1. Training is Over—Now What? Practical Management Pearls for the Trainee in Musculoskeletal and Sports Medicine AAPMR Annual Meeting| Boston, MA| October 1st, 2015 Jason L. Zaremski, M.D., CAQSM Assistant Professor, Department of Orthopaedics & Rehabilitation Divisions of PM&R, Sports Medicine, & Research, University of Florida TEAM

2. I have no disclosures

3. Starting a High School Outreach Sports Medicine Program from the Ground Up

4. What Will You Need…Personally 1. Motivation 2. Learn how to NOT say No – Can you take an add-on HS athlete at 4:50pm? – Can you take an additional Concussion at 7am Friday morning for clearance? 3. Cover Cover Cover I cover 12-18 HS football Games/season Everyone has different schedules, distances to drive, etc… 4. Departmental Support -Head of Sports Medicine (if that is not you) -Chairman -Business Office -Marketing/Promotions

5. What Will You Need…Work Setting 1. High School Contracts 2. Relationships -Coaches, ADs, Colleagues, Community 3. Athletic Trainers (ideally) 4. Understanding of your respective states rules – FHSAA.ORG – Contact for Sports Medicine Advisory Committee – Concussion – ECG – Heat – Sickle Cell Disease v Trait – Other…

7. High School Contracts What Will You Provide For HS – Coverage of all HS Football Games Home – Consider Coverage of all HS Football Games Away – Athletic Trainer & EAP – Free Lectures/Events – Athletes Seen in a timely manner Translation  Immediately – Coverage of Major Events Winter Basketball Tournament Large Swim Meets or Track & Field Meets What the HS Will Provide For You – Advertising on Field/Court/HS – Recommend sending patients to your clinic – Access – Unlikely but potentially some $

8. Heat, Heart, and Head

9. Average Week Clinic: 4 days per week – Typically Athletes come in 2-4 pm to minimize missing school but double book anytime they want Outreach – Lectures, Spring Football Practices, Meeting with EMS, AT, and other personnel Athletic Game/Practice Coverage – Atleast 1 HS Football Game/week per/HS – Athletic Training Room 1x/week after clinic – Cell Available to AT at anytime – Other Sports as needed (Soccer, Wrestling, Lacrosse, Basketball Tournaments, etc…)

10. Seasonal Fluctuations-FLORIDA July: Meetings, prepare for Football season August-Nov/Dec: Concussions, Acute bony injuries due to contact sports (Football), Heat Illness, Cardiac Dec-March: Soccer, Basketball, Swimming Jan-March: Throwing Injuries Summer: Lower Numbers…time to breathe… – Increase in Crossfit-Type Injuries due to no school, more time to train Continuously: Overuse Training, Running, Throwing

11. Seasonal Fluctuations- NOT FLORIDA July: Meetings, prepare for Football season August-Nov/Dec: Concussions, Acute bony injuries due to contact sports (Football, Soccer), Heat Illness, Cardiac Nov-March: Hockey, Basketball, Swimming March-June: Throwing Injuries (earlier in warm weather states) Summer: Lower Numbers…time to breathe… – Increase in Crossfit-Type Injuries due to no school, more time to train Continuously: Overuse Training, Running (spring-fall), Throwing

12. Pre-Participation Examinations

13. Prove You’re The Experts

14. Be Prepared…For Anything September 2015 HS Football Game Play Ended… Fans started screaming “Trainer” and “Run” This Happened…

15. Mindset A Coach or Parent needs to think: “If My Student-Athlete/Child gets hurt, I need him to see Dr. X immediately.”

16. End With a Case Wednesday August 13 th, 2014 Approximately 1 week into Contact Football Practice 11:15am: Wide Received hit on right shoulder and driven into ground. Athletic Trainer evaluates. Suspicion of clavicle fracture. 11:30am: Call made to my cell. Can we see? Noon: Parent and athlete in xray. Radiographs confirm non-displaced mid-shaft clavicle fracture. 12:15pm: Sling and education re: injury. 1:00pm: Back on practice field watching

17. Thank You zaremjl@ortho.ufl.edu