Principles of Athletic Training 14 th Edition

1. Principles of Athletic Training 14th Edition William E. Prentice

2. Principles of Athletic Training 14th EditionPowerPoint Presentations Jason Scibek, PhD, ATC Duquesne University

3. Chapter 1: The Athletic Trainer as a Health Care Provider

4. Athletic trainers specialize in preventing, recognizing, managing and rehabilitating injuries Function as a member of a health care team which also incorporates and involves a number of medical specialties Provide a critical link between the medical community and physically active individuals

5. Historical Perspective • Early History • Evidence suggests that coaches, physicians & therapists existed in Greek and Roman civilizations • Assisted athletes in reaching top performance • Athletic trainers came into existence in the late 19th century in intercollegiate & interscholastic sports • Early treatments involved rubs, counter-irritants, home remedies and poultices

6. Evolution of Contemporary Athletic Trainer Traditional setting of practice included colleges and secondary schools Dealing exclusively with an athletic population Today certified athletic trainers (ATC) work in a variety of settings and with a variety of patient populations Professional sports, hospitals, clinics, industrial settings, the military, equipment sales, physician extenders

7. Rapid evolution of the profession following WW I • Athletic trainers became specialists in preventing and managing injuries • Dr. S.E. Bilik wrote, The Trainer’s Bible (1917) • The Cramer brothers developed a line of liniments to treat ankle sprains (1920’s) and followed the publication The First Aider (1932) • In the 1930’s the NATA started to come into existence but then disappeared during WW II • In 1950 the NATA was reorganized and it has continued to flourish and expand

8. With the evolution of the profession a number of milestones have been achieved Recognition of Acts as healthcare providers Increased diversity of practice settings Passage of practice acts Third party reimbursement for athletic trainers Constant revision and reform of athletic training education

9. Changing Face of Athletic Training Profession Role of the athletic trainer is more in line, today, as a health care provider 40% of athletic trainers are employed in clinics, hospitals, industrial and occupational settings Also involved in NASCAR, performing arts, military, NASA, medical equipment & sales, law enforcement, and the US government Has resulted in changes in athletic training education

10. Athletic trainers do not just provide medical care to athletes or those just injured during physical activity Becoming more aligned as a clinical health care profession Requires terminology changes Patients and clients vs. athletes Athletic clinic or facility vs. athletic training room Athletic trainers – NOT TRAINERS!!

11. Sports Medicine and Athletic Training Broad field of medical practices related to physical activity and sport Involves a number of specialties involving active populations Typically classified as relating to performance enhancement or injury care and management

12. Sports Medicine Human Performance Injury Management Exercise Physiology Practice of Medicine Athletic Training Biomechanics Sport Psychology Sports Physical Therapy Strength Conditioning Sports Massage Personal Fitness Trainers Sports Podiatry/Orthotists Sports Dentistry

13. Growth of Professional 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) National Academy of Sports Medicine (1987)

14. International Federation of Sports Medicine Federation Internationale de Medecine Sportive (FIMS) Principal purpose to promote the study and development of sports medicine throughout the world Made up of national sports medicine associations of over 100 countries Organization includes many disciplines that are concerned with physically active individuals

15. American Academy of Family Physicians To promote and maintain high quality standards for family doctors who are providing continuing comprehensive health care to the public It is a medical association of more than 93,000 members Many team physicians are members of this organization

16. National Athletic Trainers’ Association To enhance the quality of health care for athletes and those engaged in physical activity, and to advance the profession of athletic training through education and research in the prevention, evaluation, management and rehabilitation of injuries The NATA now has 32,000 members

17. Figure 1-1

18. American College of Sports Medicine Patterned after FIMS (Umbrella Organization) Interested in the study of all aspects of sports Membership composed of medical doctors, doctors of philosophy, physical educators, athletic trainers, coaches, exercise physiologists, biomechanists, and others interested in sports >20,000 members

19. American Orthopaedic Society for Sports Medicine To encourage and support scientific research in orthopaedic sports medicine and to develop methods for safer, more productive and enjoyable fitness programs and sports participation Members receive specialized training in sports medicine, surgical procedures, injury prevention and rehabilitation 1,200 members are orthopaedic surgeons and allied health professionals

20. National Strength and Conditioning Association To facilitate a professional exchange of ideas in strength development as it relates to the improvement of athletic performance and fitness and to enhance, enlighten, and advance the field of strength and conditioning 30,000 strength and conditioning coaches, personal trainers, exercise physiologists, athletic trainers, researchers, educators, sport coaches, physical therapists, business owners, exercise instructors and fitness directors Accredited certification programs Certified Strength and Conditioning Specialist, (CSCS) NSCA Certified Personal Trainer (NSCA-CPT)

21. American Academy of Pediatrics, Sports Committee Dedicated to providing the general pediatrician and pediatric sub-specialist with an understanding of the basic principles of sports medicine and fitness and providing a forum for the discussion of related issues To educate all physicians, especially pediatricians, about the special needs of children who participate in sports

22. American Physical Therapy Association, Sports Physical Therapy Section To provide a forum to establish collegial relations between physical therapists, physical therapist assistants, and physical therapy students interested in sports physical therapy Promotes prevention, recognition, treatment and rehabilitation of injuries in an athletic and physically active population Provides educational opportunities through sponsorship of continuing education programs and publications

23. NCAA Committee on Competitive Safeguards and Medical Aspects of Sports Collects and develops pertinent information regarding desirable training methods, prevention and treatment of sports injuries, and utilization of sound safety measures Disseminates information and adopts recommended policies and guidelines designed to further the above objectives Supervises drug-education and drug-testing programs

24. National Academy of Sports Medicine Founded by physicians, physical therapists and fitness professionals Focuses on the development, refinement and implementation of educational programs for fitness, performance and sports medicine professionals Offer a variety of certifications (fitness and performance)

25. Other Health Related Organizations Various aspects of health related professions have also become involved Dentistry, podiatry, chiropractic medicine National, state and local organizations have also emerged Focus on athletic health and safety All bodies have worked towards the reduction of injury and illness in sport

26. Sports Medicine Journals A variety of publications exist, providing excellent resources to the sports medicine community Journal of Athletic Training Journal of Sports Rehabilitation International Journal of Sports Medicine Physician and Sports Medicine Clinics in Sports Medicine American Journal of Sports Medicine Sports Health Athletic Therapy Today Training & Conditioning Athletic Training & Sports Health Care

27. Employment Settings for the Athletic Trainer Employment opportunities are becoming increasingly diverse Dramatic transformation since 1950 Due largely to the efforts of the NATA Started out primarily in the collegiate setting, progressed to high schools and are now 30% are found primarily in hospital and clinic settings

28. Settings include: Clinics and hospitals Physician extenders Industrial/Occupational settings Corporate settings Colleges or Universities Secondary schools School districts Professional sports Amateur/Recreational/Youth sports Performing arts Military & Law enforcement Health & fitness clubs

29. Figure 1-3

30. Treating Physically Active Populations Consists of athletic, recreational or competitive activities Requires physical skills and utilizes strength, power, endurance, speed, flexibility, range of motion and agility

31. The Adolescent Athlete Focuses on organized competition A number of sociological issues are involved How old or when should a child begin training? Skeletal maturity presents some challenges with respect to healthcare Physically and emotional adolescents can not be managed the same way as adults

32. The Aging Athlete Physiological and performance capability changes overtime Function will increase and decrease depending on point in lifecycle May be the result of both biological and sociological effects High levels of physiological function can be maintained through an active lifestyle The impact on long-term health benefits have been documented Beginning an exercise program

33. Exercise program should be gradual and progressive as long as no unusual signs or symptoms develop Individuals over age 40 should have a physical and exercise testing before engaging in an exercise program

34. Occupational Athlete Occupational, industrial or worker “athlete” are involved in strenuous, demanding or repetitive physical activity May result in accidents and injury Involves Instruction on ergonomic techniques to avoid injury associated with physical demand of job responsibilities Intervention when injuries arise Correcting mechanics, faulty postures, strength deficits, lack of flexibility Injury prevention is still critical

35. Roles & Responsibilities of the Athletic Trainer Charged with injury prevention and health care provision for an injured patient Athletic trainer deals with the patient and injury from its inception until the athlete returns to full competition

36. Roles and Responsibilities: Board of Certification Domains Prevention Clinical evaluation and diagnosis Immediate care Treatment, rehabilitation and reconditioning Health care administration Professional responsibilities

37. Prevention Ensure safe environment Conduct pre-participation physicals Develop training and conditioning programs Select and fit protective equipment properly Explaining important diet and lifestyle choices Ensure appropriate medication use while discouraging substance abuse

38. Clinical Evaluation & Diagnosis Recognize nature and extent of injury Involves both on and off-field evaluation skills and techniques Understand pathology of injuries and illnesses Referring to medical care Referring to supportive services Immediate Care Administration of appropriate first aid and emergency medical care (CPR, AED) Activation of emergency action plans (EAP)

39. Treatment, Rehabilitation Reconditioning Design preventative training systems Rehabilitation program design Supervising rehabilitation programs Incorporation of therapeutic modalities and exercise Offering psychosocial intervention Organization & Administration Record keeping Ordering supplies and equipment Establishing policies and procedures Supervising personnel

40. Professional Responsibilities Athletic trainer as educator Athletic trainer and continuing education Athletic trainers as counselor Athletic trainers as researcher Incorporation of evidence medicine and participating and acquisition of evidence for efficacy of patient care

41. Personal Qualities of the Athletic Trainer Stamina and the ability to adapt Empathy Sense of humor Communication Intellectual curiosity Ethical practice Professional memberships

42. Athletic Trainer and the Athlete Major concern on the part of the ATC should be the injured patient All decisions impact the patient The injured patient must always be informed Be made aware of the how, when and why that dictates the course of injury rehabilitation

43. The patient must be educated about injury prevention and management Instructions should be provided regarding training and conditioning Inform the patient to listen to his/her body in order to prevent injuries

44. Athletic Trainer and Parents Athletic trainers must keep parents informed, particularly in the secondary school setting Injury management and prevention The parents decision regarding healthcare must be a primary consideration Insurance plans may dictate care Selection of physician

45. The athletic trainer, physician and coaches must be aware and inform parents of Health Insurance Portability and Accountability Act (HIPAA) Regulates dissemination of health information Protects patient’s privacy and limits the people who could gain access to medical records

46. The Athletic Trainer and 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 the athletic trainer must be able to work together Have similar philosophical opinions regarding injury management Helps to minimize discrepancies and inconsistencies

47. The physician is responsible for compiling medical histories and conducting physical exams Pre-participation screening Diagnosing injury Deciding on disqualifications Decisions regarding athlete’s ability to participate based on medical knowledge and psychophysiological demands of sport Attending practice and games Commitment to sports and athlete

48. Potentially serve as the academic program medical director Coordinates and guides medical aspects of program Provides input into educational content and provides programmatic instruction

49. The Athletic Trainer and the Coach Must understand specific role of all individuals involved with the team Coach must clearly understand the limits of their ability to function as a health care provider in their respective state Directly responsible for injury prevention Athlete must go through appropriate conditioning program

50. Coach must be aware of risks associated with sport Provide appropriate training and equipment Should be certified in CPR and first aid Must have thorough knowledge of skills, techniques and environmental factors associated with sport Develop good working relationships with staff, including athletic trainers Must be a cooperative relationship