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The First Aider

Let's Get This 100-Year Anniversary Party Started!

March 13, 2018

When Frank and Chuck Cramer started the Cramer Chemical Co. in 1918, they couldn’t have imagined that the liniment whipped up in their mother’s kitchen would ultimately launch the profession of athletic training and the sports medicine industry—but that’s just what it did.

For a full century, Cramer has been taping, wrapping, splinting, hydrating, icing, warming up, and treating athletes. We’ve been educating, too, with The First Aider newsletter. It’s been published since 1933 and has given many athletic trainers of a certain age their start in the profession. It continues to be a helpful resource today. Our hands-on involvement began with the legendary Cramer summer workshops for high school students and that spirit lives on through our sponsorship of the Colonial Sports Medicine Summer Camp at William & Mary.

More than anything, though, we’ve been dedicated to the athletic trainers we serve. It’s your dedication to the health and well-being of athletes that inspires us every day. You challenge us and teach us, and we’re so grateful for that!

For our centennial birthday, we’re throwing a surprise party—and the surprises are for you! So, consider 2018 a year-long party with you, our athletic training partners, as our invited guests. Look for launches, visits, giveaways, and events throughout the year. It’s all designed to thank you for giving us an amazing century, and since we feel like we’re just getting started, to help us prepare for the next 100 years of success!

So let’s get the party started! Since Chuck and Frank Cramer helped found the NATA in 1950, we think it’s only fitting this year to pay the registration fee for some athletic trainers who would like to attend the NATA 69th annual Clinical Symposium and Athletic Trainer Expo! It’s in New Orleans this year, from June 26-29. We’ll randomly select multiple names every month through June 10—so act now! Click here for details and to enter.

Whether or not you win a paid registration, trust us: you don’t want to miss this year’s NATA meeting.

Finally, make sure to follow us on Facebook and Twitter. Throughout the year, we’ll announce contests and giveaways in honor of our 100th year. You’ll only find out about these fun opportunities to get free Cramer stuff through these social media platforms. Don’t miss out!

The Cramer name is synonymous with athletic training, and we’re excited to be turning 100. We’re proud of our heritage and the profession it helped found, and it’s nice to take a moment and reflect on the remarkable evolution of athletic training since those early days when Frank and Chuck sold that liniment. Looking ahead feels great though, too. Our commitment to providing leadership and promoting the profession has never been stronger. Our dedication to helping every athletic trainer succeed is as fervent as ever. In fact, we’re just getting started. So here’s to the next 100 years! Read More

Lessons Learned, Lessons Shared

March 13, 2018

Experience, as we all know, is a great teacher. And those who have learned from experience are great teachers as well! With that in mind, we asked the elite athletic trainers on Cramer’s Advisory Committee to share valuable lessons learned from experience. Their wisdom is timely for students getting ready to graduate and equally as helpful to athletic trainers at any point in their career.

Chris Crawford, MS, ATC

It’s a tough profession when you get into it right off the bat. You’re exposed to a lot, you’re asked to do a lot, and some of it might be a little bit out of your comfort zone. But sticking with it, asking questions, and doing your best to work your way through the situations is what’s going to help you in the future. You’ll figure things out, you’ll say okay I’ve been through this before, this is what I did and this is how I can make it through. That perseverance is a big key.

Collin Francis, MS, ATC, LAT

Always be the hardest worker in the room. I grew up with athletic trainers who grinded for 30-plus years, not missing a day of work, not missing a game, and just working hard and being a tireless advocate for our profession. I’ve learned, especially this year, don’t sweat the small stuff. You have to be able to differentiate what’s important and what’s not. Sacrifice a little argument in the athletic training room for the greater good.

Jim Spooner ATC, LAT, CSCS

Do a really good job of using your mentors, people that have been around awhile. The profession is changing so much right now in terms of what we do, the educational component, what students are taught. They’re coming out with so much more information than when I graduated 15 years ago. But I don’t know if they have a good grasp into the profession’s past and some of the work that’s been done to get where we’re at. They need to get that education from the mentors or people who have been in the profession for a while to continue on those traditional components of athletic training.

Jose Fonseca MS, LAT, ATC

Open your ears before you open your mouth. Listen to what people are telling you. Observe and watch, before you act. I think it goes a long way. It’s sort of a lost art form these days. People want to talk a lot and they don’t want to listen, they don’t want to see what’s going on around them. Learn from your mentors.

Kelly Quinlin, ATC, CSCS, LAT

The advice I would give to new grads would be to know that your hard work will pay off. I remember telling myself that multiple times when I was younger: All this hard work, all this time, all this effort will pay off. And it did. Another thing is not to be complacent in what you know. Always want to learn more; always want to know what’s the newest rehab technique, treatment, modality that works really well.

Mike Harrison, ATC, LAT

You don’t learn everything in your curriculum program. It’s just not possible. Your first year out on the job by yourself is going to be a huge, huge learning curve. You’re going to get the most experience by being hands-on. So the biggest thing is to communicate. Communication is key. You’re going to have to learn to communicate with coaches, parents, and athletes, and you have to do it on their terms. But if you have a position on something, you need to be firm about it. It’s okay to agree to disagree and disagree to agree. You’ll work it out. But communication is probably, by far, the biggest thing in our industry.

Paul Silvestri, MS, LAT, ATC

Listen. Listen to the people that have been through and walked the path that you’re about to start on. Don’t think you have all the answers. The first thing the young ATCs need to learn is to be humble and check their ego at the door. I always tell our kids if you don’t have the passion for this profession, you need to get out now and figure out a new major because the hours that you work, and the demands that are put on you, and the stress of getting an athlete back on the field and dealing with coaches and parents and everything…it’s not for everybody. You’ve got to decide that early on, that you’re going to be passionate about it and love it.

Tandi Hawkey, MA, ATC

To new athletic trainers I would say address the life balance issue, and that you just need to have good boundaries when you start your position. Make clear expectations with the student athletes about their communication with you. Younger people these days have different feelings about when it’s appropriate to text and communicate with you, contacting you on social media, things like that. If you enter your position with clear expectations for your relationship with your student athletes, you’re going to be a lot better off because you can feel like you have that time away from your student athletes when they know that it’s not okay for them to contact you all hours of the day. Read More

Your Kit's Not Complete Without Skin-Lube®!

March 13, 2018

Since its founding 100 years ago, Cramer has remained steadfast in its commitment to provide high quality, effective athletic training products. That legacy is something we take quite seriously…starting at the most basic level.

Take Skin-Lube, for example--Cramer’s tried-and-true lubricating ointment. Since creating the product more than 60 years ago, we’ve stayed loyal to the original formula for one very good reason: it works. Skin-Lube both treats and prevents, and is a versatile, basic essential that’s a must for every kit.

Skin-Lube’s reputation was built on its remarkable ability to lubricate the skin, reduce chafing, and prevent blisters, chafing and burns. Use it on the feet, hands, thighs, shoulders, chest and other areas of the body that experience high friction. This protective ointment is heavier, thicker, and has a higher melting point than petroleum jelly. Skin-Lube stays on the skin during heavy use and stands up to heat and sweat like nothing else, making it long lasting and effective.

Skin-Lube is known for its ability to prevent blisters, but you’ll also want to make it your go-to product when a blister is already there. The ointment forms a thick, protective shield that stays put under socks. Your athletes will be back in the game, without the irritating pain. They’ll forget they have a blister!

There are even more uses for Skin-Lube. Depend on this basic kit essential…

  • To prevent/reduce wind burn
  • As a long-wearing lip balm
  • To protect the skin from the rain
  • For a perfect accompaniment to Cramer’s Heel and Lace Pads
  • To keep the skin moist during cold, dry weather—especially hands and feet that are prone to cracking
  • As protection against humidity-induced rubbing
  • For an effective massage ointment

Skin-Lube has legions of fans. It’s the ideal product for football, soccer, hockey and basketball players, as well as runners and cyclists. It’s perfect for endurance events such as marathons, triathlons and ultra running. Swimmers love Skin-Lube because it stays on in the water, and it’s also a favorite among hikers.

"Cramer is a company that I truly trust,” says Kelly Quinlin, ATC, LAT, CSCS. The products they make have withstood the test of time, and even the new ones they're coming up with are terrific. There's just a gamut of products that Cramer provides that I need as an athletic trainer. If I don't have my kit with those supplies in it, I can't perform as an athletic trainer so those are very vital."

Cramer’s Skin-Lube contains petrolatum, zinc stearate, silicone, propylene glycol, diazolidinyl urea, methyl paraben, and propyl paraben. It’s available in a 2.75-ounce tube; one-pound or five-pound jar; or 25-pound bucket. The ointment goes on easily and stays on. Your kit’s not complete without Skin-Lube! Read More

FROM THE TRAINING ROOM

March 13, 2018

INTRODUCTION:

What does the research say about the use of kinesiology tape? How can instrument-assisted soft tissue mobilization (IASTM) be incorporated into a treatment plan? And when should dry needling and cupping be considered as effective modalities? Phil Page, PhD, PT, ATC, CSCS, FACSM, and editor-in-chief of the Journal of Performance Health, and Sue Falsone, PT, MS, ATC, CSCS, COMT, RYT, share their expertise and candid thoughts on these modalities in this Q and A. Click here to read the Journal of Performance Health.

An Interview with Sue Falsone PT, MS, SCS, ATC, CSCS, COMT, RYT®

Below Phil Page, PhD, PT, ATC, CSCS, FACSM and Editor

in Chief of the Journal of Performance Health, discusses the specifics of different treatment plans in more detail with Sue Falsone.

Kinesiology Tape

Phil:

We’ve been athletic trainers for a long time and tape is a big part of what we do as athletic trainers. Kinesiology tape is something I’ve been using for quite a while and I think it works really well for some people. What are some from your experiences with kinesiology tape and how do you use it in your practice?

SF:

Yes, I’ve used it for a very long time and I think over the years you adjust how you use certain tools. When it comes right down to it, the thing that I use kinesiology tape the most for is for pain relief. I’ve really gotten away from using it for other reasons because I feel like pain relief has been the most effective way for me to utilize kinesiology tape in my practice. But you know the research better than I do, what does the research say?

Phil:

You’re exactly right. Kinesiology tape is a short-term pain reliever that, when it’s compared against minimal or no intervention, works. It’s not more effective than other traditional things we would use such as the modalities, manual therapy, or exercise. But it’s really best used for short-term pain relief for musculoskeletal pain. And you brought up a good point, which is there’s not a lot of re-search supporting the use of tape for things like improving performance or even reducing edema after an ankle sprain. Quite honestly, it’s been shown to not have an effect on how fast that edema is reduced in an acute ankle sprain. So, the question then becomes: is that something you want to spend your time and money on? Are there other things that are as effective or more effective for both time and money as well?

SF:

What about different things such as activating a muscle or decreasing the tone of a muscle? What does the research tell us about that?

Phil:

I’m really glad you asked that because one of the things I’ve learned very recently is kinesiology tape gets a bad rap because people don’t think there is a lot of research about how the tape can activate muscles. However, there are over 400 published articles on kinesiology tape. According to the science, this whole argument of applying it in one direction versus another is absolutely false. I have tons of studies that have compared the direction of application on muscle activation and I can tell you, without a doubt, there is no difference on which way you apply it. You cannot facilitate or inhibit a muscle.

IASTM

Phil:

You know, Sue, I have been personally affected by certain treatments. I had tennis elbow for six months and a friend recommended instrument-assisted soft tissue mobilization, or IASTM as it’s called. Within two treatments, my pain was gone and I have not felt any more problems with that tennis elbow. I thought to myself, “There’s something definitely going on here.” It’s an effective pain reliever and very robust in its effect. I actually looked into the research and there’s some basic science behind it. It’s still really murky and there are not any real outcomes to measure, other than case studies out there. I tend to use it. Athletes love it. I know athletic trainers have been doing it for a while. How are you using it in your practice?

SF:

I have used some form of instrument-assisted soft tissue mobilization for probably a decade. I find it to be extremely effective with those really inspectional tendinopathies, those areas of pain that people are having right as the tendon is coming off the bone. That bone tendon interface is really where I tend to have really, really good results with it. And I continue to use it in my practice. I feel that, as a clinician, the clinical practice always precedes the research literature, right?

Our clinical practice drives clinical questions, which then drives the research side. And so, the research is always going to be lagging behind clinical practice. That doesn’t mean I don’t do things, because if I waited for research to tell me what to do, I might not have any therapeutic intervention to perform. And so, there’s so much information, whether it’s histological, or circulatory, or physiological, or even pain management type things that I think, clinically, those of us who use the modality “know” it works. And I’ll say that in quotes. We know it works, we’ve seen it work. We’ve had stories like you had, and so we continue to utilize it. And we just need to continue to search for answers as far as why is it working and how does it work. Just because we don’t know how it works or why it works doesn’t mean it doesn’t work.

Phil:

That’s right. Another great thing about IASTM, as we both know, is that it takes care of your hands. When we’re doing a lot of manual work with our patients, those instruments really do help us to do more during the day than we could without them.

SF:

Absolutely, and the longer I practice, the more I need hand-saving techniques. So, yes, instrument-assisted tools definitely help save our hands. And even if that’s the only reason to use them, I think it is a very valid one.

Dry Needling and Cupping

Phil:

Another new great modality that’s out there that I’m seeing a lot of is dry needling. I’m really excited to hear your story of it. I know you teach it regularly with your courses and it’s something that I’ve had done to myself. My wife is certified in dry needling and I think that there are some benefits, too. Tell me a little bit about how you came about to start with dry needling and what are the benefits. What can you tell me about it?

SF:

I started using dry needling probably around 2008-2009. I studied and took many different classes over the course of several years. I had the opportunity to create an education company last summer. Now I really teach about dry needling and how I utilize it within my clinical practice, both as an athletic trainer and as a physical therapist. As I said, I’ve had some really, really great results with it. It’s been one of those things that definitely has been practice-changing for me. We don’t exactly know how it works or why it works, but we certainly know that it can work. And I think that it is important to make the distinction between dry needling and acupuncture because everybody asks that question.

Acupuncture, when you look at the root words, “Acu” is sharp and “puncture” is to puncture, so are we utilizing to sharp object to puncture the skin? Yes, we are. That is where traditional Chinese acupuncture comes from, rooted in traditional Chinese medicine. There are so many different offshoots and specialties of traditional Chinese medicine and traditional Chinese acupuncture. Then there’s Western medical acupuncture with even more subcategories. Dry needling is one of those. I’m

a huge advocate that the tool does not define the professional. Each profession, whether you are an athletic trainer, or a chiropractor, or physical therapist, or an acupuncturist, has overlapping skills. We all use manual therapy. We utilize exercise and taping. And a fine filiform needle is no different; it’s just a tool that overlaps multiple health care professions. And we use it in very specific ways based on our education. Just because

I use a fine filiform needle does not make me an acupuncturist; just like when I utilize manipulation, I don’t magically become a chiropractor either. I am not defined by the tools that I use.

Phil:

One of the things that I think a lot of younger therapists don’t know is that dry needling was popular for many years in the 70s with Dr. Travell, remember? The myofascial pain, that’s the way Dr. Travell treated a lot of trigger points. They’ve treated trigger points medically for years and years with really great success. So, I know that it’s a great modality that we can really use in our clinics, and I appreciate all you’re doing to make it safe and have other people actually apply it. How does that fit within the realm of the athletic trainer? I know that it’s mostly done by the physical therapist today. Where does this fit within the scope of athletic training?

SF:

Athletic trainers are healthcare professionals and they function under the guidance of a physician. Every state has different laws, and we have to follow the different state licensure laws. I would just encourage the athletic trainer to look at their state laws and see if this is something that they are able to perform or not. Have that discussion with the supervising physician to see if this is something that you can incorporate

into your practice.

Phil:

Right. Another thing you do that again unique but now is popular is cupping, right? You’ve been doing cupping for years, and I was in China many years ago and I saw the traditional way of doing cupping. But after the Olympics last year, I was intrigued by it, then all of the sudden it explodes. Tell me a little bit about the role, what cupping does. What’s its role in your overall treatments?

SF:

Cupping is an interesting soft tissue modality because everything we have, whether you’re sticking your thumb in someone or using a massage stick or a foam roller, everything is compressive to the tissue. And so, for the first time we really have a distraction in the tissue by utilizing negative pressure. And the cup, it lifts the tissue up and it causes a decompression of the tissue. Now there is compression under the rim and I think that compression to decompression interface is very, very interesting. So, for the first time, we have the ability to decompress tissue. And we don’t exactly know how that is good, bad, or indifferent, or if it’s better than compression in and of itself. But I think, in general, the body likes periodization. We don’t like to eat the same thing every single day. We don’t do the same exact workout every single day. The body adapts to those things.

I think if we purely look at cupping as a way to periodize our soft tissue work, that alone is interesting to me. Let alone, what does decompression do the tissue? What are the circulatory changes? I think there are a lot of other interesting things going on there. But we know, in general, the body does adapt to the same stimulus day in and day out. And yet, we’ll have our athletes grab a foam roller and they’ll foam roll when they come in to the athletic training room, when they leave on an off day, before a workout, after a workout. I mean I can way overprescribe foam rolling. I think cupping gives us an alternative. Again, exactly how that works, I’m not sure, but that doesn’t mean it doesn’t work. Just because I can’t explain it doesn’t mean I don’t have good results with it. Read More

FROM THE ARCHIVES From the March 1, 1957 issue of The First Aider

March 13, 2018

Excerpts from “Cross Country”

By Bill Easton

Cross Country and Track Coach, University of Kansas

Editor’s Note: Here are some excerpts from Bill’s eleven-page article on Cross Country. This article is distributed by him to all prospective track athletes. It contains some prime material – suggestions that will fit into any athletic program in any sport.

“For the first two or three weeks of your work, job – over distance in gym shoes or rubber soled warmups, with a change in pace, and walking. CAUTION – DO NO SPRINT WORK WHATSOEVER. Early sprinting is the reason for so many shin splints.

Daily supervised workouts, if only for a short period, means a constant physical build up toward a better performance. In overdistance running a boy learns relaxation, stride, pace, proper breathing and the finesse that makes for a good track man. Speedwork adds the “finishing” touch.

“Eating between meals is one of America’s worst habits. A good athlete, in training, will limit himself to eating only at meal time. If hungry at bedtime, eat fresh fruit – grapes, oranges, apples, dates.

“Fatigue is of two kinds, mental and physical. Never fall into a set stride and stay there. This is a rut and leads to monotony with mental fatigue. Get out by sprinting out.

“Increase in the length of stride near the finish line is generally a sign of fatigue. It starts with long steps and becomes a lumbering, awkward gait.

Never fall on the ground at the finish of a race. It indicates either a showoff or a boy who is not taking care of himself, hence, is not in condition.

“Training is a matter of self-discipline. The boy who really wants to be a fine cross country and track man must train for himself. It takes a man to be a good athlete.

A Training Hint

…for the student trainer

Occasionally, you will find an athlete with feet that seem to be habitually cold and clammy. They have a slimy film that feels like cold sweat. They feel greasy to the touch.

It would be proper for you to assume that the athlete is troubled with improper circulation through the low-back and hips.

We would immediately suggest daily stretching exercises for this low-back area. We would also use massage and the Cramergesic Pack. Read More