Transcript Essentials of Athletic Injury Management 8 Edition th

Essentials of Athletic Injury
th
Management 8 Edition
William E. Prentice, PhD, PT, ATC
© 2010 McGraw-Hill Higher Education. All rights reserved.
Essentials of Athletic Injury
th
Management 8 Edition
PowerPoint Presentations
Jason Scibek, PhD, ATC
Duquesne University
© 2010 McGraw-Hill Higher Education. All rights reserved.
Chapter 1: Fitness
Professionals, Coaches, and the
Sports Medicine Team:
Defining 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 ?
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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 © 2010 McGraw-Hill Higher Education. All rights reserved.
Human
Performance
Injury Care
& Management
Exercise Physiology
Practice of Medicine
Biomechanics
Sports Physical Therapy
Sport Psychology
Athletic Training
Sports Nutrition
Massage therapy
Fitness Training
Orthotist/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
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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
Medicine 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 postrehabilitation 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
• 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
• Minimum of CPR/AED and
First Aid
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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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• 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 wellinformed
– 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
Medicine Team
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Physicians
Dentist
Podiatrist
Nurse
Physicians Assistant
Sports Chiropractors
Physical Therapist
Massage Therapist
Orthotist/prosthetist
Equipment Personnel
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Exercise Physiologist
Biomechanist
Nutritionist
Sport Psychologist
Emergency Medical
Specialists
• Strength &
Conditioning Coach
• Referees
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