AHAI: A Step aHead Baseline Testing

A Step aHead baseline testing is now open

AHAI: A Step aHead Baseline Testing

Amateur Hockey Association of Illinois (AHAI), Athletico Physical Therapy, the Chicago Blackhawks, and NorthShore University HealthSystem has come together to create the AHAI: A Step aHead Baseline Testing initiative to combat one of the most common head injuries: concussions.

These four groups pledge to educate the Illinois youth hockey community on the importance of concussion management and to be proactive with implementing baseline testing. Through A Step aHead, we offer free baseline concussion testing, as well as educational programs, to youth hockey players in the AHAI program.

Head Injury and Concussion Management
presented by:

AHAI Baseline Testing

For more information contact an Athletico Baseline Testing Professional by emailing baselinetesting@athletico.com.

Click here to register for an AHAI Baseline Test

Tracking Patient Outcomes; Tips for the Aging Athlete; Active Father finds Healing after Tissue Transplant

Episode 17.21 with Hosts Steve Kashul and Dr. Brian Cole. Broadcasting on ESPN Chicago 1000 WMVP-AM Radio, Saturdays from 8:30 to 9:00 AM/c.

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Segment One (01:20): Dr. Nikhil Verma from Midwest Orthopaedics at Rush discusses the importance of tracking patient outcomes: value based care; measuring quality ofnikhil verma care vs cost; which techniques work best based on patient outcomes; how the outcomes meet specific conditions and expectations.

Dr. Verma is a Professor and Director, Division of Sports Medicine, Fellowship Director, Sports Medicine, Department of Orthopedics, Rush University Medical Center, Team Physician, Chicago White Sox/Chicago Bulls.

Dr. Verma specializes in treatment of the shoulder, elbow and knee with an emphasis on advanced arthroscopic reconstructive techniques of the shoulder, shoulder replacement, knee ligament reconstruction and articular cartilage reconstruction and meniscal transplantation.

Midwest Orthopaedics at Rush is widely recognized as the regional leader in comprehensive orthopedic services. 

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Segment Two (11:23): Dr. Leython Williams from Athletico Physical Threrapy discusses the benefits of accepting and adjusting to the inevitability of aging. Aging gracefully is linked to healthy diet, regular exercise and good genes.

Athletes both professional and amateur often refuse to let age slow them down. However, even the most elite athletes are not immune to aging; rebuilding bone and gaining muscle; trading intensity for duration; cooling down for gradual decrease in intensity.

Dr. Williams is a Doctor of Physical Therapy and facility manager for Athletico Physical Therapy at their Lincolnshire facility. He is a former Division 1 athlete that infuses his experience as an elite athlete into his evidence-based practice in the outpatient orthopedic setting.

Dr. Williams is an expert in musculoskeletal function and rehabilitation as he seeks to restore functionality and decrease pain. His mission aligns with Athletico is providing progressive outpatient therapy through personalized care that emphasizes patient education and injury prevention.

Schedule a Complimentary Injury Screen


Segment Three (21:07): Cartilage transplant Phil Pizzano is an active husband, father and former Division I soccer player discusses his tissue transplant with Steve and Dr. Cole.

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In 2012, he began to suffer from debilitating knee pain. After enduring years of pain and surgery, he met with a doctor who told him he was a candidate for an osteochondral allograft transplant. In the two and a half years since that surgery, he’s been able to keep up with his two children and even picked up CrossFit.

Learn More at Allograft Possibilities

Counsel patients, parents on concussion risks in football

iStock-471035985.jpgDrs. Anthony Romeo and Gregory Cvetanovich co-authored this articlein Orthopedics Today about the rising awareness and reported incidences of concussion and how parents, athletes and coaches should be more careful about making informed decisions about play and return to play. They added that orthopedic physicians have a responsibility to share information regarding the risks of contact sports.


There has been increased awareness of sports-related concussions and risks associated with head trauma. The reported rates of concussions have doubled during the past decade, especially among youth and high school athletes. Much of the increase is attributable to greater recognition and diagnosis, as well as more media attention.

Among youth and high school athletes, American football has the highest risk of concussions, accounting for almost half of sport-related concussions in United States and the highest rate of concussions per player. Male athletes have more concussions overall due to greater participation in contact sports, however, female athletes are diagnosed with almost twice the rate of concussions compared with males in comparable sports, such as soccer. Younger athletes may have greater susceptibility to concussions, risk of recurrence, chance of second impact syndrome, as well as prolonged symptoms and recovery.

Risks of concussions

Treatment of concussions in young athletes consists of cognitive and physical rest along with symptom management. Short-term concussion risks include prolonged symptoms consistent with post-concussive syndrome and rare, but potentially fatal, second impact syndrome if the athlete sustains a second head injury too soon after the first. Patients with prior concussions are also at two- to five-times greater risk of sustaining another concussion. Long-term concerns include reported increased rates of dementia and depression potentially related to chronic traumatic encephalopathy (CTE).

In a published study, researchers analyzed the brains of 202 deceased football players. They found an overall 87% rate of CTE on neuropathology. Former high school players had a 21% rate of mild CTE, and the rates of CTE increased based on highest level of play to 99% of former National Football League (NFL) players who had predominantly severe CTE on pathology.

The study had limitations, but it was proposed that CTE may be related to repeated blows to the head in football and the severity may increase as athletes reach high levels of play. Many questions remain about the impact of early exposure to head impacts from youth football and of hits sufficient to result in clinical diagnosis of concussion vs. clinically silent subconcussive hits.

Due to these concerns, football leagues of all levels, as well as those of other sports, have made rule changes designed to reduce head injuries. Many of the interventions have had success in reducing the rate of concussions, although the effect on potential long-term cognitive effects of repeated head trauma and rates of CTE remain unknown. Some rule changes have been shown to have paradoxical increases in rates of concussions, which more likely reflect simultaneously increasing awareness of concussions among players, coaches, trainers and team physicians, rather than a causative relationship of the rule changes and increased concussions. Equipment changes, such as improved helmets and increased use of mouth guards have been made, but show mixed data on their impact on concussion rates.

Counseling patients, parents

As orthopedic sports medicine physicians, we should have a low threshold to suspect and diagnose concussions in athletes in conjunction with trainers and other health care providers. Patients should be removed from play to prevent further injury and allowed to undergo appropriate concussion treatment prior to consideration of return to play. A multidisciplinary team approach can be valuable, particularly in patients with prolonged or recurrent concussion symptoms.

Athletes recovering from concussions along with their parents, in the case of youth athletes, should be advised that certain contact sports are associated with elevated risk of concussion. This risk is inherent to contact sports despite attempts to reduce risks with rule changes, equipment modifications and coaching. Once an athlete is symptom-free and completes a concussion protocol, return to play may be considered as a shared decision with patients and parents.

Counseling patients and families on the long-term risks of single or repeated concussions is more challenging, including risks for cognitive, behavioral and mood disorders and neurodegenerative changes of CTE. Patients should be informed that the growing evidence connects CTE and its associated symptoms to football, particularly prolonged and high-level play.

Existing data make it impossible to project these risks for an individual athlete with a concussion or repeated subconcussive hits to the head. Furthermore, it is unclear how early participation in football and concussions sustained in youth and high school football influence long-term cognitive function. However, we owe it to our patients to discuss the potential risks although we cannot provide firm guidelines about number of concussions or head impacts after which they should consider not returning to play.

Despite uncertainty about long-term and patient-specific risks, the decision to participate in contact sports comes down to an informed decision by patients and parents. Orthopedic sports medicine physicians should provide information about the current understanding of the risks, which patients and parents can use to make decisions about what short- and potential long-term risks are acceptable.                       

Meal Timing: Does It Matter When You Eat?

Meals and snacking patterns often need to be altered when traveling. As a result, I get questions from both athletes and non-athletes alike about how to best fuel their bodies: Should I stop eating after 8:00 p.m.? Which is better: to eat three or six meals a day? Does it really matter if I skip breakfast? Because meals can be a central part of our social life—and busy training schedules can contribute to chaotic eating patterns—many athletes disregard the fact that food is more than just fuel. When (and what) you eat impacts your future health (and today’s performance).

Food consumption affects the central clock in your brain. This clock controls circadian rhythms and impacts all aspects of metabolism, including how your organs function. Restricting daytime food and eating in chaotic patterns disrupts normal biological rhythms. The end result: erratic meal timing can impact the development of cardiovascular disease (CVD), type-2 diabetes and obesity.

Breakfast: Is It Really the Most Important Meal of the Day? If you define breakfast as eating 20 to 35 percent of your daily calories within two-hours of waking, about one-fourth of U.S. adults do not eat breakfast. This drop in breakfast consumption over the past 40 years parallels the increase in obesity. Breakfast skippers tend to snack impulsively (think donuts, pastries, chips and other fatty foods). They end up with poorer quality diets and increased risk of diabetes, heart disease, high blood pressure and overweight/obesity.

Eating a wholesome breakfast starts the day with performance enhancing fuel at the right time for your body’s engine. If you exercise in the morning, fuel up by having part of your breakfast before working out and then enjoy the rest of the breakfast afterwards. This will help you get more out of your workout, improve recovery—and click with natural circadian rhythms.

Meal Frequency: Is it Better to Eat 1, 3, 6, 9 or 12 Times a Day? In terms of weight, eating 2,000 calories divided into 1, 3, 6, 9, or 12 meals doesn’t change your body fatness. In a study where breakfast provided 54 percent of the day’s calories and dinner only 11 percent of calories—or the reverse, the subjects (women) had no differences in fat loss. Yet, in terms of cardiovascular health, the big breakfast led to significant reductions in metabolic risk factors and better blood glucose control. The bigger breakfast matched food intake to circadian rhythms that regulated metabolism.

Athletes who skimp at breakfast commonly get too hungry and then devour way too many calories of ice cream and cookies. If they do this at night, when the body is poorly programmed to deal with an influx of sweets, they are paving their path to health issues. Hence, if you are eating a lot of calories at night, at least make them low in sugary foods, to match the reduced insulin response in the evening. This is particularly important for shift workers, who eat at odd hours during the night and tend to have a higher rate of heart disease.

Should you stop eating after 8:00 p.m.? There’s little question that late-night eating is associated with obesity. Research with 239 U.S. adults who ate more than one-third of their calories in the evening had twice the risk of being obese. Among 60,000 Japanese adults, the combination of late-night eating plus skipping breakfast was associated with a greater risk of diabetes, heart disease and obesity.

A study with 2,200 U.S. middle-aged women reports each 10 percent increase in the number of calories eaten between 5:00 p.m. and midnight was associated with a 3 percent increase in C-reactive protein, a marker of inflammation. Inflammation is associated with diabetes, CVD and obesity. Wise athletes make a habit of eating the majority of their calories earlier in the day, to curb evening eating.

The Best Plan: Plan to Eat Intentionally. Failing to plan for meals can easily end up in missed meals, chaotic fueling patterns and impaired health, to say nothing of reduced performance. If you struggle with getting your food act together, consult with a sports dietitian who will help you develop a winning food plan. Use the referral network at http://www.SCANdpg.org to find a local sports RD.

Instead of holding off to have a big dinner, enjoy food when your body needs the fuel: when it is most active. If you worry you’ll eat just as much at night if you eat more during the day (and you’ll “get fat”), think again. Be mindful before you eat and ask yourself: Does my body actually need this fuel?

Most active women and men can and should enjoy about 500 to 700 calories four times a day: breakfast, early lunch, second lunch, and dinner. To overcome the fear that this much food will make you fat, reframe your thoughts. You are simply moving calories in your pre- and/or post-dinner snacks into a substantial and wholesome second lunch (such as a peanut butter-honey sandwich, or apple, cheese and crackers). The purpose of this second lunch is to curb your evening appetite, refuel your muscles from your workout earlier in the day (or fuel them for an after-work session) and align your food intake to your circadian rhythms. Give it a try?

By Nancy Clark, MS RD CSSD