1. © 2007 McGraw-Hill Higher Education. All rights reserved. Essentials of Athletic Injury Management 7 th Edition William E. Prentice, PhD, PT, ATC

2. © 2007 McGraw-Hill Higher Education. All rights reserved. Essentials of Athletic Injury Management 7 th Edition PowerPoint Presentations Jason Scibek, PhD, ATC Duquesne University

3. © 2007 McGraw-Hill Higher Education. All rights reserved. Chapter 1: Fitness Professionals, Coaches, and the Sports Medicine Team: Defining Roles

4. © 2007 McGraw-Hill Higher Education. All rights reserved. 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. © 2007 McGraw-Hill Higher Education. All rights reserved. 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. © 2007 McGraw-Hill Higher Education. All rights reserved. What Is Sports Medicine ?

7. © 2007 McGraw-Hill Higher Education. All rights reserved. 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 and support Sports medicines generally focuses on areas of performance enhancement, injury care and prevention,

8. © 2007 McGraw-Hill Higher Education. All rights reserved. Practice of Medicine Human Performance Human Performance Injury Management Injury Management Exercise Physiology Biomechanics Sport Psychology Sports Nutrition Sports Physical Therapy Athletic Training Sports Massage

9. © 2007 McGraw-Hill Higher Education. All rights reserved. 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

10. © 2007 McGraw-Hill Higher Education. All rights reserved. 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)

11. © 2007 McGraw-Hill Higher Education. All rights reserved. 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

12. © 2007 McGraw-Hill Higher Education. All rights reserved. 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, sports chiropractor or a sports physical therapist Typically, care provided on a fee for care basis

13. © 2007 McGraw-Hill Higher Education. All rights reserved. The Players on the Sports Medicine Team

14. © 2007 McGraw-Hill Higher Education. All rights reserved. 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

15. © 2007 McGraw-Hill Higher Education. All rights reserved. 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

16. © 2007 McGraw-Hill Higher Education. All rights reserved. Personal Fitness Trainer –Responsible for designing a comprehensive exercise program to meet an individuals needs and goals while also considering a person’s health history –Field emerged in the 1970’s and expanded tremendously in the 1980’s Become 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

17. © 2007 McGraw-Hill Higher Education. All rights reserved. –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 1,2,3 and in basic First Aid 1,2 (Red Cross 1, National Safety Council 2 or American Heart Association 3 )

18. © 2007 McGraw-Hill Higher Education. All rights reserved. –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

19. © 2007 McGraw-Hill Higher Education. All rights reserved. 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 1,2,3 and in basic First Aid 1,2 (Red Cross 1, National Safety Council 2 or American Heart Association 3 ) –Must work with the athletic trainer when it comes to modifying a strength training program relative to injury

20. © 2007 McGraw-Hill Higher Education. All rights reserved. –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

21. © 2007 McGraw-Hill Higher Education. All rights reserved. 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.

22. © 2007 McGraw-Hill Higher Education. All rights reserved. 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 1,2,3 and in basic First Aid 1,2 (Red Cross 1, National Safety Council 2 or American Heart Association 3 )

23. © 2007 McGraw-Hill Higher Education. All rights reserved. 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

24. © 2007 McGraw-Hill Higher Education. All rights reserved. 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

25. © 2007 McGraw-Hill Higher Education. All rights reserved. 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, ATCs, strength coaches, nutritionists, team physician) –Must be sure that all individuals have the necessary credentials and are willing to work as a team

26. © 2007 McGraw-Hill Higher Education. All rights reserved. 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

27. © 2007 McGraw-Hill Higher Education. All rights reserved. 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 1,2,3 and in basic First Aid 1,2 (Red Cross 1, National Safety Council 2 or American Heart Association 3 )

28. © 2007 McGraw-Hill Higher Education. All rights reserved.

29. Construct injury prevention conditioning programs Must provide high quality and properly fit protective equipment Apply proper first aid if necessary Be CPR and First Aid certified Possess appropriate coaching licenses and certifications Have understanding of skill techniques and environmental factors associated with sport Continuing education Function as a coach

30. © 2007 McGraw-Hill Higher Education. All rights reserved. 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 –Equipments sales/marketing

31. © 2007 McGraw-Hill Higher Education. All rights reserved.

32. 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

33. © 2007 McGraw-Hill Higher Education. All rights reserved. Injury prevention –Ensure appropriate training, monitor environment, nutrition, maintain & fitting equipment, appropriate use of medication Recognition, evaluation, assessment of injuries Immediate care of injuries and illnesses –(Minimum of CPR and First Aid) Treatment, rehabilitation and reconditioning –Knowledge of equipment, manual therapy, therapeutic modalities Organization & administration –Budgeting, inventory, injury records, supervision of assistants and students, dealing with insurance matters Professional responsibility –Educating the public through seminars, research & providing good care

34. © 2007 McGraw-Hill Higher Education. All rights reserved. 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

35. © 2007 McGraw-Hill Higher Education. All rights reserved.

36. 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

37. © 2007 McGraw-Hill Higher Education. All rights reserved. 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

38. © 2007 McGraw-Hill Higher Education. All rights reserved. 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 ATC must make a point of educating the student-athlete

39. © 2007 McGraw-Hill Higher Education. All rights reserved. Family and the Sports Medicine Team Parents will also be involved at the high school and junior high 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)

40. © 2007 McGraw-Hill Higher Education. All rights reserved. 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