Jan 29, 2015
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HITS For High School

Their bodies and brains are still developing, but high school football players often take blows to the head just as forceful as those experienced by their college and NFL counterparts. That finding is the initial piece of data to emerge from the first test of Head Impact Telemetry System (HITS) technology in a high school population.

The HITS technology places accelerometers inside players’ helmets and sends information regarding the magnitude, length, and location of impacts to the head to a laptop computer on the sidelines. The system has been used in several college studies, and that data is shedding light on what kinds of blows produce concussions. This fall, 32 varsity football players at Unity High School in Tolono, Ill., wore helmets equipped with HITS after undergoing baseline neurocognitive testing at the start of the season.

“High school football players represent the largest group of athletes playing the sport–there are 1.2 million of them nationwide–but they’re the group we know the least about,” says Steven Broglio, PhD, ATC, Professor of Kinesiology and Community Health at the University of Illinois and the study’s lead researcher. “They’re also the ones most likely to be affected throughout their lives by blows they take now, so studying them is really important.”

Broglio expects much of the college HITS data to apply to high school players, but he anticipates some differences as well, based on the fact that high school players’ brains are still developing. “We also think smaller players may be more susceptible to head injuries, because they’re going up against much larger players,” he says. “Imagine a 95-pound freshman taking a hit from a 250-pound senior. You don’t see size discrepancies like that at other levels.”

While Broglio anticipated seeing the high school players taking less forceful hits than older players, that’s turned out to be only partially true. “On average, they are taking smaller hits, but we have recorded hits on the same level as what’s been published for college and NFL players,” he says. “Of the data we have so far, the most important thing for high school athletic trainers to know is that these physically immature kids are at times being hit extremely hard.”

What will eventually come from all the HITS data being gathered? For one thing, Broglio believes more teams at all levels may end up using HITS-equipped helmets as the cost of the technology goes down, enabling athletic trainers to better determine whether a concussion has occurred. Changes to traditional helmets are another possibility. “With our data, we might be able to go to manufacturers and say, ‘We need to put more padding here,'” Broglio says. “We might also learn that high school players need a different type of helmet specifically designed for the kinds of hits they tend to take.”

Broglio’s research team will publish preliminary data based on the 2007 season and continue the project next season. “We’re hoping to make this a multi-year study,” he says. “Once we gather enough concussion data, we’ll publish something bigger.”

Prevention Program Reduces Groin Injuries

Athletes whose sports predispose them to groin injuries may benefit greatly from a training program targeted at injury prevention. In a recent study, professional male soccer players who took part in a stretching and strengthening routine throughout the preseason had 28 percent fewer groin injuries during the season than a control group.

The 315 athletes enrolled in the program performed a 20-minute routine consisting of a warmup phase, a dynamic stretching phase, and a pelvic stabilization and strengthening phase. The players did the routine two or three times a week before practices during the preseason. Some voluntarily continued the routine once the season started and others did not, according to principal researcher Michael Gerhardt, MD, Director of the Center for Athletic Hip and Groin Disorders in Santa Monica, Calif., and Team Physician for US Soccer.

Overall, players in the prevention program had 0.44 groin injuries per 1,000 hours of play, while those not in the program had 0.61 injuries per 1,000 hours. “A growing body of research shows that targeted strengthening and stretching programs can reduce the risk of injuries,” Gerhardt says. “We already knew it was possible to reduce ACL tears this way, and now it looks like we can reduce groin injuries with a similar strategy.”

The fact that strengthening the groin area can prevent injuries may not be surprising to athletic trainers, but it can get athletes to buy in. “When you tell them there’s strong data showing that a program can prevent them from getting an injury, it becomes an easier sell,” Gerhardt says.

Gerhardt has submitted an article on the study to the American Journal of Sports Medicine. The “MLS Groin Injury Prevention Protocol” can be downloaded from our Web site at: www.training-conditioning.com/pdf/groin_injury.pdf

Ice Baths Fail to Deliver

The idea that soaking in ice-cold water after an intense workout reduces soreness and speeds recovery seems intuitive, and many athletes believe it, but a recent study suggests the practice doesn’t help and may actually backfire. Published in the British Journal of Sports Medicine, the research examined the experiences of 40 untrained volunteers who performed an eccentric loading protocol with their non-dominant leg. After the exercise, participants’ legs were immersed in either ice water or tepid water for one minute.

Twenty-four, 48, and 72 hours after the exercise, participants were evaluated for pain and tenderness (using a visual analog scale), swelling (by measuring thigh circumference), and function (using a one-legged hop for distance). Their maximal isometric strength and serum creatine kinase levels were also measured.

When the researchers compared the results to participants’ baseline measurements, they found only one significant difference between the intervention group and the controls: Those who were immersed in the ice baths experienced more pain when going from standing to sitting at 24 hours than those who took the tepid water dip. The authors concluded that ice-water immersion failed to minimize delayed-onset muscle soreness and claim that their study should cause athletes to think twice before using it as a recovery strategy.

The study, “Ice-water immersion and delayed-onset muscle soreness: a randomized controlled trial,” can be viewed online by visiting: http://bjsm.bmj.com and typing “ice bath” into the keyword search window.

Preseason Rules Get Mixed Review

New Jersey athletic trainers are applauding new preseason practice guidelines for fall high school sports issued by the New Jersey State Interscholastic Athletic Association’s Medical Advisory Committee. Put into place this past fall, they ask coaches to allow for a three-day acclimatization period, limit practice to five total hours per day (including warmup, stretching, conditioning, and weight training), and allow at least two hours of recovery time between practices. The recommendations also include a ban on consecutive days with more than three hours of practice.

Coaches, however, are not as excited about the protocol. Football coaches have complained that the guidelines are overly restrictive and unnecessary, since there have been few health problems resulting from preseason workouts in the state. They wonder why all practices are treated the same regardless of weather conditions and worry that decreased opportunities to teach blocking and tackling will leave players at greater risk for injuries during the season.

They’re also upset that the guidelines are only recommendations, leaving the final decisions up to conferences and individual schools. As a result, some teams will have the opportunity to practice more often than others.

But schools that choose to ignore the guidelines could be putting themselves at risk, Phil Hossler, ATC, Head Athletic Trainer at East Brunswick (N.J.) High School, told the Asbury Park Press. “I think [they] might be wandering down a dangerous road,” Hossler said, “not only for the health of the athletes, but also the fact that there has been a recommendation made and you are ignoring it.

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