Notes for Ath. Med. by Chapter
The Athletic Trainer as a Health-Care Provider
Key Terms
Patient- Any individual who is ill or injured who is being treated by an athletic trainer
Athletic Training Clinic- A health care facility for treating individuals who have an illness or injury
Evidence-Based Practice- Making clinical care decisions based on supporting evidence available in the literature
PICO- Patient, Information, Comparison, Outcome
ATC- Certified Athletic Trainer
Training- The act of coaching or teaching
Athletic trainers are healthcare professionals specializing in:
Preventing injuries.
Recognizing injuries.
Managing injuries.
Rehabilitating injuries.
They work with physicians, allied health personnel, administrators, coaches, and parents.
Athletic trainers are a critical link between the medical community and physically active individuals.
Historical Perspectives
Early civilizations had coaches, trainers, and physicians (like Hippocrates and Galen) who helped athletes.
After the Roman Empire, interest in sports waned until the Renaissance.
Athletic training emerged in the late 19th century with intercollegiate and interscholastic athletics.
Early athletic training techniques included rubs, counterirritants, and home remedies.
S.E. Bilik wrote the first major text on athletic training, The Trainer’s Bible, in 1917.
In the 1920s, the Cramer family started a chemical company producing liniments for ankle sprains and later published First Aider in 1932 to enhance communication among coaches, trainers, and athletes.
An effort to establish a national organization in the late 1930s was interrupted by World War II.
Evolution of the Contemporary Athletic Trainer
Terms like "training" and "athletic training" were often confused; training implies coaching, while athletic training concerns the athlete’s health and safety.
Athletic training evolved after World War I with the rise of intercollegiate athletics.
National Athletic Trainers’ Association (NATA)
Between 1947 and 1950, athletic trainers organized into regional conferences.
In 1950, 101 athletic trainers formed NATA to establish professional standards.
NATA membership has grown from 4,500 in 1974 to over 42,000 today, including over 500 internationally.
Positive milestones include:
Certification exam.
Recognition as healthcare providers.
Increased diversity of practice settings.
Practice acts regulating athletic trainers in most states.
Third-party reimbursement for services.
Ongoing reevaluation and reform of education programs.
The Changing Face of the Athletic Training Profession
Historically, athletic trainers worked in colleges, universities, and secondary schools, serving primarily athletic populations (traditional settings).
Today, over 40% are employed in clinics, hospitals, and industrial settings, working under physicians.
Athletic trainers now work in various settings, including:
Hospitals.
Professional sports (rodeo, NASCAR).
Industrial settings.
Performing arts.
Medical equipment sales.
Military.
Law enforcement.
Government agencies (NASA, U.S. Senate, Pentagon).
This expansion necessitates changes in education programs to establish universal professional competencies.
When treating an injured athlete, the terms patient or client are preferred
The term athletic training clinic is now used to refer to a healthcare facility for treating injuries or illnesses.
Sports Medicine and Athletic Training
Sports medicine is a broad field of healthcare related to physical activity and sport.
It includes performance enhancement (exercise physiology, biomechanics, sport psychology, sports nutrition, strength and conditioning) and injury care/management (medicine, athletic training, physical therapy, massage therapy, dentistry, osteopathic medicine, orthotics/prosthetics, chiropractic, podiatry, emergency medical technology).
The American College of Sports Medicine (ACSM) defines sports medicine as multidisciplinary, related to exercise and sports.
Growth of Professional Sports Medicine Organizations
Professional organizations aim to:
Upgrade the field via professional standards.
Bring together competent individuals to exchange ideas.
Enable collective achievement of objectives.
Key organizations include:
International Federation of Sports Medicine (FIMS).
American Academy of Family Physicians (AAFP).
National Athletic Trainers’ Association (NATA).
American College of Sports Medicine (ACSM).
American Orthopaedic Society for Sports Medicine (AOSSM).
National Strength and Conditioning Association (NSCA).
American Academy of Pediatrics, Council on Sports Medicine and Fitness.
American Physical Therapy Association, Sports Physical Therapy Section.
NCAA Committee on Competitive Safeguards and Medical Aspects of Sports.
National Academy of Sports Medicine (NASM).
Key Organizations:
International Federation of Sports Medicine (FIMS):
Founded in 1928.
Promotes sports medicine study and development worldwide.
Includes national sports medicine associations from over 100 countries.
American Academy of Family Physicians (AAFP):
Founded in 1947.
Promotes high-quality standards for family doctors.
Many team physicians are members.
National Athletic Trainers’ Association (NATA):
Founded in 1950.
Enhances healthcare quality provided by certified athletic trainers.
Has over 42,000 members.
Publishes journals and holds annual conventions.
American College of Sports Medicine (ACSM):
Established in 1954.
Studies all aspects of sports.
Has over 45,000 members.
Publishes Medicine and Science in Sports and Exercise.
American Orthopaedic Society for Sports Medicine (AOSSM):
Created in 1972.
Encourages research in orthopedic sports medicine.
Provides specialized training in sports medicine.
Has 3,000 members.
Publishes the American Journal of Sports Medicine.
National Strength and Conditioning Association (NSCA):
Formed in 1978.
Facilitates exchange of ideas in strength development.
Has over 30,000 members in 52 countries.
Offers certification programs (CSCS, NSCA-CPT).
Publishes journals.
American Academy of Pediatrics, Council on Sports Medicine and Fitness:
Organized in 1979.
Educates physicians about children's sports needs.
American Physical Therapy Association, Sports Physical Therapy Section:
Established in 1981.
Promotes prevention, recognition, treatment, and rehabilitation of injuries.
Has 6,000 members.
Publishes the Journal of Orthopaedic and Sports Physical Therapy.
NCAA Committee on Competitive Safeguards and Medical Aspects of Sports:
Develops information about training methods, injury prevention, and drug education.
Publishes the Sports Medicine Handbook.
National Academy of Sports Medicine (NASM):
Founded in 1987.
Focuses on education programs for fitness, performance, and sports medicine professionals.
Serves over 100,000 members in 80 countries.
Other Health-Related Organizations
Many health-related professions (dentistry, podiatry, chiropractic) are interested in sports health and safety.
Other Sports Medicine Journals
The International Journal of Sports Medicine
The Journal of Sports Medicine and Physical Fitness
Journal of Sport Rehabilitation
Athletic Therapy and Training
The Physician and Sportsmedicine
Physical Therapy
Clinical Management
Physical Medicine and Rehabilitation Clinics
Clinics in Sports Medicine
Training and Conditioning
Sports Health: A Multidisciplinary Approach
Athletic Training and Sports Health Care: The Journal for the Practicing Clinician
Employment Settings for the Athletic Trainer
Employment opportunities for athletic trainers have significantly diversified.
Clinics and HospitalsThe largest percentage of certified athletic trainers are employed in clinics and hospitals.
Athletic trainers may be employed in outpatient ambulatory rehabilitation clinics working in general patient care, in hospital emergency rooms, as health, wellness, or performance enhancement specialists, or as clinic administrators.
Athletic Trainers in Physician Practice
Athletic trainers in physician practices work directly in the physician’s office, treating patients of all ages and backgrounds.
They function in injury prevention, evaluation, diagnosis, management, rehabilitation, health education, nutrition, training and conditioning, pre-participation physicals, and documentation.
Industrial/Occupational Settings
Athletic trainers oversee fitness and injury rehabilitation programs for employees, understanding workplace ergonomics.
Corporate Settings
Athletic trainers work in business, sales, or marketing of sports medicine products, or administer health, wellness, and fitness programs.
Colleges or Universities
Athletic trainers can be full-time or part-time, with teaching responsibilities or clinical roles in athletic departments or health centers.
Secondary Schools
Ideally, every secondary and middle school should have a certified athletic trainer.
Often, athletic trainers are employed as teachers with additional athletic training duties.
Professional Sports
Virtually every professional team employs at least one certified athletic trainer.
Amateur/Recreational/Youth Sport
Athletic trainers work at all levels of amateur sport, including the Olympics, national governing bodies, and community-based programs.
Performing Arts
A growing field, athletic trainers work with dance companies, theater groups, television shows, and touring bands.
The Military/Law Enforcement/Government
The U.S. military is increasing emphasis on injury prevention and healthcare for troops, with athletic trainers playing a key role.
Health and Fitness Clubs
Athletic trainers may work as performance-enhancement specialists or instructors.
Treating Physically Active Populations
Athletic trainers treat a wide range of physically active populations.
The Adolescent Athlete
Adolescents present unique challenges due to their skeletal immaturity and require specialized care.
The Aging Athlete
Aging involves physiological and performance changes; however, regular physical activity can delay or prevent degenerative processes.
The Occupational Athlete
Occupational athletes engage in strenuous physical activities, and athletic trainers can help prevent injuries and reduce worker's compensation costs.
Athletes with Disabilities
Athletic trainers need advanced knowledge to work with athletes with disabilities.
Roles and Responsibilities of the Athletic Trainer
The athletic trainer is intimately involved with patient care, from initial injury to complete return to activity.
Board of Certification Domains of Athletic Training
The BOC defines the profession of athletic training based on practice analysis.
The five major domains are:
Injury/illness prevention and wellness promotion.
Examination, assessment, and diagnosis.
Immediate and emergency care.
Therapeutic intervention.
Healthcare administration and professional responsibilities.
Injury/Illness Prevention and Wellness Promotion
Minimizing injury risk by:
Conducting preparticipation exams.
Ensuring appropriate training and conditioning.
Monitoring environmental conditions.
Selecting/fitting protective equipment.
Ensuring proper nutrition.
Using medications appropriately.
Conducting Preparticipation Physical Examinations
The athletic trainer obtains medical history and conducts physical examinations.
Should include measurement of height, weight, blood pressure, and body composition.
Developing Training and Conditioning Programs
Athletic trainers work with coaches to develop effective training programs that enhance performance and prevent injury.
Ensuring a Safe Playing Environment by Minimizing Safety Hazards
The athletic trainer ensures a safe environment for competition.
Selecting, Fitting, and Maintaining Protective Equipment
The athletic trainer selects and maintains protective equipment.
Explaining the Importance of Diet and Lifestyle Choices
Athletic trainers provide guidance on diet, weight management, and lifestyle choices.
Using Medications Appropriately
Athletic trainers have essential knowledge of medication effects.
Examination, Assessment, and Diagnosis
Athletic trainers must accurately diagnose injuries and illnesses.
Understanding the Pathology of Injury and Illness
Injuries must have the opportunity to follow through with the healing process before active rehabilitation and excercises.
Referring to Medical Care
Referrals to physicians and support services are essential.
Immediate and Emergency Care
Athletic trainers administer first aid and make correct management decisions following acute injury.
Therapeutic Intervention
Athletic Trainer work under the team physician, with treatment being rehabilitation and reconditioning.
Designing Rehabilitation Programs
Rehabilitation begins immediately after evaluation and diagnosis.
Supervising Rehabilitation Programs
Constant re-assessment of the injury is important for determining appropriate rehabilitation treatments.
Incorporating Therapeutic Modalities
Modalities are tools to assist with successful rehabilitation.
Healthcare Administration and Professional Responsibilities
The Athletic Trainer is responsible with the organization and administration of athletic training. Including proper record keeping, ordering and maintaining the training room, supervision of personnel, and all operations of the athletic training program.
Record Keeping
Accurate and detailed record keeping is critical.
Ordering Equipment and Supplies
Athletic trainers manage supply and equipment inventories.
Supervising Personnel
Athletic trainers supervise assistant athletic trainers and students.
Establishing Policies for the Operation of an Athletic Training Program
The athletic trainer establishes policies for emergency management and injury referral.
Professional Responsibilities of the Athletic Trainer
The Athletic Trainer and Continuing Education
Athletic trainers should continuously expand their knowledge.
The Athletic Trainer as an Educator
Athletic trainers are responsible for educating athletic training students, using various instructional techniques.
The Athletic Trainer as a Counselor
The Athletic Trainer is responsible for helping athletes with prevention and rehabilitation.
They should encourage the patients that are hurt along their rehabilitation to get back into playing.
The Athletic Trainer as a Researcher
Athletic trainers should engage in research and scholarly publication.
The Importance of Engaging in Evidence-Based Practice for the Athletic Trainer
Key components of the five steps in EBP 1) Develop questions. 2) Find the best evidence to use and consider using databases like EBP or medical subject heading terms. 3) Appraise 4) Apply and 5) Asses the outcome. These are important when using Evidence Based Practices to come up with conclusion.
Outcomes Assessment based on:
Patient-centered/rated outcome measures (PROMs)
Professional Behaviors of the Athletic Trainer
Personal Qualities
Key characteristics include stamina, adaptability, empathy, humor, communication skills, intellectual curiosity, and ethics.
Stamina and Ability to Adapt
Athletic training is physically and emotionally demanding; burnout is a potential concern.
Empathy
Empathy is the ability to understand the feelings of others.
Sense of Humor
Athletic trainers with humor help release tension and provide a relaxed atmosphere.
Ability to Communicate
Good communication skills are necessary because there's a lot of communication needed.
Intellectual Curiosity and Critical Thinking Ability
Intellectual Curiosity an Critical thinking skills are highly encouraged.
Ethics
A code of ethics is a necessary behavior for the athletic trainer.
Professional Memberships
Membership and activity in professional organizations is essential.
The Athletic Trainer and the Athlete
The Athletic Trainer needs to inform athlete's about prevention and management of injury.
The Athletic Trainer and the Athlete’s Parents
For athletes of secondary-school age, the parents’ decisions regarding health must be considered.
The Athletic Trainer and the Team Physician
The athletic trainer works under the direction of the team physician.
The Athletic Trainer and the Coach
The athletic trainer is responsible to prevent team injuries, and to create training sessions.
Referring the Patient to Other Medical and Nonmedical Support Services and Personnel
Coordination with Support personnel like nurses, school, physician's, dentist and more.
School Health Services
Coordination with Support personnel.
Nurse (RN, LPN, NP)
Working beside athletic trainers is expected.
Physician (MD)
A number of physicians can help the patient.
Recognition and Accreditation of the Athletic Trainer as an Allied Health Care Professional
Athletic Training as an allied health profession is important to have a a better work place.
The committee for accreditation of athletic training Education is important to further give higher ups a better look at your work to accredit your work.
Requirements for Certification as an Athletic Trainer
Board of certification ensure and test skills for certified athletic trainers.
State Regulation of the Athletic Trainer
Many states have created roles to provide better quality of health for certified trained athletic trainers. The state of being regulated can limit those not under it from working which can be a form of job security, and can be positive or restrictive based on how you look at it.
Future Directions for the Athletic Trainer
The athletic trainer has an upward trend, and will likely be a highly valuable role in the future due to the high amount of health required for athletes.
Athletic trainers are essential healthcare professionals focused on injury prevention, management, and rehabilitation, collaborating with physicians and coaches. The profession has evolved significantly, with the creation of NATA in 1950 establishing standards for practice and certification. Today, athletic trainers work in various settings, from hospitals to professional sports, emphasizing the importance of education and professional organization engagement. Their roles encompass not only patient care but also administrative responsibilities, education, and ongoing professional development, positioning them as vital contributors to health in sports.