1. AN approach to Sports Medicine – “THE SPORTS MEDICINE MODEL”
Dr Louis Holtzhausen
Program director: Sports Medicine
University of the Free State
South Africa
April 22, 2017

2. Definition of Sports Medicine
Not only the management of injuries
The medicine of exercise
Total medical care of the exercising individual
Brukner and Khan, 2001

3. The scope of Sports Medicine
Prevention of injury
Diagnosis of illness and injury
Treatment and rehabilitation
Performance enhancement
Training
Nutrition
Psychology
Management of medical problems caused by exercise
The role of exercise in chronic disease
Cardiac disease
Diabetes
Asthma and COPD
Arthritis
The needs of special exercising populations
Children
Females
Older people
Persons with disabilities
Medical care of sporting teams and events
Medical care in situations of altered physiology
Diving and aviation
Heat
Altitude
Ethical issues
Drugs in sport

4. “THE SPORTS MEDICINE MODEL”

5. The traditional medical model
Brukner P, Khan K. Clinical Sports Medicine. 2007

6. The Sports Medicine model
Brukner P, Khan K. Clinical Sports Medicine. 2007

7. The multi professional team approach
“A champion team will always beat a team of champions“
Know your skills and limitations and that of other team members
Team may differ in different settings
Multi skilling
Geographically isolated
Travelling
Overlap
Case manager/ co-ordinator
Primary contact is the choice of the athlete – responsibility of the practitioner is to know his/her place in the multi professional team and utilise other members

8. Challenges of management
Diagnosis
Clinical (“Victim“): Specific, anatomical, pathological
Cause: (“Culprit“)
Interaction between body (with its physical properties) with the environment and a training schedule

9. Causes of chronic injury
Intrinsic causes:
Biomechanics
Body mass
Level of fitness and skill
Extrinsic causes:
Equipment
Footwear
Playing surface
Environmental conditions
Training factors:
Frequency
Intensity
Time
Type

11. Challenges of management
Treatment
Presenting injury/illness
Cause
Consider all aspects of injury
Return to sport issues

12. Philosophy of injury rehabilitation
Understand the healing process
Understand the pathomechanics of injury
Understand the kinetic chain
Psychological aspects
The tools of rehabilitation
Goal setting

13. The components of injury rehabilitation
Control of swelling and pain
Restoring range of motion
Restoring muscular strength, endurance and power
Restoring neuromuscular control
Restoring postural control and stability
Maintaining cardio-respiratory fitness
Psychological aspects
Monitor possible complications
Functional progression and testing
Return to sport
Criteria for full recovery

14. Meeting individual needs
Individual needs of individual athletes determine management plan
Contextual variables have to be considered
The role of the coach
Communication
Shared decision making
Ultimate responsibility to patient

16. The Bio-psycho-social model
HOLISTIC PATIENT CARE
The Bio-psycho-social model

18. Ashburnpsychologist.com 2012

20. Systems theory Before injury Effects of injury
Engel, 1980 in Mc Whinney IR. A Textbook of Family Medicine. 1989

21. Systems theory Resolution
Engel, 1980 in Mc Whinney IR. A Textbook of Family Medicine. 1989

22. A biopsychosocial method: The three stage assessment
Intrinsic
Training
Extrinsic
Social/contextual:
Effect on social systems
Personal/PsychologicalThoughts
Feelings
Fears
Expectations

23. The athlete support system
Athlete and agent
Clinician
Coach
Brukner P, Khan K. Clinical Sports Medicine 3rd Ed, 2007

24. Love thy sport
Know thy sport

25. The sports medicine consultation
Subjective assessment
History
Determine type, severity and cause
Objective assessment
Clinical evaluation
Assessment summary
Clinical
Personal
Contextual
Plan
Case manager
Multi professional
Stages of rehabilitation
Goal setting
Follow-up
Return to sport

26. Thank you! Dr Louis Holtzhausen Sports Medicine
University of the Free State