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Return to Play Following Brain Injury
Published in Mark R. Lovell, Ruben J. Echemendia, Jeffrey T. Barth, Michael W. Collins, Traumatic Brain Injury in Sports, 2020
Ruben J. Echemendia, Robert C. Cantu
There are a host of individuals that may be involved in the RTP decision. Although each of these individuals may not be present in every situation, it is usually the case that many of these people will provide input into the process. In most instances, it is the team physician who holds the ultimate responsibility of when an athlete should be returned to sport. It is the role of the team physician to gather the necessary information, weigh the various sources of information, and ultimately decide whether to clear the player for RTP. Teams vary significantly as to the designation and involvement of the team physician. In some instances the team physician is dedicated to the particular team. He or she travels with the team, knows the players, staff and family. These physicians know the coaches well and have good working relationships with a variety of specialists who they rely on for consultation. In other situations, there may be a group of team physicians that are assigned to various teams (usually the case in Division I sports). These physicians generally do not travel with the team (except for the marquis sports) but they do get to know the players and coaches quite well. Some colleges do not have team physicians and rely on the general student health service or the local hospital. Many high school districts do not have team physicians. Usually, players are treated by their primary care physicians.
Sports and Physical Activity for Women and Girls
Published in James M. Rippe, Lifestyle Medicine, 2019
The risk-stratification tool can be used at the point of care to guide clearance and return-to-play decisions with athletes in a transparent way. Athletes with a score of 2–5 points fall into the provisional or limited clearance category. Athletes with provisional clearance can typically participate in full training/competition based on the athlete’s compliance and follow through with a written contract. Athletes given limited clearance typically have limitations placed on training and competition as a consequence of underlying health concerns. Those scoring 6 or more points may be restricted from training and/or competition depending on the severity of risk factors, and athletes with active eating disorders should be restricted from participation. Restriction should not be considered permanent for the vast majority of individuals, in hopes that risk factors can be ameliorated sufficiently to allow for safe participation. It also bears mentioning that “past history” risk factors may be non-modifiable (e.g. past history of disordered eating (1 point), delayed menarche (up to 2 points), past history of stress fractures (up to 2 points), previously low DXA Z-score (up to 2 points), resulting in a score greater than 6 in an athlete who is currently eating healthfully, maintaining a normal body weight, and regularly menstruating). In such cases, clinical judgment by the sports medicine team physician, the athlete care team, and the athlete herself is warranted to determine safe participation in sports.
The Role of the Physician in Hospice
Published in Bruce Jennings, Ethics in Hospice Care: Challenges to Hospice Values in a Changing Health Care Environment, 2018
By being devoted to direct patient care activities, the team physician is better able to positively influence pain and symptom management decisions made by attending physicians and other members of the team. The opportunity for direct physician/patient contact provided by hospice team physician visits at home or in hospice inpatient beds not only allows for more optimal pam and symptom management, but often has significant psychosocial benefits for patients and families. The value of these visits should never be underestimated! Finally, there is additional time available for the hospice physician to educate members of the hospice patient care team in pain and symptom management techniques, and they often can provide valuable staff support during times of stress (Beszterczey 1977).
Injuries in elite road cyclists during competition in one UCI WorldTour season: a prospective epidemiological study of incidence and injury burden
Published in The Physician and Sportsmedicine, 2023
Christopher Edler, Jan-Niklas Droste, Ruben Anemüller, Aki Pietsch, Matthias Gebhardt, Helge Riepenhof
Ten team physicians from the relevant cycling teams, trained in Sports Medicine, Rehabilitation or Orthopedics, contributed to the medical records after being briefed about the aim and details of this study and met on a regular basis during the season. Team physicians were present on every race day and collected information from the athletes immediately after every stage. In case of injury, diagnostics, and treatment were performed immediately. Athletes requiring hospital admission were followed by the team physician. If necessary, the subsequent rehabilitation process was also accompanied by a team physician until return to competition. Injuries were classified in categories according to Soligard et al. [7] for the Rio Olympic Games 2016. Body regions were chosen following the suggestion of the IOC consensus statement for reporting of epidemiological data on injury in sports [17] and the Orchard Sports Injury and Illness Classification System (OSIICS) [18]. All data was collected via a standardized electronic form and transferred to an electronic database (Excel 2010, version 14.0.7263.5, Microsoft Corporation, USA).
The epidemiology of injury and illness at the Vitality Netball World Cup 2019: an observational study
Published in The Physician and Sportsmedicine, 2022
Dina C (Christa) Janse van Rensburg, Grace Bryant, Sharon Kearney, Praimanand Singh, Arnold Devos, Audrey Jansen van Rensburg, Martin P. Schwellnus, Tanita Cronje
Sixteen netball teams (squad size limited to 12 players/team; n = 192) contested the NWC2019 tournament. Once the tournament started, teams could not exchange or replace listed players of the squad with additional players. Five teams automatically qualified by their position in the INF world rankings, and England qualified as the host nation. The remaining ten teams qualified via regional qualification tournaments, with two teams selected from each of the five international netball regions: Africa, Americas, Asia, Europe and Oceania [1]. The event took place over a total of 10 days whereby every team played a minimum of 7 matches and the top 4 teams played 10 matches. Players presenting with an injury or illness during the tournament were seen by their team physician or the venue medical officer. Countries that participated in the NWC2019 included: Australia, Barbados, England, Fiji, Jamaica, Malawi, New Zealand, Northern Ireland, Samoa, Scotland, Singapore, South Africa, Sri Lanka, Trinidad and Tobago, Uganda and Zimbabwe.
Athletic trainer employment, physician access and care delivery in secondary schools
Published in The Physician and Sportsmedicine, 2020
Aaron J. Provance, Matthew K. Brewer, Corrine N. Seehusen, Bridget T. Younger, David R. Howell
Overall, our results indicate that most ATs at the secondary school level have an assigned team physician, but significant variation exists among sports medicine team structures for many aspects of student athlete care. According to the American Medical Association, an AT is responsible for serving as an athletic health coordinator under the direction of a team physician.1 However, professional relationships between ATs and physicians vary across different secondary school settings. Team physicians should be able to work cohesively within the sports medicine team, encouraging development and treatment resolutions, and ensuring protocols are up-to-date. This integral role should be in collaboration with the AT and should help facilitate management of injuries, standing orders, and return to play decision-making [4,5,24].