Trainers warn athletes of MRSA, heat stroke, concussions


By Robin Fambrough
The Advocate

BROADMOOR, La. — A coach can use the words "triple threat" to compliment a versatile athlete.

When an athletic trainer uses the same words, they take on a different meaning.

Heat-related illnesses, the staph infection MRSA and concussions make up a triple threat coaches, athletes and parents can't forget as high schools begin fall practice.

"The heat issue has gotten so much attention nationally this summer," St. Amant High athletic trainer Scott Arceneaux said. "But when you look at high school athletics, it really is only part of what we have to worry about and be prepared for."

Those preparations seem to start earlier each year. The Louisiana High School Athletic Association's first official date for football practice with helmets/shoulder pads is Aug. 10.

However, most schools will already be in session by Aug. 10. Many schools will ramp up conditioning and hold team camps as soon as this week.

Athletic trainers like Arceneaux, Tim Gonda of Broadmoor, David Bourque of Denham Springs and Ronnie Harper of Dutchtown have seen the "big three."

They say education and preparation are the keys to avoiding tragedies that often dominate headlines.

Yes, the heat is on
One such tragedy, a heat-related death in Louisville, Ky., last August, prompted the National Athletic Trainers Association to release some stern new guidelines in June. The NATA recommended the elimination of two-a-day practices and listed specifics for temperatures and heat indexes.

The NATA guidelines are tough to apply in Louisiana. The local athletic trainers list several reasons why:

* Few schools do two-a-days because school starts so early.

* The temperature/heat index the NATA listed is difficult to use in Louisiana because our climate is much warmer than the rest of the nation.

* Though an NATA spokesman criticized high school coaches for their role in heat-related illnesses, the local athletic trainers consider coaches in this area to be cautious.

Players are allowed to drink fluids throughout practice and breaks are taken at least every 15 minutes.

Because of the popularity of seven-on-seven summer passing leagues, players are also in better physical condition when fall practice starts.

"If we went by some of the heat guidelines they suggest, we'd never be able to practice," Gonda said. "Players are allowed to drink all they want. They take frequent breaks.

"Schools that do multiple practices start early. They're not out in the middle of the day. Practices are shorter and they're followed by time in air-conditioning with meals and rest. That makes a difference."

Gonda is beginning his 31st year at Broadmoor. He remembers a case from his first year like it was yesterday.

"Practice was over and we were in the locker room," Gonda recalls. "We knew it was heat-related and it was serious when the player went down. And at that time, we didn't have air conditioning.

"We put him on a spine board and packed him in ice. He looked like he came off a shrimp boat. The team doctor lived around the corner. We took him there first, and from there, got an ambulance."

The player recovered and rejoined the Broadmoor team. After the incident, Gonda was told the player had a heat-related episode the year before, pointing to the value of medical history forms that are now required, but were not in 1979.

"When you have a kid who has a history of problems with the heat, you watch them carefully," Harper said. "It's the same when someone who comes out for the team late.

"When that happens at our school, the coaches give those guys to me. They're with me and condition for a week before they see the field."

MRSA - the dirty truth
Methicillin-resistant staphylococcus aureus, or MRSA, has become a major problem in recent years.

Health clubs, hospitals and cruise ships have had their issues as the strain of staph infection has become increasingly resistant to antibiotics.

"People don't believe this, but you're more likely to lose a player to MRSA than you are to a knee injury like an ACL," Arceneaux said.

Bourque can attest to that based on an experience two seasons ago.

"We had a guy who had shaved his legs because he was getting his ankles taped every day," Bourque said. "On Monday, we noticed a spot the size of pimple on his shin.

"It looked like an infected hair. Three days later, it was the size of a quarter and we sent him to the doctor."

Bourque said the player had to take oral and intravenous antibiotics and wound up missing more than two weeks.

An athlete's sweat can provide a breeding ground for an infection like an MRSA. Cleanliness and hygiene are crucial, too.

That's why athletic trainers, including Bourque, use anti-bacterial spray on shoulder pads at least once weekly. Some apply it daily.

Players are reminded to wash and disinfect their hands regularly and to not use the same towels or gear.

DSHS players take turns cleaning the locker room and shower areas. While all Ascension Parish schools like Dutchtown and St. Amant use an industrial strength cleaner, some use a bleach/water mixture.

A real heads up
Facts about concussions continue to evolve. Gonda said the physicians' group that rates the severity of concussions altered its system during the summer.

Based on an experience he had last spring, the Broadmoor trainer favors the changes. Gonda says the seriousness of a head injury varies individually.

"Before, the scale associated the most serious concussions as those where the athlete lost consciousness," Gonda said. "That's not always the case.

"We had a kid who hit his head practicing the pole vault. A coach walked him over to me and he never lost consciousness. It took him weeks to recover fully because the concussion was so severe."

The National Federation of State High Schools Sports Medicine Handbook notes while most concussions are mild, all can lead to prolonged brain damage or death if not handled properly.

Concussions are most closely associated with football, but the occurrences are rising in other sports like soccer.

One frightening danger is that some mild concussions go undetected or unreported, making it possible for another blow to the head to cause a secondary concussion with potentially serious consequences.

An athlete with a concussion is removed from action and must be cleared by a physician before returning to action or practice.

Most schools require an athlete with a concussion to sit out at least a week.

"You work and educate and you plan," Harper said. "Usually, nothing serious happens. The possibility is always there."

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