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News From the Consortium
**REMINDER**

If you have graduated or switched institutions/job titles, please contact Abbey Thomas so she can update your profile on the website.
Announcements
 
We are in the process of updating our website. Please check out our new Clinician Resources page where our clinician members can find valuable resources on promoting long-term joint health. We have also added a new Student Resources page where will we begin putting useful tips for students on everything from statistics to job/post doc searches. As a reminder, the password for our members only content is ATscanstopOA.

Please welcome our new webmaster, Katie Collins, doctoral student at Michigan State University...welcome! 

Please join us for "A Women's Online Round table" on November 1st at 12:30 PM EST. During this round table, we will discuss building a career focused on promoting long-term health and osteoarthritis prevention and treatment with three female leaders in the profession. Dr. Hubbard-Turner, Dr. Lepley and Dr. Albohm have graciously offered their time and expertise to be apart of this event. We want to hear from our members about what questions they may have for our panel. Join the Webinar at: https://msu.zoom.us/j/236212100. Please email Caroline Lisee with questions to include in the discussion.

The Annual Meeting Work Group will be meeting to start planning the 2020 ATOAC Meeting in October.  All members are welcome to send suggestions or ideas for our next meeting to Jennifer Howard at howardjs@appstate.edu

A congratulations goes out to Sarah Ward who has been accepted into a Research Fellowship in New Zealand, called the Division of Health Sciences Postdoctoral Fellowship. She will be based at the University of Otago in New Zealand...congratulations, Sarah

Reminders
Please remember to include the ATOAC logo in your posters or presentations. Logos and a QR code for the ATOAC webpage are available here.

We are looking to continue our clinician interview series and are seeking suggestions of experienced clinicians who would be willing to share their thoughts on the importance of thinking long-term about athlete/patient wellness. If you know of anyone who might be interested, please contact Abbey Thomas.

If anyone is interested in helping to engage more clinicians in the ATOAC please e-mail  Brian Pietrosimone or Abbey Thomas.
 
If you have an EBP talk please notify Abbey Thomas with the name of the talk and the number of EBP CEUs.
 

ATOAC Library
The ATOAC is generating a library of clinician interviews on the importance of thinking long-term about an athlete's health. To date, we have interviewed Mark Laursen, MS, ATC, Clinical Assistant Professor and Director of Athletic Training Services at Boston University and Tom Abdenour, MS, ATC, former athletic trainer for San Diego State University and Golden State Warriors. These two seasoned clinicians have shared their experiences on treating collegiate and professional athletes and provided advice for young clinicians on how to optimize long-term recovery following joint injuries. We want to continue this video series and need recommendations for people to interview. Please send your suggestions to Abbey Thomas.
Become a Founding Member: Donate to the ATOAC!

ATOAC Members Presenting

Multiple ATOAC members will be hopping across the pond to participate in the 2019 International Ankle Symposium (IAS), hosted in Amsterdam!

Poster Presentations

Bain KA, Kosik KB, Gribble PA. Regional Interdependence: A multi-modal Approach to chronic ankle instability examination.

Cain MS, Song K, Blackburn JT, Migel K, Wikstrom EA.  The immediate effects of joint mobilization on ankle musculotendinouos stiffness in individuals with chronic ankle instability.

Migel K, Song K, Wikstrom EA.  Kinematic and kinetic assessment of a double limb squat in chronic ankle instability. 
 
Song, K, Blackburn JT, Cain MS, Migel K, Wikstrom EA.  Associations between plantar flexor musculotendinous stiffness and jump landing stiffness. 
 
Wikstrom EA, Song K.  Generic and psychological patient reported outcome deficits in those with chronic ankle instability.

Free Papers

Kosik KB, Hoch M, Tezanos A, Gribble PA. Prediction of Opioid Use Among Emergency Departments Across the United States for an Ankle Sprain Visit: An Analysis of the National Hospital Ambulatory Medical Care Survey.

Gribble PA, Kosik KB, Johnson N, Terada M. White matter Microstructure and Self-reported Disability and Function in Individuals With and Without Chronic Ankle Instability.

Hoch MC, Heebner N, Quintana C, Bergin R, Han D, Abt J. Neurocognition and Dynamic Postural Control in Collegiate Athletes with a History of Ankle Sprain.

Marshall A, Lam K. Comparison of Clinician Practice Patterns with the International Ankle Consortium Recommendations for the Clinical Assessment of Lateral Ankle Sprain Injuries: A Report from the Athletic Training Practice-Based Research Network.

Lam K, Marshall A. Assessment of Patient-Reported Outcomes at Return to Sport Following Lateral Ankle Sprain Injuries: A Report from the Athletic Training Practice-Based Research Network. 

Needle A, Bruce A, McBride J, Werkhoven H, Howard J. Four weeks of Eccentric Training and Anodal Transcranial Direct Current Stimulation Decreases Disablement in Patients with Chronic Ankle Instability: A Preliminary Investigation. 

Koldenhoven R, Abel M, Saliba S, Hart J, Hertel J. Gait Biomechanics at Three Walking Speeds in Individuals with Chronic Ankle Instability and Ankle Sprain Copers.

Corbett R, Vela L, Saliba S, Harris P, Hertel J. Intercollegiate Athletes' Perceptions of Ankle Sprains. 

Terada M, Uchida M, Suga T, Isaka T. The Gut Microbiota Profile in Individuals with a History of Lateral Ankle Sprain. 

Duong Z, Hiller C, Yan A, McKeon P, Pourkazemi F. The Foot Lift Test: A Validity Study. 

Simon J, Yom J, Grooms D. Single-Leg Hop Performance is a Predictor of Patient-Reported Outcomes Following a Lateral Ankle Sprain. 

Symposium Speakers

Gain a Footing for Patients with Chronic Ankle Instability
Hoch, MC. Sensorimotor Deficits of the Foot Associated with Chronic Ankle Instability
McKeon, P. The Foot Core: Implications for Patients with Chronic Ankle Instability

The CAI Rehabilitation Spectrum: A Multifaceted Approach to Improving Patient Outcomes.
Rosen, A. Bringing the real-world to the clinic: the use of functional testing
Turner, T. Increasing Physical Activity Across the Lifespan in CAI Patients

Quantitative Analysis of the Mechanism of Ankle Inversion Sprain Injury
Terada, M. Does Proximal Joint Function Contribute to Ankle Sprain Mechanisms?

Neuromechanical Strategies Adopted by Chronic Ankle Instability Patients: Perspectives on Re-injury
Son JS. Prediction of Recurrent Ankle Sprains Based on Descriptive and Clinical Test data. 

Workshop Hosts

McKeon J, McKeon P. Demystifying the Functional Subtalar Joint through a Better Understanding of its Functional Demands. 

Burcal C, Rosen A. Blinking and Counting: How to Rehabilitate the Brainkle Sprain

Hoch, M, Kosik K. Talocrural Joint Mobilization for Patients with Chronic Ankle Instability. 

Keynote Speakers

Hertel, J. An Updated Model of Chronic Ankle Instability

Wikstrom EA.  Ankle Sprains to OA: Implications for Mitigating Cartilage Degeneration

ATOAC Members in the News

Please let us know about any news coverage or press releases.

ATOAC Members Who Recently Received Funding or Awards

Student Zone
 
Hello STUDENTS of the ATOAC!
 
We are encouraging our student members to get more involved, so please take a moment fill out the survey so we can get you involved and gain insight into how to make your student membership more valuable! We are working with our executive board to get you all involved in the areas you indicated were of interest to you. I will be in contact over the next few weeks to expand on your interest and get you involved in some of our upcoming events and task!   This month we are putting the spotlight on our three student liaisons:
 
Katie Bain
‘The woman behind the newsletter’
  • Katie is a 2nd year PhD student in Rehabilitation Sciences at the University of Kentucky.
  • Her main research interest focuses on how to transition individuals with Chronic Ankle instability (CAI) into Copers, and specifically, what neurophysiological elements influence those mechanisms.
  • Katie is a dual credentialled PT and ATC and hopes to split her time between teaching and research, and potentially be able to still work in the clinic at least 1day/week.
  • You can find Katie swimming, play water polo, going to concerts, and practicing hot yoga
  • Katie would time travel back to Italy during the Renaissance to meet all of her favorite artists.
  • She takes advice from Winston Churchill: “If you’re going through hell…keep going!”
 
Danielle Torp
‘The woman behind the Student Zone and Clinicians Corner’
  • Danielle is a 3rd year PhD student in the Interdisciplinary Biology program at the University of North Carolina at Charlotte and a Teaching Assistant in the Department of Kinesiology
  • Her main research interest is developing rehabilitation strategies to improve neuromechanical and sensorimotor adaptations, long-term joint health, and patient-reported outcomes following ankle sprains.
  • She’s known as Auntie Danie by her nibling, Torpedo by her past teammates, and Blitz by the kids at the YMCA.
  • Danielle enjoys the outdoors- hiking, climbing, camping, and running.
  • “If you want something you've never had, you must be willing to do something you've never done.”
  • Danielle would time travel to when Leonardo da Vinci was painting the Mona Lisa and tell him to make it bigger.
 
 
Caroline Lisee
‘The woman behind social media’
  • Caroline is a PhD Candidate (Currently ABD!!) at Michigan State University.
  • Her research interests are identifying and addressing modifiable risk factors of cumulative loading to promote long term knee joint health and reduce long-term disability in individuals with a history of ACLR.
  • Caroline hopes to continue on to a post-doc to gain more experience and eventually find a tenure-track position at a research-intensive institution.
  • In high school she was called Kat, in college, she was called Carrie, and at MSU she’s referred to as ‘Killer Carol’ because she’s the best 1st base kickballer you'll ever see.
  • She spends her time as a movie/tv critic, cardio-boxing, and playing cribbage.
  • Caroline would time travel to the future- after her dissertation defense.
  • “Empowered women empower women”


We want to hear from you! If you have suggestions on information you would like to see here or updates you feel are important to students of the ATOAC, please e-mail Danielle Torp!!
Clinicians' Corner
 
The clinicians’ corner will feature the previous month’s most-talked-about research article. We ask the authors for a clinical take-home message and ask a clinician to provide feedback on how they can use the research to improve their practice. This month we will feature two articles.

Herzog MM, Mack CD, Dreyer NA, Wikstrom EA, Padua DA, Kocher MS, DiFiori JP, Marshall SW. Ankle Sprains in the National Basketball Association, 2013-2014 Through 2016-2017. The American journal of sports medicine. 2019:036354651986467.
 
Herzog and colleagues collected data regarding ankle sprains in the National Basketball Association and provided the following take-home messages:
  • Based on the past 4 seasons, an NBA player has a 1 in 4 chance of sustaining an ankle sprain each season, and a 1 in 8 chance of sustaining an ankle sprain that results in missing a subsequent game.
  •  A majority of sprains were lateral (80%) and involved a contact mechanism (71%). However, high ankle sprains resulted in more NBA games and days missed due to injury than lateral or medial sprains.
  • Among players with a history of ankle sprain in the past year, the rate of ankle sprain in games was higher compared to those without a history in the past year.
  • More research on basketball-specific injury prevention strategies for reducing the incidence of ankle sprain and integrating injury prevention programs into the management of initial sprains may be beneficial.
 Clinical Opinion
Dr. Quinton Sawyer, the Associate Head Athletic Trainer for the Charlotte Hornets, provides insight into the findings of Herzog and colleagues’ NBA database search. His approach to managing ankle injuries, or any injury among his elite athletes, is an individualized one. He does not like to make generalizations about any injury he treats and notes “anytime an elite athlete has an injury or illness, their performance will likely be affected.” While ankle sprains have a 1 in 8 chance of causing a player to miss a game, Dr. Sawyer views his job as a healthcare provider is “to ensure that their performance can still be effective for them to perform their jobs without additional risk of injury.” Even though contact ankle sprains were highly prevalent in the NBA, these are almost impossible to prevent, yet not every contact mechanism results in an injury. When asked about his prevention strategies for contact injuries, Dr. Sawyers explains “people who have a more robust capacity for movement have been shown to have a higher resiliency to injury.” So, his efforts are focused on protecting patients against unpredictable and unpreventable contact injuries by incorporating movement strategies into everyday practice and training. His goal: “increase the patients’ movement library available to them on the court.” Further, he was not surprised that high ankle sprains caused more missed games among professional athletes and he views these are a completely different injury than a lateral ankle sprain. The differences in injury mechanism and structures involved with high ankle sprains do not surprise Dr. Sawyer that they have different recovery times.
 
According to his individualized treatment philosophies, Dr. Sawyer doesn’t have “hard and fast rules” when designing rehabilitation protocols. Rather, he uses “education and communication to help develop a plan with each patient as a member of the team.” He stated repeatedly the importance of treating the whole body in his elite athletes and the ability of athletes to “withstand the rigors of athletic participation without injuries” is reliant on their ability to “incorporate movements from different body segments” in a unified and coordinated manner.
 
Quinton Sawyer, DAT, ATC
Associated Head Athletic Trainer
Charlotte Hornets
 
 
Our second featured article this month is:
Grooms DR, Diekfuss JA, Ellis JD, Yuan W, Dudley J, Foss KDB, Thomas S, Altaye M, Haas L, Williams B, Lanier JM, Bridgewater K, Myer GD. A Novel Approach to Evaluate Brain Activation for Lower Extremity Motor Control. Journal of Neuroimaging. 2019;29(5):580-588.
 
The authors have provided us with three take-home messages they believe highlight the relevance for their novel methodological work in regard to improving patient care: 
  • Neuroimaging can capture brain activity for loaded multi-joint lower extremity sensorimotor control reliably.
  • This neuroimaging paradigm can be used to determine changes in brain activity from an intervention or injury.
  • This more ecologically relevant assay of neural activity for lower extremity sensorimotor control may provide new insights into lower extremity injury prevention and rehabilitation design.
Clinical Opinion
Dr. Terry Grindstaff, Associate Professor at Creighton University and 20 years of experience as a dual credentialled Physical Therapist and Athletic Trainer, provides his clinical view on the importance of understanding the underlying mechanism of sensorimotor control. The neuroimaging techniques utilized by Grooms et al. are advancing our knowledge of the mechanisms behind rehabilitation programs and giving mechanistic researchers the basis for understanding the true neurological effects interventions have during the recovery of motor control. There is still a disconnect between neuroimaging mechanisms and clinical practice. Dr. Grindstaff believes the first step in connecting the dots is by “taking a step back” from simply treating localized joint injuries and “also looking to the brain and spinal cord as the central driver and their influence in the recovery process.” As an example, Dr. Grindstaff talks about a patient recovering from an ACL reconstruction: “if a patient is struggling with something simple like a post-op quad sets, they have to look at their quad more, or they have to really think about doing an exercise, maybe the patient is trying to tell us something very early on. Maybe the patient is starting to lay down a maladapted motor pattern. We should figure out what are the different ways we can cue an exercise or better address impairments that contribute to these bad patterns so we can potentially better restore function.” He goes on to say maybe we need to add a visual perturbation to these tasks and to challenge different aspects of the sensorimotor system in order to guide patients into a better neurocognitive pattern.

 Clinicians are good at focusing their efforts at the specific joint that is injured and is it difficult to “wrap our head around these true neuromuscular consequences of an injury and what to do about them.”  He also explains researchers like Dr. Grooms is using knee injuries as a model to understand these mechanisms but that “the neurocognitive influence and approach is probably the same for someone having an ACL reconstruction as it is for an ankle sprain or low back injuries.” In order to begin to understand the influence of the brain in the rehabilitation process, Dr. Grindstaff urges clinicians to be “more intentional and purposeful in their thinking” about specific reasons certain exercises are being prescribed. For example, incorporating a balance task on a foam pad with eyes closed is a great exercise to challenge balance, but clinicians should understand what each of those manipulations is adding to the neurocognitive rehabilitation following joint injury. A balancing task targets the somatosensory system, but it also has a vestibular and visual component. “Clinicians should be intentional with exercise prescription with the awareness of the neurocognitive.” Further, clinicians should understand the brain is going to be affected by any joint injury, but we should better determine which responses help best maximize patient function and health.

Terry Grindstaff, PhD, PT, ATC
Associate Professor Department of Physical Therapy
Creighton University
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September Publications by ATOAC Members
  1. Bruce AS, Howard JS, van Werkhoven H, McBride JM, Needle AR. The Effects of Transcranial Direct Current Stimulation on Chronic Ankle Instability. Med Sci Sports Exerc. 2019 Aug 22. doi: 10.1249/MSS.0000000000002129. [Epub ahead of print]
  2. Shultz SJ, Schmitz RJ, Cameron KL, Ford KR, Grooms DR, Lepley LK, Myer GD, Pietrosimone B. Anterior Cruciate Ligament Research Retreat VIII Summary Statement: An Update on Injury Risk Identification and Prevention Across the Anterior Cruciate Ligament Injury Continuum March 14-16, 2019, Greensboro, NC. J Athl Train. 2019 Aug 28. doi: 10.4085/1062-6050-54.084. [Epub ahead of print]
  3. Huang YL, Jung J, Mulligan CMS, Oh J, Norcross MF. A Majority of Anterior Cruciate Ligament Injuries Can Be Prevented by Injury Prevention Programs: A Systematic Review of Randomized Controlled Trials and Cluster-Randomized Controlled Trials With Meta-analysis. Am J Sports Med. 2019 Aug 30:363546519870175. doi: 10.1177/0363546519870175. [Epub ahead of print]
  4. Burland JP, Toonstra JL, Howard JS. Psychosocial Barriers After Anterior Cruciate Ligament Reconstruction: A Clinical Review of Factors Influencing Postoperative Success. Sports Health. 2019 Aug 30:1941738119869333. doi: 10.1177/1941738119869333. [Epub ahead of print]
  5. Baez SE, Hoch MC, Hoch JM. Psychological factors are associated with return to pre-injury levels of sport and physical activity after ACL reconstruction. Knee Surg Sports Traumatol Arthrosc. 2019 Sep 5. doi: 10.1007/s00167-019-05696-9. [Epub ahead of print]
  6. Clark BC, Woods AJ, Clark LA, Criss CR, Shadmehr R, Grooms DR. The Aging Brain & the Dorsal Basal Ganglia: Implications for Age-Related Limitations of Mobility. Adv Geriatr Med Res. 2019;1. pii: e190008. doi: 10.20900/agmr20190008. Epub 2019 Aug 16.
  7. Davies MAM, Kerr ZY, DeFreese JD, Arden NK, Marshall SW, Guskiewicz KM, Padua DA, Pietrosimone B. Prevalence of and Risk Factors for Total Hip and Knee Replacement in Retired National Football League Athletes. Am J Sports Med. 2019 Sep 9:363546519870804. doi: 10.1177/0363546519870804. [Epub ahead of print]
  8. Helton GL, Cameron KL, Zifchock RA, Miller E, Goss DL, Song J, Neary MT. Association Between Running Shoe Characteristics and Lower Extremity Injuries in United States Military Academy Cadets. Am J Sports Med. 2019 Sep 9:363546519870534. doi: 10.1177/0363546519870534. [Epub ahead of print]
  9. Goetschius J, Hertel J, Saliba S, Brockmeier SF, Hart JM. The effects of patellar tendon vibration on quadriceps strength in anterior cruciate ligament reconstructed knees. Phys Ther Sport. 2019 Sep 4;40:71-77. doi: 10.1016/j.ptsp.2019.08.014. [Epub ahead of print]
  10. Hunt ER, Villasante Tezanos AG, Butterfield TA, Lattermann C, Jacobs CA. Upregulation of Systemic Inflammatory Pathways Following Anterior Cruciate Ligament Injury Relate to Both Cartilage and Muscular Changes: A Pilot Study. J Orthop Res. 2019 Sep 13. doi: 10.1002/jor.24467. [Epub ahead of print]
  11. Jacobs CA, Hunt ER, Conley CE, Johnson DL, Stone AV, Huebner JL, Kraus VB, Lattermann C. Dysregulated Inflammatory Response Related to Cartilage Degradation after ACL Injury. Med Sci Sports Exerc. 2019 Sep 12. doi: 10.1249/MSS.0000000000002161. [Epub ahead of print]
  12. Koldenhoven RM, Hart J, Saliba S, Abel MF, Hertel J. Gait kinematics & kinetics at three walking speeds in individuals with chronic ankle instability and ankle sprain copers. Gait Posture. 2019 Sep 10;74:169-175. doi: 10.1016/j.gaitpost.2019.09.010. [Epub ahead of print]
  13. Slauterbeck JR, Choquette R, Tourville TW, Krug M, Mandelbaum BR, Vacek P, Beynnon BD. Implementation of the FIFA 11+ Injury Prevention Program by High School Athletic Teams Did Not Reduce Lower Extremity Injuries: A Cluster Randomized Controlled Trial. Am J Sports Med.2019 Sep 17:363546519873270. doi: 10.1177/0363546519873270. [Epub ahead of print]
  14. Wang HM, Shultz SJ, Ross SE, Henson RA, Perrin DH, Schmitz RJ. ACL Size and Notch Width Between ACLR and Healthy Individuals: A Pilot Study. Sports Health. 2019 Sep 17:1941738119873631. doi: 10.1177/1941738119873631. [Epub ahead of print]
  15. Voigt TB, Tourville TW, Falcone MJ, Slauterbeck JR, Beynnon BD, Toth MJ. Resistance training-induced gains in knee extensor strength are related to increased neural cell adhesion molecule expression in older adults with knee osteoarthritis. BMC Res Notes. 2019 Sep 18;12(1):595. doi: 10.1186/s13104-019-4642-0.
  16. Disser NP, Sugg KB, Talarek JR, Sarver DC, Rourke BJ, Mendias CL. Insulin-like growth factor 1 signaling in tenocytes is required for adult tendon growth. FASEB J. 2019 Sep 16:fj201901503R. doi: 10.1096/fj.201901503R. [Epub ahead of print]






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Athletic Trainers' Osteoarthritis Consortium · 35 Kneeland Street · Boston, MA 02111 · USA

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