Baseball Pitchers & Elbows, an Epidemic?

Spring is here, baseball has begun and all over this land are the sounds of bats swinging and pops in the glove of playing catch. My favorite, but emotional scene in Field of Dreams is when Kevin Costner ask his dad “Hey Dad, wanna play catch?” Kids are playing baseball year round and if not know will see the effects over time. Already this season at least seven Major League pitchers are scheduled to undergo this procedure. With Tommy John surgery now 40 years old and performed on 1000’s of pitchers it may be a time to take a look and re-evaluate.

Former major league pitcher Tommy John says it’s “unreal” that so many pitchers need elbow surgery 40 years after he was the first to undergo the procedure that now bears his name.”It’s unreal,” John told the Watertown Daily Times. “ nd it’s crazy that they would pick 2014 to be an epidemic year, it seems like guys are going down right and left.”

“Throwing pitches in the big leagues will not hurt your arm,” John told the Daily Times. “It’s what you did down the road when you were younger. … In essence, the injury itself is a buildup of overuse. And not overuse as an adult, but overuse as a kid.

“What I would like to see these guys do, these surgeons and all, is ask all the guys who have had the surgery — ‘How much did you pitch as a kid and how often, and did you pitch year-round?’ And nowadays, probably 70 to 80 percent of the pitchers today have been pitching 12 months a year since they were seven, eight or nine years old. And your arm is not made for that.”
Quotes from ESPN 4-24-2014 & Watertown Daily Times
Jim Mackie, M Ed, ATC, LAT

Why Professional Involvement?


I recently attended the annual Southeast Athletic Trainers Association Clinical Symposium & Members Meeting and the constant question I hear is why do more people not attend and what value is it to me? Well, I could not begin to address it all but there is great value, both tangible and intangible. The professionals and friends I have met and conversed with through the years are invaluable to my personal growth as a professional. I learn different ways of gaining outcomes beyond the research, though that is valuable too. I developed mentors and may actually teach others to through conversations you can’t have staring at a computer screen. Passion for my profession and career choices have only been enhanced. With an unfortunate chasm that is growing between educators and the traditional Athletic Trainers that grieves me. We can learn from each other and I’d challenge all educators to annually spend time in the clinic or on the field mastering their skills. One of my mentors regularly volunteers and or contracts her time with sports teams. What better way to engaged and practice what you preach. Those in traditional settings benefit from opportunities to teach or guest speak. Our students need to see it all and grow in their confidence, not just pass the exam. Opportunities at the District level allow a connectivity with our national, state and district leaders. You have time to talk one on one and express your views and concerns. Take advantage of that as we have a vibrant profession with limitless opportunities for learning and growth. Do it with passion, get involved and make your voice heard. It’s more than just another CEU opportunity.  By the way, the picture is of our SEATA / NATA Hall of Fame members.
Jim Mackie, M Ed, ATC, LAT
President, Southeast Athletic Trainers association

Legendary Bobby Bowden Addresses Athletic Trainers and Physicians

Recently, I’ve attended conference of Physicians statewide who are working to place an Athletic Trainer in every high school. Coaching legend and highly successful successful coach Bobby Bowden shared many stories and supports this cause. More education of the public and administrators is needed to garner support of this effort. Certainly,IMG_0194 a jobs creation program that benefits many as well as saving healthcare dollars.

March is National Athletic Trainers Month




What an important role the Athletic Trainer can play in your life or that of your child’s. I recently met a local Athletic Trainer who helped to save the life of a high school female basketball player by using an AED & CPR. Athletic Trainers do save lives. The Jacksonville Sports Medicine Program is hosting it’s annual Symposium at Brooks & Everbank Field April 11-12. Experts will share the latest on concussion, C-spine management, asthma, sickle cell, and more. Certainly this is a premier educational opportunity. More info at Athletic Trainers celebrate National Athletic Trainers Month with the theme “We’ve got your back.”  Join us March 27th at JSMP at 6:30 for a tailgate dinner and educational program on “The Spine and Sports.”  Say hello to retiring Jaguar Athletic Trainer Mike Ryan as he move on to new adventures.

We all play an important role in life


It was disturbing to hear recently that a long time athletic trainer was dismissed for his role in a bullying scandal within an NFL team.  Disturbing, that it was going on in the first place and disturbing a colleague got caught up in it by not intervening for an associate.  We all are accountable for our actions and the atmosphere we tolerate or accept be it in a locker room, athletic training facility, office or wherever we have to accept responsibility.  The culture of sports is changing, be it the rules, the intensity, the language, the locker room atmosphere, gay & lesbian athletes becoming more visible in sports.  Even Sports Illustrated with their “swimsuit” or lack there of issue. Personally, I handed it to my wife upside down and asked she destroy it then & there, she did so gladly. It’s degrading to women and decent values.  All leads to a changing or evolving mindset.  How will you respond when and if any of this is right in front of you? Hopefully with love, compassion and a willingness to see people as a person and not some object.

Jim Mackie, M.Ed, ATC, LAT

Hot topics in sports health in 2014?

Hot topics in sports health in 2014?
Jim Mackie, MEd, ATC, LAT

Sports concussions remain in the spotlight. According to recent publications declining numbers at the youth and high school levels, not to mention the avalanche of data coming out about the severity of head injuries, should alarm the NFL. Pop Warner’s participation levels, which were released in November, suffered nearly a 10 percent drop in participation between 2010 and 2012, the largest two-year decline since the organization began collecting that data. On the high school level, there has been slightly more than an 8 percent drop in participation, according to the Florida High School Athletic Association’s numbers from 2011-12 to ’12-13.

Secondly, that we’re not all Adrian Peterson in regards to ACL surgical repairs, as we cannot return at timetables beyond what we can manage and our bodies allow. The fear of re-injury following ACL surgery is a key factor in predicting ones full return to competition. According to a study by Brand & Nyland in Orthopedics, May 2009 “Some meta-analyses have reported that, after ACL reconstruction, only 65% to 70% of patients return to their pre-injury level of sports activity.4,5 Psychological influences such as self-efficacy, health locus of control, pain, kinesio-phobia, anxiety, depression, overall mood, patient willingness and/or commitment, or catastrophization of the index injury may contribute to this patient outcome disparity (Figure). Increasing our understanding of a patient’s psychological profile prior to ACL reconstruction, rehabilitation, and return to play may assist the surgical and rehabilitative decision-making process.”

Do it right the first time!

Do it right the first time
Jim Mackie, M.Ed., ATC, LAT

One of the principles Winston Churchill lived by was to “aim high in all you do” We hear “Pay attention to detail”, “If you don’t have the time to do it right the first time when will you have time to do it again”, “Get it right the first time.” Looking at my weakness, I see that I try to get so much done that I hit the return button before thoroughly reviewing and making sure it’s correct or what I am really trying to say. My nature is to finish something quickly and get it out there, but it’s a reflection on me as well as any I represent if I am careless in what I say or do. Do I think about the tone of my thoughts I am trying to convey or what may be inferred by what is written or said? We’ve become so used to things like e-mail and text that we lose the emotion in what we are trying to say. Take the time to communicate effectively by being thorough in our actions and the work we do. It will make us better providers in the work we seek to accomplish. Slow down and take the time, your consideration will be appreciated by all.

A Championship Season

Jim Mackie, M.Ed., ATC, LAT

The Trinity Christian Academy Conquerors won their 4th State Football Championship in early December. It has been a privilege to work with an incredible group of coaches and young men this season as their Athletic Trainer. They are a most focused and dedicated group who kept their eye on the goal and the prize ahead. We were fortunate to stay relatively healthy this year though had some significant JV injuries. All are healing well and should be ready for spring practice. Thanks to a great medical team from Dr. Kevin Murphy of Heekin Orthopedic, Amy his assistant, Heartland Rehab led by Kristen and her fine staff, and two UNF Athletic Training students Kirstie & Adam. With each component we had a fine team of professionals working to get the kids in quickly, evaluated, diagnosed and with a safe return to play. Thank you and Congratulations TCA!

What Are They Thinking?

What are they thinking?
Jim Mackie, M.Ed., ATC, LAT

Parents make some incredible decisions and after raising two kids and a number of grandkids I do respect the complexity at times. Growing up we had a show which featured, “kids say the darnedest things” But really, parents too sometimes say the darnedest things and do make you think, what are they thinking. On the good side I had a parent recently say to me regarding their son’s injury “we are looking to you for direction and will do whatever you think best.” Others though, can make you scratch your head, like the parent (not at any school I am directly affiliated with) whose child was removed from a football game with concussion signs & symptoms, interjects by giving them medicine and saying “oh it’s just their migraine from the past two concussions.” Another parent wanting their child to play in an upcoming game after two weeks in a cast for a broken hand, cuts off the cast and says “i’ll write a note and please let them play.” “I can’t take them to the MD due to the government shutdown & I don’t have insurance.” Well due to regulations, athletes are not allowed to play if they don’t have insurance, so if he doesn’t have insurance he can’t play. Sure that many have their parent “horror stories” but these keep us enlightened and maintaining a sense of humor. Also another reason every school needs a Certified Athletic Trainer.

Deadly Reactions to Food Allergies Jim Mackie, M.Ed., ATC, LAT

According to the American Academy of Allergy, Asthma, & Immunology Society one in every 13 children has a food allergy. For these, an accidental exposure or ingestion of a food allergen, such as peanuts, fish, shellfish and be life-threatening.

An anaphylactic reaction or anaphylaxis, is a hypersensitive reaction that can occur in seconds or minutes after exposure to food allergens, including peanuts, tree nuts, fish, shellfish, or severe reaction to insect venom, medications, vaccines & chemicals.

Blood pressure drops suddenly and the throat swells which blocks normal breathing. Signs and symptoms of anaphylaxis can include a rapid, weak pulse; swelling of the face, eyes, lips or throat; a skin rash, wheezing, nausea & vomiting.

If not treated immediately, it can lead to unconsciousness or death. An epinephrine injector delivers medication to the bloodstream that can treat the acute allergic reactions and stave off anaphylactic shock. It opens the airways and is usually administered to the thigh.

Previous Florida legislation in 2006 allowed students to carry the prescription epinephrine auto-injector available but thanks to legislation (HB369/SB284) which took effect July1, 2013 schools may develop an anaphylaxis protocol with a licensed physician and keep a stock supply of the auto-injectors available for emergency use.

Epinephrine comes in two auto-injector devices. Epi-pen and Auvi-Q are safe for children with the most common side effect being a transient increase in heart rate. They are designed for self administration by non-medical personnel and require minimal training to use. The manufacturers, Mylan and Sanofi-Aventis of the auto-injectors have agreed to distribute devices to every public and private school in the state.

The bill was sponsored by Sen. Joe Negron and Rep. Mike LaRosa. The amendment was proposed by the 150 allergists in Florida of the Florida Allergy, Asthma & Immunology Society as well as supported by the Florida Medical Association, The Florida Osteopathic Medical Association, numerous other Florida medical societies, patient advocacy groups and concerned parents of children with food allergies.

Thank you to the author of much of this material, Patrick DeMarco, MD, a board certified allergist with Allergy & Asthma Specialists of North Florida, President of the Florida Allergy, Asthma & Immunology Society and a member of the Duval County Medical Society.