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Chapter 2
THE ATHLETIC HEALTH CARE TEAM
Effective delivery of health care to sports participants is best achieved through a team
approach. A Team includes a BOC Certified Athletic Trainer, a medical physician director, and
EMS personnel who then work in concert with additional personnel such as school nurses, medical
specialists, dentists, counselors, and others. This group comprises the athletic health care team
(AHCT) and it coordinates on-site with coaches, administrators, athletes and parents to plan all
aspects of a comprehensive medical care plan for a particular setting, typically a secondary school
setting. The critical functions of the AHCT were recently outlined in detail in a publication in the
Journal of Athletic Training and were based on the findings of a task force that identified and
defined the components necessary to effectively provide medical care in the secondary school
setting.
The athletic trainer can be on-campus daily and make decisions regarding injury severity,
medical referral, and return to play. This individual can serve as the “point person” in coordinating
the day to day operation and directives of the athletic health care team. When an athletic trainer is
unavailable, coaches who are trained in first aid and CPR should offer basic first aid and lifesupport services.
The physician, athletic trainer, and coaching staff should coordinate efforts regarding injury
prevention. The team should also be involved in pre-participation health screening; development
and implementation of an emergency plan; medical supervision; injury recognition, treatment, and
rehabilitation; record keeping; and education programs.
I. Sports Medicine.
A. Sports medicine is defined as “a field that uses a holistic, comprehensive, and
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multidisciplinary approach to health care for those engaged in sporting or recreational
activity.”
1. Sports medicine practitioners include primary care physicians, orthopedic
surgeons, athletic trainers, sports physical therapists, dentists, exercise physiologists,
conditioning coaches, and sports nutritionists.
B. Sports medicine services for professional athletes typically include conducting preseason
physical exams; proper skill instruction; conditioning programs; nutrition education and
dietary counseling; preventive taping, strapping, and bracing; and acute injury care, referral,
and rehabilitation.
1. Interscholastic athletes typically have fewer services available, but usually include
preseason physical evaluation/examination. A growing number of schools employ a
BOC-certified athletic trainer. The NATA publishes Appropriate Medical Care for
Secondary School– Aged Athletes that outlines essential components and members of
the team.
C. In the past, an orthopedic surgeon provided health care for professional and college
athletes. Current trends indicate that more “primary care” physicians will become providers
of sports care medicine. Physicians can receive specialized training by entering sports
medicine fellowships that last 1 to 2 years and can lead to the credential, Certificate of
Added Qualifications in Sports Medicine (CAQ).
II. Key Members of the Team. The coach, team physician, and BOC-certified athletic trainer are
essential members of the team.
A. Coaches in public school settings should receive training in basic conditioning
procedures, maintenance and fitting of protective equipment, first aid and CPR, operation of
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an automatic external defibrillator, recognition and management of common sports injuries,
and skills instruction for athletes. This is especially critical in contact/collision sports that
are inherently more dangerous and can be made even more so by athletes performing skills
incorrectly.
B. Team physicians are medical doctors who agree to provide at least limited medical care
to a particular sports program or institution. The duties of the team physician are listed on
page 26 under “Medical Management of the Athlete” and “Administrative and Logistic
Duties.” Physicians may be willing to volunteer as team physicians.
C. A BOC-certified athletic trainer is an allied health care professional who completes a
bachelor’s or master’s degree with extensive academic and clinical training in care and
prevention of sports injuries.
1. Athletic trainers provide services in the following areas: prevention; clinical
evaluation and diagnosis; immediate care; treatment, rehabilitation and
reconditioning; organization and administration; and professional development and
responsibility.
D. In the United States, the NATA is the professional membership organization for the
profession of athletic training. BOC certification is granted upon qualifying for and
successfully completing the certification examination that is now offered via a national
network of computerized testing centers.
1. To qualify, one must complete an educational program that is accredited by the
Commission on Accreditation of Athletic Training Education (CAATE). A list of
core-subject matter areas in CAATE-accredited curriculums is shown on page 27.
III. Requirements for Application for the BOC Certification Examination. When they apply to take
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the certification exam, students must meet the criteria listed on page 27. To remain certified, an
athletic trainer is required to earn continuing education credits and report these to BOC every 3
years.
IV. Professional Settings for the Practice of Athletic Training. With the growth of the field of sports
medicine in the 1980s, there was a parallel growth in a new type of medical clinic within the U.S.,
known as a sports medicine clinic, these practices were typically staffed with an orthopaedic
surgeon and allied health personnel including athletic trainers and physical therapists. Their patient
population consisted of high school, college and recreational athletes. Services included outpatient
physical therapy, fitness evaluation and exercise prescription, lifestyle counseling, evaluation and
treatment of injuries, and even sports medicine research. Growth in the number of these clinics was
characterized as explosive through the 1980s and many athletic trainers found employment in this
setting.
A. In addition to clinics, many hospitals provide sports medicine health care as part of
outpatient services. A few corporations also provide on-site health and fitness programs that
offer professional opportunities for athletic trainers. Professional sports teams also provide
jobs for athletic trainers.
B. The Secondary School Setting. To reduce costs, schools can hire teachers who are also
certified athletic trainers. A recent study found that the national average annual salary for
high school athletic trainers was approximately $47,822.
1. A certified athletic trainer on staff can reduce the school’s legal vulnerability for
claims relating to sports injuries. Additionally, the trainer can teach classes such as
basic injury care, first aid and CPR, nutrition, and physical conditioning.
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C. Locating a BOC Certified Athletic Trainer. NATA has a placement service for certified
athletic trainers. Another option for locating qualified persons is to contact universities that
offer CAATE-approved curriculums in athletic training for information about recent
graduates from the programs.
REVIEW QUESTIONS
1. Define the term sports medicine.
2. What is the CAQ and how does it relate to the team physician?
3. List the specific services that should be provided to the athlete by the team physician.
4. What are the six practice domains that comprise the role of the BOC-certified athletic trainer?
5. List several professional medical organizations that promote the study of sports medicine.
6. What has been the largest employment market for athletic trainers in recent years?
7. Briefly describe seven different employment options for a BOC-certified athletic trainer in the
school setting. Elaborate on the advantages and disadvantages of each option.
8. True or False: It is generally acknowledged that sports medicine service in the future will be
provided by medical specialists rather than primary care physicians.
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9. List the 10 specific subject areas in the basic and applied sciences that are required by the
CAATE for accredited curriculums in athletic training.
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