Chapter 14. Athletic Training. Athletic Training. Definition, Description, & Scope

Transcription

1 Chapter 14 Athletic Training Athletic Training Allied health profession dealing w/ the prevention, care, & rehabilitation of injuries to physically active individuals Associated w/ Sports Medicine ACSM defines sports medicine as the physiologic, pathologic, psychological, and biomechanical phenomena associated w/ exercise & sport Definition, Description, & Scope Athletic Medicine Sports medicine team Headed by the physician The athletic trainer is the on-site representative of the physician who evaluates injuries & provides the information necessary to make a definitive diagnosis 1

2 Job Sites Sports medicine clinics Largest job placement Works in conjunction w/ physical or occupational therapists & medical personnel Outreach placements in high schools Job Sites Secondary schools Second largest placement Teacher and athletic trainer College and universities Third largest placement, < 10% Professional sports 1% of trainers Industrial setting Domains of the Body of Knowledge 6 domains that make up the body of knowledge established by the NATA 1. Prevention of athletic injuries 2. Recognition, evaluation, & assessment of athletic injuries 3. Immediate care of athletic injuries 4. Treatment, rehabilitation, & reconditioning of athletic injuries 5. Organization & administration 6. Professional development & responsibility 2

3 Prevention of Athletic Injuries Injury prevention Safe environment Physical examinations Education of athletes of signs & symptoms On the job training in industrial setting Recognizing adverse environmental conditions Recognition, Evaluation, & Assessment of Athletic Injuries Injury Eyes and ears of physicians First person to intervene Systematic approach to injury evaluation Comprehensive written record Communication of results Injury evaluation systems Refer to Figure 14-2 Injury Evaluation Common elements of injury evaluation systems Primary survey is completed first Secondary survey evaluates the specific complaint of the athlete Care to avoid bld borne pathogens OSHA requires trainers to use latex gloves Category I for exposure to Hepatitis B & HIV 3

4 Injury Evaluation Primary Survey Unconscious athlete Responsiveness Airway, Breathing, Circulation (ABCs) Bleeding Alert EMS Secondary Survey Conscious athlete Primary survey Secondary survey Injury history Observation Palpation Special tests Treatment and EMS or Release Immediate Care of Athletic Injuries RICE Rest Ice Compression Elevation CPR Emergency care plan Treatment, Rehabilitation, & Reconditioning of Athletic Injuries Immediate effects of injury Pain, swelling, decreased ROM, & loss of function Inactivity leads to disuse atrophy & decreased strength, endurance, & neuromuscular coordination 4

5 Use It or Lose It Joints, ligaments, and bone need stress to maintain or expand tissue content & efficiency of their function CDV impairments due to disuse include Decrease in heart rate 0.5 bpm/day Decreases in stroke volume, cardiac output, & respiratory function Forms of Exercise Isometric Exercise contraction of a muscle without movement of the joint through a ROM Isotonic Exercise contraction of a muscle resulting in the moving of a joint through a ROM Concentric-- shortening of the muscle against the force of gravity Eccentric-- lengthening of the muscle against the superior force of gravity Rehabilitation Primary goals are the recovery of proprioception, normal ROM, & neuromuscular coordination Functional progression is the movement from the acute inflammation phase to the repair phase to the remodeling phase May take days to months 5

6 Organization & Administration Personnel management Facility management and design Preparticipation physical examinations Medical record keeping Insurance Public relations Professional Development & Responsibility Duty to maintain his or her knowledge & skills at current standards of practice Continuing education programs Educating student athletic trainers Frequent practice Focus on Science Common Athletic Injuries Inflammatory Response Tissue Repair Therapeutic Modalities 6

7 Athletic Injuries Injuries occur usually from direct trauma or overuse Classification Symptom subjective information described by the athlete (pain) Sign information obtained through objective assessment (heart rate) Common Athletic Injuries Sprain stretch of a ligament beyond the normal physiologic limit Strain stretch of a muscle, tendon, or muscletendon unit beyond normal physiologic limits Contusions (bruises) compression injuries ranging from superficial to deep muscle or bone bruising w/ significant hematoma Overuse injuries are caused by repetitive microtrauma Common Athletic Injuries Dislocations complete disruption of articulating joint surfaces with tearing of some or all ligaments surrounding the joint, involves joints of the extremities Fractures disruption in the continuity of a bone caused by stress Open fractures Closed fractures 7

8 Inflammatory Response Body s attempt to control the effects of trauma, bacterial & viral invasion, and decreased bld supply Signs & symptoms Pain Redness Temperature Swelling Loss of function Inflammatory Phases Early Phase Begins immediately after injury &d lasts up to 3 days Phagocytosis (WBC) Swelling Late Phase Overlaps early phase & continues up to a week longer Secondary injury due to enzymes and hypoxia Factors Limiting Damage Bld clotting Platelets are exposed to molecules, become sticky & clump together, sealing capillaries Accumulation of bld into a hematoma or mass of bld Could reduce ROM 8

9 Tissue Repair Begins 3 rd day after injury Continues for about 3 weeks 1st week involves scar formation Synthesis of collagen in random directions Scar begins to contract, closing injury Remodeling begin on day 9 Collagen molecules are reordered along stress lines through injury site Scar is only 70% of strength of original tissue, w/ few bld vessels Therapeutic Modalities Physical agents, machines, massage, & manual exercise are used to modify an inflammatory response, restore tissue, or increase strength & ROM Therapeutic Modalities Acute inflammation Cold treatment Minimizes edema by decreasing bld flow Decreases hemorrhage Analgesic effect Decreases spasm Average 20 minutes 9

10 Therapeutic Modalities Heat treatment Switch to heat after hours if tissue is at rest & 14 days for the active population Postacute & chronic inflammation Relieves pain & muscle spasm Increases bld flow Increases metabolic rate Decreases posttraumatic edema Advances in Athletic Training Certification Accredited athletic training education programs 10