I had the most amazing time in London, learned so many great things that I cannot wait to apply in clinical practice and made some amazing friends. But, I am very ready to get home and see my friends and family. Most of all an excited to geek out with my preceptors!
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Our last day of the conference, bitter sweet! We again had a very early morning but rushed to the University. I was very excited about the lectures today because today we got to move off the upper body and got a little bit of the lower body. We started with Dr. Fares Haddad, MD who talked to us about Hamstring surgeries. Hamstring surgeries, besides to take the hamstring for an ACL reconstruction. He too like Dr. Keith Miester believes in rehab before the surgical intervention. However, depending on the intensity of the injury surgery may be the only intervention. He said that 40% of all hamstring injuries will reoccur. Next was Stephanine Lazarczuk, BsC she presented her hamstring research as well as the best imaging. She presented that the gold standard is 2-D ultrasound. Scott Sheriden, ATC talked about the Statistics of Tommy John in the MLB, He discussed the different techniques that have developed over time starting with a cross methods and more anchors. The gold standard being MRI to diagnose UCL tear. We then had another break for tea and coffee. After tea my favorite talk, from Jamie Reed, ATC about Specializing in a single sport. This lecture was absolutely shocking. The chances decrease 75% to make it to the MLB from the Minors if surgery is done. He also showed a shocking map of the top hitters that are drafted to the MLB are from the south and the top pitchers are from the north. Players that are from the north are not able to practice all year round because of the snow so they are forced to go inside and play another sport. Jamie promotes five major things play multiple sports, play multiple positions, smart conditioning, coach the coaches, and log pitch counts with innings pitched from a young age. We then heard from Luke Hughes, PhD about his work which he is presenting on Monday to a board about BFR, blood flow resistance. We headed to lunch after hearing from Luke.
After lunch we heard from our last lecturer Ian Rollo, PhD about nutrition for athletes, I was hoping he would educate us on what we should feed our athletes to have optimal energy. However, his talk was for only the male population of a 18-30 year age in shape. He suggested they should intake over 200 grams of protein a day with 40 grams before right before bed. We lastly headed to our break-out sessions. First, an in-season program for shoulder, where we learned about exercises to do before going out on the field and exercises once getting off of the field. I learned a great program to do for our players to prevent injury that I cannot wait to share. Second, Evaluation of the shoulder and elbow, I CANNOT wait to do this in the clinical. I have always felt not as good at eval of the shoulder and elbow and now that I know an easy way to do an eval and how a surgeon would do it I am excited to show my skills. Third, Blood flow restriction I was able to talk to Luke and he will be in the States for two months and will be traveling the east coast so I told him that Emory & Henry would love to have him stop by and talk to all of us and teach us a little more about BFR. We finished with closing from the presidents then headed back to the hotel. After changing we headed out to a pizza place and got a drink with pizza to say a final goodbye to everyone in the group! AND they had gluten free pizza! Finally, we headed back to the hotel where we had giant ice cream sundaes then packed and headed to bed. We had to get a very early start to our day meeting in the lobby at 7:30. It was much colder than it was yesterday, so I tried to get everyone moving fast so I led the group.
We started off our day with Timothy Uhl, PhD a professor at University of Kentucky, he started off our day with Neuromuscular and biomechanics assessment of throwers. He was also a very intelligent and I felt like most of the time he was talking way over my head but then brought it all back around and discussed the importance of not only the shoulders being healthy but also the lower body because it is all a chain, during the whole throwing process. We next had Scott Sheridan, ATC the head Athletic Trainer for the Phillies he lectured on In-season upper extremity patterns. He first started with patchers having a 38% injury exposure rate. Some major red flags that they run into while doing draft injury evaluation are less than 15 degrees of internal rotation and less than 10 degrees of external rotation and always check the history of a UCL. Next we heard from Nick Kenney, ATC he discussed Prevention strategies he discussed a lot of modalities and if some are not able to be used other things that can be used such as a cryotherapy chamber for some of the players that are used to being farther south and the warmer weather. We then had a break for tea and coffee. After the break we heard from two of the UK lecturers Steve McCaig, EcB and Jamie Tallent, PhD who discussed Cricket injuries and the patterns between the two sports. Although the sports a slightly similar the injury patterns are opposite cricketers are more prone to lower leg and ankle injuries whereas baseball players are more prone to shoulder and elbow. However, thigh injuries are the number one injuries in baseball. Before lunch I was able to talk to Mark O’neal who is the president of PBATS about my job this summer in Puerto Rico and he suggested that I would look really good for the PBATS internship this summer and should definitely apply. I also got to hold his World Series ring, which is pictured below. After lunch we heard again from Dr. Keith Miester he talked about Surgical repair of the rotator cuff, labrum, and biceps, he told us that surgery was “the last house of the block” he likes to rehab and strengthen before surgery is performed. If he has to go in the shoulder no matter if nothing is done at all it is a 10-12 week recovery. He also stressed the importance of TOUCH with a patient so they understand you are there for them. We next heard from Timothy Uhl, PhD about the surgical recovery. He talked to us about the important of following the phases as they are instructed. During rehab only going up in 15% increases each time and not speeding through their recovery. Next we heard from Jamie Reed, ATC again about Post- surgical guidelines for return to play. He started off with shocking fact in baseball 90% of injuries in baseball are overuse. He also stressed the importance of following the protocol. When progressing to throwing making sure that while throwing it is going in a straight line and not lobbing the ball. Then took another tea and coffee break. After a much needed tea break we continued with two UK instructors, Ben Ashworth, PhD and Ben Senington, PhD who was just completing his PhD. Both lectures were very interesting but not something I can apply to my clinical experience. We then attended a venter social with all the venters and participants. Which was awesome we made some great new friendships with some of the Saint Mary’s students so hopefully if they even come over to the States they will come visit. To end the night I was able to introduce myself to Tory , the NATA president and make a great new contact for the future. I was also able to get a picture with Tory Lindley and Brian Zeller. We first started on day in a rush to get on the train into the city. Getting over 60 students on one train is very difficult, especially when people want to all go through a single door. Once on the train we thought a little bit through our day. We were starting off with the London Tower and the London Bridge. We started off as a group through the London Tower. The architecture in London is absolutely breathtaking. We walked all around the outside buildings through many different rooms including the older crown jewels, old bedroom, and an exhibit with information on all the animals they had from a polar bear to monkeys. After walking around the border we walked in to see the crown jewels, they had a moving belt so no one would stop and stare the whole time. We ended our tour with a walk through all of the armor of the past kings and princes.
After we finished we were all extremely hurry so we decided to walk across the bridge to a pub. While walking across the bridge I looked down, the water was nasty. But the most exciting part of the morning was lunch… GLUTEN FREE burger with the bun! After finishing lunch we started our trek back, we left at 1:45 and did not make it back to the hotel until 3:20. We got dressed and ready for the start of the conference. We were able to walk to the University, only a 15 minute walk! We started the conference with a panel with some of the speakers being able to ask questions. We learned a lot about future internships with PBATS, professional baseball athletic training society, very exciting and I will be applying in the next week. We were able to eat dinner in the “refractory” cafeteria, which was great, a lot less salt which I love. We started off our lectures with Dr. Keith Meister the team orthopedic surgeon for the Texas Rangers. He talked about TOS, thoracic outlet syndrome, and the indications as well as how it can be commonly overlooked during an evaluation. A lot of people will commonly mistake it for biceps tendinopathies he said his key is the use special tests that have them moving as well. He discussed the different types and showed us what to look for with patients with, numbness, “I don’t feel the ball,” “My arm feels heavy”. He was an extremely intelligent man, and told us never to jump too fast to a diagnosis. Next we heard from Jamie Reed, ATC the Head Athletic Trainer for the Texas Rangers and Nick Kenney, ATC the Head Athletic Trainer for the Kansas City Royals they discussed rehab and return to play. At the end of each session we were able to questions for the lecturers. I will be using a lot of the things I learned for example Jamie showed us a trick for rolling for tight backs, called a peanut, two tennis balls taped together. After the day was over we were supposed head to a pub for a social with the Saint Mary's students, however it was very late and everyone was tired and ready for bed. I do not believe that my vlogs will be working while I am over here, I only have wifi on my computer in the hotel and it's not the best. BUT I will write about my day instead!
Yesterday, the day we arrived, only one word can describe it CRAZY. It was a very very long day with only one to one and a half hours of sleep on the plane and upon arriving standing in the immigration line was an hour and a half wait which only delayed our start to our day by two hours. Everyone who did not travel with the group ending up getting lost in the airport while trying to find the main group. Most people did not know each other and had no clue who they were really looking for which made things 10 times more difficult. After finally meeting up with the group and getting on our coach, to us known as a bus, we were on our way to the hotel. After dropping our luggage off at the hotel in Teddington, we ran to the train and heading into London around 12 pm. The trains were crazy, fast and did not mind if we were not on the train or half on.. those doors were closing. They were PACKED and no such thing as personal space, going into the city as well. After getting off the train we had a guided tour around the city, which I posted pictures of in my last post. Sadly Big Ben in under construction so no Big Ben photos AND the London eye is also closed! We were not able to eat until after the tour at 4 o'clock so I went from 6am this time to 4 without food. After dinner in our small groups we got back on the train, but our guides left.. So we had no clue where we were going and got half lost on the way back to the hotel. My body was exhausted, being on a five hour time difference, so my roommate, Paige and I went straight to sleep after we get back to the hotel. Today! We first started off waking up at 7am, so I was able to get 11 hours of sleep! After eating breakfast we get on the train into the city. Then got on the underground train which took us right to Saint Paul's Cathedral, the tour was amazing! However while in the Cathedral we were not allowed to take photos, but after walking 35 flights we were able to take photos at the very top of the Cathedral, pictures below. The inside of the Cathedral was absolutely breathtaking, the detail was amazing. We had separated from our group of seven and were on our own. We get back on the train and headed back into London to Leicester Square, where all the cheesy stores are, the Legos store and the M&M store. My favorite was not a cheesy store, The TWTG shop a fine tea shop with some amazing smelling teas! After shopping for a little bit we eat some lunch at a local pub then started toward Buckingham Palace where we planned to meet up with our group. After getting our group back together at the Palace, we watched the guards change and took some pictures. Then we walked to the Churchill War rooms which was very informative and neat to be able to walk in his shoes, during the middle of the tour there was a cafe so myself, Paige, and Jordyn finished the tour then went back to the cafe AND THEY HAD A GLUTEN FREE BROWNIE! So we sat down and had some tea while waiting for the rest of the group to finish. We started to head toward back to Leicester Square to get back on the train, while we were heading bad it was rush hour for them here so it was a bit crazy and packed. While on the train we made a friend and talked to him the train ride on home, he was born and raised near Teddington so it was very good to talk to him and get the inside scoop on where to go. After getting back to the hotel we dropped all of our stuff off then headed back out to a pub for dinner. Over here they do not "gluten free" many places so eating out has been little difficult and I have tried to mostly get salads to avoid any reactions. |
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