If experience is the best teacher, Brian Siddall could be a professor of athletic training.
His 34 years of experience has given him insight to some injuries most have not, and may never wish to, witness firsthand. He's treated a college athlete who was paralyzed because of a sports injury, he's provided CPR to an athlete in one case and to a spectator in another, and he trained a student athlete to use an AED to restore a college athlete.
You might say he's seen a lot.
Siddall, the supervisor of Fisher Titus' athletic training services, does it because it's valuable and rewarding each day.
"When we're directly involved in an athlete's recovery, and seeing him or her return obviously gives you a lot of satisfaction," he said. "There are relationships you develop with athletic staff and the school, and there's the opportunity to work with several health care professionals, physicians and occupational therapy physicians."
Siddall is one of three athletic trainers at Fisher Titus, which serves seven schools in its immediate area -- Norwalk, St. Paul, Edison, Monroeville, Western Reserve, New London and South Central. Each trainer is assigned to two schools -- Siddall oversees St. Paul and Monroeville -- and the level of services vary because each school selects its level of coverage.
Siddall spends his mornings at the Ralph and Alice Walcher Rehabilitation Center, a 22,000-square foot facility, updating records and documents, and speaking with doctors to follow up on rehab. In the afternoons, he is on site at practices or games.
After completing graduate school at Western Michigan, Siddall became the head athletic trainer at Sturgis High School in Michigan from 1977-79, then was the head trainer for Hillsdale College from 1979-81. After that, he spent 20 years (1981-2001) as the head athletic trainer at Ashland University before joining Fisher Titus as its supervisor of athletic training services.
"Schools in Ohio recognize the importance of having a certified athletic trainer on site," Siddall said. "It's become such an area of speciality. Twenty years ago, coaches knew more about sports injuries than they do today. There's a lot of advancement in the management and care of sports injuries. And a lot of attention to concussions."
Fisher Titus uses baseline testing for head injuries in contact sports. In a baseline test, athletes answer questions that evaluate recognition and cognitive skills before the season. If a brain injury occurs or is suspected, the athlete retakes the test and Siddall can "compare cognitive abilities to the past results and identify any deficiencies."
In high school athletes, the brain and body is still maturing, Siddall said. That can make the recovery time longer than a matured athlete.
There are also progressive steps FTMC uses in bringing an athlete back after injury. Athletes undergo imaging procedures like CT scans and MRIs to help reveal serious injuries, such as internal bleeding. Siddall also evaluates any pre-existing conditions to help identify ongoing problems.
From there, athletes are phased back into the sport after injury. There is complete rest to let any injuries heal, then riding a stationary bike to get the body accustomed to muscle movement, functional patterns relative to the sport (change of direction movements for football, for example) and finally a return with full contact.
But athletes must pass baseline testing for head injuries before they begins the steps to returning to the field. Athletes risk second injury syndrome by returning early from head injuries too soon. A second impact to the brain before it is fully healed can cause more damage than the initial injury.
"We try to be involved in what the state is requiring," Siddal said. "And we try to be leaders. We've been doing baseline testing for three years."
Siddall and other trainers have pressure from many people when dealing with an injury and rehab, whether it's from a player, parents, or coaches.
"Communication is the key," SIddall said. "We try to keep everyone --athletes, coaches, parents, doctors -- informed and updated on their status. But we have to remain objective and consistent. The guiding philosophy I have is an athlete can go back out there without risking further injury."
There's also a team approach with physicians, Siddall said. "Our network of doctors here in Norwalk has the expertise in management and care, and that makes us and them more confident because they have athletic trainers who are communicating to have their orders carried out. They know trainers are following the rules on returning to play."
Aside from the common strains and sprains trainers treat -- strains occur in the muscle, sprains occur in the ligaments that attach to bones -- Siddall and his staff see other injuries experienced from poor technique.
"We see a lot of injuries to the lower back, hips, knees ... We emphasize core development," Siddall said, showing the area below his chest to the middle of his hip. "This is what holds the head to the back and the knees to the hip."
There is also emphasis on stretching an flexibility during offseason camps.
Athletic trainers must be certified by the National Athletic Trainers Association. To receive that certification, a trainer must complete the following criteria:
n Earn a bachelor of science from an NATA accredited school.
n A six-hour certification exam.
n A state licensing exam.
Siddall is also certified by the OHSAA to assess hydration tests and weight assessment -- programs that certify wrestlers to compete in the proper weight class for their body type and to ensure they're properly hydrated while maintaining weight.