Athletic Training

Athletic Training. . . “Is an allied health profession dealing with the prevention, care, and rehabilitation of injuries to physically active individuals” Began between 1900 and 1925 Draws from many specific areas Closely aligned with sports medicine

Athletic Training Practice in. . . Limited scope of medical practice Individual and team sports Educational and Professional settings Sports medicine and orthopedic clinics Industrial settings Limited scope of medical practice

Athletic Medicine Physicians and athletic trainers make primary medical team Medical team provides immediate support services Receive related support MUST WORK IN CONJUNCTION with coaches, athletic directors, administrators, and strength coaches

Sports Medicine Team Headed by the physician Athletic trainer is the on-site representative Evaluates injuries Provides physician with the information for a definitive diagnosis

Job Sites Largest placement is in Sports Medicine 2nd Largest placement is as a teacher and Athletic trainer in secondary school 3rd Largest placement is at colleges as trainer or teacher Less than 10% Preferred profession to many Only 1% work for professional teams Industrial setting

Domains of Body of Knowledge Established by NATA Board of Certification Core of AT is split into 6 domains Prevention of Athletic Injuries Recognition, Evaluation, and Assessment of Athletic Injuries Immediate Care of Athletic Injuries Treatment, Rehabilitation, and Reconditioning of Athletic Injuries Organization and Administration Professional Development and Responsibility

Prevention of Athletic Injuries Most important is for the participant to be fit before engaging in activity AT needs to inform person that injury is possible Know the signs and symptoms of injuries Minimize risk of injury

Prevention of Athletic Injuries Industrial setting Instruction in proper body movements Worksite fitness centers Assessing body mechanics Implementing lifetime fitness programs Exercise Caution

Recognition, Evaluation, and Assessment of Athletic Injuries Athletic Trainers are the eyes and ears of physicians at practice and competitions AT is the first to intervene to evaluate injury AT takes the evaluation to physician for diagnosis Must possess current certification in CPR from… American Red Cross American Heart Association National Safety Council First aid is strongly encouraged

Recognition, Evaluation, and Assessment of Athletic Injuries Primary Survey ABCs required Secondary Survey to evaluate specific complaint OSHA requirement must be met Use latex gloves Immunizations

Secondary Survey Injury history Observation of body language What, When, and How Observation of body language Observation of injured area Palpation of injured area Ask athlete to point to area Special testing to establish structural and functional integrity of injured body area Circulation beyond injury site Response to touch Ability to activate muscle Range of Motion is tested Active, Passive, and Resistive

Recognition, Evaluation, and Assessment of Athletic Injuries After injury is evaluated the athlete… Returns to sport (mild injury) Removes the athlete from sport (moderate to severe) Activates EMS (severe to catastrophic) Written record always kept after evaluation Format necessary so physician and future trainers will understand it SOAP Subjective Objective Assessment Plan

Immediate Care of Athletic Injuries Acute injuries are seen by AT before anyone else Most common treatment is RICE Rest Ice Compression Elevation Emergency Care Plan Implemented to prevent secondary injury Written document with roles for all involved

Treatment, Rehabilitation, and Reconditioning of Athletic Injuries Immediate effects of injury are pain, swelling, decreased range of motion, loss of function Period of inactivity = disuse atrophy Restoration incorporates physiological and accessory movements Physiological=movements of joint Accessory=repositioning Exercise types Isometric Isotonic  Eccentric, Concentric, Isokinetic

Treatment, Rehabilitation, and Reconditioning of Athletic Injuries Closed kinetic chain activities Use proprioceptive input Functional progression Acute inflammation Repair Remodeling

Organization and Administration Negligence is a consideration in health-care administration Elements: duty, breach of duty, causation, damage All four elements must exist for a successful claim Accused does something wrong or an act of omission Moving injured athlete when it’s not safe Allowing athlete to return to play prematurely Missing an injury Improper risk management Medical record keeping

Organization and Administration Personnel Management Facility Management and Design Budgeting Preparticipation physical examinations Medical record keeping Insurance Public Relations

Professional Development and Responsibility Maintenance of knowledge and skills Assist in education of student athletic trainers as mentors and clinical instructors

Focus on Science Athletic trainer can have major influence on course of injury using therapeutic modalities Limit inflammatory response to injury Increase rate of repair and remodeling Incorrectly used can lengthen healing time or lead to complication Common Injuries, Inflammatory Response, Tissue Repair, Therapeutic Modalities

Common Athletic Injuries Usually from direct trauma or overuse Signs, symptoms, and functional significance are evaluated for injury classification Sprains Graded according to severity Contusions Strains Overuse Injuries Dislocations (luxations) Fractures Neurological injuries

Inflammatory Response Body seeks to control effects of trauma, bacterial and viral invasion, decreased blood supply Pain, redness, temperature, swelling, loss of function Early phase begins immediately and can last up to 3 days Late phase continues for about a week longer

Tissue Repair Process begins on 3rd day and continues for about 3 weeks Scar formation in 1st week Some people scar more than others Only 70% of strength of original tissue Collagen replaces blood vessels Remodeling begins on 9th day Continues on for a year or more Some things modify inflammatory and repair stages NSAIDs, immobilization, electrical stimulation, hyperbaric oxygen, ultrasound

Therapeutic Modalities “Combinations of physical agents, machines, massage, and manual exercise are used to modify an inflammatory response, restore tissue, or increase strength and range of motion” Cold (confusion as whether to switch from cold to heat) Heating used most successfully on postacute and chronic inflammation

Advances in Athletic Training Originally students would earn a physical education degree then work in an apprenticeship 1959 – formal course work in athletic training 1970 – Certified Athletic Trainer (ATC) became entry-level credential Formal education programs developed by NATA 1983 – competency-based education Six domains indentified by NATA Currently developing new competencies to split into 11 domains

Advances in Athletic Training 1980s – profession evolving similar to physical therapy State credentialing become a necessity 1994 – first accredited athletic training programs endorsed CAHEA 1996 – NATA adopted 18 reforms for educating athletic trainers 2004 – only graduates in education programs can take certification examinations 1990s – growth in credentialing, now credentialed by 38 states