WEBVTT 00:00:00.000 --> 00:00:03.160 What would be the reason for injuries in the 00:00:03.160 --> 00:00:06.839 gym and in general? Well, reasons why, you know, 00:00:06.860 --> 00:00:09.400 I just think me watching athletes in a group 00:00:09.400 --> 00:00:11.880 workout together and they, unfortunately, they'll 00:00:11.880 --> 00:00:14.939 play the comparison game and they're like, no, 00:00:15.080 --> 00:00:16.800 I'm strong, you know, and they start to, you 00:00:16.800 --> 00:00:18.600 know, joke around with each other and I'm stronger 00:00:18.600 --> 00:00:20.980 and I'm better. And that is always when I see 00:00:20.980 --> 00:00:23.780 more injuries, soft tissues, not necessarily 00:00:23.780 --> 00:00:26.079 emergent, but, you know, that's usually when 00:00:26.079 --> 00:00:27.480 they end up hurting themselves because they're 00:00:27.480 --> 00:00:31.699 trying to do better than John next to him. Hi, 00:00:31.800 --> 00:00:33.820 Kathy. It's my pleasure to have you on Evidence 00:00:33.820 --> 00:00:36.020 Strong Show. If you could briefly introduce yourself, 00:00:36.119 --> 00:00:38.560 that would be awesome. Hi, my name is Dr. Kathy 00:00:38.560 --> 00:00:41.560 Williams. I am a certified athletic trainer. 00:00:41.719 --> 00:00:44.359 I've been certified since 1999. I have my undergraduate 00:00:44.359 --> 00:00:47.219 degree in sports medicine. Along those lines, 00:00:47.259 --> 00:00:51.159 I ended up going for my master's in 2001 in college 00:00:51.159 --> 00:00:53.600 counseling. And I also decided that I wanted 00:00:53.600 --> 00:00:57.200 to get the NSCA's strength and conditioning certification, 00:00:57.619 --> 00:01:00.039 so the CSCS. So I've been certified since then. 00:01:00.219 --> 00:01:02.859 And that was back when you actually had to go 00:01:02.859 --> 00:01:06.709 to the site to go get tested. I've been working 00:01:06.709 --> 00:01:08.349 as an athletic trainer and then helped with some 00:01:08.349 --> 00:01:09.890 strength and conditioning programming throughout 00:01:09.890 --> 00:01:11.950 the years. Worked in many different settings, 00:01:12.230 --> 00:01:15.230 gyms, clinics, and then I usually work with high 00:01:15.230 --> 00:01:18.469 school or collegiate athletes. And I got my doctorate 00:01:18.469 --> 00:01:20.709 in educational leadership, but I helped start 00:01:20.709 --> 00:01:23.549 different programs and I got a chance to create 00:01:23.549 --> 00:01:26.730 and start a human performance and a master's 00:01:26.730 --> 00:01:29.170 program in applied kinesiology. And I've done 00:01:29.170 --> 00:01:31.430 undergraduate health science programs and have 00:01:31.430 --> 00:01:33.730 always had strength and conditioning as a part 00:01:33.730 --> 00:01:36.709 of the coursework. Amazing. huge, huge baseline 00:01:36.709 --> 00:01:39.629 of knowledge and experience. And today we will 00:01:39.629 --> 00:01:43.230 try to learn from you about emergencies in the 00:01:43.230 --> 00:01:46.909 gym. So what may happen? in the gym in times 00:01:46.909 --> 00:01:49.290 of emergencies? I was looking through in the 00:01:49.290 --> 00:01:51.230 emergency department statistics for weightlifting 00:01:51.230 --> 00:01:54.370 injuries in the United States. Based on our information, 00:01:54.670 --> 00:01:57.150 estimated annual ED visits are anywhere from 00:01:57.150 --> 00:02:00.010 20 ,000 to 30 ,000 weightlifting related injuries 00:02:00.010 --> 00:02:03.969 a year here in the U .S. And I know you had spoken 00:02:03.969 --> 00:02:06.989 about it previously on a podcast, but it's roughly 00:02:06.989 --> 00:02:09.250 like two to four injuries per 1 ,000 hours of 00:02:09.250 --> 00:02:12.430 training. A lot of times the age groups that 00:02:12.430 --> 00:02:16.159 get injured the most are adolescent. males. 13 00:02:16.159 --> 00:02:18.319 to 18 -year -olds are really the highest risk 00:02:18.319 --> 00:02:20.860 group, mainly due to, you know, technique errors, 00:02:21.180 --> 00:02:24.199 growth plate vulnerabilities. Adult males, 18 00:02:24.199 --> 00:02:26.759 to 30, were also the majority of injuries overall. 00:02:27.159 --> 00:02:29.439 I think, you know, that population obviously 00:02:29.439 --> 00:02:32.879 strives to, you know, push themselves. And at 00:02:32.879 --> 00:02:34.879 times, though, when they're trying to push themselves 00:02:34.879 --> 00:02:38.840 and, you know, get stronger and develop or have 00:02:38.840 --> 00:02:41.240 better lifting techniques, instead they actually 00:02:41.240 --> 00:02:43.180 have improper technique, right? They just try 00:02:43.180 --> 00:02:45.259 to lift too much weight too quickly. They drop 00:02:45.259 --> 00:02:47.960 weights. You could have a crushing injury, right, 00:02:48.000 --> 00:02:49.719 if you accidentally have two weights and your 00:02:49.719 --> 00:02:52.159 finger's stuck in between them. Overexertion 00:02:52.159 --> 00:02:54.199 or equipment failure, you know, if they don't 00:02:54.199 --> 00:02:57.580 have the proper spotting as well. Some of the 00:02:57.580 --> 00:03:00.340 common injuries, soft tissue injuries for sure, 00:03:00.500 --> 00:03:03.400 strains, sprains. I've had a lot of people, you 00:03:03.400 --> 00:03:05.400 know, oh, I hurt my shoulder. I was, you know, 00:03:05.400 --> 00:03:08.379 racking the barbell and I went too far back. 00:03:08.500 --> 00:03:10.400 And you could have back injuries. Back injuries 00:03:10.400 --> 00:03:13.219 are quite common. Shoulder injuries, hand and 00:03:13.219 --> 00:03:15.659 finger trauma. That's, you know, really more 00:03:15.659 --> 00:03:18.300 from like dropping weights or them getting pinched. 00:03:18.300 --> 00:03:22.020 And then more serious ones, but not. Definitely 00:03:22.020 --> 00:03:24.759 not as common. I've seen pectoral tears. I've 00:03:24.759 --> 00:03:27.500 seen bicep tears. People could have spinal injuries 00:03:27.500 --> 00:03:30.439 or some type of fracture. So those are some of 00:03:30.439 --> 00:03:32.979 the more common things I think that most everybody 00:03:32.979 --> 00:03:35.919 sees. The other end of it is now, okay, say this 00:03:35.919 --> 00:03:37.819 just, you know, some type of injury happens. 00:03:38.080 --> 00:03:40.919 And so obviously if that is a case where you 00:03:40.919 --> 00:03:42.819 think somebody is severely injured, you would 00:03:42.819 --> 00:03:44.740 want to make sure they stop the activity immediately. 00:03:45.099 --> 00:03:47.300 You want to prevent any further damage from happening 00:03:47.300 --> 00:03:49.400 in any way, shape or form. You want to keep the 00:03:49.400 --> 00:03:51.960 athlete calm, still. We could always give it 00:03:51.960 --> 00:03:54.800 more as like an example, a squat, and they have 00:03:54.800 --> 00:03:57.560 too much valgus, knee valgus. And so they are 00:03:57.560 --> 00:03:59.500 getting some knee pain. You know, you'd want 00:03:59.500 --> 00:04:01.460 to ask them like, okay, let's stop the exercise. 00:04:01.780 --> 00:04:04.379 You know, where is the pain? If they notice something 00:04:04.379 --> 00:04:06.900 that you, they quickly identify something's wrong, 00:04:06.979 --> 00:04:09.219 you could see them, you know, jerk or have a 00:04:09.219 --> 00:04:11.560 moment of pain. Where is it? Did you hear a pop, 00:04:11.719 --> 00:04:14.870 a snap? We've all seen those. gory videos of 00:04:14.870 --> 00:04:16.930 dislocations. You know how they have, there's 00:04:16.930 --> 00:04:19.389 a doctor I follow that's fun on Instagram, but 00:04:19.389 --> 00:04:21.949 he always is assessing like, hey, this is, you 00:04:21.949 --> 00:04:24.569 know, what the exercise was. And then this is 00:04:24.569 --> 00:04:26.589 the injury that resulted from it. And, you know, 00:04:26.610 --> 00:04:29.410 and why did it happen? And so obviously more 00:04:29.410 --> 00:04:31.889 like the snatch, I would think some of the clean 00:04:31.889 --> 00:04:33.750 and jerk, some of the more explosive, right? 00:04:33.910 --> 00:04:35.750 Movements would be the ones that I think we've 00:04:35.750 --> 00:04:39.069 seen somebody dislocate a shoulder, elbow. So 00:04:39.069 --> 00:04:40.769 you would just want to make sure like if something 00:04:40.769 --> 00:04:42.709 like this did happen, you know, can they move? 00:04:42.800 --> 00:04:44.879 the limb? Can they even bear weight if it's a 00:04:44.879 --> 00:04:47.959 lower body injury? You know, the number one thing 00:04:47.959 --> 00:04:50.519 besides getting them to stop the activity and 00:04:50.519 --> 00:04:52.339 ask them how they are, you'd really want to make 00:04:52.339 --> 00:04:54.300 sure if anyone has numbness, tingling, or any 00:04:54.300 --> 00:04:56.319 type of deformity, right? So deformity obviously 00:04:56.319 --> 00:04:58.319 is a huge red flag, like they're going to have 00:04:58.319 --> 00:05:00.459 to go to the emergency room. Numbness and tingling 00:05:00.459 --> 00:05:02.899 though, anything to do with nerves is always 00:05:02.899 --> 00:05:05.639 a little bit concerning, is very concerning actually. 00:05:05.779 --> 00:05:07.199 So you're just concerned, like, did something 00:05:07.199 --> 00:05:09.660 happen in central C -spine? Do we have to worry 00:05:09.660 --> 00:05:11.699 about there's some type of nerve compression? 00:05:12.009 --> 00:05:15.449 based off of either a dislocation or maybe even 00:05:15.449 --> 00:05:17.829 like a torn muscle that can affect it. If there's 00:05:17.829 --> 00:05:19.410 any signs of serious injury, you know, don't 00:05:19.410 --> 00:05:21.949 move the athlete unnecessarily. We could have, 00:05:22.129 --> 00:05:24.009 you know, make sure you seek emergency help right 00:05:24.009 --> 00:05:26.970 away. You want to call personnel. Depending on 00:05:26.970 --> 00:05:29.250 the injury, if you have it, if for soft tissue 00:05:29.250 --> 00:05:32.029 and acute injuries, we could always use the RICE 00:05:32.029 --> 00:05:34.509 method that they call it. So rest, ice, compression, 00:05:34.750 --> 00:05:37.110 elevation, immobilizing and avoiding movement, 00:05:37.370 --> 00:05:39.529 managing pain and swelling. You know, you could 00:05:39.529 --> 00:05:42.329 always have people take ibuprofen. or those non 00:05:42.329 --> 00:05:44.829 -steroidal anti -inflammatories. They can always 00:05:44.829 --> 00:05:47.490 help. Avoiding any type of heat and massage in 00:05:47.490 --> 00:05:49.769 the first 48 hours right after someone gets injured 00:05:49.769 --> 00:05:52.470 is usually the best case. And then just making 00:05:52.470 --> 00:05:54.189 sure that you're keeping an eye on your athlete, 00:05:54.290 --> 00:05:55.850 you know, watching for increased pain, swelling. 00:05:56.069 --> 00:05:58.370 If they have changes in sensation, you definitely 00:05:58.370 --> 00:06:01.779 want to, you know. be on alert and then see if 00:06:01.779 --> 00:06:05.699 you need to refer. If you had shoulder dislocation 00:06:05.699 --> 00:06:08.980 or say someone does dislocate their elbow or 00:06:08.980 --> 00:06:11.439 even their elbow, you don't want to try to relocate 00:06:11.439 --> 00:06:12.600 it, right? You don't want to try to actually 00:06:12.600 --> 00:06:15.319 put the joint back in unless you're trained to 00:06:15.319 --> 00:06:17.740 do so. But the biggest thing is immobilizing 00:06:17.740 --> 00:06:20.399 and then being able to transport them to the 00:06:20.399 --> 00:06:22.800 ER. And then after they're there, right, they'll 00:06:22.800 --> 00:06:25.959 get an x -ray, they'll reduce the joint for them, 00:06:26.060 --> 00:06:27.800 and then they'll have to have some type of rehab 00:06:27.800 --> 00:06:31.810 with a physiotherapist. or a PT, but mobilizing 00:06:31.810 --> 00:06:36.189 could even be the ground. So if someone is like 00:06:36.189 --> 00:06:39.050 their, you know, joint shoulder came out anteriorly, 00:06:39.050 --> 00:06:41.610 you know, if you had to, you could like lay them 00:06:41.610 --> 00:06:43.769 down if they feel more comfortable and just have 00:06:43.769 --> 00:06:46.230 that against the ground. There's different splints 00:06:46.230 --> 00:06:48.350 that people could have that are actually pretty 00:06:48.350 --> 00:06:51.870 easy to use. You could have arm slings if it 00:06:51.870 --> 00:06:54.129 was, you know, dislocated and their arm was actually 00:06:54.129 --> 00:06:56.170 more down in front of their body. So there's 00:06:56.170 --> 00:06:57.850 a few different things that'd be nice to have. 00:06:58.439 --> 00:06:59.980 suggest that everybody should have some type 00:06:59.980 --> 00:07:02.779 of basic first aid course. And then I'm hoping 00:07:02.779 --> 00:07:06.680 that all strength coaches also get CPR and AED 00:07:06.680 --> 00:07:09.079 certified for sure. They've found that there's 00:07:09.079 --> 00:07:11.759 actually a pretty high correlation to more cardiovascular 00:07:11.759 --> 00:07:15.079 incidents at times during strength training sessions 00:07:15.079 --> 00:07:17.199 than there always is necessarily in practice. 00:07:17.560 --> 00:07:20.339 Coaches, how can they prepare and what should 00:07:20.339 --> 00:07:22.839 they have in the gym or ideally what would be 00:07:22.839 --> 00:07:26.000 in the gym for them to use in case of emergency? 00:07:26.300 --> 00:07:27.959 If they wanted to, they could have an arm. sling 00:07:27.959 --> 00:07:29.620 if something does happen right to someone's shoulder 00:07:29.620 --> 00:07:32.620 elbow. A SAM splint it's called. A SAM splint 00:07:32.620 --> 00:07:36.060 is actually this like it's somewhat mobile comes 00:07:36.060 --> 00:07:39.399 wrapped up in like a little cylinder and then 00:07:39.399 --> 00:07:42.500 you can unwrap it and you could have the other 00:07:42.500 --> 00:07:44.180 thing would be good to have is ACE wraps. ACE 00:07:44.180 --> 00:07:46.879 wraps for compression right so someone like sprains 00:07:46.879 --> 00:07:48.300 their ankle or does something their knee they 00:07:48.300 --> 00:07:50.259 could apply those but the ACE wrap goes along 00:07:50.259 --> 00:07:52.339 with that SAM splint and it can help you split 00:07:52.339 --> 00:07:54.699 an injury if you needed to. I would always think 00:07:54.699 --> 00:07:57.040 being able to if you think it's a really severe, 00:07:57.399 --> 00:07:59.579 like say they, you know, go unconscious because 00:07:59.579 --> 00:08:01.500 their blood pressure is tight. It's always good 00:08:01.500 --> 00:08:03.720 to try to take vitals if the coach is capable. 00:08:03.920 --> 00:08:06.160 So if you're trained and first able to do that, 00:08:06.220 --> 00:08:08.660 a pulse oximeter is the most simplest thing that 00:08:08.660 --> 00:08:10.459 you can use. I know a lot of people during the 00:08:10.459 --> 00:08:12.339 pandemic got comfortable with those and it's 00:08:12.339 --> 00:08:14.319 just this little tiny device. It goes on your 00:08:14.319 --> 00:08:17.339 finger and it measures your blood oxygen levels 00:08:17.339 --> 00:08:19.139 and then your pulse. So then at least you can 00:08:19.139 --> 00:08:21.319 know if they have a high pulse rate or low or, 00:08:21.339 --> 00:08:23.399 you know, how is the person feeling. If they 00:08:23.399 --> 00:08:25.319 feel comfortable, they could have even just the 00:08:25.319 --> 00:08:27.610 automatic. now blood pressure cuffs that you 00:08:27.610 --> 00:08:29.290 could just put on somebody and you just got to 00:08:29.290 --> 00:08:30.829 press a button and at least they'll tell you 00:08:30.829 --> 00:08:32.450 the readout of what their blood pressure is. 00:08:32.649 --> 00:08:37.809 Having access to ice, ice bags, also an AED, 00:08:37.850 --> 00:08:42.350 a first aid kit for any type of wounds if they, 00:08:42.629 --> 00:08:44.289 you know, I know some people used to like scrape 00:08:44.289 --> 00:08:46.809 that bar along their shins and then they're bleeding 00:08:46.809 --> 00:08:49.179 at the end. when they're trying to stay close 00:08:49.179 --> 00:08:51.659 to the body. But, you know, having a towel, just 00:08:51.659 --> 00:08:54.259 simple things that you could use that you could 00:08:54.259 --> 00:08:56.720 help to like a distance, some type of like a 00:08:56.720 --> 00:08:59.320 wound cleanser spray. They say don't use like 00:08:59.320 --> 00:09:01.000 peroxide anymore and like make sure it's some 00:09:01.000 --> 00:09:05.000 type of a wound cleanser. Sterile gauze, band 00:09:05.000 --> 00:09:08.399 -aids, those type of just basic supplies can 00:09:08.399 --> 00:09:10.759 really help you. Roller gauze could also be another 00:09:10.759 --> 00:09:13.860 good one to have in case of any type of like 00:09:13.860 --> 00:09:17.000 blood. So, okay. So basically any type of dislocation. 00:09:17.039 --> 00:09:19.600 If something happens and you notice that a joint 00:09:19.600 --> 00:09:21.940 came out, very first thing is you're going to 00:09:21.940 --> 00:09:24.860 make sure that they stay splinted or don't move. 00:09:24.940 --> 00:09:27.919 You call for help, your emergency personnel. 00:09:29.340 --> 00:09:31.419 there's little things that you could try to do. 00:09:31.460 --> 00:09:33.059 Sometimes people start to feel like they go numb 00:09:33.059 --> 00:09:34.779 and tingly. There's little things where you can 00:09:34.779 --> 00:09:37.059 like actually even press on the fingertips and 00:09:37.059 --> 00:09:39.100 it's called capillary refill. And you could see 00:09:39.100 --> 00:09:41.440 their, you know, their fingers go white and then 00:09:41.440 --> 00:09:43.259 turn back to pink. Then you could tell like, 00:09:43.299 --> 00:09:44.899 okay, they're getting good blood flow. If they're 00:09:44.899 --> 00:09:46.559 not getting good blood flow, then you know that's 00:09:46.559 --> 00:09:48.539 even more of an emergency because something, 00:09:48.700 --> 00:09:51.379 a blood vessel could be getting occluded. Same 00:09:51.379 --> 00:09:52.940 thing neurologically, you want to make sure they 00:09:52.940 --> 00:09:56.100 can still feel all right. So trying to do those, 00:09:56.200 --> 00:10:00.669 any type of fracture, wrist, arm. leg. Same thing's 00:10:00.669 --> 00:10:03.049 going with a dislocation. You're definitely going 00:10:03.049 --> 00:10:05.169 to want to splint it in any way you can. And 00:10:05.169 --> 00:10:07.289 then just avoid movement and you have to call 00:10:07.289 --> 00:10:08.950 the EMS because really they're going to need 00:10:08.950 --> 00:10:11.549 some type of imaging, x -ray. You know, this 00:10:11.549 --> 00:10:13.610 is when people either get casted. So depending 00:10:13.610 --> 00:10:16.169 on any type of fracture and where that would 00:10:16.169 --> 00:10:19.009 be, lower body versus upper body, you know, sometimes 00:10:19.009 --> 00:10:22.169 it's even nice just to have crutches at your 00:10:22.169 --> 00:10:24.289 gym. I don't know if everybody necessarily has 00:10:24.289 --> 00:10:25.649 those, but it's been kind of, you know, comes 00:10:25.649 --> 00:10:28.799 in handy. Back injuries and spasms. Those can 00:10:28.799 --> 00:10:31.460 be tough when you really start to spasm up. I'm 00:10:31.460 --> 00:10:34.600 sure you've seen it before as well. But, you 00:10:34.600 --> 00:10:37.159 know, right away, non -weight -bearing is probably 00:10:37.159 --> 00:10:39.879 best. Sometimes even laying flat on their back 00:10:39.879 --> 00:10:41.620 isn't great. They may have to actually elevate 00:10:41.620 --> 00:10:43.960 their legs a little bit to try to take some pressure 00:10:43.960 --> 00:10:46.279 off that low back. If they spasm though, you 00:10:46.279 --> 00:10:47.360 know, they're probably going to either have to 00:10:47.360 --> 00:10:50.159 like lay down or be on their side. And then this 00:10:50.159 --> 00:10:51.899 is when you could try to ice and then give them 00:10:51.899 --> 00:10:55.440 those NSAIDs or some type of ibuprofen to help 00:10:55.440 --> 00:10:58.139 reduce the pain. the ice will really you know 00:10:58.139 --> 00:11:00.879 help actually try to slow nerve conduction and 00:11:00.879 --> 00:11:03.679 hopefully slow those spasms down those are uh 00:11:03.679 --> 00:11:05.899 usually though that's tough right because then 00:11:05.899 --> 00:11:07.139 as soon as they get up to move they'll start 00:11:07.139 --> 00:11:10.009 to spasm some again but this is when it's Depending 00:11:10.009 --> 00:11:13.429 on how, you know, I guess bad the reaction is, 00:11:13.529 --> 00:11:15.429 either you'd have to put them on a spine board 00:11:15.429 --> 00:11:17.190 or on a gurney and they would have to wheel them 00:11:17.190 --> 00:11:19.429 out. Or hopefully you could get them to calm 00:11:19.429 --> 00:11:21.789 down and, you know, within 20, 30 minutes, then 00:11:21.789 --> 00:11:24.149 they can walk out and get checked. Would you 00:11:24.149 --> 00:11:26.169 allow the athlete in this situation go back to 00:11:26.169 --> 00:11:29.049 training session or is the end of the story? 00:11:29.110 --> 00:11:31.029 They have to be medically checked before they 00:11:31.029 --> 00:11:33.350 can come back? I would, if it's significant enough 00:11:33.350 --> 00:11:37.370 where they are spasming so bad that they can't 00:11:37.370 --> 00:11:39.919 continue, then they may need. to get checked 00:11:39.919 --> 00:11:42.679 by a medical professional or an athletic trainer 00:11:42.679 --> 00:11:44.519 or physiotherapist or someone that knows like 00:11:44.519 --> 00:11:46.559 some special tests and can try to follow them. 00:11:46.639 --> 00:11:48.840 You have to be careful because what the body 00:11:48.840 --> 00:11:53.139 likes to do is it goes into a pain spasm cycle. 00:11:53.399 --> 00:11:56.120 And so we try to break that when there's some 00:11:56.120 --> 00:11:59.320 type of injury. And the body is extremely intelligent. 00:11:59.379 --> 00:12:02.580 So say, you know, like when you sprain your ankle, 00:12:02.679 --> 00:12:04.679 the first thing that happens is it hurts and 00:12:04.679 --> 00:12:06.860 you don't want to move it, right? And then it 00:12:06.860 --> 00:12:09.740 starts to swell. And, you know, the body knows 00:12:09.740 --> 00:12:12.240 that if you felt good, right, you would start 00:12:12.240 --> 00:12:14.480 to walk on it and use it. And it can't. It's 00:12:14.480 --> 00:12:17.659 injured. So you have that pain spasming as a 00:12:17.659 --> 00:12:20.159 protection for you, for your actual joint. Even 00:12:20.159 --> 00:12:21.940 though we don't enjoy it, our body's trying to 00:12:21.940 --> 00:12:23.779 tell us something, right? And then the swelling 00:12:23.779 --> 00:12:26.220 comes in. It's extremely hard to obviously have 00:12:26.220 --> 00:12:28.120 good range of motion with the swelling, but it's 00:12:28.120 --> 00:12:30.679 trying to help you heal. And, you know, it's 00:12:30.679 --> 00:12:32.500 just smart. So there's times where, like, if 00:12:32.500 --> 00:12:34.419 you maybe have, like, a hairline fracture or 00:12:34.419 --> 00:12:36.940 something, I've had what's called, like, an osteochondral 00:12:36.940 --> 00:12:40.750 defect. in their femur. And I had an athlete 00:12:40.750 --> 00:12:43.149 that was constantly having chronically tight 00:12:43.149 --> 00:12:44.990 hamstrings. And then he's always thought he was 00:12:44.990 --> 00:12:47.009 pulling his hamstrings. And every time he's trying 00:12:47.009 --> 00:12:49.789 to work out and come to find out his tight hamstrings 00:12:49.789 --> 00:12:52.190 were tightening up because it was trying to his 00:12:52.190 --> 00:12:54.950 body was trying to, I think, in a way, not use 00:12:54.950 --> 00:12:56.990 as much because he actually had these OCD lesions. 00:12:56.990 --> 00:12:59.690 So it's pretty smart, but you've got to pay attention 00:12:59.690 --> 00:13:01.649 and just make sure, you know, like there's no 00:13:01.649 --> 00:13:04.389 other underlying cause. And that's the part that 00:13:04.389 --> 00:13:06.450 can get dicey. You know, it's a little bit difficult 00:13:06.450 --> 00:13:09.659 to. without having some experience and watching 00:13:09.659 --> 00:13:12.779 people. I had another kid, same thing. They thought 00:13:12.779 --> 00:13:15.080 he was chronically having hamstring strains and 00:13:15.080 --> 00:13:17.320 trying to work out and he was losing all of his 00:13:17.320 --> 00:13:19.919 strength. And really, when you take a look, you 00:13:19.919 --> 00:13:23.139 know, I highly suggest that if you are training 00:13:23.139 --> 00:13:25.460 somebody and you notice they have a huge deficit 00:13:25.460 --> 00:13:28.379 from one side to the other. So like if you look 00:13:28.379 --> 00:13:30.000 at someone bilaterally and you're looking at 00:13:30.000 --> 00:13:32.519 both of their legs, if the right leg all of a 00:13:32.519 --> 00:13:34.620 sudden looks like the circumference of the actual 00:13:34.620 --> 00:13:36.990 muscle mass of the thigh is, you know. significantly 00:13:36.990 --> 00:13:39.669 reduced compared to the left leg you need to 00:13:39.669 --> 00:13:41.590 know then there had to have been an injury there's 00:13:41.590 --> 00:13:43.950 there's something happening and that's always 00:13:43.950 --> 00:13:46.809 my number one way to realize there's another 00:13:46.809 --> 00:13:48.850 underlying injury something must have happened 00:13:48.850 --> 00:13:51.070 in this athlete's case that i was working with 00:13:51.070 --> 00:13:53.970 i found out he was acl deficient and we never 00:13:53.970 --> 00:13:56.549 knew it i guess a year a year before he'd hurt 00:13:56.549 --> 00:13:59.190 his knee you know said it hurt but i hadn't i'd 00:13:59.190 --> 00:14:01.190 only started seeing him a year later and just 00:14:01.190 --> 00:14:02.730 kept talking about these chronic hamstrings the 00:14:02.730 --> 00:14:04.750 next thing you know we get him an mri and and 00:14:04.750 --> 00:14:07.360 that's why so Some of the more emergent things 00:14:07.360 --> 00:14:09.500 are easier almost to take care of because, you 00:14:09.500 --> 00:14:11.220 know, like you're going to have to stop and go 00:14:11.220 --> 00:14:13.580 get looked at by a physician. Where some of these 00:14:13.580 --> 00:14:16.960 like more, I guess, low line, low level injury, 00:14:17.139 --> 00:14:19.480 you know, you got to try to may also like warrant 00:14:19.480 --> 00:14:22.539 some further looks, I guess I'd say. What would 00:14:22.539 --> 00:14:26.360 be the reason for injuries in the gym and in 00:14:26.360 --> 00:14:29.580 general? Well, reasons why men are boys being 00:14:29.580 --> 00:14:31.740 boys. I'm joking. I'm not only picking on them. 00:14:31.779 --> 00:14:33.539 I know women, we can get the same thing. But, 00:14:33.539 --> 00:14:35.879 you know, I just think me. watching athletes 00:14:35.879 --> 00:14:38.539 in a group workout together and they unfortunately, 00:14:38.620 --> 00:14:41.580 though, play the comparison game and they're 00:14:41.580 --> 00:14:43.299 like, no, I'm strong, you know, and they start 00:14:43.299 --> 00:14:45.120 to, you know, joke around with each other and 00:14:45.120 --> 00:14:47.460 I'm stronger and I'm better. And that is always 00:14:47.460 --> 00:14:50.860 when I see more injuries, soft tissues, not necessarily 00:14:50.860 --> 00:14:53.120 emergent. But, you know, that's usually when 00:14:53.120 --> 00:14:54.519 they end up hurting themselves because they're 00:14:54.519 --> 00:14:57.240 trying to do better than John next to him. He's 00:14:57.240 --> 00:14:58.620 like, but look at what I put up. And I'm like, 00:14:58.639 --> 00:15:01.700 it doesn't matter. It hurts you. So I feel like 00:15:01.700 --> 00:15:04.570 that alone is a big thing and usually not. doing 00:15:04.570 --> 00:15:06.169 it with correct form on top of it all. So not 00:15:06.169 --> 00:15:07.509 only are they not doing good form and then they're 00:15:07.509 --> 00:15:09.350 trying to increase their, you know, velocity 00:15:09.350 --> 00:15:12.429 and load and it responds very poorly in their 00:15:12.429 --> 00:15:14.970 body as they usually, I know, for that. Poor 00:15:14.970 --> 00:15:18.870 form, poor and ego. Right. Oh, I see that all 00:15:18.870 --> 00:15:21.429 the time. I'm like, oh, all right. Okay. The 00:15:21.429 --> 00:15:23.389 problem, I think the biggest problem is that 00:15:23.389 --> 00:15:27.470 where people are the most prone to ego lifting 00:15:27.470 --> 00:15:31.009 is also the age when they are in their prime 00:15:31.009 --> 00:15:34.389 physically. So you want them to be pushing. You 00:15:34.389 --> 00:15:36.370 want them to be getting better because that's 00:15:36.370 --> 00:15:39.529 the best time to gain. But it's also the worst 00:15:39.529 --> 00:15:42.470 time to gain because they have very low perceived 00:15:42.470 --> 00:15:44.450 risk. They think that... They are invincible 00:15:44.450 --> 00:15:48.169 and, you know, it has pluses, but you as a coach 00:15:48.169 --> 00:15:51.129 have to really pay attention and know your athletes. 00:15:51.330 --> 00:15:53.350 Yeah, especially higher level, really, you know, 00:15:53.350 --> 00:15:56.429 self -motivated, driven athletes. I mean, those 00:15:56.429 --> 00:15:58.470 are ones that like you have to kind of just actually 00:15:58.470 --> 00:16:01.590 try to. like you said, slow them down because 00:16:01.590 --> 00:16:04.149 they will just keep going. I have so many overuse 00:16:04.149 --> 00:16:07.210 injuries right now. And a lot of it has to do 00:16:07.210 --> 00:16:08.970 with just overtraining. And what's happening 00:16:08.970 --> 00:16:10.970 is there's too many groups of us now. It's like 00:16:10.970 --> 00:16:12.809 too many cooks in the kitchen, I'm calling it. 00:16:12.909 --> 00:16:15.149 So like, you know, you have your strength coach 00:16:15.149 --> 00:16:17.870 and then you have your sport coach and then you 00:16:17.870 --> 00:16:21.029 have some, you know, other, right, speed coach. 00:16:21.090 --> 00:16:22.710 And then you have some other individual that, 00:16:22.750 --> 00:16:24.809 you know, Johnny's dad said is great. So they're 00:16:24.809 --> 00:16:26.769 going to go to that, you know, and now next thing 00:16:26.769 --> 00:16:28.590 I find out, like, I think they're just going. 00:16:28.720 --> 00:16:30.539 to a practice and doing their workouts with, 00:16:30.580 --> 00:16:31.919 you know, their strength coach. And the next 00:16:31.919 --> 00:16:33.639 thing I know, they're actually doing four more 00:16:33.639 --> 00:16:36.320 hours of, you know, some type of exertion or 00:16:36.320 --> 00:16:39.279 exercise and, you know, trying to teach them 00:16:39.279 --> 00:16:42.120 about periodization and like more does not always 00:16:42.120 --> 00:16:44.799 make better is that leads more to injuries than 00:16:44.799 --> 00:16:46.539 I feel like almost anything else that we've done. 00:16:46.600 --> 00:16:48.559 But I've really been encountering that, especially 00:16:48.559 --> 00:16:51.679 now with the rise of I'm super excited for our 00:16:51.679 --> 00:16:53.379 profession. I'm so glad that, you know, strength 00:16:53.379 --> 00:16:56.039 and conditioning specialists are, you know, growing 00:16:56.039 --> 00:16:58.789 overall and are now. knowledge base is growing, 00:16:58.929 --> 00:17:02.210 but now just making sure, you know, we're all 00:17:02.210 --> 00:17:04.750 kind of on the same page with also their sport 00:17:04.750 --> 00:17:07.049 coaches or speed coach, you know, it's kind of 00:17:07.049 --> 00:17:08.849 having that network of everybody working together. 00:17:09.049 --> 00:17:12.670 I want us to cover maybe the most scary thing 00:17:12.670 --> 00:17:16.369 in the gym that can happen, which is blackout 00:17:16.369 --> 00:17:19.869 slash concussion. So something happened and you 00:17:19.869 --> 00:17:22.930 either had an athlete accept a hit to the head 00:17:22.930 --> 00:17:26.390 or they just dropped. on the floor and they are 00:17:26.390 --> 00:17:28.809 unconscious or they are they are conscious but 00:17:28.809 --> 00:17:31.089 they're confused don't know where they are and 00:17:31.089 --> 00:17:34.609 so on so what would you have to say oh yeah that 00:17:34.609 --> 00:17:36.650 would obviously be the scariest thing that could 00:17:36.650 --> 00:17:41.390 happen so if someone passes out this is tough 00:17:41.390 --> 00:17:42.769 like as a strength coach right because i know 00:17:42.769 --> 00:17:45.130 multiple people like if you rest the bar too 00:17:45.130 --> 00:17:47.369 high right you end up like kind of occluding 00:17:47.369 --> 00:17:49.569 that carotid artery and then you end up losing 00:17:49.569 --> 00:17:52.289 consciousness because of that usually though 00:17:52.289 --> 00:17:54.490 what's going to happen right is they They fall 00:17:54.490 --> 00:17:56.589 or they go unconscious. And then after their 00:17:56.589 --> 00:17:59.170 body regulates, they will, you know, come back 00:17:59.170 --> 00:18:02.509 to us and be all right. But if they go unconscious 00:18:02.509 --> 00:18:05.210 and never regain consciousness, right? So as 00:18:05.210 --> 00:18:07.309 soon as you're unconscious, it's a medical emergency. 00:18:07.529 --> 00:18:08.890 So you'd want to make sure you call emergency 00:18:08.890 --> 00:18:11.490 personnel first. I would always suggest to make 00:18:11.490 --> 00:18:14.150 sure that this is when you go get your AED and 00:18:14.150 --> 00:18:16.230 then hopefully have CPR skills, not saying that 00:18:16.230 --> 00:18:17.670 you would need it, but just always making sure 00:18:17.670 --> 00:18:20.349 that you have the supplies needed around you. 00:18:20.430 --> 00:18:22.849 And then this is when you need to check vitals. 00:18:23.470 --> 00:18:25.470 This is why it's good for people to have those 00:18:25.470 --> 00:18:27.410 certifications and know like, okay, how can I 00:18:27.410 --> 00:18:29.690 check vitals? You know, can you check the carotid, 00:18:29.710 --> 00:18:31.869 brachial arteries just to make sure that their 00:18:31.869 --> 00:18:34.250 pulse is okay? Are they breathing? Are you going 00:18:34.250 --> 00:18:36.509 to look, listen and feel, I call it. So you can 00:18:36.509 --> 00:18:38.450 like tip their head back a little bit and put 00:18:38.450 --> 00:18:40.890 your ear and feel like if their breath is hitting 00:18:40.890 --> 00:18:43.069 your face, you're looking at their chest to see 00:18:43.069 --> 00:18:44.950 if it's rising. A lot of times I'll look for 00:18:44.950 --> 00:18:47.450 the ribs if they fall forward. As long as I see 00:18:47.450 --> 00:18:49.369 their ribs moving, I always feel better. Like 00:18:49.369 --> 00:18:50.990 when I have to run out, like, like especially 00:18:50.990 --> 00:18:52.980 like in American football, I'm like. okay, I 00:18:52.980 --> 00:18:54.559 see their ribs moving and I feel better. But 00:18:54.559 --> 00:18:56.420 then, so you'd want to make sure if they're unconscious, 00:18:56.680 --> 00:18:58.440 right? Just trying to check all of those things. 00:18:58.500 --> 00:19:00.200 And really the most thing you can do is just 00:19:00.200 --> 00:19:03.839 monitor. If it is more a head related injury. 00:19:04.200 --> 00:19:06.900 So a lot of times if you get hit in the head, 00:19:07.000 --> 00:19:09.539 this part is not going to be actually necessarily 00:19:09.539 --> 00:19:11.799 backed by research. So I will apologize now, 00:19:11.859 --> 00:19:13.200 but I always feel better if someone gets hit 00:19:13.200 --> 00:19:15.660 in the head and I see it swell out. You're because 00:19:15.660 --> 00:19:18.700 say you got hit with like a weight and you start 00:19:18.700 --> 00:19:20.240 to swell and you all of a sudden have this huge 00:19:20.240 --> 00:19:22.319 like hematoma on your head. Usually what that 00:19:22.319 --> 00:19:24.799 means is that your skull has done the job it's 00:19:24.799 --> 00:19:26.460 supposed to, right? It kind of dissipated those 00:19:26.460 --> 00:19:29.380 forces, took it, and then the skin just has an 00:19:29.380 --> 00:19:31.079 injury to it. But usually it doesn't mean that 00:19:31.079 --> 00:19:33.900 your brain did. And so, but if they pass out 00:19:33.900 --> 00:19:36.480 or fall and they happen to like hit, you know, 00:19:36.500 --> 00:19:38.200 whack their head back, their head back and they 00:19:38.200 --> 00:19:40.720 get a coup or counter coup type concussion, then 00:19:40.720 --> 00:19:43.299 this is when, right, their brain moved and kind 00:19:43.299 --> 00:19:45.539 of hit the front and back of inside that skull 00:19:45.539 --> 00:19:47.799 and now the brain is bruised. That is obviously 00:19:47.799 --> 00:19:51.059 more concerning. A lot of times people can still. 00:19:51.109 --> 00:19:53.890 They'll talk to you, but this is when you would 00:19:53.890 --> 00:19:55.690 still want to refer and make sure you get them 00:19:55.690 --> 00:19:58.710 looked at. But if a lot of times people get in 00:19:58.710 --> 00:20:00.410 the head and they're still conscious, but they 00:20:00.410 --> 00:20:01.849 don't feel right, right? You could just all of 00:20:01.849 --> 00:20:03.630 a sudden start to tell that they're off. If they 00:20:03.630 --> 00:20:06.750 start to, they should most likely, they have 00:20:06.750 --> 00:20:09.589 a headache. Then I always try to make sure that 00:20:09.589 --> 00:20:11.990 they, this is why people, when you have them 00:20:11.990 --> 00:20:13.849 follow your finger, you're trying to watch their 00:20:13.849 --> 00:20:16.230 eye tracking to see if they get the stigmas it's 00:20:16.230 --> 00:20:18.029 called. And it's, you know, it's when your eyes 00:20:18.029 --> 00:20:20.089 will bounce or jump a little bit while they're 00:20:20.089 --> 00:20:22.269 trying. to follow. So like your eye tracking 00:20:22.269 --> 00:20:24.609 looks off. And so that's the way I'll go in all 00:20:24.609 --> 00:20:27.089 these different directions. So a lot of times 00:20:27.089 --> 00:20:29.430 though, like for somebody like in my field, I 00:20:29.430 --> 00:20:31.329 would test all of your cranial nerves. So I have 00:20:31.329 --> 00:20:33.230 them stick their tongue out. I have them, you 00:20:33.230 --> 00:20:36.029 know, side eyes as, as checking abducens and 00:20:36.029 --> 00:20:39.650 you have them smile and frown and, and we look 00:20:39.650 --> 00:20:43.069 at all of that. But for the coach who there is 00:20:43.069 --> 00:20:45.190 some like concussion certifications, usually 00:20:45.190 --> 00:20:47.690 they have to have some type of working knowledge. 00:20:47.690 --> 00:20:49.650 A lot of times I know in some of like this. especially 00:20:49.650 --> 00:20:52.029 like the NCAA schools, if they are complaining 00:20:52.029 --> 00:20:55.450 about really bad headache, if they start to vomit, 00:20:55.589 --> 00:20:57.509 immediately get them to the ER because we're 00:20:57.509 --> 00:21:00.150 worried about a subdural hematoma or epidural, 00:21:00.250 --> 00:21:02.549 either one. But yeah, if they start to want to 00:21:02.549 --> 00:21:04.930 vomit, they can't right away, like light bothers 00:21:04.930 --> 00:21:07.970 them. They can't walk straight in a line. Sometimes 00:21:07.970 --> 00:21:11.609 they're super, you know, they're very discombobulated. 00:21:11.809 --> 00:21:13.910 They have no balance. And so that's why people 00:21:13.910 --> 00:21:15.730 check their balance. And, you know, it's kind 00:21:15.730 --> 00:21:17.309 of like the breathalyzer test, I guess, that 00:21:17.309 --> 00:21:18.730 they joke around. But you would have people. 00:21:18.759 --> 00:21:20.279 People try to walk in a straight line and they 00:21:20.279 --> 00:21:22.039 can't. Any of those things, when they have a 00:21:22.039 --> 00:21:24.579 combination of, you know, I would say three or 00:21:24.579 --> 00:21:26.559 more of those type of symptoms, they definitely 00:21:26.559 --> 00:21:28.440 need to go to the hospital and just get checked 00:21:28.440 --> 00:21:30.220 out. But especially if they start to like get 00:21:30.220 --> 00:21:32.160 sick right away or they're unconscious for a 00:21:32.160 --> 00:21:34.759 long period of time, just as a strength and conditioning. 00:21:35.500 --> 00:21:37.119 coach you know you would just want to make sure 00:21:37.119 --> 00:21:39.039 that you're doing the best thing for your athlete 00:21:39.039 --> 00:21:41.599 and so those times can be scary and a lot of 00:21:41.599 --> 00:21:43.940 times they are get combative you know and they'll 00:21:43.940 --> 00:21:46.160 say no look I'm fine I'm fine I can keep going 00:21:46.160 --> 00:21:48.539 the last thing you want to do that if you think 00:21:48.539 --> 00:21:51.160 there's some type of bruise that's happened to 00:21:51.160 --> 00:21:54.099 the brain right a small little brain bleeds and 00:21:54.099 --> 00:21:56.079 the last thing you want to do is then increase 00:21:56.079 --> 00:21:58.039 that intrathecal pressure right and then all 00:21:58.039 --> 00:22:00.079 of a sudden have this you know try to lift something 00:22:00.079 --> 00:22:02.380 heavy and all of a sudden your you know BP is 00:22:02.380 --> 00:22:05.140 like 280 over 200 and that would just make it 00:22:05.140 --> 00:22:06.720 that much worse, right? That's definitely the 00:22:06.720 --> 00:22:09.380 worst thing that we could do for somebody. So 00:22:09.380 --> 00:22:11.319 I would have them sit down, stop activity right 00:22:11.319 --> 00:22:15.319 away, and then just be monitored. So would you 00:22:15.319 --> 00:22:18.140 say concussion, you sit the athlete, if they 00:22:18.140 --> 00:22:20.160 look concussed, you send them off immediately, 00:22:20.259 --> 00:22:23.619 but if they look fine, you let them sit and see 00:22:23.619 --> 00:22:26.980 how they feel. Still don't let them go back to 00:22:26.980 --> 00:22:30.680 the activity, but maybe see how they go and whether 00:22:30.680 --> 00:22:34.420 to send them off to the ER or not. biggest thing 00:22:34.420 --> 00:22:36.059 is just making sure you don't leave them alone 00:22:36.059 --> 00:22:39.500 i've seen and so say you're training a large 00:22:39.500 --> 00:22:42.599 group of of athletes at one time and someone 00:22:42.599 --> 00:22:45.059 gets injured and it's really easy for we'll say 00:22:45.059 --> 00:22:47.480 once again johnny gets injured he you know he 00:22:47.480 --> 00:22:50.000 hit his head really bad or you know and sometimes 00:22:50.000 --> 00:22:52.880 like the the hit or whatever happens and looks 00:22:52.880 --> 00:22:55.380 really benign it doesn't look like it would be 00:22:55.380 --> 00:22:57.759 that bad but um something happened obviously 00:22:57.759 --> 00:23:00.759 brain contusion wise and so they will go off 00:23:00.759 --> 00:23:02.940 and say i i just don't feel great so they will 00:23:03.210 --> 00:23:05.029 They'll leave and they'll go off on their own 00:23:05.029 --> 00:23:06.589 or say, hey, I'm just going to go to the restroom 00:23:06.589 --> 00:23:08.049 or I'm going to go to the bathroom. And sometimes 00:23:08.049 --> 00:23:09.490 that's the worst things that can happen because 00:23:09.490 --> 00:23:11.809 I've had athletes, you know, over the years where 00:23:11.809 --> 00:23:13.329 I've seen people where they've gone and then 00:23:13.329 --> 00:23:15.210 they've like passed out in the bathroom or in 00:23:15.210 --> 00:23:17.410 the shower. And it's because they were left alone. 00:23:17.549 --> 00:23:19.670 So we make sure that someone stays with them 00:23:19.670 --> 00:23:22.130 all the time and they're monitored until you 00:23:22.130 --> 00:23:24.789 can get them with either their parent or, you 00:23:24.789 --> 00:23:27.329 know, be seen at an emergency department or physician. 00:23:27.390 --> 00:23:29.170 But definitely keep an eye on them and just wait 00:23:29.170 --> 00:23:32.210 to see like how they do. They'll be super reactive. 00:23:32.430 --> 00:23:34.750 to, you know, bright lights can bother them. 00:23:34.869 --> 00:23:36.890 All of a sudden, like they can't read, trying 00:23:36.890 --> 00:23:39.230 to focus to read something really hurts their 00:23:39.230 --> 00:23:41.710 head. They can't read things well. They can't 00:23:41.710 --> 00:23:43.849 remember, right? There's times where people can't 00:23:43.849 --> 00:23:46.549 remember what just happened. And so those are 00:23:46.549 --> 00:23:48.650 the ones that I always, you know, take a lot 00:23:48.650 --> 00:23:50.910 more care with. A lot of times it is, you know, 00:23:50.910 --> 00:23:53.349 the brain will heal on its own. But the worst 00:23:53.349 --> 00:23:54.970 thing I think you could do as a strength and 00:23:54.970 --> 00:23:58.690 conditioning coach is to see somebody where it 00:23:58.690 --> 00:24:00.829 looks like, you know, they're off as they say, 00:24:00.849 --> 00:24:02.299 right? Something's not right. right with the 00:24:02.299 --> 00:24:04.319 with the kid and allow them to go back anytime 00:24:04.319 --> 00:24:07.140 you think it is a concussion -based head injury 00:24:07.140 --> 00:24:09.440 i would never i just would not mess with that 00:24:09.440 --> 00:24:11.339 until you know for sure like what's going on 00:24:11.339 --> 00:24:14.400 and keep monitoring them we will just carry on 00:24:14.400 --> 00:24:18.420 this green pathway because i want to ask about 00:24:18.420 --> 00:24:21.779 other red flags so what coaches should really 00:24:21.779 --> 00:24:25.700 pay attention to okay so for concussion stuff 00:24:25.700 --> 00:24:28.240 or just in general no in general in general what 00:24:28.240 --> 00:24:31.440 what if anything if they're gym is not prepared 00:24:31.440 --> 00:24:34.960 if a person as a coach is not prepared these 00:24:34.960 --> 00:24:37.079 are the things they really have to pay attention 00:24:37.079 --> 00:24:42.259 so i think as you know uh a coach when you're 00:24:42.259 --> 00:24:44.880 honestly someone wants some of the easiest things 00:24:44.880 --> 00:24:48.599 really to um i think that to to take notice of 00:24:48.599 --> 00:24:51.180 is to make sure that your area is like clean 00:24:51.180 --> 00:24:54.039 or picked up or full of like it doesn't have 00:24:54.039 --> 00:24:56.619 all these hazards right so say you're doing a 00:24:56.619 --> 00:24:59.119 bunch of weightlifting sessions or just making 00:24:59.119 --> 00:25:00.480 sure that like you're picking Picking the weights 00:25:00.480 --> 00:25:02.619 up. There's not a chance to like trip over something 00:25:02.619 --> 00:25:04.480 because someone left a 45 pound weight behind 00:25:04.480 --> 00:25:06.779 you or you had your feet on the two plates and 00:25:06.779 --> 00:25:08.519 then you didn't move it for later. And then, 00:25:08.519 --> 00:25:10.099 you know, you fall and you hit your head on that. 00:25:10.180 --> 00:25:13.160 Right. So just picking up and having a good workout 00:25:13.160 --> 00:25:16.160 space in general is always good. And then while 00:25:16.160 --> 00:25:18.819 somebody is trying to do a workout, like obviously, 00:25:19.160 --> 00:25:21.400 you know, something dislocates, you see it like 00:25:21.400 --> 00:25:23.059 a bone visibly out of place. That's obviously 00:25:23.059 --> 00:25:25.480 a huge red flag. Any type of loss of movement 00:25:25.480 --> 00:25:27.720 or sensation. If something happens and they're 00:25:27.720 --> 00:25:29.369 lifting and then all of a sudden, you know. So 00:25:29.369 --> 00:25:31.230 if someone can't feel the right side of their 00:25:31.230 --> 00:25:34.390 body or they can't use their joint the same way 00:25:34.390 --> 00:25:37.069 they could beforehand, immediately pause and 00:25:37.069 --> 00:25:40.130 stop and try to get them some help. Severe swelling 00:25:40.130 --> 00:25:43.730 or bruising right after a lift. If they did something 00:25:43.730 --> 00:25:46.029 to a joint and they already start to swell within 00:25:46.029 --> 00:25:48.529 minutes, that's probably a severe injury and 00:25:48.529 --> 00:25:50.549 then they need to stop immediately. And then 00:25:50.549 --> 00:25:53.789 fainting, shock or breathing difficulties. You're 00:25:53.789 --> 00:25:56.069 always worried if they do faint or if they have 00:25:56.069 --> 00:25:58.509 a bad enough injury, honestly, they can actually... 00:25:58.509 --> 00:26:00.650 go into shock. And so shock is another thing 00:26:00.650 --> 00:26:02.450 that you'd want to try to keep track of where 00:26:02.450 --> 00:26:04.910 they have like the sweating. They may have a 00:26:04.910 --> 00:26:08.130 really high pulse rate. They'll get tachycardia 00:26:08.130 --> 00:26:09.990 maybe, you know, and so you really want to try 00:26:09.990 --> 00:26:12.289 to monitor them. And people like that, that you 00:26:12.289 --> 00:26:13.890 think maybe have an injury and all of a sudden 00:26:13.890 --> 00:26:15.230 they're like, oh my gosh, I'm going to be sick 00:26:15.230 --> 00:26:17.210 and I don't feel right. And you could see the 00:26:17.210 --> 00:26:19.269 perspiration. You know, those are the ones that 00:26:19.269 --> 00:26:21.230 if when you go to treat for shock, you could 00:26:21.230 --> 00:26:23.069 have them lay down. You could have them, you 00:26:23.069 --> 00:26:25.049 raise their legs up, you raise their feet up. 00:26:25.109 --> 00:26:27.029 So you try to get as much blood to stay near 00:26:27.029 --> 00:26:29.480 the heart. internal organs as possible. Sometimes 00:26:29.480 --> 00:26:30.920 they think they're cold. You could cover them 00:26:30.920 --> 00:26:33.579 with a blanket and just, you know, try to reassure 00:26:33.579 --> 00:26:36.059 them. And then it's always good to continue to 00:26:36.059 --> 00:26:38.579 talk to and monitor your athlete or patient if 00:26:38.579 --> 00:26:41.059 that's the case. When you have those times that 00:26:41.059 --> 00:26:43.480 someone really has an issue and they're, you 00:26:43.480 --> 00:26:45.500 know, something's wrong, right? They have an 00:26:45.500 --> 00:26:48.579 emergent issue. Just trying to tell them like 00:26:48.579 --> 00:26:51.079 you're okay isn't probably going to help because 00:26:51.079 --> 00:26:53.220 they know they don't feel right. They know something's 00:26:53.220 --> 00:26:55.359 seriously wrong and that's almost placating them. 00:26:55.460 --> 00:26:58.559 And so I... always encourage people to use that 00:26:58.559 --> 00:27:01.420 as a time to gain information from them and honestly 00:27:01.420 --> 00:27:03.259 if you're going to go to the hospital things 00:27:03.259 --> 00:27:05.000 that you could ask is like okay when's the last 00:27:05.000 --> 00:27:06.839 time like you ate or drank anything if you think 00:27:06.839 --> 00:27:08.980 like they're going to need a surgery what's You 00:27:08.980 --> 00:27:11.799 know, do you, are you allergic to anything? Is 00:27:11.799 --> 00:27:14.660 your parents close by? What's, you know, what 00:27:14.660 --> 00:27:17.180 is, you know, the hospital you like to use? I 00:27:17.180 --> 00:27:19.640 mean, there's so many questions, valuable questions 00:27:19.640 --> 00:27:21.859 that you could ask and gain information from. 00:27:21.980 --> 00:27:24.779 And then help list the paramedics or when people 00:27:24.779 --> 00:27:26.980 come to either get the person or say you have 00:27:26.980 --> 00:27:29.319 to transport them and hand them off. At least 00:27:29.319 --> 00:27:31.359 you'd know like, hey, they have allergies. Maybe 00:27:31.359 --> 00:27:33.740 they have asthma. Maybe they have diabetes. You 00:27:33.740 --> 00:27:35.480 know, maybe they have a pacemaker. You know, 00:27:35.480 --> 00:27:37.079 you just never know. Everybody has different 00:27:37.079 --> 00:27:39.759 health issues. using that time to try to kind 00:27:39.759 --> 00:27:42.579 of keep them. Especially if they look like they're 00:27:42.579 --> 00:27:44.599 kind of in between consciousness. I'm always 00:27:44.599 --> 00:27:46.380 trying to keep them awake and keep them talking 00:27:46.380 --> 00:27:49.980 until medical personnel arrive, especially with 00:27:49.980 --> 00:27:53.480 like the faint. And then vomiting or confusion 00:27:53.480 --> 00:27:56.160 right after a head injury or something happened, 00:27:56.240 --> 00:27:58.680 a heavy lift. And if, you know, that's the case, 00:27:58.680 --> 00:28:01.720 something else is going on. So I would be, or 00:28:01.720 --> 00:28:03.259 they, you know, they got hit in the head with 00:28:03.259 --> 00:28:05.279 a weight or they racked wrong in their neck. 00:28:05.460 --> 00:28:08.779 I mean, if you immediately have central C -spine 00:28:08.779 --> 00:28:11.299 pain or you have numbness. and tingling down, 00:28:11.519 --> 00:28:14.480 you know, an arm or both arms. Bilaterally is 00:28:14.480 --> 00:28:16.880 more of the worst case scenario, I'd say. Then, 00:28:16.880 --> 00:28:19.400 you know, you've got to stop all things. And 00:28:19.400 --> 00:28:21.039 that would make sure that they kind of just stay 00:28:21.039 --> 00:28:23.859 aligned because I know people won't always mean 00:28:23.859 --> 00:28:25.940 to know the spinal restriction movement techniques, 00:28:26.059 --> 00:28:28.380 but make sure that they're just not moving and 00:28:28.380 --> 00:28:30.359 try to call for help. Those would be some of 00:28:30.359 --> 00:28:32.599 the real big ones that I could think of off the 00:28:32.599 --> 00:28:36.299 top of my head. If you are somebody that is like, 00:28:36.380 --> 00:28:38.740 I cannot handle if I see something out of place, 00:28:38.920 --> 00:28:41.160 right? Like if they saw a dislocation, like I 00:28:41.160 --> 00:28:43.960 can't handle it. My biggest suggestion is to 00:28:43.960 --> 00:28:47.140 take a towel and cover it. So they can still 00:28:47.140 --> 00:28:49.480 stay stabilized, right? So you need to like splint 00:28:49.480 --> 00:28:51.779 or make sure they're not going to move it, but 00:28:51.779 --> 00:28:53.779 then cover it. So then you can still be there 00:28:53.779 --> 00:28:56.000 for that person and talk to them and they don't 00:28:56.000 --> 00:28:58.180 have to see it anymore and see like maybe what 00:28:58.180 --> 00:28:59.700 the injury looks like. Because a lot of times 00:28:59.700 --> 00:29:01.980 that's the other part is sometimes I try to hide 00:29:01.980 --> 00:29:05.440 it. They don't, you know, freak out more or get 00:29:05.440 --> 00:29:08.039 really upset. But that. can also help. A lot 00:29:08.039 --> 00:29:10.299 of times if someone tells me they heard a pop 00:29:10.299 --> 00:29:13.759 or felt heard or felt a pop or a crack, I usually 00:29:13.759 --> 00:29:16.759 know then either maybe a ligament has completely 00:29:16.759 --> 00:29:20.880 torn or maybe like maybe their patella like subluxed 00:29:20.880 --> 00:29:23.119 or dislocated or, you know, something else happened 00:29:23.119 --> 00:29:24.900 in the body. So usually that's kind of a sign 00:29:24.900 --> 00:29:26.380 that something a little bit more severe may or 00:29:26.380 --> 00:29:28.279 may not have happened. And just asking those 00:29:28.279 --> 00:29:30.960 good questions and then assessing them, you know, 00:29:30.960 --> 00:29:32.980 where is the pain? Usually, you know, it's there. 00:29:33.140 --> 00:29:35.140 A lot of times the coaches are with them, I would 00:29:35.140 --> 00:29:37.839 think if they. had some type of, you know, mechanism 00:29:37.839 --> 00:29:39.940 of injury, but, and just trying to keep them 00:29:39.940 --> 00:29:42.140 calm as, you know, as much as they can, but can 00:29:42.140 --> 00:29:44.480 they bear weight? Can they move the limb? And 00:29:44.480 --> 00:29:46.440 like I said, always ask about numbness and tingling, 00:29:46.539 --> 00:29:47.940 because if it's nerve related, you definitely 00:29:47.940 --> 00:29:49.740 want to make sure that you send right away. And 00:29:49.740 --> 00:29:52.200 then, like we said, soft tissue wise, that's 00:29:52.200 --> 00:29:54.599 usually a little bit easier to handle. Soft tissue 00:29:54.599 --> 00:29:57.680 and like wound care, a first aid kit would still 00:29:57.680 --> 00:30:00.059 be great. But honestly, the ice, the compression, 00:30:00.319 --> 00:30:02.460 having those ACE wraps, trying to stop the swelling, 00:30:02.720 --> 00:30:04.799 you know, elevate the body part if you can above 00:30:04.799 --> 00:30:07.490 the heart. And then, you know, just managing 00:30:07.490 --> 00:30:09.509 the pain and swelling and then trying to see, 00:30:09.589 --> 00:30:12.390 you know, if someone can't, you know, if say 00:30:12.390 --> 00:30:16.190 it was an ankle and they did something to it 00:30:16.190 --> 00:30:18.069 and then you couldn't take more than a few steps 00:30:18.069 --> 00:30:20.369 or bear weight on it, you know, even within like 00:30:20.369 --> 00:30:22.410 30 minutes, like you probably should go get an 00:30:22.410 --> 00:30:24.509 x -ray, right? That's not normal. And so there's 00:30:24.509 --> 00:30:26.089 certain ways. A lot of times there's those like 00:30:26.089 --> 00:30:28.769 Ottawa, I like those Ottawa ankle rules and C 00:30:28.769 --> 00:30:30.809 -spine rules. They came out of Canada and they 00:30:30.809 --> 00:30:32.849 have these really helpful techniques that tell 00:30:32.849 --> 00:30:35.490 you like, okay, if your patient can. do you know 00:30:35.490 --> 00:30:38.630 x y and z or have pain in certain areas this 00:30:38.630 --> 00:30:40.430 is when you should get an x -ray and this is 00:30:40.430 --> 00:30:42.869 when you know you can wait and those are always 00:30:42.869 --> 00:30:45.930 kind of helpful to to look at to use but especially 00:30:45.930 --> 00:30:48.309 if they can't bear weight or not feel the same 00:30:48.309 --> 00:30:51.130 sensation but bilaterally always make sure you 00:30:51.130 --> 00:30:53.269 also like look at both sides like I said because 00:30:53.269 --> 00:30:56.509 sometimes people may have strange actually normal 00:30:56.509 --> 00:30:59.730 deformities or odd things on their body but it's 00:30:59.730 --> 00:31:01.950 it's that's their regular and I don't know like 00:31:01.950 --> 00:31:03.190 how many strength and conditioning specialists 00:31:03.190 --> 00:31:06.190 like how you know to truly spot right if you're 00:31:06.190 --> 00:31:08.250 going heavy you're supposed to have one on like 00:31:08.250 --> 00:31:10.869 either side like do they usually have that can 00:31:10.869 --> 00:31:12.789 they use other athletes like you know i don't 00:31:12.789 --> 00:31:15.170 know how often everyone has that luxury i guess 00:31:15.170 --> 00:31:16.910 at times when they're they're training people 00:31:16.910 --> 00:31:19.730 but it's definitely one of the things you can 00:31:19.730 --> 00:31:22.170 do it's if you don't have spotters then you can 00:31:22.170 --> 00:31:25.670 use safe quadrups and around the barriers where 00:31:25.670 --> 00:31:30.109 you can't go lower than the the barrier so that's 00:31:30.109 --> 00:31:33.250 the way you can modify your training to not do 00:31:33.250 --> 00:31:36.430 heavy single when you have no one to spot you 00:31:36.839 --> 00:31:39.220 You can't do it safe. In weightlifting gyms, 00:31:39.220 --> 00:31:41.539 I think the athletes are taught or they have 00:31:41.539 --> 00:31:45.119 to learn how to drop the weight safely. Because 00:31:45.119 --> 00:31:47.920 in snatch and clean and jerk, you can't have 00:31:47.920 --> 00:31:51.440 spotters as easily as for back squat, for example. 00:31:51.440 --> 00:31:55.500 So you have to learn how to remove yourself from 00:31:55.500 --> 00:31:59.359 under the bar, wherever it is it might be. So 00:31:59.359 --> 00:32:03.039 that's a skill you may consider too. Or have 00:32:03.039 --> 00:32:07.470 spotters. or not go as heavy as your maximum. 00:32:07.809 --> 00:32:09.950 Now that you say that, that's right. We had our 00:32:09.950 --> 00:32:12.269 squat rack and thank God we at least had the 00:32:12.269 --> 00:32:15.230 bottom barriers in and this kid was squatting, 00:32:15.230 --> 00:32:17.029 one of my students, and I just look over and 00:32:17.029 --> 00:32:19.849 I'm like, oh my gosh, he pinned under that, but 00:32:19.849 --> 00:32:22.210 thank God I caught it because he just collapsed 00:32:22.210 --> 00:32:24.269 under that and I was like, oh, whatever. They 00:32:24.269 --> 00:32:26.730 were all in the classroom trying to learn and 00:32:26.730 --> 00:32:28.930 I used to have a squat rack in there. But yes, 00:32:29.009 --> 00:32:31.390 thank God for those. Yeah, they are good. Useful. 00:32:31.390 --> 00:32:33.349 All right. We have two more questions to finish. 00:32:33.509 --> 00:32:36.349 So the first one is, what is your favorite lift? 00:32:36.569 --> 00:32:39.569 I am just the standard back squat girl. I love 00:32:39.569 --> 00:32:41.369 it. I tried the front squat. I've tried other 00:32:41.369 --> 00:32:46.109 things. I'm just, that's my favorite. Now, where 00:32:46.109 --> 00:32:48.910 people can find you if they want to follow, maybe 00:32:48.910 --> 00:32:52.430 get in touch or see what you're up to, how you 00:32:52.430 --> 00:32:55.490 work and so on. Yeah. So probably the easiest 00:32:55.490 --> 00:32:59.910 way to find me is on LinkedIn. I'm just under 00:32:59.910 --> 00:33:02.349 Kathy Williams as my name. I'm listed as the 00:33:02.349 --> 00:33:04.390 Director of Clinical Education, Head Athletic 00:33:04.390 --> 00:33:06.809 Trainer for Pinecrest Physical Therapy here in 00:33:06.809 --> 00:33:09.609 Miami, Florida. Might be the easiest. Or if someone 00:33:09.609 --> 00:33:15.769 wanted to reach out, my email is kpomicht at 00:33:15.769 --> 00:33:18.009 gmail .com. Awesome. Thank you so much for today. 00:33:18.190 --> 00:33:19.650 Thank you. Thanks for having me.