience for their children.

Before they leave for camp

• Make sure your child has had a pre-participation physical examinations (required by most camps) and that you have completed any questionnaires about existing medical conditions and medications.
• If your child is on medication, find out who will be in charge of administering it. Make sure the medication will not cause adverse side effects from sun exposure or strenuous exercise.
• Find out if the camp has medical insurance so you will be prepared in case of an injury, illness or accident.
• Check any required protective equipment for proper fit and condition, and be sure to pack any ankle or knee braces or other sport-specific equipment your child needs.
• Be sure that new shoes and equipment are broken in.
• Pack a water bottle so your child can stay hydrated during activities and in the dorm at night during overnight camp.
• Pack towels and flip-flops for showers, and remind your child not to share water bottles and towels to prevent spreading illnesses.

Who will be providing medical care

• Find out who will provide care to your child in case of an injury or illness. A dedicated healthcare professional, ideally an athletic trainer, should be at the camp to reduce risk and provide emergency care. It is important that medical decisions are made by a healthcare professional, rather than a coach or camp counselor. This eliminates any potential conflict of interest.
• If your child has a medical condition (i.e., asthma, epilepsy, diabetes, allergy), meet with the athletic trainer or other healthcare professional to discuss the condition and emergency treatment.
• Determine the parent/guardian notification process in case of injury or illness.
• Coaches should have proper training and education on key health and safety issues in case an athletic trainer is not available. They should also have CPR, automated external defibrillator (AED) and first aid training.
• Make sure the camp has an emergency action plan (EAP) specific for every practice and game facility. These plans are developed to manage serious and/or potentially life-threatening injuries and should be reviewed by the athletic trainer or local emergency medical service. Individual assignments, emergency equipment, and supplies need to be included. If an athletic trainer is not employed by the camp, other qualified individuals need to be present to render care.
• The camp should have AEDs onsite and staff trained in their use. The AEDs should be readily available within three minutes (preferably one minute) during practices and games.

Heat safety and hydration

• Before camp starts, gradually acclimatize athletes to warm weather activities over a seven- to 14-day period. They need to work out in the same conditions they will experience at camp. If they will be outside in the heat at camp, they need to progressively phase-in heat exposure and intensity of activity in the heat throughout the acclimatization period. The workouts should be at a similar time and intensity as will be experienced at camp.
• Have athletes keep water or sports drinks nearby. Individual containers are ideal so drinking is quick and easy during breaks. This will also offer easy access to beverages in the evening, which will help prevent dehydration.
• A great way to avoid dehydration and hyponatremia is to ensure campers are properly hydrated before they begin an activity by checking these three things: 1) if urine is darker than the color of lemonade – it does not have to be clear; 2) if they are thirsty; and 3) if they are urinating less frequently than normal. If they notice more than one of these inadequate fluid intake indications, they are likely dehydrated and need to increase their fluid intake.
• Campers should choose their flavor or type of drink and, whenever possible, keep the beverages on ice. They are likely to drink more if they like the flavor and it is chilled.
• Food and rehydration beverages should include sufficient sodium (enough to replace losses but not an excessive amount) to prevent or resolve imbalances that may occur as a result of sweat and urine losses during physical activity.

Sun protection

• For outdoor sports, campers should use a sunscreen with a sun protection factor (SPF) of at least 30. Apply sunscreen to dry skin 15 minutes before going outside.
• Sunscreen should be applied even if the sun is not out. UV rays can be strong, even on a cloudy day.
• If campers are swimming or sweating, make sure their sunscreen is water and sweat resistant and reapplied during breaks.

Lightning safety

• For outdoor camps, ask who is in charge of monitoring weather conditions and what weather system or app is being used.
• After the first lightning strike or boom of thunder, whoever is in charge of monitoring should make sure the activities immediately stop; everyone, including campers, staff, and spectators, must seek a safe facility.
• Once indoors, everyone should stay clear of water (showers, sinks, indoor pools, etc.) as well as appliances, electronics, open windows, and doors.
• After the final “clap” of thunder and/or flash of lightning, everyone must wait at least half an hour before venturing back outdoors. Every time thunder is heard or lightning is seen, the 30-minute clock restarts.

Just as parents don’t drop off their children at a pool without a lifeguard, they shouldn’t send young athletes to camp without this vital information. The National Athletic Trainers’ Association has created infographic handouts on sun safety, lightning and hydration and heat illness. Also, visit atyourownrisk.org for additional sports safety tips for athletes and parents.

For many programs throughout the country, August represents the beginning of another promising season for young athletes. However, as temperatures continue to rise in many regions, so does the chance of heat-related illnesses that can vary in severity from heat cramps to heat stroke, which can be fatal. While not always preventable, even in the fairest of climates, exertional heat stroke can be 100% survivable.  This includes prompt recognition and immediate cooling of the individual to a safe temperature within the first 30 minutes following collapse.

It is important that parents and athletes are informed and ask the right questions to reduce the risk of heat-related illness.

• Does the team follow heat acclimatization guidelines? All athletes need to become accustomed to exercising in the heat. Heat acclimatization involves phasing in activity (duration and intensity) over seven to 14 days to help the body physically adapt to better cope with heat stress.
• Does the team monitor environmental conditions? A medical professional, such as an athletic trainer, should monitor heat-stress conditions with equipment such as a Wet-Bulb Globe Temperature (WBGT) device, which measures ambient temperature, relative humidity, wind speed and radiation from the sun. WBGT readings may warrant immediate adjustments to the team’s practice such as changing work-to-rest ratios, increasing water breaks, modification to equipment (i.e. removing excess clothing), change in length and/or intensity of activity and moving practice times to a cooler part of the day.
• How do I know if my athlete is properly hydrating? Water should be freely available during any sports activities. However, hydration shouldn’t end there, make sure your student hydrates adequately before, during and after activity. If an athlete goes to practice dehydrated, they are already putting themselves at risk for heat-related issues. Tracking urine color can be a good indication of hydration. Pale yellow usually indicates proper hydration.

In addition, all schools or teams should have protocols for the prevention and treatment of exertional heat stroke. Anyone providing sports-related oversight should be familiar with them.  Here are lifesaving measures that the school should have in place:

1. Emergency action plan (EAP). Appropriate personnel (medical staff, coaching staff and athletic administrators) should be familiar with the EAP for exertional heat illnesses and be prepared to immediately activate the plan if an emergency occurs.
2. Cold-water immersion (CWI) tub onsite.  Once exertional heat stroke is suspected, decreasing the athlete’s core body temperature to a normal range via cold-water immersion within the first 30 minutes after collapse is critical. A cold-water immersion tub should be onsite and filled with water prior to the start of activity. Ideally this would be located in the shade or under a medical tent.
3. Medical personnel readily available. Having an athletic trainer or other appropriate medical personnel onsite and available to respond to emergency situations, such as an exertional heat stroke, will ensure timely recognition of the condition and initiation of treatment. The risk of long-term or permanent complications, and even death, is directly related to the number of minutes an individual remains hyperthermic. The presence of an on-site medical professional will ensure proper emergency measures are in place and that an athlete with EHS is cooled promptly and effectively.

Below are different signs and symptoms of the spectrum of heat illnesses.

• Heat cramps: Characterized by painful muscle spasms, sweating, dehydration, increased thirst and fatigue.
• Heat syncope: Fainting in hot environments, usually during the initial days of heat exposure. Other symptoms may include dizziness, light-headedness, weakness, pale or sweaty skin and weak pulse.
• Heat exhaustion: The inability to continue exercise or physical activity in the heat. Signs and symptoms include headache, dizziness, light-headedness, fainting, fatigue, nausea and/or vomiting and weakness.
• Exertional heat stroke: An emergency condition characterized by extreme hyperthermia (body temperature above 104°F/40°C taken with a rectal thermometer) and central nervous system dysfunction (e.g. altered consciousness, combativeness, seizures, confusion, emotional instability, irrational behavior, decreased mental acuity). Other signs and symptoms include nausea, vomiting, or diarrhea, headache, dizziness, or weakness, increased heart rate, decreased blood pressure and dehydration.

Visit National Athletic Trainers’ Association (NATA) for additional information and resources available on hydration, preventing heat illness and exertional heat stroke.

From pre-participation exams to managing season schedules, the to-do list for the average sports parent can be extensive. What may not be on the checklist, but should, is inquiring about your school’s emergency action plan. Every 25 seconds a child visits the emergency room for a sports related injury, so knowing that your school is prepared can provide additional peace of mind that your child is in safe hands.

What is an emergency action plan (EAP)?

An emergency action plan is a written venue-specific plan that outlines what to do and who to call in the case of an emergency — medical, weather-related, active-shooter or otherwise. More specifically, it describes the personnel involved and their roles in an emergency, the communication process, emergency equipment location, transportation guidelines, and response times, among other things. Your school may have more than one EAP.

Whether practicing or playing a home game or on the road, every team should be able to easily access their venue-specific EAP, which needs to be reviewed and maintained by a medical professional, such as an athletic trainer, as well as the school and any other institutions involved.

Why are EAPs important?

EAPs are critical to providing a quick, appropriate and coordinated response in the wake of an injury. Athletic trainers, EMTs, school administrators and coaches should all work together to practice what to do in case of an emergency at least once a year. This preparation ensures that everyone knows their role and correct actions in managing the situation.

What are the important components of the EAP?

• Easy to Find – It should be posted and quickly accessible in the case of emergency.
• Who is in charge – It should have the names and numbers of the people executing the plan along with their qualifications and role once the plan is activated.
• Equipment needed – It should list the equipment needed to carry out the tasks required in the case of an emergency, along with the location where the equipment can be found.
• Communication – It should have an emergency communication plan that identifies who to call in the case of an emergency and where easy access to a telephone can be found. This should also include a plan B in case the designated phone is not working.
• Directions for Transportation – It should have specific directions on how to get emergency services to the activity venue. There should be a map included.
• Where to Go – It should also list the emergency care facilitates where the injured person will be taken. Appropriate personnel at this location should also be included in the creation of the document.

Questions to ask when your sign up your child

• Is there an emergency action plan? If so, where is it posted?
• Will there be a medical professional, such as an athletic trainer, at all practices and games that will be in charge of activating the EAP if needed? If not, who in charge?
• Has the emergency action plan been rehearsed by medical professionals and the local emergency medical service (EMS)? Has it been within the last year?

If the answer is “I don’t know” or “no,” then advocate for an EAP to be created and adopted ASAP. It’s critical that schools understand the critical role they play in providing appropriate care in the event of an emergency. Having a plan helps key members coordinate their roles, responsibilities, and information in a quick, appropriate and coordinated manner, a manner that could very well save a child’s life.

To learn more about sports safety guidelines that should be in place at your school, check out https://pass.nata.org/standards

A series of studies in the Journal of Athletic Training about the effects of being a specialized athlete at a young age left researchers with a distinct takeaway:

Focusing on one sport at too early an age increases the risk of major, career-threatening injury later in life.

“The theory here is that repetitive activity, performing these repetitive sport-specific tasks over and over again, will stress the tissue … and then eventually lead to a breakdown in that tissue overtime,” Dr. David Bell, a professor at the University of Wisconsin who led one of the studies, said in a press conference.

This week, the National Athletic Trainers’ Association is holding its Youth Sports Specialization Awareness Week to raise awareness of the impact of focusing too heavily on one sport and one group of muscles while the body is still developing.

In girls basketball, soccer and volleyball, specialization increased the risk of hip- and knee-joint injuries, according to a study led by Christopher A. DiCesare. In baseball, pitchers who specialized early had a higher risk of elbow and shoulder injuries, according to a study led by Amanda J. Arnold.

“From a developmental standpoint, you need to build the athlete, you need to build overall athleticism, and get kids moving well. This concept of physical literacy – getting them to move well before you’re getting them to move more and at higher intensities,” said Dr. Michele LaBotz, a professor at Tufts University who led one of the studies, said in the press conference with Bell.

“Because if you don’t have that foundation, when you start to build those very specific skills, they’re not going to be able to adapt and they’re going to break down a lot quicker.”

A study also warned that there’s little evidence suggesting sports specialization leads to full-ride college scholarships or professional opportunities. There are outliers, including some who go on to be all-time greats, such as tennis star Roger Federer, but “no data supports” specialization leading to a higher likelihood of doing either, according to a paper in the journal written by NCAA Chief Medical Officer Brian Hainline.

NATA president Tory Lindley, who moderated the press conference with Bell and LaBotz, said a question he frequently hears from college coaches, in fact, is if the athlete of interest played multiple sports in high school.

In a Q&A with parents, Bell acknowledged that youth sports culture makes it tough to get adequate time in multiple sports. Whether it’s a select league like travel baseball or AAU basketball, or coaches’ summer leagues that varsity players often need to play in to prepare for that season, there are other components at play.

“When we talk to young athletes and we survey them, they say, they perceive a lot of benefit from specialization,” Bell said.

Bell recommended playing the sport for eight months a year and taking three to four months off throughout the year. The child should should be active, but taking time off from the specific sport will allow those body parts to relax and recover.

Researchers also recommended playing multiple sports to build different muscles while learning abilities that could apply to the main sport, too.

Jamie Reed, the senior director of medical operations for MLB’s Texas Rangers, was part of the Q&A. He has spent 38 years in baseball athletic departments focusing on elbow, shoulder and spine injuries.

He said the Rangers annually get medical risk assessments of about 575 to 600 draft targets. In 2014, 41 of the players they looked at had a Tommy John surgery in their history. That number rose each year, hitting 109 in 2018, before spiking all the way to 308 in 2019.

Reed said the focus on travel baseball and sports specialization is a cause of this, comparing those body parts to “literally tread on a tire” wearing out the more athletes use them without resting.

“When we’re talking about 5-, 7-, 12-year-olds, it’s gotta be fun first,” Reed said. “Wait until talent is needed before really specializing in anything.”

A study recently showed that more than half of California schools either don’t have an athletic trainer who’s fully qualified or don’t employ one at all.

Another recent study reveals that this issue is not just prevalent in California.

It found that 34% of public and private high schools in the U.S. have no access to an athletic trainer. Also, 47% of schools that have access to athletic trainers only received part-time services.

“School districts, school education boards, state legislators and state athletic associations continue to take a reactive, rather than proactive, approach to addressing safety concerns,” Robert Huggins, the lead author of the study, said in a statement.

Similar to the study conducted for California, across the United States there is a difference in care between private and public schools. Among private schools, 45% had no access to an athletic trainer. For public schools, that number is at 31%.

“The safety of student athletes must be the top priority for schools with athletic programs, not just in rhetoric, but in allocation of resources to put the appropriate personnel in place,” NATA President Tory Lindley said in a statement.

The study was conducted by the Korey Stringer Institute. It was published in the Journal of Athletic Training, the National Athletic Trainers’ Association’s (NATA) scientific publication.