© 2010 McGraw-Hill Higher Education. All rights reserved.

Essentials of Athletic Injury Management 8th Edition

William E. Prentice, PhD, PT, ATC

© 2010 McGraw-Hill Higher Education. All rights reserved.

Essentials of Athletic Injury Management 8th Edition

PowerPoint Presentations

Jason Scibek, PhD, ATC

Duquesne University

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Chapter 1: Fitness Chapter 1: Fitness Professionals, Coaches, and the Professionals, Coaches, and the

Sports Medicine Team: Sports Medicine Team: Defining RolesDefining Roles

Chapter 1: Fitness Chapter 1: Fitness Professionals, Coaches, and the Professionals, Coaches, and the

Sports Medicine Team: Sports Medicine Team: Defining RolesDefining Roles

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• 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

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• 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

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What Is Sports Medicine ?What Is Sports Medicine ?What Is Sports Medicine ?What Is Sports Medicine ?

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• 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

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

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• 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

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Practice of MedicinePractice of Medicine

Human Performance

Human Performance

Injury Care & Management

Injury Care & Management

Exercise PhysiologyExercise Physiology

BiomechanicsBiomechanics

Sport PsychologySport Psychology

Sports NutritionSports Nutrition

Sports Physical TherapySports Physical Therapy

Athletic TrainingAthletic Training

Fitness TrainingFitness Training

Massage therapyMassage therapy

Orthotist/ProsthetistsOrthotist/Prosthetists

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

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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

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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)

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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

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• 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

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The Players on the Sports The Players on the Sports Medicine TeamMedicine Team

The Players on the Sports The Players on the Sports Medicine TeamMedicine Team

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• 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

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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

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• 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

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– 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)

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– 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

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• 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

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– 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

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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.

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• 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)

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• 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

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• 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

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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

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• 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

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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)

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• 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

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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

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• 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

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• 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

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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

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© 2010 McGraw-Hill Higher Education. All rights reserved.

• 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

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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

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• 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

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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)

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Other Members of the Sports Other Members of the Sports Medicine TeamMedicine Team

Other Members of the Sports Other Members of the Sports Medicine TeamMedicine Team

• Physicians• Dentist• Podiatrist• Nurse• Physicians Assistant• Sports Chiropractors• Physical Therapist• Massage Therapist• Orthotist/prosthetist• Equipment Personnel

• 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

• Exercise Physiologist• Biomechanist• Nutritionist• Sport Psychologist• Emergency Medical

Specialists• Strength &

Conditioning Coach• Referees