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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 [email protected]@ufs.ac.za
