AT Stories: Kate Trippier, Head Athletic Therapist - SAIT Trojans

Athletic Therapy is a unique discipline that encompasses both clinical and field practice. It is one of the few rehabilitation professions wherein one is required to manage an athletic injury at both ends of the continuum: from initial trauma to return to play. ATs work cohesively and collaboratively with other healthcare professionals and must fulfill a broad spectrum of competencies on any given day. Athletic therapists are elite caregivers that provide on-site treatment in the management of sport-related injuries. In many cases, the profession requires one to adopt emergency care protocols for injured athletes using adaptations of existing medical and paramedical standards.

 

The Competencies in Athletic Therapy are divided into five domains:

  1. Prevention
  2. Assessment
  3. Intervention
  4. Practice Management
  5. Professional Responsibility

An Athletic Therapist is an extraordinarily valuable friend and colleague to have in any stage of life and athletics. Today we will gain insight on what makes the profession so special.

(Photos courtesy of saittrojans.com)

Kate Trippier Interview

March is National Athletic Trainers Month so it is only fitting to begin with an extremely knowledgeable and insightful individual. Kate Trippier is the Head Athletic Therapist at the Southern Alberta Institute of Technology (SAIT) in Calgary. She completed her Kinesiology degree and AT certification through the partner program at the University of Calgary and Mount Royal University. After graduation, Kate worked in a private clinic until she was hired to work with the Trojans in 2016.

 

Why did you decide to become an Athletic Therapist?

 

Kate: I was born and raised in a small town in northwestern Ontario without any qualified rehabilitation professionals. I played a handful of sports growing up, primarily hockey, and at one point I fractured a vertebrae in my neck. Getting access to care and a proper plan for recovery was really challenging. It was a lengthy and often frustrating process but the experience allowed me to do a lot of research. It sparked a passion to learn about the human body and musculoskeletal world in a hands-on way.

 

What is your favourite part about working with young, elite athletes; the most challenging aspect?

 

Kate: I love how entertaining they are. Every day at work I have a great time and it is hard to go even an hour without sharing some chuckles. Athletes are highly motivated and hard working people, but they are also intelligent and hilarious.

 

The most challenging part of my job is trying to foster the understanding that there is life after the Alberta Colleges Athletic Conference (ACAC). Many athletes struggle to understand or are frustrated by why they are being held out of games or practices when they feel they could play. As you grow older, you come to understand just how much of life there is to see, and how many important and exciting experiences are waiting beyond college athletics. It is my job to keep them healthy for life, not just the season.

 

What do you currently do when you suspect an athlete could have sustained a concussion?

 

Kate: SAIT is really fortunate to have access to practicum students who are assigned to each of our varsity teams. If an injury or suspected concussion occurs during training or competition, they are immediately assessed by whoever is on site. If the athlete reveals signs or symptoms of a concussion they are immediately removed from play. The next business day the athlete will check in with our clinic and myself for a comprehensive exam. We do a full SCAT 3 and compare their results to the baseline testing conducted on all athletes prior to the beginning of each season. Depending on the results, we follow protocols from here.

 

The athlete will continue to check in daily until asymptomatic, at this point we can proceed with the return to learn protocol. If every step of this is successfully completed, we move on to the return to play protocol. This process has become quite universal and much more streamlined in recent years. By scraping the old school grading system and implementing a specific 5-stage protocol, it allows us to be more consistent and thorough across the board.

 

 At SAIT, there are numerous varsity teams and over a hundred athletes representing the Trojans. What resources do you feel best equip you to do your job? 

 

Kate: In addition to what we have already mentioned with our practicum students and certain protocols, having access to the sports medicine clinic in Calgary is invaluable. We are able to get our athletes in with Sports Medicine as soon as next day if urgent. We are fortunate to have the option to get athletes in with Dr. Brian Benson at Winsport. He is one of the leaders in concussion research. He is able to have athletes complete further testing, such as robotics, to aid in the safe return to play of anyone referred.

 

Looking to the future, how would you like to see the field of concussion science develop?

 

Kate: I am glad you asked this. The technology is progressing at a fairly rapid pace which is great to see, however there is still a long way to go. It would be great if we could get onsite testing that is more in depth that what we currently have available through the basic SCAT3. There are some technologies available at this time, but athletes can still ‘’throw the testing’’ at baseline or become accustomed to the assessment allowing them to appear to be better than they are. It’s definitely a lot to ask to have something available at our finger tips that is in depth, accurate, and without loop holes and that’s likely why it isn’t available yet.

 

Hopefully, as technology continues to advance it won’t be long before this is available for all Athletic Therapists’ to utilize. From a return to play perspective, I would love to see a more psychological aspect be added to the current model. It is known that there are psychological effects associated with concussions from frustration due to inability to participate to feeling isolated from the team. Although athletes are always advised of options on where to seek help for this aspect of health it is often not sought out.

 

"Your neck is your head's safety belt. Keep your neck muscles strong to help reduce risk for concussion." - Kate Trippier

 


 

Athletes in every field are bigger, faster and stronger. There have been advances to equipment in several sports, and training, nutrition and preparation have never been better. Once lagging behind, the scientific and medical knowledge of brain trauma is now determined to keep pace. From elite athletes to the general public, our community is growing and there have been steady increases in curiosity and understanding of concussion science. At HeadCheck, we support professionals to provide concussion testing and management for their athletes.

 


Sarah Allison

BHK - Clinical Exercise Physiology

BSN-PB Student - Nursing (RN)


Managing Assessment Variances Within Sports Medicine Teams

Athletic Therapists (ATs) are commonly the first medical providers or health care professionals available onsite to evaluate any injuries that may occur during a competition or practice. They are not only crucial during competition, but also post competition during the injury management and return-to-play decision-making process. Athletic Therapists work closely with the Team Physician in order to provide the most effective therapeutic interventions and rehabilitation of injuries. Their goal is to return an athlete to competition as quickly and as safely as possible. Not only do they play a key role in injury identification, evaluation, and management, but are also critical at the sideline for screening for concussions to mitigate the risk of permanent brain damage.

 

One of the challenges faced by an Athletic Therapist is determining whether an athlete should be removed from activity for further evaluation after a suspected hit to the head. Although even a decade ago it was acceptable to “shake it off” and return to play, new legislations in Canada and the US and standard guidelines require athletes to be removed from competition or practice if a concussion is suspected. To properly determine the risk an Athletic Therapist should complete a post-injury assessment and compare it to a test done on the same athlete at the beginning of the season. In some sports leagues, there are multiple Athletic Therapists tending to multiple teams. A reality is that a post-injury test may not be completed by the same person who did the pre-season assessment. It is important for sports medicine teams to try to manage assessment variances in order to provide the best possible information for making return-to-play decisions.

 

Managing variability through diversification 

The post-injury assessment includes a series of questionnaires, checklists, and physical testing that is identical to the pre-season test. A concussion can impact brain function in a variety of ways and because of the nature and physical demands of a sporting event an evaluation of concussion-related symptoms can be challenging. For example, an athlete may show concussion-like symptoms if they are dehydrated or have performed a strenuous activity, however this does not mean that the athlete will also demonstrate balance or neurocognitive impairments. Therefore it is important that an Athletic Therapist, his/her team and the team physician are all using a comprehensive battery of tests to assess brain function. Relying on any one type of test for the monitoring and decision making regarding return to play for an athlete provides an incomplete picture of the severity and breadth of the brain injury.

 

Managing variability through calibration meetings 

Assessment variances also happen when training and communication is limited between therapy teams. It is possible to estimate and to some degree calibrate inter-rater (tester 1 vs. tester 2) reliability. For example, when testing balance at the beginning of the season, teams can grade athlete balance errors individually and after the test is complete they can compare scores. While this provides a crude measurement, it will provide insight into how much agreement exists and provides an opportunity for coaching and education. Weekly “calibration” meetings may also help - short dedicated discussions can happen and ATs can discuss why they chose the specific values they did. Where disagreements appear, the collective unit can help form some rules to help ensure calibration in the future.

 

Managing variability with routine 

Variability can also appear as a result of intra-rater (tester 1 vs tester 1) reliability issues. For example, grading a balance video in the morning, and then watching and grading the same video in a different setting in the afternoon can generate some significant variances. With the challenges and pressures that Athletic Therapists face during a sporting event combined with subjective concussion testing, a consistent routine and method can help improve intra-rater reliability. To begin, the trainer needs the support needed from his/her therapy team to focus exclusively on the concussion assessment at hand instead of  attempting to split his/her attention between the test and the active game. Reducing situational interference (distractions from the surrounding environment) and following a consistent testing structure or methodology every time can also help.

 

Managing variability with objectivity 

Technology has enabled us to collect objective measurements where subjective grading used to take place. In his Sensorimotor Physiology lab at UBC, PhD candidate Harrison Brown developed a way to use technology to reduce variances in balance testing. He specifically looked at the balance test done in concussion assessments. By analyzing the movement of athletes performing the test and by introducing motion sensors, he was able to develop an algorithm which can objectively score an athlete's balance. “Now it doesn’t matter whether my grandma is doing the test, my favourite doctor is or both; they’re both going to get the same score.” His technology has increased the test-retest reliability of the concussion gold-standard balance test from between 40-60% reliability to over 91% reliability.