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 fifteen 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 50 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 sixteenth 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 decade, 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 or in industrial and occupational settings, working under the direction of a physician as physician extenders. 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 has gained recognition 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 sixteenth 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 sixteenth 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 sixteenth 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 the replacement of many of the older photos, and the addition of new photos to better illustrate the injuries, conditions, or clinical techniques described in the text. 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 to 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

• Added information on the Youth Sport Safety Alliance and their Secondary School Student Athletes Bill of Rights

• Added new information on the athletic trainer’s role in managing athletes with disabilities

• Updated the information on rating the levels of evidence and the strength of recommendations

• Expanded the section on patient-related outcome measures

• Added new table listing the outcome measures most often used by sports medicine professionals

• Added information on the CAATE decision to establish the entry-level degree for professional practice for athletic trainers at the masters level

• Update Board of Certification requirements for certification and continuing education

Chapter 2

• Added new information on establishing a crisis management plan

• Updated information on electronic medical records

• Reorganized, expanded, and updated the information on pre-participation exams

• Replaced old versions with new updated medical history and physical examination forms

Chapter 3

• Clarified information on negligence

• Added new information and a focus box explaining the Affordable Care Act

• Replaced outdated form with a new Student-Athlete Insurance Information form

Chapter 4

• Updated information on newest guidelines and recommendations for continuous training relative to intensity of the activity

• Updated information on high-intensity interval training

• Updated information on fartlek training

• Updated information on weight-bearing exercises

Chapter 5

• Updated new 2016 Food label

• Updated information on vegetarian diets

• Updated the calorie table for fast foods

• Added new section on Dual Energy X-ray Absorptiometry (DXA)

• Added new information on binge eating disorder

Chapter 6

• Updated NCAA-mandated guidelines for acclimatization in preseason football practices

• Updated revised information from the NATA 2015 position statement on exertional heat illness

• Changed classification of hyponatremia, which is no longer classified as an exertional heat illness

• Updated information on lightning safety

Chapter 7

• Updated table on equipment regulatory agencies

• Updated information on the selection and fitting of the newest available football helmets

• Included updated information on the effectiveness of soccer headgear

Chapter 8

• Updated the information on the effectiveness of using ankle braces versus ankle taping

Chapter 9

• Updated information on the cause of muscle cramps

• Revised information on tendinopathies to clarify the differences between tendinitis and tendinosis

Chapter 10

• Revised and clarified information on the gate control theory of pain management

Chapter 11

• Updated information on mental disorders

• Updated the keys for referring patients with mental disorders for further care

Chapter 12

• Added new information on medical “time-outs”

• Reorganized and updated new 2015 guidelines for CPR

• Added new acronym POLICE and updated discussion of acute care for musculoskeletal injuries

• Added new inter-association recommendations for removal of facemask, helmet, and shoulder pads

• Added new recommendation for treating patients with suspected cervical spine injuries, including immobilization and placing the patient on a spineboard, scoop stretcher, or vacuum mattress

Chapter 13

• Reorganized the order of topic presentation throughout to create a more logical flow of information

• Added a new discussion and photos of various functional screening tests

• Added a new discussion on applying the best available evidence in clinical decision making, including sensitivity, specificity, likelihood ratios, and more.

• Updated information and replaced all of the photos for various imaging techniques

• Added new information on refractometers

Chapter 14

• Updated the most current information regarding the immune system

• Updated the most recent worldwide and U.S. statistics in HIV and AIDS

Chapter 15

• Updated the section on shortwave diathermy

• Added new discussion of dry needling technique

• Replaced most of the pictures with updated photos of the latest therapeutic modality devices

Chapter 16

• Added new information on the mental aspects of dealing with the stress of rehabilitating an injury

• Updated information on the Graston technique

• Added new information on structural integration

• Added new information on postural restoration

Chapter 17

• Updated the table of the list of drug classifications and definitions

• Updated the athletic trainers guide to frequently used drugs

Chapter 18

• Introduced the concept of the “core” in the foot

• Clarified the functions of absorption and propulsion in the foot as they apply to pronation and supination

• Added new special tests: Mulder’s test and the Dorsiflexion-Eversion test

• Updated information on using orthotics to enhance foot control

Chapter 19

• Added new special test for the ankle: the Cotton test.

• Added clinical prediction rules for the ankle joint

• Updated information on the most recent management and rehabilitation techniques for ankle sprains

• Emphasized the importance of balance training in patients with chronic ankle instability

Chapter 20

• Added clinical prediction rules for the knee

• Updated information on shoe types and the relationship to knee injuries

• Updated most recent information on the mechanisms that cause injuries to the ACL

• Updated information on the most current strategies for preventing knee injuries

Chapter 21

• Updated information about the mechanism and treatment of hamstring injuries

• Added additional special test for the hip including: flexion-internal rotation test, scour test, patellar-pubic percussion test, resisted hip abduction test, and Craig’s test

• Added new clinical prediction rules for the hip

Chapter 22

• Added new special test: the Rent test

• Added new clinical prediction rules for the shoulder

Chapter 23

• Added new special tests: the elbow-extension test and moving valgus stress test

• Updated etiology for ulnar collateral ligament injury

• Updated information on medial and lateral epicondylitis

Chapter 24

• Added clinical prediction rule for carpal tunnel syndrome

• Updated and replaced the majority of the photos

Chapter 25

• Added new tests: Stork test, Gillet test, Gaenslen’s test, thigh thrust rest, sacral thrust test, and prone instability test

• Added clinical prediction rules for the spine

Chapter 26

• Updated the ever-changing information on prevention, assessment, and management of concussion

• Added the latest version of the Sport Concussion Assessment Tool 3 (SCAT3)

• Updated information where appropriate on facial, dental, eye, ear, and nasal injuries

Chapter 28

• Replaced almost all of the photos depicting the various types of skin diseases and disorders

Chapters 27 and 29

• Updated both chapters with the latest medical information on organs and body systems, general medical conditions to help the athletic trainer with recognition, management, and referral decisions

These resources include invaluable information to accompany the sixteenth edition of Principles of Athletic Training, including key terminology, lecture outlines, and worksheets with the accompanying answer keys. It also integrates the text with image clips. These components can be accessed via the Instructor Resources tab within Connect^®.

Test Bank

The test bank includes approximately 2,000 examination questions. Each chapter contains true-false, multiple choice, and completion test questions. The worksheets in each chapter also include a separate test bank of matching, short-answer, listing, essay, and personal or injury assessment questions that can be used as self-testing tools for students or as additional sources for examination questions.

Computerized Test Bank

McGraw-Hill’s EZ Test is a flexible and easy-to-use electronic testing program. The program allows instructors to create tests from book specific items. It accommodates a wide range of question types and instructors may add their own questions. Multiple versions of the test can be created, and any test can be exported for use with course management systems such as WebCT, BlackBoard, or PageOut. The program is available for Windows and Macintosh environments.

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

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.

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 http://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.