Central Michigan University Athletics
Coping & Connecting: Sports Medicine
5/14/2020 2:25:00 PM | General, Sports Medicine
MOUNT PLEASANT, Mich. – Challenges, difficulties and adjustments at every turn.
It's been that way for most everyone associated with Central Michigan Athletics for some two months as the quarantine, necessitated by the coronavirus pandemic, continues and the spring sports season was cancelled.
The job of the department's sports medicine professionals has been tremendously affected. Accustomed to a hands-on, face-to-face and highly interactive personal approach in dealing with myriad injuries and illnesses that are prevalent in any athletic department, the Chippewa staff has had to adjust, using video and telephone calls to diagnose, treat and rehabilitate.
"So much information in our care and management of student-athletes is often taken nonverbally," said Associate Athletic Director of Sports Medicine Brian Wiese. "It's not just what the student-athlete is telling us, it's how they're telling us, and what their facial expressions are, and what their posture is, and what their mood in their reactions are. You just don't get that over a cell phone."
Wiese oversees a staff of nine fulltime and three graduate assistant certified athletic trainers. The department also has two team physicians who split time with the College of Medicine, an orthopedic specialist, five contracted physicians a student-athlete dedicated counselor, and an insurance coordinator.
Together, they are charged with the physical, emotional and mental well-being of CMU's 435 student-athletes covering 16 varsity sports.
Though telemedicine and injury treatment and rehabilitation via videoconference is far from ideal, it can, and is, being accomplished, said Dr. Jennifer Trpkovski, medical director/head team physician.
"It's a tremendous challenge, especially in sports medicine which is such a hands-on specialty," she said. "At the end of the day, you absolutely feel at a disadvantage when you can't have that in-person interaction.
"Our student-athletes have been great and very understanding. I think they are doing a great job of following instructions and helping us help them as much as possible."
Technology has helped, Wiese said.
"If this would have happened 20 years ago, we would have not been capable of doing this," he said. "It gives you the ability to interact with somebody in a little bit more of an interpersonal manner.
"The old norm, in person, an evaluation for injury probably takes anywhere from 10-20 minutes. In the current norm of telemedicine, time contact can easily extend into a 60-minute period."
Fortunately, Wiese said, few CMU student-athletes have incurred "new" injuries since athletic activities came to a standstill in mid-March. Treatment now has focused on continuum of care to existing injuries, and on normal end-of-season or off-season care.
"That's helped us a little bit in that we're not dealing with a high volume of new injuries or illnesses, but more just making sure that we can continue to get these kids back to a point of resolution," he said.
Eduardo Godoy is an assistant athletic trainer who works primarily with the Chippewa football program. He faces substantial challenges because of the injury rate of the sport and the sheer number of participants. The Chippewas were two-thirds of the way through spring practice when the shutdown occurred.
Godoy said he has daily contact with any and all players who were battling injuries during spring ball. Those players have prescribed therapy routines that they perform either on their own at home, or at physical therapy clinics in their respective hometowns.
That most had undergone pre-pandemic ongoing treatment at the on-campus CMU facilities is a plus, making for a much smoother transition to today's reality.
"Most the guys on my list have all been in the athletic training room and they know the exercises, so it's kind of easier with where we're at," Godoy said. "They've transitioned out of 'Hey, we need to focus on this injury' to 'We need to progress you back to football.'"
Still, Godoy said, it is obviously not an easy road.
"The hardest part of any one of us is the day-to-day evaluations," he said, adding that he relies heavily on the student-athletes to report on symptoms such as pain, swelling, range of motion and potential strength increases. "It's all based on what these guys tell us, and you're just going off of their word and just knowing their personality. Do they exaggerate things? Do they not give themselves enough credit?"
Jason Castleman, another assistant athletic trainer, was among those who faced the task of dealing with an in-season team – baseball – when the season ended. The Chippewas were nearing the end of their spring-break trip to Florida at the time.
"You're trying to make sure that you're keeping an eye on athletes from a mental health standpoint, especially the seniors who just had their season taken away from them," he said. "That was challenging."
Castleman said that upon the team's return to campus, the student-athletes dispersed, and the opportunity for exit physicals was gone. He conducted those tests via videoconference, and he started with veteran players who are kinesiology or exercise-science majors. The knowledge that those student-athletes brought was valuable, he said, as a trial-and-error process of troubleshooting ensued.
"It was definitely a research-and-development mission first with a couple of guys and then after fine tuning it out, (it was) going through the rest of the guys," he said, adding that the method now "requires patients to be a little more independent.
"Exercise and moving and doing things is actually going to yield the most results over time, whereas (athletic trainers) getting our hands on somebody, while comforting or pain relieving or showing empathy, in a way may not necessarily be the best thing for them in the long view."
One aspect that helped to ease the transition from hands-on to telemedicine was preseason testing that laid the groundwork for season-long care that took place before anybody had ever even heard of coronavirus.
"In my case, I feel pretty comfortable with this because I have a great rapport and relationships with a lot of these student-athletes," said assistant athletic trainer Steve Creamer, who works with the Chippewa gymnastics program. "A lot of the work that I did with them at the beginning of the season has paid off."
In Creamer's case, he is working with a student-athlete who is rehabilitating after a surgery, which presents another level of issues when it comes to telemedicine than that of the typical in-season injury that does not require surgery.
"You have to find creative ways to find enough stimulus for her to adapt to and that's kind of hard when you don't have weights available to you, you're basically confined to your house," he said. "She can do some running, but we can't do cutting and jumping as we'd like to without the direct oversight."
That said, Creamer and the student-athlete are adapting, finding ways to put in the necessary work with an eye on the long-range goal. It's the same philosophy he has adopted with all of the gymnasts.
"It's really easy sometimes to get focused on the negatives and what we don't have rather than finding some of the positives of what we can do," he said. "And that's what we've been doing with a lot of the rehabs: We don't have weights, but we can change tempo to make something really challenging; you can change how you go about completing the muscular contraction. It forces you to think outside the box and get a little bit better yourself."
Which, frankly, could be said for the sports medicine staff in particular and the entire department in general.
"We're fortunate that our student-athletes are truly great kids that have a little something to them," Wiese said. "They've been great about working through it with us because it's got to be just as frustrating on the student-athletes' standpoint as it is ours as clinicians. It's now a completely different medium of communication/explanation.
"You really scale back and look at what's important. And it's important to make sure that the student-athletes feel that they are taken care of and they still have a voice and have some direction. We have to shift, adjust and listen to what that individual wants and is comfortable with and then match those goals associated with whatever methods we can provide or work to find to that happy medium so that they can get better over time."
It's been that way for most everyone associated with Central Michigan Athletics for some two months as the quarantine, necessitated by the coronavirus pandemic, continues and the spring sports season was cancelled.
The job of the department's sports medicine professionals has been tremendously affected. Accustomed to a hands-on, face-to-face and highly interactive personal approach in dealing with myriad injuries and illnesses that are prevalent in any athletic department, the Chippewa staff has had to adjust, using video and telephone calls to diagnose, treat and rehabilitate.
"So much information in our care and management of student-athletes is often taken nonverbally," said Associate Athletic Director of Sports Medicine Brian Wiese. "It's not just what the student-athlete is telling us, it's how they're telling us, and what their facial expressions are, and what their posture is, and what their mood in their reactions are. You just don't get that over a cell phone."
Wiese oversees a staff of nine fulltime and three graduate assistant certified athletic trainers. The department also has two team physicians who split time with the College of Medicine, an orthopedic specialist, five contracted physicians a student-athlete dedicated counselor, and an insurance coordinator.
Together, they are charged with the physical, emotional and mental well-being of CMU's 435 student-athletes covering 16 varsity sports.
Though telemedicine and injury treatment and rehabilitation via videoconference is far from ideal, it can, and is, being accomplished, said Dr. Jennifer Trpkovski, medical director/head team physician.
"It's a tremendous challenge, especially in sports medicine which is such a hands-on specialty," she said. "At the end of the day, you absolutely feel at a disadvantage when you can't have that in-person interaction.
"Our student-athletes have been great and very understanding. I think they are doing a great job of following instructions and helping us help them as much as possible."
Technology has helped, Wiese said.
"If this would have happened 20 years ago, we would have not been capable of doing this," he said. "It gives you the ability to interact with somebody in a little bit more of an interpersonal manner.
"The old norm, in person, an evaluation for injury probably takes anywhere from 10-20 minutes. In the current norm of telemedicine, time contact can easily extend into a 60-minute period."
Fortunately, Wiese said, few CMU student-athletes have incurred "new" injuries since athletic activities came to a standstill in mid-March. Treatment now has focused on continuum of care to existing injuries, and on normal end-of-season or off-season care.
"That's helped us a little bit in that we're not dealing with a high volume of new injuries or illnesses, but more just making sure that we can continue to get these kids back to a point of resolution," he said.
Eduardo Godoy is an assistant athletic trainer who works primarily with the Chippewa football program. He faces substantial challenges because of the injury rate of the sport and the sheer number of participants. The Chippewas were two-thirds of the way through spring practice when the shutdown occurred.
Godoy said he has daily contact with any and all players who were battling injuries during spring ball. Those players have prescribed therapy routines that they perform either on their own at home, or at physical therapy clinics in their respective hometowns.
That most had undergone pre-pandemic ongoing treatment at the on-campus CMU facilities is a plus, making for a much smoother transition to today's reality.
"Most the guys on my list have all been in the athletic training room and they know the exercises, so it's kind of easier with where we're at," Godoy said. "They've transitioned out of 'Hey, we need to focus on this injury' to 'We need to progress you back to football.'"
Still, Godoy said, it is obviously not an easy road.
"The hardest part of any one of us is the day-to-day evaluations," he said, adding that he relies heavily on the student-athletes to report on symptoms such as pain, swelling, range of motion and potential strength increases. "It's all based on what these guys tell us, and you're just going off of their word and just knowing their personality. Do they exaggerate things? Do they not give themselves enough credit?"
Jason Castleman, another assistant athletic trainer, was among those who faced the task of dealing with an in-season team – baseball – when the season ended. The Chippewas were nearing the end of their spring-break trip to Florida at the time.
"You're trying to make sure that you're keeping an eye on athletes from a mental health standpoint, especially the seniors who just had their season taken away from them," he said. "That was challenging."
Castleman said that upon the team's return to campus, the student-athletes dispersed, and the opportunity for exit physicals was gone. He conducted those tests via videoconference, and he started with veteran players who are kinesiology or exercise-science majors. The knowledge that those student-athletes brought was valuable, he said, as a trial-and-error process of troubleshooting ensued.
"It was definitely a research-and-development mission first with a couple of guys and then after fine tuning it out, (it was) going through the rest of the guys," he said, adding that the method now "requires patients to be a little more independent.
"Exercise and moving and doing things is actually going to yield the most results over time, whereas (athletic trainers) getting our hands on somebody, while comforting or pain relieving or showing empathy, in a way may not necessarily be the best thing for them in the long view."
One aspect that helped to ease the transition from hands-on to telemedicine was preseason testing that laid the groundwork for season-long care that took place before anybody had ever even heard of coronavirus.
"In my case, I feel pretty comfortable with this because I have a great rapport and relationships with a lot of these student-athletes," said assistant athletic trainer Steve Creamer, who works with the Chippewa gymnastics program. "A lot of the work that I did with them at the beginning of the season has paid off."
In Creamer's case, he is working with a student-athlete who is rehabilitating after a surgery, which presents another level of issues when it comes to telemedicine than that of the typical in-season injury that does not require surgery.
"You have to find creative ways to find enough stimulus for her to adapt to and that's kind of hard when you don't have weights available to you, you're basically confined to your house," he said. "She can do some running, but we can't do cutting and jumping as we'd like to without the direct oversight."
That said, Creamer and the student-athlete are adapting, finding ways to put in the necessary work with an eye on the long-range goal. It's the same philosophy he has adopted with all of the gymnasts.
"It's really easy sometimes to get focused on the negatives and what we don't have rather than finding some of the positives of what we can do," he said. "And that's what we've been doing with a lot of the rehabs: We don't have weights, but we can change tempo to make something really challenging; you can change how you go about completing the muscular contraction. It forces you to think outside the box and get a little bit better yourself."
Which, frankly, could be said for the sports medicine staff in particular and the entire department in general.
"We're fortunate that our student-athletes are truly great kids that have a little something to them," Wiese said. "They've been great about working through it with us because it's got to be just as frustrating on the student-athletes' standpoint as it is ours as clinicians. It's now a completely different medium of communication/explanation.
"You really scale back and look at what's important. And it's important to make sure that the student-athletes feel that they are taken care of and they still have a voice and have some direction. We have to shift, adjust and listen to what that individual wants and is comfortable with and then match those goals associated with whatever methods we can provide or work to find to that happy medium so that they can get better over time."
Athletic Training Facilities
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