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  • Sports Medicine: First Aid kit for Coaches & Non-Medical Personnel

    Every team or individual participating in an athletic event or competition should have access to a first aid kit. In general, commercial kits do not cover the specific needs of athletes and are relatively expensive compared to custom-made kits.

    A regular medical bag can be used, but a backpack with dividers or a small soft-sided case with a zip open top might be better alternatives. These latter two are more easily carried and washable when they become dirty.

    The following items make up a basic first aid kit for almost any sport. Quantities are not given because of variations of team sizes and needs.

    Alcohol/alcohol preps

    Arm sling (triangular bandage is fine)

    Band-Aids, assorted sizes and shapes

    Bandage scissors

    Betadine or Hibiclens scrub

    Cotton swabs

    Elastic tape, 2”

    Elastic wraps, 2”, 4”, 6”

    Eye patch

    Eye wash

    Foam padding, assorted thickness

    Hydrogen peroxide

    Latex gloves

    Moleskin

    Nail clippers

    Neosporin®/Bacitracin® ointment

    Non-stick wound dressing (telfa) pads, 3X4

    Plastic bags for ice/instant ice packs

    Powder

    Safety pins

    Several quarters for emergency phone calls

    Sterile gauze pads, 3X3 or 4X4

    Steri-strips, 1/8” to 3”

    Sunscreen

    Tape adherent

    Tape remover

    Tape underwrap

    Thermometer

    Tongue blades

    Tweezers

    Vaseline or skin lube

    White tape, 1”, 1 ½ “

    It is preferable to use regular ice instead of instant ice packs for injuries. While the instant ice packs are certainly more convenient, they can be troublesome if they break. The chemicals in the ice packs burn if they come in contact with the skin.

    Every kit should have a card with emergency telephone numbers listed. If the team has some athletes who are minors, this card should include the phone numbers where parents or guardians can be reached. If there is no phone near the practice or competition site, you may consider getting a cellular phone.

    For basic medications, the following are legal USOC drug testing standards when used with only the listed ingredients:

                                        Antacids        Acetaminophen                   Aspirin                       Ibuprofen

    Minors should not be given medications without parental consent. Therefore kits for youth sports should not contain any medications.

     

    Cryotherapy

    Cryotherapy is the use of cold for therapeutic treatment of injuries. It is the appropriate initial treatment for virtually all musculoskeletal injuries. Cryotherapy helps decrease pain and muscle spasm, produces numbness, and decreases inflammation.

    WHAT HAPPENS WHEN THE BODY IS INJURED?

    When there is an injury to the musculoskeletal system, the inflammatory process is initiated. Inflammation is the body’s method of protecting and localizing the damaged area. It has primary and secondary phases.

    With trauma, damage occurs to cells in the injured area. The primary phase of inflammation involves cell death, hemorrhage (bleeding), and hematoma (pooling of blood). The secondary phase begins as damaged cells die and release enzymes called histamines. Histamines increase capillary permeability, which allows fluids to leak through capillary walls. So, not only are damaged blood vessels leaking blood, but also non-injured vessels leak plasma, proteins, colloids, and water into the injured area. Both processes produce swelling or edema.

    SIGNS OF SWELLING/EDEMA

    • Increased size when compared to uninjured body part
    • Loss of normal contour
    • Increased tissue temperature at injury site
    • Pain
    • Redness
    • Muscle splinting (spasm)
    • Loss of function/restricted range of motion

     

    USING CRYOTHERAPY

    Different methods of applying cryotherapy include ice packs, ice massage, cold baths and cold pressure wraps. The preferred method depends upon the body area and type of injury. A standard guide for treatment length for ice packs, cold baths, and cold pressure wraps is fifteen to twenty minutes, three to four times daily. (Artificial chemical ice packs can cause frostbite if left in place too long or if they are wrapped on the injury.) Ice massage is generally performed for five to ten minutes, three to four times per day.

    Cryotherapy is the appropriate initial treatment for any musculoskeletal injury. For acute injuries, use ice packs, cold baths, or cold pressure wraps for a minimum of fifteen to twenty minutes. The procedure should be repeated several times daily during the first 48-72 hours following an injury. After this time, cryotherapy can be continued, especially if the athlete is getting better. Treatment can change to heat after the first 48-72 hours following an injury or when the athlete stops making progress with cryotherapy.

    When cryotherapy is first applied, the athlete will feel intense cold, which should diminish in intensity during the first five minutes of treatment. It should be replaced by a feeling of numbness.

    An athlete may develop a local allergic reaction to cold. An allergic reaction appears in the area where the cryotherapy was applied and is identified by raised, red, and warm areas similar to hives. If an allergic reaction results, cryotherapy should be discontinued immediately. Any further cold applications should be insulated from the skin by moist towels.

    EFFECTS OF CRYOTHERAPY

    • Decreases the size of blood vessels, which reduces blood flow to the area (vasoconstriction).
    • Decreases cellular metabolic rate causing reduced use of oxygen and less cell death
    • Decreases tissue temperature
    • Decreases pain (analgesia)
    • Decreases muscle spasm
    • Decreases inflammation

     

    Blisters

    Blisters occur when motion causes layers of skin to separate and accumulate fluid. Fluid may be clear (serous) or dark (blood) depending upon the depth of the blister. Deep blisters tend to be filled with bloody fluid because they are closer to blood vessels.

    Soft skin, whether from non-use or sweat, is more prone to blisters than tough skin. Blisters are usually more of a problem early in the season when the athletes are unaccustomed to heavy work. Obviously, prevention is the key.

    The following may help reduce the chance of blisters:

    1. - Increase work load gradually. It is helpful to use required equipment with a proper fit during pre-season training.
    2. - Break in new shoes gradually and allow them to dry between training sessions.
    3. - Wear the correct shoe size. Don’t assume that you can wear the same shoe that you wore last season. Shoe designs change and the same brand and model could have a different fit.
    4. - Wear the proper shoe. For example, running shoes should not be worn for court sports. An improper shoe will not only rub, but it can also increase the chance of other injuries.
    5. - Wear clean tube socks. Two thin pairs are better than one thick one. The socks then rub on each other rather than on your foot. Acrylic blend socks may also help prevent blisters better than other materials.
    6. - Powder your feet to decrease friction between your foot and the sock.
    7. - Cover any known problem spots with tape or moleskin.

     

    If you get a blister, proper treatment will keep the blister from becoming infected and permit you to return to activity without discomfort.

     

    IF THE BLISTER HAS NOT BROKEN

    1.    Clean the area with surgical soap and put pressure on the blister with a bandage or non-sticking dressing. This helps the body re-absorb the fluid in the blister.

    2.    Use a donut pad to take the pressure off the blister. Try to keep the skin over the blister from tearing.

    3.    If the blister is large, it may need to be drained. Clean the skin again with surgical soap and use a sterile needle or scalpel to make a small hole for the liquid to drain out.

    <--- DO NOT DRAIN THE BLISTER OF ANOTHER PERSON WITHOUT WEARING LATEX GLOVES! SINCE YOU WILL BE IN CONTACT WITH BROKEN SKIN AND BODY FLUIDS, YOU COULD BE EXPOSED TO INFECTIOUS DISEASES SUCH AS HEPATITIS B OR HIV -->

    4.    Clean the area again with surgical soap.

    5.    Use a donut pad with antibiotic ointment. (Neosporin®, Bacitracin®, Polysporin®)

    6.    Monitor the blister for any signs of infection: redness, increased tenderness, increased pain, and increased temperature.

    7.    If there are any signs of infection, contact an athletic trainer or physician immediately.

     

    IF THE BLISTER HAS BROKEN

    1.    Clean the area with surgical soap. If you are working on another person, wear latex gloves since you will be in contact with broken skin and body fluids.

    2.    Apply an antibiotic ointment. (Neosporin®, Bacitracin® Polysporin®)

    3.    Use a donut pad to reduce pressure and cover with a dressing.

    4.    Monitor the blister daily for any signs of infection: redness, increased tenderness, increased pain, and increased temperature.

    5.    If there are any signs of infection, contact an athletic trainer or physician immediately.

     

    Callus Care

    Calluses result from constant, gradual pressure or friction to the skin. The skin responds by becoming thicker. Calluses serve as a protective mechanism and need only be addressed if they become excessively large, uncomfortable, cracked, ripped, or blistered underneath.

    Calluses may appear anywhere on the body. They are more common on the hands and feet because these body parts are exposed to the most stress. However, sport-specific equipment may cause calluses elsewhere. For example, figure skaters and skiers often develop calluses on their ankles.

    Calluses also develop from equipment that doesn’t fit properly. To assure a proper fit, a complete change of equipment may be necessary. In many instances, auxiliary pads, wedges, or donuts can be used to reduce friction from equipment.

    Not all athletes will develop calluses. Those who do should be aware of how to take care of them. Following is a list of suggestions on callus care:

    1.    Keep calluses filed down and smooth with a callus file. Some athletes prefer to do this after a shower when calluses are soft. This should be a daily or every-other-day ritual.

    2.    Keep calluses soft with hand lotion during the day and petroleum jelly at night. Other products that may be helpful include Bag Balm® and Corona Ointment®.

    3.    If calluses are large or cracking, try an intensive program of sanding and softening. If this does not help, consult an athletic trainer or physician.

    4.    If a blister develops underneath a callus, sand the callus and protect the callus/blister with a donut pad to reduce pressure. DO NOT ATTEMPT TO DRAIN THE BLISTER. The blister can become infected very easily. If you notice redness, increased temperature, or increased pain around the blister, consult an athletic trainer or physician.

    PREVENTION IS THE KEY TO CALLUS CARE. PROPER FITTING EQUIPMENT, DAILY SANDING AND MOISTURIZING OF CALLUSES SHOULD PREVENT MOST PROBLEMS.

     

    First Aid – Sprains and Strains

    The terms sprain and strain are often mis-used when describing injuries to the musculoskeletal system – the system of muscles and bones of the human body.

    A SPRAIN is an injury to a ligament tissue connecting one bone to the same or another bone. Ligaments generally cross a joint, the intersection of two different bones. Therefore, a joint dislocation is a type of sprain.

    A STRAIN is an injury to muscle or tendon that connects muscle to bone. Common strains include those to the quadriceps, muscles on the front of the thigh, or hamstrings, muscles on the back of the thigh.

    The terms sprain and strain are not synonymous. A muscle cannot be sprained and, conversely, a ligament cannot be strained.

    Both types of injuries are ranked by degree.

    A first-degree injury means a structure was stretched but no fibers torn. The injured tissue is painful but functional and stable.

    A second-degree injury indicates structural damage including some fiber tearing. The injured structure is partially intact. An evaluation of the number of damaged fibers may vary from 1-2% up to 99%. The injured structure is not totally functional or stable due to this tearing.

    A third degree injury indicates the tissue is torn in half. This is obviously a very serious injury with accompanying instability and loss of function.

     

    TREATMENT

    Initial treatment for all strains and sprains of any degree is R-I-C-E: Rest, Ice, Compression and Elevation. This first aid helps reduce swelling and pain associated with the injury. It also helps prevent additional damage to nearby cells from the pressure of swelling. If a lower extremity sprain or strain is painful when weighted, the athlete should not walk until the injury is evaluated by a medical professional. If an upper extremity sprain or strain is painful during movement, the arm should be immobilized in a sling until evaluated by a medial professional.

    IF THERE IS ANY DEFORMITY OF THE INJURED BODY PART (compared with opposite side) OR ANY PAIN OUT OF PROPORTION TO THE APPARENT INJURY, THE ATHLETE SHOULD SEEK MEDICAL ATTENTION IMMEDIATELY.

    RICE should be continued for an absolute minimum of 48-72 hours following any acute injury. Ice should be kept in place for 15-20 minutes and repeated every 2-3 hours. Ice should not be wrapped on the injured area too tightly due to the possibility of frostbite. Do not ever wrap a chemical cold pack, either instant or reusable, on an injury. The pack is too cold and will cause frostbite. If the athlete is feeling better with the RICE treatments, they can certainly be continued past the 72-hour phase of injury.

    If icing results in extreme numbness or any tingling, it should be removed immediately. Never use heat for initial treatment or an acute injury as it may produce additional swelling and damage that will complicate the healing process.

     

    PREVENTION

    Many sprains and strains are preventable. Warm-up thoroughly before any activity. Include stretching, but remember stretching by itself is not a sufficient warm-up. An adequate warm-up combines stretching with large muscle activity such as running, cycling, drills, etc., intense enough to cause sweating. Sweating indicates your internal body temperature is above resting levels, and the body is ready for activity.

    Get in shape to play your sport; do not use your sport to get in shape. Many injuries occur in early season practices and games because athletes are not in condition, aerobically or anaerobically. Consequently, they become fatigued, cannot react as quickly to situations, and may be injured more easily.

    In addition, lack of strength or flexibility contributes to possible injury. Strength permits athletes to control their bodies. Flexibility permits extra motion around a joint allowing it to absorb additional energy before being injured.

    Inspect your personal equipment. Shoes wear out reducing their support. Protective equipment wears reducing its protective ability. Loose clothing may be comfortable for you but a hazard to another athlete’s hands and fingers.

    Inspect the area where you are practicing or competing. Are there any obstacles such as holes, bushes or trees in the immediate area? Are there any slippery spots due to water or mud?

    Athletes with prior injuries should not practice or compete until fully rehabilitated and released by their physician. Lack of strength, flexibility, or conditioning, either aerobic or anaerobic, will predispose an athlete to injury. Coaches should not permit any athlete returning from an injury to jump into a full practice the first day back. Individual and team sport skills must be gradually re-introduced until the athlete can perform at a level with the rest of the team. When in doubt, keep athletes out!

     

    First Aid – Contusions

    A contusion, or bruise, is caused by an object striking the body with enough force to crush the tissues beneath the skin.  The greater the force of the blow, the greater the tissue damage. If the blow is over a bony area, the bone also may be contused.

    A contusion results in varying amounts of swelling and disability, directly related to the force of the blow and its location. A contusion damages tissue cells and capillaries. This results in blood and waste products leaking into the area around the cells. These blood and waste products gradually travel to the skin, producing the characteristic black and blue mark of a contusion. Because of gravity, the “black and blue mark” may appear below the actual contusion.

    When there is a lot of damage, large amounts of blood and waste products are produced. They may collect in a pool instead of dispersing throughout the tissue. This is a hematoma. Hematomas commonly form following a severe contusion to the thigh. Blood loss can be severe and may result in shock. If you suspect a hemoatoma, remove the athlete from al activity immediately.

    As mentioned above, bone can also be contused. When this happens, swelling occurs between the covering of the bone, the periosteum, and the bone itself. Due to limited circulation, swelling reduces very slowly, and the contusion remains very tender for an extended period of time.

     

    TREATMENT

    Treatment for contusions is the same as for other injuries and can be remembered by the acronym RICE: rest, ice, compression and elevation. The athlete should be removed from activity, and the injured area cooled, compressed, and elevated as soon as possible to minimize damage to uninjured tissues. Do not permit the athlete to try to “run off” a contusion as the muscle activity may increase the bleeding in the contused area.

    Athletes with minor contusions can often return to activity very quickly. Serious contusions may impair an athlete for months. An accurate assessment of the seriousness of a contusion is beyond the scope of a non-medical person. However, if the athlete can use the injured body part with full strength and can move it through a full range of motion with little or no discomfort, it is probably safe to return. When in doubt, do not permit an athlete to return to play. This type of judgement error may complicate a simple injury.

     

    PROTECTION

    After a contusion, the injured area must be protected from further trauma. The use of additional pads or pads with a different design can provide this protection. For example, an athlete who repeatedly falls should wear kneepads. Football players may wear additional or larger pads. Sometimes, custom pads are made to protect a contused area, but this should be done by a medical professional. Not only do custom-made pads protect the injured athlete, but they are also designed to pose no threat to other athletes.

    Obviously, the best treatment is prevention of the contusion in the first place. Sports-specific protective equipment should be approximately sized and fitted to every athlete. Protective equipment that is either too small or too large is not effective.

    It is the responsibility of the coach to ensure all athletes wear required protective equipment that fits properly and is in good condition. Equipment left in the locker does not do any good. Also, the fit and condition of protective equipment should be checked regularly. Improperly sized or worn out equipment provides little or no protection and gives athletes a false sense of security.

     

    First Aid – Abrasions and Lacerations

    Common athletic injuries to the skin include abrasions (road rash, strawberries, floor burns) and lacerations (cuts). While usually not serious, both require prompt attention to prevent infection and reduce scarring.

    WHEN TREATING ANY OPEN WOUND, BE AWARE THERE IS A POSSIBILITY FOR TRANSMISSION OF INFECTIOUS DISEASES SUCH AS HEPATITIS B AND HIV --> ALWAYS WEAR LATEX GLOVES.

     

    ABRASIONS

    An abrasion is the removal of the top layer or layers of skin by the friction of anything rubbing directly on the skin. Usually, an abrasion oozes blood or fluid from injured capillaries (small blood vessels). Because superficial nerve endings in the skin are exposed, abrasions tend to be very uncomfortable.

    As soon as possible, clean the abrasion with clear water and soap, wearing latex gloves if you are treating anyone other than yourself. A surgical soap, Betadine® or Hibiclens®, is preferable, but any mild soap without fragrance, such as Ivory® dishwashing soap, can be used in a pinch. Try to remove all foreign material from the wound using a washcloth or sterile gauze pads. Do not use a scrub brush as it is too harsh. If you cannot remove all imbedded material, seek additional medical care. Remaining material may cause infection or tattooing of the skin.

    Generally, abrasions should be covered with an anti-bacterial ointment such as Bacitracin®, Polysporin® or Neosporin® and any non-stick dressing. Change this dressing several times a day until healing is complete. When an abrasion is over a joint or a moving body part, keep the abrasion moist until healed. Otherwise, scabs may be torn loose during the movement and hinder the healing process

     
     

    IF AT ANY TIME THE ABRASION SHOWS SIGNS OF INFECTION SUCH AS REDNESS, INCREASED TENDERNESS, INCREASED PAIN, OR INCREASED TEMPERATURE, SEEK MEDICAL ATTENTION IMMEDIATELY.

     

     

     

    LACERATIONS

    A laceration is a wound that penetrates all layers of the skin and may also continue below the skin into subcutaneous fat, muscle, blood vessels, and nerves. A laceration will display a gap in the skin that can be opened or closed when pressure is applied along the sides of the wound.

    Lacerations may also damage blood vessels. If a laceration is bleeding profusely, apply direct pressure, remembering to wear latex gloves if treating someone other than yourself. Use whatever is available to control the bleeding but a sterile gauze pad is preferred. Apply additional gauze as needed. Do not remove the previous gauze pads as they become saturated with blood. If a laceration is spurting bright red blood, an artery may have been damaged. If so get immediate medical attention immediately. Do not apply a tourniquet.

    Most lacerations need suturing (stitches) by a physician. This promotes healing and reduces scarring. Follow your physician’s instructions to care for a sutured laceration. The length of time stitches stay in depends upon the location of the laceration, its length and/or depth, and associated tissue damage. AGAIN, IF THERE ARE ANY SIGNS OF INFECTION, SEEK MEDICAL ATTENTION IMMEDIATELY.

    IF YOU ARE AT ALL UNSURE OF HOW TO TREAT AN ABRASION OR LACERATION, SEEK PROFESSIONAL MEDICAL ADVICE AS SOON AS POSSIBLE. LACK OF ATTENTION MAY RESULT IN A WORSENED CONDITION.

     

    Flexibility

    Flexibility is the range of motion of a joint. It is somewhat genetically determined but can be increased and refined through proper stretching exercises. The terms flexibility and stretching are often used synonymously. However, an athlete can be flexible without stretching and conversely, an athlete can stretch without gaining flexibility.

    Every sport has its own flexibility requirements. Some sports, such as gymnastics and figure skating, require extensive flexibility for successful participation. Other sports require joint specific flexibility. For example, swimmers need shoulder flexibility and track hurdlers need hip flexibility.

    Some athletes are successful in spite of flexibility problems. However, adequate flexibility permits better technique – which should lead to better performance.

    In the past, medical practitioners tested athletes and classified them as flexible or non-flexible. Theory followed that flexible athletes were more prone to ligament injuries since their joints were hypermobile or loose. Flexible athletes were given strengthening programs so muscles could protect loose joints. Non-flexible athletes were more prone to muscle injuries since their muscles absorbed forces not dissipated by joint range of motion. These athletes were given flexibility programs to increase joint range of motion.

    Later studies did not support this theory. Additionally, more sensitive tests found athletes could have a flexible upper body and an inflexible lower body or vice versa. An athlete may be flexible in some joints but not in others.

     

    STRUCTURES LIMITING FLEXIBILTY

    Flexibility is determined by the bony construction of a joint and the soft tissues surrounding it. Soft tissues include ligaments, joint capsules, tendons and muscles crossing the joint, subcutaneous fat, and skin overlying the joint.

    Certain joints permit more motion because of their construction. Ball and socket joints, like the shoulder and hip, permit the most motion. Hinge joints, such as the fingers, permit motion only in one direction. Some joints, like the radio-ulnar joint at the elbow, pivot one bone on another. The small joints between the spinal vertebrae permit small sliding-type motions individually, though several joints may combine to produce larger motions.

    The joint capsule and ligaments support the joint and permit motion determined by a joint’s anatomical construction and oppose any abnormal motion. If the joint capsule or ligaments are injured, resulting scar tissue may limit motion. Conversely, a torn joint capsule or ligament may permit too much motion or motion in inappropriate directions.

    Tendons and muscles crossing a joint also limit its range of motion. If the muscles and tendons are tight, joint motion is limited. This tightness is alleviated through aggressive stretching.

    If the skin over a joint has been injured, it may lose its elastic properties and not stretch. For example, a scar from a burn may not stretch as the joint moves, limiting motion.

    If a person is overweight (not usually a problem with athletes) motion may be limited by two body parts running into each other. For example, hip motion may be limited by a large abdomen hitting the thighs rather than hamstring muscle tightness.

     

    TYPES OF STRETCHING

    Three types of stretching are commonly used.

    1.    Ballistic stretching uses a bounding motion to increase joint range of motion. While an argument may be made that sports are ballistic in nature and stretching should be similar for specificity of training, ballistic stretching causes a protective muscular reflex, the stretch reflex, to fire and shorten the muscle while it is being stretched. Since the athlete is trying to lengthen the muscle while the stretch reflex is contracting it, there is an increased chance of injury while stretching ballistically.

    2.    Static stretching applies a slow, controlled lengthening force to the muscle. A muscle is gradually put under tension until a comfortable stretching sensation is felt in the muscle. This position is held for 30-60 seconds. As the stretching sensation diminishes, tension is increased to re-establish the original sensation. The stretch and hold pattern is repeated 1-3 times for maximum results.

    3.    Contract-relax stretching uses neuromuscular reflexes to stretch more effectively. A muscle is first contracted isometrically, without joint motion, for 3-5 seconds then stretched statically for 15-30 seconds. This contract-relax-stretch pattern is repeated 3-5 times to achieve maximum results. This stretching usually requires a partner to apply the resistance and then stretch.

    These three types of stretching all increase joint range of motion. Some are easier to perform than others. Some take more time. Some have a lesser risk of injury. All must be done in a controlled manner. If a stretching sensation is felt anywhere other than in a muscle or tendon, the position is wrong and needs to be re-evaluated. Stretching should increase the length of muscles and tendons not stress joints or ligaments.

     

  • Gameday Nutrition - Key #1

    HYDRATION

    I'm sure you've all seen Man Vs. Wild, where Bear Grylls defies death in every region of the earth.  That guy is world class lunatic.  I have every episode Tivoed.  Part of me wants to see the Nascar crash, where he battles it out with a carnivorous bear in some deep backcountry wilderness but that's another story.  While shooting an episode in the Australian outback he stated an amazing fact.  He said that "humans can only survive a few hours in that heat without water".  In this episode Bear goes as far as drinking his own pee for hydration.  (Please don't try this at home.)  But the fact of the matter is you can live around 5 weeks without food but without water a human can last only 5 days in normal circumstances.  On average, the human body is about 60% water.  Our brains are 70% water, our blood is 80% water and our lungs contain about 85% water. (It's hard to believe, but Dicky Dunn wrote it so it must be true.)  Only oxygen is more vital to sustaining life.  Throughout the day we lose water through regular perspiration, going to the bathroom, breathing, and of course perspiration by exercising.  Hydration is by far the most important factor in your game preparation. If you're not properly hydrated your athletic performance will suffer. Even minor dehydration impairs contractile strength in the muscles, speed, concentration, coordination, reaction time, and stamina.  Remember this, the human thirst mechanism is faulty, so waiting until you are thirsty to drink is TOO LATE. Hydration must be a priority for peak performance. 

     

    TIPS:

    • As a guideline try to drink 1/2oz -1oz per pound/per day.
    • 190 lbs = at least 95 oz fluid per day (2.75 - 5 liters per day).
    • Weigh-in before and after practices, training, and games.  There shouldn't be a drastic change either in weight loss or gain. (This is especially true for goalies.  I remember hearing that Glen Healy lost 14 lbs in water weight during a game in the 1993 playoffs.  Not only will this effect performance during the present game but also any future games.)
    • Given the nature of a hockey game with 2 intermissions, athletes should consume electrolytes to enhance absorption and prevent cramping.  Choose a carb/electrolyte drink for 16 oz- of your replacement fluids perhaps during an intermission, but then the rest of your fluid needs should be met with water.  You don't need to replace all your fluids on the ice.
    • Carb/electrolyte drinks- the concern with a number of the electrolyte drinks on the market is they are a combination of non-purified water, sucrose, glucose, fructose (sugars manufactured by factories from corn) and artificial colors with electrolytes (potassium and sodium) thrown in. More research needs to be done on the nutritional value of them. (With the explosion of new drinks onto the market including "energy drinks", you can drop a lot of money with little to no effect.  (Might as well be drinking tap water) Some feel that they do more harm than good. You can't go wrong consuming natural mineral or spring water, fresh vegetable juice, or diluted fruit juices.  But good 'ole water is still the best bet. Nothing replaces pure water for hydration.  Try to get the other nutrients you need from your meals, not from marketed sugar drinks.

     

    Pre-event

    Immediately prior to event

    During event

    Immediately Post event

    Post event recovery

    1-2 hours

    0-10 minutes

    Drink early (6-8 oz) & at regular intervals (10-15 min.) when possible

     

    Take in carb/protein drink (2:1 or 3:1 ratio) & banana

    Re-hydrate: 20 oz per pound lost during competition. Tomato juice is good choice for part of this replacement

    17-20 oz

    7-10 oz

     

    EAS -Myoplex

     

    Water/shake

    Water/electrolytes

     

    Nutrilite  - meal replacement

     

     

     

     

    Make your own: see recipes

     

     

    Game Day Hot Tip: Monitor your hydrations level by the color of your urine.  The clearer the color, the better ... if you have bright yellow urine or it has a strong smell, start pumping the fluids.

     

  • Player Development: Following the Research

    Hockey has fallen victim to the “quick fix” and “instant results” mentality that seems to be increasingly dominating our culture. The new norm is parents spending countless amounts of money for private lessons and private trainers to accelerate the player development process, while overlooking the actual science behind long-term athletic development. Parental expectations for success continue to rise while the overall level of patience falls, and as a result adults are forgetting that our hockey players are developing children. Research and practice has proven that athletic development is a long-term process, a marathon not a sprint. It requires movement away from early specialization and constant adult directives towards an active multi sport lifestyle guided by self-drive and intrinsic motivation.

     

    MULTI-SPORT LIFESTYLE

    Numerous studies have reveled that children who specialize in sports at young ages (meaning roughly 14 and younger) suffer from higher rates of adult inactivity, more overuse injuries, and early burnout.  No study has yet to produce supporting evidence that specializing early in hockey is beneficial for player development.  Conversely, the benefits of multi-sport participation are proven to include (among others) improvement in skills and ability, increased motivation, better decision-making, stronger pattern recognition skills, and higher levels of creativity.

    The opposite of the early specialization is the multi-sport lifestyle.  Creating a multi-sport lifestyle takes planning and a commitment to become active away from organized sports.  During a week, we have 168 hours to fill. If a child spends 8-10 hours per night for sleep, 30-40 hours per week for school, and time to eat 5-7 meals per day, the time spent on health related fitness should be 20 hours per week. For the younger ages, less than half of the 20 hours per week should be used for team/hockey club specific activities.

    • 6U – 10U: 5 – 8 hours run by club, 12 – 15 multisport on their own

    • 10U – 14U: 8 – 10 hours run by club, 10 – 12 multisport on their own

    • 15U – 19U: 10 – 15 hours run by club, 5 – 10 hours multisport on their own

    The multisport activities during a sport season should include any type of non-structured sport. This includes skiing, biking, hiking, walking, running, playing tag, and much more. To truly maximize long-term development, the multisport experience away from the hockey club should only be self-motivated sport experiences. It’s tough to justify at young ages that supplemental private training and extra practice time run by adults is self-motivating activity. Like a properly run off-ice training program, engaging in other sports that use different muscle groups enhances agility, balance and coordination, and will actually accelerate the player development process.

    SELF-DRIVE

    Research has always exposed the benefits of inner-motivation and self drive (intrinsic motivation) as the vehicle to maximize player development. As opposed to being motivated through rewards and avoiding punishment (extrinsic motivation), athletes experience better long-term development success when the desire is to become competent and self-determining. To get the most out of practices and competition, players must learn how to best motivate themselves to train, perform, compete, and manage adversity. For most intrinsically motivated players, their focus is on skill development and continuous improvement, not on contest outcomes or negative consequences. They are usually self-starters that experience consistency in practices and games. Taking ownership of one’s effort and developing self-drive is critical to learning and harnessing intrinsic motivation.

    The coaching culture in Finland places a great emphasis on an athlete’s self drive and their perceptions of ownership, and the results are proven. By giving athletes the ability to be creative and learn to make decisions without relying on over-reaching adult directives, they better learn skills and conceptual awareness. During practices coaches should design drills with a purpose that keeps the players moving and solving problems. The days of spending precious practice time on the ice with young teams walking through a robotic breakout, defensive zone coverage, or power plays should be left in the past.  Although spending time prepping for competition may provide some short-term competitive success, this time has shown to hinder long-term developmental success.  Research has proven that creating practices that encourage creativity and fun has a much stronger impact on long-term development compared to spending time on the ice teaching the game robotically with rote X’s and O’s training.

  • Gameday Nutrition - Key #2

    CARBOHYDRATES

    I was always told to "Carb" up the night before and during pre-game meal. Seemed good to me. I could crush all the French Fry's, Coke, and chocolate bars I wanted in the name of creating an energy burst out on the ice. Not good. Lead me straight to the fat bike for 45 minutes after every practice in Juniors. Carbs can be complicated to figure out with the glycemic index, fiber, and cooking choices available. So what carbs do you want to eat and when? Here's a little excerpt from the book 7 Pre-Game Habits of Pro Hockey Players.

    Behind hydration, complex carbohydrates are next in critical importance for athletic performance.  These are found only in products made from plants. If you've ever been on a hockey bus throughout Canada or the Midwestern US, then you've seen the fields of wheat, barley, beans, and others that go into producing complex carbs.   Bread, pasta, cereals, grains, fruits, and vegetables contain complex carbohydrates rich in important micronutrients of vitamins, minerals and trace elements. In terms of athletic performance, carbs provide glucose for energy before and during performance. They also provide glucose for glycogen synthesis or energy storage for any future activity.

    TIPS: 

    • Athletes should strive to get 55-65% of their calories from carbs (20-25 cal per pound).
    •  The best foods to choose are the ones least processed. In other words the fewest steps foods are removed from nature the better. Organic is a far better choice when available and the budget allows.  
    • Remember: Refining and processing grains reduces nutrient values and raises their glycemic index.
    • Look for 3g of fiber per serving or more on the label. If it DOESN'T have it, put it back and find something that does.


    Digestion of Foods

    Liquids as well as some foods get absorbed right away. Other foods are worked over by your intestinal track for hours before getting digested. If you want to feel light on your feet then eat the foods on the left side of the timeline below. If you want to feel sluggish and lethargic like you do after a Thanksgiving meal then eat the foods on the right side of the below timeline. Study this timeline and begin to develop pre-game meals and snack plans for game day.    


    Digestion time line:

         Shortest                                                          Longest              

    <-------------------------------------------------------------------------->

    Liquid             fruits          vegetables        starches       fats

     

    Tips:

    • The closer you get to game time means you eat items on the timeline's left side. These foods and liquids require the shortest amount of time needed for absorption through the digestive system and excretion of excess waste.
    • It takes 1-4 hours for peristalsis to push food out of the stomach and into the first part of the small intestine. The foods on the right side of the timeline should be eaten 3-5 hours before the puck drops so enough time can elapse.

               

    Game Day Hot Tip:  Get back to grains, vegetables, and some fruit as your main source of energy versus the traditional steak and mounds of chicken pre-game meal. There's more protein in some of the grains, fruits, and vegetables than you realize.

  • How to Choose the Best Hockey Camp for Your Player

    When bombarded with information about off-season hockey camps, it’s easy to feel panic and think, “If I don’t get organized, get him signed up—and pay!—for these camps today, I’m holding him back!” Dreams of the NHL, the college scholarship or maybe just an A team fizzle before your eyes as you contemplate putting your tax refund toward more hockey. How do you evaluate all the information and decide what’s right for your player? We asked Angelo Ricci, a skills and stickhandling coach with more than 20 years experience, for help.

    According to Ricci:

    Focus on Fun: When selecting what hockey camp to attend, please consider a camp that promises two things: fun and hockey skills. I think fun is the most important consideration and many parents forget this part. This is a “summer hockey camp,” so please remember that it is summer and it is a camp, so it should fun. If the player is not having fun, the learning part will not reach its maximum potential.

    Fundamentals are Key: This game is all about skating and puck control skills. I encourage you to look for a camp that will teach your player the fundamentals of all skills, offer repetition of puck and skating skills, and improve on their existing skills—plus correct anything that might be wrong with a player’s skills.

    Checking Camp is Crucial: At the PeeWee level, checking skills and body contact drills become very important. It is imperative that players are properly taught how to give and receive checks. It will help their confidence immensely when they transition from Squirts to PeeWees.

    When reviewing camp information, compare the following:

    • Instructors’ qualifications, experience and character as role models
    • Instructor-to-player ratio (6 or 7 kids per coach is good; the important thing is that the coaches who are there interact with the kids)
    • Availability of off-ice training
    • Price (a general guideline is $25-$30 per hour of camp; costs vary by location)
    • Schedule: Are there many choices to work around your busy schedule
    • Camp choices: General or specific skill development
    • Convenience: Can we get there easily, on time?
    • Fun: Is it marketed as fun? Will my kid want to come back next summer?

    Ricci concludes that the best way to find out which camps are beneficial to player development is by word of mouth from other hockey parents. If their kids attended the camp, ask them if they enjoyed it. Ricci also recommends a less structured three-on-three or four-on-four summer league: “It will allow players to develop their skills, be creative and not feel the pressure of negative feedback from a coach if a mistake is made.”

    CampVine Note: Thank you to Angelo Ricci for providing information for this article. Ricci is founder, head instructor and consultant for Ricci Hockey Consulting (www.riccihockey.com). With 20+ years experience as a skills and stickhandling coach, he conducts/oversees more than 40 programs year-round that develop over 1,000 players each year.

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