Sports Medicine Broad field of medical practices related to physical activity and sport Involves a number of specialties involving active populations Typically classified as relating to performance enhancement or injury care and management

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

The Players on the Sports Medicine Team Physicians Dentist Podiatrist Nurse Physicians Assistant Physical Therapist Athletic Trainer Massage Therapist Ophthalmologist Dermatologist Gynecologist Exercise Physiologist Biomechanist Nutritionist Sport Psychologist Coaches Strength & Conditioning Specialist Social Worker Neurologist Osteopath Psychiatrist

The Athletic Trainer Charged with injury prevention and health care provision for the athlete Athletic trainer deals with the athlete and injury from its inception until the athlete returns to full competition

Roles and Responsibilities: Performance Domains Prevention of athletic injuries Clinical evaluation and diagnosis Immediate care of injuries Treatment, rehabilitation and reconditioning of athletic injuries Health care administration Professional responsibilities

Athletic Training Education Competencies Twelve Content Areas Risk management Pathology of injuries and illnesses Assessment and evaluation Acute care Pharmacological aspects of injury and illness Therapeutic modalities

Athletic Training Education Competencies Therapeutic exercise General medical conditions and disabilities Nutritional aspects of injury and illnesses Psychosocial intervention and referral Organization and administration Professional responsibilities

Personal Qualities of the Athletic Trainer Stamina and the ability to adapt Empathy Sense of humor Communication Intellectual curiosity Ethical practice

Employment Settings for the Athletic Trainer Employment opportunities are becoming increasingly diverse Dramatic transformation since 1950 Due largely in part to the efforts of the NATA Started out primarily in the collegiate setting, progressed to high schools and are now found primarily in hospital and clinic settings

Settings include: Secondary schools Colleges and universities Professional teams Sports medicine clinics Corporate/Industrial settings Military Physician extenders Medical supply & equipment sales Research Administration

Accredited Athletic Training Education Programs AT programs are accredited by CAATE (Commission of Accreditation for Athletic Training Education) Masters’ Degree is required to sit for the national exam

Specialty Certifications NATA is in the process of developing specialty certifications Further enhance professional development Aid in expanding scope of practice Specialty certifications build on entry level knowledge

Seven proposed areas Business practice, medical care management, occupational health, wellness, pediatric/adolescent health, adult/geriatric health, special health populations Candidates will have to complete experiential requirements and pass a standardized examination

Requirements for Certification as an Athletic Trainer Must have extensive background in formal academic preparation and supervised practical experience Guidelines are set by the Board of Certification (BOC) Graduation from an accredited AT Program is required (CAATE)

BOC certification is a prerequisite for licensure in most states 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 BOC certification is a prerequisite for licensure in most states

Continuing Education Requirements Ensure ongoing professional growth and involvement Requirements that must be met to remain certified 50 CEU’s over the course of two years

Purpose: To encourage ATC to obtain current professional development information To explore new knowledge in specific areas To master new athletic training related skill and techniques To expand approaches to effective athletic training To further develop professional judgement To conduct professional practice in an ethical and appropriate manner

CEU’s are awarded for: Attending symposiums, workshops, seminars Serving as a speaker or panelist Certification exam model Participating in the USOC program Authoring a research article; authoring/editing a textbook Completing post-graduate work Obtaining CPR and first aid certification

State Regulation of the Athletic Trainer Athletic trainers in many individual states organized efforts to secure recognition by seeking some type of regulation of the athletic trainer by state licensing agencies To date 49 of the 50 states have enacted some type of regulatory statute governing the practice of athletic training Rules and regulations governing the practice of athletic training vary tremendously from state to state

Types of Regulation Licensure Limits practice of athletic training to those who have met minimal requirements established by a state licensing board Limits the number of individuals who can perform functions related to athletic training as dictated by the practice act Most restrictive of all forms of regulation

Certification Registration Does not restrict using the title of athletic trainer to those certified by the state Can restrict performance of athletic training functions to only those individuals who are certified Registration Before an individual can practice athletic training he or she must register in that state Individual has paid a fee for being placed on an existing list of practitioners but says nothing about competency

Exemption State recognizes that an athletic trainer performs similar functions to other licensed professions (e.g. physical therapy), yet still allows them to practice athletic training despite the fact that they do not comply with the practice acts of other regulated professions Legislation regulating the practice of athletic training has been positive and to some extent protects the athletic trainer from litigation

Future Directions for the Athletic Trainer Will be determined by the efforts of the NATA and its membership Ongoing re-evaluation, revision and reform of athletic training education JRC-AT will become an accrediting agency Third party billing will gradually become the rule not the exception for ATC’s Standardization of state practice acts ATC’s will seek specialty certifications Expanding breadth and scope of practice

Increase in secondary school employment of ATC’s Increase in recognition of ATC as a physician extender Potential for expansion in the military, industry, and fitness/wellness settings With general population aging = increased opportunity to work with aging physically active individuals Continue to enhance visibility through research and scholarly publication

Continue to be available for local and community meetings to discuss healthcare of the athlete Increase recognition and presence internationally Most importantly, continue to focus efforts on injury prevention and to provided high quality healthcare to physically active individuals who are injured while participating in sport

Athletic Trainer and the Athlete Major concern on the part of the ATC should be the athlete All decisions impact the athlete The injured athlete must always be informed Be made aware of the how, when and why that dictates the course of injury rehabilitation

The athlete must be educated about injury prevention and management Instructions should be provided regarding training and conditioning Inform the athlete to listen to his/her body in order to prevent injuries

Athletic Trainer and Parents ATC must keep parents informed, particularly in the secondary school setting Injury management and prevention The parents decision regarding healthcare must be a primary consideration Insurance plans may dictate care Selection of physician

Louisiana ATs Must be aware of La. Laws and regulations: AT Law Act 314 (concussion law) Serious Injury Rule Must pass the BOC in 3 or less attempts Must be licensed to practice by the LSBME (La. State Board of Medical Examiners) and can apply for temporary exemption

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 Have similar philosophical opinions regarding injury management Helps to minimize discrepancies and inconsistencies

Roles and Responsibilities Compiling medical histories and conducting physical exams Pre-participation screening Diagnosing injury Deciding on disqualifications Decisions regarding athlete’s ability to participate based on medical knowledge and psychophysiological demands of sport

Responsibilities of the Coach Must understand specific role of all individuals involved with the team Coach must clearly understand the limits of their ability to function as a healthcare provider in their respective state Directly responsible for injury prevention Athlete must go through appropriate conditioning program

Coach must be aware of risks associated with sport Provide appropriate training and equipment Must have knowledge of CPR and first aid Must have thorough knowledge of skills, techniques and environmental factors associated with sport Develop good working relationships with staff, including athletic trainers Must be a cooperative relationship

ATC, physician and coaches must be aware and inform parents of Health Insurance Portability and Accountability Act (HIPAA) Regulates dissemination of health information Protects patient’s privacy and limits the people who could gain access to medical records

Referring the Athlete to Other Personnel ATC must be aware of available medical and non-medical personnel Athlete may require special treatment outside of the “traditional” sports medicine team Must be aware of community based services and various insurance plans Typically the ATC and team physician will consult on the particular matter and refer accordingly