If you were like me as an undergrad, then you remember having different preceptors show you how they like to do things in the clinic such as types of treatments, tapings, or bracings. No doubt most of what you learned as a student has stuck with you in your own practice as a now certified athletic trainer. The only problem is how do we know that what we are doing in the clinic is actually the best method of treatment/care?

You could argue that you have gotten great results in the past, and while that is probably true, how do you know that there isn’t something out there that works even better and would give you better results? I had this discussion with myself one day and I made a promise to myself I wouldn’t fall into a routine and not change how I practice for the next 30+ years of my career. I believe being in the medical profession we need to be willing to change with the new developments that come about. We owe that to our athletes and patients to ensure they are getting the absolute best care possible. If you feel like you might be stuck using the same techniques/methods that you were taught in undergrad, it could be time to shake up your routine and reevaluate what you were taught as a student athletic trainer.

New Advances in Equipment and Technology

The technology and equipment that are available now may have not been available yet to the preceptors that taught us in school. Technology and equipment are ever changing and improving. Because of this, we as athletic trainers need to be constantly aware as to what is available to us so we can use the best equipment and technology in our practice for our athletes. We owe them the best quality of care we can provide.

Better Understanding of How the Body Works

Due to the advances in technology, we also now have a better understanding of how the body works and what actually helps it versus what we used to think worked the best. Some of the things we have learned about the body actually show us that some of the treatments we thought were helping were actually a hindrance to the body.

An example would be lace up ankle braces. The original thinking was that the compression and support provided worked like taping, and while that is true, neither the tape or lace up braces are the best option for the ankle. It limits the natural range of motion of the ankle which in turn limits the athlete’s ability to fully perform. Both these options also loosen up within about a half hour (or less) of activity and they lose their support that prevents lateral (inversion and eversion) movements. This is why looking at hinged braces for your athletes is a better option for support of their ankles.

Learn Outside of Your Mentors

A lot of clinical practice has been passed down from mentor to mentee. This doesn’t always mean it’s the best practice; it’s just what we are used to. Our mentors might not have been exposed to better practice. This is not a knock on our mentors – I was blessed with some of the best mentors I could imagine but due to region and resources some mentors might not be aware of what new practices and technologies are out there.

New Advancements May Lead to Better Results

What’s the harm in trying something new if it could potentially have a better result than what you are currently doing? There is only one way to find out if something new out there is worth implementing into your practice and that’s by actually trying it out. If it doesn’t work as well as what you currently do then switch back to original practice or equipment.

Older Methods and TecHniques Are Still Valid

Just because a new technique or piece of equipment comes out and it’s better does not make previous technique or equipment invalid or wrong. Like all types of technology and equipment, it was the best thing and very useful for its time but now it is outdated and new discoveries bring better ways to treat injuries and conditions. I like to think of this as when flip-top, original cell phones were first invented. They were amazing and great at the time but no one today would ever dare to use one now when we have smartphones available to us. It is important to keep this in mind as a reminder that it’s okay to revise our practice and leave what we once did in the past. This is what research is for. It’s done to improve our clinical care so we are able to treat our athletes and patients in the best way possible.

When it comes to shaking up your routine as an athletic trainer, what do you do? Let me know in the comments! 

Post written by guest author Lauren Dybwad, ATC.

Ultra Zoom

Help prevent ankle injuries all season long.

Ultra High-5

Reinforce the ankle after a history of multiple ankle injuries

Ultra CTS

Maximize stabilization to treat acute ankle injuries

Have you ever thought about the fact that while knee bracing keeps advancing in terms of design and materials, ankle bracing advancement is stagnant? The only difference between the first lace-up (which was introduced over a century ago) and the lace-ups of today is a figure-8 strap has been added.

For this reason, some athletic trainers have started to rethink the use of a lace-up design that restricts non-injury range of motion, loses support rapidly, collects bacteria, stinks and is a pain to fit. Athletic trainers would never recommend a lace-up knee brace, which is why they are now rethinking why they would recommend a lace-up ankle brace. However, if not a lace-up ankle brace, then what is the best option for ankle injury prevention or mild/moderate ankle instability?

Athletic trainers tend to learn early on that the brace we prefer the athlete to wear and the ankle brace they will actually wear might be two different things. Take semi-rigid, hinged braces as an example – we see these ankle braces as providing more long-lasting ankle support, but the athlete sees them as being big, bulky and uncomfortable.

This leaves athletic trainer’s stuck between using an outdated and ineffective lace-up ankle brace or insisting their athletes wear bulky and uncomfortable semi-rigid, hinged braces. Instead of settling for these decades-old technologies, they are starting to rethink their methodologies by adopting a new ankle brace technology that has significant appeal to both athletes and athletic trainers.

The latest ankle brace advancements have resulted in products that are comfortable and low-profile enough to satisfy the athlete while utilizing a hinged-cuff design that provides long-lasting ankle support to meet the requirements of the athletic trainer. So, what is this emerging ankle brace design that satisfies both the athlete and athletic trainer? It all starts with a thermoplastic elastomer resin.

You may not know the term “thermoplastic elastomer” but it could become your best friend at preventing and treating the ankle injury. Rethinking the ankle brace starts with rethinking the material the ankle brace is made from. Thermoplastic elastomer material, trademarked Performathane® by Ultra Ankle®, is used to form the soft shell of the Ultra Zoom performance ankle brace.  The Performathane soft shell reacts to body heat by form-fitting to the ankle for a comfortable custom-fit that athletes love. The hinged-cuff design of the Ultra Zoom restricts excessive inversion and rotation to help prevent both low and high (syndesmotic) ankle injuries

Rethinking ankle bracing also comes with rethinking the cost per season. A lace-up ankle brace will typically last only a high school sports season or less. The Ultra Zoom typically lasts three full sports seasons making your cost per season much lower. 

Every once in a while, we need to step back and rethink our bracing recommendations.  Innovation moves forward with new techniques, materials and designs providing better outcomes for athletes and athletic trainers.  At Ultra Ankle we keep advancing ankle bracing technology in order to perfect the best possible ankle brace for ankle injury prevention, chronic ankle instability and acute injury care.

Ultra Zoom

Help prevent ankle injuries all season long.

Ultra High-5

Reinforce the ankle after a history of multiple ankle injuries

Ultra CTS

Maximize stabilization to treat acute ankle injuries

Every athletic trainer I know, including myself, loves what they do. The day in and day out tasks of working with athletes and teams to keep them safe, healthy, and performing at a high level is something I’ve been passionate about for years. As with any profession, however, there are some pet peeves I’ve developed over time that relate to my athletic training career. Here are some of them I wanted to share with you that myself and my friend/fellow athletic trainer, Gerald, put together for fun :

Do you have any Gatorade?

Athletes today think Gatorade actually flows from the faucets in the athletic training room and our supply is unlimited and it’s free.  It’s not.

No fear, Dr. Mom is here…

How many times have you ran on to the court or field to evaluate a player who just sustained an injury only to get partially through your evaluation when Dr. Mom or Dr. Dad comes out of the stands? Occasionally they may even ignore you and start performing their own evaluation as though they are medical professionals. Hey! I’m a sports medicine professional in the middle of an injury evaluation on your child. I know you’re worried about them, but it’s easiest for me to help keep them safe when given the proper space to evaluate their injury.

We need a trainer to cover this new event we just added!

This is a two-part double whammy pet peeve. First of all, I hate being called a “trainer.”  The word trainer doesn’t represent our profession at all. In fact, using the word discredits the good work we do.  The NATA is doing a pretty good job of getting the message out that we are Athletic Trainers, not trainers. However we all need to politely correct those who use the “T” word.  The other pet peeve is someone is always adding new events for me to cover when I have my hands full already. No explanation needed there!

What type of athletes do you train?

Are you ever out to dinner and someone inquires as to what you do professionally?  You politely reply, I’m an athletic trainer.  And then here it comes, “what type of athletes do you train?” Now, I can’t really blame people for thinking I “train” athletes – I mean, that’s what my title is after all! But as medical professionals, “training” athletes isn’t really what we do.

I always need to describe my profession with this example – “You know when you watch sports and see an athlete get hurt? And you see those guys running on the field to evaluate the injury? Those are athletic trainers.”  Of course they then say, “So why are you called athletic trainers when you don’t train anybody?”  Oh boy, here we go again.

Can I borrow a few coolers?

This happens so often I should start charging people to rent coolers. A coach or athlete asks to borrow some coolers for their event and of course being a nice guy I say OK. A few days after the event I notice the coolers have not been returned to the athletic training room. When I do finally track them down and have them returned they are filthy both inside and out. I don’t know if you’ve ever scrubbed out a moldy cooler, but trust me it’s not a pleasant experience.

Do you know how to tape?

For me, the first thing I learned in college was how to tape. Whether it’s a curse or a blessing it would seem that taping is what athletic trainers are most known for. If that’s the case, why do we have so many people ask us if we know how to tape? That’s like asking a surgeon if he knows how to cut.

This lack of knowledge might tie back into the fact that a lot of people don’t know the difference between a personal trainer and an athletic trainer. Working to educate parents, players, and others on our profession and what we can/can’t do seems to be a never ending process but something I’m happy to do to help spread awareness of athletic trainers and their careers.

We will pay you to work this tournament!

I get asked to cover outside events like travel basketball tournaments or wrestling tournaments all of the time, but I rarely agree to work them. Unfortunately, these events typically pay an embarrassingly low wage for someone to spend their day medically treating athletes and it simply isn’t worth my time so I must decline to work the event. Hopefully if enough ATCs refuse to work these extra events for low wages we can eventually help raise the standard pay overall.

So there you have it – my top six athletic training pet peeves. If you’re an athletic trainer, would you agree or disagree with the statements above? What pet peeves would you add to this list? Let us know in the comments!

Ultra Zoom

Help prevent ankle injuries all season long.

Ultra High-5

Reinforce the ankle after a history of multiple ankle injuries

Ultra CTS

Maximize stabilization to treat acute ankle injuries

A few weeks ago I was watching a press conference with Seahawks quarterback Russell Wilson who was commenting on how the ankle injury he sustained in the previous game was progressing.  When explaining his ankle situation the day after the injury he said the first thing he did was to take off the walking boot, because “You can’t play in a boot.” 

As athletic trainers we often use a walking boot to calm down a recently injured ankle, but we all know the sooner you transition out of a walking boot the better.  But the real question is, transition out of a walking boot to what?

What comes after wearing a walking boot is where athletic trainers earn their money.  The transition from the safety and security of a walking boot to the next phase of returning the athlete to competition is critical.  The ankle will need some sort of external ankle brace support because tape alone is not enough.  But what kind of ankle brace would provide a good transition from a walking boot? 

If the athlete has weight bearing pain, then you will need an ankle brace that unloads or offloads the ankle.  Meaning the brace will absorb most of the impact, not the sore ankle, thus reducing weight bearing pain.  Tape and lace-up supports have a soft bottom and cannot unload the ankle.  The ankle brace design that is the most efficient at unloading the ankle is a semi-rigid hinged-cuff ankle brace.  ‘Hinged-cuff’ means it’s a hinged ankle brace but with a cuff that encircles the posterior of the lower leg.  What makes this design the most effective is because you encircle the ankle/foot and lower leg in both the vertical and horizontal plane which provides a stable platform to absorb impact and control movement. 

Now that you solved the weight bearing pain issue, the next focus is providing sufficient ankle stability to secure the injured ankle and prevent further injury.  Yes, you can tape the ankle for stability, but tape loosens the longer you wear it.  We have ruled out lace-ups because they can’t unload the ankle.  Once again, a semi-rigid hinged-cuff ankle brace is the best option because it can provide more initial and long-lasting ankle support. Because the brace is hinged, it moves with normal ankle range of motion which keeps the straps securely in place maintaining long lasting ankle stabilization.  Every knee brace is designed upon that same principle.  Also, the cuff portion of the hinged-cuff design helps to restrict excessive ankle rotation which causes syndesmotic ankle injuries

To sum things up, when you come out of a boot it’s important to unload the ankle to reduce weight bearing pain and stabilize the lower leg and ankle to prevent further injury.  The hinged-cuff ankle brace design is the most effective when transitioning from a walking boot back to competition, because you can’t play in a walking boot.

Ultra Zoom

Help prevent ankle injuries all season long.

Ultra High-5

Reinforce the ankle after a history of multiple ankle injuries

Ultra CTS

Maximize stabilization to treat acute ankle injuries

While I have yet to find someone who claims to be passionate about having a sweaty, stinky foot stuck in their face, most athletic trainers I know (myself included) are still passionate about their career as a whole. Taking into consideration the long hours, hectic schedules, and general lack of appreciation of the profession there are still athletic trainers who wouldn’t trade their job for the world.

Do you think you have what it takes to be an athletic trainer? If you’re currently an ATC can you relate to any of these signs that your job was “meant to be?”  Check out the character traits below that myself and fellow certified athletic trainers, Glen Snow and Becky Clifton, compiled and let us know in the comments what you would add!

You Love Athletics

From a young age you probably watched sports on TV and/or played sports either with your friends or as a part of a team. If you didn’t play sports, you most likely could be found hanging around the team either as a manager or student athletic trainer. The thrill of everybody working together to accomplish a goal was something you wanted to be a part of and you enjoy being a team player.

You Care About People’s Wellbeing

You’ve probably always had a natural way of looking after people – whether it was your siblings, friends, or even a stranger in need. If they were sick you comforted them, if they were down in the dumps you encouraged them. Everybody could always count on you as being a good and reliable friend willing to help out and solve problems and now you can use those same skills to be the leader in the athletic training room.

You Don’t Mind Working Long Hours

While a lot of professions tend to work long hours, it’s still something that you have to be able to handle as an ATC. They say “as long as you love doing something it’s not considered working” and that rings true with many athletic trainers. Your willingness to invest your time in others shows you are passionate about your career as well as the people you’re helping both in the athletic training room and on the field.

You’ve Always Been Interested in Science or Medicine

As a young boy I spent my time on our family farm operating on bugs and hoping to bring them back to life. I don’t know if that was a precursor to being an athletic trainer or not but I’ve always been fascinated by how muscles and bones worked. Figuring out how to take things apart and/or put them back together is something that most people interested in the medical field grow up doing.

You’re Half Crazy

You must be half crazy to work with those smelly, demanding athletes for such long hours at such low pay…right? You should have your head examined which, thankfully for you, is actually now a part of the concussion protocol. All jokes aside, athletic trainers are a special group of people and their passion and eccentric personalities often make for a fun (and crazy) time when a group of them gets together. If you’re able to take a stinky situation (literally) and make the most of it with a smile on your face you might be an athletic trainer.

You Love to Wear White

For those of you over 60 you know what I’m talking about. In the early days of athletic training it was common for all athletic trainers to wear a starched white shirt and slacks. Some say this look was to promote the fact that athletic trainers are medical professionals and because doctors and nurses wore white, they wore white. If you’re an old school athletic trainer like myself, what other things have you noticed that have changed over the years? Anything you wish that was still the same?

You Don’t Mind Sweating or Freezing to Death

With August football practice you sweat to death, then comes spring football practice and you freeze to death. Athletic trainers for other outdoor sports suffer the same consequences – it’s just part of the job. Through pouring rain, heat, humidity, and snow you can be found tending to the needs of athletes helping to ensure they are as safe as possible. If you’re not easily bothered by weather conditions, among many other things, you’ll fit right in as an athletic trainer.

You Know Where the Light Switch Is

Athletic Trainers are typically the first one to arrive at the facility and the last to leave for the day. So even though your job description probably doesn’t mention much about closing up shop, you’ll end up finding yourself turning off the lights, checking the doors, and making sure everything is put away before heading home for the day. Hey, someone’s gotta do it.

You’re Willing to Put Yourself Second

Recently there was a photo that went viral of a sports medicine professional tending to a high school football player while 35 weeks pregnant with her 3-year-old child on her back – the ultimate example of someone willing to put others before themselves. If you’re a selfish person you’re probably not going to be a good athletic trainer because the profession requires compassion, time, and sacrifice. If you’re willing to put others before yourself and do whatever it takes for the good of the athlete and team, then you’d probably make a great athletic trainer.

As you’re reading through these character traits I’m sure you noticed a few common themes throughout them all such as passion, selflessness, and ambition. Are there any things I’ve missed that you would want to add to the list? Let me know in the comments!

Ultra Zoom

Help prevent ankle injuries all season long.

Ultra High-5

Reinforce the ankle after a history of multiple ankle injuries

Ultra CTS

Maximize stabilization to treat acute ankle injuries

Lace-up knee braces are great – right?! Wrong.

Lace-up knee braces haven’t been a preferred bracing technology in decades for multiple reasons – lack of support, restriction of athletic performance, and durability to name a few. We’ve found that while ATC’s would never consider using a lace-up knee brace on their athletes, they commonly advise them to use lace-up ankle braces despite the functional similarities between the two.

Lace-Up Braces Have a Lot in Common

Rapid Loss of Support – The goal with any brace is not the support you achieve when you first apply the brace, but the support you maintain in 30-45 minutes of wear during activity. One primary goal of bracing is to provide “long-lasting support” and to achieve this goal the mechanics of the brace must move with normal, non-injury joint range of motion (ROM).

When a brace can move with the joint, not against it like with lace-ups, the straps are able to stay securely in place and remain tight, maintaining long-lasting ankle support.  Any brace that loosens during wear will experience a rapid loss of support during activity and will gradually stretch out over time reducing its long-term effectiveness.

Restricts Normal ROM & Athletic Performance – Every advanced knee brace is designed upon the principle of allowing non-injury joint ROM while providing long-lasting support. Both lace-up knee and lace-up ankle braces restrict normal, non-injury ROM so in turn they end up losing support rapidly while also restricting athletic performance.

It’s our job as athletic trainers, if possible, to avoid using a product on an athlete that is going to restrict their athletic performance. However, many athletic trainers unknowingly do this every day by recommending braces that restrict non-injury joint ROM. A recent study released by the University of South Alabama concluded that a “lace-up ankle brace negatively affected ankle joint motion and muscle function by significantly decreasing plantar flexion-dorsiflexion ROM across the velocity spectrum and by significantly decreasing muscle torque, work, and power.”

Not Budget Friendly – One of the few perks for purchasing a lace-up brace is that they’re relatively inexpensive and readily available. While the initial investment may be low, don’t let the price fool you. Due to many factors such as rapid loss of support, cleanliness, quality of materials, and durability lace-up braces tend to stretch out, stink, and need to be thrown away after each sports season, if they even last that long.

The cost of wearing a cloth, lace-up brace that houses bacteria and needs to be replaced often ends up being more expensive over the long run than investing in an advanced hinged brace that can last multiple years and playing seasons.

It’s Time to Replace Lace-Up Ankle Braces

If you remember the days (in the 1970s) when wearing lace-up knee braces was the norm, you probably can recall some of the negatives associated with them and how relieved you/athletes were when new, hinged knee bracing technology came onto the market offering more long-lasting support and unrestricted athletic performance. The same transition to a more functional technology that happened with knee braces is now happening with ankle braces.

Not convinced that lace-up ankle braces are an outdated technology? Leave us a comment below, or send us a message! We’d love to discuss our technology a little further with you, set up a demo, or see if you qualify for a free ankle brace sample for your team.

Ultra Zoom

Help prevent ankle injuries all season long.

Ultra High-5

Reinforce the ankle after a history of multiple ankle injuries

Ultra CTS

Maximize stabilization to treat acute ankle injuries