1. Putting together a sports medicine team & defining their roles
Chapter 1

2. Sports Medicine
Broad field of medical practices related to physical activity & sports
The field of sports medicine includes a number of more specialized aspects of dealing with the physically active or athletic populations
There are 2 categories under the sports medicine umbrella:
Performance Enhancement
Injury Care & Management

3. Sports Medicine Umbrella
Performance Enhancement: Make Better Athletes
Injury Care & Management: Make Athletes Better

4. Performance Enhancement
Exercise Physiology: training & conditioning techniques, body composition analysis & nutritional considerations
Biomechanics: study of the mechanics of a living body, especially those forces extended by muscles & gravity on the skeletal structure. How & why the body moves.
Sports Psychology: relate to the psychological aspects of the rehabilitation process. The way the athlete feels about his or her injury & how it affects his/her social, emotional, intellectual, & physical dimensions can have a substantial effect on the course of a treatment program & how quickly the athlete may return to competition
Sports Nutrition: May plan eating program for the physically active & assists athletes who may need special nutritional counseling
Strength & Conditioning Specialist: advise athletes on training & conditioning programs. National Strength & Conditioning Association certifies CSCS
Make Better Athletes

5. Injury Care & Management
Practice of Medicine: M.D. or D.O. physicians with a wide variety of specializations
Athletic Training: Allied healthcare professional concerned with prevention, management, evaluation, & rehabilitation of injuries related to physically active individuals. ATC certified by National Athletic Trainers’ Association Board of Certification (4 year degree, undergraduate)
Physical Therapy: Supervise & design rehabilitation programs for injured athletes. DPT certified by passing National Physical Therapy Examination (3 year degree, graduate)
Massage Therapy: Training in all areas of massage. Used primarily in pre- competition & post-competition phases of athletic events; warm up, cool down, recovery. Can be used for rehabilitation of injury.
Sports Dentistry: Treat dental injuries, provide first aid & emergency care, fit custom mouth pieces
Orthotist & Prosthitist: Custom fit, design & construct braces, orthotics & supportive devices based on physician prescriptions
Chiropractor: Use spinal & joint manipulation techniques to treat musculoskeletal injuries. Have a doctorate (PhD) & are NOT MEDICAL DOCTORS
Nurse: Work under the direction of a physician & in liaison with the athletic trainer & school health services. LPN, ADN, BSN, MSN, NP
Make Athletes Better

6. Discussion
What do you think?
A new high school has hired a coach to establish & develop a football program. Unfortunately, the school does not have the funds to also hire an athletic trainer. The coach must assume the responsibility of creating a safe playing environment for the athletes.
What considerations should the coach make to ensure that his athletes will be competing under the safest possible conditions?

7. Practice of Medicine Medical Doctors Doctors of Osteopathy
Orthopedist: treat injuries to bones, muscles, ligaments & tendons
Neurologist: injuries to nervous system; head or nerve injuries
Internist: treat diseases of internal organs
Family Medicine: treat general illness & non-operative injuries
Ophthalmologist: treat eye injuries, can operate if necessary (optometrist = glasses)
Pediatrician: treat injuries in children & adolescents
Psychiatrist: diagnosis, treatment & prevention of mental illness. Can prescribe medicines. (psychologist = PhD)
Dermatologist: treat skin disorders or skin disease
Gynecologist: treat reproductive health issues in females
Endocrinologist: treat disorders of the endocrine system & hormones. Hormones may affect growth, differentiation & coordination of metabolism, respiration, excretion, movement, reproduction, & sensory perception
Podiatrist: treat foot injuries operatively & non-operatively
Cardiologist: treats illness & injuries related to the heart & circulatory system
Medical Doctors
Doctors of Osteopathy

8. How do I become a ________?
Orthopedic Surgeon – MD or DO
Physician Assistant - PA
4 year undergraduate degree
4 years medical school
4 year residency
1-2 year fellowship
4 year undergraduate degree
2 year PA school

9. How do I become a ________?
Physical Therapist - DPT
Nurse - RN
4 year undergraduate degree
3 years PT school
ADN, 2 year program at technical school
BSN, 4 year undergraduate degree
MSN, 2 year graduate degree after 4 year undergraduate degree

10. Athletic Training - ATC
Athletic Training is practiced by athletic trainers, health care professionals who collaborate with physicians to optimize activity & participation or patients & clients. Athletic training encompasses the prevention, diagnosis, & intervention of emergency, acute & chronic medical conditions involving impairment, functional limitations & disabilities
Athletic Training started in the United States in the 1930’s
National Athletic Trainers’ Association (NATA) was founded in in Kansas by 200 athletic trainers
Today there are approximately 35,000 members
The NATABOC tests & certifies athletic trainers nationally
Athletic trainers must meet state licensing requirements to practice in individual states
Currently, 48 states have some form of regulation for Athletic Trainers: licensure, certification, registration or exemption
California & Alaska currently don’t have regulations, but bills were proposed in 2013 that would require athletic trainers to have state licensure
Registration in WV, CO, OR, MN
ATC
Athletic Trainers function under the DIRECTION of a physician

11. Athletic Training - ATC
Currently Athletic Trainers must obtain 50 continuing education units every 2 years in order to maintain NATA certification. SC DHEC licenses athletic trainers in SC. Athletic trainers licensed in SC must renew every 2 years & are required to complete 2 of the 4 DHEC courses offered every 2 years.
The American Medical Association recognizes athletic training as an allied healthcare profession.
In order to sit for the NATABOC exam, students must graduate from an CAATE accredited curriculum program.
SC – C of C, CSU, USC, Erskine, Lander, Winthrop, Limestone
GA – GCSU, GSU, North Georgia, UGA, Valdosta State

12. Athletic Training - ATC
Traditional Settings
High School Athletics
College Athletics
Professional Athletics
Nontraditional Settings
Clinical – Hospitals, Physical Therapy Clinics, Sports Medicine Clinics
Industrial/Corporate
Olympics
NASCAR
NASA
Military
Law Enforcement/Public Safety
Performing Arts
Movie or production companies – WWE, Leatherheads
Rodeo
Fields of Employment

13. Athletic Training
Women in athletic training
1st female athletic trainer in NFL, Pittsburg Steelers Ariko Iso 2002
1st female athletic trainer in MLB, LA Dodgers Sue Falsone 2011

14. Roles & Responsibilities of the Athletic Trainer
Stamina Ability to Adapt
Good Communication Skills
Problem Solver Ethical Empathetic
Sense of Humor Intellectual Curiosity
Risk Management
Training & Conditioning
Environmental Conditions
Equipment, Nutrition, Medications
Recognition, Evaluation, & Assessment of Injuries
Pre-participation Physical Exams
Injury Evaluation
Referrals
Immediate Care of Injuries & Illnesses
First Aid
CPR
Triage
Treatment, Rehabilitation & Reconditioning
Rehabilitation of Injuries
Modalities
Return to Play
Counseling
Administration
Record Keeping, Budget
Insurance
Supervision of Student Athletic Trainers
Policies, Procedures, Protocols,
Ordering Supplies
Professional Development
Code of Ethics
Laws, State Regulations
Decision Making
Conferences& Research

15. Roles & Responsibilities of the Team Physician
A team physician must be committed to athletes, must have knowledge of sport, must be interested in dealing with athletes at all levels, should live locally, & should consistently maintain a high quality of care for all athletes.
Relationship with the Athletic Trainer
The most important relationship in regards to the athletes’ health care
Must advise ATC while trusting their decision making
Allows ATC to function independently
Same treatment philosophy as other team members
Compiling Medical History
Conduct PPE
Screen for serious Medical Conditions
Compile complete medical history
Establish baseline
Diagnosing Injury
Physician Responsibility
Aware of rehab & treatment provided by ATC
Good communication with ATC about initial evaluation
Provide written diagnosis
Deciding on Disqualification
Physician has final say on an athlete’s disqualification based on medical grounds
Return to play is determined by physician based on recommendations from ATC & PT
Attending Practices & Games
More common in college or professional setting
Must be readily available to ATC, School, Athlete

16. Central Sports Medicine Team
Peripheral Sports Medicine Team
EMT
PT - PA
Nutritionist
Massage Therapist
Equipment
Student AT
Strength & Conditioning Coach
Dentist - Endocrinologist
Podiatrist – Neurologist – Primary Care Physician
Cardiologist – Dermatologist - Psychologist
Nurse – Gynecologist - Chiropractor
Central Sports Medicine Team
ATHLETE
ATC
COACH
PARENTS
TEAM PHYSICIAN

17. Think Again
What do you think now?
A new high school has hired a coach to establish & develop a football program. Unfortunately, the school does not have the funds to also hire an athletic trainer. The coach must assume the responsibility of creating a safe playing environment for the athletes.
What considerations should the coach make to ensure that his athletes will be competing under the safest possible conditions?
Should schools require coaches to be responsible for medical care?
What kind of risks are athletes exposed to when a school does not have proper medical personnel on staff?

18. Discussion
What do you think?
How can a school who may be short on money provide adequate medical coverage for it’s athletic teams?
Where can a school find an athletic training coverage?