AN APPROACH TO SPORTS MEDICINE – “THE SPORTS MEDICINE MODEL” Dr Louis Holtzhausen Program...

AN APPROACH TO SPORTS MEDICINE – “THE SPORTS MEDICINE MODEL”

Dr Louis HoltzhausenDr Louis HoltzhausenProgram director: Program director:

Sports MedicineSports MedicineUniversity of the Free University of the Free

StateStateSouth AfricaSouth Africa

April 21, 2023

DEFINITION OF SPORTS MEDICINE

Not only the management of injuries

The medicine of exercise

Total medical care of the exercising individual

Brukner and Khan, 2001

THE SCOPE OF SPORTS MEDICINE• Prevention of injury• Diagnosis of illness and injury• Treatment and rehabilitation• Performance enhancement

– Training– Nutrition– Psychology

• Management of medical problems caused by exercise

• The role of exercise in chronic disease

– Cardiac disease– Diabetes– Asthma and COPD– Arthritis

• The needs of special exercising populations

– Children– Females– Older people– Persons with disabilities

• Medical care of sporting teams and events

• Medical care in situations of altered physiology

– Diving and aviation– Heat– Altitude

• Ethical issues– Drugs in sport

“THE SPORTS MEDICINE MODEL”

THE TRADITIONAL MEDICAL MODEL

Brukner P, Khan K. Clinical Sports Medicine. 2007

THE SPORTS MEDICINE MODEL

Brukner P, Khan K. Clinical Sports Medicine. 2007

THE MULTI PROFESSIONAL TEAM APPROACH

• ““A champion team will always A champion team will always beat a team of champions“beat a team of champions“

• Know your skills and limitations and that of other team members

• Team may differ in different settings

• Multi skilling– Geographically isolated– Travelling

• Overlap

• Case manager/ co-ordinator

• Primary contact is the choice of the athlete – responsibility of the practitioner is to know his/her place in the multi professional team and utilise other members

CHALLENGES OF MANAGEMENT

• Diagnosis

– Clinical (“Victim“): Specific, anatomical, pathological

– Cause: (“Culprit“)

– Interaction between body (with its physical properties) with the environment and a training schedule

CAUSES OF CHRONIC INJURY

CHALLENGES OF MANAGEMENT

• Treatment– Presenting

injury/illness– Cause– Consider all aspects of

injury– Return to sport issues

PHILOSOPHY OF INJURY REHABILITATION

• Understand the healing process

• Understand the pathomechanics of injury

• Understand the kinetic chain

• Psychological aspects• The tools of rehabilitation• Goal setting

THE COMPONENTS OF INJURY REHABILITATION

• Control of swelling and pain• Restoring range of motion• Restoring muscular strength,

endurance and power• Restoring neuromuscular control• Restoring postural control and stability• Maintaining cardio-respiratory fitness• Psychological aspects• Monitor possible complications• Functional progression and testing• Return to sport

– Criteria for full recovery

MEETING INDIVIDUAL NEEDS

• Individual needs of individual athletes determine management plan

• Contextual variables have to be considered

• The role of the coach– Communication– Shared decision making– Ultimate responsibility to

patient

HOLISTIC PATIENT CARE

• The Bio-psycho-social model

Ashburnpsychologist.com 2012

SYSTEMS THEORY

Engel, 1980 in Mc Whinney IR. A Textbook of Family Medicine. 1989

Before injury Effects of injury

SYSTEMS THEORY

Engel, 1980 in Mc Whinney IR. A Textbook of Family Medicine. 1989

Resolution

A BIOPSYCHOSOCIAL METHOD: THE THREE STAGE ASSESSMENT

Biological: Biological: Clinical: diagnosis and cause(Effects on organismic level)

Personal/Personal/PsychologicalPsychologicalThoughtsFeelingsFearsExpectations

Social/contextual:Social/contextual:Effect on social systems

THE ATHLETE SUPPORT SYSTEM

Brukner P, Khan K. Clinical Sports Medicine 3rd Ed, 2007

LOVE THY SPORT

Know thy sport

THE SPORTS MEDICINE CONSULTATION

• Subjective assessment– History– Determine type, severity and

cause• Objective assessment

– Clinical evaluation– Determine type, severity and

cause• Assessment summary

– Clinical– Personal– Contextual

• Plan– Case manager– Multi professional– Stages of rehabilitation– Goal setting– Follow-up– Return to sport

THANK YOU!

Dr Louis HoltzhausenDr Louis HoltzhausenSports MedicineSports MedicineUniversity of the Free StateUniversity of the Free StateHoltzhausenLJ@ufs.ac.zaHoltzhausenLJ@ufs.ac.za