1.) Risk minimization during warm ups - During a team warm-up period all personnel actively conducting the warm-up activities should be properly attired for the duties required. Special attention should be given to ensure that auxiliary personnel are wearing appropriate footwear for active participation and electronic devices such as music devices and cell phones are not being used.
2.) Illegal libero replacement penalties - An illegal libero replacement occurring before the whistle/signal for serve is an unnecessary delay. For example, a libero attempting to replace a player (who is not going to serve next) without sitting out a rally, a second libero entering the same game, etc. Once the referee whistles and signals for serve an illegal libero replacement is considered illegal alignment and a loss of rally/point is awarded to the opponent. If the illegal libero replacement is not detected until contact of the serve the penalty is also illegal alignment.
3.) Officials signals and mechanics - Proper execution of signals and mechanics by officials are essential in communicating game decisions. Signals are intended to clearly communicate violations and results. Signals should be precise and clearly visible. Officials should review all signals and mechanics during pre-season training and during prematch official’s conferences.
Special attention should be given to reviewing signals such as the proper technique and hand placement for the line violation (signal #2) and ball lands in bounds (signal #13), as well as the situations in which ball touched (signal #10) and out-of-bounds (signal #14) should be used.
4.) Fan behavior and respect for the game - Good sporting conduct is an integral part of the interscholastic volleyball program. The rules of volleyball state that any type of cheering, yelling, or other actions which are done in a manner to disconcert, be derogatory or taunting toward the opposing team or a specific player is considered inappropriate. Cheering and other support should always be positive. Inappropriate behavior, if not addressed allows a loss of respect for the game and the players.
5.) MRSA and communicable skin conditions - Methecillin-Resistant Staphylococcus aurues (MRSA) is a relatively new problem in our communities and in the sports world. However, it is an increasingly more common problem with potentially serious consequences. The risk to our athletes can be reduced dramatically by proper preventive measures, early identification, precautions to minimize spread to team members and opponents, and quick and appropriate treatment. The NFHS Sports Medicine Advisory Committee (SMAC) has developed multiple position and policy statements on this topic and that of communicable skin diseases in general over the last few years. These can be found on the NFHS web site under Sports Medicine. One of the very first pages in this NFHS Rules Book deals with this issue.
MRSA represents the evolution of a common bacteria, “Staph”, to an aggressive and resistant bacteria. This has occurred, in part, because of the wide spread use of antibiotics. As we kill off the sensitive or “easy staph”, the stronger more virulent ones, who are resistant to penicillin and standard antibiotics, grow stronger and more aggressive. Scientists continue to develop new antibiotics to attack these stubborn bacteria but it is a race where the scientists need help to stay ahead of the resistant bacteria. Judicious use of antibiotics, as well as measures discussed in this point of emphasis can help all of us be safer from communicable diseases of all types and especially the more dangerous ones like MRSA.
Most skin infections are transmitted by skin-to-skin contact or by contact with equipment that has the “germ” present. Our skin is a very strong protective organ in our body but the risk of transmission of bacteria, fungus, and viruses is greater if the integrity of the skin is weakened by a scrape, scratch, or other open place. Football, because of the equipment, and wrestling, because of the extensive skin-to-skin contact and the wrestling mat are considered the highest risk sports for MRSA and other skin diseases like ring worm (tinea corporis), herpes simplex and herpes gladiatorum, and impetigo.
PREVENTION OF CONTRACTING SKIN INFECTIONS
In medicine, prevention is always considered the best treatment for any disorder, when possible. Basic hygienic principles are the foundation to help reduce/prevent the development and spread of these infectious diseases. Individual athletes need to shower after each event or practice, use his/her own soap or use a liquid soap from a dispenser and not community bar soap to shower, avoid sharing towels and other items, have all open wounds or abrasions evaluated by the coach or certified athletic trainer before each practice or competition, and use clean undergarments with each practice or contest.
PREVENTION OF SPREAD OF SKIN INFECTIONS
The only thing worse for a coach and a team than having one player out of action because of a skin infection is to have multiple players coming down with infections that lead to loss of playing time and/or serious health issues for the individuals and the team. Therefore, early identification of the illness, quick removal from exposure of teammates, proper cleaning of individual equipment and shared equipment as well as appropriate treatment of the infected individuals is critical. It is impossible to know exactly when a lesion is no longer contagious to others but minimal treatment regimens have been suggested before allowing athletes to return to play. (See below) Universal precautions which are described below should be used by all concerned to minimize the likelihood of skin infection spreading.
TREATMENT
The appropriate use of antibiotics is the mainstay for treating MRSA and other bacterial infections of the skin. Topical and/or oral anti-fungal medications can be helpful in treating ring worm. In certain situations anti-viral medications may be used for such viral infections as herpes gladiatorum and herpes simplex. Even then, wounds and lesions should be covered to protect all involved. If lesions do not respond as suggested by the physician, a return visit for further evaluation should be considered as this might suggest resistant infections such as MRSA.
HYGIENIC PRINCIPLES THAT SHOULD BE FOLLOWED BY ALL COACHES AND ATHLETES
Following these guidelines will help reduce the occurrences and outbreaks of infectious diseases. This will take active participation of the coach, parent and athlete. Together this will create a healthy environment that will allow the athlete compete and reduce the risk of being sidelined.
INDIVIDUAL ATHLETES:
- Any lesion, scrape, or wound on the skin should be evaluated by a certified athletic trainer or physician
- Seek medical care as soon as possible for personal safety and to protect teammates
- Don’t return to action until advised to do so by a physician
- If lesion is not clearing as expected, return for additional medical consultation as failure to respond can be a sign of MRSA
- Coach should be made aware of any lesion considered infectious
- Shower after every practice or contest, as soon as possible
- Use clean gear and undergarments for every practice or contest
- Avoid cosmetic shaving (genital area, chest, legs)
- Use soap from a container, not bar soap
- Don’t share toiletries, towels, or other equipment
- Don’t use a whirlpool or cold tub with any open wounds, scrapes or scratches
- Shower before using whirlpools or common tubs
- All abrasions or cuts must be properly cleansed and covered before practice/competition
COACHES, CERTIFIED ATHLETIC TRAINERS, AND OTHER PERSONNEL
- Withdraw any athlete with a suspicious skin lesion until evaluated by a physician
- Clean mats, and equipment on a regular basis with appropriate disinfectants (1:100 solution of bleach like Clorox made up fresh daily)
- If an infection has occurred in team member, check other athletes daily before practice
- If several athletes develop infection with the same organism, seek consultation with physician or health department to eradicate spread as soon as possible. They may suggest special techniques to eradicate the bacteria from the skin and/or nose of team members or other epidemiological studies with cultures, etc.
- Make sure athletes are cleared by physician before returning them to practice or games. This protects everyone including your team members
- Even after medical clearance, keep lesions covered until skin is covered over and wound is healed.
- Always use “universal precautions” when dealing with a skin lesion as you would with blood and other bodily fluids. This means gloves, hand washing, proper disposal of contaminated equipment in plastic and/or bio-hazard bags
- Notify appropriate personnel at opposing school after the fact if lesions are detected in your team within a 2-3 day period of a previous contest
6.) Libero uniform in contrasting color - Rules 4-2-1 through 4 are very specific to legal uniform requirements. Even with this specificity in the rules, coaches and officials struggle with the legal libero uniform top. It is essential that the top is in sharp contrasting color to the color(s) used in the uniform top of the libero’s teammates. If a style of uniform is being worn which has a pattern of colors it may be difficult to use a libero uniform which contains these same colors. In these cases it may be wise to consider a single color top for the libero. When using home and away uniforms, if the colors are similar (dark green for home and black for away) the libero top would not be legal and a separate contrasting color must be used. Now that the libero is a part of the high school game, coaches must consider the requirements of the libero uniform when ordering uniforms to be certain compliance is reached. Thus, colors and styles must be thought through before ordering to avoid problems for the team and/or the libero.