1. The Lecture Series in Athletic Training and Sports Medicine
Jim Berry, MEd, ATC, SCAT/NREMT
Director of Sports Medicine
Head Athletic Trainer
Myrtle Beach High School
Myrtle Beach, South Carolina
© 2003

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

3. A Brief History of Sports Medicine
Sports medicine & Athletic Training dates back to ancient Rome
The first “athletic trainers” were actually physicians who worked with the gladiators
The most famous of these ancient “trainers” was Herodicus of Megara, who is perhaps more famous for being the teacher of Hippocrates who is considered to be the father of modern medicine

4. A Brief History of Sports Medicine
When the Roman Empire fell, interest in athletics declined and athletic training did not again emerge in history until the early 20th Century with the development of collegiate and professional athletic teams in the United States
Many of the early athletic trainers were also the team managers, who happened to have an interest in medicine. Many of these people were “self taught” and are responsible for many of the athletic training techniques still used today.

5. A Brief History of Sports Medicine
Today athletic trainers are the “jack of all trades” individuals that founded the profession, but rather highly trained professionals with a wide variety of specialized skills
Today, the NATA-BOC Certified Athletic Trainer plays a vital role in the daily health care of high school, collegiate, world class amateur, and professional athletes
As illustrated in the NATA video, Memories and Souvenirs, the history of athletic training in the United States is storied and rich

6. What Is Sports Medicine ?

7. What is Sports Medicine?
The term “sports medicine” means different things to different groups
Sports medicine encompasses many specialized areas related to sports
Athletic Training is just one of those
Can you think of some others?

8. 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

9. Sports Medicine Organizations
A number of professional organizations are dedicated to sports medicine and athletic training
Some of these are noted here

10. Sports Medicine Injury Exercise Physiology Practice of Medicine
Human
Performance
Injury
Management
Exercise Physiology
Practice of Medicine
Biomechanics
Sports Physical Therapy
Sport Psychology
Athletic Training
Sports Nutrition
Sports Massage

11. Sports Medicine Organizations
Professional organizations have many goals:
To upgrade the field by devising and maintaining professional standards, including a Code of Ethics
**Critical Thought….What is a Code of Ethics?
To bring together professionally competent individuals to exchange ideas, stimulate research, and promote critical thought
To give individuals an opportunity to work as a group towards a single professional goal or purpose that they would not likely achieve as an individual

12. 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)

13. The National Athletic Trainers’ Association
Most athletic trainers belong to this organization
The NATA only accepts individuals into its membership who have subscribed to certain rules, regulations, and are prepared to uphold the standards of the profession

14. 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

15. 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, sports chiropractor or a sports physical therapist
Typically, care provided on a fee for care basis

16. The Players on the Sports Medicine Team

17. The Players on the Sports Medicine Team
The primary athletic training team consists of the coach, the athletic trainer, and the team physician
The major concern of everyone on this team should be the health and welfare of the athlete
The physician always has the final decision regarding the health care of athletes. The athletic trainer works in cooperation with the physician in making these decisions and caring for injuries/illnesses. The coach should always defer and support the medical staff in matters of athletic health care.

18. The Players on the Sports Medicine Team
This is not to say that the coach should have no role in the decisions that are made. There may be particular drills or activities that an athlete should be doing in the course of recovering from an injury that coaches should assist with
Likewise, communication is vital between the coach and medical staff to insure everyone is always on the same page

19. The Players on the Sports Medicine Team
Another important part of the sports medicine team at the secondary school level is the athlete’s family
ATCs must always be sure to keep parents informed of injuries suffered by their children
ATCs must also accept the fact that parents may insist on having their children examined by physicians other than the school’s team physicians

20. Responsibilities of the Coach
All coaches should be certified in CPR and First Aid, especially if the school does not employ an ATC full-time
They should have a thorough knowledge or proper training and skill techniques for the sport they are coaching
Finally, coaches must work with ATCs to develop and understanding and awareness of each other’s responsibilities and difficulties in doing their jobs in order to function effectively

21. Roles and Responsibilities of the ATC
The ATC is most directly responsible for all phases of health care in the athletic environment. Their responsibilities include:
Preventing injuries
Providing initial first aid and injury management
Evaluating injuries
Designing and implementing timely rehab programs that can return an athlete to participation

22. Roles and Responsibilities of the ATC
Qualifications for an ATC
The ATC must be knowledgeable and competent in a variety of sports medicine specialties if he or she is to be effective in doing their job
The NATA has established specific requirements that must be met for an individual to become an ATC, including specific academic and clinical course work in athletic training settings
All ATCs take and pass the NATA BOC national certification examination

23. Roles and Responsibilities of the ATC
The major roles and responsibilities of the athletic trainer include…
Athletic injury prevention/risk management
Recognition, evaluation, and assessment of injuries
Immediate care of injuries and illnesses
Rehabilitation of injuries
Health care organization and administration
Professional development and responsibility

24. 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

25. Personal Fitness Trainer
Responsible for designing a comprehensive exercise program to meet an individuals needs and goals while also considering a person’s health history
Field emerged in the 1970’s and expanded tremendously in the 1980’s
Become 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

26. 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.

27. 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 CPR1,2,3 and in basic First Aid1,2 (Red Cross1, National Safety Council2 or American Heart Association3)

28. 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

29. Responsibilities of the Team Physician
Athletic trainer works under direct supervision of physician
Physician assumes a number of roles
Serves to advise and supervise ATC
Physician and ATC must be able to work together

30. 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

31. 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

32. 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

33. Physician Specialists
Orthopedist
Neurologist
Internist
Ophthalmologist
Pediatrician
Psychiatrist
Dentist
Podiatrist
Chiropractor (?)

34. Summing up… Sports medicine team consists of whom?
Coach, ATC, Team Physician
Primary responsibility of the coach?
Insuring safe environment and equipment
Primary responsibility of ATC?
Prevention, care, and rehab of injuries
Primary responsibility of Team Physician?
PPE’s, diagnosis & treatment, supervising ATC
Name at least 4 other health care providers who may be members of the sports medicine team