AN APPROACH TO SPORTS MEDICINE – “THE SPORTS MEDICINE MODEL” Dr Louis Holtzhausen Program...
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Transcript of AN APPROACH TO SPORTS MEDICINE – “THE SPORTS MEDICINE MODEL” Dr Louis Holtzhausen Program...
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AN APPROACH TO SPORTS MEDICINE – “THE SPORTS MEDICINE MODEL”
Dr Louis HoltzhausenDr Louis HoltzhausenProgram director: Program director:
Sports MedicineSports MedicineUniversity of the Free University of the Free
StateStateSouth AfricaSouth Africa
April 21, 2023
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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
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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
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“THE SPORTS MEDICINE MODEL”
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THE TRADITIONAL MEDICAL MODEL
Brukner P, Khan K. Clinical Sports Medicine. 2007
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THE SPORTS MEDICINE MODEL
Brukner P, Khan K. Clinical Sports Medicine. 2007
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THE MULTI PROFESSIONAL TEAM APPROACH
• ““A champion team will always A champion team will always beat a team of champions“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
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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
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CAUSES OF CHRONIC INJURY
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CHALLENGES OF MANAGEMENT
• Treatment– Presenting
injury/illness– Cause– Consider all aspects of
injury– Return to sport issues
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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
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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
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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
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HOLISTIC PATIENT CARE
• The Bio-psycho-social model
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Ashburnpsychologist.com 2012
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SYSTEMS THEORY
Engel, 1980 in Mc Whinney IR. A Textbook of Family Medicine. 1989
Before injury Effects of injury
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SYSTEMS THEORY
Engel, 1980 in Mc Whinney IR. A Textbook of Family Medicine. 1989
Resolution
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A BIOPSYCHOSOCIAL METHOD: THE THREE STAGE ASSESSMENT
Biological: Biological: Clinical: diagnosis and cause(Effects on organismic level)
Personal/Personal/PsychologicalPsychologicalThoughtsFeelingsFearsExpectations
Social/contextual:Social/contextual:Effect on social systems
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THE ATHLETE SUPPORT SYSTEM
Brukner P, Khan K. Clinical Sports Medicine 3rd Ed, 2007
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LOVE THY SPORT
Know thy sport
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THE SPORTS MEDICINE CONSULTATION
• Subjective assessment– History– Determine type, severity and
cause• Objective assessment
– Clinical evaluation– Determine type, severity and
cause• Assessment summary
– Clinical– Personal– Contextual
• Plan– Case manager– Multi professional– Stages of rehabilitation– Goal setting– Follow-up– Return to sport
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THANK YOU!
Dr Louis HoltzhausenDr Louis HoltzhausenSports MedicineSports MedicineUniversity of the Free StateUniversity of the Free [email protected]@ufs.ac.za
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