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Canada ATHLETIC THERAPY: A REWARDING PROFESSION by Gena Bugden An internship report submitted to School of Graduate Studies in partial fulfillment of the requirements for the degree of Master of Physical Education School of Physical Education Memorial University of Newfoundland November, 2002 St. John's Newfoundland Abstract Based on an eight month internship period at the University of New Brunswick, the following information has been gathered which pertains to the authors experiences. Section one describes the role of the athletic therapist, the work environment as well as treatment options available at their disposal. Section two continues by briefly describing the injury profile of three sports; ice hockey, rugby, and volleyball, which the author has had ample field experience. It further describes common injuries which continuously presented themselves among the athlete population in the clinical environment. It is by no means a literature review, as it focuses only on practical experience gained by the author. -1- Acknowledgements A very special thanks to my Supervisory Athletic Therapist, Joe Glenn at the University ofNew Brunswick, for without whom this initiative would not be possible. Your wisdom and expertise will never be forgotten. To by professors and graduate advisors, thank-you for your patience and guidance. You have made the "light at the end of the tunnel" so much clearer as well as closer. And to my family, thank-you for your encouragement and support. Your steadfast belief in my hopes and dreams has been a driving force in my achievements. You will always be an important part of everything I do. -G.N.B-. -ll- Table of Contents Section One Introduction ..................................................... ........................................................ .. l The Athletic Therapist. ...... , ................... .... .............................. ................................. 3 Injury Prevention ............. .............................................................................. 6 Recognition and Evaluation ..........................................................................7 Immediate Care ...................................................................... .......................9 Treatment and Rehabilitation .......... ....................................... ..................... 10 Administrative Duties .................................................................................. 10 Continuing Education... ............... ......................................................... ....... 11 The Canadian Athletic Therapists Association .................................. ...................... l2 The Athletic Therapy Facility................................................... ............................... 16 The Office. ............................................................................................... .... 19 Taping and Bandaging .. .............................................................................. 20 Hydrotherapy. .............................................................................................. 21 General Treatment. ...................................................................................... 21 Exercise and Rehabilitation ........................................................................ 22 Storage... ...................................... ............................................................... 22 Private Examination .............. ... ....................... ......................... .................. 23 Legal Concerns ..................................................................... ................ .................. 24 Negligence ................................. ......... .. .... ... ............. .............................. .. .. 25 -lll- Evaluation and Management of Athletes ... .................................... .. .. ..... 27 Rehabilitation .............. ............. .............. ...................... .. ....... ;........ ......... 27 Assault. ........ .............................. .................................................. ............30 Epidemiology oflnjury..... ................................................... ...... ........................ .. 36 Sprains ................................................... ..................................................3 7 Strains ................ ............. .................. ........ ...................... .............. ........... 39 Injury Management. ......................... ...................................................................40 Protection .................. ......................... ......................... ............................41 Rest ............................................ ............................ .................................42 The Function of Ice ................................................................................. 43 Compression .................. ......................................................................... 43 Elevation. ................................................................................................ 44 The Rehabilitative Process .... ................................................................ .45 Athletic Taping. ...................................................................................... 53 Therapeutic Modalities ...................................................................................... 57 Cold Modalities ..................................................................................... 58 Physiological Sequence of Events ......................................................... 61 Whirlpools ............................................................................................. 65 Ice Packs ................. ....... ................ ........................................................ 66 Heat. .......................................................................... ................. ............ 68 Physiological Effects .. ............... ............................................ ....... ......... 68 Heat Packs ................................................................................. ............ 72 - lV- Contrast Baths ..................... .. ............................................................... 75 Ultrasound ........................................................................................................ 77 Neuromuscular Electrical Stimulation ............................................................. 88 Interferential Current. ....................................................................................... 93 Pain Control ................. ........ .................................................................95 Electrode Placement ............................................................................. 96 High Voltage Pulsed Stimulation .................................................................... lOl Trans Electrical Nerve Stimulation............ ..................................................... I 06 High Frequency TENS ........................................................................ l07 Low Frequency TENS ......................................................................... I 09 Brieflntense TENS ............................................................................. llO Electrode Placement ........................................................................... Ill Massage .......................................................................................................... 113 Flexibility......................................