Megan Rapinoe Used to Hoop, too!

Summer is here!  The barbecues are starting, fireworks and mini American flags are on sale everywhere, and the sun is finally shining in Seattle with WNBA basketball under way.  I've taken the kayak out already and saw some seals and I've lost and found my sunglasses at least three times with the bipolar nature of the weather in Seattle. I've been working on a blog post about sport specialization for a while, and it has been  moving too slowly for me - primarily because I've been spending a lot less time at my computer and a lot more time in the sunshine when it comes out, but also because other topics just keep popping up that I want to write about. And then I decided I really wanted to write about the United States Women's Soccer Team this week, but... that's what everyone else has been doing.  And so, I decided to combine the two.


First,  I'll start with a definition.  In 2002, Jayanthi et al defined sport specialization as "intensive, year-round training in a single sport at the exclusion of other sports."  This came along with: “The American academy of pediatrics and the American medical society for sports medicine have both discouraged sport specialization before adolescence but acknowledge that this recommendation is largely based on expert opinion...” What does it mean?  It means that medical professionals are supporting playing multiple sports, moving in multiple different ways, participating in unorganized play that isn't a sport at all - just like playing games of tag or riding bikes around the neighborhood, or climbing a tree - so that the body moves in different ways.  

There are considerable benefits to playing sports.  Health benefits, of course, including improved heart rate and blood pressure, cardiovascular endurance, and muscular strength.  There are also mental health benefits, particularly with team sports - but also with individual sports - like community interactions, competitive spirit, sportsmanship, and having a support system.  But there are also risks.  That same article from Jayanthi also found that youth athletes with a higher socioeconomic status were more likely to sport specialize and were also more likely to experience more serious overuse injuries than lower socioeconomic status athletes.  It was also found that those youth athletes who participated in team sports tended to have less frequent overuse injuries than individual sports.

Myer et al provides some interesting statistics about the success from sport specialization: Approximately 30% of American kids specialize in one sport with the goal of earning a scholarship and reaching the professional level in that sport, but only .2-.5% make it to the elite levels. Many parents and, more dangerously, coaches believe that focusing on one sport is the way to reaching this goal.  But using the same patterns over and over again may not help develop resiliency and strength in other movement patterns. 

Some quotes from that paper:

"Single-sport specialization was first reported in Eastern Europe with athletes involved in individual sports such as gymnastics, swimming, diving, and figure skating."

"Vaeyens and colleagues59 reviewed the training history of 2004 Olympians and found that the mean age of sport initiation was 11.5 years."

"At the collegiate level, a study of National Collegiate Athletic Association (NCAA) Division 1 athletes at one university found that 70% did not specialize in their sport until at least age 12 years, and 88% had participated in more than one sport."

Since I had already been doing research for a blog post on sports specialization, I looked into the roster of the USWNT and all the other sports those athletes played - other than soccer.  Here's what I've found.

Morgan Brian played varsity basketball through her senior year of high school before specializing in soccer.
Adrianna Franch was an all star high school basketball player.
Ashlyn Harris liked to surf and skateboard with her brother.
Tobin Heath reportedly likes tennis and surfing.
Jessica McDonald played four years of high school basketball and was a state champion and record holder in the 400m in track, also participating in the same three sports for two years of junior college before heading to North Carolina where she specialized.  The USWNT has a really long list of Tar Heels and a few Penn State Nittany Lions and Stanford Cardinal grads...I guess those would be the college power houses for women's soccer the way UConn is for women's basketball. 
Alex Morgan is listed as a multi-sport athlete.  As one of the most recognized athletes on the team, I think it's important to note that she tore her ACL when she was 17 and recovered to the extremely high level of play that she currently is at. In this chat, she says she started playing soccer around age 7 or 8, but played volleyball, basketball, and softball as well and didn't start playing club soccer until she was 14 years old.
Alyssa Naeher, my fellow Connecticut native, also played basketball in high school. 
Christen Press, (who I was insanely lucky to sit next to on a flight from Hartford to Chicago last summer in which the entire USWNT was on the plane and Sam Mewis sat behind us) played tennis and ran track before heading to Stanford for college. 
Megan Rapinoe played basketball and ran track.  
Becky Sauerbrunn also played basketball and volleyball. 

Megan Rapinoe celebrating the Storm Championship

Abby Dahlkemper, Tierna Davidson, Crystal Dunn, Julie Ertz, Lindsey Horan, Ali Krieger (did you know Krieger is German for warrior?!), Rose Lavelle, Carli Lloyd, Allie Long, Sam Mewis, Kelley O'Hara, Mallory Pugh, and Emily Sonnett - are not listed to play another sport on wikipedia, though that doesn't mean they didn't or haven't.  It most likely just means they didn't play another sport in high school and specialized before then, perhaps even playing something else through middle school.  Having ten out of 23 players noting what other sports they played until about age 18 has to help demonstrate the value in playing multiple sports!

So, what should we do about it?  We need to advocate for kids to play, to have recess, to move more, and to support participation in more than one sport.  My mentor from PT School, Lindsay DiStefano refers to this as Sport Sampling.  (I'm not sure if she coined this term, but it's the first place I ever heard it, and I like the idea - sample different activiites, find the ones you like, and move more!)  "Parents and educators should help provide opportunities for free unstructured play to improve motor skill development and youth should be encouraged to participate in a variety of sports during their growing years to influence the development of diverse motor skills" again Myer et al. 

And so, it's summer time.  Let your kids go out and play.  Run at the beach, play tag, kick a ball around, throw a frisbee, swim!  Don't let them play the same sports all year round.  And watch other sports too... like basketball, because now it's game time, and I'm off to go watch the Seattle Storm in action, hopefully with soccer star Megan Rapinoe in attendance!

2019 WNBA Season Training Camp Begins Sunday, May 5th!

The 2019 WNBA Season is almost here!!! This week, the Seattle Storm Sports Medicine Staff gathered at Storm Headquarters to prepare for our upcoming team physicals and training camp!  Players will be starting to arrive in Seattle and get settled in their apartments with camp starting on Sunday, May 5th!  It was nice to see the Championship Trophies, including the most recent 2018 WNBA Championship Trophy, proudly on display along with catching up with all my sideline pals.  This will be my fifth season with the Storm and many of the medical providers have been there for at least three of those other seasons - so it's always a bit of a reunion getting back together after the off-season.

All of this is occurring in the same week as the Women's National Soccer League announcing their official roster for the 2019 World Cup and a group of over 200 professional women's hockey players announcing they'll be sitting out this upcoming season.  So much going on in women's sports!  We're facing a time of change.  You can see it in politics.  You can see it in education. You can see it on the news.  You can see it at work.  And, without question, you can see it in sports. It has been inspiring to see the platform athletes have through sports, and I do not take it for granted that I have the opportunity to stand on the sidelines and watch with a front row seat.  But, in the wake of all this change, we have the chance to embrace opportunities and seize every chance that presents itself.

So today, I'll highlight a little about what the beginning of the WNBA Season looks like for the medical team working behind the athletes. In truth - all sports teams require multiple teams to operate at their best.  You have the athletes on the court, the sports medicine providers - like the team doctor, athletic trainer, strength and conditioning coach, and other specialists - you have the business staff that makes sure the front office operates - and this can include your ticket sales team, marketing team... so many teams!

Our meeting was to get everyone organized. New members of the crew were introduced.  We reviewed the medical status of all of the incoming players.  This is helpful to prepare for our physical exams that will occur in the upcoming few days to know who is coming in injured and may need some rehab programming right from the start versus getting a strength and conditioning program ready.  We get details on who will still be playing overseas in the European Leagues - because some of the Storm players are going to be playing for championships in other countries and will join us later than other players.  We won't get into the discussion on why this occurs - it's financially based and it certainly increases the risk of injury on these athletes by not allowing them rest breaks or an off-season - which makes our physical exams even more important.

Truly, doing physicals for incoming WNBA players and attending training camp practices has been one of my favorite times to work with the team.  Here's why:

1) The WNBA has 12 teams with 12 players on each team - so there are 144 professional female basketball players in our league.  This compares to the 30 teams in the NBA which have 15 player spots available for a total of 450 possible jobs to play professional basketball.  That means, whoever gets invited to training camp is the cream of the crop, ultimate best at what they do.  Who doesn't want to meet, and work with, the greatest athletes in the sport they love?  Of the group that comes in, a handful won't make the team, but they will get exposure from their invitation to training camp which will help their future in basketball anyways.

2) The rookies are usually coming in from college, their first job away from home, and it's an awesome opportunity to help them in whatever way possible.  They all have different needs.  For example, one year, the Storm Strength Coach and I were doing our physical exams on a player who had come from college... she hadn't even graduated yet.  We asked her how she was settling into Seattle and she expressed some concerns about grocery shopping and cooking.  Her college team and college dining halls had fed them most of their meals - so she had never had to do those things before.  We could provide her with resources from day one of where to shop, what things to look for, and which players on the team were excellent cooks that they should ask for advise on techniques.  The team also has a nutritionist that they can meet with to help design meals, but for starters, we needed to make sure they stopped eating out every meal, because it is far too expensive and time consuming.

3) Some of the best basketball practices are during training camp.  Because there are only 12 spots on the team, these athletes are fighting hard for their spots.  At this level, they work hard almost all the time, but for sure this is some of their best basketball.  Training camp or the playoffs.  When it really matters the most.  And the coaching staff sets the tone for the whole season right from the start.  So you're just in for a good time if you're on the sidelines.

What will we do at team physicals?  Well - the team physician will go through the usual things that any other person would have done at a physical exam.  Height, weight.  Any pain?  How is the body moving?  How is strength?  Any recent illnesses?  Listen to heart and lungs, look in eyes, ears, and mouth. Any reason to get any blood tests?  Nothing out of the ordinary.  Hopefully you've had your own physical recently... and if it has been more than a year - schedule one!

The team Strength Coach and I will do movement screens that we have developed over the past few years.  When I was with the Connecticut Sun, our team physical therapist and strength coach did movement screens too, so I would imagine all the teams in the league are doing some sort of assessment to determine where they should start their strength and conditioning programs for each athlete and see how everyone looks.  As a physical therapist, I’m looking at their squats, jumping and landing, overhead motion, and some core strength tests.  If you're not assessing your athletes before a season, you're guessing with their training for the whole time.  Baseline measures are essential.  And that's about it.  Then we can prepare for the season!

I'm ready... who's coming to a game!?!  Go Storm!

Airplanes

"Can we pretend that airplanes in the night sky are like shooting stars, I could really use a wish right now..." - B.O.B.

I love to travel.  I enjoy seeing new places, eating new foods or the comfort foods of home, reconnecting with old friends and making new ones... and my family lives on the East Coast while I'm on the West Coast, so often my travels lead me to them.  Last weekend I went to the East Coast, flying through Chicago O'Hare each way... and my personal travels started the thought process for this week's blog.  And then the WNBA had a massive flight disaster...

Today, the Las Vegas Aces WNBA team are scheduled to play the Washington Mystics in Washington, D.C.  Initially scheduled for 7PM EST, tonight, the game was moved back an hour as the Aces were not likely to arrive in town with enough time to get to the arena before playing.  (Update: ultimately the game was canceled!) They started their travels on Thursday mid-day with repeated delays shifting back their departure and arrival.  What a nightmare! They spent several hours stranded in the Dallas airport... and with a good sense of humor... posted an injury report listing every player with a sleepy emoji.

Many of these details are outlined in this article... though I was following the action on twitter, primarily through Carolyn Swords, A'ja Wilson, and the Las Vegas Aces accounts. I'm really not sure what's been going on to cause these problems... doesn't look like there are weather issues in the mid-west... but shortly after the Aces got off the ground, the Indiana Fever had their flight cancelled heading to New York to play the Liberty - that game is scheduled for 3PM EST tomorrow... who knows when they'll arrive.

Anyways... a few days ago, I was flying from Hartford to Chicago with the entire US Women's National Soccer Team.  I waved hello to superstar Megan Rapinoe who I've had the pleasure of crossing paths with a few times in Seattle, and I was seated next to Christen Press, across from goalkeeper Alyssa Naeher and two rows behind Tobin Heath... they were all very pleasant, were able to avoid middle seats from what I could tell... and were happily taking photos with fans who recognized them.  Their matching travel outfits with the USWNT logo on them didn't help them stay incognito.  I wonder if the men's national team flies commercial... we all know the NBA doesn't.  I don't have the time to make this a gender issue, today.

Years ago I worked as the Travel Coordinator for the Connecticut Sun WNBA Team and had been looking into chartered flight costs thanks to the help of the UConn Women's Basketball office... the cost for a charter then was about $40,000... flying commercially, even if it's an expensive flight over $500 per person on the whole team and staff made a travel party around 25 people... total cost per flight is about $12,500.  It just isn't feasible right now for the WNBA teams to travel at this type of cost - especially since teams aren't permitted to travel together (unless league rules have changed).  Maybe the cities that have National Women's Soccer League teams and WNBA Teams could arrange travel together so the Storm and Reign could travel to places like Chicago together and split costs of charter... but you definitely need to have more people to fill a charter to make this cost effective in the WNBA.  The coaching staffs and medical staffs in the NBA make a much larger travel party than the WNBA is limited to at this point, as well.  I'd certainly love to get back on the road with the Seattle Storm along with the rest of the medical crew... but the budget can't fit all that!

Lastly... when I flew out to the East Coast last week... Seattle to Chicago... I experienced my first time when they paged over the speakers for a doctor on board.  Now... I know that I'm a physical therapist... but years ago I was an EMT and I am working towards urgent response training... so I figure if there wasn't a doctor on the plane, I'd potentially be more useful than someone without any medical training.  I walked to the back of the plane and made myself known to the flight attendant.  A nurse was sitting next to a gentleman who had experienced a seizure.  The nurse said things were under control and asked me to share my seat number in case another episode occurred and more hands were needed.  I went back to my seat.  But this got me thinking... you see this in movies and I don't actually know what the rules say about whether I'm supposed to help.  So I looked into it... and would you believe I could not find resources for physical therapists under emergency circumstances other than PTs working in an emergency department?  We're supposed to be CPR and First Aid trained - but that's all I found!

I also found this article which stated that airlines hope a physician won't be on board when this occurs because an on-board physician could require urgent landing where if there isn't a doctor available, the crew reaches out to medical crews on the ground who try to help remotely triage or treat the situation.  I noticed that the flight attendant had an oxygen tank and mask, first aid kit, and that there were some medications available to them.  Another article shared that 70% of in-flight medical emergencies are handled by the flight crew.  That paper outlines the most common medical emergencies that occur in-air, with chest pain being the number one listed outcome.  I did learn that there is a federal law that protects physicians and health care providers who assist during in-air emergencies, though you should always practice medicine with the intent to "Do No Harm" and within your training restrictions.  Doing absolutely nothing was not an option, in my opinion... but I'm certainly glad I didn't have to help with CPR on an airplane.

Overall - there's a lot going on up in the skies.  Back to B.O.B. ... "I could use a dream or a genie or a wish to go back to a place much simpler than this..." I'm sure the Las Vegas Aces are really looking forward to flying to Connecticut tomorrow after the disaster they faced today.  Let's hope they stay healthy through their game and get some good rest... and that no doctors are needed on their flight requiring them to land mid-route.

Professional Women's Soccer - The Seattle Reign

Hello March Madness!   My brackets for the men's NCAA basketball tournament are hanging on by a thread and UConn Women's Basketball is on a roll!  There have been so many awesome basketball games and there's still a week left to go! I openly admit that I love basketball, but soccer has started to steal a tiny place in my heart.  I think it has something to do with the fact that it's played outside and the weather is starting to get nicer. And soccer players are insanely athletic!

Last night I attended the Seattle Reign season opener versus the Washington Spirit.  For those of you who don't know, the Seattle Reign is a member of the National Women's Soccer League.  This is professional women's soccer.  The Reign play at Memorial Stadium which sits in the shadow of the Space Needle, just a stone's throw away from Key Arena where the Seattle Storm plays.  Last month it was announced that the ownership group for the Seattle Storm - Force 10 Sports Management - would be adding management responsibilities for the Seattle Reign to their ever growing portfolio.  Having been around the WNBA for the past decade, I've learned a lot about how the league operates and I know a little bit about the teams and some of their ownership groups.  Over the past few years, I have attended a handful of Reign matches, but, prior to now, hadn't given much thought to how little I knew about the team, their players, the ownership, or the league.   So I did some digging.

The league: The National Women's Soccer League (NWSL) was launched in 2012 - so 2018 is their 6th season with competition between their nine teams.  It is the longest running professional women's soccer league as the (several) leagues that came before it only lasted up to three seasons.  In 2017, the league averaged about 5,000 tickets sold per game with the Portland Thorns leading the way averaging 17,000.  Interestingly, on the men's side, Major League Soccer games averaged about 21,000 tickets sold per game in 2016 with the Seattle Sounders averaging over 40,000 per game.  Seattle is just a huge sports city!  In the WNBA, ticket sales for the league and the Seattle Storm averaged 7,700 tickets per game.  When looking at salaries, this 2016 article listed limits to NWSL salaries as $37,800 per season.  That's the limit!  WNBA minimum salaries are $35,000 and NWSL minimum salaries, according to this article, were $15,000!  In comparison, the average (men's) MLS salary of $300,000 (median $100,000) is a liveable wage.  The gender discrepancy is appalling.  The best way I can try to help combat this is to attend games and buy an occasional ticket to show my support.

The team: The Seattle Reign is owned by Bill and Teresa Predmore.  Bill Predmore founded the company POP in 1996 - they're a digital marketing solutions company whose website looks like they're doing some really cool stuff.  Fun fact about Mr. Predmore, though, is that from 1993 - 1996, he was Assistant Director/Assistant Editor for the Bill Nye Show.  His wife, Teresa Predmore, played college soccer at Oregon State and a quick google search brought up her twitter account which looks like she does some work with Water 1st which is a super cool organization that helps provide clean water and sanitation to communities who would otherwise not have access to it. (They also look to empower women and help communities own their water works once the system is implemented.)

The players: You can find the Seattle Reign roster here, but a few quick notes worthy of mention.  In last nights season opener, which the Reign won 2-1,  Megan Rapinoe scored in the 7th minute and Jodie Taylor in the 35th.  Megan is a US Women's National Team player and Olympic Gold Medalist and Jodie, born in England, plays for their national team which won a Bronze at the 2015 World Cup.  The team underwent a major overhaul with 12 new players since last season and a coaching change.  In addition to the ones I've already mentioned, the team is full of athletes who have played for numerous national teams including: Allie Long - USA including the 2016 Olympic Games, Nahomi Kawasumi Olympic Bronze medalist for Japan, Rumi Utsugi former Japanese national team member, Theresa Nielson for the Denmark national team, Jess Fishlock plays for the Welsh National Team and Elizabeth Addo plays for Ghana.  I haven't even mentioned how many of their players are on US teams that are U-23!  So much talent.

Who wants to join me for a game?!