Wrestling

Preventive care can limit skin infections

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Mike Moyer has spent a lifetime in all phases of wrestling.

The son of a high school coach, he competed at West Chester (Pa.) University and coached at George Mason University in Fairfax, Va. But it's in his current role, as executive director of the National Wrestling Coaches Association (NWCA), where Moyer hopes to have the most impact on the sport.

One of his chosen battles is skin infections.

"When I wrestled in high school, we didn't have MRSA (methicillin-resistant Staphylococcus aureus) back then -- at least that we knew about -- but we did have impetigo, skin herpes and ringworm," said Moyer, a 1979 graduate of West Lawn (Pa.) Wilson High School. "My father (Bill Moyer) was a biology teacher and the wrestling coach, so it was something to which we always were educated. Basically, a simple protocol of prevention goes a long way."

Although it's likely skin infections always will be present in wrestling given the contact between competitors, those "simple" preventive measures -- including many being used by the Ohio wrestling community -- can help keep transmission from athlete to athlete to a minimum.

"According to the (National Federation of State High School Associations), skin infections are the third most reported 'adverse event' in wrestling and the easiest to prevent," Moyer said. "Sprains and strains are the top two, but skin infections are easy to prevent with awareness."

Being thorough

Moyer said cleaning mats and clothing isn't enough to limit skin infections. It's important to read directions on disinfecting products to understand their limitations and to practice good hygiene.

When athletes wash their practice clothes, they also should clean the inside of their gym bag to kill any bacteria.

"It's like getting hamburgers ready to grill and laying them on a cutting board. Then after the burgers cook, you put them back on the dirty cutting board," he said. "People do that all of the time without thinking about. It's the same with the gym bag.

"Also, many cleaning products for the mats have on the label that they have to stay wet on the mat for up to 10 minutes to work. A lot of times, coaches have to get to work at practices and don't wait as long as they should. That allows the germs to stick around.

"Another thing that's really important is for skin-based products. Many of the ones added to the skin are alcohol-based. They kill on contact, but once they dry, they don't kill any new germs introduced."

Moyer suggests using a 4-percent solution of chlorhexidine gluconate (CHG) such as Hibiclens -- a surgical scrub soap -- to clean the skin. It remains on the skin for 24 hours.

A cleaning regimen is important for equipment (clothes, headgear and mats) and bodies.

"We make sure we are mopping the mats," Olentangy coach Dennis Lybarger said. "We also give the wrestlers antibiotic soap to shower with and make sure everyone showers before they leave. We don't let them wait and shower at home. The sooner it is washed the better."

Pickerington North coach Brad Harris said no matter how much time is spent mopping mats with specialized cleaning products or bleach-water solutions, many factors add to the possibility of skin infections.

"We keep our (practice) room pretty clean. So much of (contracting skin infections) deals with the competition in tournaments," Harris said. "You have multiple schools on those mats, which are out there all day.

"Multiple people (and) multiple coaches are stepping on them. You have people coming from the bathrooms and stepping on the mats, stuff like that. That's usually where you see it. ... This year, we've been fortunate and haven't had any major skin issues."

Having clean shoes also is essential, according to Johns-town trainer Derek Eggers.

"We use a special antibacterial solution from a medical supply company on the mats and a skin cream to lessen the skin-to-skin contact, but they have to clean their shoes," he said. "We have something like a doormat that has cleaning solution on it. Wrestlers step on that before going on the mat. If you don't do that, you're just transferring bacteria from the floor to the mat."

Finding what works

Ohio Northern University wrestling coach Ron Beaschler asked himself a question: What works best at limiting skin infections in the sport?

With funds from the NWCA, he and ONU microbiology professor Linda Young have taken steps to find the answer.

"I know what we have used on our wrestlers and what we have done to the mats, and I wanted to know what works best," Beaschler said. "I wanted to know for sure what kills germs on the mats."

Young devised a study using the 12-team Ohio Northern Invitational on Dec. 7 as her laboratory.

"We had eight mats and each mat was treated in a different disinfectant," said Young, an instructor at the school for 26 years. "We checked the mats prior to the meet, then checked the interior of the mat every two hours to get readings and again at the end.

"We swabbed hands, forearms, and inside the nostrils of all ONU wrestlers plus five volunteer wrestlers from five of the 12 visiting teams. This was done before they got on the mat and then after they were done wrestling. We did the same thing for the officials because they are down on the mats as well."

Tom Murphy of Hudson-based Eco Applicators had his company's NanoTech Spray as part of the study.

"It's a water-based solution with titanium-oxide and zinc that you spray onto the surface, it dries and reacts to light," said Murphy, whose product also is used in hospital settings. "It has a positive charge that is opposed to the negative charge of the organism. The opposites attract and it kills germs through oxidation rather than with chemicals.

"We tell (the coaches) that they should continue cleaning the way they normally do, but this is a good insurance policy for missed cleanings or incomplete cleanings."

Results of the ONU study are incomplete, but Young said she has made some preliminary observations.

"We're trying to plow through an enormous spreadsheet of data, trying to get things in order," Young said. "Right now, there are some things that have jumped out to us."

Those early findings include that "the rates of MRSA were incredibly low," according to Young, and "we found less-than-expected fecal coliforms (bacteria) from not washing hands thoroughly after going to the bathroom."

But there were other issues.

"We found a lot of Streptococcus pneumoniae on the mats, which is a bacterium common in the nasal areas and comes from sniffing, snorting and spewing during wrestling," she said. "This causes pneumonia, especially in people with H1N1 flu. Because young adults are particularly susceptible to this flu virus and our data indicate that wrestlers come in contact with Streptococcus pneumoniae during competition, I recommend that all wrestlers receive an annual flu vaccine."

Another preliminarily finding, Young said, was that "even though vendors might want to support their products ... primarily it's bleach that works best. It's cheap and very effective."

The right stuff

Central Crossing senior Josh Wimer knows firsthand the problems caused by skin infections.

The 126-pounder was held out of the Division I state tournament last year, and the same thing happened Dec. 28 before the second day of the Medina Invitational Tournament.

"My doctor has given me a lot of prescriptions, I take some vitamins and I use Hibiclens when I shower," he said. "It's something I definitely worry about. ... I have to stay on top of it."

Officials inspect wrestlers before every meet for skin infections.

Dr. Randy Wroble, the Ohio High School Athletic Association's medical consultant for wrestling, said proper treatment -- "antibiotics or a combination of ointment and pills" -- can get a wrestler back on the mat "within a few days."

However, since wrestlers put in so much effort in terms of training, the competitors and their coaches need to be equally vigilant checking for skin infections and cleaning equipment, according to Moyer.

"Skin infections are a part of all sports, not just wrestling, but in other sports, it can be hidden by equipment," he said. "The thing about wrestling is that coaches and wrestlers are cognizant of skin infections and how much they have at stake.

"It's unfortunate that skin infections sideline wrestlers because of all of the hard work they put in. But if you let one infected wrestler compete at a 10-team tournament, everyone he wrestles will come in contact with it and it spreads to the team and everyone they wrestle. We can't let that happen, but simple protocols can help reduce the likelihood of that happening."

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