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William E. Prentice
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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? basic care of sports injuries. The general philosophy
of the text is that adverse effects of physical activ-
The tenth edition of Essentials of Athletic ity arising from participation in sport should be pre-
Injury Management is written for those stu- vented to the greatest extent possible. However, the
dents interested in the fitness profession, ki- nature of participation in physical activity dictates
nesiology, coaching, or some aspect of sport that sooner or later injury may occur. In these situ-
science or physical education. The majority of ations, providing immediate and correct care can
students who take courses about the prevention minimize the seriousness of an injury.
and management of injuries that typically occur in Overall, this text is designed to take the begin-
an athletic population have little or no intention of ning student from general to specific concepts.
pursuing athletic training as a career. However, it is Each chapter focuses on promoting an understand-
also true that a large percentage of those students ing of the prevention and care of athletic injuries.
who are taking these courses are doing so because Essentials of Athletic Injury Management is di-
they intend to pursue careers in coaching, fitness, vided into four parts: Organizing and Establishing
physical education, or other areas related to exer- an Effective Athletic Health Care System,
cise and sports science. For these individuals, some Preventing Injuries in an Athletic Health Care
knowledge and understanding of the many aspects System, Techniques for Treating and Managing
of health care for both recreational and competitive Sport-Related Injuries, and Recognition and
athletes is essential for them to effectively perform Management of Specific Injuries and Conditions.
the associated responsibilities of their job. Part I, Organizing and Establishing an
Other students who are personally involved in Effective Athletic Health Care System, begins in
fitness, or training and conditioning, may be inter- Chapter 1 with a discussion of the roles and re-
ested in taking a course that will provide them with sponsibilities of all the individuals on the “sports
guidelines and recommendations for preventing in- medicine team” who in some way affect the deliv-
juries, recognizing injuries, and learning how to cor- ery of health care to the athlete. Chapter 2 provides
rectly manage a specific injury. Thus, Essentials of guidelines and recommendations for setting up a
Athletic Injury Management has been designed to system for providing athletic health care in situ-
provide basic information on a variety of topics, all ations where an athletic trainer is not available to
of which relate in one way or another to health care oversee that process. In today’s society, and in par-
for the athlete. ticular for anyone who is remotely involved with
Essentials of Athletic Injury Management was providing athletic heath care, the issue of legal re-
created from the foundations established by another sponsibility and, perhaps more importantly, legal
well-recognized textbook, Principles of Athletic liability is of utmost concern. Chapter 3 discusses
Training, currently in its fifteenth edition. Whereas ways to minimize the chances of litigation and also
Principles of Athletic Training serves as a major to make certain that both the athlete and anyone
text for professional athletic trainers and those indi- who is in any way involved in providing athletic
viduals interested in sports medicine, Essentials of health care are protected by appropriate insurance
Athletic Injury Management is written at a level coverage.
more appropriate for the coach, fitness profes- Part II, Preventing Injuries in an Athletic
sional, and physical educator. It provides guid- Health Care System, discusses a variety of top-
ance, suggestions, and recommendations for ics that both individually and collectively can re-
handling athletic health care situations when an duce the chances for injury to occur. Chapter 4
athletic trainer or physician is not available. 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
ORGANIZATION AND COVERAGE attention to sound nutritional practices and pro-
The tenth edition of Essentials of Athletic Injury viding sound advice on the use of dietary supple-
Management provides the reader with the most cur- ments. Chapter 6 provides guidelines for selecting
rent information on the subject of prevention and and using protective equipment. Chapter 7 looks at
xi
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ways to minimize the potentially negative threats Chapter 1
of various environmental conditions on the health
• Updated information on the roles and
of the athlete.
responsibilities of fitness professionals
Part III, Techniques for Treating and Managing
who may find themselves in positions that
Sport-Related Injuries, begins with Chapter 8,
require them to have some knowledge of
which details how to assess the severity of an in-
the athletic health care system.
jury and then provides specific steps that should
• Reorganized and updated the roles and
be taken to handle emergency situations. Chapter 9
responsibilities of athletic trainers accord-
provides guidelines that can help reduce the
ing to the latest role delineation study.
chances of spreading infectious diseases by taking
• Added new discussion for referring injured
universal precautions in dealing with bloodborne
individuals to the appropriate health care
pathogens. Chapter 10 discusses the more common
professionals.
wrapping and taping techniques that can be used to
• Reemphasized the role of the orthopedic
prevent new injuries from occurring and old ones
physician in caring for the injured athlete.
from becoming worse. Chapter 11 includes a brief
• Significantly updated the recommended ref-
discussion of the general techniques that may be
erences and the annotated bibliography to
used in rehabilitation following injury. Chapter 12
make them as current as possible.
discusses the psychology of preparing to compete
and proposes recommendations for how a coach Chapter 2
should manage an injury.
Part IV, Recognition and Management of • Updated information on hiring certified
Specific Injuries and Conditions, begins with athletic trainers in secondary schools.
Chapter 13, which defines and classifies the various • Added new discussion of the NATA consen-
types of injuries that are most commonly seen in the sus statement that discusses appropriate
physically active population. medical care for secondary school athletes.
Chapters 14 through 22 discuss injuries • Added new information on the 2013 Youth
that occur in specific regions of the body, in- Sports Safety Alliance’s Secondary School
cluding the foot; the ankle and lower leg; the Athletes’ Bill of Rights
knee; the hip, thigh, groin, and pelvis; the • Added new information on the Pubertal
shoulder; the elbow, forearm, wrist, and hand; Development Scale used to determine
the spine; the thorax and abdomen; and the head, pubertal growth and development.
face, eyes, ears, nose, and throat. Injuries are • Added new drawing of an ideal athletic
discussed individually in terms of their most com- health care facility.
mon causes, the signs of injury you would expect • Significantly updated the recommended ref-
to see, and a basic plan of care for that injury. erences and the annotated bibliography to
Chapter 23 provides guidelines and suggestions make them as current as possible.
for managing various illnesses and other health
Chapter 3
conditions that may affect athletes and their
ability to play and compete. Chapter 24 focuses • Added new information on the Affordable
specifically on issues related to substance Care Act.
abuse and the potential effects on the athlete. • Added a new Focus Box discussing key
Chapter 25 provides special considerations for features and benefits of the Affordable
injuries that may occur in young athletes. Care Act.
• Updated the recommended references to
NEW TO THIS EDITION
Chapter Changes and Additions Chapter 4
Numerous changes and clarifications have been • Updated information on and recommenda-
made in content throughout the entire text. tions for the warm-up.
xii Preface
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• Calisthenic exercises are now referred to Chapter 7
more correctly, as bodyweight exercises.
• Replaced the heat index chart with a new
• Added new photos that better illustrate the
chart that is much easier to read.
various exercises that may be done in a
• Updated information on psychrometers
training and conditioning program to help
used to monitor the heat index.
prevent injuries.
• Updated information on using sunscreens.
• Completely revised and updated informa-
• Replaced photo of a lightning detector with
tion on calculating a target heart rate for
the newest digital lightning detector.
improving cardiorespiratory endurance.
• Added the new American College of Sports
erences to make them as current as possible.
Medicine recommendation on training
intensities. Chapter 8
• Changed the term interval training
to the more appropriately used term • Added a new definition of an emergency.
high-intensity interval training. • Added a new Focus Box that provides a
• Significantly updated the recommended ref- sample emergency action plan.
erences and the annotated bibliography to • Reordered the life-threatening injuries in
make them as current as possible. the emergency procedures flowchart.
• Made slight adjustments in the CPR Sum-
Chapter 5 mary table to clarify the procedures.
• Replaced photos of football facemask
• Added a discussion on how the body’s me-
fasteners.
tabolism utilizes the various foodstuffs to
• Added a photo showing correct hand and
produce energy.
finger placement for taking blood pressure.
• Added new suggestions on foods that can
• Added a new photo and brief discussion of
provide energy during activity.
the head-squeeze technique for immobiliz-
• The Athletic Injury Management
ing the cervical spine.
Checklist focuses on a nutritious diet for
• Added the most current recommendations
the athlete.
from an inter-association task force to
• Added new information on binge eating as a
consider removing the helmet and shoulder
newly recognized eating disorder.
pads by trained personnel prior to trans-
porting an athlete with a suspected cervical
erences and the websites to make them as
spine injury.
current as possible.
• Significantly updated the recommended
Chapter 6 references and annotated bibliography to
• Replaced most of the photographs to
show examples of the newest available Chapter 9
equipment.
• Updated the new NOCSAE warning label • Replaced photos showing lacerations and
that must be placed on all football helmets. incision skin wounds.
• Added an update on the latest in helmet • Clarified recommendations for cleaning
technology that attempts to minimize the wounds and using an occlusive dressing.
impact forces transmitted to the athlete’s • Significantly updated the recommended
head. references and annotated bibliography to
• Added a discussion on the newest facemask make them as current as possible.
fasteners.
• Significantly updated the recommended Chapter 10
references to make them as current as • Added a discussion of kinesio taping and its
possible. efficacy as a treatment technique.
Preface xiii
pre22754_fm_i-xx.indd 13 21/09/15 5:09 PM

Chapter 11 • Clarified the information on the mechanism
of injury for a hip pointer.
• Added a discussion that clarifies the
purpose of this chapter and gives a caution
references and annotated bibliography to
about who is legally able to suggest or
supervise a program of rehabilitation for an
injured athlete.
Chapter 18
Chapter 13 • Updated photos showing acromioclavicular
• Significantly updated the recommended ref- joint sprains with labels to clarify the
erences to make them as current as possible. different grades of injury.
• Added a new drawing of biceps tenosynovi-
Chapter 14 tis that shows the location of the tendon and
the most common area of inflammation.
• Added a definition of a tailor’s bunion or
bunionette.
references and websites to make them as
current as possible.
Chapter 19
Chapter 15 • Added a new discussion of and new photos
• Added an updated photo of a new ankle for lateral and medial epicondylitis tests.
brace. • Briefly mentioned dinner fork deformity to
• Clarified the difference between Achilles refer to a Colles’ fracture.
tendinitis and Achilles tendinosis. • Added a new x-ray photo to clearly show an
• Significantly updated the recommended example of a forearm fracture of both the
references and annotated bibliography to radius and the ulna.
make them as current as possible. • Added a new drawing that shows the causes
of carpal tunnel syndrome in the wrist.
Chapter 16 • Significantly updated the recommended
• Added an in-depth discussion of shoe type
and its impact on preventing knee injuries
on different playing surfaces.
Chapter 20
• Added a new discussion of anterior and
posterior drawer tests and a new photo that • Added a new x-ray photo that more clearly
demonstrates those tests. depicts a spondylolisthesis.
• Added new information that clarifies the • Deleted reference to sleeping on a waterbed.
mechanisms of injury for both noncontact • Significantly updated the recommended
and contact ACL injuries. references and annotated bibliography to
• Added a new photo that more accurately make them as current as possible.
shows the combination of forces that col-
lectively cause ACL injury. Chapter 21
• Redefined patellofemoral pain syndrome. • Added a discussion of referred pain that often
• Significantly updated the recommended results from palpation of abdominal organs.
references and annotated bibliography to • Identified noncardiac causes of sudden
make them as current as possible. death syndrome in athletes.
• Clarified the distinction between a sports
Chapter 17 hernia, which should be more correctly
• Added in a new photo that will help explain identified as athletic pubalgia, and an
piriformis syndrome. inguinal or femoral hernia.
xiv Preface
pre22754_fm_i-xx.indd 14 21/09/15 5:09 PM

• Significantly updated the recommended Chapter 24
• Based on reviewer consensus, expanded the
discussion on abuse of recreational drugs
Chapter 22 including alcohol, abused illegal drugs, and
abused prescription drugs.
• Updated image of the brain with labels
• Updated the Focus Box on drugs banned by
more clearly showing the different regions
the NCAA and the USADA.
of the brain.
• Added a section that clarifies the relation-
references, annotated bibliography, and
ship between the terms mild traumatic
websites to make them as current as
brain injury and concussion.
possible.
• Added a new discussion of the most recent
definition of concussion and associated Chapter 25
symptoms and signs.
• Updated and added new information about • Updated Youth Sports Safety Alliance
evaluating concussions that currently uses statistics on injuries in youth sports.
the SCAT 3 as the most accepted evaluation • Updated recommendations for youth
tool. strength-training programs from the
• Added new guidelines for caring for con- American Academy of Pediatrics Council
cussions including the new state laws that on Sports Medicine and Fitness.
specify how concussions must be managed • Added information on the USOC Coaching
and return-to-play decisions. Education Department that supports the
• Added a new table, the Graded Symptoms national governing bodies of 40 sports.
Checklist, that identifies the possible symp- • Updated the table on sports injury
toms associated with concussion. prevention tips from the American
• Added a new Focus Box that details the Academy of Pediatrics.
procedures that should be followed on • Updated the Sports Parents Safety
the sidelines for a player with a suspected Checklist from Safe Kids Worldwide.
concussion. • Added a new table on the National Action
• Significantly updated the recommended Plan for Sports Safety from the Youth
references and annotated bibliography to Sport’s Safety Alliance.
make them as current as possible. • Significantly updated the recommended
references, annotated bibliography, and
Chapter 23 websites to make them as current as
possible.
• Added updated recommendations for
managing herpes simplex. Appendix A
• Added new photos showing how to
correctly use a metered-dose inhaler. • Updated the information on employment
• Replaced photos for several dermatologic of certified athletic trainers in secondary
conditions to better show exactly what schools.
these conditions look like.
• Updated treatment information for tinea
pedis (athlete’s foot). PEDAGOGICAL FEATURES
• Added a discussion of contraceptive • Chapter objectives. Objectives are
devices that are alternatives to birth- presented at the beginning of each chapter,
control pills. to reinforce learning goals.
• Significantly updated the recommended • Focus Boxes. Important information is
references and annotated bibliography to highlighted to provide additional content
make them as current as possible. that supplements the main text.
Preface xv
pre22754_fm_i-xx.indd 15 21/09/15 5:09 PM

• Margin information. Key concepts, selected INSTRUCTOR’S RESOURCE
definitions and pronunciation guides, help-
ful training tips, and illustrations are placed MATERIALS
in margins throughout the text for added Computerized Test Bank
emphasis and ease of reading and studying.
McGraw-Hill’s Computerized Testing is the most
• Illustrations and photographs. Every il-
flexible and easy-to-use electronic testing program
lustration and photograph throughout
available in higher education. The program allows
the book is in full color, with over 40 new
instructors to create tests from book-specific test
photographs that will help to enhance the
banks. It accommodates a wide range of question
visual learning experience for the student.
types, and instructors may add their own questions.
• Critical thinking exercises. Included in
Multiple versions of the test can be created. It is
every chapter, these brief case studies cor-
located in the Online Learning Center.
respond with the accompanying text and
help students apply the content just learned. PowerPoint Presentation
Solutions for each exercise are located at
A comprehensive PowerPoint presentation accom-
the end of the chapters.
panies this text, for use in classroom discussion. The
• Athletic Injury Management Checklists.
PowerPoint presentation may also be converted to
These checklists help organize the details
outlines and given to students as a handout. You
of a specific procedure when managing ath-
can easily download the PowerPoint presentation
letic health care.
from the McGraw-Hill website at www.mhhe.com
• Chapter summaries. Chapter content is
/prentice10e. Adopters of the text can obtain the log-
summarized and bulleted to reinforce key
in and password to access this presentation by con-
concepts and aid in test preparation.
tacting their local McGraw-Hill sales representative.
• Review questions and class activities. A list
of questions and suggested class activities
follows each chapter for review and appli- INTERNET RESOURCES
cation of the concepts learned. Online Learning Center
• Recommended references. All chapters have
a bibliography of pertinent references that www.mhhe.com/prentice10e This website offers
includes the most complete and up-to-date resources to students and instructors. It includes
resources available. downloadable ancillaries, web links, student quiz-
• Annotated bibliography. To further aid in learn- zes, additional information on topics of interest, and
ing, relevant and timely articles, books, and more. Resources for the instructor include:
topics from the current literature have been • Instructor’s Manual
annotated to provide additional resources. • Test Bank
• Websites. A list of useful websites is included • Downloadable PowerPoint presentations
to direct the student to additional relevant in- • Links to professional resources
formation that can be found on the Internet.
• Glossary. A comprehensive list of key Resources for the student include:
terms with their definitions is presented at • Review materials
the end of the text. • Interactive quizzes
• Appendixes. For those students interested
in learning more about athletic training,
Appendixes A and B provide information
MCGRAW-HILL CREATE™
about employment settings for the athletic Craft your teaching re-
trainer and the requirements for certifi- sources to match the way
cation as an athletic trainer. Appendix C you teach! With McGraw-
shows the directional anatomic motions of Hill Create, you can easily rearrange chapters,
the joints discussed in this text. combine material from other content sources, and
xvi Preface
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quickly upload content you have written such as As always he has provided invaluable guidance in
your course syllabus or teaching notes. Find the the preparation of the tenth edition of Essentials
content you need in Create by searching thousands of Athletic Injury Management and I cannot thank
of leading McGraw-Hill textbooks. Arrange your him enough for everything he does for me.
book to fit your teaching style. Create even allows I would also like to thank the following individu-
you to personalize your book’s appearance by se- als who served as reviewers for their input into the
lecting the cover and adding your name, school, revision of this text:
and course information. Order a Create book and
you’ll receive a complimentary print review copy in Johannah Elliott
3 to 5 business days or a complimentary electronic Arizona Western College–Yuma
review copy (eComp) via e-mail in minutes. Go to Matthew Hamilton
www.mcgrawhillcreate.com today, and register to D’Youville College
experience how McGraw-Hill Create empowers you Carie Mueller
to teach your students your way. San Jacinto College–South
Finally, I would like to thank my family, Tena, Brian,
ACKNOWLEDGMENTS and Zach, for always being an important part of
Special thanks are extended to Gary O’Brien, my everything I do.
Development Editor and most importantly my
“wing-man” on this and several additional projects. 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 Summary and comparison of heat disorders,

organizations 4 treatment and prevention 130
Clarifying roles 8 Recommendations for fluid replacement 133
Athletic injury management checklist 13 Recommendations for preventing heat
Looking to hire a certified athletic trainer? 18 illness 133
Secondary School Student Athletes’ Bill of Athletic injury management checklist 137
Rights 18 Sample emergency action plan 144
Rules and policies of the athletic health care Consent form for medical treatment of a
facility 19 minor 145
Suggestions for maintaining a sanitary CPR summary 147
environment 19 Vital signs 151
Cleaning responsibilities 20 Initial management of acute injuries 153
Recommended health practices checklist 20 Athletic injury management checklist 159
Orthopedic Screening Examination 24 Transmission of hepatitis B and C viruses and
Recommended basic health care facility human immunodeficiency virus 164
supplies 27 HIV risk reduction 165
Recommended basic field kit supplies 28 Bloodborne pathogen risk categories for sports 165
Athletic injury management checklist 30 Glove removal and use 167
Athletic injury management checklist 34 Suggested practices in wound care 170
Key Features and Benefits of the Affordable Care Care of skin wounds 171
Act 36 Athletic injury management checklist 171
Athletic injury management checklist 39 Taping supplies 180
Periodization training 45 Athletic injury management checklist 188
Principles of conditioning 46 Return to running following lower-extremity injury
Guidelines and precautions for stretching 50 functional progression 196
Techniques for improving muscular What are therapeutic modalities used for? 197
strength 60 Using ice versus heat? 198
Progressive resistance exercise terminology 62 Full return to activity 198
Comparison of aerobic versus anaerobic Athletic injury management checklist 199
activities 75 Progressive reactions of injured athletes
Rating of perceived exertion 79 based on severity of injury and length of
Athletic injury management checklist 80 rehabilitation 202
Vitamins 86 Nine factors to incorporate into goal setting for the
Major minerals 88 athlete 204
Most widely used herbs and purposes for use 93 Things a coach or fitness professional can do
Tips for selecting fast foods 97 to provide social support for an injured
Guidelines for weight loss 99 athlete 205
Recognizing the individual with disordered Athletic injury management checklist 208
eating 100 Muscles of the foot 228
Athletic injury management checklist 101 Caring for a torn blister 237
Equipment regulatory agencies 106 Managing the ingrown toenail 238
Guidelines for purchasing and reconditioning Muscles of the ankle joint 243
helmets 107 Technique for controlling swelling immediately
Proper football helmet fit 109 following injury 249
Rules for fitting football shoulder pads 115 Muscles of the knee joint 260
Shoe comparisons 119 Muscles of the thigh, hip, and groin 280
Athletic injury management checklist 124 Muscles of the shoulder complex 295
WBGT index and recommendations for fluid Muscles of the elbow 307
replacement and work/rest periods 129 Muscles of the forearm 313
xviii
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Muscles of the wrist, hand, and fingers 318 Sexually transmitted diseases 391
Muscles of the spine 329 Identifying an individual who may be using
Recommended postures and practices for performance-enhancing drugs 396
preventing low back pain 330 Examples of caffeine-containing products 396
Muscles of the abdomen and thorax 342 Examples of deleterious effects of anabolic
When an athlete shows any signs of a steroids 397
concussion 358 Banned drugs—common ground 400
The Graded Symptoms Checklist 359 Estimated number of young people ages 5–17
Common viral, bacterial, and fungal skin infections enrolled in specific categories of youth
found in athletes 375 sports 404
Preventing the spread of MRSA 377 Tanner stages of maturity 406
Basic care of athlete’s foot 378 Guidelines for Youth Strength Training 407
Symptoms and management of the acute Sports Safety Tips 411
asthmatic attack 381 Sports parents safety checklist 412
Using a metered-dose inhaler 382 National Action Plan for Sports Safety 412
Classifying blood pressure 386 Athletic injury management checklist 413
Some infectious viral diseases 387 Board of certification requirements for certification
Identifying a woman at risk for female as an athletic trainer 420
athletic triad 389
Applications at a Glance xix
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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. • Describe the role of the coach in injury
• Identify various sports medicine organizations. prevention, emergency care, and injury
• Contrast athletic health care in organized management.
versus recreational sports activities. • Identify the responsibilities of the athletic
• Discuss how fitness professionals, including trainer in dealing with the injured athlete.
personal fitness trainers and strength and • Describe the role of the team physician
conditioning coaches, relate to the sports and his or her interaction with the athletic
medicine team. trainer.
• Describe the role of an individual supervising • Explain how the sports medicine team should
a recreational program in athletic injury interact with the athlete.
management. • Identify other members of the sports medicine
• Analyze the role of the athletic administrator team and describe their roles.
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
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-
supervise and oversee these activities. Among those vented or at least minimized. Should injury occur, it
professionals are coaches, fitness professionals such is critical to be able to recognize that a problem ex-
as strength and conditioning specialists and per- ists, to learn how to correctly provide first-aid care,
sonal fitness trainers, recreation specialists, athletic and to then refer the athlete to the appropriate medi-
administrators, and others interested in some aspect cal or health care personnel for optimal treatment.
of exercise and sports science. However, it must be emphasized that these well-
Ironically, participation in any type of physi- trained professionals are NOT health care profes-
cal activity places the “athlete” in situations in sionals. In fact, attempting to provide health care to
which injury an injured or ill athlete is in most states illegal and
An athlete is an individual who is likely to likely violates the practice acts of several different
engages in and is proficient in
occur. Athletes professional health care provider groups licensed by
sports and/or physical exercise.
who engage in the state to give medical care to an injured athlete.
pre22754_ch01_001-015.indd 2 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
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FOCUS BOX 1–1
List of professional sports medicine organizations
• American Academy of Pediatrics, Council on • National Collegiate Athletic Association, Com-
Sports Medicine and Fitness, 141 Northwest petitive Safeguards and Medical Aspects of
Point BoulevardElk Grove Village, IL 60007- Sports Committee, 700 W. Washington St., P.O.
1098 www.aap.org Box 622, Indianapolis, IN 46206-6222 www
• American Board of Physical Therapy Specialists, .ncaa.org
American Physical Therapy Association, 1111 • National Federation of State High School Ath-
North Fairfax St., Alexandria, VA 22314 www letic Associations, 11724 Plaza Circle, P.O.
.abpts.org/Certification/Sports/ Box 20626, Kansas City, MO 64195 www
• American College of Sports Medicine, 401 W. .nfhs.org
Michigan St., Indianapolis, IN 46202-3233 • National Strength and Conditioning Association,
www.acsm.org P.O. Box 38909, Colorado Springs, CO 80937-
• American Orthopaedic Society for Sports Medi- 8909 www.nsca-lift.org
cine, Suite 202, 70 West Hubbard, Chicago, IL • American Osteopathic Academy of Sports Medi-
60610 www.sportsmed.org cine, 7600 Terrace Ave., Middleton, WI 53562
• National Athletic Trainers’ Association, 1620 www.aoasm.org
Valwood Parkway, Suite 115, Carrollton TX
75006 www.nata.org
refers to a situation that is generally competitive in recreational athletes is generally provided on a fee-
which there is some type of team or league involve- for-care basis.
ment, as would be the case with secondary school,
collegiate, and professional athletic teams. With or- THE PLAYERS ON THE SPORTS
ganized sports activities, the primary players on the
sports medicine team are employed on either a full-
MEDICINE TEAM
time or part-time basis by a school or organization Providing health care to the athlete requires a
and include the coach, the athletic trainer, and a group effort to be most effective.38 The sports medi-
physician who is designated as a “team” physician. cine team involves a number of individuals, each of
At the collegiate and professional levels, a strength whom must perform specific functions relative to
and conditioning coach, a sports nutritionist, a caring for the injured athlete.5,12
sports massage therapist, and a sport psychologist
are also usually involved. In organized sports ac- How Does the Fitness Professional Relate
tivities, the athletic health care system is generally to the Sports Medicine Team?
well organized and comprehensive, and in many in- Earlier in this chapter, the term fitness professional
stances the sports medicine coverage would be con- was used to refer collectively to strength and con-
sidered highly sophisticated. ditioning coaches, personal fitness trainers, and
Certainly a recreational sports activity can be others interested in exercise and sport sciences. In
competitive. However, a recreational activity is this group we may also include physical education
one that is done more for leisure and free time en- teachers, exercise physiologists, biomechanists,
joyment and involves a much less formal structure, sport psychologists, and sports nutritionists. If we
with many of the organizers being primarily vol- consider the “sports medicine umbrella” model, the
unteers. These include city- or community-based focus of this group is on improving performance.
recreational leagues and teams. Many individu- Certainly an argument can be made that if athletes
als choose to engage in fitness-oriented exercise achieve a high level of fitness through training and
activities such as running or weight training as a conditioning, they are not only more likely to per-
recreational activity. These “recreational athletes” form athletically at a higher level but they are also
may decide to hire personal fitness trainers to help less likely to sustain some type of activity-related
them with their fitness programs. Should injury injury. Therefore, there is a relationship between
occur, they are likely to consult their family physi- those areas that specialize in performance enhance-
cian, an athletic trainer, a sports chiropractor, or a ment and those that focus on health care in that
sports physical therapist. Athletic health care for both groups are concerned with injury prevention.
4 Part One ■ Organizing and Establishing an Effective Athletic Health Care System
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Strength and Conditioning Coaches The respon- or fitness pro- Fitness professionals include:
sibility for making certain that an athlete is fit for grams for an
• strength and conditioning coaches
competition depends on the personnel available to individual cli- • personal fitness trainers
oversee this aspect of an athletic program. At the ent based on • coaches
professional level and at most colleges and univer- that person’s • others associated with exercise and
sities, a full-time strength and conditioning coach is health history, sport sciences
employed to conduct both team and individual train- capabilities, and
ing sessions. Many, but not all, strength coaches are objectives for
certified by the National Strength and Conditioning fitness.18 Once thought of as a service for the rich and
Association (NSCA).24 This association has more famous, people from all income levels are using per-
than 30,000 members. It is the responsibility of sonal fitness trainers to increase their fitness levels
the strength and conditioning coach to commu- and to get advice about living a healthy lifestyle.13
nicate freely and work in close cooperation with There are around 300,000 personal trainers in
both the athletic trainers and the team coaches to North America, who offer their services to a va-
ensure that the athletes achieve an optimal level of riety of people and businesses. Although asso-
fitness.9 All strength and conditioning coaches ciations and certification agencies can count the
should be certified in CPR/AED (cardiopul- number of personal fitness trainers in their orga-
monary resuscitation/automated external de- nization, many personal fitness trainers have one
fibrillator) by the American Red Cross, the or more certifications and belong to more than one
American Heart Association, or the National professional organization, making it almost impos-
Safety Council. They should also be certified sible to accurately assess the number of certified
in first aid by the American Red Cross or the personal fitness trainers in the United States.
National Safety Council. Unfortunately, no single standard qualification
If an athlete is injured and is undergoing a re- is required before a person can practice as a per-
habilitation program, it should be the strength sonal fitness trainer.7 Washington D.C. is the only
and conditioning coach’s responsibility to com- jurisdiction in the United States where personal
municate with the athletic trainer as to how the fitness trainers must be registered. About 400 or-
conditioning program should be limited and/or ganizations in the United States offer certification
modified.22 The athletic trainer must respect the to personal fitness trainers. Of that number, only a
role of the strength and conditioning coach in get- few are considered legitimate by most profession-
ting the athlete fit. However, the responsibility for als. Among the most respected are the American
rehabilitating an injured athlete clearly belongs to College of Sports Medicine (ACSM), the National
the athletic trainer. The athletic trainer should be Academy of Sports Medicine (NASM), the National
allowed to critically review the training and condi- Strength and Conditioning Association (NSCA), and
tioning program designed by the strength and con- the American Council on Exercise (ACE).21 These
ditioning coach and to be very familiar with what organizations have specific requirements based on
is expected of the athletes on a daily basis. The tested and practical knowledge, mandatory retest-
athletic trainer should dictate what an injured ing at renewal periods, and continuing education.
athlete can or cannot do when engaging in a A recent trend by some of these organizations is to
strength and conditioning program.41 require that their certified personal fitness train-
In the majority of high school settings, a ers have a formal educational degree in exercise
strength and conditioning coach is not available. science or a related field.23 However, the require-
In this situation either the athletic trainer or team ments for other organizations are not so strict.
coach often assumes the role of a strength and con- Some award certification after a person takes a
ditioning coach in addition to his or her athletic correspondence course over the Internet or attends
training or coaching responsibilities. The athletic as little as a weekend or single-day training ses-
trainer or coach frequently finds it necessary not sion. Individuals who hire personal fitness trainers
only to design training and conditioning programs should check qualifications and certifications. All
but also to oversee the weight room and to educate personal fitness trainers should be certified
young, inexperienced athletes about getting them- in CPR/AED by the American Red Cross, the
selves fit to compete. The athletic trainer must American Heart Association, or the National
cooperate with team coaches in supervising the Safety Council. They should also be certified
training and conditioning program. in first aid by the American Red Cross or the
National Safety Council.
Personal Fitness Trainers A personal fitness trainer Personal fitness training is without question the
is responsible for designing comprehensive exercise strongest growth segment of the fitness industry, and
pre22754_ch01_001-015.indd 5 21/09/15 4:34 PM

this trend is expected to continue as personal fitness rehabilitation centers, or in long-term and residen-
trainers are beginning to offer a variety of services tial care facilities. Their job is to treat and reha-
that go beyond a general exercise program.18 Personal bilitate individuals with specific health conditions,
fitness trainers are increasingly providing services in usually in conjunction or collaboration with physi-
postrehabilitation training, sports conditioning, spe- cians, nurses, psychologists, social workers, and
cial medical needs, and weight management to a va- physical and occupational therapists. Recreational
riety of specific client populations including prenatal therapists use leisure activities—especially struc-
women, adolescents, and older persons. tured group programs—to improve and maintain
their clients’ general health and well-being. They
How Does a Recreation Specialist Relate to also provide interventions that help prevent the cli-
the Sports Medicine Team? ent from suffering further medical problems and
Recreation specialists organize, plan, and oversee complications related to illnesses and disabilities.
leisure activities and athletic programs in local rec-
reation, camp, and park areas; playgrounds; health The Role of the Athletic Administrator
clubs and fitness centers; the workplace; and theme in the Sports Medicine Team
parks and tourist attractions. An essential responsi- Without question, an athletic administrator, oversee-
bility for any individual overseeing a recreational ing both collegiate and secondary school athletic pro-
program is to ensure that the recreational environ- grams, has a significant role with the sports medicine
ment is as safe as possible to minimize the risk of team. The athletic administrator should have input in
injury. Should injury occur to a participant, the rec- hiring personnel who will make up the sports medi-
reation specialist should be able to provide immedi- cine team, including the coaches, the strength and
ate and correct first aid and then refer the injured conditioning coach, the athletic trainer, the team phy-
person to appropriate medical personnel. All rec- sician, a sports nutritionist, and a sport psychologist.
reation specialists should be certified in CPR/ It is essential for the athletic administrator to make
AED by the American Red Cross, the American certain that each individual hired has the appropri-
Heart Association, or the National Safety ate credentials and that he or she is willing and able
Council. They should also be certified in first to work in close cooperation with the other members
aid by the American Red Cross or the National
of the sports medicine team. The athletic administra-
Safety Council.
tor should make certain that policies and procedures,
Recreation and parks directors serve as advisors
a risk management plan, and emergency action plans
to local and state recreation and park commissions
are developed for the athletic health care system.
and manage comprehensive recreation programs in The administrator is also responsible for establish-
a variety of settings. They are responsible for devel-
ing a budget for funding all aspects of an athletic
oping budgets for recreation programs. Recreation
health care program, including salaries, supplies,
supervisors serve as liaisons between the director
and equipment, and purchasing necessary insurance
of the park or recreation center and the recreation
(see Chapter 2). The consistent support and commit-
leaders. They plan, organize, and manage recre- ment to an athletic health care program on the part of
ational activities to meet the needs of a variety of an athletic administrator can have a tremendous im-
populations and oversee recreation leaders. Rec- pact on the success of the athletic program.
reation supervisors with more specialized training
may also direct special activities or events or over-
The Role of a Coach in the Sports
see a major activity such as aquatics, gymnastics, or
performing arts. Recreation leaders are primarily Medicine Team
responsible for the daily operation of a recreation It is critical for the coach to understand the spe-
program. They organize and direct participants; cific roles and responsibilities of each individual
schedule use of facilities; lead and give instruction who could potentially be involved in the sports
in dance, drama, crafts, games, and sports; maintain medicine team. This becomes even more critical if
equipment; and ensure appropriate use of recreation there is no athletic trainer to oversee the health care
facilities. Activity specialists provide instruction and the coach is forced to assume this responsibil-
and coach groups in specialties such as swimming ity. It must be stressed that individual states differ
or tennis. Camp counselors lead and instruct camp- significantly in the laws that govern what nonmedi-
ers in outdoor-oriented forms of recreation, such as cal personnel can and cannot do when providing
swimming, hiking, horseback riding, and camping. health care. Coaches have the responsibility to
A recreational therapist may be considered a clearly understand the limits of their ability to
health care provider. Recreational therapists work function as a health care provider in the state
in acute health care settings, such as hospitals and where they are employed.
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All head and assistant coaches The coach experienced in coaching does not mean that he or
should be certified in CPR/AED is directly re- she knows proper skill techniques. Coaches must
and first aid. sponsible for engage in a continual process of education to
preventing inju- further their knowledge in their particular sport
ries by seeing that athletes have undergone a pre- through organizations such as the American Sport
ventive injury conditioning program. The coach Education Program (ASEP) or the National Council
must ensure that sports equipment, especially for Accreditation of Coaching Education (NCACE).
protective equipment, is of the highest quality and When a sports program or specific sport is without
is properly fitted. The coach must also make sure an athletic trainer, the coach very often takes over
that protective equipment is properly maintained.38 this role.
A coach must be keenly aware of what produces in- Coaches work closely with athletic trainers;
juries in his or her particular sport and what mea- therefore both must develop an awareness and an
sures must be taken to avoid them (Figure 1–2). insight into each other’s roles and responsibilities
A coach should be able, when called on to do so, so that they can function effectively. The athletic
to apply proper first aid. This knowledge is es- trainer must earn the respect of the coaches so
pecially important in serious head and spinal that his or her judgment in all medical matters is
injuries. All coaches (both head and assis- fully accepted.14 In turn, the athletic trainer must
tant) should be certified in CPR/AED by the avoid questioning the abilities of the coaches in
American Red Cross, the American Heart As- their particular fields and must restrict opinions
sociation, or the National Safety Council. to athletic training matters. To avoid frustration
Coaches should also be certified in first aid and hard feelings, the coach must coach, and the
by the American Red Cross or the National athletic trainer must conduct athletic training
Safety Council. 30 For the coach, obtaining these matters. In terms of the health and well- being of
certifications is important in being able to pro- the athlete, the physician and the athletic trainer
vide correct and appropriate first aid and emer- have the last word. The decisions made by the
gency care for the injured athlete. But it is also athletic trainer on matters related to health
true that not having these certifications can poten- care should always be supported by the athletic
tially have some negative legal implications for the administrators.
coach and his or her employer.
It is essential that a coach thoroughly under-
stand the skill techniques and environmental fac- The Roles and Responsibilities
tors that may adversely affect the athlete. Poor of the Athletic Trainer
biomechanics in skill areas such as throwing and It is essential for a coach or other fitness profes-
running can lead to overuse injuries of the arms sional who is working with an athletic trainer to
and legs, whereas overexposure to heat and hu- gain an appreciation of the roles and responsibili-
midity may cause death. Just because a coach is ties that an athletic trainer assumes in caring for the
athletes (Figure 1–3).6 If the coach does not have an
athletic trainer, many of those responsibilities may
fall on the coach.
FIGURE 1–3 Coaches should work closely with athletic

FIGURE 1–2 The coach is directly responsible for trainers and physicians to provide health care for the
preventing injuries in his or her sport. injured athlete.
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FOCUS BOX 1–2
Clarifying roles
The terms training and athletic training are often confused. These individuals hold the credential ATC. Certified athletic
Historically, training implies the act of coaching or teach- trainers play a major role in the health care of physically ac-
ing. In comparison, athletic training has traditionally been tive individuals in general and the athlete in particular.20,33
known as a field within the allied health care professions that Personal fitness trainers may also have some level of certi-
is concerned with prevention, management, evaluation, and fication from any one of at least 400 existing certifying or-
rehabilitation of injuries related to physical activity.42 ganizations. They are primarily concerned with developing
Recently, there has been confusion in the general pub- fitness and wellness and improving levels of physical condi-
lic among the terms trainers, certified athletic trainers, tioning in a healthy population. Strength and conditioning
personal fitness trainers, and strength and conditioning coaches (certified by the National Strength and Conditioning
coaches. A trainer refers to someone who trains dogs or Association) work primarily with athletes at the professional
horses. A certified athletic trainer (certified by the Board of or collegiate levels to enhance their levels of physical condi-
Certification) is a highly educated allied health care profes- tioning and optimize performance.
sional who is a credentialed specialist in athletic training.
Of all the professionals charged with injury pre- an individual to become certified as an athletic
vention and health care provision for the athlete, trainer.31 These requirements include a combina-
perhaps none tion of both academic coursework and clinical
Employment settings for is more in- experience in athletic training settings (see Ap-
athletic trainers: timately in- pendix B).3 Once these requirements for certifi-
• Schools volved with the cation have been met and the individual passes a
• School systems athlete than certification exam, that person earns the creden-
• Colleges and universities the athletic tial ATC. (In this text all references to athletic
• Professional teams trainer.38 The trainers imply that this individual has met the
• Clinics/hospitals athletic trainer requirements for certi-
• Corporations ATC Credential of an
is the one in- fication set forth by the individual who is certified
• NASCAR, NASA, military, etc.
dividual who Board of Certification.) as an athletic trainer.
• Performing arts
deals with the Focus Box 1–2 further clar-
athlete from ifies the differences between an athletic trainer and
the time of the a personal fitness trainer. The specific roles and re-
initial injury, throughout the period of rehabilitation, sponsibilities of the athletic trainer will differ and,
until the athlete’s complete, unrestricted return to to a certain extent, will be defined by the situation
practice or competition.38 The athletic trainer is most in which he or she works.17,32 Different states have
directly responsible for all phases of health care in an different requirements as to who can call them-
athletic environment, including preventing injuries selves an athletic trainer. It should be reempha-
from occurring, providing initial first aid and injury sized that athletic trainers working with athletes
management, evaluating and diagnosing injuries, and should be certified athletic trainers (ATC).
designing and supervising a timely and effective pro-
gram of rehabilitation that can facilitate the safe and Injury/Illness Prevention and Wellness Protection
expeditious return of the athlete to activity.31,32,40 Ath- A major responsibility of the athletic trainer is to ed-
letic trainers are employed by schools and school sys- ucate the athletes and manage risks by making the
tems, colleges and universities, professional athletic competitive environment as safe as possible to reduce
teams, sports medicine clinics, corporations in indus- the likelihood
try, and less “traditional” organizations such as the of injury. The
Roles and Responsibilities of the
performing arts, NASCAR, NASA, the military, medi- athletic trainer
Athletic Trainer
cal equipment sales/support, and the like19,29,44 (see is responsible
for organizing/ • Injury/illness prevention and
Appendix A).
wellness protection
The athletic trainer must be knowledgeable arranging phy-
• Clinical evaluation and diagnosis
and competent in a variety of sports medi- sical exami-
• Immediate and emergency care
cine specialties if he or she is to be effective nations and • Treatment and rehabilitation
in preventing and treating injuries to the preparticipa- • Organizational and professional
athlete.15,31 The Board of Certification has estab- tion screen- health and well-being
lished specific requirements that must be met for ings to identify
pre22754_ch01_001-015.indd 8 21/09/15 4:34 PM

conditions that predispose an athlete to injury (see trainer may work closely with physical therapists and/
Chapter 2), and educating parents, coaches, and ath- or strength and conditioning specialists in designing
letes about the risks inherent to sports participation. functional return to play activities.
Injury prevention includes (1) ensuring appropriate Athletic trainers should also recognize patients
training and conditioning of the athlete (see Chapter that may exhibit abnormal social, emotional, and
4); (2) monitoring environmental conditions to ensure mental behaviors. They should also be able to rec-
safe participation (see Chapter 7); (3) selecting, prop- ognize the role of mental health in injury and recov-
erly fitting, and maintaining protective equipment ery, and use intervention strategies to maximize
(see Chapter 6); (4) explaining the importance of the connection between mental health and restora-
proper nutrition (see Chapter 5) and having a healthy tion of participation. If the athletic trainer recog-
lifestyle; and (5) using medications appropriately. nizes that a problem exists, he or she should refer
the patient to the appropriate medical personnel for
Clinical Evaluation and Diagnosis The athletic intervention.28
trainer must be skilled in recognizing the nature
and extent of an injury through competency in Organizational and Professional Health and
injury evaluation. The athletic trainer must be able Well-Being The athletic trainer is responsible for
to efficiently and accurately evaluate an injury the organization and administration of the athletic
(see Chapter 8). The athletic trainer is responsible training program, including maintaining health and
for referring the injured athlete to appropriate medi- injury records for each athlete, developing emer-
cal care or support services. gency action plans, requisitioning and maintaining
an inventory of necessary supplies and equipment,
submitting insurance information to insurance com-
Immediate and Emergency Care Once the initial on- panies, supervising assistants, athletic training stu-
the-field assessment is done, the athletic trainer then
dents and establishing policies and procedures for
must assume responsibility for administering appropri-
day-to-day operation of the athletic training pro-
ate first aid to the injured athlete and for making cor-
gram (see Chapter 2).
rect decisions in the management of acute injury (see
The athletic trainer must educate the general
Chapter 8).8,36 Thus the athletic trainer must possess
public, in addition to a large segment of the vari-
sound skills not only in
ous allied medical health care professions, as to
the initial recognition
A basketball player exactly what athletic trainers are and what their
and evaluation of po-
suffers a grade 2 ankle roles and responsibilities are. This education is
tentially serious or life-
sprain during midseason perhaps best accomplished by holding profes-
threatening injuries but
of the competitive sional seminars, publishing research in scholarly
schedule. After a 3-week also in emergency care. journals, meeting with local and community orga-
course of rehabilitation, The athletic trainer nizations, and, most important, doing a good and
most of the athlete’s is required to be cer- professional job of providing health care to the in-
pain and swelling has tified in CPR/AED jured athlete.34
1–1 Critical Thinking Exercise
been eliminated. The and should be certi-

athlete is anxious to get fied in first aid by the
back into practice and American Red Cross Responsibilities of the Team Physician
competitive games as or the National Safety The team physician assumes a number of roles and
soon as possible, and responsibilities with regard to injury prevention and
Council.
subsequent injuries to
the health care of the athlete.1,2,4,27
other players have put Treatment and Reha-
pressure on the coach to bilitation An athletic Compiling Medical Histories The team physi-
force this player’s return.
trainer must be profi- cian should be responsible for compiling medical
Unfortunately, the athlete
is still unable to perform
cient in designing and histories and conducting physical examinations
functional tasks (cutting supervising rehabilita- for each athlete,
and jumping) essential in tion and reconditioning both of which Team physicians must
basketball. protocols that make can provide crit- have absolute authority in
use of appropriate re- ical information determining the health status
? Who is responsible
habilitative equipment, that may reduce of an athlete who wishes
for making the decision to participate in the sports
regarding when the
manual (hands on) the possibility
program.
athlete can fully return therapy techniques, or of injury. Pre-
37
to practice and game therapeutic modalities participation

situations? (see Chapter 12). In cer- screening by both the athletic trainer and physician
tain settings the athletic is important in establishing baseline information
pre22754_ch01_001-015.indd 9 21/09/15 4:34 PM

athlete, the coach, athletic trainer, and team phy-
sician would have nothing to do in sports. All de-
cisions made by the physician, coach, and athletic
trainer ultimately affect the athlete. It should
be clear that the physician working in coop-
eration with the athletic trainer assumes the
responsibility of making the final decisions
about medical care for the athlete from the
time of injury until full return to activity.11
The coach must defer and should always sup-
port the decisions of the medical staff in any
FIGURE 1–4 In treating the athlete, the physician matter regarding health care for the athlete.
supervises the athletic trainers. This is not to say, however, that the coach should
not be involved with the decision-making process.
to be used for comparison should injury occur dur- For example, during the time the athlete is reha-
ing the season. bilitating an injury, there may be drills or technical
instruction sessions that the athlete can participate
Diagnosing Injury The team physician should as- in that will not exacerbate the existing problem.
sume responsibility for diagnosing an injury and Thus the coach, the
should be keenly aware of the program of rehabilita- athletic trainer, and
?

tion as designed by the athletic trainer following the the team physician What are some things
diagnosis39 (Figure 1–4). The physician is ultimately should be able to ne- that a coach working
gotiate what the ath- in cooperation with an
responsible for deciding when an injured athlete
lete can and cannot athletic trainer can do
may return to full activity.26
do safely in the course to help minimize the
chances of injury?
Deciding on Disqualification The physician should of a practice.
determine when an athlete should be disqualified Athletes are fre-
from competition on medical grounds and must have quently caught in
the final say in when an injured athlete may return to the middle between
activity. The physician’s judgment must be based not coaches who tell them
only on medical knowledge but also on knowledge to do one thing and
of the psychophysiological demands of a particular medical staff who tell
sport.15 them something else.
Close communication between the coach and ath-
Attending Practices and Games Under the most letic trainer is essential so that everyone is on the
ideal circumstances, a team physician should make same page.
an effort to attend as many practices, scrimmages, Any personal relationship takes some time
and competitions as possible. This attendance obvi- to grow and develop. The relationship between
ously becomes very difficult at an institution with 20 the coach and the athletic trainer is no differ-
or more athletic teams.16 ent. The athletic trainer must demonstrate to the
It is essential that the team physician promote coach his or her capability to correctly manage
and maintain consistently high-quality care for an injury and guide the course of a rehabilita-
the athlete in all phases of the sports medicine tion program. It will take some time for the coach
program.10,25 The team physician may work closely to develop trust and confidence in the athletic
with the athletic trainer and must rely on their abil- trainer. The coach must understand that what the
ities as a health care provider.43 athletic trainer wants for the athlete is exactly the
same as what the coach wants—to get an athlete
The Relationship Between the Sports healthy and back to practice as quickly and safely
as possible.
Medicine Team and Athlete The injured athlete must always be informed
If a coach has an athletic trainer and/or a physi- and made aware of the why, how, and when fac-
cian who work together in providing health care, tors that collectively dictate the course of an in-
the relationships that exist can significantly affect jury rehabilitation program. Both the coach and
the success of that team or athletic program.35 The the athletic trainer should make it a priority to
major concern of everyone on the sports medicine educate student-athletes about injury prevention
team should always be the athlete. If not for the and management. Athletes should learn about
pre22754_ch01_001-015.indd 10 21/09/15 4:34 PM

techniques of training and conditioning that may A sports program may use a number of support
reduce the likelihood of injury. They should be health services. Those people may include a nurse;
well informed about their injuries and about listen- physicians in specialties such as orthopedics, den-
ing to what their bodies are telling them to prevent tistry, and podiatry; physician’s assistants; strength
reinjury. and conditioning coaches; nutritionists; sport psychol-
ogists; exercise physiologists; biomechanists; physical
The Importance of the Family in the Sports therapists; equipment personnel; and referees.
Medicine Team Nurse/Nurse Practitioner As a rule, the nurse is not
In a high school or junior high school setting, the usually responsible for the recognition of sports in-
coach, the athletic trainer, and the physician must juries. Education and background, however, render
also take the time to explain to and inform the par- the nurse quite
ents about injury management and prevention.3 capable in the Support personnel concerned
with athletes’ health and safety:
With an athlete of secondary school age, the par- recognition of
ents’ decisions regarding health care must be of pri- skin disease, • Nurse
mary consideration. infections, and • Physician
• Dentist
In certain situations, particularly at the high minor irrita-
• Podiatrist
school and middle school levels, many parents will tions. The nurse • Sports chiropractor
insist that their child be seen by their family physi- works under the • Orthotist/prosthetist
cian rather than by the individual who may be des- direction of the • Physician’s assistant
ignated as the team physician. It is also likely that physician and in • Strength and conditioning coach
the choice of a physician will be dictated by the liaison with the • Sport psychologist
parents’ insurance plan (e.g., health maintenance athletic trainer • Sports physical therapist
organization [HMO], preferred provider organiza- and the school • Exercise physiologist
tion [PPO]). This creates a situation in which the health services. • Biomechanist
athletic trainer must work and communicate with A nurse practi- • Nutritionist
many different “team physicians.” The opinion of tioner (NP) is a • Massage therapist
• Emergency medical specialist
the family physician must be respected even if the registered nurse
• Equipment personnel
individual has little or no experience with injuries with advanced • Referee
related to sports. education and
The coach, athletic trainer, and team physi- clinical training.
cian should make certain that the athlete and his NPs diagnose and treat common acute and chronic
or her family are familiar with the Health Insur- problems, and prescribe and manage medications.
ance Portability and Accountability Act (HIPAA),
which regulates how individuals who have health Physicians A number of physicians with a variety of
information about an athlete can share that infor- specializations can aid the sports medicine team in
mation with others and not be in violation of the treating the athlete.
privacy rule. HIPAA was created to protect a pa- Orthopedist The orthopedist is responsible for
tient’s privacy and limit the number of people who treating injuries and disorders of the musculoskeletal
could gain access to the athlete’s medical records. system. Many colleges and universities have a team
HIPAA regulations will be discussed in more de- orthopedist on their staff.
tail in Chapter 2.
Dermatologist A dermatologist should be consulted
Other Members of the Sports for problems and lesions occurring on the skin.
Medicine Team Gynecologist A gynecologist is consulted in cases
In certain situations, an injured athlete may require where health issues in the female athlete are of
treatment from or consultation with a variety of both primary concern.
medical and nonmedical services or personnel other Family Medicine Physician A physician who
than the athletic trainer or team physician. After specializes in family medicine is concerned with
the athletic trainer consults with the team physician supervising or providing medical care to all members
about a particular matter, either the athletic trainer or of a family. Many team physicians in colleges and
the team physician can arrange for appointments and universities and particularly at the high school level
refer the athlete as necessary. When referring an ath- are engaged in family practice.
lete for evaluation or consultation, the athletic trainer
must be aware of the community-based services Internist An internist is a physician who specializes
available to that athlete. in the practice of internal medicine. An internist
pre22754_ch01_001-015.indd 11 21/09/15 4:34 PM

treats diseases of the internal organs by using hospital-based diagnostic tests, and dispensing ap-
measures other than surgery. propriate medications. A number of athletic trainers
have also become PAs in recent years.
Neurologist A neurologist specializes in treating
disorders of and injuries to the nervous system. Strength and Condi-
Consultation with a neurologist is warranted in tioning Coaches Most A new high school has
certain common situations in athletics, such as cases colleges and univer- hired a coach to establish
of head injury or peripheral nerve injury. and develop the football
sities and some high

program. Unfortunately,
Ophthalmologist Physicians who manage and treat schools employ full- the school does not have
injuries to the eye are ophthalmologists. An optometrist time strength coaches enough funds to also hire
is an individual who evaluates and fits patients with to advise athletes on an athletic trainer. Thus
glasses or contact lenses. training and condition- the coach must assume
ing programs. Athletic the responsibility of
Osteopath An osteopath emphasizes the role of the trainers should rou- creating a safe playing
musculoskeletal system in health and disease, using tinely consult with environment for the
a holistic approach to the patient. An osteopath these individuals to athletes.
incorporates a variety of manual and physical advise them about in- ? What considerations
treatment interventions in the prevention and juries to a particular should the coach make to
treatment of disease. athlete and exercises ensure that his athletes
that should be avoided will be competing under
Pediatrician A pediatrician is concerned with the or modified relative to the safest possible
practice of caring for or treating injuries and illnesses a specific injury. conditions?
that occur in young physically active children and
adolescents. Sport Psychologists The sport psychologist can
Psychiatrist Psychiatry is a medical practice that advise the athlete on matters related to the psycho-
deals with the diagnosis, treatment, and prevention logical aspects of the rehabilitation process. The
of mental illness. way the athlete feels about his or her injury and
how it affects his or her social, emotional, intellec-
Dentist The role of team dentist is somewhat analo- tual, and physical dimensions can have a substan-
gous to that of team physician. He or she serves as a tial effect on the course of a treatment program and
dental consultant for the team and should be avail- how quickly the athlete may return to competition.
able for first aid and emergency care. Good commu- The sport psychologist uses different intervention
nication between the dentist and the coach or athletic strategies to help the athlete cope with injury.
trainer should ensure a good dental program. The
team dentist has three areas of responsibility: Sports Physical Therapists Some athletic trainers
use sports physical therapists to supervise the re-
1. Organizing and performing the preseason dental habilitation programs for injured athletes while the
examination athletic trainer concentrates primarily on getting a
2. Being available to provide emergency care when player ready to practice or compete. A number of
needed athletic trainers are also physical therapists.
3. Fitting mouth protectors The individual who achieves both certification
as an athletic trainer and licensure as a physical
Podiatrist Podiatry, the specialized field dealing
therapist is extremely well qualified to function in
with the study and care of the foot, has become
various sports medicine settings, including both
an integral part of sports health care. Many po-
the private clinic and the colleges and universities.
diatrists are trained in surgical procedures, foot
biomechanics, and the fitting and construction of Sports Chiropractors Chiropractors emphasize diag-
orthotic devices for the shoe. Like the team den- nosis and treatment of mechanical disorders of the
tist, a podiatrist should be available on a consult- musculoskeletal system, thinking that these disor-
ing basis. ders affect general health by way of the nervous
system. They make use of spinal and extremity ma-
Physician’s Assistants Physician’s assistants (PAs) nipulations in their treatments.
are trained to assume some of the responsibilities
for patient care traditionally done by the physi- Orthotists/Prosthetists These individuals custom
cian. They assist the physician by conducting pre- fit, design, and construct braces, orthotics, and sup-
liminary patient evaluations, arranging for various port devices based on physician prescriptions.
pre22754_ch01_001-015.indd 12 21/09/15 4:34 PM

Exercise Physiologists Exercise physiologists mon- massage. They may use their skills primarily in the pre-
itor and assess cardiovascular and metabolic effects competition and postcompetition phases of an athletic
and mechanisms of exercise, replenishment of fluids event.
during exercise, and exercise for cardiac and muscu-
loskeletal rehabilitation. Emergency Medical Specialists (EMS) These indi-
viduals are indispensable in providing transport to
Biomechanists Biomechanists are scientists who the injured athlete to a medical care facility.4
study and investigate how athletes move. They
analyze movement techniques, using mathematical Equipment Personnel Sports equipment personnel
models, and make corrections and adjustments that are becoming specialists in the purchase and proper
can potentially increase efficiency of movement, fitting of protective equipment. They work closely
thus improving performance. with the coach and the athletic trainer.
Nutritionists Increasingly, individuals in the field Referees Referees must be highly knowledgeable
of nutrition are becoming interested in athletics. regarding rules and regulations, especially those
Some large sports programs engage a nutritionist that relate to the health and welfare of the athlete.
as a consultant who plans eating programs that are They work cooperatively with the coach and the ath-
geared to the needs of a particular sport. He or she letic trainer. They must be capable of checking the
also assists individual athletes who need special nu- playing facility for dangerous situations and equip-
tritional counseling. ment that may predispose the athlete to injury. They
must routinely check athletes to ensure that they are
Sports Massage Therapists Qualified massage ther- wearing adequate protective pads.
apists have training and experience in all areas of
ATHLETIC INJURY MANAGEMENT CHECKLIST

The following checklist contains things the sports medicine team can do to minimize the chance of injury.
❏ Arrange for physical examinations and prepar- ❏ Educate parents, coaches, and athletes about
ticipation screening. the risks inherent in sports participation.
❏ Ensure appropriate training and conditioning of ❏ Teach proper techniques.
the athlete. ❏ Be certified in CPR/AED.
❏ Monitor environmental and field conditions to ❏ Be certified in first aid.
ensure safe participation.
❏ Select and maintain properly fitting protective
equipment.
SUMMARY
• The term sports medicine has many connotations, that all injuries and illnesses are properly cared
depending on which group is using it. The term en- for, that skills are properly taught, and that condi-
compasses many different areas of sports related tioning is at the highest level.
to both performance enhancement and injury care • The athletic trainer is responsible for prevent-
and management. ing injuries from occurring, providing initial first
• Athletic health care is delivered differently in or- aid and injury management, evaluating injuries,
ganized and recreational sports activities. and designing and supervising a program of re-
• Both personnel who concentrate on performance habilitation that can facilitate the safe return to
enhancement (such as fitness professionals and activity.
coaches) and personnel who focus on health care • The team physician is responsible for prepartici-
are concerned with injury prevention. pation health examinations; diagnosing and treat-
• Providing health care to the athlete requires a ing illnesses and injuries; advising and teaching
group effort to be most effective. athletic trainers; attending games, scrimmages,
• The coach must ensure that the environment and and practices; and counseling the athlete about
the equipment that is worn are the safest possible, health matters.
pre22754_ch01_001-015.indd 13 21/09/15 4:34 PM

• Other members of the sports medicine team may nutritionists, sport psychologists, exercise physi-
include nurses, physicians in specializations such ologists, biomechanists, physical therapists, chi-
as orthopedics, dentists, podiatrists, physician’s ropractors, equipment personnel, and referees.
assistants, strength and conditioning coaches,
SOLUTIONS TO CRITICAL THINKING EXERCISES

1-1 Ultimately, the team physician is responsible for making that athlete; (3) monitor environmental conditions to ensure safe
decision. However, that decision must be based on collective participation; (4) select and maintain properly fitting protec-
input from the coach, the athletic trainer, and the athlete. Re- tive equipment; and (5) educate parents, coaches, and ath-
member that everyone in the sports medicine team has the letes about the risks inherent to sports participation.
same ultimate goal—returning the athlete to full competitive 1-3 The coach should be responsible for designing an effective
levels as quickly and safely as possible. conditioning program and ensuring that protective equip-
1-2 To help prevent injury, the athletic trainer should (1) arrange ment is of the highest quality, properly fitted, and properly
for physical examinations and preparticipation screenings maintained; able to apply proper first aid; certified in CPR/
to identify conditions that predispose an athlete to injury; AED and first aid; and aware of the environmental factors
(2) ensure appropriate training and conditioning of the that may adversely affect the athlete.
REVIEW QUESTIONS AND CLASS ACTIVITIES

1. What areas of specialization are encompassed under the gen- 5. What are the specific roles of the athletic trainer in oversee-
eral heading of sports medicine? ing the total health care of the athlete?
2. List some of the professional sports medicine organizations. 6. Discuss the role of the team physician as an important mem-
3. How should the sports medicine team work together to pro- ber of the sports medicine team.
vide optimal health care for the athlete? 7. What special impact can other members of the sports medi-
4. What are the responsibilities of a coach or fitness profes- cine team have in providing health care for the athlete?
sional who becomes responsible for caring for an athlete
when an athletic trainer is not available?
RECOMMENDED REFERENCES
1. American College of Sports Medicine. 2014. 10. Dunn, W. 2007. Ethics in sports medicine. 20. Kutz, M. 2008. Leadership factors for ath-
ACSM’s resources for the personal trainer. American Journal of Sports Medicine letic trainers. Athletic Therapy Today
Baltimore, MD: Lippincott, Williams & 35(5):840–844. 13(4):15.
Wilkins. 11. Grant, M. 2014. Developing expertise 21. Lofshult, D. 2004. Personal fitness trainer
2. American Orthopaedic Society for Sports in strength and conditioning coach- certification. IDEA Health & Fitness
Medicine. 2008. Athletic health handbook: ing. Strength and Conditioning Journal Source 22(3):15.
A key resource for the team physician, 36(1):9–15. 22. Malek, M. H., Nalbone, D. P., Berger, D. E., &
athletic trainer, and physical therapist. 12. Hajart, A. 2013. The financial impact of Coburn, J. W. 2002. Importance of health
Chicago, IL: AOSSM. an athletic trainer working as a physi- science education for personal fitness train-
3. Andersen, J. 2010. Professional behaviors cian extender in orthopedic practice. ers. Journal of Strength and Conditioning
for athletic training students. Athletic Ther- Journal of Medical Management Practice Research 16(1):19–24.
apy Today 15(4):13. 29(4):250–254. 23. Massey, C. D., Maneval, M. W., Phillips, J.,
4. Boyd, J. 2007. Understanding the politics of 13. Halvorson, R. 2010. Fast, furious and func- Vincent, J., White, G., & Zoeller, B. 2003.
being a team physician. Clinics in Sports tional: Three trends shaping today’s fitness An analysis of teaching and coaching be-
Medicine 26(2):161. landscape. IDEA Fitness Journal 7(5):36. haviors of elite strength and conditioning
5. Brukner, P., & Khan, K. 2010. Sports medi- 14. Hayden, L. 2011. The role of ATs in helping coaches. Journal of Strength and Condi-
cine: The team approach. In P. Brukner coaches to facilitate return to play. Inter- tioning Research 16(3):456–460.
(ed.), Clinical sports medicine, 2nd rev. ed. national Journal of Athletic Therapy & 24. Massey, C. 2009. An analysis of the job of
Sydney: McGraw-Hill. Training 16(1):24. strength and conditioning coach for football
6. Brumels, K. 2008. Professional role com- 15. Henry, T. 2009. Desirable qualities, at- at a Division II level. Journal of Strength and
plexity and job satisfaction of collegiate tributes, and characteristics of successful Conditioning Research 23(9):2493.
certified athletic trainers. Journal of Ath- athletic trainers—A national study. Sport 25. Matheson, G. 2005. Advocating injury pre-
letic Training 43(4):373. Journal 12(2):1. vention: The team physician’s role. Physi-
7. Ciccolella, M. 2008. A public at risk: Per- 16. Herring, S., Kibler, W., & Putukian, M. 2013. cian and Sports Medicine 33(8):1.
sonal fitness trainers without a standard Team physician consensus statement: 2013 26. Matheson, G. 2011. Return-to-play deci-
of care. Professionalization of Exercise Update. Medicine and Science in Sports sions: Are they the team physician’s respon-
Physiology 11(7):10. and Exercise 45(8):1618–1622. sibility? Clinical Journal of Sport Medicine
8. Courson, R., et al. 2014. Inter-association 17. Hoffman, J. 2011. NSCA’s guide to program 21(1):25.
consensus statement on best practices for design (science of strength and condition- 27. McLeod, T., & Bliven, K. 2013. The national
sports medicine management for second- ing). Champaign, IL: Human Kinetics. sports safety in secondary schools bench-
ary schools and colleges. Journal of Ath- 18. Howley, E., & Thompson, D. 2012. Fitness mark (N4SB) study: Defining athletic train-
letic Training 49(1):128–137. professionals handbook. Champaign, IL: ing practice characteristics. Journal of
9. Duehring, M. 2010. Profile of high school Human Kinetics. Athletic Training 48(4):483–492.
strength and conditioning coaches. Jour- 19. Kirkland, M. 2005. Increasing diversity of 28. Mensch, J., & Miller, G. 2008. The athletic
nal of Strength and Conditioning Research practice settings for athletic trainers. Ath- trainer’s guide to psychosocial interven-
24(2):538. letic Therapy Today 10:5:1. tion and referral. Thorofare, NJ: Slack.
pre22754_ch01_001-015.indd 14 21/09/15 4:34 PM

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il *$8 Dutton 940.371
(Eng ed 20–10382)
“A detailed history of the operations of the Canadian Army corps,

consisting of four divisions and ‘corps troops.’ In writing this account
Captain Steele is describing in the main events that occurred under
his own observation in 1915 to the close of the war in 1918.”—R of Rs
“Captain Steele has the gift of clear, straightforward description;

and there is little to be desired in the succinctness and clarity with
which he etches in a number of Homeric incidents.”
+ Ath p816 Je 18 ’20 80w

+ Boston Transcript p8 D 1 ’20 420w
R of Rs 62:671 D ’20 60w
“Captain Steele’s book is admirably written and full of vivid detail.”
+ Spec 124:49 Jl 10 ’20 200w
STEINER, RUDOLF. Four mystery plays. 2v *$3

Putnam 832
20–6848
H. Collison, one of the translators of these plays, describes them as

representing “the psychic development of man up to the moment
when he is able to pierce the veil and see into the beyond.” (Introd.)
They embody the author’s occult philosophy and form one
continuous series. The characters are represented on their physical
as well as on their spiritual plane and include many types—the occult
leader, the seeress, the artist, scientist, philosopher, historian,
mystic, and man of the world, also the forces of evil in Lucifer and
Ahriman. Collaborators with the translator are S. M. K. Gandell and
R. T. Gladstone. The plays are: The portal of initiation; The soul’s
probation; The guardian of the threshold; The soul’s awakening.
“‘Four mystery plays’ will doubtless command the attention of the

author’s disciples, but they are too formidable to win the interest of
the average outsider. The blank verse translation is adequate, but
hardly inspired.”
+ − Dial 69:321 S ’20 70w
“The only advantage gained by the play form is, perhaps, a little
simplicity in the treatment of very abstract subjects.”
− + Springf’d Republican p7a N 28 ’20 180w

The Times [London] Lit Sup p780 N 25
’20 110w
[2]
STEPHENS, JAMES. Irish fairy tales. il *$5
(6½) Macmillan
20–21207
The first of these ancient folk-tales tells of the subduing of Tuan

mac Cairill, the powerful heathen, by Finnian, the Abbott of Moville.
Finnian lays siege to Tuan’s stronghold by seating himself before its
gates and fasting. Heathen etiquette forbade the attack of a
defenceless man and heathen hospitality a man’s starving before the
gates. So Finnian is admitted and at once proceeds to convert Tuan.
Thereupon Tuan, the grandson of Noah, tells his story which dates
back to the beginning of time in Ireland and is wonderful indeed. The
other tales are: The boyhood of Fionn; The birth of Bran; Oisin’s
mother; The wooing of Becfola; The little brawl at Allen; The Carl of
the drab coat; The enchanted cave of Cesh Corran; Becuma of the
white skin; Mongan’s frenzy. The full page illustrations in color and
the chapter vignettes are by Arthur Rackham.
“This book is written by a man who has a touch a little beyond
talent.” R. E. Roberts
+ Ath sup p783 D 3 ’20 180w

+ Booklist 17:164 Ja ’21
“It is unfortunate that in the arrangement of his book he does not

give greater heed to the various cycles in which nearly all Irish stories
belong. But lack of unity is almost the only adverse criticism that can
be brought against the book. Mr Stephens has re-told Irish legends in
a volume that should take a permanent place in literature.” N. J.
O’Conor
+ − Boston Transcript p3 D 18 ’20 1350w
“James Stephens’ writing has the gift of everlasting youth. Arthur

Rackham’s drawings have inherent magic. Wherefore the two are
fortunately met in a new book, primarily for children, but also full of
appeal to grown-ups with a sense of humor.”
+ Ind 103:442 D 25 ’20 90w
“Though some of the stories as told by Mr Stephens appear to be

more in the nature of historic legends rather than fairy tales, the
collection provides good reading in which humour of a subtle kind
abounds.”
+ Int Studio 72:206 Ja ’21 60w
“There is enough of the hard line of beauty in his work to make one
rejoice in its amplitude.” F. H.
+ New Repub 25:111 D 22 ’20 1700w
“Humor shines, here, riots in wild fancy, extravagance rides by the

side of beauty.” Hildegarde Hawthorne
+ N Y Times p8 D 19 ’20 60w
“Stephens has put a lot of himself into the telling of these tales;
they are moulded by his story-telling instinct, given finish by his
English and burnished by his humor.” D. W. Webster
+ Pub W 98:1200 O 16 ’20 200w
“Children may enjoy it, but, like Arthur Rackham’s exquisite

illustrations, it will be fully appreciated only by more sophisticated
readers.” E. L. Pearson
+ Review 3:619 D 22 ’20 170w

+ Spec 125:784 D 11 ’20 60w
“There is much good narrative, much humour, and, usually,

unstrained simplicity in the book, but above all there are passages of
enchanting beauty.”
+ The Times [London] Lit Sup p830 D 9

’20 310w
STERRETT, FRANCES ROBERTA. Nancy
goes to town. *$2 (5c) Appleton
20–18766
Nancy goes to town to take nurses’ training, telling all her friends
in Mifflin that she intends to marry a rich patient. She meets two rich
patients, one an old woman, the other an old man. The two are
business rivals and they become rivals also for Nancy’s favor. One
has a nephew, the other a grandson, both put forward as candidates
for Nancy’s hand. So the rich husband is within her reach, but Nancy
chooses, after some faltering, to marry Dr Rolf Jensen, the poor
young doctor.
“The description of hospital life from the point of view of a lively

girl, with quick wit and a keen sense of humor, is capital.”
+ N Y Times p24 Ja 16 ’21 420w
STEVENS, WILLIAM OLIVER, and

WESTCOTT, ALLAN FERGUSON. History of sea
power. il *$6 Doran 359
20–18945
This volume covers the evolution and influence of sea power from
the beginnings to the present time and treats naval history not from
the point of view of a sequence of battles but as a vital force in the
rise and fall of nations and in the evolution of civilization. It traces its
beginnings from the Island of Crete in the Mediterranean long before
the dawn of history to its present significance. The book is indexed,
has a list of references at the end of each chapter and ninety-six
maps, diagrams and illustrations. Contents: The beginnings of
navies; Athens as a sea power; The sea power of Rome; The navies of
the middle ages (two chapters); Opening the ocean routes; Sea power
in the North; England and the Armada; Rise of English sea power
(two chapters); Napoleonic wars (three chapters); Revolution in
naval warfare; Rivalry for world power; The world war (three
chapters); Conclusion.
“Though surprisingly condensed, an informative and authoritative

work.”
+ Booklist 17:143 Ja ’21
“It is a more objective and less theoretical study [than Mahan’s

‘Influence of sea power on history,’] with more interest for the
general reader; in addition to which it is a convenient reference
book.”
+ Springf’d Republican p8a D 5 ’20 620w
STEVENSON, GEORGE. Benjy. *$1.75 (*7s)

(2c) Lane
20–5234
The book recounts the fortunes of the Ainsworth family from the
time when young Dr Ainsworth drives his bride Priscilla home in the
gig, to the coming of the children—up to the number of thirteen—
with its resultant poverty; and the varied careers and fortunes of all
these in turn. Benjy, the youngest, his mother’s favorite, follows his
father into the medical profession. Outwardly his life is drab, all its
important happenings being of the nature of disappointments. The
more brilliantly endowed brother, Basil, wins and weds Benjy’s own
beloved Clara who dies in childbirth through Basil’s light-hearted
want of foresight. When Uncle Benjy adopts little Clara to save her
from a bad step-mother, death robs him of her also. Then comes the
war and offers him a welcome escape from himself.
“It is only when the children grow older and come into touch with
the world that Mr Stevenson fails lamentably. The quaint, old-
fashioned children are replaced by plain, strange young men and
women, and the author in his effort to convince us of Benjy’s purity
of heart pours over him such a great pale flood of sentimentality that
he is drowned before our eyes.” K. M.
+ − Ath p1371 D 19 ’19 420w
Reviewed by R. M. Underhill
+ Bookm 51:443 Je ’20 130w
“An almost masterly understanding of human (and English)

limitations pervades the story. It is told always with a sure judgment
and reticence.”
+ Boston Transcript p4 My 19 ’20 130w
“A calm tale; interesting incident and fairly interesting characters,

but no particular point.”
+ − Ind 103:323 S 11 ’20 20w
“Such is the charm of Mr Stevenson’s insouciant style that we lose

consciousness of the fact that we are listening to an ‘author.’ The
author’s powers of characterization are, in fact, responsible for a
minor fault in ‘Benjy’—the diffusing of interest in too many
characters.”
+ − N Y Times p25 Ag 1 ’20 550w

Outlook 124:657 Ap 14 ’20 20w
“It is well conceived and full of appreciation of individual

character.”
+ Sat R 129:234 Mr 6 ’20 60w
“Though the reader may become rather bewildered in trying to

follow each particular thread, the book is illuminated with many of
the author’s quiet touches of humour and is written with his usual
distinction of style.”
+ − Spec 124:53 Ja 10 ’20 60w

The Times [London] Lit Sup p633 N 6
’19 80w
STEVENSON, ROBERT LOUIS BALFOUR.

Learning to write; ed. by J: W: Rogers, jr. *$1.35
Scribner 808
20–6692
“This book is a compilation of everything R. L. S. has said on

writing, both in his essays on literary art and in the casual
observations made in his letters.”—Booklist
+ Booklist 16:306 Je ’20

+ Freeman 2:94 O 6 ’20 380w
“You cannot learn much about electricity by watching the lightning

in the thunder cloud. Even if Stevenson did teach himself to write as
he says he did, which is nothing more than an improbable
hypothesis, reading his extremely characteristic and technically
complex descriptions of his methods will not help a single youngster
out of the toils and troubles of the early days of his probation.” W:
McFee
− N Y Evening Post p9 My 8 ’20 1300w
“It is to be feared that Stevenson’s confidences in regard to his own

literary processes have done all too much to foster hope in the bosom
of ‘would-be’ authors.... One is inclined to take it with several grains
of salt.” R: Le Gallienne
+ − N Y Times 25:8 Je 27 ’20 2250w

+ School R 28:628 O ’20 110w
“Likely to prove a gold mine of interesting information not only to
aspiring writers, but to people who are interested in books as well.”
+ Springf’d Republican p8 Jl 24 ’20 240w
STEWART, BASIL. Japanese color prints and

the subjects they illustrate. il *$20 Dodd 761
“Mr Stewart knows just what collectors of Japanese prints want

and do not want. But they want a handbook of 300–odd pages, with
reproductions of signatures, lists of important sets, chronological
tables, brief biographical information; of handy format and popular
style. And such is the book before us. There are a glossary, a chapter
on ‘Forgeries and imitations,’ another on ‘Actor prints’ in general,
and an excursus on the ‘Forty-seven rōnins’ in history and on the
stage.”—The Times [London] Lit Sup
“It is no serious condemnation to say that ‘Japanese colour prints’

is not the book on Japanese colour prints for which we are all
looking.”
+ − Int Studio 72:33 N ’20 200w
“The ground covered is so vast that the treatment in certain cases

inevitably seems somewhat cursory. One or two inaccuracies may be
noted.”
+ − The Times [London] Lit Sup p464 Jl 22

’20 640w
STEWART, WENTWORTH. Making of a
nation. $1.50 (3c) Stratford co. 325.7
20–3491
In this discussion of Americanism and Americanization the author

holds that we cannot make American citizens of aliens by formal
educational programs, that we must take into consideration the
psychology of Americanization and treat Americanism as a thing of
the spirit rather than of naturalization papers. Certain undesirable
features in our alien population—such as foreign language
newspapers, religious worship in a foreign tongue—should be treated
by a process of elimination rather than coercion, while “all
anarchistic agitators,” and unamerican labor agitators should be
summarily dealt with. As one of the educational factors for
Americanization a modified form of the open forum is
recommended. Contents: The nation’s awakening; The nation’s task
of unification; Eliminating the handicaps to Americanism;
Constructive government and nation building; Providing conditions
for Americanism—or the application of constructive government;
The neighborhood and the nation; International sentiment and
nationalism.
STILL, JOHN. Poems in captivity. *$2 Lane 821
20–5612
The author discovered the poet in himself during his three years of
captivity in Turkey, “where each one of us was driven to seek inside
himself some alleviation of the daily dullness, many of us there found
things we had not suspected to exist.... I found these verses, all of
which were written there, and their discovery made more happy
many of the eleven hundred and seventy-nine days I spent as a
prisoner of war.” (Foreword) The poems are in five groups: Prison
verses; Woodcraft and forest lore; Tales from the Mahawansa;
Various songs and sketches. The frontispiece is a facsimile of a part
of the ms. which was concealed in a hollow walking-stick, and some
explanatory notes are appended.
“Mr Still’s work is undeniably interesting, and his chosen vehicle

seems to be the right one.”
+ Ath p1018 O 10 ’19 100w

Boston Transcript p4 Ap 21 ’20 280w
“He writes fluently and the Ceylonese legends that he relates are
interesting in themselves, but his medium hardly ever touches the
authentic heights of poetry.”
+ − N Y Times 25:16 Je 27 ’20 100w
“The merit of Mr Still’s work is that it gives aptly and agreeably a

full, warm picture of scenes picturesque and historic.”
+ The Times [London] Lit Sup p534 O 2

’19 160w
STOCKBRIDGE, MRS BERTHA EDSON

(LAY). What to drink; the blue book of beverages. il
*$1.50 Appleton 641.8
20–2272
In these days of prohibition this book solves the hostess’ problem
of what to serve to drink. All she needs is a stock of syrups, shrubs
and vinegars, says the author. “If, however, she is inclined to think it
an arduous task, let her turn to these recipes, and she will be
convinced that the labor and the time expended bring their own
reward in ... a delicious drink delightfully made.” (Foreword) The
contents present an exhaustive array of recipes for fruitades and
punches and drinks hot and cold—non-alcoholic cocktails, syrups,
grape juice, root beer and cider, hot drinks such as coffee, chocolate,
etc., drinks for invalids and children, sundaes and sauces, ice-
creams, sherbets, etc. There is an index.
Booklist 17:18 O ’20

Springf’d Republican p13a Ap 18 ’20
250w
The Times [London] Lit Sup p241 Ap
15 ’20 50w
STOCKBRIDGE, FRANK PARKER. Yankee

ingenuity in the war. il *$2.50 Harper 623
20–8261
It was as a reaction of the author’s patriotic pride to the slanderous

disparagements of America’s participation in the war that the book
was written and for that reason it is limited to the consideration of
distinctly American enterprise. It has, however, not been written for
the scientist or the technologist, but for the average American,
neither skilled nor interested in technical details. A partial list of the
contents is: The mobilization of science and industry; The Liberty
motor; American military airplanes; The chemical conquest of the
air; Potash, sulphuric acid, and dyestuffs; Poison gas; Some
extraordinary ship-building feats; Some Yankee tricks in undersea
warfare; The wonders of war wireless; Medical and surgical
achievements. The book is profusely illustrated from official
photographs.
“Interesting and informative.”
+ Booklist 17:67 N ’20

Wis Lib Bul 16:234 D ’20 70w
STOCKLEY, CYNTHIA. Pink gods and blue

demons. *$1.50 (9c) Doran
20–10303
A story of South Africa. The pink gods and blue demons are the
lightning flashes of temptation from the facets of diamonds. Loree
Temple, a young and much indulged wife, falls under their spell. Her
husband has gone north on business leaving her alone in Kimberley.
She falls under the spell of the diamonds and so into the power of the
man who can give them to her. She is extricated through the loyalty
and generosity of another woman, and, her lesson learned, goes to
join her husband.
“The tale is interesting and moves swiftly forward to a sufficiently

dramatic climax.”

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List of professional sports medicine Summary and comparison of heat disorders,

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Applications at a Glance xix

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1 Fitness Professionals, Coaches, and the Sports Medicine Team:

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M illions of individuals in our American

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FIGURE 1–3 Coaches should work closely with athletic

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been eliminated. The and should be certi-

to practice and game therapeutic modalities participation

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1–2 Critical Thinking Exercise

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1–3 Critical Thinking Exercise

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ATHLETIC INJURY MANAGEMENT CHECKLIST

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SOLUTIONS TO CRITICAL THINKING EXERCISES

REVIEW QUESTIONS AND CLASS ACTIVITIES

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− Am Pol Sci R 14:511 Ag ’20 520w

“While one cannot altogether agree with the conclusions of the

+ − Bookm 52:173 O ’20 200w

− + Boston Transcript p6 F 25 ’20 800w

“Herein lies the fundamental weakness of the discussion. One

+ − Cath World 111:254 My ’20 340w

− Nation 110:238 F 21 ’20 850w

“The book is of great value. Its analysis of American tendencies is

+ N Y Call p6 Ja 9 ’21 230w

− Review 2:229 Mr 6 ’20 1150w

STEVENSON, GEORGE. Benjy. $1.75 (7s)