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Riana R. Pryor, Douglas J. Casa, Susan W. Yeargin and Zachary Y. Kerr

Key Points ▸ Schools with multiple athletic trainers implement more heat illness safety policies. ▸ Team physicians at football practices may enhance heat illness management strategies. ▸ Team physician presence may influence riskier heat illness prevention strategies. An estimated 9,200 high

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Keith M. Gorse, Graham Johnstone and Jennifer Cruse

A rare injury in collegiate athletics is the Lisfranc fracture-dislocation of the foot. This case study will give team physicians and athletic trainers an idea of what to look for in this type of injury. It will be shown how an 18-year-old college football player received the injury, how it was evaluated by the sports medicine staff, and how it was surgically treated by the team physician. Finally, the athlete's rehabilitation will be summarized and the time frame during which full activities were started again will be outlined. This case study will give sports medicine specialists a better understanding of the Lisfranc topic and how to deal with it.

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Ron A. Thompson

While college women in general are at risk for anorexia nervosa and bulimia, these disorders may present more of a problem for the student-athlete due to her weight/body consciousness and the pressure associated with athletic competition at the college or university level. This paper discusses the physical and psychological characteristics of each disorder, their etiology, and how each affects the life and performance of the athlete. Recommendations are offered regarding the role of the sport management team (i.e., sport psychologist, team physician, coach, athletic trainer, exercise physiologist) in assisting the eating-disordered athlete.

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Robert T. Bents and Erik Marsh

This study examined trends in stimulant use and attitudes towards use among American collegiate hockey athletes. All 139 players in one college hockey conference completed a comprehensive questionnaire. Over half of the athletes (51.8%) confrmed stimulant use before a hockey game or practice. About half of the respondents (48.5%) reported having used ephedra at least one time to improve athletic performance. Additionally, 17.4% reported using pseudoephedrine to improve performance in the 30 days prior to survey administration. Over half (55.4%) were aware of the recent national ban on ephedra. Fifty-nine% stated the national ban made them less likely to use ephedra products. The majority of athletes began use prior to college. Coaches, athletic trainers, and team physicians should be aware of athletes’ patterns of stimulant use. Improved educational efforts directed at younger athletes are necessary to deter abuse of metabolic stimulants.

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Kevin M. Guskiewicz and David H. Perrin

Returning athletes to competition following injury often creates a dilemma for athletic trainers and team physicians. Most clinicians gather as much data as possible before deciding whether to return an athlete to competition following injury. The status of the postural control system and balance is important for certain pathologies and therefore should be considered in these clinical decisions. As more high-tech balance systems become available, it is important for clinicians to understand not only what is available but what these devices measure. This paper will review the relationship between the postural control system and the kinetic chain, traditional and contemporary techniques for assessing balance, and ways in which clinicians can bridge the gap between balance research and clinical practice.

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Timothy Neal

Athletic health care professionals, team physicians, and athletic trainers have an ethical obligation to safeguard the short- and long-term well-being of the athlete they care for. The potential long-term negative consequences to the student-athlete’s physical, cognitive, and mental health as a result of concussions and their mismanagement is a reality. How the athletic health care professional attends to this top priority of providing optimal health care to the concussed athlete while navigating the mitigating circumstances and influences of nonmedical entities found in competitive athletics is one of the great ethical challenges of present day sports medicine. Effectively navigating the complex challenges faced by athletic health care professionals is as important as the care delivered. Understanding the ethical challenges faced by athletic health care decision makers should be a central focus in providing the optimal care the patient deserves.

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Debra M. Vinci

This paper presents an overview of the Husky Sport Nutrition Program at the University of Washington. This program is a component of the Department of Intercollegiate Athletics Total Student–Athlete Program, an NCAA-sponsored CHAMPS/Life Skills Program that provides life skills assistance to student–athletes. Successful integration of a sport nutrition program requires an understanding of the athletic culture, physiological milestones, and life stressors faced by college athletes. The sport nutritionist functions as an educator, counselor, and administrator. Team presentations and individual nutrition counseling provide athletes with accurate information on healthy eating behaviors for optimal performance. For women's sports, a multidisciplinary team including the sport nutritionist, team physician, clinical psychologist, and athletic trainer work to prevent and treat eating disorders. Case studies are presented illustrating the breadth of nutrition-related issues faced by a sport nutritionist working with college athletes.

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Kyle Southall, Matt Price and Courtney Wisler

Presentation Patient During a game, a 20-year-old collegiate Division I football athlete fell on his right flexed elbow and immediately reported local low grade pain swelling of the area to the athletic trainer. The initial sideline assessment by the athletic trainer and team physician revealed normal range of

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Kelly L. Holzberger, Kim Keeley and Martin Donahue

’s primary care physician. Intervention The team physician ordered a transthoracic echocardiogram (TTE), a 12-lead electrocardiogram (ECG), and a 48-hr Holter monitor. The TTE revealed no structural deformities and the ECG at rest was normal. The Holter monitor showed two episodes of a narrow complex rhythm