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 Chapter 6 Selecting and Using Protective Sports Summary 159
Equipment 105 Websites 161
Safety Standards for Sports Equipment and
Facilities 105 Chapter 9 Bloodborne Pathogens, Universal
Legal Concerns in Using Protective Precautions, and Wound Care 162
Equipment 106
What Are Bloodborne Pathogens? 162
Using Off-the-Shelf versus Custom Protective
Dealing with Bloodborne Pathogens in
Equipment 107
Athletics 165
Head Protection 107
Universal Precautions in an Athletic
Face Protection 111 Environment 166
Trunk and Thorax Protection 114 Caring for Skin Wounds 169
Lower-Extremity Protective Equipment 118 Summary 172
Elbow, Wrist, and Hand Protection 123 Websites 173
Summary 124
Websites 126
Chapter 10 Wrapping and Taping Techniques 174
Chapter 7 Understanding the Potential Dangers Elastic Wraps 175
of Adverse Environmental Conditions 127 Nonelastic and Elastic Adhesive Taping 179
Hyperthermia 127 Common Taping Techniques 182
Hypothermia 134 Kinesio Taping 188
Overexposure to Sun 135 Summary 189
Safety in Lightning and Thunderstorms 135 Websites 190
Summary 137
Websites 138 Chapter 11 Understanding the Basics of Injury
Rehabilitation 191
Therapeutic Exercise versus Conditioning
PART III Exercise 191
Philosophy of Athletic Injury
Techniques for Treating and Rehabilitation 191
Managing Sport-Related Basic Components and Goals of a
Rehabilitation Program 192
Injuries 141 Using Therapeutic Modalities 197
Criteria for Return to Full Activity 198
Chapter 8 Handling Emergency Situations
Summary 199
and Injury Assessment 142
Websites 200
The Emergency Action Plan 142
Principles of On-the-Field Injury
Assessment 145 Chapter 12 Helping the Injured Athlete
Primary Survey 145 Psychologically 201
Conducting a Secondary Assessment 150 The Athlete’s Psychological Response to
Off-Field Assessment 152 Injury 201
Immediate Treatment Following Acute Predictors of Injury 202
Musculoskeletal Injury 153 Goal Setting as a Motivator to
Emergency Splinting 155 Compliance 204
Moving and Transporting the Injured Providing Social Support to the Injured
Athlete 156 Athlete 204

Contents vii

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 Return to Competition Decisions 207 Recognition and Management of Injuries
Referring the Athlete for Psychological Help 207 to the Knee 265
Summary 208 Recognition and Management of Injuries and
Websites 209 Conditions Classified as Patellofemoral Pain
Syndrome 272
Summary 275
PART IV
Recognition and Management Chapter 17 The Thigh, Hip, Groin, and
Pelvis 277
of Specific Injuries and Anatomy of the Thigh, Hip, Groin, and Pelvic
Conditions 211 Region 277
Assessing Thigh, Hip, Groin, and Pelvis
Chapter 13 Recognizing Different Sports Injuries 278
Injuries 212 Prevention of Injuries to the Thigh, Hip, Groin,
Acute (Traumatic) Injuries 212 and Pelvic Region 281
Chronic Overuse Injuries 219 Recognition and Management of Injuries
The Importance of the Healing Process to the Thigh 281
Following Injury 221 Recognition and Management of Hip
Summary 223 and Groin Injuries 284
Websites 225 Recognition and Management of Injuries
to the Pelvis 288
Chapter 14 The Foot and Toes 226 Summary 290
Foot Anatomy 226 Websites 291
Prevention of Foot Injuries 228
Foot Assessment 229 Chapter 18 The Shoulder Complex 292
Recognition and Management of Foot Anatomy of the Shoulder 292
Injuries 230 Prevention of Shoulder Injuries 294
Summary 239 Assessing the Shoulder Complex 296
Recognition and Management of Shoulder
Injuries 298
Chapter 15 The Ankle and Lower Leg 241 Summary 304
Ankle and Lower-Leg Anatomy 241
Websites 305
Prevention of Lower-Leg and Ankle
Injuries 243 Chapter 19 The Elbow, Forearm, Wrist,
Assessing the Ankle Joint 245 and Hand 306
Recognition and Management of Injuries Anatomy of the Elbow Joint 306
to the Ankle 246
Assessing Elbow Injuries 306
Assessing the Lower Leg 251
Prevention of Elbow, Forearm, and Wrist
Recognition and Management of Injuries Injuries 308
to the Lower Leg 251
Recognition and Management of Injuries
Summary 255 to the Elbow 309
Websites 257 Anatomy of the Forearm 312
Assessing Forearm Injuries 313
Chapter 16 The Knee and Related Structures 258 Recognition and Management of Injuries
Knee Anatomy 258 to the Forearm 314
Prevention of Knee Injuries 261 Anatomy of the Wrist, Hand, and
Assessing the Knee Joint 262 Fingers 315

viii Contents

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 Assessment of the Wrist, Hand, and Preventing Dental Injuries 363
Fingers 316 Recognition and Management of Specific
Recognition and Management of Wrist Dental Injuries 363
and Hand Injuries 316 Anatomy of the Nose 365
Recognition and Management of Finger Recognition and Management of Specific Nasal
Injuries 320 Injuries 365
Summary 323 Anatomy of the Ear 366
Recognition and Management of Specific
Chapter 20 The Spine 325 Injuries to the Ear 367
Anatomy of the Spine 325 Anatomy of the Eye 368
Preventing Injuries to the Spine 329 Recognition and Management of Specific
Assessment of the Spine 331 Eye Injuries 369
Recognition and Management of Cervical Spine Recognition and Management of Injuries
Injuries and Conditions 333 to the Throat 371
Recognition and Management of Lumbar Spine Summary 371
Injuries and Conditions 335 Websites 373
Recognition and Management of Sacroiliac
Joint and Coccyx Injuries 338 Chapter 23 General Medical Conditions and
Summary 339 Additional Health Concerns 374
Websites 340 Skin Infections 374
Respiratory Conditions 378
Chapter 21 The Thorax and Abdomen 341 Gastrointestinal Disorders 382
Anatomy of the Thorax 341 Other Conditions that Can Affect the
Anatomy of the Abdomen 342 Athlete 383
Preventing Injuries to the Thorax and Cancer 387
Abdomen 343 Menstrual Irregularities and the Female
Assessment of the Thorax and Abdomen 343 Reproductive System 388
Recognition and Management of Thoracic Sexually Transmitted Diseases (STDs) 390
Injuries 345 Summary 392
Recognition and Management of Abdominal Websites 394
Injuries 348
Summary 352 Chapter 24 Substance Abuse 395
Websites 353 Performance-Enhancing Drugs 395
Recreational Drug Abuse 399
Chapter 22 The Head, Face, Eyes, Ears, Nose, Drug-Testing Programs 400
and Throat 354 Summary 401
Preventing Injuries to the Head, Face, Eyes, Websites 402
Ears, Nose, and Throat 354
Anatomy of the Head 354 Chapter 25 Preventing and Managing Injuries in
Assessing Head Injuries 355 Young Athletes 403
Recognition and Management of Specific Head Cultural Trends 403
Injuries 357 Physical Maturity Assessment in Matching
Anatomy of the Face 362 Athletes 405
Recognition and Management of Specific Facial Physical Conditioning and Training 406
Injuries 362 Psychological and Learning Concerns 407
Dental Anatomy 363 Coaching Qualifications 408

Contents ix

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 Common Injuries in the Young Athlete 409 Appendix B Requirements for Certification as an
Sports Injury Prevention 410 Athletic Trainer 420
Summary 413 Appendix C Directional Movements for Body Joints 422
Websites 416
Glossary 430
Appendixes Index 434
Appendix A Employment Settings for the Athletic
Trainer 417

x Contents

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 Preface
WHO SHOULD USE THIS TEXT?
The tenth edition of Essentials of Athletic
Injury Management is written for those stu-
dents interested in the fitness profession, ki-
nesiology, coaching, or some aspect of sport
science or physical education. The majority of
students who take courses about the prevention
and management of injuries that typically occur in
an athletic population have little or no intention of
pursuing athletic training as a career. However, it is
also true that a large percentage of those students
who are taking these courses are doing so because
they intend to pursue careers in coaching, fitness,
physical education, or other areas related to exer-
cise and sports science. For these individuals, some
knowledge and understanding of the many aspects
of health care for both recreational and competitive
athletes is essential for them to effectively perform
the associated responsibilities of their job.
Other students who are personally involved in
fitness, or training and conditioning, may be inter-
ested in taking a course that will provide them with
guidelines and recommendations for preventing in-
juries, recognizing injuries, and learning how to cor-
rectly manage a specific injury. Thus, Essentials of
Athletic Injury Management has been designed to
provide basic information on a variety of topics, all
of which relate in one way or another to health care
for the athlete.
Essentials of Athletic Injury Management was
created from the foundations established by another
well-recognized textbook, Principles of Athletic
Training, currently in its fifteenth edition. Whereas
Principles of Athletic Training serves as a major
text for professional athletic trainers and those indi-
viduals interested in sports medicine, Essentials of
Athletic Injury Management is written at a level
more appropriate for the coach, fitness profes-
sional, and physical educator. It provides guid-
ance, suggestions, and recommendations for
handling athletic health care situations when an
athletic trainer or physician is not available.
ORGANIZATION AND COVERAGE
The tenth edition of Essentials of Athletic Injury
Management provides the reader with the most cur-
rent information on the subject of prevention and
pre22754_fm_i-xx.indd 11
basic care of sports injuries. The general philosophy
of the text is that adverse effects of physical activ-
ity arising from participation in sport should be pre-
vented to the greatest extent possible. However, the
nature of participation in physical activity dictates
that sooner or later injury may occur. In these situ-
ations, providing immediate and correct care can
minimize the seriousness of an injury.
Overall, this text is designed to take the begin-
ning student from general to specific concepts.
Each chapter focuses on promoting an understand-
ing of the prevention and care of athletic injuries.
Essentials of Athletic Injury Management is di-
vided into four parts: Organizing and Establishing
an Effective Athletic Health Care System,
Preventing Injuries in an Athletic Health Care
System, Techniques for Treating and Managing
Sport-Related Injuries, and Recognition and
Management of Specific Injuries and Conditions.
Part I, Organizing and Establishing an
Effective Athletic Health Care System, begins in
Chapter 1 with a discussion of the roles and re-
sponsibilities of all the individuals on the “sports
medicine team” who in some way affect the deliv-
ery of health care to the athlete. Chapter 2 provides
guidelines and recommendations for setting up a
system for providing athletic health care in situ-
ations where an athletic trainer is not available to
oversee that process. In today’s society, and in par-
ticular for anyone who is remotely involved with
providing athletic heath care, the issue of legal re-
sponsibility and, perhaps more importantly, legal
liability is of utmost concern. Chapter 3 discusses
ways to minimize the chances of litigation and also
to make certain that both the athlete and anyone
who is in any way involved in providing athletic
health care are protected by appropriate insurance
coverage.
Part II, Preventing Injuries in an Athletic
Health Care System, discusses a variety of top-
ics that both individually and collectively can re-
duce the chances for injury to occur. Chapter 4
emphasizes the importance of making certain that
the athlete is fit to prevent injuries. Chapter 5 dis-
cusses the importance of a healthy diet, giving
attention to sound nutritional practices and pro-
viding sound advice on the use of dietary supple-
ments. Chapter 6 provides guidelines for selecting
and using protective equipment. Chapter 7 looks at
xi
21/09/15 5:09 PM
 ways to minimize the potentially negative threats
of various environmental conditions on the health
of the athlete.
Part III, Techniques for Treating and Managing
Sport-Related Injuries, begins with Chapter 8,
which details how to assess the severity of an in-
jury and then provides specific steps that should
be taken to handle emergency situations. Chapter 9
provides guidelines that can help reduce the
chances of spreading infectious diseases by taking
universal precautions in dealing with bloodborne
pathogens. Chapter 10 discusses the more common
wrapping and taping techniques that can be used to
prevent new injuries from occurring and old ones
from becoming worse. Chapter 11 includes a brief
discussion of the general techniques that may be
used in rehabilitation following injury. Chapter 12
discusses the psychology of preparing to compete
and proposes recommendations for how a coach
should manage an injury.
Part IV, Recognition and Management of
Specific Injuries and Conditions, begins with
Chapter 13, which defines and classifies the various
types of injuries that are most commonly seen in the
physically active population.
Chapters 14 through 22 discuss injuries
that occur in specific regions of the body, in-
cluding the foot; the ankle and lower leg; the
knee; the hip, thigh, groin, and pelvis; the
shoulder; the elbow, forearm, wrist, and hand;
the spine; the thorax and abdomen; and the head,
face, eyes, ears, nose, and throat. Injuries are
discussed individually in terms of their most com-
mon causes, the signs of injury you would expect
to see, and a basic plan of care for that injury.
Chapter 23 provides guidelines and suggestions
for managing various illnesses and other health
conditions that may affect athletes and their
ability to play and compete. Chapter 24 focuses
specifically on issues related to substance
abuse and the potential effects on the athlete.
Chapter 25 provides special considerations for
injuries that may occur in young athletes.
NEW TO THIS EDITION
Chapter Changes and Additions
Numerous changes and clarifications have been
made in content throughout the entire text.
xii Preface
pre22754_fm_i-xx.indd 12
Chapter 1
• Updated information on the roles and
responsibilities of fitness professionals
who may find themselves in positions that
require them to have some knowledge of
the athletic health care system.
• Reorganized and updated the roles and
responsibilities of athletic trainers accord-
ing to the latest role delineation study.
• Added new discussion for referring injured
individuals to the appropriate health care
professionals.
• Reemphasized the role of the orthopedic
physician in caring for the injured athlete.
• Significantly updated the recommended ref-
erences and the annotated bibliography to
make them as current as possible.
Chapter 2
• Updated information on hiring certified
athletic trainers in secondary schools.
• Added new discussion of the NATA consen-
sus statement that discusses appropriate
medical care for secondary school athletes.
• Added new information on the 2013 Youth
Sports Safety Alliance’s Secondary School
Athletes’ Bill of Rights
• Added new information on the Pubertal
Development Scale used to determine
pubertal growth and development.
• Added new drawing of an ideal athletic
health care facility.
• Significantly updated the recommended ref-
erences and the annotated bibliography to
make them as current as possible.
Chapter 3
• Added new information on the Affordable
Care Act.
• Added a new Focus Box discussing key
features and benefits of the Affordable
Care Act.
• Updated the recommended references to
make them as current as possible.
Chapter 4
• Updated information on and recommenda-
tions for the warm-up.
21/09/15 5:09 PM
 • Calisthenic exercises are now referred to
more correctly, as bodyweight exercises.
• Added new photos that better illustrate the
various exercises that may be done in a
training and conditioning program to help
prevent injuries.
• Completely revised and updated informa-
tion on calculating a target heart rate for
improving cardiorespiratory endurance.
• Added the new American College of Sports
Medicine recommendation on training
intensities.
• Changed the term interval training
to the more appropriately used term
high-intensity interval training.
• Significantly updated the recommended ref-
erences and the annotated bibliography to
make them as current as possible.
Chapter 5
• Added a discussion on how the body’s me-
tabolism utilizes the various foodstuffs to
produce energy.
• Added new suggestions on foods that can
provide energy during activity.
• The Athletic Injury Management
Checklist focuses on a nutritious diet for
the athlete.
• Added new information on binge eating as a
newly recognized eating disorder.
• Significantly updated the recommended ref-
erences and the websites to make them as
current as possible.
Chapter 6
• Replaced most of the photographs to
show examples of the newest available
equipment.
• Updated the new NOCSAE warning label
that must be placed on all football helmets.
• Added an update on the latest in helmet
technology that attempts to minimize the
impact forces transmitted to the athlete’s
head.
• Added a discussion on the newest facemask
fasteners.
• Significantly updated the recommended
references to make them as current as
possible.
pre22754_fm_i-xx.indd 13
Chapter 7
• Replaced the heat index chart with a new
chart that is much easier to read.
• Updated information on psychrometers
used to monitor the heat index.
• Updated information on using sunscreens.
• Replaced photo of a lightning detector with
the newest digital lightning detector.
• Significantly updated the recommended ref-
erences to make them as current as possible.
Chapter 8
• Added a new definition of an emergency.
• Added a new Focus Box that provides a
sample emergency action plan.
• Reordered the life-threatening injuries in
the emergency procedures flowchart.
• Made slight adjustments in the CPR Sum-
mary table to clarify the procedures.
• Replaced photos of football facemask
fasteners.
• Added a photo showing correct hand and
finger placement for taking blood pressure.
• Added a new photo and brief discussion of
the head-squeeze technique for immobiliz-
ing the cervical spine.
• Added the most current recommendations
from an inter-association task force to
consider removing the helmet and shoulder
pads by trained personnel prior to trans-
porting an athlete with a suspected cervical
spine injury.
• Significantly updated the recommended
references and annotated bibliography to
make them as current as possible.
Chapter 9
• Replaced photos showing lacerations and
incision skin wounds.
• Clarified recommendations for cleaning
wounds and using an occlusive dressing.
• Significantly updated the recommended
references and annotated bibliography to
make them as current as possible.
Chapter 10
• Added a discussion of kinesio taping and its
efficacy as a treatment technique.
Preface xiii
21/09/15 5:09 PM
 Chapter 11
• Added a discussion that clarifies the
purpose of this chapter and gives a caution
about who is legally able to suggest or
supervise a program of rehabilitation for an
injured athlete.
Chapter 13
• Significantly updated the recommended ref-
erences to make them as current as possible.
Chapter 14
• Added a definition of a tailor’s bunion or
bunionette.
• Significantly updated the recommended
references and annotated bibliography to
make them as current as possible.
Chapter 15
• Added an updated photo of a new ankle
brace.
• Clarified the difference between Achilles
tendinitis and Achilles tendinosis.
• Significantly updated the recommended
references and annotated bibliography to
make them as current as possible.
Chapter 16
• Added an in-depth discussion of shoe type
and its impact on preventing knee injuries
on different playing surfaces.
• Added a new discussion of anterior and
posterior drawer tests and a new photo that
demonstrates those tests.
• Added new information that clarifies the
mechanisms of injury for both noncontact
and contact ACL injuries.
• Added a new photo that more accurately
shows the combination of forces that col-
lectively cause ACL injury.
• Redefined patellofemoral pain syndrome.
• Significantly updated the recommended
references and annotated bibliography to
make them as current as possible.
Chapter 17
• Added in a new photo that will help explain
piriformis syndrome.
xiv Preface
pre22754_fm_i-xx.indd 14
• Clarified the information on the mechanism
of injury for a hip pointer.
• Significantly updated the recommended
references and annotated bibliography to
make them as current as possible.
Chapter 18
• Updated photos showing acromioclavicular
joint sprains with labels to clarify the
different grades of injury.
• Added a new drawing of biceps tenosynovi-
tis that shows the location of the tendon and
the most common area of inflammation.
• Significantly updated the recommended
references and websites to make them as
current as possible.
Chapter 19
• Added a new discussion of and new photos
for lateral and medial epicondylitis tests.
• Briefly mentioned dinner fork deformity to
refer to a Colles’ fracture.
• Added a new x-ray photo to clearly show an
example of a forearm fracture of both the
radius and the ulna.
• Added a new drawing that shows the causes
of carpal tunnel syndrome in the wrist.
• Significantly updated the recommended
references and annotated bibliography to
make them as current as possible.
Chapter 20
• Added a new x-ray photo that more clearly
depicts a spondylolisthesis.
• Deleted reference to sleeping on a waterbed.
• Significantly updated the recommended
references and annotated bibliography to
make them as current as possible.
Chapter 21
• Added a discussion of referred pain that often
results from palpation of abdominal organs.
• Identified noncardiac causes of sudden
death syndrome in athletes.
• Clarified the distinction between a sports
hernia, which should be more correctly
identified as athletic pubalgia, and an
inguinal or femoral hernia.
21/09/15 5:09 PM
 • Significantly updated the recommended
references and annotated bibliography to
make them as current as possible.
Chapter 22
• Updated image of the brain with labels
more clearly showing the different regions
of the brain.
• Added a section that clarifies the relation-
ship between the terms mild traumatic
brain injury and concussion.
• Added a new discussion of the most recent
definition of concussion and associated
symptoms and signs.
• Updated and added new information about
evaluating concussions that currently uses
the SCAT 3 as the most accepted evaluation
tool.
• Added new guidelines for caring for con-
cussions including the new state laws that
specify how concussions must be managed
and return-to-play decisions.
• Added a new table, the Graded Symptoms
Checklist, that identifies the possible symp-
toms associated with concussion.
• Added a new Focus Box that details the
procedures that should be followed on
the sidelines for a player with a suspected
concussion.
• Significantly updated the recommended
references and annotated bibliography to
make them as current as possible.
Chapter 23
• Added updated recommendations for
managing herpes simplex.
• Added new photos showing how to
correctly use a metered-dose inhaler.
• Replaced photos for several dermatologic
conditions to better show exactly what
these conditions look like.
• Updated treatment information for tinea
pedis (athlete’s foot).
• Added a discussion of contraceptive
devices that are alternatives to birth-
control pills.
• Significantly updated the recommended
references and annotated bibliography to
make them as current as possible.
pre22754_fm_i-xx.indd 15
Chapter 24
• Based on reviewer consensus, expanded the
discussion on abuse of recreational drugs
including alcohol, abused illegal drugs, and
abused prescription drugs.
• Updated the Focus Box on drugs banned by
the NCAA and the USADA.
• Significantly updated the recommended
references, annotated bibliography, and
websites to make them as current as
possible.
Chapter 25
• Updated Youth Sports Safety Alliance
statistics on injuries in youth sports.
• Updated recommendations for youth
strength-training programs from the
American Academy of Pediatrics Council
on Sports Medicine and Fitness.
• Added information on the USOC Coaching
Education Department that supports the
national governing bodies of 40 sports.
• Updated the table on sports injury
prevention tips from the American
Academy of Pediatrics.
• Updated the Sports Parents Safety
Checklist from Safe Kids Worldwide.
• Added a new table on the National Action
Plan for Sports Safety from the Youth
Sport’s Safety Alliance.
• Significantly updated the recommended
references, annotated bibliography, and
websites to make them as current as
possible.
Appendix A
• Updated the information on employment
of certified athletic trainers in secondary
schools.
PEDAGOGICAL FEATURES
• Chapter objectives. Objectives are
presented at the beginning of each chapter,
to reinforce learning goals.
• Focus Boxes. Important information is
highlighted to provide additional content
that supplements the main text.
Preface xv
21/09/15 5:09 PM
 • Margin information. Key concepts, selected
definitions and pronunciation guides, help-
ful training tips, and illustrations are placed
in margins throughout the text for added
emphasis and ease of reading and studying.
• Illustrations and photographs. Every il-
lustration and photograph throughout
the book is in full color, with over 40 new
photographs that will help to enhance the
visual learning experience for the student.
• Critical thinking exercises. Included in
every chapter, these brief case studies cor-
respond with the accompanying text and
help students apply the content just learned.
Solutions for each exercise are located at
the end of the chapters.
• Athletic Injury Management Checklists.
These checklists help organize the details
of a specific procedure when managing ath-
letic health care.
• Chapter summaries. Chapter content is
summarized and bulleted to reinforce key
concepts and aid in test preparation.
• Review questions and class activities. A list
of questions and suggested class activities
follows each chapter for review and appli-
cation of the concepts learned.
• Recommended references. All chapters have
a bibliography of pertinent references that
includes the most complete and up-to-date
resources available.
• Annotated bibliography. To further aid in learn-
ing, relevant and timely articles, books, and
topics from the current literature have been
annotated to provide additional resources.
• Websites. A list of useful websites is included
to direct the student to additional relevant in-
formation that can be found on the Internet.
• Glossary. A comprehensive list of key
terms with their definitions is presented at
the end of the text.
• Appendixes. For those students interested
in learning more about athletic training,
Appendixes A and B provide information
about employment settings for the athletic
trainer and the requirements for certifi-
cation as an athletic trainer. Appendix C
shows the directional anatomic motions of
the joints discussed in this text.
xvi Preface
pre22754_fm_i-xx.indd 16
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to teach your students your way.
ACKNOWLEDGMENTS
Special thanks are extended to Gary O’Brien, my
Development Editor and most importantly my
“wing-man” on this and several additional projects.
As always he has provided invaluable guidance in
the preparation of the tenth edition of Essentials
of Athletic Injury Management and I cannot thank
him enough for everything he does for me.
I would also like to thank the following individu-
als who served as reviewers for their input into the
revision of this text:
Johannah Elliott
Arizona Western College–Yuma
Matthew Hamilton
D’Youville College
Carie Mueller
San Jacinto College–South
Finally, I would like to thank my family, Tena, Brian,
and Zach, for always being an important part of
everything I do.
William E. Prentice

Preface xvii

pre22754_fm_i-xx.indd 17 21/09/15 5:09 PM

 Applications at a Glance
List of professional sports medicine
organizations 4
Clarifying roles 8
Athletic injury management checklist 13
Looking to hire a certified athletic trainer? 18
Secondary School Student Athletes’ Bill of
Rights 18
Rules and policies of the athletic health care
facility 19
Suggestions for maintaining a sanitary
environment 19
Cleaning responsibilities 20
Recommended health practices checklist 20
Orthopedic Screening Examination 24
Recommended basic health care facility
supplies 27
Recommended basic field kit supplies 28
Athletic injury management checklist 30
Athletic injury management checklist 34
Key Features and Benefits of the Affordable Care
Act 36
Athletic injury management checklist 39
Periodization training 45
Principles of conditioning 46
Guidelines and precautions for stretching 50
Techniques for improving muscular
strength 60
Progressive resistance exercise terminology 62
Comparison of aerobic versus anaerobic
activities 75
Rating of perceived exertion 79
Athletic injury management checklist 80
Vitamins 86
Major minerals 88
Most widely used herbs and purposes for use 93
Tips for selecting fast foods 97
Guidelines for weight loss 99
Recognizing the individual with disordered
eating 100
Athletic injury management checklist 101
Equipment regulatory agencies 106
Guidelines for purchasing and reconditioning
helmets 107
Proper football helmet fit 109
Rules for fitting football shoulder pads 115
Shoe comparisons 119
Athletic injury management checklist 124
WBGT index and recommendations for fluid
replacement and work/rest periods 129
xviii
pre22754_fm_i-xx.indd 18
Summary and comparison of heat disorders,
treatment and prevention 130
Recommendations for fluid replacement 133
Recommendations for preventing heat
illness 133
Athletic injury management checklist 137
Sample emergency action plan 144
Consent form for medical treatment of a
minor 145
CPR summary 147
Vital signs 151
Initial management of acute injuries 153
Athletic injury management checklist 159
Transmission of hepatitis B and C viruses and
human immunodeficiency virus 164
HIV risk reduction 165
Bloodborne pathogen risk categories for sports 165
Glove removal and use 167
Suggested practices in wound care 170
Care of skin wounds 171
Athletic injury management checklist 171
Taping supplies 180
Athletic injury management checklist 188
Return to running following lower-extremity injury
functional progression 196
What are therapeutic modalities used for? 197
Using ice versus heat? 198
Full return to activity 198
Athletic injury management checklist 199
Progressive reactions of injured athletes
based on severity of injury and length of
rehabilitation 202
Nine factors to incorporate into goal setting for the
athlete 204
Things a coach or fitness professional can do
to provide social support for an injured
athlete 205
Athletic injury management checklist 208
Muscles of the foot 228
Caring for a torn blister 237
Managing the ingrown toenail 238
Muscles of the ankle joint 243
Technique for controlling swelling immediately
following injury 249
Muscles of the knee joint 260
Muscles of the thigh, hip, and groin 280
Muscles of the shoulder complex 295
Muscles of the elbow 307
Muscles of the forearm 313
21/09/15 5:09 PM
 Muscles of the wrist, hand, and fingers 318
Muscles of the spine 329
Recommended postures and practices for
preventing low back pain 330
Muscles of the abdomen and thorax 342
When an athlete shows any signs of a
concussion 358
The Graded Symptoms Checklist 359
Common viral, bacterial, and fungal skin infections
found in athletes 375
Preventing the spread of MRSA 377
Basic care of athlete’s foot 378
Symptoms and management of the acute
asthmatic attack 381
Using a metered-dose inhaler 382
Classifying blood pressure 386
Some infectious viral diseases 387
Identifying a woman at risk for female
athletic triad 389
pre22754_fm_i-xx.indd 19
Sexually transmitted diseases 391
Identifying an individual who may be using
performance-enhancing drugs 396
Examples of caffeine-containing products 396
Examples of deleterious effects of anabolic
steroids 397
Banned drugs—common ground 400
Estimated number of young people ages 5–17
enrolled in specific categories of youth
sports 404
Tanner stages of maturity 406
Guidelines for Youth Strength Training 407
Sports Safety Tips 411
Sports parents safety checklist 412
National Action Plan for Sports Safety 412
Athletic injury management checklist 413
Board of certification requirements for certification
as an athletic trainer 420
Applications at a Glance xix
21/09/15 5:09 PM
pre22754_fm_i-xx.indd 20 21/09/15 5:09 PM
 PART I
Organizing and Establishing an Effective Athletic
Health Care System

1 Fitness Professionals, Coaches, and the Sports Medicine Team:

Defining Roles
2 Organizing and Administering an Athletic Health Care Program
3 Legal Liability and Insurance

pre22754_ch01_001-015.indd 1 21/09/15 4:34 PM

 1
Fitness Professionals, Coaches,
and the Sports Medicine Team:
Defining Roles
■ Objectives
When you finish this chapter you will be able to:
• Define the umbrella term sports medicine.
• Identify various sports medicine organizations.
• Contrast athletic health care in organized
versus recreational sports activities.
• Discuss how fitness professionals, including
personal fitness trainers and strength and
conditioning coaches, relate to the sports
medicine team.
• Describe the role of an individual supervising
a recreational program in athletic injury
management.
• Analyze the role of the athletic administrator
in the athletic health care system.
M illions of individuals in our American
society participate on a regular basis in
both organized and recreational sports
or physical activities. There is great demand for
well-educated, professionally trained personnel to
supervise and oversee these activities. Among those
professionals are coaches, fitness professionals such
as strength and conditioning specialists and per-
sonal fitness trainers, recreation specialists, athletic
administrators, and others interested in some aspect
of exercise and sports science.
Ironically, participation in any type of physi-
cal activity places the “athlete” in situations in
which injury
An athlete is an individual who is likely to
engages in and is proficient in
occur. Athletes
sports and/or physical exercise.
who engage in
pre22754_ch01_001-015.indd 2
• Describe the role of the coach in injury
prevention, emergency care, and injury
management.
• Identify the responsibilities of the athletic
trainer in dealing with the injured athlete.
• Describe the role of the team physician
and his or her interaction with the athletic
trainer.
• Explain how the sports medicine team should
interact with the athlete.
• Identify other members of the sports medicine
team and describe their roles.
organized sports and/or recreational activities have
every right to expect that their health and safety
will be a high priority for those who supervise or
organize those activities. Thus it is essential to have
some knowledge about how injuries can best be pre-
vented or at least minimized. Should injury occur, it
is critical to be able to recognize that a problem ex-
ists, to learn how to correctly provide first-aid care,
and to then refer the athlete to the appropriate medi-
cal or health care personnel for optimal treatment.
However, it must be emphasized that these well-
trained professionals are NOT health care profes-
sionals. In fact, attempting to provide health care to
an injured or ill athlete is in most states illegal and
likely violates the practice acts of several different
professional health care provider groups licensed by
the state to give medical care to an injured athlete.
21/09/15 4:34 PM
 Medic
The intent throughout this text is to provide
students who intend to become coaches, fitness

rts
o
professionals, recreation specialists, athletic
administrators, physical education teachers,
exercise physiologists, biomechanists, sport

Sp

ine
psychologists, or sports nutritionists with an Performance Injury Care &
introduction or exposure to a variety of topics Enhancement Management
that relate to athletic injury management. This
Exercise Physiology Practice of Medicine
chapter introduces the members of the sports medi-
Biomechanics (Physicians, Physician’s
cine team with whom these professionals are likely Sport Psychology Assistants)
to interact throughout their careers. Specific roles Sports Nutrition Athletic Training
and responsibilities of each member of the sports Strength & Conditioning Sports Physical Therapy
Personal Fitness Training Sports Massage Therapy
medicine team in managing the health care of the Coaching Sports Dentistry
athlete are discussed in detail. Physical Education Osteopathic Medicine
Orthotists/Prosthetists
Sports Chiropractic
WHAT IS SPORTS MEDICINE? Sports Podiatry
Emergency Medical Specialists
The term sports medicine refers generically to a
broad field of health care related to physical activ-
ity and sport. The American College of Sports Medi- FIGURE 1–1 Areas of specialization under the sports
cine (ACSM) has used the term sports medicine to medicine “umbrella.”
describe a multidisciplinary approach to health man-
roles that members of their organizations play in
agement or achievement of full potential, including
providing health care to an injured patient. Profes-
the physiological, biomechanical, psychological, and
sional organiza-
pathological phenomena associated with exercise
tions have many Many professional organizations
and sports. The clinical application of the work of
goals: (1) to up- are dedicated to achieving
these disciplines is performed to improve and main-
grade the field health and safety in sports.
tain an individual’s functional capacities for physi-
by devising and
cal labor, exercise, and sports. It also includes the
maintaining a set of professional standards, includ-
prevention and treatment of diseases and injuries
ing a code of ethics; (2) to bring together profes-
related to exercise and sports. The field of sports
sionally competent individuals to exchange ideas,
medicine encompasses under its umbrella a num-
stimulate research, and promote critical thinking;
ber of more specialized aspects of dealing with the
and (3) to give individuals an opportunity to work
physically active or athletic populations that may be
as a group with a singleness of purpose, thereby
classified as relating either to performance enhance-
making it possible for them to achieve objectives
ment or to injury care and management (Figure 1–1).
that, separately, they could not accomplish. Ad-
Those areas of specialization that are primarily con-
dresses and websites for these organizations are
cerned with performance enhancement include ex-
listed in Focus Box 1–1.
ercise physiology, biomechanics, sport psychology,
Many of the national organizations interested in
sports nutrition, strength and conditioning, personal
athletic health and safety have state and local as-
fitness training, coaching, and physical education.
sociations that are extensions of the larger bodies.
Areas of specialization that focus more on health
National, state, and local sports organizations have
care and injury/illness management specific to the
all provided extensive support to the reduction of
athlete are the practice of medicine (physicians and
illness and injury risk to the athlete.
physician assistants), athletic training, sports physi-
cal therapy, massage therapy, dentistry, osteopathic
medicine, orthotists/prosthetists, sports chiropractic,
sports podiatry, and emergency medical specialists.
ATHLETIC HEALTH CARE
Certainly, some of the specializations listed under IN ORGANIZED VERSUS
this umbrella could be concerned with both perfor-
mance enhancement and injury care and manage-
RECREATIONAL SPORTS
ment (for example, sports nutrition). ACTIVITIES
The system or methods by which athletic health
Sports Medicine Organizations care is delivered by members of the sports medi-
A number of professional organizations are dedi- cine team largely depend on whether the activity
cated to the field of sports medicine and dictate the is organized or recreational. An organized activity

Chapter One ■ Fitness Professionals, Coaches, and the Sports Medicine Team: Defining Roles 3

pre22754_ch01_001-015.indd 3 21/09/15 4:34 PM

 FOCUS BOX 1–1
List of professional sports medicine organizations
• American Academy of Pediatrics, Council on
Sports Medicine and Fitness, 141 Northwest
Point BoulevardElk Grove Village, IL 60007-
1098 www.aap.org
• American Board of Physical Therapy Specialists,
American Physical Therapy Association, 1111
North Fairfax St., Alexandria, VA 22314 www
.abpts.org/Certification/Sports/
• American College of Sports Medicine, 401 W.
Michigan St., Indianapolis, IN 46202-3233
www.acsm.org
• American Orthopaedic Society for Sports Medi-
cine, Suite 202, 70 West Hubbard, Chicago, IL
60610 www.sportsmed.org
• National Athletic Trainers’ Association, 1620
Valwood Parkway, Suite 115, Carrollton TX
75006 www.nata.org
refers to a situation that is generally competitive in
which there is some type of team or league involve-
ment, as would be the case with secondary school,
collegiate, and professional athletic teams. With or-
ganized sports activities, the primary players on the
sports medicine team are employed on either a full-
time or part-time basis by a school or organization
and include the coach, the athletic trainer, and a
physician who is designated as a “team” physician.
At the collegiate and professional levels, a strength
and conditioning coach, a sports nutritionist, a
sports massage therapist, and a sport psychologist
are also usually involved. In organized sports ac-
tivities, the athletic health care system is generally
well organized and comprehensive, and in many in-
stances the sports medicine coverage would be con-
sidered highly sophisticated.
Certainly a recreational sports activity can be
competitive. However, a recreational activity is
one that is done more for leisure and free time en-
joyment and involves a much less formal structure,
with many of the organizers being primarily vol-
unteers. These include city- or community-based
recreational leagues and teams. Many individu-
als choose to engage in fitness-oriented exercise
activities such as running or weight training as a
recreational activity. These “recreational athletes”
may decide to hire personal fitness trainers to help
them with their fitness programs. Should injury
occur, they are likely to consult their family physi-
cian, an athletic trainer, a sports chiropractor, or a
sports physical therapist. Athletic health care for
4 Part One ■ Organizing and Establishing an Effective Athletic Health Care System
pre22754_ch01_001-015.indd 4
• National Collegiate Athletic Association, Com-
petitive Safeguards and Medical Aspects of
Sports Committee, 700 W. Washington St., P.O.
Box 622, Indianapolis, IN 46206-6222 www
.ncaa.org
• National Federation of State High School Ath-
letic Associations, 11724 Plaza Circle, P.O.
Box 20626, Kansas City, MO 64195 www
.nfhs.org
• National Strength and Conditioning Association,
P.O. Box 38909, Colorado Springs, CO 80937-
8909 www.nsca-lift.org
• American Osteopathic Academy of Sports Medi-
cine, 7600 Terrace Ave., Middleton, WI 53562
www.aoasm.org
recreational athletes is generally provided on a fee-
for-care basis.
THE PLAYERS ON THE SPORTS
MEDICINE TEAM
Providing health care to the athlete requires a
group effort to be most effective.38 The sports medi-
cine team involves a number of individuals, each of
whom must perform specific functions relative to
caring for the injured athlete.5,12
How Does the Fitness Professional Relate
to the Sports Medicine Team?
Earlier in this chapter, the term fitness professional
was used to refer collectively to strength and con-
ditioning coaches, personal fitness trainers, and
others interested in exercise and sport sciences. In
this group we may also include physical education
teachers, exercise physiologists, biomechanists,
sport psychologists, and sports nutritionists. If we
consider the “sports medicine umbrella” model, the
focus of this group is on improving performance.
Certainly an argument can be made that if athletes
achieve a high level of fitness through training and
conditioning, they are not only more likely to per-
form athletically at a higher level but they are also
less likely to sustain some type of activity-related
injury. Therefore, there is a relationship between
those areas that specialize in performance enhance-
ment and those that focus on health care in that
both groups are concerned with injury prevention.
21/09/15 4:34 PM
Another random document with
no related content on Scribd:
in Europe and N. America, while several species of Palaemon occur
in lakes, streams, and estuaries of the tropical Old and New World.
The expeditions of Moore and Cunnington to Lake Tanganyika
brought back an exceedingly rich collection of Prawns, comprising
twelve species, all of which are peculiar to the lake,[173] and this is all
the more surprising since Lakes Nyasa and Victoria Nyanza are only
known to contain one species, Caridina nilotica, which ranges all
over Africa and into Queensland and New Caledonia. The
Tanganyika species, however, all belong to purely fresh-water
genera, and do not afford any suggestion that they are part of a relict
marine fauna. It would appear that they have been differentiated in
the lake itself during a long period of isolation.
Two groups of Brachyura, viz. the Thelphusidae and the
Sesarminae (a sub-family of the Grapsidae), are fresh-water.
Thelphusa fluviatilis is an inhabitant of North Africa, and penetrates
into the temperate regions of the Mediterranean, and is said to be
exceedingly common in the Alban Lake near Rome. Both these
families have representatives on land, e.g. Potamocarcinus in
Central and South America, and certain species of Sesarma, and the
closely related Gecarcinidae of the West Indies.
The remaining families to be dealt with are the two Crayfish
families—the Astacidae and the Parastacidae—which live in rapidly
moving rivers and streams, and occasionally in lakes. A few species
of both families have taken to a subterranean mode of life, and
excavate burrows in the earth, e.g. the Tasmanian Crayfish, Engaeus
fossor. The distribution of the Crayfishes has long engaged the
attention of naturalists. It was first seriously studied by Huxley,[174]
and has subsequently been followed up, especially in North America,
by Faxon[175] and Ortmann,[176] but our knowledge of the South
American and Australian forms is still very incomplete. The
Astacidae inhabit the northern temperate hemisphere, the
Parastacidae the southern temperate hemisphere, the tropical belt
being practically destitute of Crayfishes. Of the Astacidae the genus
Astacus (Potamobius), including the common Crayfishes of Europe,
occurs in Europe and in North America west of the Rockies. The
genus Cambaroides, which in certain respects approaches
Cambarus, is found in Japan and Eastern Asia. The very large genus
Cambarus, on the other hand, only occurs in North America east of
the Rockies, so that Cambaroides occupies a very isolated position.
The occurrence of a Cambarus, C. stygius, in the caves of Carniola,
has been recorded by Joseph, so that it would appear that this genus
had a much wider range formerly than now.
Of the southern temperate Parastacidae, Australia and Tasmania
have the genera Astacopsis and Engaeus; New Zealand has
Paranephrops, South America Parastacus, and Madagascar
Astacoides. The last named genus is rather isolated in its characters,
possessing a truncated rostrum and a highly modified branchial
system, but it agrees with all the other Parastacine genera, and
differs from the Astacidae in the absence of sexual appendages on
the first abdominal segment, and in the absence of a distinct lamina
on the podobranchiae. The largest crayfish in the world is Astacopsis
franklinii, found in quite small streams on the north and west coast
of Tasmania. Specimens have been caught weighing eight or nine
pounds, and rivalling the European Lobster in size. Crayfishes
appear to be entirely absent from Africa.
It seems reasonable to suppose that the two families of Crayfishes
characteristic respectively of the northern and southern hemispheres
have been independently derived from marine ancestors, which have
subsequently become extinct. Their complete absence in the tropics
is striking, and Huxley drew attention to the fact that it is exactly in
those regions where the Crayfishes are absent that the other large
fresh-water Malacostraca are particularly well developed, and vice
versa. Thus the large fresh-water Prawns are typically circumtropical
in distribution, while the South African rivers abound with River-
crabs, which, in general, are found wherever Crayfishes do not occur.
A few of the more interesting features in connection with the
distribution of fresh-water Crustacea have now been touched upon.
With regard to the origin of this fauna, we can see that a number of
the species are comparatively recent immigrants from the sea,
working their way up the estuaries of rivers, a proceeding which can
be observed to be taking place to-day in a district like the Broads of
Norfolk. Others, again, but these are few, appear to be true relict
marine animals left stranded in arms of the sea that have been cut off
from the main ocean, and have been gradually converted into fresh-
water lakes and seas. Such are, perhaps, Mysis relicta and the rich
Gammarid fauna of Lake Baikal, a lake that, in the presence of Seals,
Sponges, and other marine forms, has clearly retained some of the
characters of the ocean from which it was derived. The majority of
the fresh-water species, however, have probably been evolved in situ,
and their origin from marine ancestors is lost in an obscure past. The
Crustacean fauna of the Caspian Sea[177] shows us in an interesting
manner the effects of isolation and changes in salinity, etc., on the
inhabitants of a basin which once formed part of the ocean. The
waters of the Caspian Sea are not fresh, but they are on the average
about one-third as salt as that of the open ocean. The Crustacea,
described by Sars, belong to undoubtedly marine groups, e.g. the
Mysidae, Cumacea, and Amphipoda Crevettina, but the remarkable
feature of these Caspian Crustacea is the great variety of peculiar
species representing marine genera which are very poorly
represented in the sea, thus indicating that the variety of the fauna is
not due to a great variety of species having been shut up in the
Caspian Sea to begin with, but rather that, after the separation from
the sea, the isolated species began to vary and branch out in the most
luxuriant way—whether from lack of competition or owing to the
changing conditions of salinity it is difficult to say. As an example,
the Cumacea of the Caspian Sea are ten in number, all belonging to
peculiar genera related to Pseudocuma, except one species which is
included in that genus. These Caspian forms make up the Family
Pseudocumidae, which contains in addition only two marine forms
of the genus Pseudocuma (see p. 121). A very similar condition is
found in the numerous Amphipods of the Caspian Sea. Considering
the enormous changes that must have taken place in the distribution
of land and water even during Tertiary times, it is astonishing that
the fresh waters of the world do not contain more species in common
with the ocean, but it must be considered that the limited area and
comparatively uniform conditions of fresh-water lakes and streams
would only permit a limited number of these forms to survive which
could most easily adapt themselves to the changed conditions. And
these would in all probability be the littoral species that were in the
habit of passing up into the brackish waters of estuaries and lagoons,
so that the uniform and limited nature of the fresh-water fauna can
be accounted for to a certain extent by this hypothesis.
We have seen in dealing with the marine Crustacea of the littoral
zone that the chief condition determining their distribution is
temperature, and that the world may be divided into three chief
areas of distribution for these animals, viz. the north temperate
hemisphere, the tropics, and the south temperate hemisphere. It
seems that the same division holds good for fresh-water Crustacea.
We have already seen that the Crayfishes follow this rule, being
practically absent from the tropics, and represented in the two
temperate hemispheres by two distinct families, the Astacidae in the
north and the Parastacidae in the south. Characteristic of the tropical
belt are the absence of Crayfishes and the great development of
Prawns and River-crabs. In the case of Entomostraca the great
majority of the genera are cosmopolitan, especially those which live
in small bodies of water liable to dry up, because these forms always
have special means of dissemination in the shape of resting eggs
which can be transported in a dry state by water-birds and other
agencies to great distances; but those genera which inhabit large
lakes are more confined in their distribution. The Copepod genus
Diaptomus, characteristic of lake-plankton, ranges all over the
northern hemisphere and into the tropics, but it is almost entirely
replaced in the southern hemisphere by the related but distinct
genus Boeckella,[178] which occurs in temperate South America, New
Zealand, and southern Australia, and was found by the author to be
the chief inhabitant in the highland lakes and tarns of Tasmania,
Diaptomus being entirely absent. Of the Cladocera there are a
number of pelagic genera (e.g. Leptodora, Holopedium,
Bythotrephes) entirely confined to the lakes of the northern
hemisphere. The distribution of Bosmina is interesting. This genus is
distributed all over the north temperate hemisphere in lakes and
ponds of considerable size, not liable to desiccation; in the New
World it passes right through the tropics into Patagonia,[179] the chain
of the Andes doubtless permitting its migration. In the tropics of the
Old World it is unknown, but it turns up again, as the author recently
found, as a common constituent in the plankton of the Tasmanian
lakes. There is another instance of a group of Crustacea,
characteristic of the north temperate hemisphere, being entirely
absent from the tropics, at any rate of the Old World, but
reappearing in the temperate regions of Australasia. The commonest
fresh-water Amphipods in this region belong to the genus
Neoniphargus, intermediate in its characters between the northern
Niphargus and Gammarus, but grading almost completely into the
latter. Both Niphargus and Gammarus are absolutely unknown from
the tropics, but whether, like Bosmina, they occur in the Andes and
temperate South America is not known; it seems, however, probable
that they have reached Southern Australia by way of South America
rather than through the tropics of Asia and Australia, where there is
no range of mountains to permit the migration of a group of animals
apparently dependent on a temperate climate. The other common
fresh-water Amphipod in temperate Australia and New Zealand is
Chiltonia, whose nearest ally is Hyalella from Lake Titicaca on the
Andes, and temperate South America.
The Anaspidacea and Phreatoicidae, which are so characteristic of
temperate Australia, and are generally of an Alpine habit, have never
been found in South America, but the Anaspidacea are represented
by numerous marine forms in the Permian and Carboniferous strata
of the northern hemisphere, so that it is probable that this group
reached the southern hemisphere from the north through America.
The distribution of the fresh-water Crustacea, therefore, in the
temperate southern hemisphere affords strong evidence in favour of
the view that the chief land-masses of this hemisphere, which are at
present separated by such vast stretches of deep ocean, were at no
very remote epoch connected in such a way as to permit of an
intermixture of the temperate fauna of New Zealand, Australia, and
South America. While this connexion existed, a certain number of
forms characteristic of the northern hemisphere, which had worked
through the tropics by means of the Andes, were enabled to reach
temperate Australia and New Zealand. The existence of a coast-line
connecting the various isolated parts of the southern hemisphere
would, of course, also account for the community which exists
between their littoral marine fauna. It is impossible to enter here
into the nature of this land-connexion which is becoming more and
more a necessary hypothesis for the student of geographical
distribution, whatever group of animals he may choose, but it may be
remarked that the connexion was probably by means of rays of land
passing up from an Antarctic continent to join the southernmost
projections of Tierra del Fuego, Tasmania, and New Zealand.
 TRILOBITA

BY

HENRY WOODS, M.A.

St. John’s College, Cambridge, University Lecturer in Palaeozoology
 CHAPTER VIII
TRILOBITA

Among the many interesting groups of fossils found in the

Palaeozoic deposits there is none which has attracted more attention
than the Trilobites. As early as 1698, Edward Lhwyd, Curator of the
Ashmolean Museum in Oxford, recorded in the Philosophical
Transactions the discovery of Trilobites in the neighbourhood of
Llandeilo in South Wales; and of one of his specimens he remarked
that “it must be the Sceleton of a flat Fish.” In the following year the
same writer gave in his Lithophylacii Britannici Ichnographia
descriptions and figures of two Trilobites which are evidently
examples of the species now known as Ogygia buchi and Trinucleus
fimbriatus.
Although Trilobites differ so much from living Arthropods that it
was difficult to determine even whether they belonged to the
Crustacea or the Arachnida, yet one of the earliest writers, Dr.
Cromwell Mortimer, Secretary of the Royal Society (1753),
recognised their resemblance to Apus (see pp. 19–36). This view of
their affinities was adopted by Linnaeus, and has been supported by
many later writers. Another early author, Emanuel Mendez da Costa,
thought that the Trilobites were related to the Isopods, an opinion
which has been held by some few zoologists of more recent times.
The Trilobites form the only known Order of the Crustacea which
has no living representatives. They are found in the oldest known
fossiliferous deposits—the Lower Cambrian or Olenellus beds, where
they are represented by 19 genera belonging to the families
Agnostidae, Paradoxidae, Olenidae, and Conocephalidae. From the
variety of forms found and the state of development which they have
reached, it is evident that even at that remote period the group must
have been of considerable antiquity; but of its pre-Cambrian
ancestors nothing is yet known; consequently there is no direct
evidence of the origin of the group.
Trilobites form an important part of all the faunas of the Cambrian
system; they attain their greatest development in the Ordovician
period, after which they become less numerous; their decline is very
marked in the Devonian, in which nearly all the genera are but
survivals from the Silurian period; in the Carboniferous, evidence of
approaching extinction is seen in the small number of genera
represented, all of which belong to one family—the Proëtidae, in the
relatively few species in each genus and in the small size of the
individuals of those species. In Europe no representatives of the
group appear to have survived the Carboniferous period, but in
America one form has been recorded from deposits of Permian age.
Trilobites seem to have been exclusively marine, since they are
found only in association with the remains of marine animals. Their
range in depth was evidently considerable, for they occur in many
different kinds of sediment, and were apparently able to live
regardless of the nature of the sea-floor—whether muddy, sandy,
calcareous, or rocky. In some cases they occur in deposits containing
reef-building corals and other shallow water animals; in others they
are associated with organisms which lived at greater depths. The
group appears to have had a world-wide distribution, for the remains
of Trilobites are found in the Palaeozoic rocks of all countries. Their
range in size is considerable; for whilst a large proportion of the
species are about two or three inches in length, some, like Agnostus,
are only a quarter of an inch long, others are from ten to twenty
inches long, the largest forms including species of Paradoxides,
Asaphus, Megalaspis, Lichas, and Homalonotus.
The feature in a Trilobite which first attracts attention is the
marked division of the dorso-ventrally flattened body into a median
or axial part, and a lateral or pleural part on each side. It was this
character that led Walch, in 1771, to give the name by which the
group is now known. The axial part of the body contained the
alimentary canal, as is shown by the position of the mouth and anus,
as well as by casts in mud of the canal which are found in some
specimens. The trilobation of the body is quite distinct in the
majority of Trilobites, but in a few genera belonging to the Asaphidae
and Calymenidae (Fig. 136) it becomes more or less completely
obsolete.
In most cases the only part of the Trilobite which is preserved is
the exoskeleton which covered the dorsal surface of the body. That
skeleton consists largely of calcareous material, and shows in
sections a finely perforated structure. Generally it is arched above,
 but in some cases is only slightly
convex; in outline it is more or
less oval. Three regions can
always be distinguished in the
body of a Trilobite—the head, the
thorax, and the abdomen or
pygidium.
The carapace which covers the
head is known as the cephalic
shield (Fig. 137, A, 1), and is
commonly more or less
semicircular in outline, but varies
considerably in different genera.
Only in a few cases, as in some
species of Agnostus (Fig. 146), is
its length greater than its breadth.
The axial part of the cephalic
shield, called the “glabella” (Fig.
137, A, a), is usually more convex
than the lateral parts (“cheeks” or
“genae”), and is separated from
them by longitudinal or axial
furrows (b). The shape of the
glabella varies greatly; it may be
oblong, circular, semi-cylindrical,
pyriform, spherical, etc. Its
relative size likewise varies; thus
in Phacops cephalotes it expands
Fig. 136.—Homalonotus in front and forms the larger part
delphinocephalus, Green, × 1. Silurian.
(After Zittel.)
of the head, whilst in Arethusina
(Fig. 151, B) it is narrow and
short, being only about one-half
of the length of the head.
 Fig. 137.—Calymene tuberculata, Brünn. × 1. Silurian, Dudley. A,
Dorsal surface: 1, head; 2, thorax; 3, pygidium or abdomen. a,
Glabella; b, axial furrow; c, glabella-furrow; d, neck-furrow; e,
fixed cheek; f, free cheek; g, facial suture; h, eye; i, genal angle; k,
axis of thorax; l, pleura. B, Ventral surface of head (after
Barrande): a, hypostome; b, doublure; c, c′, facial sutures; d,
rostral suture; e, rostral plate. C, One segment of the thorax: a,
ring of axis; b, groove; c, articular portion; d, axial furrow; d-f,
pleura; d-e, internal part of pleura; e-f, external part of pleura; e,
fulcrum; g, groove. D, Coiled specimen: a, glabella; b, eye; c, facial
suture; d, pygidium; e, rostral suture; f, continuation of facial
suture.

The segmentation of the head is indicated by transverse furrows

on the glabella (Fig. 137, A, c, d). In some cases these furrows extend
quite across the glabella (Fig. 147), but commonly they are found on
the sides only and divide the glabella into lateral lobes. Only the
posterior or “neck-furrow” (Fig. 137, A, d) is continued on to the
cheeks, and the segment which it limits anteriorly on the glabella[180]
is known as the occipital or neck-ring. In front of the neck-furrow
there may be three other furrows, so that altogether five cephalic
segments are indicated by the furrows of the glabella. Commonly all
the furrows are distinct in the primitive types; but in the more
modified forms some, especially the anterior, become either reduced
in size or obsolete. The actual number of furrows present
consequently varies in different genera, and may even differ in
different species of the same genus. In a few genera all the furrows
are either indistinct or absent, as for example in Ellipsocephalus
(Fig. 150, B). In some cases four furrows are present in addition to
the neck-furrow; this is due to the division of the anterior lobe of the
glabella by fulcra which are developed for the attachment of muscles.
When the glabella reaches the front border of the head the two
cheeks are separated (Fig. 150, I); but in other cases they unite in
front of the glabella (Fig. 150, C). The outer posterior angle of the
cheeks or genae (“genal angle,” Fig. 137, A, i) may be rounded,
pointed, or produced into backwardly directed spines (Fig. 140). The
marginal part of the cephalic shield is often flattened or concave; this
border may be quite a narrow rim as in Calymene (Fig. 137, A), but
in some genera (e.g. Trinucleus, Fig. 140, B; Harpes, Fig. 150, A;
Asaphus) it attains a great development. Each cheek is usually
divided by a suture—the “facial suture” (Fig. 137, A, g)—into an inner
and an outer part; the former is the “fixed cheek” (e), and the latter
the “free cheek” (f). The course of the facial suture varies in different
genera: on the posterior part of the head it begins either at the
posterior margin (Fig. 150, C) or at the posterior part of the lateral
margin (Fig. 151, C, D); at first it is directed inwards, and then bends
forward, forming an angle. In front it may (a) end at the front margin
(Fig. 147), or (b) be united beneath the front margin by a rostral
suture (Fig. 137, B, d, D, e), or (c) unite with the other suture on the
dorsal surface in front of the glabella (Fig. 151, C). In the last case the
free cheeks also unite in front of the glabella.
The facial suture is one of the distinguishing features of the
Trilobites, and may have been of some use in ecdysis. In only a few
forms is it absent, as for example in Agnostus (Fig. 146) and
Microdiscus. In the former, however, Beecher states that a suture is
really present, but, unlike that of most other Trilobites, it is situated
at the margin of the cephalic shield, and consequently the free cheek,
if present, must be on the ventral surface. Lindström and Holm, after
a re-examination of well-preserved specimens, deny the existence of
a suture in Agnostus. By most authors Olenellus is said to be without
a suture, but Beecher maintains that although the fixed and free
cheeks have coalesced, yet a raised line passing from the eye-lobe to
the posterior margin marks the position of the suture; this view is
not accepted by Lindström.
The existence of a facial suture in Trinucleus has likewise been
disputed. But Emmerich, Salter, and M‘Coy[181] have maintained that
a suture is present in a normal position on the dorsal surface,
extending from the posterior margin just within the genal angle to
the eye (when present), and from thence bending forward and
ending on the front margin near the glabella. It must be admitted
that no indications of the suture are seen in the majority of
specimens, perhaps owing to the fact that most examples of
Trinucleus are in the form of internal casts; perhaps also to the more
or less complete coalescence of the fixed and free cheeks, since in no
specimen has the free cheek been found separated from the rest of
the head, as occurs not uncommonly in many other Trilobites. The
probability of the existence of a suture receives some support from
the fact that one is found in the allied genera Orometopus and
Ampyx (Fig. 140). Barrande and Oehlert deny its existence in
Trinucleus. There is, however, in that genus a suture running close to
the margin of the cephalic border,[182] and joining the genal angle so
as to cut off the genal spine. Lovén and Oehlert claim that this suture
represents the facial suture, but in an abnormal position; this view,
however, is not accepted by Beyrich. In this connection it should be
noted that in Acidaspis, whilst the majority of the species possess a
facial suture, there are two in which it has disappeared owing to the
fusion of the fixed and free cheeks. Such being the case, it seems not
improbable that the curved line passing backwards from the eye in
Harpes may mark the position of the suture; but it is stated that the
only suture present in that form runs at the margin of the cephalic
border, and is similar to that of Trinucleus. This matter will be
referred to again when discussing the nature of the eyes in
Trinucleus and Harpes.
The relative sizes of the fixed and free cheeks obviously depend on
the position of the facial suture; when this starts on the lateral
margin of the cephalic shield and passes forward to the outer part of
the front margin, the free cheek will be a narrow strip; when, on the
other hand, the suture starts from the posterior margin and runs
close to the glabella, the free cheek will be relatively large and the
fixed cheek narrow. The fixed cheek is small in Phacops, Cheirurus,
and Illaenus; relatively large in Remopleurides, Phillipsia, and
Stygina. It was suggested by M‘Coy[183] that the free cheek represents
the pleura of an anterior segment which has not become fused with
the other cephalic pleurae. The fixed cheek appears to be formed of
the coalesced pleurae of the other cephalic segments, but of those
pleurae the only indication seen in adult specimens is in the neck-
ring; in young specimens of Olenellus, however, the presence of
other pleurae is indicated by furrows on the cheeks in front of the
neck-furrow.
A pair of compound eyes are
present in the majority of
Trilobites. Each eye is situated on
the free cheek, at that part of its
inner margin where the facial
suture bends to form an angle
(Figs. 137, A, h, 138). The position
of the eye is consequently
determined by the position of the
facial suture; it may be near the
glabella or near the lateral margin
of the head, and either as far Fig. 138.—Phacops latifrons, Bronn, ×
1. Devonian. Showing large compound
forward as the first segment of eye. (After Zittel.)
the glabella or nearly as far back
as the neck-furrow. In many
Trilobites the eye is more or less conical, with its summit truncated
or rounded, but in some genera it is ovoid, or crescentic. In Aeglina
(Fig. 150, H) the eye is flattened and scarcely raised above the
general level of the cheek. The eye of a Trilobite is oriented so that its
longer axis is parallel or nearly parallel to the axis of the body (Fig.
150, G); but in one case (Encrinurus intercostatus) it is placed at
right angles to this axis. The size of the eye varies considerably; it is
largest in Aeglina, in which it covers nearly the whole of the free
cheek; it is small in Acidaspis and Encrinurus.
 Though the eye is always entirely on the free cheek, the adjoining
part of the fixed cheek is raised to form a buttress on which the eye
rests; this buttress, which is known as the “palpebral lobe,” is seen
clearly when the fixed cheek is removed. The eyes of Trilobites are
always sessile; for although in some species, such as Asaphus
cornigerus, A. kowalewskii, and Encrinurus punctatus, they are on
the summits of prominent stalks, yet those stalks are immovable.
Three types of compound eye have been recognised in
Trilobites[184]—holochroal, prismatic, and schizochroal.
 Fig. 139.—Eyes of Trilobites. (After Lindström.) A, B,
Sphaerophthalmus alatus, Ang. Upper Cambrian. Vertical and
horizontal sections, × 100. C, Asaphus fallax, Dalm. Horizontal
section, × 60. D, Nileus armadillo, Dalm. Vertical section, × 60, a,
prismatic lenses; b, cuticle; c, part of free cheek. E, Dalmanites
vulgaris, Salt. Part of eye, × 30. F, Dalmanites imbricatulus, Ang.
Vertical section of eye, with a part of the free cheek on the left, ×
60. G, H, Harpes vittatus, Barr. G, The two lenses of one eye, × 8;
H, vertical section of the same, × 60.

1. In the holochroal eye (Fig. 139, A, B) the lenses are globular or

biconvex and close together, so that the cornea is continuous over
the entire eye. Examples of this are seen in Bronteus and
Sphaerophthalmus.
2. In the prismatic type (Fig. 139, C, D) the lenses are prismatic
and plano-convex, and the entire surface of the eye is covered by a
smooth cuticle. The lenses are close together and usually hexagonal,
but occasionally rhombic or square. Near the margin of the eye the
lenses may become irregular, giving rise to a border in which the
prismatic structure is more or less indistinct. The prismatic type of
eye is found in the genera Asaphus, Nileus, Illaenus, etc.
3. The schizochroal eye occurs only in the family Phacopidae (Fig.
139, E, F). The lenses are biconvex and are separated by portions of
the cephalic shield, so that each lens appears to rest in a separate
socket, and the cornea is not continuous for the entire eye. The
lenses are circular in outline, but owing to the upward and inward
growth of the interstitial test they may appear, on the surface, to be
hexagonal. The diameter of a lens may be as much as 0·5 mm. The
crystalline cones have not been preserved. In specimens of Phacops
rana, in which the inner face of the lens is more convex than the
outer, J. M. Clarke[185] has obtained evidence of a posterior
spheroidal cavity in addition to the anterior corneal cavity. The
complete separation of the lenses in this type of eye has led to the
suggestion that the schizochroal eye is an aggregate rather than a
compound eye. But the difference between this and the holochroal
eye is probably less than appears at first sight if the statement made
by Clarke is confirmed, namely, that in young specimens of
Calymene senaria the lenses are relatively large and similar to those
of Phacops, whereas in the adult the eye is holochroal.
These three types of eye, according to Lindström, have appeared
successively in chronological order: the prismatic occurring first in
the Olenus beds (Upper Cambrian), the holochroal first in the
Ceratopyge Limestone (Uppermost Cambrian), and the schizochroal
first in the Ordovician. The number of lenses in the eye varies
greatly. For example, in Trimerocephalus volborthi there are 14
only, whilst in Remopleurides radians there are as many as 15,000.
Even in different species of the same genus there may be
considerable differences. Thus Bronteus brongniarti possesses 1000,
B. palifer 4000, lenses in each eye. The number increases from the
young up to the adult, but decreases in old age. The lenses are
usually arranged in alternating rows. In Trilobites with a conical eye
the outer segment of the cone bears the visual surface. It has been
stated that the eyes of Trilobites resemble those of Isopods,[186] but
close comparison is difficult to make, since in Trilobites no part of
the eye beneath the lenses is preserved. In some genera a threadlike
ridge, called the “eye-line,” passes from the glabella, generally from
the front segment, to the eye, where it often ends in the palpebral
lobe; this eye-line is found in nearly all genera which are confined to
the Cambrian period, and persists in a few of later date, as for
example in Triarthrus, Euloma, and some species of Calymene from
the Ordovician; in Arethusina and Acidaspis from the Silurian; and
in Harpes from the Devonian (Fig. 150, A).
In Harpes and in some species
of Trinucleus eyes are present,
but have been stated to be of a
different type. They are described
as simple eyes, and have been
compared with ocelli; they are
never found in Trilobites which
possess the compound eyes
described above. In Harpes (Fig.
150, A) the eye is near the middle
of the cheek, in the position
where compound eyes occur in
other genera; it appears to consist
of two or three granules or
Fig. 140.—Trinucleidae. A,
Orometopus elatifrons, Ang. × 5.
tubercles which are really lenses,
Restoration based on specimens from and is connected with the front of
the Upper Cambrian (Tremadoc) of the glabella by an eye-line. No
Shineton, Shropshire. B, Trinucleus facial suture can be seen,
bucklandi, Barr. Ordovician, Bohemia. consequently the whole of the
A complete but not fully-grown cheek is stated to be the fixed
individual showing eyes. Natural size.
cheek.[187] In Trinucleus (Fig. 140,
(After Barrande.) C, Ampyx rouaulti,
Barr. × 3. Ordovician, Bohemia. (After B) a single tubercle is found on
Barrande.) the middle of the cheek in the
young of some species, and is
sometimes connected with the
glabella by an eye-line; the latter disappears before the adult state is
reached, and in some species the tubercle also disappears, but in
others (such as T. seticornis, T. bucklandi) it persists in the adult
individuals.
 From the lateral position of these eyes they can hardly be
compared with the median simple eye of other Crustacea. In Harpes
it is more probable that, as suggested by J. M. Clarke, they are
schizochroal eyes imperfectly developed. Their structure (Fig. 139, G,
H) is somewhat similar to that of schizochroal eyes, and moreover, in
one species, H. macrocephalus,[188] there are, in addition to the three
main tubercles, other smaller tubercles in regular rows. Further, the
eye-line occupies the same position as in other Trilobites which have
undoubted compound eyes. The absence of a facial suture cannot be
taken as evidence against these eyes being of the ordinary type, since
in some species of Acidaspis (e.g. A. verneuili, A. vesiculosa) which
possess compound eyes there is, in consequence of the coalescence of
the fixed and free cheeks, no suture.
In some species of Trinucleus (Fig. 140, B) the simple eye is found
in the same position as the eye in Harpes, and if, as some writers
have maintained, there is evidence of the existence of a suture in that
genus, then there is no reason for regarding the eye as other than a
degenerate form of compound eye. The probability of its being such
is supported by the existence of a compound eye in a similar position
in the allied form Orometopus (Fig. 140, A) which possesses a facial
suture.
In some species of Trinucleus (Fig. 140, B) and Ampyx there is a
small median tubercle on the front part of the glabella, which from
its position may be a simple unpaired eye, but its structure appears
to be unknown.
Some Trilobites possess no eyes. Well-known examples of such are
Agnostus, Microdiscus, Ampyx, Conocoryphe, and some species of
Illaenus and Trinucleus; such blind Trilobites are almost confined to
the Cambrian and Ordovician periods. All the forms of later periods,
with the exception of a species of Ampyx, and possibly one or two
other species, possess eyes. In addition to those undoubtedly blind
forms Lindström considers that most of the Olenidae and
Paradoxidae were without eyes. Many of the members of these
families possess a lobe closely resembling a palpebral lobe, and a
corresponding excavation in the free cheek; such forms have been
generally regarded as possessing eyes; and the absence of any
indication of lenses in those cases, on which Lindström lays stress,
has been explained by the comparatively imperfect preservation of
these early Trilobites. The development of the supposed eye-lobe in
some of the Paradoxidae and Olenidae differs from that of the eyes in
other families of Trilobites. In the latter the eye appears first at the
margin of the head and always in connexion with the facial suture.
But in Olenellus, in which there is said to be no facial suture,
development shows that the crescentic eye-like lobe (Fig. 145, E) is
really of the nature of a pleura coming off from the base of the first
segment of the glabella. In Paradoxides, which resembles Olenellus
in many respects, a facial suture is present and forms the outer
boundary of the eye-like lobe, but it is developed subsequently to the
appearance of the latter, which seems to be similar to that of
Olenellus. In some genera of the Olenidae the eye-line, which comes
off from the first segment of the glabella, ends in some cases in a
swelling or knob which has hitherto been regarded as a palpebral
lobe, but according to Lindström’s view no trace of an eye has been
found in connexion with that lobe, nor is there any space between the
lobe and the free cheek in which the eye could have occurred. If this
view is correct it follows that the majority of the Cambrian Trilobites
were blind. The earliest genus with eyes would then be Eurycare
found in the Olenus beds of the Upper Cambrian. Sphaerophthalmus
and Ctenopyge, found in the higher beds of the Cambrian, also
possessed eyes, but Olenus and Parabolina were probably blind.
On the ventral surface of the head there is a flat rim around the
margin (Fig. 137, B, b); this rim or “doublure” is the reflexed border
of the cephalic shield. In many Trilobites its median part in front is
cut off by sutures so as to form a separate plate (e); such is the case
when the two facial sutures (c, c′) cut the anterior margin of the
cephalic shield and are continued across the doublure, where they
are joined by a transverse or rostral suture (d) just below the margin.
When, however, as in Phacops and Remopleurides, the two facial
sutures unite on the dorsal surface, in front of the glabella, the
median part of the doublure is not separated from the lateral parts,
or from the dorsal part of the cephalic shield.
 Fig. 141.—A, Hypostome of Bronteus polyactin, Ang. showing
maculae, × 4. B, Left macula of Bronteus irradians, Lindst. × 12.
(After Lindström.)

The “labrum” or “hypostome” is attached to the doublure in front

(Fig. 137, B, a); it is commonly an oval or shield-shaped plate, but is
occasionally nearly square. Its surface is sometimes divided into two
or three areas by shallow transverse grooves (Fig. 141, A), Just
behind the middle of the hypostome, or when transverse grooves are
present either in or near the anterior groove, there are often found a
pair of small patches or “maculae” which are more or less oval or
elliptical in outline (Fig. 141). The maculae may be (1) surrounded by
a raised border, or (2) in the form of pits, or (3) raised like tubercles.
In some cases the entire surface of a macula is smooth and glossy; in
others either the whole or a part is covered with granules, and in the
latter case the granules may be limited to the internal third (Fig. 141,
B) or to the central portion. Sections of a macula show that the
granules are really globular lenses similar to those of the compound
eyes on the dorsal surface of the head. Some of the maculae which
are without lenses show no structure, but in others there is a spongy
or irregularly polyhedric structure with prisms, resembling the
marginal zone of the prismatic eyes of some genera. There seems no
doubt that the maculae with lenses are visual organs, and those
without are degenerate eyes. They occur in some genera which,
according to Lindström, are without eyes on the dorsal surface.
Maculae do not appear to be present in other Crustacea, but they
have been compared with a median organ, found just in front of the
hypostome in Branchipus.[189] Maculae, have so far been found in 136