Sports Medicine

1. Sports Medicine • 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

2. Sports Medicine Human Performance Injury Management Exercise Physiology Practice of Medicine Biomechanics Sports Physical Therapy Sport Psychology Athletic Training Sports Nutrition Sports Massage

3. Physicians Dentist Podiatrist Nurse Physicians Assistant Physical Therapist Athletic Trainer Massage Therapist Ophthalmologist Dermatologist Gynecologist Exercise Physiologist Biomechanist Nutritionist Sport Psychologist Coaches Strength & Conditioning Specialist Social Worker Neurologist Osteopath Psychiatrist The Players on the Sports Medicine Team

4. The Athletic Trainer • Charged with injury prevention and health care provision for the athlete • Athletic trainer deals with the athlete and injury from its inception until the athlete returns to full competition

5. Roles and Responsibilities: Performance Domains • Prevention of athletic injuries • Clinical evaluation and diagnosis • Immediate care of injuries • Treatment, rehabilitation and reconditioning of athletic injuries • Health care administration • Professional responsibilities

6. Athletic Training Education Competencies • Twelve Content Areas • Risk management • Pathology of injuries and illnesses • Assessment and evaluation • Acute care • Pharmacological aspects of injury and illness • Therapeutic modalities

7. Athletic Training Education Competencies • Therapeutic exercise • General medical conditions and disabilities • Nutritional aspects of injury and illnesses • Psychosocial intervention and referral • Organization and administration • Professional responsibilities

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

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

10. Settings include: • Secondary schools • Colleges and universities • Professional teams • Sports medicine clinics • Corporate/Industrial settings • Military • Physician extenders • Medical supply & equipment sales • Research • Administration

11. Accredited Athletic Training Education Programs • AT programs are accredited by CAATE (Commission of Accreditation for Athletic Training Education) • Masters’ Degree is required to sit for the national exam

12. Specialty Certifications • NATA is in the process of developing specialty certifications • Further enhance professional development • Aid in expanding scope of practice • Specialty certifications build on entry level knowledge

13. Seven proposed areas • Business practice, medical care management, occupational health, wellness, pediatric/adolescent health, adult/geriatric health, special health populations • Candidates will have to complete experiential requirements and pass a standardized examination

14. Requirements for Certification as an Athletic Trainer • Must have extensive background in formal academic preparation and supervised practical experience • Guidelines are set by the Board of Certification (BOC) • Graduation from an accredited AT Program is required (CAATE)

15. 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 • BOC certification is a prerequisite for licensure in most states

16. Continuing Education Requirements • Ensure ongoing professional growth and involvement • Requirements that must be met to remain certified • 50 CEU’s over the course of two years

17. Purpose: • To encourage ATC to obtain current professional development information • To explore new knowledge in specific areas • To master new athletic training related skill and techniques • To expand approaches to effective athletic training • To further develop professional judgement • To conduct professional practice in an ethical and appropriate manner

18. CEU’s are awarded for: • Attending symposiums, workshops, seminars • Serving as a speaker or panelist • Certification exam model • Participating in the USOC program • Authoring a research article; authoring/editing a textbook • Completing post-graduate work • Obtaining CPR and first aid certification

19. State Regulation of the Athletic Trainer • Athletic trainers in many individual states organized efforts to secure recognition by seeking some type of regulation of the athletic trainer by state licensing agencies • To date 49 of the 50 states have enacted some type of regulatory statute governing the practice of athletic training • Rules and regulations governing the practice of athletic training vary tremendously from state to state

20. Types of Regulation • Licensure • Limits practice of athletic training to those who have met minimal requirements established by a state licensing board • Limits the number of individuals who can perform functions related to athletic training as dictated by the practice act • Most restrictive of all forms of regulation

21. Certification • Does not restrict using the title of athletic trainer to those certified by the state • Can restrict performance of athletic training functions to only those individuals who are certified • Registration • Before an individual can practice athletic training he or she must register in that state • Individual has paid a fee for being placed on an existing list of practitioners but says nothing about competency

22. Exemption • State recognizes that an athletic trainer performs similar functions to other licensed professions (e.g. physical therapy), yet still allows them to practice athletic training despite the fact that they do not comply with the practice acts of other regulated professions • Legislation regulating the practice of athletic training has been positive and to some extent protects the athletic trainer from litigation

23. Future Directions for the Athletic Trainer • Will be determined by the efforts of the NATA and its membership • Ongoing re-evaluation, revision and reform of athletic training education • JRC-AT will become an accrediting agency • Third party billing will gradually become the rule not the exception for ATC’s • Standardization of state practice acts • ATC’s will seek specialty certifications • Expanding breadth and scope of practice

24. Increase in secondary school employment of ATC’s • Increase in recognition of ATC as a physician extender • Potential for expansion in the military, industry, and fitness/wellness settings • With general population aging = increased opportunity to work with aging physically active individuals • Continue to enhance visibility through research and scholarly publication

25. Continue to be available for local and community meetings to discuss healthcare of the athlete • Increase recognition and presence internationally • Most importantly, continue to focus efforts on injury prevention and to provided high quality healthcare to physically active individuals who are injured while participating in sport

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

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

28. Athletic Trainer and Parents • ATC 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

29. Louisiana ATs • Must be aware of La. Laws and regulations: • AT Law • Act 314 (concussion law) • Serious Injury Rule • Must pass the BOC in 3 or less attempts • Must be licensed to practice by the LSBME (La. State Board of Medical Examiners) and can apply for temporary exemption

30. Responsibilities of 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 ATC must be able to work together • Have similar philosophical opinions regarding injury management • Helps to minimize discrepancies and inconsistencies

31. Roles and Responsibilities • 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

32. Responsibilities of 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 healthcare provider in their respective state • Directly responsible for injury prevention • Athlete must go through appropriate conditioning program

33. Coach must be aware of risks associated with sport • Provide appropriate training and equipment • Must have knowledge of 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

34. ATC, 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

35. Referring the Athlete to Other Personnel • ATC must be aware of available medical and non-medical personnel • Athlete may require special treatment outside of the “traditional” sports medicine team • Must be aware of community based services and various insurance plans • Typically the ATC and team physician will consult on the particular matter and refer accordingly