Essentials of Athletic Injury Management 10th Edition

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

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

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 Well-trained professionals are not always healthcare professionals and may be in violation if they attempt to provide treatment and care

What Is Sports Medicine ?

Sports medicine refers to a broad field of healthcare related to physical activity and sport Defined by American College of Sports Medicine (ACSM) as multidisciplinary approach to health management or achievement of full potential 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

Areas of specialization that focus primarily on performance enhancement* Exercise physiology Biomechanics Sports psychology Sports nutrition Strength & conditioning Personal fitness training Coaching Physical education *Some are concerned with both performance and injury management

Areas of specialization that focus on healthcare and injury/illness management Practice of medicine (physicians & physician assistants) Athletic training Sports physical therapy Massage therapy Dentistry Osteopathic medicine Sport podiatry Orthotist/prosthetists Sports chiropractic

Sports Medicine Human Performance & Management Injury Care Exercise Physiology Practice of Medicine Sports Physical Therapy Biomechanics Sport Psychology Athletic Training Sports Nutrition Massage therapy Fitness Training Orthotist/Prosthetists

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 for exchange of ideas and research for advancement of profession Provide opportunities for individuals to work collaboratively toward single purpose

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

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

The Players on the Sports Medicine Team

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

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 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

Personal Fitness Trainer Responsible for designing comprehensive exercise program to meet an individual’s needs and goals while also considering a person’s health history No single standard qualification for a person to practice as a fitness trainer ACSM, NASM, NSCA, & ACE have specific requirements, mandatory testing/retesting, renewal periods, and continuing education for certifications

Personal Fitness Trainer, cont. All personal fitness trainers should be certified in CPR/AED and in basic First Aid 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

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. 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/AED and in basic First Aid

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

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 client’s general health and well-being May also provide interventions that help to prevent further medical problems

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, ATC’s, strength coaches, nutritionists, team physician) Must be sure that all individuals have the necessary credentials and are willing to work as a team 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

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/AED and in basic First Aid

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

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 Equipment sales/marketing

Must have extensive formal academic preparation and supervised practical experience The Board of Certification sets academic coursework and clinical experience requirements Upon meeting the educational guidelines applicants are eligible to sit for the BOC examination Passing the certification examination = BOC certification as an athletic trainer Credential of ATC

Roles & Responsibilities of Athletic Trainers Injury prevention & health promotion Ensure appropriate training, monitor environment, nutrition, maintain & fitting equipment, appropriate use of medication Clinical examination & diagnosis Recognize nature and extent of injury Acute care of injury & illness Provide first aid and management of acute injuries

Psychosocial strategies & referrals Recognize abnormal behaviors; recognize the role of mental health in injury/recovery and use of intervention strategies; refer the patient to the appropriate medical personnel for intervention Therapeutic intervention Knowledge of equipment, manual therapy, therapeutic modalities Healthcare administration Budgeting, inventory, injury records, supervision of assistants, insurance, EAP development Professional development & responsibility Educating the public through seminars, research & providing good care

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 Compiling medical histories and conducting physical exams Pre-participation screening Diagnosing injury Deciding on disqualifications Physician is responsible for determining 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

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 Must work to develop solid working relationships 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

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

Other Members of the Sports Medicine Team Physicians Dentist Podiatrist Nurse/Nurse practitioner 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