Chapter 1: Fitness Professionals, Coaches, and the Sports Medicine Team: Defining Roles © 2010 McGraw-Hill Higher Education. All rights reserved. Sports Medicine vs. Athletic Training © 2010 McGraw-Hill Higher Education. All rights reserved. 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 © 2010 McGraw-Hill Higher Education. All rights reserved. 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 © 2010 McGraw-Hill Higher Education. All rights reserved. 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 © 2010 McGraw-Hill Higher Education. All rights reserved. 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 © 2010 McGraw-Hill Higher Education. All rights reserved. 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 © 2010 McGraw-Hill Higher Education. All rights reserved. The Players on the Sports Medicine Team © 2010 McGraw-Hill Higher Education. All rights reserved. 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 © 2010 McGraw-Hill Higher Education. All rights reserved. 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 © 2010 McGraw-Hill Higher Education. All rights reserved. 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) © 2010 McGraw-Hill Higher Education. All rights reserved. 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 © 2010 McGraw-Hill Higher Education. All rights reserved. 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 © 2010 McGraw-Hill Higher Education. All rights reserved. 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 © 2010 McGraw-Hill Higher Education. All rights reserved. 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) © 2010 McGraw-Hill Higher Education. All rights reserved. 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 © 2010 McGraw-Hill Higher Education. All rights reserved. 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 © 2010 McGraw-Hill Higher Education. All rights reserved. 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 © 2010 McGraw-Hill Higher Education. All rights reserved. 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) © 2010 McGraw-Hill Higher Education. All rights reserved. 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 © 2010 McGraw-Hill Higher Education. All rights reserved. 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 © 2010 McGraw-Hill Higher Education. All rights reserved. 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 © 2010 McGraw-Hill Higher Education. All rights reserved. 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 © 2010 McGraw-Hill Higher Education. All rights reserved. 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 © 2010 McGraw-Hill Higher Education. All rights reserved. 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 © 2010 McGraw-Hill Higher Education. All rights reserved. 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) © 2010 McGraw-Hill Higher Education. All rights reserved. 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 © 2010 McGraw-Hill Higher Education. All rights reserved.