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Injury Prevention

Prevention of injuries is a critical, but often overlooked, component of the clinical practice of sports medicine. Incorporating injury prevention initiatives into an individual athlete's or team's training regimens requires forethought, planning, and persistence to maximize prophylactic benefits. To maximize these benefits, prevention initiatives must be targeted at known intrinsic or extrinsic injury risk factors, and targeted at athletes who are most susceptible to incurring the…

Basics of Taping and Orthotics

Taping During physical activity, the integrity of a joint and its associated structures can be compromised, especially during high-risk activities that may introduce injurious mechanisms. Sports medicine clinicians can supplement mechanical support to a joint through a variety of taping techniques using elastic and nonelastic materials. Guidelines have been established that define taping procedures as standard interventions for domains such as “prevention” and “immediate care.” Taping…

Modalities and Manual Techniques in Sports Medicine Rehabilitation

Modalities and Manual Therapy Modalities, physical agents, and manual therapies (MTs) are commonly applied interventions for sports-related injuries and are designed to facilitate the rehabilitation process. These treatments are often associated with pain modulation techniques that can allow an earlier implementation of therapeutic exercise. Modalities such as ice and electrical stimulation can often reduce pain, and MT techniques similarly modulate the neuromuscular system so that the…

Principles of Orthopaedic Rehabilitation

The purpose of this chapter is to describe the principles of orthopaedic rehabilitation. Orthopaedic rehabilitation should balance the load on tissues to stimulate adaptation but not so much to disrupt the healing process. This chapter will describe how loading models can be applied to the rehabilitation process and contrast how this loading is understood to effect different tissues. This paradigm will then be used to identify…

The Athletic Trainer

The name athletic trainer (AT) implies that ATs coach and train athletes to improve baseline performance. This title and the euphemism “trainer” create ambiguity regarding the AT's knowledge, skills, and abilities. ATs are multiskilled health care clinical professionals who deliver services in cooperation with and under the direction of physicians to provide optimal patient care. The AT's education and scope of practice encompass the areas of…

Anesthesia and Perioperative Medicine

The term athlete, derived from the Greek word athlon meaning “prize” or “contest,” conjures images of a healthy, fit person. Although athletes possess physical speed, strength, and talents, they also have a repertoire of medical problems as well as a number of sports-related injuries leading them to the operating room. This chapter discusses common medical problems in the sports patient within the context of surgical and…

The Para-Athlete

Participation in sports and physical activity by persons with different abilities continues to grow within the general athlete population and within the adaptive sports community. Sports participation provides these athletes with benefits in terms of their general state of health, functionality, life skills, self-esteem, and overall quality of life. Given the increase in participation, performance, and injuries among the adaptive athlete, the American College of Sports…

The Female Athlete

The Growing Importance and Recognition of the Female Athlete Over the past several decades there has been a rapid development of competitive sporting events for women, and parallel to this, an emergence of increasing numbers of excellent competitive women athletes. Before the 1970s, few women participated in organized sport. However, the passage of Title IX of the Educational Assistance Act of 1972 required institutions receiving federal…

Doping and Ergogenic Aids

Sports Pharmacology: Ergogenic Drugs in Sport There is no room for second place. There is only one place in my game, and that's first place. Vince Lombardi In this day and age, it is common for athletes to be scrutinized for using prohibited performance-enhancing drugs and methods. Our society places a high value on winning and rewards athletes who perform well. As a result, competitors are…

Sports Nutrition

Proper nutrition is often an undervalued facet of athletic competition. However, in recent years sports nutrition has gained popularity and has secured recognition as a key piece of the training regimen. Within the past decade there has been a notable increase in sports nutrition original research publications. It is undoubtedly an emerging area of science and practice that continues to thrive and progress. Proper fueling techniques…

Psychological Adjustment to Athletic Injury

Participation in athletics involves physical risk that can result in limited ability or inability to continue sports play. Medical advances have led to the improved diagnosis of athletic injury and formulation of rehabilitative treatment plans. Psychological variables influence how individuals cope with physical injury; therefore understanding and effectively managing the psychological reaction to injury can enhance recovery from injury, facilitate return to play (RTP), and aid…

Facial, Eye, Nasal, and Dental Injuries

Despite advances in protective gear for the face, facial trauma remains a common injury treated by sports medicine physicians. The face is a rather “high rent” district with sole proprietorship of four out of five senses (vision, hearing, taste, and smell) and 10 out of 12 cranial nerves (all but the vagus and spinal accessory cranial nerves). In addition, the face plays a large role in…

Dermatologic Conditions

The skin and its appendages constitute a complicated and highly regulated organ known as the integumentary system. Its functions are diverse and include protecting the body from an array of external insults by means of physical and immunologic mechanisms, regulating temperature homeostasis, providing sensory receptors for interactions with the environment, preventing water loss, and initiating vitamin D synthesis. As such, optimal athletic performance relies on the…

Environmental Illness

Epidemiology Emergency department visits in the United States for exertional heat illness (EHI) increased 133% during the period 1997–2006. Cases of EHI consisted of heat exhaustion (72.7%), heat syncope (9.7%), heat cramps (5.4%), and heat stroke (1.8%). Patients younger than 19 years (47.6%) and males (71.9%) accounted for a disproportionate percentage of EHI cases. The highest incidence of exercise-related heat illness in the United States occurs…

Sports and Epilepsy

Epilepsy is a common clinical condition characterized by recurrent, unprovoked seizures. It affects approximately 1% of the general US population, with the highest incidence in infancy and childhood. Although previous recommendations precluded sports participation for persons with epilepsy, it is now recognized that exercise is part of a comprehensive treatment plan for epilepsy and that participation in sports and exercise should be encouraged. Terminology and Classification…

Renal Medicine and Genitourinary Trauma in the Athlete

Trauma to the genitourinary (GU) tract is relatively uncommon because of the anatomic location of key internal GU organs, the kidneys and bladder. However, prompt recognition of the signs and symptoms associated with GU trauma will allow the clinician to order appropriate imaging tests and implement therapeutic plans that can save organs and even a person's life. Definition (Classifications) Table 19.1 summarizes the classification of kidney…

The Athlete With Diabetes

Definition Diabetes mellitus is a disorder of glucose metabolism that affects millions of athletes of all types around the world. It is caused by either an absolute (type 1 diabetes) or relative (type 2 diabetes) deficiency in insulin, the principal hormone that regulates carbohydrate and fat metabolism. Diabetes mellitus is one of the most common chronic medical illnesses to be encountered by sports medicine specialists, coaches,…

Infectious Diseases in the Athlete

Athletic activities and the competitive sports environment present the athlete with unique exposures and risks for infectious diseases. Infectious diseases are responsible for up to 50% of visits in high school and college training rooms. Infections in athletes pose a significant public health concern because of a high frequency of close social and physical contact with teammates, coaches, support staff, and spectators, especially in organized sports…

Hematologic Medicine in the Athlete

Athletic performance depends on proper functioning of the blood. From problems with the oxygen-carrying function of red blood cells to the prevention of bleeding by the hemostatic system, many hematologic issues can affect athletes adversely. These hematologic issues include both acquired and inherited disorders that can affect athletes of all ages. This chapter reviews many of the hematologic issues that may arise in caring for athletes,…

Gastrointestinal Medicine in the Athlete

Gastrointestinal (GI) conditions in athletes and active individuals are common and are seen frequently by sports medicine care providers. Although there are many well-defined benefits that result from high-level physical activity, exercise places significant stress on the GI tract, which in turn may result in a number of characteristic GI disorders. Collectively, GI problems are perhaps the most common cause of underperformance in endurance sports and…