TEAM PHYSICIAN

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TEAM PHYSICIAN

• Daniel Henley, M.D.
• Family Sports Medicine

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AIM HIGH - FINISH LECTURE
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THE TEAM PHYSICIAN

• History of Sports Medicine
• Role of the Team Physician
• Primary Prevention Strategies
• Fieldside Management
• Specific Injuries
• Sport Specific Injuries

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HISTORY OF SPORTS MEDICINE
Sports Medicine History - 444 BC (Herodicus)
balance in exercise and diet, massage Organization
History -1928 Winter Olympics/St. Moritz,
International Congress of Sports Medicine -1954
American College of Sports Medicine AMA
Committee on Sports Injuries -Committees on
Sports Medicine American Academy of Family
Practice
Orthopedics Pediatrics -1993
Certification Of Added Qualification in Sports
Medicine IM, FP, Peds ER -Fellowships in
Sports Medicine for Ortho Primary Care
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ROLE OF TEAM PHYSICIAN
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Responsibilities to Athletes and their Families

• Protect them from injury and illness
• Allow them to participate
• Communication
• Confidentiality

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Responsibilities to Coach, Staff and School

• Education
• Be available acquainted with staff
• Facilitate rapport
• Balance needs and finances
• Protect from liability
• Formal agreement

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Team Physician Benefits

• Personal Gratification
• Credibility - building practices confidence
• Sports Medicine experience

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Sports Medicine Team
THE TEAM DOCTOR HAS ULTIMATE AUTHORITY FOR ALL
DECISIONS REGARDING RETURN TO PLAY
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PRIMARY PREVENTION

• Preparticipation Exam
• Hazardous Conditions
• Hydration
• Nutrition
• Illness

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Preparticipation Exam

• Qualify the Athlete
• Meet legal and insurance requirements
• Determine and counsel on general health

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Hazardous Conditions

• Heat Humidity
• Cold
• Winds Storms
• Air Pollution
• Lightning
• Playing Surface
• Padding Equipment

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Prevention Strategies

• HYDRATION
• NUTRITION
• ILLNESS

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FIELDSIDE MANAGEMENT

• PREPARATION
• ON FIELD MANAGEMENT
• RAPID AND EFFICIENT DIAGNOSIS
• RETURN TO PLAY

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Fieldside Preparation

• Locker Room Practice Field
• Logistics

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On Field Management

• Informed consent
• On site coverage for high risk sports
• Stay in background - but on sidelines
• Trainer or coach first to assess injuries
• Stay alert to action - mechanism of injury

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Assessment of Injury of Illness

• Efficiently assess extent of injury
• Movement to sideline
• ASSES
• Reassess

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Return To Play

• Worsening Injuries?
• Predisposed to other Injuries?
• If in doubt - Keep Out!
• If minor - Return immediately
• Confidence of Coach

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SPECIFIC INJURIES

• Cervical Spine
• Concussion

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Cervical Spine Injuries

• Decrease since spearing prohibited - 1976
• Unconscious player C-spine injury
• Symptoms - neck pain, numbness /or weakness
• Cord contusion when neck flexed is most common
  C-spine injury
• Management - Leave Helmet On

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Concussion

• Very Common - about 20 of HS football players
• Immediate transient impairment of neural
  function
• Unable to differentiate physiologic changes
  only from structural changes
• Second Impact Syndrome
• Standardized Assessment of Concussion

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SPECIFIC SPORTS

• FOOTBALL
• BASKETBALL
• SOCCER
• BASEBALL
• HOCKEY
• SKIING
• BICYCLING

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FOOTBALL

• Most popular collision sport
• HS injury surveys - sprains, knees, running backs
• Artificial Turf
• NOCSAE
• Youth Football
• Knee Bracing

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BASKETBALL

• Collision sport without gear - few serious
  injuries
• Hand Wrist Injuries
• Lower Extremity
• Conditioning and Flexibility important
  in prevention

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SOCCER

• Worlds most popular team sport, over 1.4 million
  in US youth soccer
• Injuries uncommon under 12, girls gt boys
• Lower extremity,
  contusions, sprains
• Heading

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BASEBALL AND SOFTBALL

• Softball largest team sport in the country
• 52 under twelve years old
• Limited contact sport
• Shoulder most common injury in adults
• Prevention proper conditioning

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HOCKEY

• Harder hitting 100 mph puck
• Injuries
• Locations
• Causes

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DOWNHILL SKIING

• 100,000 Skiers growing
• Increased injuries at end of day
  beginners
• Type and Severity
• Equipment

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BICYCLING

• Recent rapid increase in popularity
  -motor vehicle involvement
• Traumatic Injuries
  -road rash most common
  -head injuries most fatal

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THE TEAM PHYSICIAN

• History of Sports Medicine
• Role of the Team Physician
• Primary Prevention Strategies
• Fieldside Management
• Specific Injuries
• Sport Specific Injuries