Essentials of Athletic Injury Management 8th Edition

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Essentials of Athletic Injury Management 8th
Edition

• William E. Prentice, PhD, PT, ATC

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Essentials of Athletic Injury Management 8th
EditionPowerPoint Presentations

• Jason Scibek, PhD, ATC
• Duquesne University

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Chapter 1 Fitness Professionals, Coaches, and
the Sports Medicine Team Defining Roles

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• Growing demand for well-educated, professionally
  trained personnel to supervise and oversee
  recreational sport and physical activity
• Coaches
• Fitness professionals
• Recreation specialists
• Athletic administrators
• Others interested in various aspects of exercise
  and sports science

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• Injury is a part of athletics
• Athletes have a right to expect that those that
  are overseeing their particular view their health
  and safety as a priority
• Critical to have individuals that are aware of
  both treatment and prevention
• Should be able to recognize injury, provide basic
  medical assistance and refer injured individual
  to appropriate medical personnel
• Well-trained professionals are not always
  healthcare professionals and may be in violation
  if they attempt to provide treatment and care

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What Is Sports Medicine ?

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• Sports medicine refers to a broad field of
  medical practices related to physical activity
  and sport
• Defined by American College of Sports Medicine
  (ACSM) as multidisciplinary
• Includes physiological, biomechanical,
  psychological and pathological phenomena
  associated with exercise and sport
• Clinical application in these areas is aimed at
  improving and maintaining functional capacities
  for physical labor exercise and sports
• Sports medicines generally focuses on areas of
  performance enhancement, injury care, prevention
  and management

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• Areas of specialization that focus primarily on
  performance enhancement
• Exercise physiology
• Biomechanics
• Sports psychology
• Sports nutrition
• Strength conditioning
• Personal fitness training
• Coaching
• Physical education

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• Areas of specialization that focus on health care
  and injury/illness management specific to the
  athlete
• Practice of medicine (physicians physician
  assistants)
• Athletic training
• Sports physical therapy
• Massage therapy
• Dentistry
• Osteopathic medicine
• Sport podiatry
• Orthotist/prosthetists
• Sports chiropractic

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Sports Medicine
Human Performance
Injury Care Management
Practice of Medicine
Exercise Physiology
Sports Physical Therapy
Biomechanics
Sport Psychology
Athletic Training
Sports Nutrition
Massage therapy
Fitness Training
Orthotist/Prosthetists
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• Specialists listed under performance enhancement
  could be concerned with both performance and
  injury care management
• (Example sports nutrition)

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Sports Medicine Organizations

• Sports medicine organizations tend to have many
  goals
• Upgrade field by devising and maintaining a set
  of professional standards (code of ethics)
• Bring professionals together in collegial fashion
  for exchange of ideas, critical thinking and
  research for advancement of profession
• Provide opportunities for individuals to work
  together toward singleness of purpose
• Many national organizations have state and local
  associations, serving as extensions of the larger
  body

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Historical Development of Sports Medicine
Organizations

• International Federation of Sports Medicine
  (1928)
• American Academy of Family Physicians (1947)
• National Athletic Trainers Association (1950)
• American College of Sports Medicine (1954)
• American Orthopaedic Society for Sports Medicine
  (1972)
• National Strength and Conditioning Association
  (1978)
• American Academy of Pediatrics, Sports Committee
  (1979)
• Sports Physical Therapy Section of APTA (1981)
• NCAA Committee on Competitive Safeguards and
  Medical Aspects of Sports (1985)

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Athletic Healthcare in Organized vs. Recreational
Sports Activities

• Delivery of healthcare is dependent on whether
  the event is organized or recreational
• Organized activity
• Generally competitive
• Involves teams, leagues (secondary schools,
  collegiate and professional teams)
• Players of the sports medicine team (coach,
  athletic trainer, physician) are employed on
  full- or part-time
• College setting may also have nutritionist,
  sports psychologist, strength conditioning
  coach, massage therapist

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• Recreational activity
• Can be competitive but often times is done more
  for leisure and is much less formal
• City and community-based recreational leagues and
  teams
• Often include fitness-oriented events
• Sometimes recreational athlete will hire a
  personal fitness trainer
• If injury occurs they are more likely to consult
  with a family physician, athletic trainer, sports
  chiropractor or a sports physical therapist
• Typically, care provided on a fee for care basis

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The Players on the Sports Medicine Team

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• Provision of healthcare requires a group effort
  to be most effective
• Involves a number of individuals
• Each member of the team must perform specific
  functions relative to caring for the injured
  athlete

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How does the Fitness Professional Relate to the
Sports Medicine Team?

• Focus of the group is on improving performance
• Argument can be made that by an athlete achieving
  a higher level of fitness, injuries are less
  likely to occur
• The relationship between performance enhancement
  and injury prevention is critical

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• Personal Fitness Trainer
• Responsible for designing a comprehensive
  exercise program to meet an individuals needs
  and goals while also considering a persons
  health history
• Field emerged in the 1970s and expanded
  tremendously in the 1980s
• Becoming an incredibly fast growing and expansive
  field
• Work with all types of individuals
• No single standard qualification for a person to
  practice as a fitness trainer

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• Four primary organizations
• American College of Sports Medicine (ACSM)
• National Academy of Sports Medicine (NASM)
• National Strength and Conditioning Association
  (NSCA)
• American Council on Exercise (ACE)
• These organizations have specific requirements,
  mandatory testing/retesting, renewal periods, and
  continuing education
• Some even require a formal educational degree in
  exercise science or another related field
• All personal fitness trainers should be certified
  in CPR/AED1,2,3 and in basic First Aid1,2 (Red
  Cross1, National Safety Council2 or American
  Heart Association3)

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• Strongest growth segment of the fitness industry
• Providing increasing services in
  post-rehabilitation training, sports
  conditioning, special medical needs, and weight
  management
• Working with a variety of client populations

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• Strength Conditioning Coaches
• Oversee fitness of an athlete
• Often employed at the collegiate level for both
  team and individual training sessions
• Typically certified by the NSCA
• All strength conditioning coaches should be
  certified in CPR/AED1,2,3 and in basic First
  Aid1,2 (Red Cross1, National Safety Council2 or
  American Heart Association3)
• Must work with the athletic trainer when it comes
  to modifying a strength training program relative
  to injury

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• The athletic trainer should dictate what the
  athlete can and cannot do when engaging in a
  strength conditioning program
• Strength conditioning coaches are typically not
  available at the high school level
• The athletic trainer or team coach typically
  assume this roles in these situations
• Will require both program development and
  overseeing the weight room

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How does a Recreation Specialist Relate to the
Sports Medicine Team?

• A recreation specialist plans, organizes, and
  oversees leisure activities and athletic programs
  in local recreation camp and park areas in
  playground in health clubs and fitness centers
  in the workplace and in theme parks
• Required to ensure that the environment is safe.

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• Should an injury occur to a participant, they
  should be able to provide immediate and correct
  first aid and then refer for additional medical
  assistance
• All recreation specialist should be certified in
  CPR/AED1,2,3 and in basic First Aid1,2 (Red
  Cross1, National Safety Council2 or American
  Heart Association3)

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• Recreation and Parks Directors
• Serve as an advisor to local and state recreation
  and park commissions to manage comprehensive
  recreation programs in a variety of setting
• Develop budgets for recreation programs
• Recreation supervisors
• Serve as liaisons between parks director and
  recreation leaders
• Plan, organize and manage various activities may
  also direct special activities or events
• Recreation leaders
• Responsible for daily operations of the
  recreation program

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• Activity specialist
• Provide instruction and coach groups in
  specialties (i.e. swimming or tennis)
• Camp counselor
• Lead and instruct campers in outdoor-oriented
  forms of recreation
• Recreational therapist
• Work in acute healthcare settings working to
  treat and rehabilitate individuals with specific
  health conditions
• Utilize leisure activities to improve and
  maintain clients general health and well-being
• May also provide interventions that help to
  prevent further medical problems

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The Role of the Athletic Administrator in the
Sports Medicine Team

• Has a significant impact on the sports medicine
  team
• Responsible for hiring personnel (i.e. coaches,
  ATCs, strength coaches, nutritionists, team
  physician)
• Must be sure that all individuals have the
  necessary credentials and are willing to work as
  a team

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• Must also oversee and develop policies
  procedures, risk management plan, and emergency
  action plans
• Responsible for the budget and for funding all
  aspects of an athletic healthcare program
• Salaries, supplies, equipment, insurance
• Commitment of the administrator can have a
  tremendous impact on the success of the athletic
  program

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Role of the Coach in the Sports Medicine Team

• Coach must be aware of the responsibilities of
  each individual associated with the team
• If there is no athletic trainer, this becomes
  even more critical
• Coach must understand limits of their ability to
  function as a health care provider in the state
  in which they are employed
• All coaches should be certified in CPR/AED1,2,3
  and in basic First Aid1,2 (Red Cross1, National
  Safety Council2 or American Heart Association3)

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• Construct injury prevention conditioning programs
• Must provide high quality and properly fit
  protective equipment
• Apply proper first aid if necessary
• Be CPR/AED and First Aid certified

• Possess appropriate coaching licenses and
  certifications
• Have understanding of skill techniques and
  environmental factors associated with sport
• Continuing education through ASEP or NCACE
• Function as a coach

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Roles and Responsibilities of the Athletic Trainer

• Work with athletes from time of injury to
  resolution
• Directly responsible for all phases of health
  care in an athletic environment
• May be employed in a variety of settings
• Colleges/Universities/Secondary schools
• Sports medicine clinics / Corporate settings
• Amateur/Professional athletics
• Military/NASA/NASCAR/Performing arts
• Equipments sales/marketing

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• Must have extensive background in formal academic
  preparation and supervised practical experience
• Guidelines are set Board of Certification
• Both in academic coursework and clinical
  experience
• Upon meeting the educational guidelines
  applicants are eligible to sit for the
  examination
• Upon passing the certification examination BOC
  certification as an athletic trainer
• Credential of ATC

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• Injury prevention
• Ensure appropriate training, monitor environment,
  nutrition, maintain fitting equipment,
  appropriate use of medication
• Clinical evaluation and diagnosis
• Recognize nature and extent of injury
• Immediate care
• Provide first aid and management of acute
  injuries
• Minimum of CPR/AED and First Aid

• Treatment, rehabilitation and reconditioning
• Knowledge of equipment, manual therapy,
  therapeutic modalities
• Organization administration
• Budgeting, inventory, injury records, supervision
  of assistants, insurance, EAP development
• Professional responsibility
• Educating the public through seminars, research
  providing good care

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Responsibilities of the Team Physician

• Athletic trainer works under direct supervision
  of physician
• Physician assumes a number of roles
• Serves to advise and supervise athletic trainer
• Physician and athletic trainer must be able to
  work together

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• Compiling medical histories and conducting
  physical exams
• Pre-participation screening
• Diagnosing injury
• Deciding on disqualifications
• Physician must have the final say on when the
  athlete should return to activity
• Attending practice and games
• It is imperative that the team physician promote
  and maintain consistently high quality care

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Relationship Between the Sports Medicine Team and
Athlete

• Primary concern should be that of the athlete
• All individuals must work cooperatively in the
  best interest of the athlete
• Coach should differ to the medical staff and
  support decisions regarding athlete health care
• Close communication between all parties involved
  is critical

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• All parties must work to develop solid working
  relationship
• Each member will have to gain trust and
  confidence in the skills and abilities of each
  other
• Imperative that the athlete is kept well-informed
• Coach and athletic trainer must make a point of
  educating the student-athlete

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Family and the Sports Medicine Team

• Parents will also be involved at the high school
  and middle school level
• Parents decision must be of a primary
  consideration
• Athletic trainer must be prepared to deal with
  multiple healthcare providers at parents request
• May be dictated via parents insurance plan
• Must also be sure that athlete and family are
  familiar with Health Insurance Portability and
  Accountability Act (HIPAA)

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Other Members of the Sports Medicine Team

• Physicians
• Dentist
• Podiatrist
• Nurse
• Physicians Assistant
• Sports Chiropractors
• Physical Therapist
• Massage Therapist
• Orthotist/prosthetist
• Equipment Personnel

• Exercise Physiologist
• Biomechanist
• Nutritionist
• Sport Psychologist
• Emergency Medical Specialists
• Strength Conditioning Coach
• Referees