Chapter 8
Sports Therapy

Sports PT section - established in 1973

Defined sports physical therapist - an individual who deals with the physiological, psychological, pathological and performance problems of athletes and attempts to intervene to prevent or correct these problems

Sports PT section began working on competencies during the late 1970's - performed a task analysis 1978-79 to:
  1. to determine clinical tasks in which competency is essential to practice sports physical therapy effectively;

  2. to determine to what extent sports physical therapy members were practicing these clinical tasks
Results of this task analysis published in 1980

SPT section petitioned the Board for Certification of Advanced Clinical Competencies for recognition as an area of specialization in 1981 - approved

Competencies were validated in a second study done in 1983.

These competencies serve as the basis for the certification examination to become a board certified clinical specialist in sports physical therapy (Sports Clinical Specialist).

The specialty competencies are divided into four areas:
  1. patient care services

  2. administration

  3. education

  4. research
I. Patient care services

  1. On-the-field examination

    1. recognize emergency vs. non emergency situations

    2. properly assess the situation

    3. select appropriate examination techniques

    4. properly interpret objective and subjective data

    5. determine appropriate course of action

      1. examples:

        1. on-the-field exam of an athlete with knee pain

        2. environmental conditions - hot, humid

  2. Dermatologic, infectious and medical problems

    1. demonstrate awareness of the etiology of various dermatologic, infectious and medical problems

    2. demonstrate knowledge of the signs/symptoms of these problems

    3. recognize potential dangers of these problems

    4. recommend appropriate course of action

    5. explain preventive measures

      1. examples:

        1. staph infection in foot being Rxed in whirlpool

        2. pre-season screening - frequent headaches with hx of multiple concussions

  3. Pre-participation physical examination

    1. identify all deviations significant for participation with respect to medical history, musculoskeletal and cardiovascular systems, dental conditions, vision

    2. accurately and completely record information on screening forms.

    3. provide a system to communicate abnormal findings to physicians, family and institutional personnel.

    4. provide a system of referral to insure appropriate follow-up evaluation and treatment

      1. example:

        1. administer pre-participation examination for multiple sports at a high school.

  4. Weight gain/loss

    1. explain methods of determining weight and body fat

    2. recognize potentially dangerous weight change

    3. explain safe methods of weight gain/loss

    4. establish and explain reasonable goals for weight gain/loss

      1. examples:

        1. gymnast using wt. loss methods indicating anorexia

        2. wrestler - drops below 5% BF to make weight

  5. Acute emergency care

    1. care should be administered in accordance to advanced Red Cross standards or the equivalent

    2. done in a safe and efficient manner, minimizing further pain and injury

    3. done using appropriate stabilizing and monitoring techniques

    4. provide for the appropriate disposition of the patient, including transportation and referral.

      1. examples:

        1. heat stroke

        2. cervical fracture

  6. External bandages, dressing and support

    1. applied with appropriate technique based on sound anatomical, physiological and biomechanical principles

    2. applied with appropriate type of bandage, dressing or support

    3. applied to meet goals

    4. applied with adequate application to injured area

    5. applied with efficient use of materials

    6. applied to provide comfort, safety and appearance

    7. applied with satisfaction to the athlete

      1. examples:

        1. recommend type of knee orthosis following MCL injury in HS basketball player

        2. choose appropriate wrap for stabilizing the ankle following an ATF lig. sprain

  7. Athletic equipment

    1. insure the safety and comfort of the athlete

    2. stay within existing resource constraints

      1. examples:

        1. recommend running shoes for pronation problems

        2. fitting an athlete for helmet and shoulder pads

        3. recommend synthetic or natural turf for practice field

  8. Preventative conditioning programs

    1. specifically design program for each sport activity with respect to flexibility, CV fitness, strength, power, agility and endurance

    2. conduct program within the time allowed

    3. specifically design program to consider relationship to the playing season

    4. specifically design program to consider the maturity level, sex, skill and preconditioning status of the athlete

    5. provide for re-evaluation process

    6. 6. be aware of contraindications by medical condition

      7. appropriately record program in individual's file

      1. example:

        1. pre-season conditioning program for an athlete with ACL reconstruction

        2. quadriceps strengthening program to equalize quadriceps bilaterally

  9. Return to activity

    1. clearly specify limitations, if any, on return to activity

    2. minimize the probability of reinjury

    3. provide the earliest possible return to full or limited activity

    4. appropriately document

    5. be consistent with standard fitness parameters

    6. provide for re-evaluation at appropriate intervals

    7. be directed to the appropriate individual on a timely basis

      1. examples:

        1. severe hamstring strain

        2. moderate ATF lig. sprain

  10. Understanding of arthrology

    1. cognitive anatomical basis for the affected area

    2. recognize arthrological effects of various sports

    3. recognize arthrological effects of various surgical procedures

    4. identify normal/abnormal in an arthrological assessment

    5. recognize arthrological effects of rehabilitation techniques, modalities and medication

      1. examples:

        1. arthrological effects of a clip

        2. arthrological effects of jogging

        3. arthrological effects of full arc RROM ex.

  11. Causative factors in macro- and micro-trauma

    1. describe or design an appropriate epidemiological study

    2. describe potential injuries of a given situation

    3. describe common mechanisms of injury

    4. recognize biomechanical principles involved in an injury

      1. examples:

        1. causative factors of ruptured Achille's
        2. tendon

          micro-trauma associated with rotator cuff tendinitis

  12. Modifications to the playing environment

    1. identify all significant potential hazards

    2. 2. provide practical solutions to problems, considering available time and resources

      3. communicate with appropriate personnel

      4. record recommendations in an appropriate manner

      1. examples:

        1. basketball gym without protective wall mats

        2. artificial vs. natural turf

        3. unprotected space heaters on the sidelines of a football game

  13. Activity limitations based on environment conditions

    1. identify all circumstances where environmental conditions warrant activity modification

    2. communicate findings to appropriate personnel

    3. be accurate with respect to the degree and type of required activity limitations

    4. recommend appropriate dress/equipment for existing conditions

    5. appropriate recommendations regarding use of ergogenic aids

      1. examples:

        1. football practice in high temperature and humidity

        2. practice in cold with moderate/high winds

  14. Health status information

    1. timely recommendations in relation to circumstances

    2. comprehensive and accurate recommendations

    3. recommendations with sufficient amounts of information to be useful the persons receiving it

    4. recommendations communicated appropriately

      1. examples:

        1. rehabilitation progress to the physician

        2. recommendations to the coach on return to activity for an athlete

        3. explanation of an injury to parents

  15. Ergogenic aids

    1. recognize indications and contraindications of using ergogenic aids

    2. identify signs of misuse of ergogenic aids

    3. define clear personal ethical values concerning use of ergogenic aids

    4. provide for referral to proper sources for counseling on use as necessary

    5. explain potential benefits/hazards of using ergogenic aids

      1. examples:

        1. steroid use

        2. blood doping

        3. isotonic solution vs water

II. Administration

  1. Sports PT/practice management skills

    1. develop appropriate personnel management system

    2. develop appropriate equipment/space management system

    3. develop responsible fiscal management system

      1. examples:

        1. establishment of an outpatient orthopedic and sports PT private practice clinic

        2. running a sports PT/athletic training clinic in a university

III. Educational services

  1. Sports PT/educational skills

    1. develop an appropriate educational program for the public, students, educators and medical professionals

      1. examples:

        1. student athletic trainer program

IV. Research

  1. Identify, investigate, report and publish current problems in sports PT

    1. use appropriate criteria for development of a problem statement

    2. use reliable and documented research methods

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