Athletic Trainer Experiences with Chicago Bulls; What is Brain Network Activation™ (BNA) Testing?

Episode 14.24 with Hosts Steve Kashul and Dr. Brian Cole. Broadcasting on ESPN Chicago 1000 AM Radio, Saturdays at 8:30 AM/c.

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Segment One – Dr. Brian Cole and Fred Tedeschi, former Head Trainer for the Chicago Bulls talk about their experiences and friendship over 13 years managing the Bulls training and injuries and the changes that have occurred over that time. Fred also talks about his new role as director of athletic training services at Oregon State University. Some of Fred’s achievements include:

NBATA Joe O’Toole Athletic Trainer of the Year in 2007; President of the National Basketball Athletic Trainers Association (NBATA) from 2005-07; Certified Performance Enhancement Specialist (PES) and a Corrective Exercise Specialist (CES) by the National Academy of Sports Medicine (NASM); athletic trainer for NBA’s Basketball Without Borders in Paris, France in August 2007 and Johannesburg, South Africa in September 2006;  served as Eastern Conference representative to the NBATA executive board (2001-03); member of the National Athletic Trainers Association since 1983; head athletic trainer at the University of California-Berkeley; head athletic trainer at Vanderbilt; training assistant with the San Francisco 49ers from 1983-84.

Segment Two – Athletico’s Mike Palm, MS, MBA, ATC, Manager of Concussion Services talks about measuring brain function pre and post concussion to helps determine when an athlete can safety return to play.

A Brain Network Activavtion™ (BNA) Test uses an advanced software program to process measured brain activity. This cutting edge technology allows us to gain full insight into brain function as the test reads, and measures all neural activity. This test is performed preseason to understand the individuals typical brain function.

Advantages of Brain Network Activation™ Testing

  • Allows physicians to better understand a brain injury such as a concussion
  • Detects and measures actual brain activation
  • Reassurance for return to participation decisions
  • First-of-its kind, groundbreaking technology that measures brain function
  • Athletico is the only Brain Network Activation™ Testing Center in Illinois
  • Annual preseason test used to compare a change in brain activity following a brain injury
  • Cleared by the FDA, unlike many concussion testing protocols on the market.

The BNA Testing Process

The BNA Test process starts with scheduling your BNA Test. The next step is then receiving the test at one of Athletico’s BNA™ Testing Centers. Once the BNA Test is complete, your Brain Network Activation (BNA) report is stored in a secure, de-identified cloud-based database, that can be accessed by a physician if a brain injury were to occur. Read more>>

Play Podcast – 30 minutes

Meet The Painted Warrior

By CorePower

Who Is The Painted Warrior?

You may have seen him at a Spartan Race, or on social media. Half man, half art project, and 100% committed to his fitness goals. Meet Stephen Sinek, a.k.a. The Painted Warrior. His mission is to become a Spartan Champion, while using his body as a canvas for the art of fitness and the art of body paint. We caught up with Stephen to find out how he prepares for the challenges of his next Spartan Race.

THUNDER PAINTED WARRIOR

Core Power: Hi Stephen. How did you get started in obstacle racing?

Stephen Sinek: After a death-defying four-day hike down the back country trails of the Grand Canyon, my friend challenged me to our next adventure; something new and intimidating: Obstacle Racing.

CP: How Many Spartan Races have you done?

Stephen: Currently, I have done over 60 obstacle races, with more than 50 being a Spartan Race. I average about 1-2 a month, so my tally grows very rapidly.

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CP: How did your body paint idea start?

Stephen: My wife Aeni is a professional makeup artist, so it almost seemed destined for the body painting ritual to develop. We originally did it for my first race to try and win the costume contest. At that time, I was not competitive, but as racing became more serious for me, so did our efforts to make the paint a real artistic expression for the unique audience that is drawn to Spartan Races.

CP: How do you decide the body paint design for each race?

Stephen: Lately we try to tie the inspiration for each new body paint design to the race location in some way, whether it be drawing from the state bird, Native American cultures of the region, or anything else we feel deserving. The final product can be designed by either one of us, or sometimes as part of a collaborative effort.  In either case, it is always something we both agree upon.

CP: How do you train for Spartan Races?

Stephen: When training for a Spartan Race, do what the Spartans do! There is no better way to get better at something than by doing that “something”.  I practice spear throwing, rope climbing, tire flipping and many other Spartan-specific skills in my weekly routine. I try mixing in these activities when my heart rate is up, say during a run or after a set of burpees, rather than when I’m feeling fresh. If you do this, when race day comes, you’ll be more than ready to crush those challenges.

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CP: What’s your daily fitness routine/diet?

Stephen: My fitness routine consists of a “CrossFit Endurance” style of workout, through the Spartan Group X training program on Monday, Wednesday and Friday. This includes strength training with weights. In between those days, I have a programmed run that focuses on interval training to help improve my running efficiency and speed. On the weekend I will switch it up between some type of obstacle race simulation (boot camp) or I’ll go for a long, slow run, or maybe even a sandbag hike. Sunday is usually my only day of rest unless my body feels like it needs another workout. My diet is not super strict, though I do make an effort to eat healthy, so fast food is not on the menu! I do incorporate Core Power high protein shakes into my diet, 2-3 times a day, to aid in muscle adaptation and recovery.

CP: Can you give us a workout that our fans can include in their routine?​

Stephen: A good 20 minute workout that can be done anywhere without any equipment is a series of Tabata exercises. A Tabata protocol goes as follows: 5 intervals of 20 seconds all-out intensity exercise followed by 10 seconds of rest. I like to create my Tabata interval workouts in a phone app like RunKeeper with an audible cue for interval changes. You can also add a cardio warm up and cool down (jog in place, jumping jacks, or rowing machine if you’re at the gym).

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Are You Craving Caffeine and Sugar, or Simply More Zzzs?

By Karen Malkin, HC, AADP

Does this sound familiar? It’s 10:30 pm. You know you should go to bed (maybe you’re even stifling a yawn), but instead of winding down, you grab the sugary snack you’re craving and stay up for another hour or more. You toss and turn and wake up feeling sluggish with a foggy brain–you need coffee, STAT! Throughout the day, you chase a sugary or carb-laden boost to keep you going. And the cycle repeats, day in…day out….

This makes sense because daytime fatigue (or, cravings for sleep) can actually manifest as an increase in appetite and cravings for sugar, refined carbs, soda, and caffeine. Sleep deprivation increases the hunger hormone, ghrelin, which leads to refined carb and sugar cravings. While what your body actually craves is sleep, you’re tricked into thinking you need these nutrient-poor foods as a quick source of energy. These are unnatural cravings; you are designed to crave healthy whole foods, such as dark leafy greens and rich proteins, which provide sustained energy without a crash.

WHAT’S IN YOUR CUP?

When you have a night of poor sleep, it’s common to reach for caffeine to “wake” you up. But the coffee you have in the morning can contribute to a pattern of diminished sleep. Here’s why: Caffeine has a half-life (the time it takes your body to eliminate half of it) of 6 hours. If you drink your cup of coffee at 8 am, only half of it will be gone 2 pm, and 3/4 by 8 pm. The caffeine from the remaining 1/4 cup of coffee might be what keeps you up at night, leaving you feeling restless in bed. Breaking your morning coffee habit is tough and should be done gradually, but once you cut down on your caffeine intake you’ll sleep more soundly, and by extension, think more clearly.

Alcohol is a more complicated situation. One or two drinks can help you relax and may help you fall asleep, but when the body’s natural sleep cycle begins to lighten between 2-4 am, the alcohol metabolizes and acts like more of a stimulant. This is why you often wake up throughout the night after drinking. Quality sleep is compromised and can lead to you feeling wiped out the next day. Ideally, keep alcohol intake to a minimum and avoid drinking right before bed.

THE STRESS FACTOR

Stress directly impacts sleep. Stress is any real or imagined threat to the body and how your body reacts to it. Your thoughts play a huge role in how you handle stress, so it’s good to notice how you react in stressful situations. Stress causes a rise in cortisol, your fight-or-flight hormone. When levels of cortisol are chronically high in your body, it’s not only hard to lose weight; weight gain is often imminent. The opposite of the stress response is the physiological relaxation response. During relaxation your body experiences optimum digestion and assimilation of nutrients, enhanced calorie-burning capacity, better decision-making ability, and a more restful sleep. Finding this relaxation response begins with the breath. It’s physiologically impossible to feel stress while you are deep breathing. This is why yoga and meditation are so great for relaxation and digestion!

Studies show that slow-wave sleep enhances connectivity between neurons, which is why sleep is especially important for children and teenagers’ brain function and memory. Getting adequate sleep (sleeping through the night) also becomes more difficult as you age, so making sleep a priority is important for healthy aging.

EATING TO PROMOTE ZZZs

Protein may help you stay alert during the day as it blocks your brain’s ability to produce serotonin, the mood regulating chemical that promotes sleep. Protein and high-quality fats should be eaten at breakfast and lunch. Carbohydrates have the opposite effect, triggering your brain to produce serotonin, hence inducing sleep. For dinner, try eating such complex carbs as brown rice and quinoa along with lots of colorful veggies and some lean protein. A starchy food just might be your sleeping pill!

Attempt to front load your water early in the day and avoid excessive water intake after dinner. Same with physical activity – do this during the day and not before bed.

SLEEP HYGIENE

With all the health benefits outlined here, it’s clearly important to prioritize your sleep, and this can be done by establishing good sleep hygiene. Here are some tips for achieving optimal sleep:

  1. Do not eat within 2 hours of sleeping.  Eating a heavy meal before bed will lead to poor quality sleep as the body needs to work to digest the food instead of resting, rebuilding, and detoxifying.
  2. Turn off the computer two hours before bed. The blue light of the screen stimulates your brain.
  3. Try a hot Epsom salt bath to relax your muscles and relieve stress.
  4. Get a massage or stretch out your muscles before bed.
  5. Try laying a hot water bottle on your midsection. This raises your core temperature and helps you relax.
  6. Aim for 7-8 hours of sleep and go to sleep at the same time each night.
  7. Pay attention to the days you feel great and make connections around your sleep and cravings.

Creating a pattern with your sleep habits will help ensure you get quality sleep every night. And before long, you’ll wake up feeling refreshed and watch your cravings slip away like a bad dream from long ago…

To your good health,

Karen Malkin, HC, AADP

Certified health, nutrition and eating psychology counselor

Karen Malkin wellness

Hip Labral Tears: What Effect Does Specialized Rehab Have?

By Accelerated Rehab

With the NFL season in full swing now the prevalence of injuries during games and practice unfortunately become almost a daily occurrence with teams and players. The constant grind along with excessive impact that these players put on their bodies put them at more of a risk for potential injuries. Hip injuries in the past few seasons have come into the limelight with players like Brandon Marshall, Percy Harvin, Corey Wooten, and Ed Reed having to undergo surgical procedures to repair a torn hip labrum. So how does something like this happen and how do these athletes return to a high level of play?

The labrum in the hip is a strong piece of cartilage that sits on the outside rim of the hip socket. It acts as a sort of gasket for the hip joint and helps the hip to form a suction seal for stability. With a tear in the labrum the hip joint loses stability and in turn causes increased pain especially with rotational movements and during higher impact activities. Many times arthroscopic surgery, which involves sewing together and re-attaching the labrum to the acetabulum (socket) of the hip joint. This provides the athlete with the ability to perform higher-level activities like jumping and cutting with proper stability, and without pain.

Structured rehab and return to sport programs are imperative for athletes such as these to return to a high level of sport. In the case of Brandon Marshall after undergoing his arthroscopic procedure, in the 2010 season he caught 86 passes for 1,014 yards and followed that up in 2011 with 81 catches for 1,214 yards and six TDs. After undergoing another arthroscopic procedure on the hip in January of 2013 he put up tremendous numbers including setting single season Bears receiving records for 2013. Other players such as Percy Harvin were also involved in specialized rehab and return to sport programs to combat the years of wear and tear they have put on their bodies. As a rehab professional it would be irresponsible to return a worker back to work before making sure that they could do their full job duties, so why is it different for returning to high level sport? It is necessary for us to provide this high level of return to sport rehab so that the athlete returns to sport safely and efficiently.

Imagine driving a car that can only run in first and second gear. You are able to start, but if you want any power and speed you can’t have it. A torn labrum inhibits that athlete from switching into third and fourth gear. Involvement in a structured rehab and return to sport program tunes the athlete’s engine so that it performs at its maximum ability. At Accelerated Physical Therapy we have a team of trained hip specialists that are able to screen athletes for potential hip problems, and provide that primary rehab and return to sport rehab in order for them to return to their high level of sport.

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Zipping Back to an Active Life after Shoulder Surgery

My name is Shea McGovren. I am a daughter, sister, girlfriend, friend, niece, cousin, granddaughter and health care provider. I love to laugh, waterski, snowski, live, white water raft, walk our dog and to practice physical therapy. For nearly 10 years I was unable to enjoy all these activities and many others due to the excruciating pain that I endured. At 15 years young, I injured my shoulder in an extreme traction mechanism in my high school English class. I was forced to see many doctors but there was only one team that specifically knew what procedure would completely end my pain – Dr. Brian Cole and his wonderful Physician Assistant, Kyle Pilz.

August 2006: Anterior Capsular Shift
October 2008: Bicep Tenodesis to Soft Tissue
August 2009: Debridement
July 2010: Possible Bicep Tenotomy but physician stated ‘could not find bicep’
November 11, 2011: Bicep Tenodesis Revision by Dr Brian Cole [yes, I still have my bicep!]

I am so lucky to truly say I have been given my life back but only due to Dr. Cole and his team. I am currently able to sleep through the night, do my job with ease, be generally happier and put greater energy into my relationships with family, friends and boyfriend.

Recently my wonderfully supportive, loving, beautiful mother and I won a trip to Miraval Resort and Spa where we went zip lining. As I jumped from the platform, I sped away from all the pain, anger, nights spent crying, the tests, the medications and into a completely different life with a completely different Shea.

Thank you to these wonderful people who put up with me day in and day out.

My Mother – Susan, for never giving up. We knew I wasn’t crazy! :)
My Father – John, for always supporting me.
My Brother – Matt, for always asking how I was.
My Boyfriend – Brad, your consistent optimism was exactly what I needed.

    — Shea McGovren

Shea McGovren Shea McGovren

Torn Hip Labrum, Hip Arthroscopy

What happened to Colorado Rockies shortstop Troy Tulowitski? How soon will he be back on the field after hip surgery?

 

By Dr. Shane Jay Nho from Midwest Orthopaedics at Rush:

Troy Tulowitski has a torn hip labrum and underwent hip arthroscopy. Hip labral tears are common among high-level athletes due to an underlying bony deformity called femoroacetabular impingement. These deformities can cause shear stress on the cartilage and labrum until the labrum tears and becomes painful.

Treatment Options:

The treatment requires hip arthroscopy to repair the torn labrum and remove the areas of bony deformities to improve the movement of the hip joint. Although the surgery is performed on an outpatient basis, the recovery and rehabilitation time differ depending on what is found and what is performed at the time of surgery. Generally, recovery after hip arthroscopy is about 6 months after surgery. It can be longer or shorter depending on the injury and patient.

In Troy’s case, he will not return until the spring season, but most studies to date do report a high return-to-sport. Those athletes who are able to return-to-sport are able to do so at the same level of competition. We do expect that he will recover and be ready in time to play in 2015.

Dr. Nho is originally from the northern suburbs and a graduate from Northwestern University. HeShane Nho, M.D. enrolled in the MD/MS program at Rush Medical College and the Graduate College of Rush University. He completed his surgical internship at New York Presbyterian Hospital of Weill Cornell Medical College and a residency in orthopaedic surgery at the Hospital for Special Surgery in New York. He returned to the Chicago area to complete a fellowship in sports medicine at Rush University Medical Center. He was the recipient of the Herodicus Society Traveling Fellowship and has trained with hip arthroscopists and hip joint preservation surgeons from the United States and Switzerland.

Knee Pain- When to Seek a Professional

By Michelle Helberg, MBA, ATC, EMT-B from Athletico

With fall sports underway, injuries are prone to happen.  With the cutting, twisting and tackling movements that occur in sports, such as football and soccer, Medial Collateral Ligament (MCL) injuries can occur.

Jumpers Knee PainThe MCL is a ligament that attaches to your femur (thighbone) and tibia (shinbone) and stabilizes the knee. This protects the knee from giving way toward the inside of the knee. Injury to this ligament can arise from a force outside of the knee or when a quick, twisting motion occurs. The MCL is one of the four major ligaments that stabilize the knee. Unfortunately, when MCL injuries occur, other ligaments such as the ACL are prone to injuryas well. While this is not always the case, it has the potential to happen.

Some symptoms of MCL injuries are joint line pain (where the knee bends), stability issues in the knee, swelling and pain with lateral motions. The first few steps to take after this injury occursis to decrease

the pain and swelling. To do this, place ice on the injured area for 15-20 minutes. Taking over the counter NSAIDS (anti-inflammatory) medication will also help. Many people choose to wear a knee brace for additional knee support.

The next step is to get your knee examined by a medical professional. Athletico offers complementary screens at any of our locations and our trained professionals can supply recommendations of doctors who treat these injuries. Determining the severity of the problem helps you understand the potential length of time until your knee starts feeling better.

 Severity Information:  

  • Grade 1- no opening with a valgus stress test (this is an orthopedic test to test the medial stability of the knee) but pain in the joint line. Knee is in very stable condition.
  • Grade 2- Mild opening with a valgus stress test, pain, swelling, partial tearing
  • Grade 3- Significant swelling, unstableness, valgus stress test reveals a lot movement.

After the professional examination, x-rays and MRI are standard procedure for determining severity and correct treatment. Occasionally individuals are put on crutches or placed into a hinged knee braceuntil they can walk normally. Strengthening exercises then start to get the knee stronger through conservative measures such as ice, rest, bracing and physical therapy. On rare occasions surgery is indicated, but more often than not, the above mentioned practices are the way most MCL injuries are treated.

To schedule a complimentary injury screen for knee pain or any other complaints click here.

Athletico Physical Therapy

What is Kinesio Taping?

 

Have you ever wondered about the brightly colored tape that adorns the shoulders and knees ATI Physical Therapy discusses Kinesio Tape, why it's used, and how it may help patients during rehabilitation.of athletes? 

It’s called Kinesio Tape.

Check out this video by ATI physical therapist Bradley Pearsall from our Belleville, Michigan clinic.  He explains Kinesio Tape, why it’s used, and how it may help patients during rehabilitation.

The information provided by this website or this company is not a substitute for a face-to-face consultation with your physician, and should not be construed as individual medical advice.  If you think you may benefit from Kinesio Taping or have questions about this technique, contact your local ATI clinic to schedule a Complimentary Injury Screening.

ATI Physical Therapy

Will Tanaka’s Elbow Survive Without Surgery?

By Accelerated Physical Therapy

Have you ever tweaked a muscle and you knew right away something wasn’t right? That’s exactly what happened on July 8,2014 while playing the Indians Masahiro Tanaka, the NY Yankees huge off season pitching acquisition left the game knowing something wasn’t right. An MRI on his elbow revealed a partial tear of his UCL and a faced a tough decision as to how to treat it.

Surgery or no surgery, that is the question.

The UCL or better knows as “Tommy John Ligament” is a relatively small ligament on the inside of your elbow that resists the tremendous forces created by pitching. Studies have revealed that every pitch thrown has enough force to tear your UCL if there was no help from the secondary stabilizers such as bones and other surrounding soft tissue structures. If this ligament is compromised and does not do its job, the surrounding soft tissue structures, flexor-pronator muscles will have to work harder to support the medial elbow. Additional work will have to be done along the kinetic chain, especially the shoulder to make up for the loss of velocity. It is no surprise that Tanaka recently started to have general arm soreness after mound progression and simulated game throwing.

In our opinion, he will most likely wind up going under the knife to repair this torn ligament and could very well return next year as the dominant thrower he left as. I do understand and respect the Yankees decision to try non-op rehabilitation as current literature has shown that the return to play rates for UCL reconstruction are not as high as once thought. That discussion will be for another post.

As sports medicine professionals, it’s our job to identify those at risk of UCL injuries. At Accelerated Physical Therapy we have video analysis systems that can identify flaws in mechanics and help correct them before the body breaks down. We film youth baseball pitchers throughout the Midwest to help put the brakes on this injury that continues to plague America’s pastime.

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Related Article Update

Low-Carb Beats Low-Fat for Weight Loss, Heart Health

THE QUESTION Cutting carbohydrates has become a popular way to lose weight. In the process, might you also be helping your heart?

Low-Carb Beats Low-Fat for Weight Loss, Heart Health: StudyTHIS STUDY involved 148 men and women, about 47 years old on average, who were obese but did not have cardiovascular disease or diabetes. They were randomly assigned to follow either a low-carb diet (no more than 40 grams of carbohydrates daily) or a low-fat diet (less than 30 percent of daily calories from fat). They also met periodically with a dietitian, individually and in groups. A year later, people in the low-carb group had lost, on average, more weight than those on the low-fat diet (12 pounds vs. four pounds). They also experienced a greater reduction in risk factors for cardiovascular disease, including a drop in body fat, a lower ratio of total cholesterol to high-density lipoprotein (HDL) cholesterol, and lower triglyceride levels. Also, levels of HDL, sometimes called good cholesterol, rose more among those on the low-carb diet.

WHO MAY BE AFFECTED? Adults, especially those who are overweight. Nearly 27 million Americans have heart disease, and about 600,000 die from it every year — more than from any other cause. Eating as few fatty foods as possible has been part of the mantra for preventing heart disease, along with controlling blood pressure, exercising and not smoking, but cutting carbs has not traditionally been on that list.

SOURCE: bit.ly/1qjI8OG Annals of Internal Medicine, online September 1, 2014