The Third Man - Skin Checks

[T-Rex]

I’ve debated ever since I took “The Third Man” column on, as whether to write on this topic or not. I have so many personal feelings associated with this rule, the health of competitors and officials that I couldn’t put down into words just rules without getting too deep into specific situations. Hopefully this is filled with more facts than opinions.

Methicillin Resistant Staphylococcus Aureus? Molluscum Contageosum? Tinea? Foliculitis? Impetigo? - Any of those sound familiar? How about Ringworm, Herpes Simplex I, Athletes Foot, fungal infections? Now it’s becoming a little clearer huh?

Please let me start by saying I’m not a Doctor, nor do I play one on TV. I do have an Emergency Medical Technician License; however that only helps me with broken bones and bleeding, and attending to those in dire need of emergency medical care until someone with real training can take over. However, the problems officials deal with on the mat in some sort or other on a daily basis concern skin conditions. You name it; the officials have seen it in some form. We’ve seen things that the wrestler never knew they had, things they knew were wrong, and even conditions that some coaches tried to pass through skin checks knowingly.

This article is basically to familiarize everyone with the skin check procedures that we go through every single dual, tri, quad and tournament. I will explain some of the most recent rule changes, updates, and clarifications. I will add some personal commentary (as always) and give you the absolute truth as to how you can best be prepare to successfully make it through one of the nation’s toughest skin-checks if you prepare correctly.

Every single event – we’ll use a large multi-team tournament as an example – starts out the same way. Several teams, or weight classes, are herded into a room where scales are provided. There is usually a plethora of officials to administer the weigh-ins; some of these officials are responsible for skin checks. I usually write my columns gender-indifferent; however this one will be male specific since almost all experience I have is with male wrestler weigh-ins. The contestant is usually in some sort of suitable undergarment, the official asks the wrestler to stretch his arms out to his sides, is examined from head to toe, the contestant turns 180 degrees, and the same examination is carried out. If any condition from a blemish all the way to some sort of full-blown communicable condition exists, the officials is required by NFHS rule to examine further.

Here is where skin checks sometimes take a turn for the worse, in a coach’s opinion. Let me give you a few rules:

Rule 4.2
ART. 2: Each contestant shall comply with standard health, sanitary and safety measures. Because of body contact involved, these standards shall constitute the sole reasons for disqualification. Application of this rule shall not be arbitrary or capricious.

ART. 3 . . . If a participant is suspected by the referee or coach of having a communicable skin disease or any other condition that makes participation appear inadvisable, the coach shall provide current written documentation as defined by the NFHS or the state associations, from a physician stating that the suspected disease or condition is not communicable and that the athlete’s participation would not be harmful to any opponent. This document shall be furnished at the weigh in for the dual meet or tournament. The only exception would be if a designated, on¬site meet physician is present and is able to examine the wrestler immediately after the weigh in. Covering a communicable condition shall not be considered acceptable and does not make the wrestler eligible to participate.

ART. 4 . . . If a designated, on¬site meet physician is present, he/she may overrule the diagnosis of the physician signing the physician’s release form for a wrestler to participate with a particular skin condition. Very important my friends. This states that if you do have a note, that the onsite physician can over-rule it and disallow you from competing. The onsite physician is the medical authority at the weigh-ins.

ART. 5 . . . A contestant may have documentation from a physician only indicating a specific condition such as a birthmark or other non-¬communicable skin conditions such as psoriasis and eczema, and that documentation is valid for the duration of the season. It is valid with the understanding that a chronic condition could become secondarily infected and may require re¬evaluation.

Here is the form that ALL skin conditions, no exception, have to be noted on. If you bring a doctor's note and it is not on this form, you have wasted your time. http://www.twoa-gc.org/assets/downloads/SkinForm08-09.pdf

2008¬09 NFHS CASE MANUAL:
4.2.3 SITUATION A: In the middle of a multi-team event, it is determined that the 125¬pound wrestler from Team A has an active case of ringworm. How should a referee handle this and how would this affect the scoring of this wrestler? RULING: As soon as it is detected that the wrestler has a communicable skin disease, the wrestler would be disqualified from any further competition in the multi-school event. This is not a flagrant disqualification; therefore, all points the individual had earned up to the time of disqualification would remain with the team.
4.2.3 SITUATION B: During the weigh-in, the coach presents current, written documentation as defined by the NFHS or the state association, from a physician indicating evidence of a communicable disease with a wrestler and stating that there will be no problem as long as it is properly covered. Does this documentation make it permissible for the individual to wrestle? RULING: Covering a communicable condition shall not be considered acceptable and does not make a wrestler eligible to participate. If a wrestler has a skin disease that is in the communicable stage, the wrestler shall not compete regardless of any statement from a physician.
4.2.3 SITUATION C: During the weigh-in for a tournament and prior to the start of competition, the referee suspects an individual of having a communicable skin disease. The coach of the individual indicates to the referee that their team doctor has checked it, but they do not have current written documentation as defined by the NFHS or the state association, from a physician. Would it be permissible for this individual to wrestle if current written documentation was obtained prior to start of competition? RULING: The rule states that the documentation must be furnished at the weigh-¬in. If the documentation is not provided at the weigh-¬in or the individual is not cleared by the designated, on¬site meet physician for that competition immediately following the weigh in, the individual would not be allowed to compete.
4.2.3 SITUATION E: At the weigh-in, a coach notices a suspicious skin lesion on a wrestler. The wrestler’s coach is asked to present the required, current, written documentation to indicate that the wrestler has been cleared by a physician. Neither the wrestler nor his coaches have the required documentation. No physician has been designated as the on¬site meet physician for this particular competition. Following the conclusion of the weigh in and prior to the competition, the wrestler presents written, current documentation signed by a physician who has just arrived at the site to watch the competition and has examined the wrestler and found the skin condition to not be contagious and in a state that it would not be harmful to any opponent. Is this wrestler now allowed to compete in this competition? RULING: The wrestler would not be allowed to compete in this competition. The necessary documentation is required to be presented at the weigh in. The physician who provided the clearance is not the designated, on¬site meet physician for this particular competition and therefore that clearance is not valid for this competition. The rule requires wrestlers with suspect skin conditions to be prepared with documentation at weigh in or to be examined by the designated, on¬site meet physician in those cases where there is a designated meet physician present. The document obtained by the wrestler from the physician, provided that it remains current and fulfills the requirements defined by the NFHS or state association, could be valid for the next competition if it is presented at the weigh in.

Ok great – got all of that? Ready to be an official? All of these things deal with JUST skin conditions during the pre-competition time. The NFHS has recently put a heavy emphasis on grooming and medical checks as stated below:

2008-09 Point of Emphasis
Grooming and Medical Checks
According to Rule 3-1-4, the referee has the duty of meeting with each team to inspect each contestant for long fingernails, improper grooming and skin conditions. These inspections usually take place at weigh-¬ins. All contestants must meet Rule 4-2-1, the grooming rule. They must be clean shaven, sideburns trimmed no lower than earlobe level and the hair trimmed and well groomed. The hair, in its natural state, shall not extend below the top of an ordinary shirt collar in the back, on the sides not to extend below earlobe level and in the front not to extend below the eyebrows (new rule change for 2008-09). Each wrestler must be free of any communicable skin condition that might be contagious. Should a questionable skin condition exist, the coach/wrestler must present at weigh-ins, the appropriate skin form documentation signed by a physician as to the clearance of that condition. The skin form must be marked with the exact location of the condition for which the physician is giving clearance. If the referee is not present at weigh-ins, it is the referees’ responsibility to make sure that the inspection of athletes has been conducted and that all athletes have been inspected for any skin conditions with appropriate forms signed and dated by physicians provided at weigh-ins. See new rules change for 2008-09 regarding use of season-long form.

Now with that said – let me try and give some pointers as promised earlier. These will assist you in decreasing your chances of developing a skin condition that would disqualify you from competition.

1) Examine yourself. Hopefully you shower at least once per day, look for anything that doesn’t belong on your skin. Mention it to your parents and coach so that it can be addressed. Simple topical anti-fungal cream available over the counter does wonders.
2) Use anti-bacterial soap when washing. Wash your hands and face after practice/competition if you do not shower immediately anyway.
3) Know the rules. Many of these situations presented disqualify a contestant because either he AND/OR the coach don’t know the rules on skin conditions.

The rule change this year is a big one. If a skin condition is present, and there is no designated physician present at weigh-ins, there is simply no choice for the official but to disqualify the contestant. If the official is in question, we will err on the side of safety and not allow the condition to get on the mat. Since we are not doctors, we do not want to take the risk of the condition infecting other wrestlers, US, contaminating the mat, etc.

I’ve included a few links to read below. The first is an NFHS mandate on rule changes for this year, and includes pictures skin conditions. Please don’t look at the pictures immediately after eating.

http://matref0.tripod.com/Articles/2009_Skin_Disorder_Rules.pdf

How about this one, where the whole state of Minnesota shut down it's wrestling program last year.

http://www.usatoday.com/sports/preps/wrestle/2007-01-30-minnesota-wrestling_x.htm

Next I encourage you to Google MRSA+wrestling. You will find literally hundreds of articles of how wrestlers have died; wrestling rooms, schools, programs and even entire State High School Wrestling competitions have been shut down due to these drug resistant staph infections.

If you’ve read this far, you’re a trooper. Please ask any questions as a reply to this message so that we can all share in the findings.

[dennismc]

Rex,

A couple of questions, first I do not show anywhere in the rule book that states that the head official can over rule the on-site physician on matters of skin conditions. Can you clarify this? Second, how would you handle a situation where you have cleared a wrestler, then the opposing coach questions a skin condition. If there is no on-site physician, would you then expect the wrestler to come up with the NFHS form? And if he does not have it, would you then disqualify the wrestler? Thanks.

[T-Rex]

Fair question Dennis, I'll do my best to answer gracefully. What is spelled out in Rule 3-1 Art. 2 is "...The referee has the sole authority for ruling on infractions or irregularities not covered withing he NFHS wrestling rules". So, on-site physicians at the weigh-ins have authority to approve someone to wrestle based on their assessment.

Now, trying to delve deeper into what you're asking - when would I as an official overrule the onsite physician? The only possible time I can ever think this might happen would be an issue of ethics. No need to go into this any further as I don't want to give anyone any ideas, but it has happened in the past, and will continue to happen in the future.

Second question - I have cleared a wrestler and the opposing coach questions a condition. I would check the wrestler to see if I have seen the condition yet or not, and simply re-evaluate. If I missed it in weigh-ins and/or it has become irritated to the point of being illegal, then a note would be required. If he does not have it, disqualification would be the result. This has happened in the past where a skin condition passed through weigh-ins and was noticed on the mat. I can give you a specific example of a collegiate tournament I officiated this past weekend where a contestant had a ringworm on his upper chest and a fellow official caught it in the second round, disqualifying him. It can happen, and must be corrected at the earliest opportunity.

Does that make sense? Again, just my opinion. I'm hoping the suggestions of wrestlers and coaches examining themselves would prevent someone from not having a note in hand.

[JR]

In my time as an official the single most difficult (by far) "off the mat" work dealt with skin checks. Just this alone should show parents, fans and coaches that officials really sacrifice to be on the job. Skin checks are not fun. Frankly they can be well how do I say this ??? You get my drift.

I know on the east coast in the really big tournaments they have at least two doctors who specialize in skin condition and some very bright lights so that nothing gets through that shouldn't.

I know this my grandson is having trouble getting on the mat because mommy is very paranoid about skin problems. I have no idea how to fix this.

My whole point:

Show referees more respect when you think for just a moment all that is involved in their jobs and in their repsponsibility.