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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
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