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Essentials of Athletic Injury Management 8th Edition

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1 Essentials of Athletic Injury Management 8th Edition
William E. Prentice, PhD, PT, ATC

2 Jason Scibek, PhD, ATC Duquesne University
Essentials of Athletic Injury Management 8th Edition PowerPoint Presentations Jason Scibek, PhD, ATC Duquesne University

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

4 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

5 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

6 What Is Sports Medicine ?

7 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

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

9 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

10 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

11 Specialists listed under performance enhancement could be concerned with both performance and injury care & management (Example: sports nutrition)

12 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

13 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)

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, athletic trainer, 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 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

18 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

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

20 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)

21 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

22 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

23 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

24 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.

25 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)

26 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

27 Recreational therapist
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

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, 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

29 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

30 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)


32 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

33 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


35 Guidelines are set Board of Certification
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

36 Clinical evaluation and diagnosis
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

37 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


39 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

40 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

41 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

42 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 parents 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)

43 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

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