AN approach to Sports Medicine – “THE SPORTS MEDICINE MODEL”

1. AN approach to Sports Medicine – “THE SPORTS MEDICINE MODEL” Dr Louis Holtzhausen Program director: Sports Medicine University of the Free State South Africa

2. 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

3. 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 The scope of Sports Medicine

4. “THE SPORTS MEDICINE MODEL”

5. The traditional medical model Brukner P, Khan K. Clinical Sports Medicine. 2007

6. The Sports Medicine model Brukner P, Khan K. Clinical Sports Medicine. 2007

7. The multi professional team approach “A champion team will always 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

8. 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

9. Causes of chronic injury

11. Challenges of management Treatment Presenting injury/illness Cause Consider all aspects of injury Return to sport issues

12. 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

13. 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

14. 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

16. HOLISTIC PATIENT CARE • The Bio-psycho-social model

18. Ashburnpsychologist.com 2012

20. Systems theory Before injury Effects of injury Engel, 1980 in Mc Whinney IR. A Textbook of Family Medicine. 1989

21. Systems theory Resolution Engel, 1980 in Mc Whinney IR. A Textbook of Family Medicine. 1989

22. A biopsychosocial method: The three stage assessment Social/contextual: Effect on social systems Personal/PsychologicalThoughts Feelings Fears Expectations

23. The athlete support system Brukner P, Khan K. Clinical Sports Medicine 3rd Ed, 2007

24. Love thy sport Know thy sport

25. 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

26. Thank you! Dr Louis Holtzhausen Sports Medicine University of the Free State HoltzhausenLJ@ufs.ac.za