What would be the reason for injuries in the
gym and in general? Well, reasons why, you know,
I just think me watching athletes in a group
workout together and they, unfortunately, they'll
play the comparison game and they're like, no,
I'm strong, you know, and they start to, you
know, joke around with each other and I'm stronger
and I'm better. And that is always when I see
more injuries, soft tissues, not necessarily
emergent, but, you know, that's usually when
they end up hurting themselves because they're
trying to do better than John next to him. Hi,
Kathy. It's my pleasure to have you on Evidence
Strong Show. If you could briefly introduce yourself,
that would be awesome. Hi, my name is Dr. Kathy
Williams. I am a certified athletic trainer.
I've been certified since 1999. I have my undergraduate
degree in sports medicine. Along those lines,
I ended up going for my master's in 2001 in college
counseling. And I also decided that I wanted
to get the NSCA's strength and conditioning certification,
so the CSCS. So I've been certified since then.
And that was back when you actually had to go
to the site to go get tested. I've been working
as an athletic trainer and then helped with some
strength and conditioning programming throughout
the years. Worked in many different settings,
gyms, clinics, and then I usually work with high
school or collegiate athletes. And I got my doctorate
in educational leadership, but I helped start
different programs and I got a chance to create
and start a human performance and a master's
program in applied kinesiology. And I've done
undergraduate health science programs and have
always had strength and conditioning as a part
of the coursework. Amazing. huge, huge baseline
of knowledge and experience. And today we will
try to learn from you about emergencies in the
gym. So what may happen? in the gym in times
of emergencies? I was looking through in the
emergency department statistics for weightlifting
injuries in the United States. Based on our information,
estimated annual ED visits are anywhere from
20 ,000 to 30 ,000 weightlifting related injuries
a year here in the U .S. And I know you had spoken
about it previously on a podcast, but it's roughly
like two to four injuries per 1 ,000 hours of
training. A lot of times the age groups that
get injured the most are adolescent. males. 13
to 18 -year -olds are really the highest risk
group, mainly due to, you know, technique errors,
growth plate vulnerabilities. Adult males, 18
to 30, were also the majority of injuries overall.
I think, you know, that population obviously
strives to, you know, push themselves. And at
times, though, when they're trying to push themselves
and, you know, get stronger and develop or have
better lifting techniques, instead they actually
have improper technique, right? They just try
to lift too much weight too quickly. They drop
weights. You could have a crushing injury, right,
if you accidentally have two weights and your
finger's stuck in between them. Overexertion
or equipment failure, you know, if they don't
have the proper spotting as well. Some of the
common injuries, soft tissue injuries for sure,
strains, sprains. I've had a lot of people, you
know, oh, I hurt my shoulder. I was, you know,
racking the barbell and I went too far back.
And you could have back injuries. Back injuries
are quite common. Shoulder injuries, hand and
finger trauma. That's, you know, really more
from like dropping weights or them getting pinched.
And then more serious ones, but not. Definitely
not as common. I've seen pectoral tears. I've
seen bicep tears. People could have spinal injuries
or some type of fracture. So those are some of
the more common things I think that most everybody
sees. The other end of it is now, okay, say this
just, you know, some type of injury happens.
And so obviously if that is a case where you
think somebody is severely injured, you would
want to make sure they stop the activity immediately.
You want to prevent any further damage from happening
in any way, shape or form. You want to keep the
athlete calm, still. We could always give it
more as like an example, a squat, and they have
too much valgus, knee valgus. And so they are
getting some knee pain. You know, you'd want
to ask them like, okay, let's stop the exercise.
You know, where is the pain? If they notice something
that you, they quickly identify something's wrong,
you could see them, you know, jerk or have a
moment of pain. Where is it? Did you hear a pop,
a snap? We've all seen those. gory videos of
dislocations. You know how they have, there's
a doctor I follow that's fun on Instagram, but
he always is assessing like, hey, this is, you
know, what the exercise was. And then this is
the injury that resulted from it. And, you know,
and why did it happen? And so obviously more
like the snatch, I would think some of the clean
and jerk, some of the more explosive, right?
Movements would be the ones that I think we've
seen somebody dislocate a shoulder, elbow. So
you would just want to make sure like if something
like this did happen, you know, can they move?
the limb? Can they even bear weight if it's a
lower body injury? You know, the number one thing
besides getting them to stop the activity and
ask them how they are, you'd really want to make
sure if anyone has numbness, tingling, or any
type of deformity, right? So deformity obviously
is a huge red flag, like they're going to have
to go to the emergency room. Numbness and tingling
though, anything to do with nerves is always
a little bit concerning, is very concerning actually.
So you're just concerned, like, did something
happen in central C -spine? Do we have to worry
about there's some type of nerve compression?
based off of either a dislocation or maybe even
like a torn muscle that can affect it. If there's
any signs of serious injury, you know, don't
move the athlete unnecessarily. We could have,
you know, make sure you seek emergency help right
away. You want to call personnel. Depending on
the injury, if you have it, if for soft tissue
and acute injuries, we could always use the RICE
method that they call it. So rest, ice, compression,
elevation, immobilizing and avoiding movement,
managing pain and swelling. You know, you could
always have people take ibuprofen. or those non
-steroidal anti -inflammatories. They can always
help. Avoiding any type of heat and massage in
the first 48 hours right after someone gets injured
is usually the best case. And then just making
sure that you're keeping an eye on your athlete,
you know, watching for increased pain, swelling.
If they have changes in sensation, you definitely
want to, you know. be on alert and then see if
you need to refer. If you had shoulder dislocation
or say someone does dislocate their elbow or
even their elbow, you don't want to try to relocate
it, right? You don't want to try to actually
put the joint back in unless you're trained to
do so. But the biggest thing is immobilizing
and then being able to transport them to the
ER. And then after they're there, right, they'll
get an x -ray, they'll reduce the joint for them,
and then they'll have to have some type of rehab
with a physiotherapist. or a PT, but mobilizing
could even be the ground. So if someone is like
their, you know, joint shoulder came out anteriorly,
you know, if you had to, you could like lay them
down if they feel more comfortable and just have
that against the ground. There's different splints
that people could have that are actually pretty
easy to use. You could have arm slings if it
was, you know, dislocated and their arm was actually
more down in front of their body. So there's
a few different things that'd be nice to have.
suggest that everybody should have some type
of basic first aid course. And then I'm hoping
that all strength coaches also get CPR and AED
certified for sure. They've found that there's
actually a pretty high correlation to more cardiovascular
incidents at times during strength training sessions
than there always is necessarily in practice.
Coaches, how can they prepare and what should
they have in the gym or ideally what would be
in the gym for them to use in case of emergency?
If they wanted to, they could have an arm. sling
if something does happen right to someone's shoulder
elbow. A SAM splint it's called. A SAM splint
is actually this like it's somewhat mobile comes
wrapped up in like a little cylinder and then
you can unwrap it and you could have the other
thing would be good to have is ACE wraps. ACE
wraps for compression right so someone like sprains
their ankle or does something their knee they
could apply those but the ACE wrap goes along
with that SAM splint and it can help you split
an injury if you needed to. I would always think
being able to if you think it's a really severe,
like say they, you know, go unconscious because
their blood pressure is tight. It's always good
to try to take vitals if the coach is capable.
So if you're trained and first able to do that,
a pulse oximeter is the most simplest thing that
you can use. I know a lot of people during the
pandemic got comfortable with those and it's
just this little tiny device. It goes on your
finger and it measures your blood oxygen levels
and then your pulse. So then at least you can
know if they have a high pulse rate or low or,
you know, how is the person feeling. If they
feel comfortable, they could have even just the
automatic. now blood pressure cuffs that you
could just put on somebody and you just got to
press a button and at least they'll tell you
the readout of what their blood pressure is.
Having access to ice, ice bags, also an AED,
a first aid kit for any type of wounds if they,
you know, I know some people used to like scrape
that bar along their shins and then they're bleeding
at the end. when they're trying to stay close
to the body. But, you know, having a towel, just
simple things that you could use that you could
help to like a distance, some type of like a
wound cleanser spray. They say don't use like
peroxide anymore and like make sure it's some
type of a wound cleanser. Sterile gauze, band
-aids, those type of just basic supplies can
really help you. Roller gauze could also be another
good one to have in case of any type of like
blood. So, okay. So basically any type of dislocation.
If something happens and you notice that a joint
came out, very first thing is you're going to
make sure that they stay splinted or don't move.
You call for help, your emergency personnel.
there's little things that you could try to do.
Sometimes people start to feel like they go numb
and tingly. There's little things where you can
like actually even press on the fingertips and
it's called capillary refill. And you could see
their, you know, their fingers go white and then
turn back to pink. Then you could tell like,
okay, they're getting good blood flow. If they're
not getting good blood flow, then you know that's
even more of an emergency because something,
a blood vessel could be getting occluded. Same
thing neurologically, you want to make sure they
can still feel all right. So trying to do those,
any type of fracture, wrist, arm. leg. Same thing's
going with a dislocation. You're definitely going
to want to splint it in any way you can. And
then just avoid movement and you have to call
the EMS because really they're going to need
some type of imaging, x -ray. You know, this
is when people either get casted. So depending
on any type of fracture and where that would
be, lower body versus upper body, you know, sometimes
it's even nice just to have crutches at your
gym. I don't know if everybody necessarily has
those, but it's been kind of, you know, comes
in handy. Back injuries and spasms. Those can
be tough when you really start to spasm up. I'm
sure you've seen it before as well. But, you
know, right away, non -weight -bearing is probably
best. Sometimes even laying flat on their back
isn't great. They may have to actually elevate
their legs a little bit to try to take some pressure
off that low back. If they spasm though, you
know, they're probably going to either have to
like lay down or be on their side. And then this
is when you could try to ice and then give them
those NSAIDs or some type of ibuprofen to help
reduce the pain. the ice will really you know
help actually try to slow nerve conduction and
hopefully slow those spasms down those are uh
usually though that's tough right because then
as soon as they get up to move they'll start
to spasm some again but this is when it's Depending
on how, you know, I guess bad the reaction is,
either you'd have to put them on a spine board
or on a gurney and they would have to wheel them
out. Or hopefully you could get them to calm
down and, you know, within 20, 30 minutes, then
they can walk out and get checked. Would you
allow the athlete in this situation go back to
training session or is the end of the story?
They have to be medically checked before they
can come back? I would, if it's significant enough
where they are spasming so bad that they can't
continue, then they may need. to get checked
by a medical professional or an athletic trainer
or physiotherapist or someone that knows like
some special tests and can try to follow them.
You have to be careful because what the body
likes to do is it goes into a pain spasm cycle.
And so we try to break that when there's some
type of injury. And the body is extremely intelligent.
So say, you know, like when you sprain your ankle,
the first thing that happens is it hurts and
you don't want to move it, right? And then it
starts to swell. And, you know, the body knows
that if you felt good, right, you would start
to walk on it and use it. And it can't. It's
injured. So you have that pain spasming as a
protection for you, for your actual joint. Even
though we don't enjoy it, our body's trying to
tell us something, right? And then the swelling
comes in. It's extremely hard to obviously have
good range of motion with the swelling, but it's
trying to help you heal. And, you know, it's
just smart. So there's times where, like, if
you maybe have, like, a hairline fracture or
something, I've had what's called, like, an osteochondral
defect. in their femur. And I had an athlete
that was constantly having chronically tight
hamstrings. And then he's always thought he was
pulling his hamstrings. And every time he's trying
to work out and come to find out his tight hamstrings
were tightening up because it was trying to his
body was trying to, I think, in a way, not use
as much because he actually had these OCD lesions.
So it's pretty smart, but you've got to pay attention
and just make sure, you know, like there's no
other underlying cause. And that's the part that
can get dicey. You know, it's a little bit difficult
to. without having some experience and watching
people. I had another kid, same thing. They thought
he was chronically having hamstring strains and
trying to work out and he was losing all of his
strength. And really, when you take a look, you
know, I highly suggest that if you are training
somebody and you notice they have a huge deficit
from one side to the other. So like if you look
at someone bilaterally and you're looking at
both of their legs, if the right leg all of a
sudden looks like the circumference of the actual
muscle mass of the thigh is, you know. significantly
reduced compared to the left leg you need to
know then there had to have been an injury there's
there's something happening and that's always
my number one way to realize there's another
underlying injury something must have happened
in this athlete's case that i was working with
i found out he was acl deficient and we never
knew it i guess a year a year before he'd hurt
his knee you know said it hurt but i hadn't i'd
only started seeing him a year later and just
kept talking about these chronic hamstrings the
next thing you know we get him an mri and and
that's why so Some of the more emergent things
are easier almost to take care of because, you
know, like you're going to have to stop and go
get looked at by a physician. Where some of these
like more, I guess, low line, low level injury,
you know, you got to try to may also like warrant
some further looks, I guess I'd say. What would
be the reason for injuries in the gym and in
general? Well, reasons why men are boys being
boys. I'm joking. I'm not only picking on them.
I know women, we can get the same thing. But,
you know, I just think me. watching athletes
in a group workout together and they unfortunately,
though, play the comparison game and they're
like, no, I'm strong, you know, and they start
to, you know, joke around with each other and
I'm stronger and I'm better. And that is always
when I see more injuries, soft tissues, not necessarily
emergent. But, you know, that's usually when
they end up hurting themselves because they're
trying to do better than John next to him. He's
like, but look at what I put up. And I'm like,
it doesn't matter. It hurts you. So I feel like
that alone is a big thing and usually not. doing
it with correct form on top of it all. So not
only are they not doing good form and then they're
trying to increase their, you know, velocity
and load and it responds very poorly in their
body as they usually, I know, for that. Poor
form, poor and ego. Right. Oh, I see that all
the time. I'm like, oh, all right. Okay. The
problem, I think the biggest problem is that
where people are the most prone to ego lifting
is also the age when they are in their prime
physically. So you want them to be pushing. You
want them to be getting better because that's
the best time to gain. But it's also the worst
time to gain because they have very low perceived
risk. They think that... They are invincible
and, you know, it has pluses, but you as a coach
have to really pay attention and know your athletes.
Yeah, especially higher level, really, you know,
self -motivated, driven athletes. I mean, those
are ones that like you have to kind of just actually
try to. like you said, slow them down because
they will just keep going. I have so many overuse
injuries right now. And a lot of it has to do
with just overtraining. And what's happening
is there's too many groups of us now. It's like
too many cooks in the kitchen, I'm calling it.
So like, you know, you have your strength coach
and then you have your sport coach and then you
have some, you know, other, right, speed coach.
And then you have some other individual that,
you know, Johnny's dad said is great. So they're
going to go to that, you know, and now next thing
I find out, like, I think they're just going.
to a practice and doing their workouts with,
you know, their strength coach. And the next
thing I know, they're actually doing four more
hours of, you know, some type of exertion or
exercise and, you know, trying to teach them
about periodization and like more does not always
make better is that leads more to injuries than
I feel like almost anything else that we've done.
But I've really been encountering that, especially
now with the rise of I'm super excited for our
profession. I'm so glad that, you know, strength
and conditioning specialists are, you know, growing
overall and are now. knowledge base is growing,
but now just making sure, you know, we're all
kind of on the same page with also their sport
coaches or speed coach, you know, it's kind of
having that network of everybody working together.
I want us to cover maybe the most scary thing
in the gym that can happen, which is blackout
slash concussion. So something happened and you
either had an athlete accept a hit to the head
or they just dropped. on the floor and they are
unconscious or they are they are conscious but
they're confused don't know where they are and
so on so what would you have to say oh yeah that
would obviously be the scariest thing that could
happen so if someone passes out this is tough
like as a strength coach right because i know
multiple people like if you rest the bar too
high right you end up like kind of occluding
that carotid artery and then you end up losing
consciousness because of that usually though
what's going to happen right is they They fall
or they go unconscious. And then after their
body regulates, they will, you know, come back
to us and be all right. But if they go unconscious
and never regain consciousness, right? So as
soon as you're unconscious, it's a medical emergency.
So you'd want to make sure you call emergency
personnel first. I would always suggest to make
sure that this is when you go get your AED and
then hopefully have CPR skills, not saying that
you would need it, but just always making sure
that you have the supplies needed around you.
And then this is when you need to check vitals.
This is why it's good for people to have those
certifications and know like, okay, how can I
check vitals? You know, can you check the carotid,
brachial arteries just to make sure that their
pulse is okay? Are they breathing? Are you going
to look, listen and feel, I call it. So you can
like tip their head back a little bit and put
your ear and feel like if their breath is hitting
your face, you're looking at their chest to see
if it's rising. A lot of times I'll look for
the ribs if they fall forward. As long as I see
their ribs moving, I always feel better. Like
when I have to run out, like, like especially
like in American football, I'm like. okay, I
see their ribs moving and I feel better. But
then, so you'd want to make sure if they're unconscious,
right? Just trying to check all of those things.
And really the most thing you can do is just
monitor. If it is more a head related injury.
So a lot of times if you get hit in the head,
this part is not going to be actually necessarily
backed by research. So I will apologize now,
but I always feel better if someone gets hit
in the head and I see it swell out. You're because
say you got hit with like a weight and you start
to swell and you all of a sudden have this huge
like hematoma on your head. Usually what that
means is that your skull has done the job it's
supposed to, right? It kind of dissipated those
forces, took it, and then the skin just has an
injury to it. But usually it doesn't mean that
your brain did. And so, but if they pass out
or fall and they happen to like hit, you know,
whack their head back, their head back and they
get a coup or counter coup type concussion, then
this is when, right, their brain moved and kind
of hit the front and back of inside that skull
and now the brain is bruised. That is obviously
more concerning. A lot of times people can still.
They'll talk to you, but this is when you would
still want to refer and make sure you get them
looked at. But if a lot of times people get in
the head and they're still conscious, but they
don't feel right, right? You could just all of
a sudden start to tell that they're off. If they
start to, they should most likely, they have
a headache. Then I always try to make sure that
they, this is why people, when you have them
follow your finger, you're trying to watch their
eye tracking to see if they get the stigmas it's
called. And it's, you know, it's when your eyes
will bounce or jump a little bit while they're
trying. to follow. So like your eye tracking
looks off. And so that's the way I'll go in all
these different directions. So a lot of times
though, like for somebody like in my field, I
would test all of your cranial nerves. So I have
them stick their tongue out. I have them, you
know, side eyes as, as checking abducens and
you have them smile and frown and, and we look
at all of that. But for the coach who there is
some like concussion certifications, usually
they have to have some type of working knowledge.
A lot of times I know in some of like this. especially
like the NCAA schools, if they are complaining
about really bad headache, if they start to vomit,
immediately get them to the ER because we're
worried about a subdural hematoma or epidural,
either one. But yeah, if they start to want to
vomit, they can't right away, like light bothers
them. They can't walk straight in a line. Sometimes
they're super, you know, they're very discombobulated.
They have no balance. And so that's why people
check their balance. And, you know, it's kind
of like the breathalyzer test, I guess, that
they joke around. But you would have people.
People try to walk in a straight line and they
can't. Any of those things, when they have a
combination of, you know, I would say three or
more of those type of symptoms, they definitely
need to go to the hospital and just get checked
out. But especially if they start to like get
sick right away or they're unconscious for a
long period of time, just as a strength and conditioning.
coach you know you would just want to make sure
that you're doing the best thing for your athlete
and so those times can be scary and a lot of
times they are get combative you know and they'll
say no look I'm fine I'm fine I can keep going
the last thing you want to do that if you think
there's some type of bruise that's happened to
the brain right a small little brain bleeds and
the last thing you want to do is then increase
that intrathecal pressure right and then all
of a sudden have this you know try to lift something
heavy and all of a sudden your you know BP is
like 280 over 200 and that would just make it
that much worse, right? That's definitely the
worst thing that we could do for somebody. So
I would have them sit down, stop activity right
away, and then just be monitored. So would you
say concussion, you sit the athlete, if they
look concussed, you send them off immediately,
but if they look fine, you let them sit and see
how they feel. Still don't let them go back to
the activity, but maybe see how they go and whether
to send them off to the ER or not. biggest thing
is just making sure you don't leave them alone
i've seen and so say you're training a large
group of of athletes at one time and someone
gets injured and it's really easy for we'll say
once again johnny gets injured he you know he
hit his head really bad or you know and sometimes
like the the hit or whatever happens and looks
really benign it doesn't look like it would be
that bad but um something happened obviously
brain contusion wise and so they will go off
and say i i just don't feel great so they will
They'll leave and they'll go off on their own
or say, hey, I'm just going to go to the restroom
or I'm going to go to the bathroom. And sometimes
that's the worst things that can happen because
I've had athletes, you know, over the years where
I've seen people where they've gone and then
they've like passed out in the bathroom or in
the shower. And it's because they were left alone.
So we make sure that someone stays with them
all the time and they're monitored until you
can get them with either their parent or, you
know, be seen at an emergency department or physician.
But definitely keep an eye on them and just wait
to see like how they do. They'll be super reactive.
to, you know, bright lights can bother them.
All of a sudden, like they can't read, trying
to focus to read something really hurts their
head. They can't read things well. They can't
remember, right? There's times where people can't
remember what just happened. And so those are
the ones that I always, you know, take a lot
more care with. A lot of times it is, you know,
the brain will heal on its own. But the worst
thing I think you could do as a strength and
conditioning coach is to see somebody where it
looks like, you know, they're off as they say,
right? Something's not right. right with the
with the kid and allow them to go back anytime
you think it is a concussion -based head injury
i would never i just would not mess with that
until you know for sure like what's going on
and keep monitoring them we will just carry on
this green pathway because i want to ask about
other red flags so what coaches should really
pay attention to okay so for concussion stuff
or just in general no in general in general what
what if anything if they're gym is not prepared
if a person as a coach is not prepared these
are the things they really have to pay attention
so i think as you know uh a coach when you're
honestly someone wants some of the easiest things
really to um i think that to to take notice of
is to make sure that your area is like clean
or picked up or full of like it doesn't have
all these hazards right so say you're doing a
bunch of weightlifting sessions or just making
sure that like you're picking Picking the weights
up. There's not a chance to like trip over something
because someone left a 45 pound weight behind
you or you had your feet on the two plates and
then you didn't move it for later. And then,
you know, you fall and you hit your head on that.
Right. So just picking up and having a good workout
space in general is always good. And then while
somebody is trying to do a workout, like obviously,
you know, something dislocates, you see it like
a bone visibly out of place. That's obviously
a huge red flag. Any type of loss of movement
or sensation. If something happens and they're
lifting and then all of a sudden, you know. So
if someone can't feel the right side of their
body or they can't use their joint the same way
they could beforehand, immediately pause and
stop and try to get them some help. Severe swelling
or bruising right after a lift. If they did something
to a joint and they already start to swell within
minutes, that's probably a severe injury and
then they need to stop immediately. And then
fainting, shock or breathing difficulties. You're
always worried if they do faint or if they have
a bad enough injury, honestly, they can actually...
go into shock. And so shock is another thing
that you'd want to try to keep track of where
they have like the sweating. They may have a
really high pulse rate. They'll get tachycardia
maybe, you know, and so you really want to try
to monitor them. And people like that, that you
think maybe have an injury and all of a sudden
they're like, oh my gosh, I'm going to be sick
and I don't feel right. And you could see the
perspiration. You know, those are the ones that
if when you go to treat for shock, you could
have them lay down. You could have them, you
raise their legs up, you raise their feet up.
So you try to get as much blood to stay near
the heart. internal organs as possible. Sometimes
they think they're cold. You could cover them
with a blanket and just, you know, try to reassure
them. And then it's always good to continue to
talk to and monitor your athlete or patient if
that's the case. When you have those times that
someone really has an issue and they're, you
know, something's wrong, right? They have an
emergent issue. Just trying to tell them like
you're okay isn't probably going to help because
they know they don't feel right. They know something's
seriously wrong and that's almost placating them.
And so I... always encourage people to use that
as a time to gain information from them and honestly
if you're going to go to the hospital things
that you could ask is like okay when's the last
time like you ate or drank anything if you think
like they're going to need a surgery what's You
know, do you, are you allergic to anything? Is
your parents close by? What's, you know, what
is, you know, the hospital you like to use? I
mean, there's so many questions, valuable questions
that you could ask and gain information from.
And then help list the paramedics or when people
come to either get the person or say you have
to transport them and hand them off. At least
you'd know like, hey, they have allergies. Maybe
they have asthma. Maybe they have diabetes. You
know, maybe they have a pacemaker. You know,
you just never know. Everybody has different
health issues. using that time to try to kind
of keep them. Especially if they look like they're
kind of in between consciousness. I'm always
trying to keep them awake and keep them talking
until medical personnel arrive, especially with
like the faint. And then vomiting or confusion
right after a head injury or something happened,
a heavy lift. And if, you know, that's the case,
something else is going on. So I would be, or
they, you know, they got hit in the head with
a weight or they racked wrong in their neck.
I mean, if you immediately have central C -spine
pain or you have numbness. and tingling down,
you know, an arm or both arms. Bilaterally is
more of the worst case scenario, I'd say. Then,
you know, you've got to stop all things. And
that would make sure that they kind of just stay
aligned because I know people won't always mean
to know the spinal restriction movement techniques,
but make sure that they're just not moving and
try to call for help. Those would be some of
the real big ones that I could think of off the
top of my head. If you are somebody that is like,
I cannot handle if I see something out of place,
right? Like if they saw a dislocation, like I
can't handle it. My biggest suggestion is to
take a towel and cover it. So they can still
stay stabilized, right? So you need to like splint
or make sure they're not going to move it, but
then cover it. So then you can still be there
for that person and talk to them and they don't
have to see it anymore and see like maybe what
the injury looks like. Because a lot of times
that's the other part is sometimes I try to hide
it. They don't, you know, freak out more or get
really upset. But that. can also help. A lot
of times if someone tells me they heard a pop
or felt heard or felt a pop or a crack, I usually
know then either maybe a ligament has completely
torn or maybe like maybe their patella like subluxed
or dislocated or, you know, something else happened
in the body. So usually that's kind of a sign
that something a little bit more severe may or
may not have happened. And just asking those
good questions and then assessing them, you know,
where is the pain? Usually, you know, it's there.
A lot of times the coaches are with them, I would
think if they. had some type of, you know, mechanism
of injury, but, and just trying to keep them
calm as, you know, as much as they can, but can
they bear weight? Can they move the limb? And
like I said, always ask about numbness and tingling,
because if it's nerve related, you definitely
want to make sure that you send right away. And
then, like we said, soft tissue wise, that's
usually a little bit easier to handle. Soft tissue
and like wound care, a first aid kit would still
be great. But honestly, the ice, the compression,
having those ACE wraps, trying to stop the swelling,
you know, elevate the body part if you can above
the heart. And then, you know, just managing
the pain and swelling and then trying to see,
you know, if someone can't, you know, if say
it was an ankle and they did something to it
and then you couldn't take more than a few steps
or bear weight on it, you know, even within like
30 minutes, like you probably should go get an
x -ray, right? That's not normal. And so there's
certain ways. A lot of times there's those like
Ottawa, I like those Ottawa ankle rules and C
-spine rules. They came out of Canada and they
have these really helpful techniques that tell
you like, okay, if your patient can. do you know
x y and z or have pain in certain areas this
is when you should get an x -ray and this is
when you know you can wait and those are always
kind of helpful to to look at to use but especially
if they can't bear weight or not feel the same
sensation but bilaterally always make sure you
also like look at both sides like I said because
sometimes people may have strange actually normal
deformities or odd things on their body but it's
it's that's their regular and I don't know like
how many strength and conditioning specialists
like how you know to truly spot right if you're
going heavy you're supposed to have one on like
either side like do they usually have that can
they use other athletes like you know i don't
know how often everyone has that luxury i guess
at times when they're they're training people
but it's definitely one of the things you can
do it's if you don't have spotters then you can
use safe quadrups and around the barriers where
you can't go lower than the the barrier so that's
the way you can modify your training to not do
heavy single when you have no one to spot you
You can't do it safe. In weightlifting gyms,
I think the athletes are taught or they have
to learn how to drop the weight safely. Because
in snatch and clean and jerk, you can't have
spotters as easily as for back squat, for example.
So you have to learn how to remove yourself from
under the bar, wherever it is it might be. So
that's a skill you may consider too. Or have
spotters. or not go as heavy as your maximum.
Now that you say that, that's right. We had our
squat rack and thank God we at least had the
bottom barriers in and this kid was squatting,
one of my students, and I just look over and
I'm like, oh my gosh, he pinned under that, but
thank God I caught it because he just collapsed
under that and I was like, oh, whatever. They
were all in the classroom trying to learn and
I used to have a squat rack in there. But yes,
thank God for those. Yeah, they are good. Useful.
All right. We have two more questions to finish.
So the first one is, what is your favorite lift?
I am just the standard back squat girl. I love
it. I tried the front squat. I've tried other
things. I'm just, that's my favorite. Now, where
people can find you if they want to follow, maybe
get in touch or see what you're up to, how you
work and so on. Yeah. So probably the easiest
way to find me is on LinkedIn. I'm just under
Kathy Williams as my name. I'm listed as the
Director of Clinical Education, Head Athletic
Trainer for Pinecrest Physical Therapy here in
Miami, Florida. Might be the easiest. Or if someone
wanted to reach out, my email is kpomicht at
gmail .com. Awesome. Thank you so much for today.
Thank you. Thanks for having me.