training is over—now what? practical management pearls for the trainee in musculoskeletal and...
TRANSCRIPT
Training is Over—Now What? Practical Management Pearls for the Trainee in Musculoskeletal
and Sports Medicine
AAPMR Annual Meeting| Boston, MA| October 1st , 2015
Jason L. Zaremski, M.D., CAQSMAssistant Professor, Department of Orthopaedics & RehabilitationDivisions of PM&R, Sports Medicine, & Research, University of Florida
TEAM
I have no disclosures
Starting a High School Outreach Sports Medicine Program from the Ground Up
What Will You Need…Personally1. Motivation2. Learn how to NOT say No
– Can you take an add-on HS athlete at 4:50pm?– Can you take an additional Concussion at 7am Friday morning for clearance?
3. Cover Cover CoverI cover 12-18 HS football Games/seasonEveryone has different schedules, distances to drive, etc…
4. Departmental Support-Head of Sports Medicine (if that is not you)-Chairman-Business Office-Marketing/Promotions
What Will You Need…Work Setting1. High School Contracts2. Relationships
-Coaches, ADs, Colleagues, Community3. Athletic Trainers (ideally)4. Understanding of your respective states rules– FHSAA.ORG– Contact for Sports Medicine Advisory Committee– Concussion– ECG– Heat– Sickle Cell Disease v Trait– Other…
High School Contracts• What Will You Provide For HS
– Coverage of all HS Football Games Home– Consider Coverage of all HS Football Games Away– Athletic Trainer & EAP– Free Lectures/Events– Athletes Seen in a timely manner
• Translation Immediately
– Coverage of Major Events • Winter Basketball Tournament• Large Swim Meets or Track & Field Meets
• What the HS Will Provide For You– Advertising on Field/Court/HS– Recommend sending patients to your clinic – Access– Unlikely but potentially some $
Heat, Heart, and Head
Average Week• Clinic: 4 days per week – Typically Athletes come in 2-4 pm to minimize missing
school but double book anytime they want• Outreach– Lectures, Spring Football Practices, Meeting with EMS, AT,
and other personnel• Athletic Game/Practice Coverage– Atleast 1 HS Football Game/week per/HS – Athletic Training Room 1x/week after clinic– Cell Available to AT at anytime– Other Sports as needed (Soccer, Wrestling, Lacrosse,
Basketball Tournaments, etc…)
Seasonal Fluctuations-FLORIDA
• July: Meetings, prepare for Football season• August-Nov/Dec: Concussions, Acute bony injuries
due to contact sports (Football), Heat Illness, Cardiac
• Dec-March: Soccer, Basketball, Swimming• Jan-March: Throwing Injuries • Summer: Lower Numbers…time to breathe…– Increase in Crossfit-Type Injuries due to no school,
more time to train• Continuously: Overuse Training, Running, Throwing
Seasonal Fluctuations- NOT FLORIDA
• July: Meetings, prepare for Football season• August-Nov/Dec: Concussions, Acute bony injuries due to
contact sports (Football, Soccer), Heat Illness, Cardiac• Nov-March: Hockey, Basketball, Swimming• March-June: Throwing Injuries (earlier in warm weather
states)• Summer: Lower Numbers…time to breathe…
– Increase in Crossfit-Type Injuries due to no school, more time to train
• Continuously: Overuse Training, Running (spring-fall), Throwing
Pre-Participation Examinations
Prove You’re The Experts
Be Prepared…For Anything
• September 2015• HS Football Game• Play Ended… • Fans started screaming “Trainer” and “Run”• This Happened…
MindsetA Coach or Parent needs to think:
“If My Student-Athlete/Child gets hurt, I need him to see Dr. X immediately.”
End With a Case• Wednesday August 13th, 2014• Approximately 1 week into Contact Football
Practice• 11:15am: Wide Received hit on right shoulder and
driven into ground. Athletic Trainer evaluates. Suspicion of clavicle fracture.
• 11:30am: Call made to my cell. Can we see?• Noon: Parent and athlete in xray. Radiographs
confirm non-displaced mid-shaft clavicle fracture.• 12:15pm: Sling and education re: injury. • 1:00pm: Back on practice field watching
