Athletic Health Care Research Articles

Coaches

The number of children and adolescents who participate in interscholastic athletics demands attention to the quality of the coaching they receive and to the opportunities that the athlete-coach relationship provides for modification of high-risk behaviors, social skills training, and character formation. Although the need for coaches has increased due to the advent of girls' athletic programs, which was mandated by Title IX legislation, only a minority of states require certification for coaches who work in school systems. Four coaching curricula are summarized and contrasted: the American Coaching Effectiveness Program, the curriculum of the National Youth Sports Coaches Association, the Athletic Health Care System, and the Coach Effectiveness Training Program. Recommendations for coach certification by states, physician advocacy for coaching standards, and improved sports medicine services are discussed.

Sports Protective Equipment

It is important for the primary care and team physician to become more involved and better informed regarding the athletic equipment process. With the increase in litigation related to sport participation and caused by athletic protective equipment misuse or malfunction, the primary care and team physician can not afford to be an uninformed bystander. Primary care and team physicians serve a very necessary role in the protection of an athlete because they are usually able to serve independently of the school or sponsoring group, thus keeping the athlete's safety and health the primary consideration. Many athletic injuries occur as "unavoidable" accidents, but many others are "preventable." One of the variables involved in preventing injuries is to follow high standards of quality, fitting, use, and maintenance of athletic protective equipment. When we obtain athletic protective equipment, we have made a decision to control the risk of injury. The primary care and team physicians should accept a share of the responsibility in decreasing risk of sports injuries. Diverse public opinion has been generated over catastrophic injuries resulting from sport participation. Most of those injuries involve either the head or neck and may be either permanently disabling or lethal. Any part of the body may be subjected to injury. Sports protective equipment is available for many different sports, with many different injury risks, and for any part of the body. Many involved in the athletic health care delivery system continue to struggle with the "noncompliant" athletic patient. Not surprisingly, the "noncompliant" athletic patient. Not surprisingly, the noncompliant athletes have a higher recurrence rate of injury than do those who are compliant. Anything that the primary care and team physicians can do to decrease the desire of the athletic patient to resist orders for modification of activities to allow an injury to heal is important.

Quality assessment of athletic trainers.

This paper reports the first published assessment of the quality of services provided by athletic trainers. Medical coverage for the 1985 Junior Olympic Games was provided by certified athletic trainers (ATC), physicians, and other health care personnel. This study assessed the services of the 30 attending ATCs who managed 121 significant injuries. Standard injury information was collected by the ATCs and separately collected by their physicians. Nine months after the Games, phone interviews were conducted with the injured participants and assessment questionnaires were given to the attending physicians. Results revealed that young, injured, Junior Olympic participants generally did not inform their parents about their injuries or medical contact while at the Games. Athletes and physicians overwhelmingly agreed that they were positively impressed with the capabilities of the ATCs with whom they had contact. About 70% recovered from the symptoms and limitations of injury, as determined by the athlete, within the month following the Games. About 17% sustained some type of injury recurrence to the same body part, and at 9 months about 97% of the athletes had fully recovered from their injuries. These data not only indicate that athletic trainers can accurately identify minor athletic injury but signify the importance of long-term followup in our athletic populations. Multisport events, such as the Junior Olympic Games, impose considerable problems to a communication effort. The athletic trainer, as an ever-present figure in collegiate and professional circles, can be the central focus of an adequate communication effort regarding the patient care of other athletic populations.

THE ATHLETIC HEALTH CARE AND TRAINING PROGRAM (A COMPREHENSIVE APPROACH TO THE PREVENTION AND MANAGEMENT OF ATHLETIC INJURIES IN HIGH SCHOOLS)

The Athletic Health Care and Training Program was developed to meet the educational, organizational and record-keeping needs of the interscholastic athletic program of the Seattle Public Schools. The program components were the education of coaches, school nurses and student trainers; development of a centralized training room; implementation of written procedures, and establishment of a record-keeping system. At the end of the three-year study period, schools involved in the program were better prepared to handle emergencies than were control schools. Schools involved in the program were found to have an injury-recognition rate comparable to that previously reported for high schools that had athletic trainers, a rate substantially higher than that in the control schools. The experimental schools were judged to have managed these injuries satisfactorily 95% of the time, compared with a satisfactory management rate of 14% for the control schools.

High School Coaches' Perceptions of Their Responsibilities in Managing Their Athletes' Injuries

The purpose of this study was to ascertain coaches' perceptions of their responsibilities in managing their athletes' injuries. Thirty high school interscholastic coaches were interviewed from the South San Francisco Bay area of California. Coaches were asked six open-ended questions regarding their responsibilities and abilities for athletic health care and opinions about certification and liability. Results of this study indicated that coaches shared similar perceptions concerning their responsibilities. The similar perceptions involved conditioning and warm-ups for preventative care, administration of first aid for immediate injury care, and adherence to physician prescription and administering modality treatments for rehabilitative care. There were few significant differences regarding coaches' perceptions of their responsibilities. Findings from this report suggested that athletic health care at the high school level should be upgraded, and more health care professionals need to be involved in assisting coaches in providing athletes with optimum health care.

Survey of Scholastic Athletic Health Care and Sports Medicine Clinics

The increasing number of athletes requiring health care has spurred the growth of the development of sports medicine clinics. The diversity of such clinics is readily apparent. These clinics primarily function to provide evaluative and rehabilitative measures to all groups of athletic participants. Scholastic health care for athletic participants has not proceeded in a similar pattern. Sports medicine clinics are not effectively meeting the needs of the scholastic athlete, primarily because of location and financial limitations. This survey was conducted to collect information to further delineate the problems associated with scholastic health care of athletic participants. It appears that sports medicine clinics are manned by several levels of health care professionals. Scholastic athletes are least adequately covered by insurance and also suffer from being within a somewhat isolated environment. The need for on-field care and follow-up care within the school system remains a key problem associated with scholastic health care. Further research into the relationship of insurance policies which will adequately meet the needs of the scholastic population must be pursued. J Orthop Sports Phys Ther 1983;5(2):78-81.