January 2014 • Volume 3 • Issue 1
PROFILE: Phil Page, PhD, PT, ATC, CSCS, FACSM
Phil Page grew up in Laplace, La., located between Baton Rouge and New Orleans. As a high school sophomore, in 1983, he was asked to be a “student trainer” for the football team. “My mother wouldn’t let me play football,” Phil explains, “but she said I could be the trainer if I got good grades. I thought being a trainer meant weight training, but then the coach told me I’d have to tape people and take care of their injuries. I said okay. So he gave me a book on how to tape ankles and a key to the training room, and told me to learn about everything in a cabinet that was mostly filled with Cramer products.”
Phil attended his first Cramer camp at LSU in 1984, and learned to tape. “There were few high school trainers in those days,” he says, “so as a student, during my junior and senior years of high school, I was in charge of the athletic training program. I knew it was what I wanted to do, and that it was the profession for me.” Phil went to LSU and was the head student athletic trainer there for baseball, football, and basketball. He graduated in 1990.
With plans to work in professional baseball, Phil earned a master’s degree at Mississippi State. While there, he worked with baseball and football, and realized that he enjoyed the rehab aspect of being an athletic trainer. So it was back to LSU, where he graduated in 1994 with a degree in physical therapy.
Phil worked for two years doing football outreach at Health South as a clinical coordinator, physical therapist, and athletic trainer. In 1996 he worked at Tulane University as a physical therapist for the medical school and for the football team. After two years in that position, he joined his current employer, TheraBand (now Performance Health), as manager of clinical education and research. Phil has been there for 15 years and is now the global director for education and research.
As a proponent of lifelong learning, Phil earned a Ph.D. in kinesiology at LSU in 2009. “It’s so important to continue to learn and to grow,” he says. “I encourage athletic trainers to not get stuck in a rut because you’re so busy taking care of so many people at one time. Professional development goes beyond attending the annual convention. It includes reading articles and books, taking continuing education courses either live or online, and keeping up with new techniques and technologies to stay ahead of the curve. As a profession, we’re at risk of being left behind if we just continue doing the same things we’ve always done. We must look at our interventions and things we’re doing to make sure that they work through research rather than just saying, ‘that’s the way I’ve always done it.’ It becomes difficult to find time outside of the training room to do these things, but it has to be a priority.”
Phil enjoys sharing information on exercise and rehabilitation with other professionals around the world and speaks at many conferences and seminars across United States and in other countries as well. He is a recognized expert on the Janda Approach to muscle imbalance syndromes and chronic musculoskeletal pain, pioneered by Czech physician Dr. Vladimir Janda, a polio survivor. Before Dr. Janda passed away in 2002 Phil trained with him for several years to learn his approach. “Dr. Janda recognized these characteristic syndromes that he called the upper crossed and lower crossed syndromes. For example, the upper crossed syndrome has characteristic patterns of muscle tightness and muscle weakness. He found that specific muscles tended to be tight or tended to be weak. These syndromes were regulated by the central nervous system; they were patterns in the brain that can be recognized, and then treated a little bit differently than you would treat a structural problem.” After Janda’s death, Phil created a continuing education course and a textbook based on Janda’s approach to muscle imbalance syndromes.
An accomplished writer, Phil has authored three books and dozens of articles and abstracts. An interesting fact is that his first published work was in the October 1986 issue of The First Aider! “I wrote an article about how to become part of a college athletic training program,” he says. “I had gone through that process in the previous year, and wrote about it. I was pleased to see my name in print.”
Phil’s websites contain many interesting posts, articles, and resources on various aspects of rehabilitation, professional development, and research. His sites are:
“Athletic training is a great profession that is very important to me,” Phil says. “It’s important that athletic trainers look for opportunities to be a part of the healthcare system and have a voice in that system.”
Degenerative tendon disease in athletes improved by PRP therapy
Ultrasound-guided delivery of platelet-rich plasma (PRP) improves functionality and reduces recovery time in athletes with degenerative disease in their tendons, according to a study presented at the annual meeting of the Radiological Society of North America in early December.
PRP therapy is a recent development in which blood is collected from the patient and then spun in a centrifuge to separate the PRP from other blood components. The PRP is then injected under ultrasound guidance into the target area, where it stimulates cellular growth and healing.
The therapy has grown popular among professional athletes from a variety of sports, who are looking to avoid surgery or prolonged recovery periods. Tiger Woods, Peyton Manning, Kobe Bryant and Rafael Nadal are among the sports superstars who are reported to have undergone PRP therapy in recent years.
"PRP enables regeneration of the tendons and reduction of pain thanks to its regenerative and anti-inflammatory properties," said study author Alice La Marra, M.D., radiology resident at the University of L'Aquila in L'Aquila, Italy.
Dr. La Marra and colleagues recently evaluated PRP in 50 athletes who had degenerative tendinosis in the Achilles tendon, and 30 who had tendinosis in the patellar tendon. The patients underwent ultrasound-guided PRP every 21 days for a total of three treatments. MRI was performed before the procedures and 30 days and one year after the last treatment. The researchers used standard measures of functionality and pain to determine the severity of the tendinosis.
Patients with tendinosis of the Achilles tendon saw an overall improvement of 80 percent in pain and 53 percent in functionality after the PRP treatment. Those patients who had tendinosis in the patellar tendon saw a 75 percent improvement in pain and a 50 percent improvement in functionality.
The signal intensity on MRI, which provides a measure of tissue integrity, normalized in 90 percent of the PRP patients.
"Our study showed that in patients who underwent PRP treatments, there was an improvement of functionality, a decrease in pain and a normalization of the signal intensity seen on MRI," Dr. La Marra said. "Therefore, our experience proves that PRP infiltration may be a good therapeutic alternative for the treatment of Achilles and patellar tendinopathy in athletes."
Current treatment for degenerative diseases of these tendons is based on the severity of the lesion and the age and activity level of the person, Dr. La Marra said. Common treatment options include physical therapy, corticosteroids and surgery.
"Our study showed that PRP is the better option. Compared to the other therapies, it allows a faster and more efficient recovery," she said. In addition, Dr. La Marra pointed out that the use of corticosteroids is risky for professional athletes, as it can result in failed drug tests.
"Considering the results obtained in recent years, we hope that the use of PRP in tendinosis becomes routine for patients who practice sports activities, even at a competitive level," she said.
TrueSport teaches ethics, hard work, and no shortcuts
You’re undoubtedly familiar with the U.S. Anti-Doping Agency (USADA)--the non-profit, non-governmental agency founded in 2000 to preserve the integrity of competition, inspire true sport and protect the rights of athletes in Olympic, Paralympic and Pan-American sports in the United States. But have you heard of USADA’s initiative launched in 2012 called TrueSport? It is designed to empower young people, as well as their parents, coaches, and teachers, to cultivate the positive, ethical life lessons that sport teaches. Being a TrueSport means, “finding your unlimited potential through hard work, respect, and integrity, and without shortcuts.”
According to Erin Hannan, USADA’s Communication Director, “We launched TrueSport because doping is an issue of ethics based on a ‘win at all costs’ mentality -- because if winning is everything, some athletes will do anything to win. We believe athletes should push themselves and want to win, but not at the cost of their integrity and their respect for themselves and others. TrueSport includes a code of conduct, principles and a pledge; a curriculum applicable for classroom, sport camp, and coaching environments; a parent handbook, and nutrition guidelines.”
The ethical issues that lead to doping are rooted in the high value society places on sports and sports heroes—a phenomenon that starts with the youngest of athletes. “Many young kids are pressured by their parents to be high-performing athletes,” Erin says. “There’s a culture that pushes kids to be on competitive teams, and then the kids have to live up to that promise. Then if other people’s teenagers are searching for the holy grail of athletic college scholarships and are on the best teams, even those who don’t want to perpetuate the culture have to jump on the bandwagon and can’t get off. It feeds on itself and creates a vicious cycle that can lead to that ‘win at all costs’ mentality. It is becoming perhaps more the rule than the exception in our culture. With TrueSport, we’re working to turn the tide on that.”
The TrueSport website, www.truesport.org, includes important resources for parents, students and coaches. For example, the TrueSport Coaching Education Program is an online learning platform empowering coaches, as the most significant influencers in the lives of young athletes, with “the knowledge and resources to cultivate, champion, and uphold the rich promise and highest potential of sport.” Those completing the three online classes earn the designation of TrueSport Certified Coach. The site also includes codes of conduct for athletes, parents and coaches; a newsletter; a downloadable TrueSport app; an activity book for very young children; and much, much more.
The website also includes the bios of a special group of athletes who serve as TrueSport ambassadors. “At USADA we can talk all day about this stuff,” Erin says, “but hearing the personal stories from our ambassadors can have a lasting impact on a young athlete. Our TrueSport Ambassadors are all committed to being positive role models and sharing their experiences and life lessons with young people. Our ambassadors help young athletes understand the importance of goal setting, dedication, and hard work, and how all those things contribute to success. They inspire young people to do things the right way and not look for shortcuts, and are living proof there are rewards for doing that.” The 20 TrueSport ambassadors include 2012 Olympic Track and Field Gold Medalist DeeDee Trotter; swimmer Bradley Snyder, 2012 Paralympic Gold Medalist; and 2011 Pan American Games Mountain Bike Bronze Medalist Jeremiah Bishop. “As we continue developing TrueSport programming,” Erin notes, “our ambassadors will be central to those programs, sharing experiences in person or on video. We’ve found this has a strong impact on young people, and is a differentiating feature of TrueSport programs.”
A TrueSport pledge is also found on the website. “Research shows that if you put something in writing and express your intention to someone else, you are far more likely to act on it,” Erin explains. “So we encourage people to take the step to formally say in writing, ‘I will compete clean and I will respect my sport,’ by signing the TrueSport pledge. If a team or a league or a school is united in that philosophy, and it is articulated as a guiding principal for the organization, then the chances of success are much greater.”
USADA views TrueSport as a long-term, evolving, organic movement that will make an impact over the course of the next generation. Schools that have adopted the TrueSport curriculum are seeing excellent results: http://www.ednewscolorado.org/news/taking-on-a-win-at-all-costs-society-in-the-classroom
Erin says, “If you look at professional, college and Olympic sports, the athletes are seen as icons and heroes, and there’s a lot of money, power, influence, and fame that goes along with it. Many of these athletes are placed on a pedestal and as a result, there is a risk that they might feel the rules no longer apply to them. And unfortunately, society tends to support that and it all trickles down to the children who are watching. Sport is a microcosm of society, and what is derived from athletics transcends the playing field into family life, work life, faith, and all different facets of society. TrueSport provides an actionable pathway to sport with honor, and helps create not just good athletes, but good people.”
FROM THE ARCHIVES
So-called staleness may come from a mental complex—a lack of being able to concentrate 100% on the game. It could be trouble at home or with the girl friend, or worry over studies, or squad friction.
Staleness may come from other causes—overwork, bad teeth, a lack of sleep, irregular eating habits, over-confidence or an inferiority complex, or injury – all resulting in a loss of enthusiasm.
If an entire squad seems stale it very likely comes from overwork or a lack of variety in practice—a monotony of repetition which dulls the mental processes.
Quite often youngsters take offense at some comment or criticism regarding their play. Psychologically, they build up a complex which takes a part of their time and energy. In college they gripe to the trainer and it’s his job to placate them. In high school they just continue to stew.
Staleness has become one of those intangibles of sports. It is experienced in tennis and golf—without any obvious reason. Even coaches suffer with it on occasion—especially when they lay awake nights dreaming up plays.
It is unquestionably contagious, and the alert coach is constantly on the lookout for it and tries hard to combat it, usually by eliminating routine and monotony for a few days.
SELECTED BASKETBALL HINTS
If the gym temperature is too hot, ask that the heat be reduced.
Always be ahead of time, so that you don’t have to hurry your squad.
When traveling by car, or bus, see that motors are running ahead of time and that cars are warm.
If there is any question about the drinking water, have the players drink hot, weak tea at meal times—and carry a home supply of water for game use. It shouldn’t take much.
Fit athletic socks just as carefully as you do shoes. You will cut foot troubles in half.
Make your training room a place of business—not a place for loafing or questionable stories.
A big breakfast will answer many of the so-called diet and pre-game problems.
If a boy doesn’t improve daily as the season progresses, have his teeth examined.
Walking in a sweat suit, until cooled off is a good practice after a hot game.
Smelling salts is an economical, efficient method of giving a lift—at time out!
Cramer’s new Performance Short:
Cramer’s new Performance Short is a perfect garment for athletes who want enhanced core support and muscle performance during training and competition. The body of the short is made of 78 percent nylon and 22 percent spandex, and the elastic is 90 percent polyester and 10 percent spandex.
The short’s advantage comes from its anatomical design and elastic cross band, and the lightweight fabric promotes endurance and mobility. Michael Chan, ATC, Associate Athletic Director/Sports Medicine at Wayne State University, tried out the Performance Short on his players during football season. Both Mike and his athletes liked the results.
“The guys loved the Performance Short,” Mike says. “It’s comfortable, especially after the first wash when they soften a bit. The Performance Short gives support where they need to give support. Some of the athletes we gave them to had been wearing another brand of short, and say the Performance Short is comparable in every way. The short provides support in the hip region where it’s needed most. It serves as a prophylactic type of product, similar to the way an ankle brace provides stability to an ankle. Wearing the short possibly could minimize the extent of an injury or a pull. Our guys wear them when they’re working out, lifting, and practicing—they wear them all the time, whenever they’re active. We had 12 pairs of the shorts, and the guys were asking me for them all the time. I’m going to have to get more!”
The Performance Short comes in black and white, and with five sizes (small, medium, large, extra large, and double XL), you’ll find the right fit for waist circumferences from 26” – 44”.
“From an equipment standpoint,” Mike says, “I see the Performance Short as sports medicine equipment rather than an athletic garment like shoulder pads or pants. The shorts are a preventive measure to keep athletes healthy. For example, when an athlete is working his way back to activity following a hamstring or hip flexor injury, the short’s compression retains heat, helping the muscle stay warm throughout activity.”
What can Cramer’s Performance Short do for your athletes? Check it out here!