Chapter 1: Fitness
Professionals, Coaches, and the
Sports Medicine Team:
Defining Roles
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Sports Medicine
vs.
Athletic Training
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Sports Medicine
• 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
• Sports medicines generally focuses on areas
of performance enhancement, injury care,
prevention and management
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Performance
Enhancement
•Exercise Physiology
•Biomechanics
•Sport Psychology
•Sports Nutrition
•Strength and Conditioning
•Personal Fitness Training
•Coaching
•Physical Education
Injury Care &
Management
•Practice of Medicine
•Athletic Training
•Sports Physical Therapy
•Sports Massage Therapy
•Sports Dentistry
•Osteophathic Medicine
•Orthotists/Prosthetists
•Sports Chiropractic
•Sport Podiatry
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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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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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Athletic Healthcare in Organized
vs. Recreational Sports Activities
• 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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Fitness Professionals
• 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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Personal Fitness Trainer
• Over 400 certification organizations - Four “credible”
–
–
–
–
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 Cross , National Safety Council
1
or American Heart
2
Association3)
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Personal Fitness Trainer
• 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 Coach
• 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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Strength & Conditioning Coach
• 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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Recreation Specialists
• 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.
• 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 Specialists
• 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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Recreation Specialists
• 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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Athletic Administrator
• 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
• 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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Coach
• 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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Coach
• 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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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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Athletic Trainer
• 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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Domains of Athletic Training
• 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 –
(CPR/AED and First Aid)
• 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
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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
• Compiling medical histories and conducting physical
exams
• 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
• 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 well-informed
– 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
•
•
•
•
•
•
•
•
•
•
Physicians
Dentist
Podiatrist
Nurse
Physicians Assistant
Sports Chiropractors
Physical Therapist
Massage Therapist
Orthotist/prosthetist
Equipment Personnel
•
•
•
•
•
Exercise Physiologist
Biomechanist
Nutritionist
Sport Psychologist
Emergency Medical
Specialists
• Strength &
Conditioning Coach
• Referees
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