Wednesday, December 19, 2012

Practical management of sudden cardiac arrest on the football field

The British Journal of Sports Medicine recently published guidelines for the management of sudden cardiac arrest (SCA) on the football (soccer) field. These guidelines are certainly applicable to all sporting events.
What are the take home points?

1. Make an Emergency Plan and make sure all coaches know this plan.
2. All coaches must know CPR and how to use an AED.
3. An AED should be at every event and coaches must know where it is!

For the complete guidelines, see below.

Key recommendations for emergency planning for sudden cardiac arrest on the football field

  • Every team and venue hosting football training or competition should have a written emergency response plan for SCA.
  • Potential responders to SCA on the field (ie, coaches, referees, physiotherapists, athletic trainers, and other medical staff) should be regularly trained in CPR and AED use, and demonstrate skills proficiency in this regard.
  • An AED should be immediately available on the pitch during competitions.
  • Both teams should review prior to the match the location of the AED and details of the emergency response plan.
  • AED, automated external defibrillator; CPR, cardiopulmonary resuscitation; SCA, sudden cardiac arrest.
    Practical management of sudden cardiac arrest on the football field
    • Prompt recognition of SCA
    • SCA should be assumed in any collapsed and unresponsive athlete
    • Seizure-like activity, and abnormal breathing or gasping must be accepted as SCA until proven otherwise
    • Early activation of the emergency medical response system and call for additional rescuer assistance
    • Early CPR
    • If unresponsive and not breathing normally, begin Hands-Only (compression only) CPR—push hard, push fast
    • C−A−B (chest compressions−airway−breathing).
    • Immediate retrieval of the AED or manual defibrillator.
    • Application of the AED or manual defibrillator as soon as possible—while CPR continues. Stop CPR only for rhythm analysis and shock delivery if indicated
    • If no shock is delivered, CPR and life support measures should be continued until the player becomes responsive or a non-cardiac aetiology can be clearly established.
    • If a shock is delivered, immediately continue CPR for 2 minutes, then allow AED to reanalyse the rhythm.
    • On the discretion of the senior clinician on scene, transport of the SCA victim to a hospital facility capable of advanced cardiac life support, realising that effective CPR should be continued en route.
    • Upon return of spontaneous circulation, while still in coma, rapid cooling (induced hypothermia) for SCA victims with VF arrest has been shown to improve survival and decrease neurological complications.
    • AED, automated external defibrillator; CPR, cardiopulmonary resuscitation; SCA, sudden cardiac arrest; VF, ventricular fibrillation.

Monday, December 17, 2012

Soccer Specific Fitness

Dawn Scott, the fitness coach for the U.S. Women’s National Team, has written a great article on soccer fitness.
The key points are:
  1. The two key aspects of soccer fitness are speed and endurance.
  2.  There is a “new term called ‘repeated sprint ability,’ or RSA, which refers to speed endurance, or how you repeatedly sprint in a game. You don’t run at one pace for 90 minutes in a game. Rather, you constantly sprint and recover, or run at different speeds and recover. Players want to be able to sprint with the same qualities in the 90th minute as they do in the first minute. RSA is a measure of this.
  3. “Strength is the basis to every other aspect of fitness. If you don’t have strength, you can have a weakness when you try to develop any other type of fitness.
  4. One of the things with females that research has shown is that you tend to have a higher incidence of ACL injury in female players. With that in mind, I would make sure that female players are doing appropriate strength programs, especially strengthening the areas around the knees, to try to offset the chance of injuries like that.
  5. “At the younger ages I would be doing specific sessions focused on developing agility, balance, and coordination. It doesn’t have to be intense but it’s programming the body to move in a certain way and building up basic strength using body weight, fun games and so on. You’re doing age appropriate work at those ages and then as they get older you can develop those programs and add in other components of fitness that are appropriate.
  6. Recovery strategies are critical. Nutrition, hydration, sleep, and ice baths are important

Friday, December 14, 2012

The BioPhotonic Scanner as a Biomarker of Health

What is the BioPhotonic Scanner?
Watch this ....

Is this real science? Does the scanner really measure carotenoids?
Watch this ...

How are doctors using the scanner in medical practice?
Watch this ...

Get scanned today!

Call Dr. Steve Horwitz, D.C. at 301-254-5571 or email at:

Thursday, December 13, 2012

Getting Up and Down Of the Floor as a Measure of Health

For decades I have been saying that getting up and down off the floor was the best test for overall physical ability and health. Well. read this ..... 

Friday, December 7, 2012

Injury Prevention = Performance: The Functional Movement Screen

What does injury prevention have to do with sports performance? EVERYTHING! 

Here are the take away key points:
  1. Start with the Functional Movement Screen. ALL athletes should be screen first. The strength and conditioning program they perform is built around the results of the FMS.
  2. Build a mobile and stable athlete first.
  3. “Everybody is getting corrective work every day.”
  4. If one athlete has specific issues, that athlete must work on those issues.
  5. “Kids are bigger, faster, stronger, but they move worse.” They all need to work on basic movement patterns like stopping, starting, and changing direction.
  6.  The athletes who score poorly on the FMS are the athletes you see in the training room all the time.
  7. If you want your son or daughter on the court and field, injury prevention is key.
  8.  “Mobility, stability, and movement should supersede their [athletes] strength development in the weight room.”
  9. “The more mobile and more stable they are, the stronger they are going to end up being….”
  10. When a first string athlete gets injured, that effects the entire team. If a top receiver goes down, then a less experienced athlete must move up and may not be ready for the increased workload.
  11. The FMS is used at the NFL combine.
  12. Focus on quality over quantity.