Preface

Since the first edition of Principles of Athletic Training was published in 1963, the profession of athletic training has experienced amazing growth, not only in numbers but also in the associated body of knowledge. During all those years and in sixteen previous editions, the authors of this text, Daniel Arnheim, John Klafs, and now Bill Prentice, have taken it as a personal responsibility to provide the reader with the most current clinical information in athletic training and sports medicine. It has always been based on the most current research evidence and, consequently, it has endured as one of the preeminent textbooks for athletic training students and professionals for more than 57 years.

The text is designed to lead the student from general foundations to specific concepts relative to injury prevention, evaluation, management, and rehabilitation. As with other health care professions, the gold standard for athletic trainers is to make decisions about the clinical care of individual patients based on the current best available evidence in the professional literature to achieve the most optimal patient outcomes. It has always been important for this text to address all of the competencies and clinical proficiencies that the profession has identified as critical relative to both the education of our students and to the practice of athletic training. The changes, updates, and additions to this seventeenth edition are a reflection of my commitment and passion toward continuing Dan Arnheim's and John Klafs's tradition.

Over the years since the origins of the athletic training profession in the 1930s, the majority of athletic trainers have been employed at colleges and universities, and in secondary schools, providing services almost exclusively to an athletic population. Historically, this work environment has been referred to as the “traditional setting” for employment for athletic trainers.

During the past two decades, the role of the athletic trainer has gradually evolved into one that is unquestionably more aligned with that of a health care provider. Today, more than 40 percent of certified athletic trainers are employed in clinics and hospitals, in industrial and occupational settings, or working in physician practices. Although many athletic trainers continue to work in colleges, universities, and secondary schools, others can be found working as health care providers in all kinds of professional sports, including rodeo and NASCAR; in performing arts and the entertainment industry; in medical equipment sales and support; in the military; with law enforcement departments; and with government agencies, including NASA, the U.S. Senate, and the Pentagon.

This expansion of potential employment settings has forced the profession not only to change the methods by which health care is delivered to a variety of patient populations but also to change athletic training education programs to teach and/or establish professional competencies and proficiencies that are universal to all settings.

Depending on the employment settings in which they work, athletic trainers no longer provide health care only to athletes, nor do they only provide health care to individuals who are injured as a result of physical activity. Thus, the athletic trainer is more closely aligned with other allied health professionals, and athletic training is widely recognized as a clinical health care profession.

Principles of Athletic Training: A Guide to Evidence-Based Clinical Practice should be used by athletic trainers in courses concerned with the scientific, evidence-based, and clinical foundations of athletic training and sports medicine. Practicing athletic trainers, physical therapists, and other health care professionals involved with physically active individuals will also find this text valuable.

The 29 chapters in the seventeenth edition are organized into six sections: Professional Development and Responsibilities, Risk Management, Pathology of Sports Injury, Management Skills, Musculoskeletal Conditions, and General Medical Conditions.

As in previous editions, developing the seventeenth edition included serious consideration and incorporation of suggestions made by students, as well as detailed feedback from reviewers and other respected authorities in the field. Consequently, this seventeenth edition reflects the major dynamic trends in the field of athletic training and sports medicine. Furthermore, it is my hope that this newest edition will help prepare students to become competent health care professionals who will continue to enhance the ongoing advancement of the athletic training profession.

In addition to the inclusion of material that focuses on evidence-based practice, this newest edition continues to undergo changes in content. The changes and additions are reflective of the ever-increasing body of knowledge that is expanding the scope of practice for the athletic trainer.

Throughout the text, information relevant to athletic trainers working in a variety of employment settings is included. As is the case for those working in secondary schools and colleges or universities, athletic trainers working in clinical, hospital, corporate, or industrial settings must be competent in preventing and recognizing injuries, and supervising injury rehabilitation programs. However, staff athletic trainers working in these settings treat and rehabilitate a wider range of patients both in terms of age and physical condition. The athletic trainer may provide care to pediatric, adolescent, young adult, adult, and geriatric patients. Patients may have physical ailments that may or may not be related to physical activity.

This latest edition of Principles of Athletic Training: A Guide to Evidence-Based Clinical Practice continues to evolve in concert with the profession. Historically, the authors have tried diligently to stay on the cutting edge of the athletic training profession with regard not only to presenting a comprehensive and ever expanding body of knowledge but also with the latest techniques of delivering educational content to students. Most evident in this edition is an extensive update of the references that have been used to find the most current available research-based evidence in the professional literature that can be used by clinicians in their clinical practice to enhance patient outcomes. In addition to the hard copy of this text, the author has created an online library of approximately 1,400 instructional videos that clearly demonstrate specific clinical techniques, injury evaluation skills, rehabilitative exercises, and manual therapy skills that are used by experienced athletic trainers. There is also an online eBook version of this text that will facilitate direct access to the instructional videos from within the body of the text.

One of the objectives throughout this text has been to incorporate the best available evidence to support the recommendations being made relative to patient care. The strength of those recommendations (SoR) based on the NATA Position, Official, and Consensus statements is identified within the text and can easily be found next to the reference where appropriate.

For the special tests presented in Chapters 18–25, the specificity, sensitivity, and positive and negative likelihood ratios are included wherever possible to show the usefulness and diagnostic accuracy of each of those tests based on the best available evidence in the literature.

Chapter 1

• Updated definition of the athletic training profession

• Updated the Mission Statement of the NATA

• Added new information on the athletic model vs. the medical model of organizational infrastructure

• Reorganized and updated information on the process of becoming certified as an athletic trainer

• Discusses the process of transitioning to the Masters as the entry-level professional degree

• Added information of the development of Specialty Certification

• Expanded information on the International Classification of Functioning Model

• Updated the list of available patient-related outcome measures used in sports medicine

• Added new information on work–life balance for athletic trainers

• Updated information on the NATA Code of Ethics

Chapter 2

• Updated information on electronic health records and electronic medical records

• Added new information regarding writing progress notes

• Reorganized the discussion of general medical screening

Chapter 3

• Added new information on developing policies and procedures for team road trips

• Updated information on filing insurance claims

• Added new information on the NATA Political Action Committee

• Update the listing of current CPT codes for athletic trainers

Chapter 4

• Added new information on the value of a dynamic warm-up prior to exercise

• Added a new mathematical formula for predicting maximum aerobic capacity

• Updated American College of Sports Medicine (ACSM) recommendations for exercise

• Reorganized and clarified discussion for how to calculate a target training heart rate

• Updated information on high-intensity training

• Updated information on theories underlying muscle hypertrophy

• Updated information about how age is related to the ability to generate muscular force

• Added new information on the effects of strength training on skeletal muscle

• Added new information on a variety of strength training techniques

• Added new information on measuring joint range of motion with a goniometer or inclinometer

• Updated information on stretching techniques

• Added new information on a dynamic progressive velocity flexibility program

Chapter 5

• Updated information on creatine supplementation

• Added new information on gluten-free diets

• Updated information on ingestion and resynthesis of carbohydrates

• Added new information on the “train low and compete high” model

• Added new information on using ultrasound to measure tissue thickness

• Added new information on avoidance/restrictive food intake disorder (ARFID)

Chapter 6

• Updated information on hyponatremia

• Updated information on fluid and electrolyte replacement

• Updated information on sunscreens

• Updated information on synthetic turf and its interaction with various shoe types

Chapter 7

• Updated list of equipment regulatory agencies

• Updated the most recent football helmet warning label

• Updated information on wearing protective headgear in soccer

• Updated information on wearing faceguards, eye shields, and protective eyewear

• Clarified the definition of a shoe upper

• Updated information on the effectiveness of ankle bracing

• Updated information on the effectiveness of functional knee braces

Chapter 8

• Updated information of the effects of ankle taping on proprioception

• Updated the effectiveness of Kinesio tape

Chapter 9

• Updated information on recommendations for managing osteoarthritis

Chapter 10

• Added new information on the importance of nutrition to the healing process

• Updated information on nerve healing

• Updated information on fracture immobilization

• Added caution about the use of medication to manage pain

Chapter 11

• Added new information on the integrated model of psychological response to injury

• Added new information on the biopsychosocial model of psychological response to injury

• Added new information self-talk as a technique for cognitive restructuring

Chapter 12

• Updated information on hypertension

• Added new information on oxygen saturation level (SpO₂)

• Updated information on the vacuum mattress splint

• Updated information from the Spine Injury in Sport Group (SISG), which has provided the most recent recommendations for the appropriate care of the spine injured athlete

• Clarified recommendations regarding when to use spinal motion restriction

• Clarified information on using a cervical spine collar

• Added new information on the Kendrick Extrication Device (KED)

Chapter 13

• Added new information on the Movement Efficiency (ME) Score

• Added new clinical prediction rules to Tables 13 and 14

• Updated the standard abbreviations and symbols used in medical documentation table

• Redefined the term objective findings

• Updated the Normal Laboratory Values of a Complete Blood Count (CBC) Panel

• Updated the Basic Metabolic Panel table

• Updated the Normal Laboratory Values of a Urinalysis table

• Added a Normal Blood Lipids Panel table

• Added new information on glucagon testing

• Added new information on spirometry

Chapter 14

• Reorganized and clarified the innate immune response

• Updated information on Hepatitis B, Hepatitis C, and human immunodeficiency viruses

• Added new information on using antiretroviral (ART) therapy for treating and preventing HIV infection

• Updated table on behaviors that may lead to increased risk of HIV infection

• Added new information on testing procedures for HIV

Chapter 15

• Added new information on Thermacare® Heat Wraps

• Added new information on contrast baths

• Added new information on whole-body cryotherapy

• Clarified and reorganized information on types of electrical current and waveforms

• Clarified information on continuous current modulation

• Added new information on Hivamat®

• Added new information on transcranial electrical stimulation

• Added new information on a rebound shortwave diathermy unit

• Updated and reorganized information on light therapy (LASER)

• Added new information on light emitting diodes (LED)

• Updated recommendations for ultrasound treatment

• Updated information on the non-thermal effects of ultrasound

• Added new information on extracorporeal shockwave therapy

• Updated information on cupping therapy

Chapter 16

• Updated information on functional testing

• Added information on self-myofascial release therapy

Chapter 17

• Clarified state and federal laws for athletic trainers administering and a dispensing medications

• Added new information on buying medications

• Added new information on storing medications

• Added new information on traveling with medications

• Added new updates on fluoroquinolones

• Added updates on anabolic steroid use

• Added new information of the use of electronic cigarettes (vaping)

• Added new information on cannabidiol and the use of medical marijuana

• Updated information on the use of opioids including Oxycodone and Fentanyl

• Added new information on the use of Narcan

Chapter 18

• Updated and clarified information on structural variations in the foot

• Updated information on over-pronation and over-supination

• Updated information on the use of orthotics

• Updated information on treatment for plantar fasciitis/fasciosis

Chapter 19

• Updated information on the use of taping, bracing, and high-top shoes for preventing ankle sprains

• Updated information on cause of recurrent ankle sprains

• Added new information on the Star Excursion Balance Test

• Added new information on the Lower Quarter Y-Balance Test

• Updated information on the treatment of acute ankle sprains and chronic ankle instability throughout

• Updated information on treatment decisions in managing compartment syndromes

Chapter 20

• Added new information on the newly discovered anterolateral (ALL) ligament

• Clarified information on synovial joints

• Added the Lever Sign Test for assessing ACL injury

• Updated and added new information for prevention of ACL injuries

• Added new information on surgical repair techniques for a torn ACL

• Updated information on managing and treating patellar tendinopathy

Chapter 21

• Clarified information on leg length discrepancy

• Updated information on groin strain

• Updated information on trochanteric bursitis

• Added new information on the Copenhagen Hip and Groin Outcome Score and the International Hip Outcome Tool

• Added new information on femoroacetabular impingement pain syndrome

• Updated information on Legg–Calve–Perthes disease

• Updated information on osteitis pubis

Chapter 22

• Updated information on prevention of shoulder injuries

• Clarified information on the full and empty can tests for the supraspinatus

• Added new information on the Bear Hug Test and the Lift-off Test for subscapularis tears

• Added new information on subjective shoulder scale assessments including the Disability of Arm, Shoulder and Hand, Constant–Murley Shoulder Score, and the Oxford Shoulder Score

• Added new information on techniques for reducing a dislocated shoulder and subsequent management

• Added new information on surgical versus non-surgical treatment of recurrent shoulder instability

• Updated information on rehabilitation of the shoulder joint

Chapter 23

• Updated information on the valgus and varus stress tests

• Added new information on the Single-Arm Seated Shotput test

• Added new information on the Upper Quarter Y-Balance test

• Added new information on the One-Arm Hop test

• Updated information on elbow contusions

• Updated information on muscle and tendon injuries about the elbow

• Updated information on olecranon bursitis

• Updated information on the effects of glenohumeral rotation deficit and valgus instability on ulnar collateral ligament injuries

• Updated information on both lateral and medial epicondylitis/epicondylosis

• Updated information on elbow osteochondritis

• Updated information on little league elbow

• Updated information on elbow dislocations

Chapter 24

• Updated information on the triangular fibrocartilage complex

• Updated information on trigger finger

• Updated information on mallet finger

• Updated information on boxer's fracture of the metacarpals

• Updated information on distal phalangeal fractures

Chapter 25

• Added new information on posture control shirts

• Updated information on the straight-leg raising test

• Updated information on cervical spine dislocations

• Updated information on recurrent and chronic low back pain

• Updated information on management of myofascial pain syndrome

• Updated information on management of lumbar ligament sprains

• Updated information on treating a herniated lumbar disk

Chapter 26

• Added new information on the Vestibula/Ocular-Motor Screening Form in the Appendix

• Added new information on the King–Devick test

• Added new information on smartphone apps for evaluating balance

• Updated the new Sport Concussion Assessment Tool 5 (SCAT5)

• Updated the most recent information on managing concussions in athletes

• Added the new Graduated Return to Sport Strategy and the Graduated Return to School Strategy tables

• Updated information on managing recurrent concussions

• Updated information on chronic traumatic encephalopathy (CTE)

• Updated information on post-concussion syndromes

• Add new information on temporomandibular joint dislocations

• Updated information on the effectiveness of mouthguards

• Added new information on a deviated septum

• Updated information on a nasal hematoma

• Updated information on corneal abrasions

• Updated information on conjunctivitis

Chapter 27

• Added new information on American Cancer Society Recommendation for breast cancer screening

• Updated information on sudden cardiac death in athletes

• Updated information on commotio cordis

• Updated information on kidney contusions and kidney stones

• Updated information on urinary tract infections

• Updated information on gastroesophageal reflux disease (GERD)

• Updated information on appendicitis

• Updated information on scrotal contusion

• Updated information on injury to the spleen

• Updated information on management of hernias

Chapter 28

• Updated information on management of calluses

• Updated information on management of friction blisters

• Added new information on the alternatives to sutures for wound closure

• Updated information on herpes viruses

• Updated information on spider bites

• Updated information on psoriasis

Chapter 29

• Updated information on treating the common cold

• Updated information on managing influenza

• Updated information on managing measles, mumps, and chicken pox and recommendation for vaccinations during childhood to prevent these diseases

• Updated information on viral pharyngitis

• Updated information on multiple sclerosis

• Updated information on amyotrophic lateral sclerosis

• Updated information on viral meningitis

• Updated information on diabetes mellitus

• Updated information on epilepsy

• Updated information on hypertension

• Updated recommendations for physical activity and exercise during pregnancy and the post-partum period

Test Bank

The test bank includes approximately 2,000 examination questions. Each chapter contains true-false, multiple choice, and completion test questions.

PowerPoint Presentation

A comprehensive and extensively illustrated PowerPoint presentation accompanies this text for use in classroom discussion. The PowerPoint presentation may also be converted to outlines and given to students as a handout. You can easily download the PowerPoint presentation from the Instructor Resources tab in Connect®.

Instructional Videos

More than 800 instructional videos are available on Connect® for Principles of Athletic Training. These visual aids are designed to illustrate key concepts, promote critical thinking, and engage students on the most relevant topics in athletic training. Videos demonstrating specific clinical techniques, injury evaluation skills, rehabilitative exercises, and manual therapy skills used by experienced athletic trainers are aligned with the corresponding figures from the text.

Connect^® for Principles of Athletic Training.

Connect is an online learning system composed of interactive exercises and assessments, like those that appear on the new Board of Certification exam. Videos, animations, and other multimedia features enable students to visualize complicated concepts and practice skills. All of the activities are automatically graded and can be submitted to the instructor's grade book. For more information, visit connect.mheducation.com

Connect® for Principles of Athletic Training was developed by Amanda Benson, PhD, ATC, from Louisiana State University, and Linda Bobo, PhD, ATC, from Stephen F. Austin Slate University, and has been updated for the new edition. Connect® is a Web-based assignment and assessment platform that gives students the means to better connect with their coursework, their instructors, and the important concepts that they need to know for success now and in the future. Students can practice important skills at their own pace and on their own schedule, receive instant feedback on their work, and track performance on key activities. With Connect®, students get 24/7 online access to an eBook—an online edition of the text—to aid them in successfully completing their work, wherever and whenever they choose. With Connect®, instructors can deliver assignments, graphing questions, quizzes, and tests easily online.