She is on to something here, we are our own soulmates and to be complete we don’t need another person. It’s a hard truth to accept and fully lean into when our society values relationships. It makes sense. If we look at relationships through a sociological and anthropological lens, they serve a function. Relationships build societies, culture, create safety and protection, and serve a purpose of reproduction. Humans are social beings and part of that socialness is that of building relationships–especially those who we want to “settle down” with.
If you’ve been in any form of couples counseling or have heard anything about healthy relationships, it’s important to be your own person and to love yourself. To know who you are outside of your relationship. It kind of reminds me of the infamous RuPaul quote, “If you can’t love yourself how the hell you going to love anyone else?”. There is so much truth and power in her outro. For years I watched Drag Race and was like that’s such a nice sentiment. But it wasn’t until I turned thirty, started to connect to myself, and eventually leaving my marriage, did I learn how to truly love myself. I thought I was loving myself but I wasn’t.
I thought loving myself was taking care of others–my clients, my family, my husband. Serving them and putting their needs and wants before my own. I was raised with the adage that it’s kind to serve others and to put your husband first.
I thought loving myself was making myself small and not taking up space. To not be a pain or burden to those around me. When I was in the midst of a gastro flare up I would do all I could to take care of it myself and not ask for help. Even if I was writhing on the floor puking my guts out. I took care of my recovery and even when my eating disorder voice wanted me to relapse and that area was looking very gray, I just kept it all to myself. Not to worry others or make their situations or stress seem less.
I thought loving myself was making myself presentable for others. Dressing and adorning myself in a way they wanted me to appear. Covering myself and not coloring my hair or doing things that I always wanted. But still treating myself to spa days, manis and pedis, and treating myself to clothes.
But this was pseudo self love. It didn’t do anything for me. Self love is loving who you are–the good, the bad, the alright, the imperfections, the dimples, pimples, your super loud obnoxious gut laugh, and the fact that you crave attention and affection.
I started putting myself first and doing little things that made me happy–like buying flowers. I got tired of waiting around for someone to buy me flowers. So I started buying them because I LOVE them and they make me smile. Every Sunday after my tennis lessons–another thing I started to do for myself, I bought flowers and made flower arrangements.
I dyed my hair blue. Something I always wanted to do, but felt like I couldn’t. I also began getting my hair done more often because it made me feel pretty and confident and I’ve been through hell and I deserve it. I started wearing crop tops and while I always ended up wearing what I wanted, I truly started living up to the fashionista I always wanted to be.
I stood up for myself. That was the biggest self love act of all.
Leslie Ann Ellingburg is a trauma informed movement educator based out of Tennessee. She is a certified exercise physiologist through the American College Sports Medicine (ACSM), dance teacher, a certified Yoga Instructor with over 800 hours of teaching, holds Levels 1 & 2 of the Yoga 4 Eating Disorders Mentorship Program, recently completed her trauma informed training through Yoga 4 Trauma, and is beginning to pursue her master’s degree in Public Health/Community Health. Leslie’s passion is that of recovery (eating disorder, exercise addiction, other addictions) and helping individuals reconnect to their bodies in a positive, affirming, and fun way. Her philosophy is based on the Sanskrit words, “shanti” (peace) and “leela” (play)-finding inner peace through the play and practice of Yoga. When she isn’t moving on or off her mat you can find her playing with her furbaby Winston (#dogiwinston), curating the perfect playlist, writing, practicing her photography skills, and making the best coffee a home barista can.
Our teens athletes have more on their plate than just about any previous generation. Youth are specializing in sports at younger and younger ages, which means not only an increase in the number of chronic use injuries and recurring pain, but also in the amount of pressure our teens are under to perform well in their chosen sport.
Gone are the days of multisport participation in school and the three-season athlete. More and more, our teens are competing for spots on both their school and club teams, with pressure from all directions to be great.
In addition to the demands of their sport training, our teens are also having to prove themselves academically. There is a rise for being the well-rounded student-athlete, with high performance being asked for in both the classroom and on the field. Enrolling in AP class beginning their Freshman year is the norm. Applying for Ivy League and Division I programs, with the hope of recruitment to a sports team, as well as acceptance to the college is the goal.
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Our teens are rising at dawn for pre-school training, transitioning from after school practice to club practice, grabbing a bite on the run and burning the midnight oil to get their schoolwork done. Add to this other extracurricular activities, such as Youth Group and volunteering, and it’s a wonder many of our teens are still upright!
It isn’t surprising that increasingly teens are struggling with burnout and overwhelm these days. We are asking a lot, and if we think about it, we’re asking our teens to take on much more than many adults would be willing to. As parents, we do our best to support them, but in reality we’re struggling with our own bouts of overwhelm and may not fully understand what our teens are going through in our own attempts to keep it together.
So, what’s to be done? As parents, our number one focus needs to be monitoring how our teen athletes are handling the loads that they are juggling. Are we seeing any signs of burnout or distress? If we do, are we helping them learn how to manage their time and priorities, and advocating for their health by connecting them to counselors, or running interference with overbearing coaches? We have great goals for our kids and will do anything to support their dreams, but just as we would throw ourselves in front of a bus to save them, we have to help them protect their physical and mental health as well.
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Burnout affects the athlete in various stages:
The athlete is placed in a situation that involves new or varying demands on their physical ability and time management
The athlete at some point – usually early on as a young athlete, or later if a more experienced athlete – views the demands as excessive or non-productive
The athlete feels as if their performance is being hampered by the demands of participation and the inability to rest and recover
The athlete starts experiencing subtle signs and symptoms of physical and mental burnout
Burnout takes place and the physical and mental toll on the athlete impacts their lives and performance on and off the field, perhaps even discontinuing sports participation
Signs and symptoms of burnout include:
Leveling off or diminished performance or conditioning, including strength and stamina losses, chronic fatigue, and recurring pain & injury.
Physiological signs such as having a higher resting heart rate and blood pressure
Cognitive issues such as difficulty in concentration or diminished work in school, forgetfulness
Illnesses as a result of suppressed immune system
Emotional issues such as disinterest, moodiness, irritability
Low self-esteem, increased anxiety and depression as a result of falling short of sport demands
As parents, it’s important that we’re aware of the signs and symptoms of burnout in our kids. When we notice some of the signs above, we must be their advocates to take action. This means gathering the team around – the coaches, athletic trainer, teachers, counselors, and of course the athlete themselves. This is the time to start assessing the situation and make sure that her training aligns with her future goals.
This may mean taking yourself out of the dreaming stage and truly listening to what your teen wants. What are their goals? What do they feel like they can handle right now? There’s a good chance that they want to make you and their coaches happy, and they need to be assured that their wants are being heard and the team is working in their best interests now – even if the long-term plan has changed.
If you don’t have a mental health professional or teen coach who works with athletes as a part of your team, this is the time to bring one in. Often our teens just need an outside adult to help them craft a plan and work on shifting their mindset a bit. Letting go is a key for many teens who have that athletic-mindset. Many teen athletes feel a need to be perfect and set the bar much higher than what can be achieved in the current situation. Teen coaches and therapists can help teens start letting go of the unrealistic goals that others have put on them, and begin to adopt new habits and mindset shifts that are manageable and aligned to their goals. Similarly, teens also need to learn to work through and let go of negative emotions that come up when feeling stressed. Once they tap into the root of those emotions, teens can learn to step back and look at them with a neutral eye and better address the underlying triggers. Often, the act of simply letting go of the idea that you are not enough or have to do more, can greatly reduce overwhelm and allow for clearer focus on the things that matter.
The demands on our teens aren’t going away anytime soon, but if we, as parents, begin to notice the signs of overwhelm and burnout when they begin to creep up, those demands become more manageable. There may be tears, there may be hurt feelings (for us), but part of our roles as parents is to protect our teens health – physical and mental. Recognizing the signs of burnout is one of the best forms of protection we can give.
by Cassandra McCoy MAT, ATC, LAT, RYT with Guests Dr Corey Babb; OBGYM, Rachel Warner MAT, ATC, LAT; Jessica Wilkerson CPT, PN1; Keli Kirwin Postpartum Doula.
Sex postpartum is an area of concern for many women. With the process of labor, challenges postpartum such as injury or lack of sleep, and the added layer of the emotional/mental unknown, sex can be intimidating. Sex, among other women’s health concerns, is exactly what this interview with Dr Corey Babb OBGYN is about. Join in that conversation here:
After this interveiw, a few of the Be HEaRd Contributors discuss a variety of labor/postpartum experiences. Join us as we discuss our personal experiences, professional knowledge and just have a down to earth chat about the real things that help postpartum. Join us here:
If you would like to join in the conversation, we would love to have to join us over on Facebook in our private women’s groups:
Written by Dr Michael K. Van Antwerp, Edited by Andrea Vasquez
Groin and Front Hip Pain
Groin and front hip pain are common areas we see in women’s health. These can have a host of causes with some more evident than others.
Some of the causes of pain in the groin and front hip can be: hip impingement, labral tear, sports hernia, hip flexor strain, hip adductor strain, inguinal ligament sprain, endometriosis, cam or pincer deformity, hernia, arthritis, osteitis pubis, round ligament pain, stress fractures, nerve entrapments, interstitial cystitis, pelvic floor dysfunction, gynecological or urological pathologies, pelvic or hip surgery complications, SI joint dysfunction, sacral or pelvic plexus injuries.
In the first article of this series, we will look at the musculoskeletal causes.
Functional Hip Impingement
Functional hip impingement is caused by malpositioning of the ball in the hip socket which causes pressure or rubbing to occur in one area. This can be caused by prolonged sitting postures where the hip is flexed with tight hip flexor muscles and tissues. Although it seems simple, it can be debilitating in more severe cases.
Femoroacetabular Impingement (FAI)
In structural hip impingement, bone growth is present at the ball-and-socket joint limiting movement usually with some type of cam or pincer deformity. This structural limited movement and pain is referred to as a femoroacetabular impingement (FAI). It is possible for FAI to lead to osteoarthritis or labral tear. It seems plausible that limited hip movement can also lead to pelvic instability including pubic and sacroiliac joint dysfunction as well as low back pain in addition to the presence of groin/front hip pain.
Labral Tear
The labrum is a gasket-like ring of cartilage that runs around the outside of the hip socket and acts like a suction cup. It can tear due to trauma, structural abnormalities or repetitive motions. An MRI with contrast dye (MRI arthrogram) is the best way to view a labral tear since an MRI without contrast dye can give false negatives. Sometimes labral tears will need surgery; oftentimes, they can be managed with conservative therapy, sports chiropractic and rehab.
Sports Hernia
A sports hernia is often defined as any sprain/strain of ligament, muscle or tendon in the lower abdomen or groin area. However, it may be more specific to an injury of the transversalis fascia with pressure on genital branch of the genitofemoral nerve or it might be an injury to the pubic aponeurosis. It is a different injury than a traditional hernia which is why it is sometimes referred to as athletic pubalgia and more recently core muscle injury (CMI). In the past, it was referred to as Gilmore’s groin. A sports hernia will often have no anterior bulge; whereas, a traditional hernia often has bulge from the internal organs pressing or pushing through tissue. The presence of femoroacetabular impingement and pelvic instability seem to lead to increased risk of sports hernia. A sports hernia can be quite painful with difficulty in sitting up or moving and has even ended sports careers.
Hip Flexor Strain
The psoas and iliacus are front hip muscles that help flex the hip. They can be strained in activities such as running, but oftentimes can start hurting from prolonged sitting. In addition, the upper quadriceps and upper sartorius muscle can be tender and/or strained as well. This can often mimic FAI, athletic pubalgia and labral tears initially.
Hip Adductor Strain
The pectineus, part of adductor magnus, adductor longus, adductor brevis and gracilis all attach at the pubic bone. These muscles pull the thigh inward from the hip joint and control the rate of outward movement of the thigh. These muscles can often be strained in sporting activities.
Inguinal Ligament Sprain
The inguinal ligament runs from the front point of the pelvis to the pubic bone, and one is present on each side of the pelvis. It forms the angled crease we have in our groin area. On occasion it can be sprained. In other cases, it can be quite tender although a definite sprain may not have occurred. The lateral femoral cutaneous nerve, femoral nerve, femoral artery, femoral vein, inguinal lymph nodes and genitofemoral nerve all run across this inguinal area.
Round Ligament Pain
The round ligament is a round band of fibromuscular tissue that connects the upper front part of the uterus to the groin. One is present on both the left and right sides. It is part of the several supportive ligaments of the uterus. Normally the cardinal ligaments support the uterine angle, but during pregnancy the round ligaments help maintain this angle. As the round ligaments stretch, they can cause a sharp pain and/or spasm feeling on one or both sides of the lower belly or groin. Rapid movements such as sneezing, coughing or quick exercise can set off the pain. It is often considered a normal sign in pregnancy and is more common in the second trimester. A technique for helping create space for a baby to turn when in the breeched position called the Webster Technique uses relaxation of the round ligaments along with sacral positioning.
Stress Fractures
Stress fractures can occur from repetitive stress to the bone from impact activities such as running. They can also occur from non-impact activities in individuals with osteopenia or osteoporosis.
Hip Arthritis
Osteoarthritis (osteoarthrosis, wear-and-tear, degenerative joint disease) can affect the hip. The joint space of the ball-and-socket area can thin along with having bone spurs. This can be caused by wear over time. However, a previous injury could also be the cause of hip degeneration over time. In a lot of cases, movement and rehab can help keep the hip moving. In severe cases, a hip replacement can be helpful.
Osteitis Pubis
Osteitis pubis is inflammation of the inner pubic bones at the pubic symphysis (cartilage disc between the two pubic bones) and the surrounding muscle insertions. It can be caused by pelvic surgery, pregnancy, trauma or sports injury. The sports that this occurs more often are ones that involve repetitive quick changes of movement such as soccer, rugby and racewalking.
Sacroiliac Joint Dysfunction
Sacroiliac (SI) joint dysfunction can refer pain to the front of the hip and groin even though the problem is in the back. In the absence of hip ball-and-socket pathology, it makes sense to look at the lumbar and SI joint. It has been found that SI joint dysfunction was more likely to cause groin pain than lumbar disc herniation and lumbar spinal stenosis.
Discussion
An evaluation by a licensed healthcare provider that specializes in the hip and pelvis is a good place to start in figuring out the cause of groin and hip pain. Since we are discussing musculoskeletal causes today, an extremity chiropractor, physical therapist and athletic trainer can be good place to start for this type of evaluation. Imaging with x-ray or MRI may be ordered if needed. A diagnosis is developed along with a treatment plan. An orthopedist or other surgical specialist might be needed depending on the severity of the condition. A physiatrist and pain management specialist might also be needed depending on the condition.
Functional hip impingement, hip flexor strain, hip adductor strain, inguinal ligament sprain, round ligament pain and SI joint dysfunction can all be managed with conservative care if they do not have any higher-grade tissue ruptures. They do will with rest, manual therapy, extremity chiropractic, physical therapy and eventual progression of rehab exercises. There are maneuvers that really open up movement of the hip joint as well as maneuvers to help the muscle and other soft tissue. For example, I use the wishbone maneuver by Whyte-Ferguson to aid in mobility of the hip joint and reduce anterior pressure. Mobility exercises progressed to stability and strength can be quite helpful. Eventual progression to full daily and sports activity is usually the goal.
Osteitis pubis often needs rest and removal of activities that irritate it with eventual progression to a rehab program.
FAI can often be managed conservatively, but sometimes needs surgery if the cam or pincer is too progressed and is limiting any recovery.
Suspected stress fractures need rest from impact activity, but often need imaging to confirm their diagnosis; if they are confirmed, they need to be seen by an orthopedist.
Labral tears can be managed conservatively, but need MRI arthrogram to properly visualize them with an orthopedic surgeon consult if found to be present.
Hip arthritis develops over time as is expected with wear-and-tear. Maintaining movement through a mobility and strength program along with some therapy can be helpful. It is possible that a severely arthritic hip might need a hip replacement.
Round ligament pain during pregnancy can be conservatively managed by healthcare providers experienced in therapy with a pregnant patient. There are techniques in prenatal chiropractic such as Webster Technique that can help. Therapy techniques with a physical therapist experienced in pelvic floor and prenatal can be helpful. There are specialties in athletic training and yoga for pregnancy that can be quite useful.
I am always fascinated how front hip pain can occur. It can be simple but difficult to figure out. For example, I have treated intense front hip pain from a patient that hooked one foot behind the leg of their office chair. After several weeks we finally figured out that this position tractioned the front hip at an odd angle which caused the front hip pain. I had a friend that swore they needed hip replacement because their hip was hurting so badly, but it turned out after asking questions that they were sleeping with one hip in frog-legged position. This was the cause of their intense front hip pain. A skateboarder friend who had multiple falls common to the sport turned out to nut just have impact injury and old hematomas but revealed a cam deformity that was the cause of their pain. We were able to manage it conservatively. Earlier on in practice, I was working with a racewalker that was having pubic area pain; I discussed this with a colleague who had worked as an US Olympic Team chiropractor and he gave a suggestion to check for osteitis pubis; I went back and checked, and it was; I have found this with several racewalkers since. Even though athletic pubalgia is more common in males than females, I have seen several cases in gymnasts, soccer players and dancers.
Thank you for your time. We will explore nerve impingements and organic causes of groin and hip pain in future articles.
Dr. Michael K. Van Antwerp
Dr. Michael Van Antwerp is a specialty chiropractor called a Certified Sports Chiropractic Physician (CCSP). There are only ten CCSPs in Oklahoma, and he is the first one in Tulsa. He has trained with the top extremity chiropractic practitioners in the United States and has developed his own specific hip and shoulder treatment protocols. About half of his practice involves working with extremity issues. Besides athletes, he has a full practice treating a wide variety of patients from infants to seniors. He sees patients during pregnancy and treats a variety of pelvis and hip issues.
In addition to his chiropractic degree, he has the additional professions of Certified Strength and Conditioning Specialist (CSCS), Certified Pedorthist (CPed), and Fellow of the American Society of Acupuncture (FASA). He also has a host of certifications including Chiropractic BioPhysics (CBP), Kinesio Tape (CKTP), CrossFit Movement and Mobility, MovNat and Neurokinetic Therapy (NKT).
Dr. Mike became interested in chiropractic through injuries in martial arts. He later transitioned to marathon running and cycling. He is active in yoga and climbing. He works with a variety of coaches and trainers in town.
Do you find yourself saying that phrase often? Or how about “I’m so tired”?
I get it sister, we all feel that and that feeling is real. There’s no shortage of things on your to-do list and it’s constantly growing. Whether it’s the never ending battle with laundry or working your side-hustle so you can live your passion and be your own boss. You’re doing amazing things in this world but that comes at the expense of your sleep and sanity too often.
So I want to share a few time management tips that I’ve seen work not only in my life but in my student’s lives too. I’ve coached many yoga teachers who are working hard to build their business while also being a wife, sister, mother, partner, friend and so many other things.
As a wife, daughter, friend, step-mom and business owner myself I’ve learned the hard way on how to balance many things. And now I get asked on a weekly basis “Amanda, how in the world do you get it all done?”. Well friend, I’ve got you covered with these tips! Buckle up sister!
Know Your MIT
I’m not the first person to use this phrase but I’m not sure who to give credit to or else I would. But there isn’t a day that goes by that I don’t know my MIT = Most Important Task. This is the thing that has to get done or *things* will hit the fan. You know that thing. Maybe it’s sending an email, paying a bill or picking up your kiddo from school. It’s the thing that needs to get done, TODAY. I like to look at this in a few ways: daily and weekly. So if you’re working your side hustle and you want to make constant progress in your business, you might have a weekly MIT but you might work on smaller chunks each day. Make this work for you but know your MIT at least weekly.
Be Okay With The Minimum
This goes hand in hand with your MIT because sometimes you will get the minimum done. Yes, you want to do all the things and rock your day but we can’t do that every day. You will burn out if you go this hard. So we need to know what that minimum is that we need to get done but we also have to be okay (for real) when we can only do the minimum. And if you’re like me, you have to be really, really with yourself on this one. Because in my head the “minimum” usually includes the kitchen being clean, I’m at inbox zero and I’m in bed by 8pm. Let me tell you how many days this happens — not many. That’s not the minimum, that’s my ideal situation. So we need to be realistic with what the minimum is and really be okay with it when it happens. Heck, I would love to say celebrate it just like you would an ideal day!
Systems, Systems, Systems!
The best businesses I know have rock-solid systems in place to help with order and efficiency. Let’s learn from these businesses and put some systems in place for your time management.
First up…do you know how you’re truly spending your time? If you and I were talking and I asked you “how much time do you spend doing laundry?” or “how much time do you spend on your side hustle?” or “how much time do you spend on Facebook?”, would you know the answers? Be real now, would you really know? The answer for me was no for a while but I decided to change that and it made a BIG impact. I started tracking my time and it sure helped me waste less time. You can use an electronic time tracker (I use Toggl) or you can write this down on a piece of paper, it doesn’t need to be fancy. Track your time and it will tell you how to use it better, I promise.
The other system I would encourage you to use is planning your day. Whether it’s a paper or digital planner, you do you! But you need a system that works for you. One that I’ve seen work really well for most people is the 15 Minute Planner from Steph Crowder. I’ve learned a ton from her and actually hired her as my business coach last year. Check her out and use this quick 15 minute method to plan your week.
If you’re looking for a way to help you stay on track during your day, I would highly recommend an electronic task management system. I personally use Asana every work day (but I put my personal stuff on there too). There are other systems such as Trello, Monday and you can set up tasks in Google. Find what works for you and run with it, don’t worry about what other people are using. Use what works for you!
Make sure to check in with these systems as you move forward. Put a reminder on your calendar for 3 months from now to check in and see how these systems have helped you. You can only make progress and changes if you have a plan for evaluating them because it will encourage you to actually implement them.
Automate Everything You Can
Let’s talk about how cool it is that we live in a world where we can have groceries delivered to our house! For real, this is a game changer. I’ve tracked our families spending since we signed up for Shipt and we’ve actually saved money – even with tipping the incredible people who do the grocery shopping for us. I cannot rave about this enough but it’s not the only thing you can automate in your life. I would love to encourage you to look for ways you can automate things in your life and the amazing news is that they don’t all cost you a fortune! Some are more pricey than others but do what you can sister!
Automation Ideas:
Grocery shopping through Shipt
Dinner ideas from Hello Fresh or Freshly or any of the other companies out there! There are seriously so many incredible options.
Vacuuming using Roomba. Yes, I know it’s a pricey vacuum but how much time will it save you if it runs once a week or every other day? Think about it.
Deposit checks using your banking app. You don’t need to drive to the bank my friend, save the time and download the app.
Bundle your errands in one trip. I know this isn’t automating but it will save you so much time. And bonus points if you can think ahead for your trip to town and only make right turns, no joke this saves time.
Set your coffee maker timer. There’s no reason for you to have to do this manually if you have a timer on your coffee maker. Use what you paid extra for!
Order pet food to be automatically delivered. Check with your vet, they have services for you! If your vet doesn’t have one, use Chewy. Set it and forget it.
Give Yourself Grace
You’re doing amazing things in this world. If you’re reading this article then you’re a driven woman who’s changing the world for the better, I 100% believe this. So give yourself some grace in this process dear friend. Remember that you’re doing the best you can with all that you have.
Stay connected with other women who are doing amazing things so you can be supported and you can support other women. Keep going sister, you got this!
Your cheerleader,
Amanda McKinney
About Amanda McKinney Amanda McKinney is a Marketing Coach with a passion for empowering yoga teachers to earn more money doing what they love. She does this through her podcast: Marketing Yoga With Confidence and Online Offerings. All of which focuses on building confidence and community with an extra dose of encouragement every step of the way. You can learn more from her on her podcast: Marketing Yoga with Confidence or on her website: https://www.marketingyogawithconfidence.com/ But her favorite place to be is Instagram so follow her @amandamckinneyyoga
What is a Certified Athletic Trainer and what do they do? What is a Physical Therapist and what do they do?
What about a Women’s Health Athletic Trainer? Pelvic Floor Physical Therapist?
All of these titles, professions and letters can get confusing, so let’s break down the professions of an Athletic Trainer and a Physical Therapist. Also, in Part 2 I will introduce the role and capacity of a Women’s Health Athletic Trainer and break down how two professions (Women’s Health ATCs/Pelvic Floor PTs) can work together to improve women’s health worldwide.
Here are a few basics definitions:
ATC/AT: Certified Athletic Trainer
LAT: Licensed Athletic Trainer
PT: Physical Therapist
PFPT: Pelvic Floor Physical Therapist
According to the National Athletic Training Association (NATA), an Athletic Trainer is defined as “Health care professionals who render service or treatment, under the direction of or in collaboration with a physician, in accordance with their education and training and the state’s statutes, rules, and regulations. As a part of the health care team, services provided by athletic trainers include primary care, injury and illness prevention, wellness promotion and education, emergent care, examination and clinical diagnosis, therapeutic intervention, and rehabilitation of injuries and medical conditions.”
Athletic Trainers are seen in various settings with examples including military, orthopedic clinics, performing arts, physical therapy departments, private practice and so much more. ATCs/LATs do more than just tape ankles; we are medical healthcare professionals who have the education to prevent, rehab, educate, and treat active population across the lifespan. (Myth busting: You don’t have to be an athlete to see an athletic trainer!)
According to the American Physical Therapy Association (APTA), a Physical Therapist is defined as “health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives.” Physical Therapists are seen in hospitals, physical therapy departments, pediatrics, hospice services, private practices and more.
Now, there has been a lasting conflict between the physical therapist profession and athletic trainer profession. Turf wars, conflicting opinions and more. In some settings, we see this divide disappearing. PTs are able to send their patients to a knowledgeable AT in order to continue their patients healing and help them return to what they love. ATs are able to work with active population in a variety of settings, patients they believe need more narrowed and concentrated help can refer a patient back to a PT.
Stay tuned for part two on how these two professions can come together to change the dynamic of their professions, women’s health and bridge the gap in women’s health.
March is National Athletic Training Month as well as National Women’s History Month, so I thought I’d share a little of this woman’s history with athletic training. I have wanted to be an athletic trainer since I was a sophomore in high school. My mom had persuaded me to see that I was not going to be on the US women’s national soccer team because I got injured too often and let’s face it, I was no child prodigy. I spent a lot of time in the athletic training room doing rehabilitation for injuries, getting ice after practice or games, and soaking up everything. I got a good idea of what an athletic trainer did and their involvement in sports. When I sprained my MCL my sophomore year, I already knew what was wrong with me before I went to the doctor. I had done all the research, looked at the anatomy, read about the mechanism of injury. Needless to say, the doctor was impressed (toot toot!). While my story is my own, the context is not unique; many athletic trainers have the same origin story of being an athlete, being injured, and having their first experience with athletic training.
Athletic training is a catch-all profession; we are Jacks of all trades, MacGyver, artists, allied healthcare professionals. We are required to take a national certification exam to demonstrate competencies in evidence-based practice, prevention of injury, health promotion, clinical examination, acute care of injury and illness, therapeutic interventions, psychosocial strategies, health care administration, and professional development and responsibilities. Athletic training as a profession has been recognized by the American Medical Association since 1991. We work with people who move their bodies from age 5 to 105 in settings from schools and pro sports to the workplace. We are finding other places our skillset can serve all the time, like the military.
I currently work in the high school setting. It’s a small school and I know 90% of my athletes by name, even if they haven’t stepped foot in the athletic training facility. If you asked me what task I performed the most, it would be cleaning up blood and covering wounds. The second most common thing I do is listen when an athlete comes into my room after a tough day. Which is every day. Hellooooooo high school students.
Not every day is as easy as listening to kids and cleaning up a little blood. Some days I’m watching wrestling sitting on the edge of my seat praying that shoulder doesn’t dislocate. Some days I’m cradling an athlete’s head in my arms stabilizing their c-spine because they took a head-to-head hit and they can’t feel their legs. Some days my heart is breaking for my athlete who had their senior year taken from them because they tore their ACL. And some days I spend the entire afternoon doing paperwork and coming up with rehab programs. Our days are truly a box of chocolates. Athletic trainers are always expecting the worst, ready to take action when they happen, and there to feel the feels with the team whether they win state or lose a family member.
This unique relationship between athletic trainer and athlete brings trust and closeness. Being caretakers and having just about anything you could imagine in our human repair kits, many of the female variety athletic trainer report being called “mom.”
Women have become a large percentage of the population of NATA members; in fact, the 2018 count had women at 56% of members while in 1996 we only counted 44%. While we can only speculate, this shift is likely to come from increased exposure of athletic training to young female athletes, the increase of female athletes, and the ability of athletic trainers to work more “traditional” hours. We are also expanding and breaking the glass ceilings that seemed unattainable for so long. If you watched any TV around Super Bowl time this year, you probably saw a tablet commercial featuring Katie Sowers, the first female coach at the Super Bowl. She wasn’t the only female making a first at the Super Bowl; Laura McCabe provided care for the 49ers, Tiffany Morton and Julie Frymyer for the Chiefs These are huge positions of visibility that allow what seemed to be a dream for a child (or professional) to become a reality.
Women in athletic training are making huge strides across the nation. While we have never been discouraged to become athletic trainers, we have certainly met limitations. In 2010, women represented close to 50% of assistant, associate, or graduate assistant athletic trainers at the D1 level5. However, women held less than 20% of head athletic trainer positions. Those that did become head athletic trainers did so due to their persistence and strong leadership skills. We will always have work-life balance as an obstacle to the highest reaches of our profession, just as men do. However, until women can be universally supported in the prospect of having a family and a time-consuming head athletic position, we will not obtain an even split or majority of head positions.
5. The Experiences of Female Athletic Trainers in the Role of Head Athletic Trainer. Journal of Athletic Training 2015; 50(1): 71-81. doi: 10.4085/1062-6050-49.3.50
As women, it seems our bodies and hormones are in flux almost our whole lives. The ebb and flow (pun intended) of menstrual cycles, pregnancy and delivery, breastfeeding, then finally perimenopause and menopause.
We live in a culture that speaks of these changes and shifts as awful. I believe it’s time to reconsider and understand that the design of our bodies is, instead, “awe-ful” and powerful. I spent 40+ childbearing years capable of growing a baby and producing milk to feed the baby without ever having to consciously give it a thought. I never once had to decide which hormone to release or which hormone to inhibit to make any of that happen. I was in awe of what my body could do (yes, even though things didn’t always go perfectly, and though I had four cesareans), and I celebrated and appreciated that season. Then perimenopause began…
I had heard horror stories from my friends. I expected wild mood swings, hot flashes, night sweats, insomnia, heart palpitations, weight gain, and loss of interest in sex.That’s all I had ever heard about menopause, even though women in cultures that value aging and celebrate menopause do not report extreme symptoms. I wondered if I could make it different somehow. I did.
But let’s back up a bit. In my early forties, I began to see a chiropractor for a muscle spasm. Besides chiropractic adjustments, he began teaching me how I should be eating. It changed my health head to toe, inside and out. It changed my career path. It changed my life. For ten years prior to perimenopause, I was eating organic whole foods without restriction, eliminating or reducing toxins in my home and health and beauty products, and I was physically active. One of the benefits of this lifestyle change is my hormones became balanced. No more PMS, just a regular gentle cycle of rising and falling estrogen and progesterone doing their graceful dance along with other complementary hormones. This set the stage for how I would transition through menopause.
I remember the first time my cycle was late. Here I was, in my early 50s buying a home pregnancy test, both hoping it would be positive and hoping it would be negative. It was negative. For the next few years, my cycles were regularly spaced three months apart (perimenopause) and eventually stopped (menopause). To support my body during this stage, I supplemented my healthy diet with hormone balancing herbs. This was going to be easy-peasy!
Then it happened. I was driving home from a seminar in Dallas in a blinding rain storm and I had just received a phone call telling me of a family emergency. I pulled to the side of the highway with my heart racing and I was warm through my whole body, and I was shaking with anxiety. I was reminded what hormone pathways could cause this sudden onset of symptoms and knew what I needed to do.
The adrenal glands are very small and sit atop the kidneys, and have a mighty effect on the body. They produce stress hormones such as adrenaline and cortisol, but since they also produce an estrogen precursor, they are one of your body’s main sources of estrogen after menopause. Your body uses estrogen for many processes, including bone repair and remodeling and regulating cholesterol, and once your ovaries slow estrogen production your body will convert the precursor provided by the adrenal glands for use. (Fat cells also produce an estrogen precursor, in case you were wondering.) Periods of high stress cause your adrenal glands to produce more stress hormones and less estrogen precursor.
During periods of intense stress, I have experienced heart palpitations and “warm hugs” as I call them since they are not as extreme as the hot flashes others have described. Recognizing this, I have learned to manage stress and take care not to become overwhelmed. I am deliberate in nourishing my body as during times of stress the adrenal glands require more C and B vitamins, so I consume more foods rich in these nutrients and supplement with organic whole food vitamins focused for adrenal support, a high quality wheat germ oil as a whole food source for Vitamin E, and Ashwaghanda which is an herb that has been traditionally used for adrenal support. In my practice I utilize BioScan SRT (Stress Relief Therapy) and Reflexology, and I regularly use these on myself.
One other vitally important therapy that is free and can be practiced anywhere is deep belly breathing. The intra-abdominal pressure created by core breathing gives the adrenal glands a little massage with every breath. It also engages the parasympathetic nervous system, which is the “rest and digest” state, instead of staying in a constant state of “fight or flight”.
Menopause doesn’t have to be miserable. Use this season to take care of yourself and celebrate the new freedom
Mona Turrell, NC, D PSc serves as Nutritional Consultant at ProActive Sport and Spine in Broken Arrow, OK. She also offers comprehensive Holistic Health Assessments, Reflexology, and Lifestyle Counseling. Mona has been active in promoting natural health in the Tulsa area since 2008, even appearing on all four network affiliates promoting real food recipes and community health initiatives. Her passion is helping others feel their best by developing strategies for eating well, moving well, and thinking well.
February is Heart Month, and February 13 is #WearRed day, a day dedicated to recognize and support the women in our lives who suffer with heart disease, and to advocate to reduce the gaps in cardiac science and care for women around the world.
Did you know that heart disease kills more women than all cancers put together? It affects 2/3 of women in their lifetime, and kills 1/3 of us.
It can indeed happen to you, so please learn the signs, and believe it. If you think you are having a heart attack, you just might be.
In 2015, I was a very healthy 49 year old, yet I woke up one morning and had a spontaneous heart attack while checking morning emails (seriously, the S in my diagnosis, “SCAD” actually stands for ”Spontaneous”). I had never spent a night in hospital, never had any surgery, and found myself in an ambulance, the Emergency Room, and ICU in quick succession.
5 years ago, SCAD was considered very rare, however, due to more research and better angiographic imaging, it is finally becoming more “known”. SCAD is an acute condition that can be fatal if you don’t get help fast. You can’t see it coming, you can’t prevent it and it accounts for up to 40% of heart attacks in women under 50. 90% of the time, SCAD affects women, which may be one reason that until recently no-one bothered to research it, although to be fair, they could only find it on autopsy until imaging tools got precise enough to find it in the living.
When we think of heart disease, we are actually thinking of Coronary Artery Disease (CAD), which is where cholesterol creates plaque that blocks your arteries, and that does account for about 80% of heart attacks, but there are other conditions and situations that can cause heart attacks as well. We have been conditioned to think of older women, maybe overweight, they don’t exercise, they smoke, eat unhealthy foods. The reality is that while these risk factors are true, and living well will help protect you from CAD, there are other risk factors that we can’t control. Things like genetics, hormones, high stress, physical strain, pregnancy and childbirth, autoimmune or inflammatory conditions can all put us at higher risk of CAD or other heart conditions.
I am very fortunate to have experienced wonderful treatment from the University of Ottawa Heart Institute and their Cardiac Rehabilitation team were instrumental in helping me recover successfully. I participated fully in every support recommended to me, and later trained as a Peer Support Facilitator with the innovative Women@Heart Support Program, designed specifically for women with heart problems. I learned a lot from this program: some things made me sad, and some made me mad, but ultimately they made me a passionate advocate for change.
Let me share the things that made me mad, and fuelled my commitment to changes, both for myself and for others. What I want you to know………….
1) Until about 20 years ago, almost all medical research and testing was based on men. Female hormones “confused” the results. This means that women react differently to medications, and we are not always taken seriously because “it’s not listed as a side effect”. This is changing, but we have a lot of ground to make up!
2) Women often have different symptoms than men, and because these symptoms didn’t come up during the men’s research, they are considered “atypical”, even though they affect more than half the population! Many doctors are not even aware of these differences, and might therefore send a woman home with anti-anxiety medication or indigestion pills. I have met women who have coded in the hospital parking lot after being discharged with indigestion!
3) Women are less likely to be recommended for certain treatments, procedures or cardiac rehabilitation than men.
4) Women recover better with social and emotional supports, which are only just emerging in more progressive rehabilitation programs.
5) People think heart disease is a men’s problem. As women, we don’t generally believe we might have a heart problem, we don’t understand our risks, and we don’t put ourselves first. We also decline supports like cardiac rehab because we “don’t have time”.
My ask on #WearRed day is that you pay attention to your bodies, stand up for yourselves and ask for and accept help to recover. If you think you might be having a heart attack, believe it might be true, and call 911. Advocate for basic blood tests and EKG to check for cardiac stress, and if you do have a heart attack, then ask for cardiac rehab if it is not offered and take the time to go!
And help raise awareness of this really important issue by wearing red, and sharing pictures on Social Media with #WearRed and #HerHeartMatters. Get your friends and family involved – together we can change the world!
