Treating sports injuries
Area schools have full-time athletic trainers
By Greg Seubert
Just like touchdowns, three-pointers and home runs, injuries are a part of high school sports.
That’s why athletic trainers like Gary Premo and Cassie Glodowski are a familiar sight on the sidelines and on the court at Weyauwega-Fremont and Waupaca high schools.
Premo, is a full-time athletic trainer at Weyauwega-Fremont High School, while Glodowski, holds the same position at Waupaca High School. Both work for ThedaCare, a Fox Cities-based community health system consisting of seven hospitals and numerous clinics in northeastern Wisconsin.
“It’s kind of a double-sided coin,” Premo said when asked if high school football is safer now than it was 20 years ago.
“With all the equipment we have now, it’s safer on the kids than when we played back in the day,” he said. “The helmets are better, the shoulder pads are better, all the equipment is better. The other side is we have kids that are bigger, faster and stronger. They’re hitting harder, they’re running faster. When they make those collisions, it’s a higher impact.
“Along with athletes getting bigger and stronger, coaching has changed enormously,” he said. “I think better coaching or teaching of skills – how to tackle correctly or block – and the amount of time coaches go over game film to correct the players’ technique or ability to perform a skill (make the game safer). That, with mandates on how long a team can practice and ensuring safety of the team, has changed greatly.”
A concussion is the most common type of traumatic brain injury.
“Are we seeing more concussions?” Premo asked. “I can’t say we’re seeing more, but we’re documenting more. It used to be where we’d call it a bell ringer and if you didn’t go unconscious and you had your wits about you, you’d go back in.
“Now we know that can’t be the case and there are some underlying things there that can be long-ranging side effects if they don’t get the proper rest,” he said. “We’re dealing with the athletes much better to get them back safely and so they’re not going back out there damaged. If an official has an idea that the kid has his head rocked, he’ll send him to the sidelines and want us to check him. A coach can see it if he sees a player’s not playing up to his normal stuff. He’ll send him over to have him checked. We may see it.”
Wisconsin Act 172 went into effect in 2012. The law states: “An athletic coach or official involved in a youth athletic activity or health care provider shall remove a person from the youth athletic activity if the coach, official or health care provider determines that the person exhibits signs, symptoms or behavior consistent with a concussion or head injury or the coach, official or health care provider suspects the person has sustained a concussion or head injury.”
“Any time there is an athlete in question, (they) must be pulled out and checked by a health care provider that’s been trained in concussion management,” Premo said. “Normally, that’s an MD. PAs (physician assistant) and athletic trainers fall under that. Once they’re checked, we can make that determination on the sideline if they can return to play or they’re going to be held out.”
Waupaca High School has utilized ImPACT, a concussion management test, since 2009.
“We baseline these athletes every two years in high school,” Premo said. “Once we have that, if they get injured during a game, we have them come back in and do another test. Then, we do the comparative analysis. We use that for every athlete because we never know and kids do a lot of things at home. I’ve had many kids that have gotten injured at home and have come in and said, ‘Man, I’m not feeling good. I’ve had a headache that’s been going on for days.’ They hit their head on a shelf or something fell off a shelf. I get a lot of kids who go snowboarding in the winter.”
Trainers also test middle school football players in Waupaca and Weyauwega-Fremont.
“When we first started in 2009, we documented between Waupaca and Weyauwega 24 head concussions in one school year,” Premo said. “In 2012-13, we documented 76. It usually stays around 50 to 60 concussions per year. That’s a lot. We’re dealing with at least 1,000 middle school and high school athletes between the two schools.”
The Hortonville Area School District invested $20,000 last year in the Riddell InSite Response System, which records impacts on five key areas of a football helmet. Sideline staff receive instant alerts if there’s a problem.
Other injuries trainers deal with include ankle sprains and knee injuries.
“Our female athletes are four times more likely to get an ACL (anterior cruciate ligament) tear,” Premo said. “We do see a fair share of ACL injuries and we encourage girls – and guys – for speed and agility programs in the summer. That can be the saving grace for them, but we just don’t see that many athletes coming to see that as one would think.
“We’ll see some ACL injuries again this year only because we’re not able to prepare them,” he added. “There’s a series of things we can do for them. We can analyze them and put them on a specific training program to help strengthen them so they can avoid these types of injuries. We’ll see ACLs in basketball and soccer. There are some in football, but not as many as you might think. I’ve seen them in volleyball. When you get into baseball and softball, it’s the arm injuries that we see.”
Athletes and parents can work together to prevent major injuries, according to Premo.
“It all starts with getting to the parent meetings in July,” he said. “They can contact their athletic trainer. That’s the big thing: get together with your athletic trainer and talk about what you can do. We have a number of programs to analyze the athlete. I do a functional movement stream. We can document weaknesses there and create a program for the athlete. It’s all about the athlete, the parents and the athletic trainer coming together and putting something together.”
Nutrition is another factor.
“Most of your athletes are coming into practices in the afternoon undernourished,” Premo said. “They don’t have enough calories to sustain the energy that they’re outputting. That causes their bodies to not work as well or function correctly and that makes them more susceptible to injury. As we see athletes get more tired, we see an increase in injuries.”
Several school districts have either hired athletic trainer or have contract with a health care provider.
“An athletic trainer really becomes part of the team,” Premo said. “We’re able to see how the athletes are functioning on a day-to-day basis. We can recognize at a moment’s notice if they’re not working like they normally would be. We can recognize some deficiencies and help counteract that. Part of our importance in being there is the prevention of injuries. That’s why it’s so important to have an athletic trainer on staff.”
Premo used to split his time between Waupaca and Weyauwega-Fremont before Glodowski, a Waupaca High School graduate, came on board last year.
“If Cassie has more games than she can cover and I’m not covering a game in Weyauwega, then I’ll slide over and help out,” Premo said. “If we’re both full and we still have games going on, we’ll call in Christie Kettleson and she’ll help out, especially if we’re going to be taking care of middle school football in Waupaca.”
Premo will also accompany the Weyauwega-Fremont football team on its road games this season.
“I’ve seen quite a bit, but that’s one of the neat things about athletic training,” he said. “You never know what you’re going to see or when you’re going to see it. Every new day brings something new, which makes it really exciting.”