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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
