Football Safety – PediaCast 051
Dr Tom Pommering
Medical Director of the Sports Medicine Program
Nationwide Children's Hospital
The Ohio State University College of Medicine
Announcer 1: This is PediaCast.
Announcer 1: Welcome to PediaCast, a pediatric podcast for parents – the Interview Edition. And now, direct from Birdhouse Studios, here is your host, Dr. Mike.
Dr. Mike Patrick: Thanks, Katie. Hello, everyone and welcome to PediaCast. It is Episode Number 51 for Thursday, September 28th, 2007.
I told you I'd be back, folks. I have a feeling some of you didn't believe me. Because, you know, things in life get busy and there had been times in the past when I've said I'd be here and then, I'm not. But I'm really trying to make a commitment to doing this every weekday, with the shorter programs.
So today, we have an interview for you coming up in just a few minutes. I talked to Dr. Tom Pommering about football safety and we'll talk a little bit more about Dr. Pommering in just a couple of minutes.
But first, once again, we're going to weekday format here for a little while. We'll see how it works out. And I would appreciate your comments if you think it's a good thing, a bad thing, let me know. If you think it's a bad thing though, please don't choose iTunes as the forum for your complaint.
Dr. Mike Patrick: Just email me or use the Contact page, that'd be fine.
I also want to mention, since we're going to get together on a daily basis here, one of the things that as a pediatrician that has started to happen already — and I think it's important to talk about it — and that is, to remember that once school gets started, kids are passing viruses back and forth. And we have to remember that virus illnesses typically last anywhere from one to two weeks. That's typical. Usually, start with a fever that can last anywhere from one to four or five days. You know, the one with the runny nose, cough congestion, sore throat, that sort of thing.
Now, if your child has a sore throat, it is a good idea to see your doctor to get a throat swab because you want to make sure that they don't have strep throat, because that needs an antibiotic. But if your doctor says it's a virus, trust their opinion that that's what it is and please don't hound them. I've already been hounded. Of course, I won't mention any names.
But you know, typically what happens is, a mom or dad, they're sick, too. They go see their doctor. Their doctor says it's bronchitis. They've been coughing for a week. Their doctor gives them antibiotic and by golly, they're starting to feel better. And so, now, their child has the same symptoms for two or three days and mom or dad brings him in because they want to avoid it lasting so long. And so, "Doc, can you please prescribe an antibiotic?" It's really not appropriate if you do the exam and they don't have strep throat, they don't have any ear infection, they don't have pneumonia. And if your doctor really thinks it's a virus, please don't hound them for an antibiotic. Because inappropriate use of antibiotics is definitely one of the ways that we're getting resistant bacteria that's becoming more and more difficult to treat with antibiotics when you really need them.
And I know you've heard this before. But it seems like every year, once school gets started, we go through this again, because it takes about two or three weeks after the beginning of the school year and then the kids start passing the viruses back and forth and are getting sick and parents are frustrated. But still, we're all in this together. Yeah, it sounds like high school musical.
[Hums] We're all in this…
OK, I won't do my singing thing. In any case, my kids get sick too and I know it's frustrating, but antibiotics are not always the answer.
OK, let's go ahead and move on. Don't forget, if there's a topic that you would like us to discuss on PediaCast, it's easy to get hold of us. Just go to pediacast.org and click on the Contact link or you can email me at firstname.lastname@example.org. Or call the voice line at 347-404-KIDS. That's 347-404-K-I-D-S.
OK, Dr. Tom Pommering is the director of Sports Medicine at the Columbus Children's Hospital. He's also a professor of Pediatrics and Family Medicine at the Ohio State University College of Medicine. And he was kind enough to stop by to talk about football safety. So after our short break, we will be back with Dr. Pommering.
Before we take the break though, I have to remind you, as always, the information presented in this podcast is for general educational purposes only. We do not diagnose medical conditions or formulate treatment plans for specific individuals. If you have a concern about your child's health, call your doctor and arrange a face-to-face interview and hands-on physical examination.
Dr. Mike Patrick: All right, welcome back to the program. We are pleased to have with us during our Interview Segment this week, Dr. Thomas Pommering. Dr. Pommering is a professor of Pediatrics and Family Medicine at the Ohio State University and medical director of the Sports Medicine program at Columbus Children's Hospital. So, welcome to the program, Dr. Pommering.
Dr. Thomas Pommering: Thanks, Mike. I'm glad to be here.
Dr. Mike Patrick: That's great. I guess we do have to give a little bit of a disclaimer here. Because I've been kind of hesitant to have people on the show who I know personally from the past. I'm not sure why that's been but I haven't done an interview yet with sort of someone from my own training. And Tom and I know each other going way back and his wife, Phyllis, is actually a pediatrician that I trained with. So, it's really particularly good to have you on the program.
Dr. Thomas Pommering: Well, it's good to be here. Thanks.
Dr. Mike Patrick: We are going to talk about football. And I thought a good place to start with this in terms of high school and, I guess, Pee Wee football leagues, just how do you think student athletes should prepare for the football season over the summer time? I know we're a little bit late on this topic with it already being football in full swing. But just in general, Tom, how do you think that kids should get ready for the season?
Dr. Thomas Pommering: That's a good question, Mike. Ohio certainly is a football-crazy state.
Dr. Mike Patrick: [Laughter]
Dr. Thomas Pommering: It's big time everywhere you go in Ohio. I think if you're talking about Pee Wee football leagues, the thing with these kids is to — because football usually starts up in August, one of our hottest month — is to have time outside playing during the summer so they can be acclimatized. And by that, I mean, get out and play. It doesn't have to be football. It can be running around the neighborhood and doing the things that kids do and get used to sweating and get used to enduring the heat and develop those mechanisms that we naturally have but need time to get working, and that will help us cool during the hot months. I think that's one of the big things.
Older kids or high school kids, they usually have pretty well-established condition programs that start in Spring and go through the summer, whether it's camps or lifting programs. And those generally sufficed pretty well for the high school athletes. They need to have a lot of time to do much more than that.
Dr. Mike Patrick: Sure. And then, continuing on with that, once the season gets started, what kind of things outside of the regular practices should they do to stay fit and prevent injuries?
Dr. Thomas Pommering: I think that's also a good thing to think about. One of the things we see a lot of times then — you know, they're high school kids — they'll come in with football injuries but they didn't get this on the field. A lot of them are playing with their buddies on the weekend, they watch the game and they're all excited, so they go outside and play some pickup football and they play tackle football. And they come in with injuries and I'm sure they don't have their coaches too happy about it. Sometimes, it's a season ending injury and they're playing tackle football without pads.
So, kids really probably middle school and up, they're big enough and strong enough to really do some damage, shouldn't be playing tackle football. There's enough I think they do in the field that keeps them fit. And I think, really, what's almost as important as getting some practice time is getting a rest time. Because if you're not giving your body a chance to recover and heal and adapt to some of the things that you do in practice to push yourself and make you stronger, you won't ever get a chance to realize that.
Dr. Mike Patrick: That's great. Great advice. And in terms of student athletes, since your specialty really is on the student athlete, how do student athletes or kids who play sports, how do they differ from adult athletes in terms of mechanism of injury in the types of things that you see?
Dr. Thomas Pommering: Well, obviously, with our younger kids who have not gone to puberty yet, their biggest risk is growth rates.
Mike, I must switch phones then, if you will. My battery's dying here.
Dr. Mike Patrick: OK, sure.
Dr. Thomas Pommering: Bear with me just for a second.
Dr. Mike Patrick: Not a problem at all.
Dr. Thomas Pommering: I'm experiencing potential technical difficulty here. I hear a beep on my end, so that's why.
Dr. Thomas Pommering: OK.
Dr. Mike Patrick: This is the beauty of the podcast, really.
Dr. Thomas Pommering: Yeah.
Dr. Mike Patrick: [Laughter]
Dr. Thomas Pommering: This is the grassroots generally
Dr. Mike Patrick: Yeah, that's exactly right.
Dr. Thomas Pommering: [Laughter]
Well, again, the younger kids have growth rates and there are areas in their bone that are growing and weaker than other parts of the bone. They are always at high risk for having special injuries to these whether they're true fractures or even just stress injuries.
Another thing to think about is the spine itself. We see a special kind of stress fracture in the spine that's called spondylolysis. And we'll see that in the kids who are involved in repetitive extending exercises such as divers, linemen, gymnasts, things like that.
Dr. Mike Patrick: Sure. Are you all set there?
Dr. Thomas Pommering: Yup. I just got to run up the stairs there for a second. If you're having trouble, let me know.
Dr. Mike Patrick: OK, sure. No, no, I'm fine, doing great. I can hear you great.
Dr. Thomas Pommering: Great.
Dr. Mike Patrick: So then, what would you say are the most common injuries that are seen in high school football?
Dr. Thomas Pommering: Well, I think you have to think about the knee, the ankle and the shoulder. Specifically, you will see things like ligament injuries in the older kids, sprains, dislocation in the shoulder. Concussions are a big thing that we need to think about and be very careful about as well.
Dr. Mike Patrick: Sure. And in particular, of the most common injuries that you see, is there anything that the student athlete can do better to prevent those things other than just the regular padding that they have? Is there anything special that they should be thinking about when they're on the field to prevent the most common injuries?
Dr. Thomas Pommering: Yeah. I think, especially for the Pee Wee League, it's really important to have proper fitting equipment. Because a lot of these leagues are a bit strapped for money and the equipment they got are sort of the most common sizes. And helmets, shoulder pads, knee pads and pants, they all need to be properly fitted. They need to make sure that they wear their girdle pads and have all their pads in.
The helmets are a big thing. They need to really fit well. And if there are bladder helmets, they need to be constantly checked and repumped if they need to be pumped up. So that's the big thing in terms of something you actually have some control over.
Dr. Mike Patrick: Sure. And you mentioned concussions as well. And that's something that a lot of times there's confusion about, then sometimes disagreement between trainers and coaches and parents. What exactly are the rules for concussion in terms of when players, if you think they have a concussion, when can they play again? How many concussions are too many, I guess, that's what I'm trying to ask.
Dr. Thomas Pommering: Well, that's a good question as well. I think if you've been watching TV the last several months, it's been a huge topic, even from the professional level down. Unfortunately, there's a lot we don't know about concussion. There's a few things that the experts agree on.
And one is, anybody who has a concussion should not be playing. And maybe we should even back up and explain what a concussion is, because I think a lot of people feel that you have to be knocked out to have a concussion. And fortunately, that's a small majority of our concussions. Concussion is simply a blow to the head, to the face, or jaw that causes the brain to not act right. And that can be simply things like confusion, disorientation, headache, nausea and vomiting, light sensitivity. Things like that's an athlete is just not right.
And for the real obvious concussions, you can usually pick those up. But some kids, it's more subtle than that. And you have to really watch these kids and kind of know what their behavior tendencies tend to be. For example, a kid that comes to the sideline is very emotional after a play. And sometimes that's a teenager, but sometimes, that can also be a sign of a concussion happening – so emotional liability.
It's important to know what a concussion is. But certainly anybody who's having any kind of any kind of symptoms that you suspect could be a concussion and even if you're not sure until you have a chance to kind of sort these kids out, they need to be protected and kept out of play. And the big reason for that is, kids who get hit a second time — after not recovering from a concussion and this can be during the same contest or could be several days later, where they brain haven't returned to normal yet can experience a little bit almost a 100% fatal phenomena called sudden impact syndrome. This has never seen in adults, it's a purely pediatric phenomena, probably has something to do with the maturation of the young brain compared to the adult brain.
And what happens, if it's sudden impact syndrome is, you get hit in the head a second time — it didn't have to be a big hit, it could be something pretty benign looking, if you look back in cases where they have on film and radio on this — and that causes the brain to undergo a cascade of events that are completely out of the ordinary. For example, blood can get into the brain and blood has to also get out and the brain is held encased by a nice hard skull that can expand. So if blood can get in to the brain and can't get out, the brain swells and undergoes fatal herniation or near fatal. So that's what we really ultimately are trying to prevent when we protect kids from concussions.
Dr. Mike Patrick: Sure.
Dr. Thomas Pommering: You got to pull them out if there's any chance of them having one.
Dr. Mike Patrick: And then, how long should they stay out afterwards. Or does it really depend on their symptoms so you have to go on an individual case-by-case kind of basis?
Dr. Thomas Pommering: Yeah, exactly. Some of the older guidelines attempted a kind of cookbook approach to this, to try to grade the concussion based on its severity and then, try to guess or estimate how long they will be out. And coaches and parents love to have that prognostic information…
Dr. Mike Patrick: Yes.
Dr. Thomas Pommering: Ahead of time. But, unfortunately, we don't know how quick they're going to clear or come back to normal or heal until we can watch them. So it's really kind of a day-to-day and sometimes, week-to-week thing. And you watch these kids and they sometimes develop a post-concussion syndrome which can be a lot of different symptoms but it can be headaches or nausea. Or school-aged kids, you really have to pay attention to how they're doing in school and emotionally, how they're doing. Because a lot of these kids will have temporary learning disorder after concussion. They can't concentrate and retain information.
If they're high school kids where school is fairly demanding, they can get in trouble pretty fast. So you really need to get the school involved as soon as you think this is happening and special arrangements can be made for testing and half-days and that kind of stuff. Because, really, the only treatment we have for concussion that's effective and there are no medicines right now, is protection from being re-injured and rest.
It's important to understand that rest also means avoiding stimulation from video games and TV and things like that. So we watch these kids that need to be examined serially. In other words, everyday, they need to be… If you have to get access to the kids in the locker room or the training room or the way they play by their prima care doctors or concussion physicians. That's important.
Then, once they're cleared — in other words, once their concussion symptoms cleared — it's different for every child what their concussion symptom might be. It's very individual. And even if there's individual child, the second and third concussion, their symptoms can be different. And so, once all of those have cleared, then we'll go to a progression process where we let them do aerobic activity first. And again, they have to engage in stress. So, if they run or do anything aerobic-wise, they should not have recurrence of their concussion symptoms. After that, what we can do is resistance training which is like lifting weights. After that, they can do light contact and after that…
Dr. Thomas Pommering: Are you still there, Mike?
Dr. Mike Patrick: Yeah.
Dr. Thomas Pommering: OK, so I'm getting a lot of beeps on my end.
And after that, light contact. So that can take anywhere from a week till several weeks depending on how they're doing.
Dr. Mike Patrick: Great. That's great advice. Now, this is one of the things that I see a lot in pediatric office in terms of younger kids who may be a little bit on the big side. They're overweight and maybe dad's on the big side. Dad played football and you hear him say, "Oh, yeah, he needs to be this big because he's going to be a linebacker."
Dr. Mike Patrick: How was it that kids who are large which would seem to go well with playing a sport like football and yet, when you have kids with a large body mass, you have to worry about things like their lipids and their risk for Type 2 Diabetes and their blood pressure and those kind of things. How do you balance the need to have a lot of mass and yet stay healthy.
Dr. Thomas Pommering: Yeah, that's also a good question. I think coaches get really big eyes when they see an elementary kid who's four standard deviations and huge and who's going to take up a lot of space in the line. And while he may be pretty effective as a football player, those are kids you have to be careful about in terms of their health just for the reasons you talked about — epidemic and obesity and all of the things that go along with that including Type 2 diabetes and hyperlipidemia and hypertension.
And we encourage those kids to stick to the same types of health recommendations that we would offer them if they were not a football player. We would like to get their BMI's down to acceptable level. And really, kids are going to be healthy in the long run if they do that. Especially, when we talk about the elementary, even middle school kids, a leaner, faster kid is going to be more effective than a heavy, slow child.
And the other thing you have to remember about in terms of football is kids that are obese and really overweight have a lot of trouble cooling down. They cannot cool off as well as everyone else. Besides all the other things we talked about, they're at much much higher risk for heat illness. And I think if you even just look at this as you go out, decades and decades and beyond a professional player's career, there were a lot of linemen in the professional football league, in NFL and down the road, their health has really suffered because they're 30% overweight their whole life. And I don't think there's any sports that's worth… You can't buy good health. You really can't.
So it is a balance and I think we try to encourage kids to not bulk up in terms of food but to try to get bigger and stronger natural ways by lifting and running and doing things that are appropriate for their age.
Dr. Mike Patrick: Great. Now, I'm going to ask you to put in a little bit of a plug here for pediatricians and family practice doctors, too. It seems like lot of schools these days hire out doctors to do sport physicals at the school. Or when parents need a sport physical quickly, they go to an urgent care, something like that. But talk a little bit about the advantage I guess that kids get if they go see their regular doctor for pre-participation exams.
Dr. Thomas Pommering: Yeah. I'm glad you mentioned this, because as a sports medicine center, we kind of get… Once they played with pre-participation exam, we do do this for the schools because it's something that the schools have come to expect over the years and the regulations in Ohio in terms of getting pre-participation exams for middle school and high school kids requires that they do this every year. And what we tend to do is, we like to send a letter out to the parents well in advance begging them to go to their primary care doctors, pediatricians or family doctors first because we know that number one, it's absolutely best thing to have this done. Your physician knows you better than anybody else. If we go to a school and do several hundred physicals, there might be two or three kids I know and just barely. And it's not a good place to do a good exam.
And really, if you think about the health of adolescents and pre-adolescents, if you look at what causes them the most detriment in their health or their highest morbidity, they are problems related to drugs and alcohol and suicide and just general risk-taking behavior. And we just can't address that properly at a mass physical setting. And that's really the most important part of the well check or their pre-participation exam is a chance for them to sit down with somebody they know and trust and can really kind of screen them for being a high risk. Because I think so many parents have had kids kind of get in trouble and they just didn't see it coming. If there's one chance for there to be an intervention by somebody's who's trained and kind of pick this stuff up, well, that's worth everything in the world.
So I can't agree with you more. We'd like for everyone to go back to their primary care physician to get this done because they can do a much, much better job. And especially if you have any health problems, I think getting this mass physicals done, while they do meet the requirement for the state of Ohio, they don't really serve student athletes the way they should.
Dr. Mike Patrick: Right. And there's been so many changes, too, recently in the immunization schedule that doesn't get addressed necessarily like it should. And also, a lot of these kids who are large, you worry about Type 2 Diabetes and hyperlipidemia and I doubt that you guys are ordering blood work…
Dr. Thomas Pommering: No.
Dr. Mike Patrick:… and doing those kind of things.
Dr. Thomas Pommering: Yeah, we make a lot of phone calls to kids who have pediatricians if we pick up something up, trying to make sure they get that kid. The only advantage where this pre-participation exams in the mass that come handy, where it seem to have some kind of real benefit is that if there's a child that does not have a doctor and they're not in the medical system yet and we pick something up that needs to be done and we can kind of get them in the system. But by and large, I would say that's a pretty big minority, at least in most of central Ohio schools that we do this in.
It's a shame because I think some parents substitute this mass physical as a well check. And it's just not the same thing at all. You don't have to twist my arm to put a plug in there. I have offices like yours.
Dr. Mike Patrick: [Laughter]
All right. One of the things I think is important too is what are the things that schools should be doing to support the health and safety of student athletes above and beyond having a trainer on the field and practices or having a team physician present? But what other things can school systems do support student athletes?
Dr. Thomas Pommering: That's a good question. And I think, you know, first of all, you kind of mention the athletic trainer, for most schools, that's more something you see at the high school level. You'll see a little bit more middle school coverage for certified athletic trainer. But I can't say enough good things about someone who's a certified athletic trainer who's watching over your athletes. These folks have bachelors and often masters degree, they have to pass a state-certified exam. So make sure if there's someone helping out the team that they are certified athletic trainers because occasionally you'll see different types of other health-related professionals doing this and they're probably not trained as well.
But I think it's important, off-season, in terms of high school kids and especially if you pick a sport like soccer. We're talking about football right now, but we can't forget our soccer players and ACL prevention programs are a big thing right now. When you look at ACL or anterior cruciate ligament tears in the knee, that's the main ligament at your knee that gets a lot of pressure and there's a big injury if the student's tear requires a surgery to be repaired and a four to six-month recovery period. It's an injury that occurs five, ten to twenty times more often in girls, in female athletes that are boy athletes, if you compare the same sport.
And there's a lot of reasons for this that we don't completely understand. There's more than one reason. There's been some good research that had come out in the last couple of years with some real simple prevention programs that help teach our female athletes how to kind of land and jump and how to develop muscle balance between their thigh muscles and their hamstring muscles. And they're actually effective; maybe lowered the ACL tear rate to as much as 95%.
There are simple things that we can teach coaches to do or the athlete trainers can do over summer time or short program over the summer. And that's a big thing when you're talking about injury prevention. Otherwise, I think, let's just be smart about practicing in the heat. They're trying to avoid the hottest times of the day, allow free access to water. Let's get the pads off when it's super hot. Just cancel practice if you have to. Protecting the athletes from environmental stuff is a big thing.
AEDs are a big part of public health safety. And really, if you think about that way, AED is an automatic external defibrillator and it's something that is designed so that any lay person, even when he's not really certified in basic life support, can probably put these pads on someone who's in cardiac arrest and potentially save their lives. So know that when people go to cardiac arrest, the single greatest chance of survival is to get the heart shocked and beating again.
Dr. Mike Patrick: And it's more likely to be a coach or a ref or a bystander. See, you don't always think about the safety of the people who come to watch and who are running the sports. But you have to think about them, too.
Dr. Thomas Pommering: Absolutely. I think I can count on one hand many more times I've had a spectator or an adult coach with a potentially serious problem more than the young athletes. So that's why I've said they're good to have for everybody, not just for the athletes that can be there.
Dr. Mike Patrick: Yeah. And I can attest. Not that I've used one in real situation. But you know, I've seen them and they're pretty straightforward. I mean, anybody who can read a few lines, a few sentences, can understand how to do it. You just follow the directions in the box.
Dr. Thomas Pommering: Yeah, they really are designed to be successfully used by someone who's never even seen them. Although, obviously, if they happen at your school, we want all the coaches and staff and the athletic trainers to be trained on them so that they have a much better chance of working under pressure.
Dr. Mike Patrick: Right. And I wanted to make another point as well and that's parent involvement. We talked about making sure that plenty of water's available and to be smart about the heat. But sometimes, I guess parents have to be the best advocate for their kids. And if it seems like the coaching staff is not making a smart decision, as a parent, you really are obligated, I think, to bring that to someone's attention.
Dr. Thomas Pommering: Absolutely. And I think moms are probably better at this than dads.
Dr. Mike Patrick: [Laughter]
Dr. Thomas Pommering: I think it's sad but true that sometimes dad, we get caught up in the moment. And I think moms have always been the voice of reason. And you do have to look out for that, because even though I think most of our coaches are well-meaning, sometimes their enthusiasm can supersede their reason. So, sometimes, you have to kind of remind the coaches that they need to make an adjustment. And there's ways to that are not so confrontational. But if you have to do that, I mean, you have to do whatever you need to do to kind of protect your kids if you think there's a need.
Dr. Mike Patrick: Right. And then, there's the moms who go a little bit overboard, I think and basically say, "Oh, my son is not going to play football." They're very worried about the safety issues and maybe they've had someone in their family who suffered a big injury and they're very fearful about it. But, of course, there are risks as there are with anything that we do. But there's also a lot of benefits to participating in a team sport. Can you speak to some of these?
Dr. Thomas Pommering: Yeah, absolutely. As a parent, I certainly can identify with worrying about your kids. I think moms bear the brunt of the worry for the family sometimes when it comes to looking out for them. It's hard to be able to understand and watch your kids go through all the emotions they go through when they're competing, whether it's victory and success and jubilation. Or the other way it works, frustration and defeat, and even to watch your child be injured, it's just one of the hardest things in the world.
But certainly, team sports — and it doesn't have to be football — but team sports and even just sports participation in general have a lot of benefits for kids. I think it teaches kids team work and perseverance. It teaches them to work hard, to earn something, to set goals. They learn discipline. There are plenty of studies that show that athletes are a lot times better at organizing their time and in their respect for each other. Hopefully, they're learning sportsmanship and getting things right. And self-esteem and positive body image are some of the things that we see.
And the other thing to think about beyond childhood is, many athletes who were active in athletics or active in some type of sports activity — doesn't have to be an organized sport — often go on to be active adults. And that's really important too, it teaches them a lifestyle that's healthy.
Dr. Mike Patrick: Great. Well, I really appreciate you taking the time to stop by and as I said, we've known each other for quite some time. And it's really been great having you on the show. We'll have to have you stop back again sometime.
Dr. Thomas Pommering: Oh, anytime. I think that the PediaCast website that you have and all the information I had a chance to look through, I think it's just wonderful. I think you're doing a great job and I really feel privileged to be able to talk on your show. So, thank you very much.
Dr. Mike Patrick: Isn't he a great guy? I mean, really, it was just a pleasure having Tom on the show. And he has already agreed to come back. So coming up in the winter, at some point, we're going to do a show on wrestling — so a lot of wrestlers out there — and some injuries and skin conditions that they get. So he is going to come back sometime in the winter and talk wrestling. So I think that's exciting.
So, thanks again to Dr. Tom Pommering. He is the medical director of the Sports Medicine program at Columbus Children's Hospital. So, thank you, Tom.
Also, I want to thank Vlad over at Vlad Studio. He is the artist who does the wonderful artwork for our Feed in the website and our t-shirts in the PediaCast Shop. He does have a store online where you can purchase his prints to hang up in nurseries or decorate really any place that you like. And you can find the link to his site in the sidebar at pediacast.org.
He also has this new really cool thing. Although, right now, I think you can only do it if you have a PC and being a Mac person, I feel a little bit left out. But it basically is a wallpaper with his artwork that changes every minute so it can keep the time. So it's like a wallpaper clock. But it's pretty cool and if you go to vladstudio.com, you can take a look at it there.
I also want to remind you that at pediacast.org, on the Poster page, we do have promotional materials. And downloading and printing up of poster and taking to your pediatrician and family doctors so they can make copies of it and possibly hang them in examination room. You can also use those around the community centers and church bulletin boards, that sort of thing. Anything you can do to help spread the word about PediaCast is certainly appreciated.
So we're going to go ahead and sign off because we're already the second day of this new format plan and I'm already five minutes over. So someone in iTunes review did — and they gave me five stars — but they mentioned that the shows can be a little long-winded at times. And yeah, I know, you can get me talking and it just goes on and on. So I'm sorry about that. But anyway, I'll try to do better tomorrow and keep it a little bit shorter.
So until tomorrow, this is Dr. Mike, saying stay safe, stay healthy and stay involved with your kids. So long everybody!