Roles of allied team in sports rehabilitation

• Definition
Team physicians have the leadership role in
the organization, management and provision
of care of athletes in individual, team and
mass participation sporting events.
 Roles of medical doctor
• The goal of this is to outline the duties of the
team physician to best serve athletes. To
accomplish this goal, the team physician should
possess, be responsible for and/or understand:
• Medical qualifications and education
• Medical and administrative duties and
responsibilities
• Ethical issues
• Medico legal issues
• The team physician must have an unrestricted
medical license and be a Medical Doctor (MD) or
Doctor of Osteopathy (DO).
• He/she has the leadership role in the organization,
management and provision of medical care for
individual, team and mass participation sporting
events.
• The most important responsibility of the team
physician is the medical care of athletes at all ages
and all levels of participation.
• The team physician should possess special
proficiency in the prevention and care of
musculoskeletal injuries and medical
conditions encountered in sports.
 Qualifications and Education
• Is an MD or DO in good standing, with an unrestricted
license to practice medicine.
• Possesses a fundamental knowledge of on-field
medical emergency care (e.g., concussion, cardiac
emergencies, spinal injuries and heat-related illnesses)
• Is trained in basic cardiopulmonary resuscitation (CPR)
and automated external defibrillator (AED) use.
• Has a working knowledge of musculoskeletal injuries,
medical conditions and psychological issues affecting
the athlete
• Medical specialty board certification
• Fellowship training in sports medicine
• A significant portion of clinical practice
focused on sports medicine.
• Continuing medical education in sports
medicine.
• Membership and participation in a sports
medicine professional association or society
• Involvement in teaching, research and
publications related to sports medicine
• Training in advanced cardiac and trauma life
support .
• Knowledge of medicolegal, disability, and
workers’ compensation issues.
• Media training including communication skills
and knowledge of social media
 Duties of team physician
• Establishes a chain of command for injury and illness
management
• Coordinates the assessment and management of
game-day injuries and medical problems.
• Understands medical management and prevention of
injury and illness in athletes
• Recognizes other issues that affect athletic
performance, including strength and conditioning,
nutrition, ergogenic aids, substance abuse and
psychological response to injury.
• Recognizes unique issues in females, master
athletes, adolescent athletes, and other
defined athletic populations.
• Integrates medical expertise with the athletic
care network.
• Provides for documentation and medical
record keeping.
 Ethical Issues
• Confidentiality: Respecting the rights of
patients and safeguarding confidences within
the constraints of the law. The confidentiality
relationship with athletes may need to be
clarified in advance.
• Examples include: Drug testing results.
• Informed consent: The content of information
and the process of supplying information in
order for the athlete and/or parent/guardian
to make an informed decision.
• Examples include: Discussion of all reasonable
treatment options, including short- and long-
term risks and benefits
 Medico legal Issues
• Compliance with school and governing body
guidelines, standards, policies, regulations and rules .
• Compliance with local, state, and/or federal rules,
regulations and laws.
• Compliance with privacy laws.
• Evaluation and management of significant on-field
injuries and illnesses (e.g., concussion, cervical spine,
cardiac, heat-related illness)
• Medical record documentation.
 Roles of coach
• Advisor - Advising athletes on the training to be
conducted and suitable kit and equipment.
• Assessor - Assessing athletes performance in
training and in competition.
• Counsellor - Resolving emotional problems on
the basis that sharing anxieties can be both
relieving and reassuring. Demonstrator -
Demonstrate to the athletes the skill you
require them to perform.
• Facilitator - Identify suitable competitions for them to
compete in to help them achieve their overall
objectives for the year.
• Fact finder - Gathering data of national and
international results and to keep abreast of current
training techniques.
• Fountain of knowledge - This may be part of the
advisor role in that you will often be asked questions on
any sporting event, events that were on the television,
diet, sports injuries and topics unrelated to their sport.
• Instructor - Instructing athletes in the skills of their
sport.
• Motivator - Maintain the motivation of all the athletes
the whole year round.
• Organizer and planner - Preparation of training plans
for each athlete and organise attendance at meetings
and coaching clinics.
• Role Model - A person who serves as a model in a
particular behavioral or social role for another person
to emulate.
 Coaching skills

• Organizing In organizing the training session you

need to plan in advance how you will manage the
athletes, equipment and area - group athletes
accordingly to numbers, ability and the activity -
continually check the plan is safe during the session.
• Safety in providing a safe environment for the
athletes you must assess the risk of the area,
equipment and athletes - continue to assess risk
throughout the session - keep athletes on the set
task and follow correct practice and progressions.
• Building Rapport In building rapport with the
athletes learn and use their names, smile and make
eye contact, coach the athlete rather than the sport,
show interest in and respect for the athletes.
• Instruction and explanation In providing Instruction
and Explanation you should think about and plan
what you are going to say, gain the athlete's
attention, ensure they can all hear you, keep it
simple and to the point and check they understand
by asking open questions.
• Demonstration In providing demonstration
make sure you are in a position where the
athletes can clearly see and hear you.
• Feedback In providing feedback encourage the
athlete to self analyze by asking appropriate
open questions, provide specific and simple
advice.
 Role of athletic trainer
There are six domains of athletic training:
• Prevention
• Clinical evaluation and diagnosis
• Immediate care
• Treatment, rehabilitation, and reconditioning
• Organization and administration
• Professional responsibilities
 Injury/Illness Prevention and Wellness
Protection
• Assess patients or clients to screen for potential
injuries/illnesses or risk
• factors that would increase their risk of injury/illness. These
screening procedures may include, but are not limited to:
• pre-participation physical exams
• musculoskeletal flexibility assessment
• muscular strength and endurance assessment
• cardiovascular fitness assessment
• postural and ergonomic assessment
• body composition assessment
 Clinical evaluation and diagnosis
• Obtaining a thorough medical history.
• Conducting a physical examination
• Arriving at a differential diagnosis.
• Recognizing the role of medications in the
management of orthopedic injuries and
medical illnesses.
• Identifying disordered eating and nutritional
disorders and intervene and refer accordingly
 Immediate and Emergency Care
• Perform an initial assessment of the patient or
client to determine his/her level of
consciousness and the severity of the
condition.
• Implement appropriate emergency injury and
illness management strategies following a pre-
established emergency action plan (e.g., CPR,
AED, splinting,use of spine board, control of
bleeding)
 Treatment and Rehabilitation
• Manual therapy (e.g., massage, joint mobilization,
proprioceptive techniques, muscle energy techniques)
• Techniques to restore joint range of motion and
muscle extensibility
• Exercises to improve strength, endurance, speed and
power.
• Proprioceptive activities to improve balance,
neuromuscular control and coordination
• Agility training.
• Exercises to improve cardiorespiratory fitness
• Sports specific and/or functional exercises
• Modalities
Thermal agents (e.g., hot pack, cold pack, etc.)
a) Electrical stimulation
b) Therapeutic ultrasound
c) Mechanical agents (e.g., traction)
d) Therapeutic laser
e) Biofeedback
 Role of physiotherapist
• conducting an assessment of the players',
athletes' or participants' readiness and advising
on exercises prior to an event or fixture.
• testing joints for ease and range of movement;
strapping, taping, offering massage and
preparing players, athletes or participants both
physically and mentally.
• providing emergency aid in a sport and exercise
environment.
• examining and assessing injuries and
determining whether the athlete or
participant can continue playing or taking
part.
• examining and assessing injuries and dealing
with traumas, e.g. cuts, bruises and blisters.
• treating injuries, alleviating pain, mobilising
injuries, giving various types of massage.
• rehabilitating injuries by using manual therapy
techniques, apparatus and electrotherapy.
• designing and monitoring rehabilitation
programmers appropriate to the injury and/or
sport and level.
• deciding whether athletes, players or
participants need extra treatments and
coordinating referrals to other practitioners.
• advising players or athletes on diet and nutrition
(when therapists are appropriately trained).
• working alone or with coaches, trainers and/or
fitness advisers to implement exercise,
conditioning, core stability and injury prevention
programmes, so that athletes, players or
participants reach and maintain peak performance.
• liaising with other health professionals in the sports
sector and in mainstream medicine.
 Sports Dietitian

• Number one goal of a sports dietitian or

nutritionist is to identify the best eating and
drinking strategies to meet an individual’s
schedule and training/competition needs.
• Ultimately the aim of the sports dietitian is
maximize performance.
• The achieve this, the main specific areas that a
dietitian can make a difference are the
following:
• General health and immunity
• Energy levels
• Concentration
• Growth and body composition
• Recovery
 Dietary analysis

• Nutrient adequacy; such as Carbohydrate, Fat,

Protein, Micronutrient levels; Ca, Fe, Zn, Vit C etc.
and Antioxidant density
• Pre- and post-training eating patterns
• Timing of carbs/protein intake related to training
stage
• Food variety checks
• Lookout for and deal with medical issues such as
diabetes, anemia, eating disorders, food allergies.
Weight management
• Strategies for skinfold reduction
• Psychology of eating
Bulking up
• Nutrition planning to meet requirements of
weights training program
• Supplements
Meal planning
• Recipe ideas
• Dietary periodization
Competition eating
• Preparation, such as Carbohydrate loading and
Hydration
• Single day vs multi day events
• Eating on the road, e.g. Local, Interstate and
Overseas travel
Hydration issues
• Daily fluid needs for body size
• Training hydration strategies
• Fluid types and effect on hydration status - Water, sports
drinks, coffee, tea, energy drinks, juice, milk
Anthropometry
• Weight and height (BMI)
• Waist Hip Ratio (WHR)
• Skinfold testing
• Girth measurements
 Other Services

• Implementation of Nutrition Systems

– Supplement provision
– Recovery Strategies
– Nutrition support for Team travel
• Produce education resources
• Nutrition research
• Group education sessions
• Hydration testing
 Exercise physiologist

• fitness testing of athletes and team members so

that an accurate physiological profile of the
individual can be obtained.
• developing specific fitness training programmes
and monitoring adherence to them.
• providing regular monitoring and reassessment
of an athlete's training plan.
• engaging with coaching staff to maximise the
effects of training.
• educating and advising athletes and coaches
on areas such as heart rate monitoring,
recovery techniques, hydration strategies,
overtraining, acclimatisation and periodisation
(the breaking down of a training programme
into a cycle of sub-programmes).
• providing benchmark physiological information
to enable long-term athletic development.
• working in collaboration with other sport and
exercise professionals such as physiotherapists,
dietitians, strength and conditioning coaches
and sport psychologists.
• using specialist resources and equipment such
as aqua pacers, osmometers and electronic
timing systems.
• producing reports and longitudinal studies.
• keeping up to date with ongoing research.
• raising awareness of health and fitness issues
and promoting the benefits of sport and
exercise.
• attending local, regional and national
meetings, seminars and conferences.
• teaching on academic courses.