My Athletic Training Adventures

There is never a best time to reflect on your experiences, as I quickly learned throughout my internship with the San Francisco 49ers. Just now, I logged into my blog and realized that there are so many things to write about from the past nine months. After graduating from CBU and immediately working for the 49ers, patient care to me quickly became more than just dishing out health science knowledge and making someone feel better. It was establishing relationships and gaining trust and how these bonds can drastically affect outcomes. Working with all sorts of personalities from every single department, I learned that it is not easy to simply be yourself and how important it is to stay on top of your game. It takes a lot of character and confidence to complete so many different tasks in such a high stress environment. When the team is putting in a huge amount of effort to win games on Sundays, you must match their dedication and grind to propel them to the endzone.

I want to apologize to myself for not updating this blog on a consistent basis, but I can guarantee that I can recount so many different memories that have shaped me today. If I had to redo my whole seasonal experience, I would do so in a heartbeat, but for now, I can calmly say that I accept everything that has happened in the past and it is time for me to move on. Like what Manny says, and every football coach says, “the play is over and move on.”

Being a young athletic trainer has its challenges, you are expected to know everything that you learned in school. Every detail matters because your patients depend on you. One detail missed and you start to lose trust from your patients. Because you are graduated and newly certified, there is a higher standard to be upheld. You may love one domain of athletic training more, but you cannot forget the other domains. That was something that I had to keep reminding myself, if I forget something, ask. There is nothing wrong with asking. The worst thing you can do is hurt someone, not get yelled at, and at the professional level, that is not what is supposed to happen. There are times when I feel like I was inept with my athletic training skills, but making these mistakes were important to me. I remember it better, and to have it stick and making sure I won’t make the same mistake again takes practice. I should have taken more initiative throughout the regular season to practice and ask Manny more questions. Instead I became more apprehensive, afraid that I was going to make the same mistake again. In some regards, I always have that notion that everyone is staring at me, and waiting for me to do something for them to criticize, but the real mindset is that everyone is going to criticize about something and it just doesn’t matter any more. You either take the feedback with kindness and apply it to your practice, or you can toss it out the window and not grow.

Every detail mattered for the sake of efficiency. I could not keep track of all the times I got yelled at for not counting things correctly, or when I should have spoken up about a pressing issue when it comes to inventory. I think what was also frustrating was trying to be the same page as everyone else. I wanted to take initiative too late at times, and there were times when the information should have just been spread by everyone. The more I think about who it is to blame, the more I realize that we are all at fault to some capacity. I like to look back to my mistakes as reminders, and the consequences that happen if I don’t catch the detail.

I am in this internship to better myself as a clinician. I got to see my communication skills at its lowest and when I communicate clearer, I could see many projects and tasks go smoothly. What I did not like was that I was bossed around all the time, forcing myself to accept and adhere to everything. I always had the inclination to just go with what other people say just to get over the fact that the task had to be done. I never spoke for myself nor did I ever stand up for myself. When people want to make fun of me, I tend to laugh it off or ignore them simply because I have nothing to say back to them and whenever I do have something to say with my intentions to lighten up the mood, it was either not funny, or someone became offended. Sometimes my actions just confuse people, but I react this way because I respect my peers, and I would never intentionally say something to hurt them. I let them make fun of me because I want to prove to everyone that I have a thick skin. All in all, the real lesson is that I should learn how to loosen up and dish some jokes back, and not feel all threatened all the time.

While being in this high-stress environment for a full season offered so many different challenges, I kept reminding myself to never give up. The more I became lost with myself, the more distant I was to my dream of working in professional football as a full-time clinician. Another mistake I made was reading a lot of different non-fiction books, and thinking about so many different things at once. I think it showed that I scrambled to look for any information that would better me as a person. I read books for a different purpose, and forgot about the people around me. I couldn’t concentrate on the words I was reading and I was so caught up with my perception as an athletic trainer. I eventually stopped reading books halfway towards the season, knowing that it would drive me mentally down to the ground.

When reading did not work, I found an activity that I could confidently say changed my life outside of work, and that was joining a Judo academy near my home. I would go 3-4 times a week to relieve some stress. Being around a small group of people each day who breathed Judo was what I could say saved my life. I looked forward to learning a new throwing technique, or ground work move, and I didn’t receive satisfaction when I threw someone down, but it was when someone threw me down and taught me why. My mindset started changing, and the more I learned the life lessons from Judo, the more comfortable I was applying them to my job. It was a bumpy road trying to change for the better, but I am glad I found Judo during the regular season to be an outlet for me.

Being certified to me is an everyday challenge. It holds me accountable to how much information I have retained from my education and looks at me in the eye and asks how courageous I am to apply the knowledge for the betterment of every patient. For some odd reason, I have experienced spurts of confidence and moments of doubt, pointing out how inconsistent I am with my competencies. It still has not hit me that I am an athletic trainer, for there is always something to learn each and every day.

I came back to work as a season-long athletic training intern for the San Francisco 49ers right after graduating from CBU. I must say, it is definitely a whole other experience compared to being a summer intern. I am held to a higher standard of providing care and my knowledge is challenged constantly. It has been a month and a half and I am still finding ways to expand my comfort zone. I learned so much about myself in the span of time. The way I act around others when I get nervous changes how I explain certain things to patients and usually they are confused. I am still learning how to make my intentions more discernable and not having my colleagues, my superiors and the players guess what I am trying to do or say. Some days, I feel like a foreigner in athletic training room, and I am trying so hard to just be myself. I never had this magnitude of a problem where I just wanted to self-diagnose myself with social anxiety and beat around the bush to a quick resolution.

Today, Jia and I were in charge of running the AB Miller High School Clinic with Heather observing us, forcing us to take the initiative on setting up, providing care at the track meet and cleaning up afterwards. The whole day felt as if it was never going to end, as we kept realizing what supplies we have forgotten and how we were trying to figure out on the go how to direct orders to others. The whole day made me so caught up in trying to fail or hesitate that I ended up psyching myself out and making so many mistakes. I did not think things through and I honestly felt like I lost my confidence.

I did not think on my feet fast enough. I was absorbed in so much manual therapy that I forgot about the supplies that I could use to relieve a patient’s pain. After that incident, I felt so stupid and I couldn’t let go of the fact that I forgot that I could use this. I did not look at the bigger picture and I should not have kept doing the same things over and over again.

Jia and Heather were telling me afterward that I should not even worry and just learn from my mistakes. I don’t know what it is, but I still can’t let go of failure, let alone accepting it as a learning experience. How am I supposed to learn out of disappointment. It is easier said than done when you feel pretty crummy looking back at all of the mistakes made. What else could you do afterwards when everything is spoken and done?

This post is not related to athletic training at all. As the name of this post suggests, this is a personal post. While athletic training may take over one’s life through all of the hours we spend on facing challenges we face in patient care, we never forget our loved ones, no matter how far apart we are from each other. I take this time to share with you some personal challenges I have faced in the past two months, and how I had overcome them. The saying cannot be any more true, your family and friends will always be there for you, as long as you are real with yourself. I am not saying that I am completely real with myself, but part of being real with myself has to do with recognizing that there is a support system. It is ok to ask for help. 

Another saying is to always love your family, no matter what happens. To cherish every moment you have with them can go a long way, especially in the athletic training profession when sometimes the long hours in the clinic and the away games stretches the distance. I have learned to appreciate my family way more, after I learned of my grandfather’s passing, getting into my first major car accident, and traveling to Taiwan for my grandfather’s funeral. 

After receiving news of my grandfather’s death, the melancholy sunk in. It made me shed tears for the first time in many years. I had so many regrets in my life and one of them was to visit Taiwan more often. I wish I made more time out of my schedule to visit my grandparents and aunt rather than focusing my efforts on school and a career. I tried so hard to stop the weeping, but realizing that I missed my opportunity to visit my grandfather again was just unbearable. I had to accept the fact that he is now in a better place. 

A month later, I was involved in a car accident on the highway on my way back from AB Miller High School. I unintentionally rear ended another car after applying the brakes 300 feet away from slowing traffic. It was one of the scariest moments in my life, embracing the aftershock and countless afterthoughts that came with the accident. I couldn’t think clearly immediately after the crash. I sweated out of my dress shirt and I kept worrying about the consequences. I sat in the driver’s seat staring at the deployed airbags, the bent hood and the van in front of me. It was a blessing that the driver and the passenger were okay, but that still could not get rid of the shock after the impact.

These events could not have happened at a much worse time, when I needed the time to study for the Board of Certification exam and so many different papers and projects due. I kept worrying about my plans and kept saying to myself “These events are not supposed to happen. Why was I put into these situations?” The more I was victimizing myself, the more stressed I was. I was stagnant with my thought processes and I could not figure out how to start my assignments or even function at clinic. After the car accident, I had to figure out how would I commute from Riverside to Fontana for clinical rotations without my own car: how would I get groceries, and a more important question, how will I travel to Yucaipa to take my BOC exam? So many things were piling upon one another and what is amazing is to know that I was not alone in my personal challenges. 

To have classmates and mentors care for me and remind me to ask for help when I need it was very comforting. Dr. Dickert pointed out to me that she knows that I am the kind of individual who does not ask for help and that she is there for me when I need it; all I have to do is ask. My classmates would offer me rides to places whether it be to clinical rotations or to get groceries. I don’t think I would have gotten through the rest of the semester without a supportive cast, and I know that I would do the same for those who needed help as well. As much as I wanted to be independent and figure things out on my own, it forced me to continue my education in humility and ask for help. Having the BOC exam coming up, I forced myself to not get ahead of myself and take things one at a time, do what I can, and at least put in 100% of my efforts in the things I could do.

The week of the BOC exam flew past my head. Having planned to travel to Taiwan for my grandfather’s funeral, I reminded myself constantly to take these events one at a time. After taking the BOC exam and packing up to travel to Taiwan, everything was moving in fast forward, Arriving in Taiwan may have been the best thing for me at the moment, taking me out of a stressful semester for three days and appreciate the proximity of my family. My perspective on life changed as my family and I mourned for my grandfather. Watching my dad for the first time, as someone who is regarded as stern and never sad, shed tears hit me hard personally. I never want to mourn for my father, no matter how hard he has been on me growing up. Witnessing my grandmother trying to control her emotions as she was handed a basket of flowers by funeral attendants made my heart ache. Watching so many people attend the funeral and pay respects to my grandfather and my family put me in a state of awe. I could not have been any more proud of my grandfather for all of the effort he put in for his children and grandchildren to live better lives.

Being at AB Miller High School has brought back so many memories of when I was in high school, as a clueless teenager and a graduate student rotating through Santiago High last year. Watching the high school students trickle into the athletic training clinic always makes me wonder what I was like in high school back then, and I would question the way I interacted with other students and teachers. Although this is not my first time being in the high school setting, being at a new high school with different demographics is always new to me, and there is always something to learn not only about the patient care, but also about myself.

Although I only participated in swimming my freshman year of high school, it made me realize how fortunate these kids have Heather Harvey as not only an athletic trainer, but a mentor for guidance as they go through their high school careers. Students and coaches can always go to Heather for advice and eat lunch in the clinic and have a great time. The kind of example Heather sets for the students is what any teenager would love to have in their high school career, someone to talk to and learn from.

The transition from being in a college setting to a high school setting is definitely huge, as anticipated (haha, I just realized I wrote the same thing in my older post from last year “High School and Tape Applications"). I guess being at CBU for 18 weeks has made me get used to the operations, that getting out of a CBU mindset is hard. The contrast of maturity between both patient populations is conspicuous, and I had to adjust quickly. What I have noticed is that my explanations have been quite hard to comprehend for the high school students so I have been doing my best to use simpler terms. In this setting, no one really knows other manual therapy techniques or innovative interventions, they just want to be pain-free when they play. The patient’s pain perception can also be reliable if the history is thorough. While many students can exaggerate their pain levels or act as a malingerer, there may be something from a psychosocial aspect that needs to be considered. It takes a lot of patient education and developing a bond to ensure the patient that he or she can participate, and understanding their history with respect and keen senses.

Treatments at AB Miller are very quick, in a sense that the patient load can be large in a matter of seconds. It definitely turns into a triage situation and making quick clinical decisions with the limited resources gets tricky. I learned that even with acute injuries and only a set of hands, one may not always need to go by the book, at least give them something for the time being to buy into the care you are providing.

What I found quite remarkable was how tense every student is when they ask one of us to stretch them. They would, by reflex, guard themselves as their passive range of motion is assessed. I am still learning how it is that they rarely feel physically relaxed at AB Miller, perhaps I can take patient outcomes and compare the differences. I am figuring out what other cues I can use or what other subjective and objective hints I can rely on in order to figure out their complaint.

It has been a week since I finished my lead sport assignment with the CBU Wrestling team. I must say, it had been great experience working with a resilient, determined group of men and learning under a transparent and wise preceptor in Charlie. Being a lead student not only taught me the responsibilities of an athletic trainer, but the products of success that come with it when diligent commitment takes place. I loved working with the team day in and day out and getting to know each wrestler in the athletic training clinic, at practices and at the wrestling matches. I saw so much of how athletic training is an art as it is a science. Knowing what interventions work and what does not work and paying undivided attention to each patient honed my knowledge of athletic training. Every day, I wanted to come in early because I loved being at the CBU athletic training clinic, and even if I started my day on a rough note, the athletic training staff and the team always made me feel better indirectly, reminding myself that we are all in this together.

Some of the key things I learned:

- Act efficient, not fast: It took me a while to learn this concept, but even from the 49ers Training Camp, I am still trying to wire my common sense and reorder my priorities, but to delve into the daily duties and adjust the routine according to the schedule can become a challenge. Checking in Charlie, referring to the calendar and listening to the coaches’ announcements before each practice helped me take note of when the team is meeting for the next practice or match and what I should expect. It helped me to physically take notes of what we needed to restock as well. When it came to injuries and acute emergencies, it was important to make sure that everything else was ruled out and that the pressing issues (i.e. bleeding, consciousness) were addressed before doing a secondary assessment.

- Listen, Listen, Listen: Always listen in a conversation and pick up the details that may benefit to a clinical decision. It is okay to not know something, but it is not okay to leave it ignored. If there was something that I did not understand, I learned to have the patient re-explain what he or she was feeling. Also, not sounding like a checklist helped me appear more personable and approachable with the patient, and gain their trust.

- Be yourself, be creative: Working with wrestling gave me the opportunity to create different therapeutic exercises that were specific to their sport. Observing their movements during practice and figuring out what positions that they get themselves into or how they attack their opponents laid a blueprint for the exercises I can come up with. There were also moments when we did not have to go by the book, but at least have down the basics and tailor the patient’s rehabilitation program to their needs. Tailoring the program to their needs goes back to listening to them and considering what they want to improve in when the return from injury. For example, if they had a problem with shooting a double leg or single leg takedown, there should be some exercises that help them generate the power and progress them into the technique they want to get back into. This was also a chance to apply other techniques outside of the textbook. Incorporating diaphragmatic breathing and manual therapy techniques in the patient’s rehabilitation techniques allowed me to reflect on what I can fix and compare the outcomes on a week by week basis. Whenever an intervention failed to work, I learned to not immediately blame on the intervention itself. I made sure to fix my own mistakes with humility and take note of what worked and did not work for the patient.

- Everyone has a bloody nose: Many of the acute injuries that happened during the practices and the matches taught me to be calm and be prepared for anything that could happen. I learned about the many items we could use for facial injuries from vaseline to benzoin tincture and what to do when the bleeding still persisted. I also learned to never worry about the time, but still put in the best effort to stop the bleeding and have the patient return back to practice. As the season progressed, my anxiety during emergent situations went down and stopping nosebleeds seemed second nature to me.

Reading my first entry when I started working with the team back in October 2015, I realize how much I have grown as a student. When I first started, I was immediately humbled by the slip-ups, but I did my best to not burden myself with the guilt and improve every single day. Comparing the start of the season, to the end of the season, I can confidently say that I am pleased with the progress I made as a student. Picking up the smaller details and being consistent with applying them in the clinic has made me more committed with the decisions I make. It led me to appreciate the sport of wrestling way more than it is typically perceived. Watching what the wrestling team has to go through before each wrestling match and the strenuous conditioning sessions and weight cutting was very inspiring to me as well. Knowing that they work just as hard on the mat made me want to work as hard for them to get to the NCAA Division II championships.

The team after the NCAA Division II Championships. 4 All-Americans and 1 Champion!

Finishing strong is always easier said than done. The stress levels get high, unexpected events occur, and everyone tries to get past the finish line with such intensity. I chose “Finish Strong” to be the title of this blog post because of many reasons. One, as there are less than two months left until I graduate, what other adage is there to remind myself to not give up? Second, I think of the program, trying to end the hectic year with an MS, ATC behind our names and reflecting is challenging with time flying fast. Third, the wrestling season is coming to an end, as Cal Baptist sent five of the wrestlers to the NCAA Division II Championships, and I am praying that the team finishes strong in South Dakota.

I realize how easy it is to become lackadaisical when the end is near. I look back to the month of February, and so many things were going on that month. From finishing our research posters, to attending the CATA and Hit the Hill Conference, figuring out how to finish all of these projects in a matter of weeks, February looked like an American Ninja Warrior challenge. But now that we survived and grinding into the first week of March, everything seems like a breeze. If we were able to get through February, which I thought was the busiest month of this semester, then the remainder of the semester should not be that bad. I remember telling Dr. Salley, how relaxed I feel this month and how surprising it was for me to feel that way. I guess at this point, I have developed a mindset that I will be prepared as I will ever be. Taking in a balance of academia and clinical experience has built my knowledge in athletic training and I hope it translates well into the BOC exam and my future career as an athletic trainer.

I never knew how comfortable I would be going to this year’s CATA Annual Symposium and Hit the Hill event. For the most part, I was nervous leading up to the weekend because I am typically introverted and not as outgoing as others, but then I thought of all of the peers and mentors whom I could think of that could possibly be at the symposium this year. Once Edgar, Matt and I made it in time for the Young Professional’s Social (We stopped by San Jose to celebrate my sister’s birthday), we reunited with friends whom we met at last year’s CATA symposium, and made new friends along the way. It was great to hear how everyone else was doing, even the CBU graduates whom graduated in 2015. Hearing their stories on how they found their jobs and what they have encountered in their young careers was very inspiring; it made me realize how close I am to becoming a health care professional in the world of Athletic Training.

Sunday came and Nate Swift, Heather Harvey and Dr. Steven Winter presented a myriad of topics that benefited our leadership skills and education. Nate presented on what preceptors truly look for in their students and reiterated that it is acceptable to make small mistakes. Preceptors are not looking for perfectionists, they want to teach students who are willing to be active learners and hard workers. One quote that stood out to me was “never put yourself above a water bottle”. This quote reminded me of my experiences over the summer handing out water during the 49er training camp. It also made me think of what Laura said to me, that we specialize in injury and illness prevention. Hydrating patients as quickly and efficiently as possible may look like a petty task, but essentially, we were preventing heat illnesses with every swig of water the patients take during practices and games. Heather and Dr. Winter presented about multiple intelligences and love languages. The way we act towards our peers and patients makes a huge difference in patient care, and our behaviors in the clinic could be the final push over the fence towards full recovery. From a sports medicine staff perspective, it is important to praise each other in a nurturing way. Constructive criticism with a positive attitude is vital for a staff to grow and drive the athletic training profession forward.

As I reflect on the presentations that were given at the symposium, I wonder how much do we as students retain this information and apply it to our classroom or clinical rotations. All of the points made by the presenters can be viewed as obvious, and that to me is a huge trap. And how many clinicians practice what they preach on a consistent basis? I can only speak for myself or from what I have seen, but having these questions does not make them an excuse for starting conflicts or neglecting thereof; it encourages us to minimize the rough patches we may have in our careers.

We also had the opportunity to present our research posters in between the lectures. Through all of the highs and lows of completing our research study (The Potential Benefits of Mulligan Concept Mobilization with Movement Technique on Meniscal Lesions), I could see how relieved Edgar and Nathan were as we were explaining to our audiences what our case study was about. People were very receptive to what we found and with every question asked, I felt very confident answering them. As much as we wished to see the best results possible (improvements in both pain and activities of daily living) this provided great results to reflect on as a clinician. Potentially, our study could get published, and a part of me is really considering this project in the near future!

Hit the Hill 2016 was a totally different experience for me this year. I was not afraid of introducing myself to other athletic trainers fighting for the AB2007 bill on youth sports safety and concussions for non-school programs. In fact, I reconnected with athletic trainers whom I were in meetings with last year and made new connections. I felt more comfortable talking about my experiences as an athletic training student and how important it is for these bills to pass for the better of sports medicine. It is one thing to know how small the athletic training world is but also how amazing that every athletic trainer remembers each other even after months or a year.

Being in the meetings with assemblymen and senators was very empowering. Every meeting that I was in was full of support, and while we still have a long way to go towards our ultimate goal of licensure in California, everyone we spoke to understood our cause. It was baffling to hear that some wonder why we as athletic trainers, out of all professions, want to fight for regulation, when it costs us money, paperwork, etc. The fact that we are fighting for the safety and well being of our patients proves that we are an unselfish profession and we want to hold each other accountable as a profession.

Nathan, Edgar and I (Norma and Siraaj not included) with our poster presentation on Mulligan Concept Mobilization with Movement on Meniscal Lesions.

The Hit the Hill War Room!

Edgar and I in front of the Capitol Building

UC Davis reunion! (Lisa V, Aaron and Malisa)

I stepped out of the athletics world and stepped into the sports medicine clinic of professional bull riding on January 30th. My classmate, Lauren Mott, my professor Dr. Dickert, and I got to work a Professional Bull Riders (PBR) event at the Honda Center in Anaheim, CA. The experience working with meeting Peter Wang and Dave Edwards was very unique and I felt fortunate to participate in this opportunity. Looking at how other settings operated in the athletic training world reaffirmed that patient care in athletic training is the same across the board, no matter where athletic trainers are. 

Many elements of PBR sports medicine were very similar to the traditional athletic setting. When Lauren and I arrived to the makeshift clinic in the Honda Center, we saw Dave and Peter treating their patients. Most of the interventions they rely on are manual therapy techniques, ranging from active release techniques to strain-counter strain (similar to Positional Release Therapy). Peter mentioned that as their experiences grow, they have picked up fine details of examining the thoracic spine and noting any abnormalities or asymmetries on their patients. A lot of their patients sustain traumatic injuries from being slammed to the ground off the bull or if they get stepped on. It amazes me how many of these patients still ride bulls after sustaining significant injuries from fractures to dislocations and how vital having a sports medicine team behind them is in the bull riding world.

Lauren and I got to learn a lot about correcting posture from Dave. He showed us several release techniques and mentioned how the pectoralis minor and the latissimus dorsi muscles are common offenders of poor posture. He also taught us about the psoas major muscle being a muscle that frequently is overactive and contributes to pelvic alignment. He also mentioned that as bull riders, the gluteal muscles are constantly shut off because they rely mostly on their adductors and their hip flexors to stay on the bull by squeezing their legs onto the saddly of the bull. Dave provided many tips on how to find these discrepancies as we observed how he assessed and evaluated his patients.

Event coverage was very unique. We were stationed behind a gate that would let us into the bull riding arena. Peter would open the gate after each bull ride and make sure that there were no injuries. A paramedic, Don, would also be with us to cover the event. Dave stayed behind in the clinic and waited for any acute injuries to evaluate. As the event went on, we talked about our backgrounds and where we were from and what we wanted to do. It was awesome to know how much Peter and I had in common that we both went to the same school for our undergraduate degree and that we had mutual connections. Don also shared his experiences working at UFC events and Boxing Fights (he worked the Floyd Mayweather vs. Manny Pacquiao fight). Hearing their stories were very awe-inspiring and all of the emergency scenarios they had to deal with made me respect their professions more. As bull riders were coming in and out of the arena, we got to see how they managed each injury and how they communicated with their team physician. It was very straight-forward and everyone was on the same page for each patient.

One piece of advice that Peter gave to us was to never forget about the big things. All of the finer details in evaluation will come with more experience, but never forget to rule out the major injuries. We could put the patient’s life in danger if we did not rule out pathologies such as anterior compartment syndrome or brachial plexopathies. It was a great reminder as we study for the BOC exam, and reviewing the major concepts before delving into more advanced topics. In retrospect, I felt that there was a lot to take away from this opportunity from how to identify certain structures that contribute to a dysfunction to how to be a professional in the athletic training field.

My professor, Dr. Salley brought up an interesting analogy when it came to figuring out an etiology that had no apparent mechanism or cause. We were discussing a particular patient case that involved an idiopathic pathology. The patient, who was a water polo player was complaining of medial arch pain for weeks. She does not remember a specific moment when she started noticing the pain. After digging as much information we could get as far as her activities outside of water polo for more specific history, it was bizarre to see that a water polo player would have medial arch pain.

The analogy was this, if someone was to hear pounding hooves in a town of Montana, what animals could you possibly look for in Montana? Horses? Bulls? Those seem realistic possibilities, but what about zebras? Not likely, but it is not impossible to find a zebra walking around in Montana. When Dr. Salley mentioned this analogy, I immediately reflected on how I evaluate injuries at my clinical rotations. I tend to connect the dots more quickly than surely and forget to rule out other possibilities. As I reflected on my clinical evaluation, I wonder what does it take to rule out everything else so efficiently? I also thought, were the interventions that I chose for the patient helpful at all?

We decided to apply kinesiotape the water polo player’s foot and I asked her to come into the clinic before or after practice to do therapeutic exercises. The kinesiotape intervention seemed to help with her pain as she was walking or performing flip turns in between swimming laps. Over the weekend, she comes in and describes her pain feeling much better. I do not know if she kept the kinesiotape on for the weekend, and it just became much more bizarre for me.

The first week of Spring Semester has finally passed. I never thought that I would have made it this far, but it sure is a different feeling compared to the past semesters. It is surreal knowing that I will be taking my BOC exam and graduating with a Master’s degree in April. Going into my last semester and the second half of my lead sport assignment, I know I have to be the most confident that I have ever been as a student and to carry a work ethic assimilating that of a seasoned athletic trainer. I hope to finish out my graduate school career strong and be ready for the professional world.

The last courses that we are taking allow us to apply everything that we have learned in past semesters in our clinical rotations. One course that I am excited about is our Therapeutic Interventions course, which introduces the development of clinical reasoning behind the interventions decided for the patient. From therapeutic modalities, to therapeutic exercises and manual therapies, we are able to formulate our choice of intervention using evidence in current literature, patient preference, and clinical experience. Dr. Salley and Professor Friesen have been instrumental in guiding us on how to tie all three aspects of evidence-based medicine into our growing clinical practice. While there is so much clinical resistance in taking patient-reported outcomes, figuring out a way to record the progress of our patient’s rehabilitation in the busy athletic training setting has been seen as a major challenge worth overcoming. I look forward to heeding more advice from my professors on how to hone my clinical rationale.

Another course that I look forward to as well is Management in Athletic Training. Dr. Dickert told us how there will be many controversies discussed in class and how there are a multiple facets of administration that we need to learn how to manage as athletic trainers. From designing a facility to enhancing professional development, there is not one topic that seems to be my least favorite. Everything is equally important and I do not feel forced to learn any of these topics. What I am looking forward to is the debates that we will have throughout the semester on pressing issues in the athletic training profession. While these issues are ongoing and controversial, I wonder me or my classmates will change their stances on certain issues.

Recently I was fortunate to travel with Charlie and the CBU wrestling team to Stanford this past weekend for their dual meet. What was awesome about this trip was seeing the athletic facilities on the Stanford campus. I met Eitan, the athletic trainer for the Stanford wrestling team and he gave us a tour of the athletic training clinic and the strength and conditioning room. The amenities in these facilities included a wet room with contrast baths and numerous treatment and taping tables. The athletic training clinic and the strength and conditioning room were also next together similar to what I saw at Northeastern University. The athletic training room also had a juice bar station with different energy and recovery bars arranged on the adjacent counter. It seemed as if Stanford Athletics was very serious in how they treat their athletes and making sure they get the best care possible.

The dual meet went well overall, considering that the guys faced against a very tough NCAA Division I team. Throughout the matches, I felt more comfortable with my role and did the best I could to assist Charlie. I made sure that I was punctual with the tasks at hand and attended to the wrestlers whenever they needed something after their match. Afterwards, everyone was excited to go home, albeit a 7 hour bus ride back to Riverside. Unfortunately, one of the bus tires popped and we were stuck in Bakersfield for nearly three hours. I remember someone asking me jokingly if I was reconsidering my career goals as we struggled patiently in our bus seats. I responded with a no and it reminded me of how not every situation is perfect the way everyone envisioned each situation to be. As cliche as it sounds, it takes a lot of patience and thought to get around unexpected obstacles. Returning to Riverside at three in the morning, I thoroughly enjoyed traveling with the team. All of the opportunities to get to know the patients I work with on a personal level and learning more about and from my preceptor have been great memories that I could never forget.

Having a first-year student for this rotation has also been very helpful. Anna keeps me humble as she continually asks Charlie and me questions. Anna and I also go over a lot of different techniques from joint mobilizations and specific therapeutic exercises and reviewing anatomy during practice. Her energy and strong work ethic also makes our days much more fun and productive. So far, it is safe to say that this rotation could only be much more exciting and memorable!

2015 and onward. I am looking forward to the upcoming year and what it has in store for me. It hadn’t hit me that I would be graduating in only a couple months’ time during the fall semester of 2015. I had just applied to register for the BOC exam and for some reason, I do not feel excited at all. And maybe it is because I have three more months to muster up all of the excitement and anxiety, but I also think that there was so much about the 2015 year to reflect on before even planning for the 2016 year.

Ever since I decided that athletic training would be my future career, I never realized that I was drawn to every single aspect of athletic training. I loved being at sporting activities, I saw patients and their injuries as puzzles and mysteries, I encountered emergencies as a thriller movie. Everything about athletic training provided so much stimulus that motivated me to stick to something that I was passionate about. Looking back at the 2015 year, being able to reflect on all the tribulations and the success that I’ve had proved to me that if I could smile through all of the challenges, I think athletic training will serve me a career for a very long time. I never minded staying behind for extra time to learn something new, or to help someone out whether it be cleaning the athletic training room or documenting, it was something that I felt was my responsibility and that I would be doing someone out there a disservice if it was not done.

Looking back to the challenges I faced in the beginning of the year at UCR and at the University of Redlands, the lessons I learned from each situation shaped me into a more open-minded individual. My mentors made sure that I was doing things not only the correct way, but also with efficiency. Every time I made a mistake, I motivated myself to not repeat the same mistake and pushed myself to be better the next day. While I may never be the perfect student or the perfect clinician, I could only prove to my mentors and my peers that I am willing to be coached and will do whatever it is necessary to improve. Making mistakes during injury evaluations allowed me to reflect on what else I needed to do to be better at diagnosing and coming up with a reason for a certain intervention. Although there were many fascinating manual therapies that we learned as interventions in our tool box, my preceptors made sure that we had at least a reason for choosing an intervention rather than simply using it for its known analgesic effect.

Working as an intern for the 49ers changed my views about patient care in a positive way. Practicing a consistent habit of working diligently cemented the importance of being their for the patient as soon and as often as possible. Through all of the small chores over the summer, I could formulate questions about how other clinicians approach certain cases. I found interest in learning more about diaphragmatic breathing and paying attention to the details of various interventions that they used for their patients. In a fast paced environment, it was challenging to pick up on the small, but important aspects of patient care, but as I dialed back and started asking simple questions, the aspects became much more clear to me and I could understand why certain clinicians choose particular approaches.

If I had to choose one word representing my 2015 year that I am thankful for, I am thankful for the challenges that force me to think outside of the box. Being a second-year student put me in a position to take more initiative and be more confident in the decisions I make. While I have a lot to learn, learning for me has become exponentially more fun for me. During the fall semester, my professors and my preceptors introduced to me new topics that made me want to read more about, explain the concepts to myself for understanding, and apply them the next day. In the 2016 year, I look forward to applying myself more as the wrestling season approaches the halfway point and continue to challenge myself in becoming a better clinician each day.

Two weeks ago, I went to my first wrestling tournament with Charlie and the team. It was the Cliff Keen Tournament, a major wrestling tournament where schools from all over the country compete in and held in Las Vegas. Forty teams participated in this tournament, with the majority of the teams being Division I teams. The tournament was full of physicality, and so many of the Division I wrestlers were very quick and accurate with their takedowns. Going into this tournament, I knew Charlie and I would have a long trip ahead of us and we had to be on our toes and prepared for anything our way. Luckily no one was severely injured, but the tournament served as a test of mental endurance for me as we jumped around from mat to mat as each CBU wrestler’s name was called. It was definitely a busy day for us and from the trip, I have learned so much.

We arrived in Las Vegas by bus, a three-hour bus ride to a local hotel 15 minutes away from the Cashman Center, where the tournament was held. After checking in and settling into our hotel rooms for about 15 minutes, we headed out to the Cashman Center for practice. Arriving to the Cashman Center, I was able to get a glimpse of what Division I wrestling looked like, as teams such as Wisconsin and Oklahoma, top wrestling programs, were warming up and drilling with each other. From that moment, I knew that it was going to be a long day tomorrow, yet for some reason, I was not nervous at all. I was very excited to see how other athletic trainers handle wrestling injuries on the mat and how other wrestlers wrestle at this huge tournament. After practice, we headed back to the hotel. I had some homework to do, but I only had a short amount of time to work on it since we had to wake up at 5 AM the next morning for skin checks and weigh-ins at 6 AM.

The next morning flew by so fast, maybe it was because I saw hundreds of wrestlers and the view of everyone on eight juxtaposed wrestling mats made everything move quickly. Everyone had different ways of warming up, from leap frogging over each other, to rolling around the mats. After warming up for about half an hour, the wrestlers had to go through skin checks and weigh-ins. The announcers gathered all of the athletic trainers to the front of the stage and went over the skin check protocols. The athletic trainers were paired up and checked two different teams. Witnessing this whole process made me sympathize for the athletes, and how much they have to go through to compete at their respective weight classes. They looked drained of energy, as they filed in line. After skin checks and weigh-ins all of the wrestlers rushed back to their respective team areas and wolfed down snacks from bagel sandwiches to fruits before the matches commenced at 9 AM. Charlie and I took a walk to the nearest mart and bought coffee and some breakfast.

Walking through Las Vegas made me think about how travel trips sound so exciting, but it does not involve a lot of sightseeing at the tourist-known places. Although it would have been nice to go to the Venetian or the MGM (I am somewhat kidding), sightseeing around the event location was also fun too. Outside of the strip, Las Vegas very similar to what you would find on the streets of Oakland or South Central LA. Even though we were not in the glamorous part of Las Vegas, I was appreciative of what else was out there. Seeing the impoverished side of Las Vegas made me more appreciative with what I had. Every opportunity that I have had in my life has been a unique and telling experience for me and without those opportunities, I would have never been the person I am today.

Once the wrestling matches started, it was time to go to work. I kept multiple pairs of gloves with me, a pack of gauze and some Vaseline. Although Charlie would be the first one to respond to any blood or other injury, I had to be prepared for my role of making sure the mat was clean and that no one else had any blood. I relished my role of assisting and to see what Charlie had to do throughout the day was eye-opening. He had to make very quick decisions from how to keep a scalp and facial laceration from bleeding and when should wrestlers be taped before their matches. A lot of time management was involved in the day and I had to learn by watching and doing. I had to make sure that the water bottles we brought were always filled throughout the day as more wrestlers were wrestling multiple matches. It did not help that the event staff was very inefficient on filling the coolers that they had on the tables, and how sometimes they would fill all four of the coolers with sports drinks when most of the wrestlers just wanted water. As much as I did not want to, I had to resort to filling the water bottles with the water fountains they had. Being able to work around obstacles was a great learning experience for me, especially at an event that was busy.

Although I barely got any of my academic work done, I could not have missed this opportunity to learn on the road. My trip with the team was also a memorable one. I felt that I was bonding closer with the team and coaches as well. Understanding what some athletes like and what some athletes do not like helped me do my job more efficiently and it is never a problem to crack jokes and play games with them on the bus either!

The team practicing the day before the tournament

So many wrestlers warming up!

The past few weeks have been a whirlwind, but more exciting than terrifying. I am three meets in and I can definitely feel the confidence in me growing whenever I am doing rehabilitation programs with the wrestlers or covering practice and handling first aid emergencies. I have been seeing so much already, from ankle and shoulder injuries to skin conditions and the complexities of medical insurances. I would like to think that I have learned quickly, as there have been some weekends when Charlie traveled with the Men’s Water Polo team for their away games and many of the responsibilities were on me for the time being.

I never expected so much more autonomy that it has helped me take more steps towards being a better clinician. Charlie has put me in situations where I really have to think on my feet. On days when Charlie is traveling with the Men’s Water Polo team, I have to hold down the fort and make sure the wrestlers get their treatments and that practice is set up on time. He definitely made sure that I was put under pressure to make sure that I can manage my time and maintain efficient patient care.

Being three meets in did not tell me that I have grown a lot since my start in the CBU program, but it was a constant reminder of how much I have yet to learn. The first meet, Shiho and I covered the Blue and Gold Intrasquad meet since Charlie was traveling with Men’s Water Polo for that weekend. I was so concentrated on perfection that it stressed me in little amounts. I kept replaying possible emergency scenarios and practiced a 911 call speech in my head if an extreme injury occurred. I double checked our insurance cards, the emergency action plan binder, made sure we had all of our supplies and waited for the wrestling meet to start. I was on my toes the whole time and it turned out that no injury occurred. I was relieved, yet I also felt dumbfounded for all of that worrying. It made me realize how confusing the world worked, when we prepare for the worst moments and in reality, nothing devastating happened.

The second meet was a home dual meet with Embry-Riddle, an NAIA school from Prescott, Arizona. That experience made me see first hand how dedicated the wrestlers are to their sport. When we went to the wrestling room to perform skin checks before the matches, I saw how uncomfortable they looked. They spent the past days and hours cutting weight to wrestle in their weight class, drenched in sweat after exercising intensely. Wrestlers were laying on the ground, waiting for the day to be over. Watching them prepare for the meet made me more motivated to put in more effort into my clinical experience.

Since their wrestling team did not bring an athletic trainer, Charlie asked me to host their side and attend to their needs. The meet was as low-key as the intrasquad meet with the exception of having a bloody nose on the Embry-Riddle team. Quickly learning the rules of the sport, I had to consider the blood time and have my first aid supplies ready to stop the bloody nose. I did not have to worry about taking too much time once I had everything prepared. It was one good experience under my belt that I could reflect upon and hone my skills from.

The third meet was our big meet, known as Take it Outside. It was the second year that they hosted an event like this and this year was against CSU Bakersfield. It was held outside on the CBU campus front lawn, with bleachers set up and food stands serving the audience nearby. UFC and Bellator fighters from all over and Stephen Neal, a CSU Bakersfield alum and 3-time Super Bowl Champion came to visit the meet. The event was massive, with approximately 3,000 people coming in and out of the venue, watching two teams duke it out on the lawn.

This event introduced many different elements that we had to look out for as athletic trainers. Since it was hot outside, we had to worry about possible heat illnesses and exercise-induced cramps. Also, because the mat was hot to the touch, abrasions could happen more frequently. It was important for us to be cognizant of these new variables and we had to stay on our toes.

One of my classmates, Norma, wanted to work this event ever since she heard about this as an undergraduate student at CBU and when she helped us out that day, she told me how much fun she had. Since CSU Bakersfield did not have an athletic trainer with them, Norma and I helped out on their side while Charlie and Dave, a first year student in the program was on the CBU side. We had a few blood incidents and we all worked cohesively to make sure the blood was off both wrestlers and the mat as quickly as possible. Norma and I got to witness a cauliflower ear injury on CSU Bakersfield’s side and managed it properly. This event itself was such an unique event for an NCAA Division II school that I am glad I got the experience and the privilege to work this meet.

Norma, Charlie, Dave and I working Take It Outside

My classmates and I were having a heartfelt discussion after our clinicals about how we were surviving the first two months being in our last year of grad school. We vented about our challenges and we ranted and raved about our peers, like how normal human beings in society would (don’t lie, we all judge to an extent). There was one thing that we did come to full circle about, and it was about the lack of passion that used to be exuded by all of us in our program. The effects of the changes have changed my mindset this year. I am either frustrated about learning, or I am learning to be more and more frustrated with myself.

I am not saying that we are not happy to be athletic training students, but the burning fire of solving problems burns dimly compared to last year, and I could only speak for myself. I still pull my own hairs whenever a patient tells me that he or she still feels pain after doing an intervention with full confidence in reducing pain. It is like holding a Rubik’s cube after solving two faces but every time I want to solve the third one, I mess up the other two solved faces.

This phase reminds me of a quote said by Ray Lewis, “I am pissed off of greatness because if you ain’t pissed off for greatness, that means you’re OK with being mediocre.” Frustration seems to be normal to me, and the importance of controlling the frustration is apparent when communicating with the patient. To have the patient trust me means that I need to show them my clinical reasoning through patient education and compliance. The fact that I would not give up on their challenges shows that I have passion in the field that I work in. It is not the end of the world to lose a battle in a day, but with passion and knowledge, a war can be won.