Back To School Sports Medicine
Host: 00:09 Good Day Ladies and gentlemen, welcome to the latest episode of the best health podcast with wake forest baptist health. Thanks for listening in today. We appreciate it. We have a great guests here with us. Uh, Chris Ina, he's the manager of our athletic training programs here at Wake Forest Baptist health. So welcome Chris. How's it going? Good Justin. Good to see you. Yeah, thanks for joining us today. Um, so we're going to talk a lot about back to school. So it's back to school time, which means we're getting, uh, we're ramped up for fall sports, right? So practices for fall sports just recently started and, um, Chris is here to talk us through, um, our athletic trainer agreements and partnerships that we have with multiple schools in their region and also about, um, our sports medicine program here at Wake Forest Baptist health and, um, the different types of, uh, services that we provide and tips and injury prevention ideas that we have through sports medicine as well. Uh, but before we jump into all that, Chris, just tell us a little bit about yourself, um, where you're from. And, uh, when did you wake up one day and say, I want to get into athletic.
Chris Ina: 01:23 I don't know if that was what happened, but, uh, I'm from Ohio, grew up outside of Cleveland. Uh, went to school, College at University of Toledo. Okay. And then I went across country to California and got my Grad degree at Fresno state and then drove cross country and wound up at wake forest for about 14 years. Worked a multitude of sports but mainly football there. Wake Forest, the university university and deacons. Demon deacons. That's right. So I worked football there for about 14 years. Um, and then this opportunity came with the hospital to kind of develop and manage their outreach athletic training program and uh, something that interests me. And, uh, I got that job and three years later here I am here. Just like yesterday. Yeah. So I started out in a PT school, like most athletic trainers do, I guess. And then, uh, you have to do rotations through clinics and get hours. And when I was doing my rotation through PT clinics and working with a workers' compensation patients or total hip total joint patients, that really didn't interest me much. But when I worked with athletic population that really seemed to fit me better. Um, so then I just asked around and say, what other jobs can we do working with athletes? And that's Kinda how I got stumbled on athletic training. And here sit again where you go.
Host: 02:54 All right, cool. So, um, we'll be talking a lot about, um, student athletes today. And, um, there are parents that are listening to this where their theirs, their kids, their students have been playing sports for years and years and years and they're pretty well adept to the system. And then there's maybe parents that, um, this is gonna be their first year with her, with their students playing organized sports. And, um, throughout the community we work with a, to some degree local, um, youth, uh, sports organizations. And then we also work with various school systems here in the area. So I'm Chris, just tell us a little bit about, um, our athletic training program here at Wake Forest Baptist health and the different partnerships that we do have. Sure. So about three years ago
Chris Ina: 03:43 go, uh, went to Salem for a, the county schools was interested in putting an athletic trainer in each school in their district and they were really looking for a medical center to really kind of flagship that and partner with to really provide those athletic trainers. Um, you know, school budgets are tight. Um, so they were looking to kind of offload some of the expense and still have services. So we partnered with the Forsyth county schools to provide them a contracted athletic trainer to each school. Um, so that was kind of the first step. Um, so from there it just Kinda, it's just grown and grown and grown. Um, in the more school districts find out about our program and especially parents when parents find out that, you know, kids that go to Winston San Forsyth county schools that plays sports have this medical person at school every day on the sidelines at football games and basketball games and all events. Um, they start asking those questions to their school saying, how come we don't have that? And then those calls end up coming into us. And then that's kind of how new partnerships tend to develop and grow, um, more from like a need basis and a want basis. Um, so that's kind of where our program is and where we started with 12, and now we're up to 24. Wow. High schools, uh, in the region here.
Host: 05:11 So we have Winston-Salem, Forsyth County schools that we partner with. And then, um, who else would we partner with it that gets up to the 24 schools?
Chris Ina: 05:18 So we have a, we have one school in Davidson County and Lexington city schools. Okay. So we go all the way down south and then when we move west, we have, uh, we just started with Yadkin county schools. Nice. And now we have Wilkes County schools. And then moving into the, uh, east side, we've got, uh, some schools in high point and Guilford county about four schools in the, in that region.
Host: 05:40 Nice. Um, so with those partnerships, um, you did point out that the athletic trainer is assigned to each of those schools and, um, so when they're, when they're there onsite at the schools and, um, if parents are listening
Chris Ina: 05:58 to this, give us an idea of what they're doing at the schools. How are they interacting with the coaches, the students. Um, you know, maybe some parents or anyone who's been to a game before sees a trainer on the sideline, but it's much more involved than, hey, just showing up for a game and sitting on the sideline. Right. Absolutely. And I think one of the things that differs our program from other programs is our athletic trainers are at the school every single day. Um, some programs just to provide athletic trainers just for football season. That's not what we do. Our, our staff is there every single day throughout the school year, including summers. Cause as we know, sports never stop anymore. Kids are always working out, always conditioning. So our staff is always there. Um, and another unique part is, um, they're assigned to that school. So they're not floating between a couple of different schools.
Chris Ina: 06:51 One day here, one day there. Like when you get an athletic trainer from Wake Forest Baptist health, that's your athletic trainer. Gotcha. So that athletic trainer, you know, they probably roll into school around noon, one o'clock, you know, they set up for practices, get the water stations ready and anything else they need to do, uh, to get ready for practice. They got, you know, paperwork and injury reports to do if kids have time, they come in and do a little rehab maybe between classes or during lunchtime or something like that. And immediately when school's over, that's when, you know, everything kicks into high gear, practices start, games start. So then they're out on those fields, you know, caring, you know, caring for those athletes. And then when practices and games are over, you know, they, they clean up and leave for the day. So they're putting a good eight hours in there every day.
Chris Ina: 07:41 But with them being there every single day, that's how you build those relationships with the kids. The kids notice you're there every day for them and they see you, not just at football games, they see you at the volleyball match or they see you at the tennis match or something like that. Um, and then the coaches notice too, because again, you're covering their sport as well as football. So then you start to build those relationships and as time goes on, you know, you see those kids when they're a freshman all the way to a senior and then the next group comes in and you know, like you were saying, that kid, the senior, maybe his brothers now in, in the school and those parents are already familiar with you so they know the kind of care that you're going to provide for their son or daughter throughout school. So it's, that consistency is a really big piece to our program. Sounds great. Um, so with, uh, them being there with the student athletes, um, obviously, um, if they're at all the practices, all the games, they're there when a student does get injured and injuries happen sometimes. Um, so maybe just describe, um, for, for people listening, um, what would happen? Um, I guess walk us through the process of, of, you
Host: 08:56 know, we see someone, a kid, a student get hurt on the field, right. So then we see the trainer go out there and do the initial assessment. So talk to us about that from that time period, um, through, um, additional evaluation on the sideline and then maybe, um, getting them into, um, the, the clinic, the sports medicine clinic or doing rehab. Just walk us through, um, how athletic trainers might go through that process. Sure. You know,
Chris Ina: 09:24 again, being there every day for all those events were like that first line of defense. So, you know, again, being there, so we see that kid get injured, we see them twist their ankle or hurt their knee. Um, so we see that mechanism injuries. So that gives us a good idea of kind of what's going on. We do that initial evaluation and at that point the athletic trainer is really good at triaging that. Is this an injury that really needs to be seen by a physician or is it something that that they can handle and rehab themselves and see if they can get that kid back to playing as fast as possible. So at that point is when they make that, you know that decision and a lot of times they might make that decision and a week later the kid, you know, he's really not responding or not getting well quick enough.
Chris Ina: 10:09 And then that's when that referral might be like, well let's go see a physician now rather than some schools without an athletic trainer, all those types of injuries go get directed straight to the emergency department. And that's really not where they need to be. That's a cost to the parents. So that's something that the athletic trainer can kind of navigate and really hopefully save time and money for the parents kind of deciding like what really need, what can we do here with this injury? They have the facilities at the schools where they're able to do some of that Rehab. Um, and they all know their limitations. Like if they just can't, they don't have the facility, they don't have the space, they don't have the time, you know, then of course they're gonna say, look, you know, I'm just not equipped to do this. Let's go get checked out by a physician and get some, some proper rehabilitation.
Host: 11:00 MMM. Gotcha. Well, I'm glad you mentioned physician. So if I'm not mistaken, each school that we partner with, um, or I guess anytime where our athletic trainers are out at a, at an event, whether it's a, a local high school or, or some other organization or event that we are providing coverage for, there is a physician that is linked to the athletic trainer. Um, and that is as part of our structure here at wake forest baptist health. Um, so I guess speak to that a relationship real quick between the athletic trainer in the team physician and, um, how that team physician is there as an additional resource for, for each school or each organization we work with. Sure.
Chris Ina: 11:41 Uh, in order to be an athletic trainer in North Carolina, you have to have a license and to obtain a license, you have to work underneath the direction of a physician. So it's, it's an easy, you know, connected.game that we play here with our athletic trainers and our physicians. Um, so that's number one. We can't practice without supervision from a team or from a physician. Sure. And with each school having their own, again, consistent team, physician or team doctor, you know, that athletic trainer always has someone that they can, you know, give a call, ask them questions, refer an athlete out over to see them in clinic. Um, if an athlete does go see them in clinic, they can pick up the phone right away and say, Hey, what did you think? Because sometimes getting information back when a kid goes to a doctor from a 14 to 16 or 18 year old is, is, you know, the message gets lost. Um, so it's easy for them just to pick up the phone and just call him and shoot them a text message or something like that. Um, and get some additional information. Um, so that partnership is really important in, uh, with the physician, with cooperation from the physicians. Again, it takes time out of their schedule. Um, they're on sidelines of a lot of the football games on Friday nights. Um, so having, you know, having their, you know, willingness to volunteer their time to the schools, you know, really makes this program successful.
Host: 13:06 That's really good information. Um, so one of the touch base on, on kind of one of the, the hot button topics, if you will. Um, so there seems to be a lot of national attention in regional and local attention on, on concussions. So, um, there's a lot of information on the Internet about concussions. Um, so, um, parents obviously, and rightly so, or it's on their minds and they're thinking about it and wondering, um, asking questions. Um, so I guess just give us a brief, brief overview of, of how, um, our, our athletic trainers and our physicians here at Wake Forest Baptist, um, uh, work with, um, concussions. I, I guess on the Front End, uh, hopefully helping prevent them, but if a student does sustain a concussion or they think there could be a suspected concussion, walk us through that process with, with what the athletic trainer and the team physician would do.
Chris Ina: 14:03 So with, with a pro from a prevention standpoint, um, you know, when you think concussion, you think football, right? But not all concussions happen in football. You know, soccer has a high concussion rate also, you know, cheerleading, believe it or not, it has a high concussion rate. Interesting. Um, especially when they're stunting, falling off those pyramids and, and whatnot. That makes sense. So let's not just pigeonhole concussions into football. Sure. Obviously that's a big one, but not the only one. Sure. Um, so when it comes to a prevention standpoint, you know, the athletic trainers are at football practice every day. Maybe there's a drill being done that, you know, technique might be wrong, something might look like it could predispose those kids to maybe, you know, in a concussion. So that's where they can kind of maybe talk to the coach and say, Hey, you know, we've had a couple of kids run through this and you know, they're coming out with concussions and maybe we should modify this drill or something like that.
Chris Ina: 15:02 So that's one way we can help with prevention. But the other ways we really help with education and research has shown that as soon the sooner you recognize a concussion and start to treat it, the quicker that the student athlete kind of heals or, or bounces back and gets back to playing. Um, and that's a message that we get across to all parents and all kids. Cause there's always this stigma attached to concussions. Like no one, like if you're an athlete, you don't want to admit that you have a concussion cause it might make you look weak or like you don't want to play or something like that. Um, but as soon as they realize, you know, that they recognize that concussion quickly rather than try to hide it for a week or two, and then the symptoms are going to get worse and worse and worse, and they're going to end up missing actually more time.
Chris Ina: 15:49 If they would have just come to us at the beginning and say, hey, I don't feel well, I feel dizzy or nauseous or, or whatnot. Um, then they can start getting treatment quickly. Um, and as soon as the athletic trainers recognize a concussion, you know, we, we have some testing, some cognitive testing that we do, um, to kind of help, you know, concussions don't, there's no one test to say you have a concussion. You can't get a blood test. You can't get, uh, you know, a brain scan to say you have a concussion. Um, so there's, there's no definitive tests for concussion. It's, it's very symptom based. Um, so they kinda run through their, their symptom score, their symptom test. And at that point, if they recognize they have concussion, then we refer them to one of our concussion physicians. Um, and then, uh, that's Kinda when they start that protocol to get back on the field.
Chris Ina: 16:40 And a lot of that protocol is done at school with the athletic trainer. Um, it doesn't require additional physician visits or anything like that. Um, the athletic trainer is well trained to Kinda handle in and run that protocol for under the direction of the physician. Sure. And their help to guide them back to their return to play status. Right. Yeah. And you know, there's a, a return to learn component now, which kind of they get some school modifications. Um, cause you know, the mental part of the concussion, you know, your brain's still trying to work but it's not working efficiently. Um, so modifying some school tends to help recovery also, whether that's a half day of school, maybe it's not doing testing, uh, maybe it's sitting in the front row of the class rather than in the back row or something like that. To give those kids a little bit of a break and give their brain a little bit of a break so it can heal.
Chris Ina: 17:34 Um, one other, uh, top specific treatment or, or, um, or, uh, other topic that I wanted to talk about that seems to be getting, um, some attention right now just cause it's still during the warm months is hydration or dehydration or proper hydration. So, um, it, it is warm in. If you're an organized sports and you're outside, you're definitely going to be sweating a lot and losing a lot of fluids. Uh, but this is good information. Even if you're just going out for a hike or going, you know, going out, bike riding on a trail, um, during these warm months, uh, there's, there's this idea of staying properly hydrated and consuming enough water in I guess people, they, uh, maybe sometimes maybe dismissed that. Oh yeah. Okay. Drink some water. Sure. Fine. Um, but really talk to us about, um, what that does to the body when it's not getting the proper amount of water and why it's so important to plan ahead for staying hydrated.
Chris Ina: 18:35 So if you know you're going to be outside participating in an activity for a long time, maybe, you know as you're walking out onto the field is not the time to start drinking fluids and hydrated. Yeah. So talk to us a little bit about that. So when you, when you sweat and you're not just losing fluid, you're losing, you know, you lose salts. Have you ever tasted your sweat? It tastes salty or you watched the, you know, baseball players, they have their hat on, they have that like little white ring on their hat on the outside. Cause that's all the salt that you sweat out. Yes. So Lou, that's an electrolyte. So losing that electrolyte, that's what really is going to affect your performance. And they said if you lose 2% of your electrolyte balance, it really affects your athletic performance. Interesting. So you know, that's where Gatorade makes all their money, right?
Chris Ina: 19:23 So that's what they put into Gatorade is that salt, that electrolyte, that carbohydrate, that gives you a little bit of energy. Sure. So if you, if you're thirsty, that what they always say is your thirsty already dehydrated. So don't use thirst as a really your main reason to drink some water. Yes. That's interesting. So what we always tell our athletes is you need to hydrate before your game, at least an hour before, you know, drink a bottle of water, bottle Gatorade, and then continue to hydrate during competition. You know, as best you can. And then definitely after, don't just say up games over, I'm good to go. You need to keep hydrating after. Um, so if you use that before, during and after kind of philosophy, it should help you stay hydrated for that event. And when you're, everyone knows when you're dehydrated, that's when you get those muscle cramps.
Chris Ina: 20:14 You get the headache, you get that fatigue. So no one wants to play any type of sport, ride a bike, run a marathon when they have a headache or they're feeling tired. Um, so that's why hydration is a key. And there's also research out there. If you're into research nerd like I am, that, you know, when you're dehydrated, you're more likely to pull a muscle. You're more likely to sprain your ankle because your body's just not at full strength. It doesn't have that full control, so you're a little bit more likely to maybe catch an injury rather if you're just properly hydrated. Um, so yes, hydration is very important, you know, not just in the heat too. It's, it's almost more important. And when you're, you know, in the colder months, cause you're not sweating and you're not losing all that fluid but you still need to be hydrated.
Chris Ina: 21:06 Well, um, yeah, to perform. Yeah. Um, that's, that's great info. Um, in there, uh, I'll do one of my shameless plugs here. So there's lots of information about hydration and stretching and nutrition on our sports medicine guide and we update it each year. So the new one just came out on our website. So if you got to wake health.edu/sports medicine, you can download, um, our sports medicine guide with lots of great tips in there. You may or may not see Chris's picture and there better be an extra bonus. Uh, so, um, I want to transition a little bit and we're getting close to wrapping up, but, um, if someone's an organized sports, a youth sport or an adult rec league, um, or they're not in organized sports, they're out riding their bike on a trail or, um, you know, they're up in the mountains hiking and, uh, they sustain an injury.
Chris Ina: 22:01 Heck, I've sustained an injury, you know, walking up a few steps injured my foot before. Um, so I guess talk to us a little bit about, um, some of the services available at our sports medicine clinics. So you, um, spend some of your time at one of our sports medicine clinics here in the triad. Um, so talk to us a little bit about, um, the providers they're in, in a lot of, I guess some of the common, um, injuries or issues that you see come through the sports medicine clinic. Sure. Uh, you know, our sports medicine, Stratford location is our, I would say one of our flagship locations. Um, you know, it's, we really tried to dedicate it to sports and sports injuries. Um, you know, we have sports trained orthopedic Physicians, we have sports trained family practitioners, we have sports trained, um, PAS. There also.
Chris Ina: 22:56 Um, we really focus on the athlete at our facility. We also have a full physical therapy department that does, you know, obviously our sports rehab. We have a nice little indoor turf area that we do. We can do a lot of return to play activities. Um, we're also attached with, uh, Chris Paul's Basketball Academy and, um, we're able to use their basketball courts, um, when necessary for, you know, any type of return to play for like a basketball player, a volleyball player or something to get that court experience. Um, but having that facility available to, uh, anybody in the community and weekend warriors, mud runners, marathoners, golfers, you know, that's why we work perfect partnership with the high schools. Cause that's our target is, you know, is that student athlete or the, um, that's, it's a perfect facility for them to kind of come in and see a sports doctor, um, and get a proper, uh, you know, proper evaluation and a proper plan for returning to whatever activity they need. Wants to return to. Gotcha. Um, you know, w w one of the nice things too, we offers same day, next day service. Yeah. Um, so if you do call for an appointment, you don't have to wait two weeks to see in orthopedics. Many times you might even be able to be seen that day or you know, uh, within the next couple of days if not the next day.
Host: 24:20 Personal experience, that is a huge help when your, your foot is hurting, your knee is hurting. Getting there and getting seen that same day or the next day, it, it, it just helps getting on the road to recovery as soon as possible.
Chris Ina: 24:34 You know, athletes have a different mentality. They want to get back, they want to get ready, they want to get better as fast as possible. So waiting two weeks to see a physician when your knees hurting really isn't the greatest, uh, answer to, to a true athlete.
Host: 24:46 Sure, sure. Um, well I'm, I appreciate you taking the time with us today, Chris. This is awesome. Information is, um, school's getting ready to ramp back up and fall. Sports are ramping up. And, um, you know, we're still towards the end of summer and getting ready for fall. So there's lots of activity, people being active outdoors, either in organized sports or outside of organized sports. So, um, this is, this is been a great overview of, of our partnership with our athletic trainers and, um, also some just good information on concussions and, and hydration and, and what our sports medicine program can provide for anyone in the community. Um, and I know you mentioned Sports Med Stratford, which is a great, great location, but, um, I just want to let her know, I know we do have, I think total orthopedic and sports medicine locations across the region. Now we're up to about 25 locations.
Host: 25:39 So we have locations from Wilkesboro down into the triad of course, screens, Rowe, Winston high point and down in the Ashburn as well. So, um, I, I encourage anyone if they're having a, a strain, a, a pole, muscle, lace or ankle, a sore Haines or any sore knee, anything. Um, if something's preventing you, I think Dr Thorton or Dr Coats maybe told me this. If it's, if it's preventing you from what you normally do or would like to do, then maybe it's time to pick up the phone and make an appointment. Um, so seven one six week is our, is our number. You can call and make an appointment. You can also go to wakehealth.edu/sports medicine and there's information about all of our locations and how to make an appointment there. And, um, I'll give one last plug to download our, our all new updated sports medicine guide on that website as well. And I'm Chris, I hope you come back and visit, visit with us sometime soon. Maybe when we get into winter sports you can come back and with us. Sure, no problem.
Chris Ina: 26:44 And I encourage all parents out there listening. If your school has an athletic trainer, seek them out and meet them. Talk to them so you know who they are and you get to know them. Cause, uh, they're very, uh, important part of athletics in a very poor, important part of the health and safety of your child. And if your school doesn't have an athletic trainer, you got to get on those administrators and ask those questions. Why don't we have one? There you go. Call Wake Forest Baptist health and we'll, we'll see what we can do. That's right. Great Info, Chris.
Speaker 1: 27:12 Appreciate the time today. Hey, everyone out there listening. Thank you for your time and uh, hope you come back and listen to us again soon. This is Justin Gomez with wake forest baptist health. Have a great day. Thanks for listening to this episode of the best health podcast brought to you by wake forest baptist health. For more wellness info, check out wakehealth.edu and follow us on social media. Wake Forest Baptist health, the gold standard of healthcare.