Bulletin Board

January 29, 2015

NATA Lawsuit Moving Forward

The NATA received good news this fall when its antitrust lawsuit against the American Physical Therapy Association (APTA) weathered a few potential roadblocks. The Federal District Court in Dallas overseeing the case denied a motion by the APTA to dismiss the lawsuit, and also turned down a request to have the case transferred to Virginia (where the APTA's main offices are located).

Filing suit in February, the NATA claims the APTA improperly restricts athletic trainers from learning manual therapy techniques by limiting access to education and practice opportunities. The NATA believes the APTA is trying to prevent competition from athletic trainers in providing rehabilitation services.

"Through this lawsuit, the NATA is seeking to protect its members' right to fairly compete in the manual therapy marketplace," says Paul Genender, Partner at K&L Gates, LLP, the NATA's legal counsel. "The NATA considers the lawsuit essential to protecting those rights, and believes the athletic training profession will benefit from the association standing up on behalf of its members."

Next in the process is the discovery phase and then a trial, although no date has been set. In the meantime, Genender says the NATA remains willing to discuss possible solutions with the APTA.

"Athletic trainers have a long history of working alongside physical therapists in a team-oriented way," Genender says. "The best thing for athletic trainers to do while the lawsuit moves on is to continue being the valuable healthcare providers they are by practicing the profession at a high-quality level."

For the latest updates on the NATA Fair Practice Initiative, visit: www.nata.org/fairpractice.


New Studies Explore Recovery Aids
Two recent studies are spotlighting everyday grocery store products that may aid in workout recovery. The first, published in the July issue of the Journal of Applied Physiology, found that athletes who ingested a combination of caffeine and carbohydrate post-exercise had more glycogen in their muscles four hours after an exhaustive workout than when they consumed carbohydrate only.

Australian researchers followed seven endurance cyclists through two cycle-to-exhaustion sessions. After each session, spaced seven to 10 days apart, participants ingested either a drink containing carbohydrate alone or a caffeine-carbohydrate combination with eight milligrams of caffeine per kilogram of body weight, then rested for four hours. Researchers took muscle biopsies and blood samples during the athletes' rest time.

The double-blind, placebo-controlled experiment found that one hour post-exercise, all participants' glycogen stores were replenished to roughly the same levels. But after four hours, those who had ingested the caffeine-carbohydrate drink had 66 percent higher glycogen stores. Since glycogen is muscle's primary fuel source during exercise, athletes competing in multi-day events may benefit from this finding. However, it's important to note that the caffeine amounts used in the study translate to about five cups of coffee for someone weighing 150 pounds.

The second study, which looked at using milk as a recovery aid, was published in the August issue of Applied Physiology, Nutrition and Metabolism. Researchers from England studied four groups of six healthy males who consumed either milk, a milk-based carbohydrate-protein supplement, a sports drink, or water after muscle-damaging resistance exercise.

Measurements were taken immediately before exercise and again 24 and 48 hours after exercise. After 48 hours, participants who had ingested milk or the milk-based carbohydrate-protein supplement had greater increases in creatine kinase and myoglobin levels. Overall, more muscle was preserved in these participants than in those who ingested the sports drink or water.

A related study published in 2006 showed that chocolate milk has recovery benefits as well. Cyclists who ingested chocolate milk between exercise bouts were able to ride 50 percent longer than their counterparts who ingested either an isotonic sports drink or a high-protein sports drink.

To view the abstract of the caffeine study, "High rates of muscle glycogen resynthesis after exhaustive exercise when carbohydrate is co-ingested with caffeine," go to: jap.physiology.org/content/vol105/issue1.

To view the abstract of the milk study, "Acute milk-based protein-CHO supplementation attenuates exercise-induced muscle damage," go to: pubs.nrc-cnrc.gc.ca/eng/home.html and click on "Journals," then "Applied Physiology, Nutrition and Metabolism." Select "Previous issues," and then "August 2008."


H.S. Steroids Testing Update
Whether or not high school athletes should be tested for steroids continues to be a knotty issue. Over the past year, seven states have addressed the topic, with many different results.

The Florida High School Athletic Association began testing athletes for steroid use during the 2007-08 school year, and one test out of 600 came back positive. But when state lawmakers were budgeting this past spring, the $100,000 needed to continue testing this school year landed in the cuts pile.

Some legislators said last year's results proved steroid use is not a big enough issue to warrant continued funding. Others, however, are hoping to get the testing program funded again next year.

Texas is taking the opposite course. This past spring, over 10,000 athletes were the first to be tested in the state, and two were found to be using steroids. This year, the University Interscholastic League (UIL, the governing body for high school sports in the state) expects to test between 30,000 and 40,000 athletes, and the state legislature has allocated $6 million for the program.

UIL Athletic Director Charles Breithaupt says reactions to the state's testing program have been mixed. Some administrators are in favor of the increased testing, and others have told him they think the $6 million could be spent in better ways.

For the third year in a row, about 500 New Jersey student-athletes competing in state championships will be randomly selected for steroids testing. And testing may soon become law, if a bill that unanimously passed the state senate continues to gain supporters. It would mandate that steroids testing continue, and also require high school athletic departments to educate student-athletes about the risks of performance-enhancing drug use.

The Illinois High School Association is the latest group to implement a steroids testing program. This school year, student-athletes who make the postseason will be randomly tested. If a test turns up positive, the athlete will be ineligible for 365 days, but can apply for reinstatement after 90 days.

Meanwhile, state lawmakers in Pennsylvania and Delaware recently discussed creating steroids testing programs, but both have chosen to funnel state funds toward drug education instead. Delaware officials assembled a task force in January to study logistics and prospective costs, and ultimately recommended not implementing a testing program. And the Pennsylvania legislature's Health and Human Services Committee has said education is the top priority for the state's student-athletes. Although still in the discussion stages, both states' plans would encourage head coaches and athletic trainers to educate and advise their athletes about the negative effects of performance-enhancing drugs, and discuss how to properly fuel for optimal performance in their sport.

Finally, Washington is one state where steroids testing won't even be contemplated. The Washington State Supreme Court ruled in March that random drug testing--including testing for performance-enhancing drugs--violates the state constitution.


Baking Soda Enhances Performance
A spoonful of sugar may make the medicine go down, but does a spoonful of baking soda help an athlete perform better? Evidence is mounting that the answer is yes, as two small studies recently found that ingesting sodium bicarbonate before a race led to performance gains.

The International Journal of Sports Medicine published a study in June from researchers at Loughborough University in England that timed nine swimmers under three different race conditions: without taking any sort of supplement; 60 to 90 minutes after ingesting a sodium bicarbonate capsule; and 60 to 90 minutes after taking a placebo. Eight of the nine swimmers were fastest after ingesting the baking soda capsule.

In another study, presented at the American College of Sports Medicine (ACSM) Annual Meeting in May by Ronald Deitrick, PhD, FACSM, Program Director of the Department of Exercise Science and Sport at the University of Scranton, 800-meter runners who took sodium bicarbonate 90 minutes before a race performed better than their counterparts who ingested a placebo. Both studies reported some side effects, however--mostly gastrointestinal discomfort and nausea.

Based on his study results, Deitrick says the use of sodium bicarbonate as a performance enhancer should be banned. "It comes down to whether or not the athlete has a competitive advantage by taking an aid," he said in an ACSM press release. "And in the case of sodium bicarbonate, I believe the answer is yes. It violates the spirit of fair play by artificially enhancing performance."

But for now, sodium bicarbonate has not made the banned substances list maintained by the World Anti-Doping Agency, and Jonathan Folland, PhD, lead researcher of the swimming study, doesn't expect it will. "There are always going to be ethical arguments, but if sports drinks and carbohydrate loading, both of which can enhance performance, are allowed, there should be no issue with sodium bicarbonate," he told the London Times. "If you are serious about exercise and can stomach it, it may help."

To view the abstract of the swimming study, "Sodium Bicarbonate Improves Swimming Performance," go to: www.thieme-connect.com/ejournals/toc/sportsmed and select pages "449-536 (6)" from the "Other issues" pulldown menu.
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