Sports Medicine / Training Room

CCC. SPORTS MEDICINE/TRAINING ROOM

1. GENERAL

SPORTS MEDICINE

1. The Sports Medicine Physicians are responsible for the medical care of University of Delaware student athletes.

2. The referral of athletes for specialized consultation (i.e.orthopedics, neurology, etc.), physical therapy, and diagnostic testing (laboratory, X-ray, etc.) will be arranged only by the Sports Medicine Physicians and their office staff.

3. Any athlete who, by personal choice, receives the above mentioned care without such referral by a University of Delaware Sports Medicine Physician must be cleared by a University Sports Medicine Physician prior to resuming participation in any University of Delaware sponsored conditioning, practices or, games.

4. The only places for recording and maintaining medical care information are in the patient's medical records in the Sports Medicine Clinic and Athletic Training Room.

For assessment made by the Sports Medicine Physician outside of the Clinic (e. g. on the field, in the athletic training room, in practice or during the game, etc.) the Sports Medicine Physician will record the findings using the standard S. O. A. P. format in the patient's record upon returning to the Sports Medicine Clinic.

If a specialist consultation is requested by the Sports Medicine Physician, a note of that assessment, examination, and treatment will be recorded in the patient's record. Unless it poses an imminent danger to the athlete, that assessment will be made in the Sports Medicine Clinic.

5. The Sports Medicine Clinic will be under the direction of the University of Delaware Student Health Services Sports Medicine Physicians. The clinic's role, in cooperation with the University Health Center, is to provide total health care for student-athletes certified for intercollegiate athletics and medical care for other students referred by the Student Health Center.

NOTE: Student-athletes injured in a sport while on a roster will continue, even if cut from the roster, to be treated by the Sports Medicine Clinic and the Athletic Training Room to resolution of that injury. (Approved by AGB, 4/10/03)

The Sports Medicine Physicians shall:

Establish office hours to be kept as posted from Monday through Friday and have the facility available as necessary.
Provide stand-by service by a Health Center physician, or another approved sports medicine physician, when the Sports Medicine Physicians have an authorized absence.
Examine and medically approve all student-athletes who participate in intercollegiate athletics prior to any active participation. A form certifying such approval will be distributed to the coach, equipment room staff, weight room staff and training room staff.
Provide to the University athletic trainer, and the coach when necessary, information concerning the medical condition of a student-athlete.
Comply with confidentiality requirements as directed by law. University regulations and the physician's code.
Provide, during championship and non-championship seasons, prescription drugs for athletically-related injuries incurred during scheduled and coach-supervised practices and competitions, by student-athletes, who are certified for intercollegiate competition. (Approved by Athletics - 1/03)
Refer certified student-athletes for intercollegiate athletics and other students to the University Athletic Training Room for treatment.
Inform the Senior Secretary, Insurance, of all applicable injuries for insurance purposes. "Athletic Injury Report" forms need to be forwarded to the Senior Secretary, Insurance.
Determine which student-athletes shall have participation waivers and file forms. These "Release and Waiver of Responsibility for Athletic Injury" forms are available only through the Sports Medicine Clinic.
Administer all medically related University policies including those for prescription pharmaceutical and over-the-counter drugs.
Administer the exit physical policy.

6. The coach plays a vital role in Sports Medicine and shall:

Provide the Assistant Director, Compliance and Operations a team roster well in advance of the first practice for certification or recertification through Sports Medicine Clinic.
Prohibit any student-athlete from participating without medical certification. The coach will be held responsible and subject to disciplinary action if a student is permitted to participate without medical certification.
Protect the student's health, safety and welfare as a top priority.
Refer a student-athlete whose health, safety or welfare is in question to a University athletic trainer or Sports Medicine Physicians immediately.
Encourage students to make Sports Medicine Clinic appointments immediately following referral by the athletic trainer.
Be prohibited from making referral of students to external physicians, therapy services or laboratory evaluations.
Comply with confidentiality requirements as directed by law, FERPA, HIPPA and University regulations.

ATHLETIC TRAINING ROOM

10. The administration of the Athletic Training Room is the responsibility of the Head Athletic Trainer. The Associate, Assistant, Graduate Assistant and students are responsible to that person in all matters pertaining to Athletic Training.

The Head Athletic Trainer will be responsible to the Sports Medicine Physician for clinical care of athletes, but will be administratively responsible to the Director of Athletics.

The athletic training room staff will follow all Delaware State laws relating to athletics training and physical therapy. A copy of the Delaware Code relating to physical therapy is kept on file in the Bob Carpenter Center, Delaware Field House and Carpenter Sports Building Athletic Training Rooms.
Athletes with minor sprains, strains and contusions who have not been evaluated by the Sports Medicine Physician will be carefully monitored by the Athletic Training Room. Athletes who do not show continued improvements within a reasonable time (4 days) shall be referred to the Sports Medicine Physician. Athletes with more serious injuries shall be restricted from practices and/or competition until they have been evaluated and cleared by the Sports Medicine Physician or his/her designee.
Physical Therapy services will only be provided by direct referral (written or verbal) by the Sports Medicine Physician.
Athletic trainers will not make referrals to outside consultants without consultation with the Sports Medicine Physician. The Student Health Service and/or the Sports Medicine Clinic are open 24 hours a day during the fall, winter and spring semesters when residence halls are open. There are, however, specific periods of time when there may be limited (day time only or no night and weekend) physician availability. These specific times are:
End of Fall Semester until beginning of Winter Session
Thanksgiving weekend
Spring recess
Summer recess

If during these dates a University of Delaware varsity athlete is injured and the team physicians or his/her designee is unavailable for consultation and/or medical referral and it is deemed the athlete should be evaluated by a physician, the University of Delaware Athletic Training staff may refer the injured athlete using the SHS Consultant List. When an athlete is referred to a consultant the Sports Medicine Clinic should be notified at the earliest convenience. When the athlete returns from the consultant he/she should be referred to the Sports Medicine Clinic with all medical documents.

e. The Head Athletic Trainer or his/her designee shall:

Provide first aid, treatment and rehabilitation for injuries incurred by certified student-athletes without consultation with the Sports Medicine Physician when treatment and/or rehabilitation has been delegated by the Sports Medicine Physician to the athletic trainers.
Provide first aid, treatment and/or rehabilitation for students other than certified student-athletes when referred by the Sports Medicine Physician or the Student Health Center.
Provide confidentiality of a student-athlete's medical history, record of injury or surgery, record of serious illness and rehabilitation results. If an organization requests this information as a determination for offering employment, it will only be released if the student-athlete signs a release authorization provided by the Sports Medicine Clinic.
Comply with confidentiality requirements as directed by law and University regulations.

11. Upon completion of eligibility in their final sport, student-athletes are requested to schedule an appointment with the Sports Medicine Clinic, prior to the conclusion of the academic term, for the purpose of an exit physical. If a student-athlete chooses not to have an exit physical, the University will be relieved of any liability and/or financial responsibility for any damages or injuries sustained as a result of the athletics participation. This policy is implemented through the office of the Director of Athletics. Head coaches are sent a "Postseason Injury Questionnaire" for each student-athlete completing eligibility by the Executive Secretary. Head coaches are responsible for ensuring that all applicable student-athletes are informed of the exit physical policy upon receipt of the "Postseason Injury Questionnaires". In addition, coaches are responsible for confirming the names of such individuals with the Executive Secretary.

12. All licensed Athletic Training Room personnel, as official representatives of the University of Delaware will be expected to adhere to the following standards.

The rules and regulations of the State of Delaware Physical Therapy and Athletic Training Practice Act will be strictly followed.
In accordance with the law, prescription pharmaceuticals may not be stored in or dispensed by the Athletic Training Room.
The administration of medication by phonophoresis or iontophoresis must be coordinated with, and under the prescription of, the Sports Medicine Physician or a Student Health Service Physician.
The following Over-the-Counter (OTC) pharmaceuticals may be dispensed on a unit dose basis by Licensed Athletic Trainers. These medications will be provided to the Athletic Department Athletic Training Room by the Sports Medicine Clinic. A log will be kept by Sports Medicine as to the amounts of these medications being provided to each
team. No more than a 3 day supply may be dispensed to a given student athlete without further evaluation by a Sports Medicine Physician. No other OTC medications may be dispensed by the Athletic Training Room staff without direct communication with a Team Physician.

Acetaminophen (Tylenol)
Tums (Antacid)
Imodium (Anti-diarrhea agent)
Phenylephrine (Decongestant)
Throat Lozenges
Pepto Bismol Tablets

In event of injury to an athlete, standard first aid procedures will be applied.
Physical therapy and rehabilitation programs will be administered only to full-time University students by non-athletic department physical therapists through:

written prescription by the Sports Medicine Physicians
Written prescription by a physician from the Student Health Service.
Exceptions to this may be approved only by the Director of Athletics.

Complete records of physical therapy, athletic training, rehabilitation and records of progress shall be maintained.
In the event of an injury to any member of the authorized traveling party of a team playing away from Newark, athletic training room personnel shall:

Follow the rules and regulations of the State of Delaware Physical Therapy and Athletic Training Practice Act regarding the care of athletic injuries.
Request services by the home team physician, or utilize the local emergency room when an injury should be seen by a physician prior to returning to campus.
For any injury that occurs during an away event that will require a referral to the SMC, a team physician or the Sports Medicine Clinic should be notified as soon as safely possible.
Upon return to campus, an athlete whose injuries require immediate medical attention should be taken to the Student Health Service, Newark Emergency Center, or Christiana Hospital Emergency Room.

13. The physical rehabilitation policy is:

All coaches, faculty, physicians, administrators and staff must be aware of the importance of and strictly adhere to the University policy regarding medication and drug usage/distribution as well as the Athletic Training Room and physical rehabilitation policy.
Non-compliance with some sections of the policy could, and probably would, result in criminal action.
The conduct of the program as it relates to the laws governing prescription and non-prescription drugs will be monitored by state officials.
The policy statement requires strict compliance and no exceptions will be tolerated. All Athletics staff, including coaches and administrators need to read, understand and comply with the policy.

14. The use of Athletic Training Room facilities by visiting teams will be governed by the following:

When treating a member of the visiting team for a pre- existing illness or injury, the athlete must have a note or prescription from his/her team physician or certified athletic trainer prior to having any treatment or therapy, unless accompanied by a certified athletic trainer.
Acute injury or illness will be seen and treated as necessary on request of athletic trainer or coach of visiting team.
No medical decision will be made about ability to participate of a member of the visiting team with a previous or chronic illness or injury.

15. The Athletic Training Room policy for athletic training students is written in the Handbook for Athletic Training Students. Copies are available in Bob Carpenter Center, Delaware Field House and Carpenter Sports Building Athletic Training Rooms.

16. For teams that travel without an athletic trainer, when medical advice is needed, coaches should first contact the home team certified athletic trainer, or if unavailable, the staff athletic trainer assigned to that sport, or, if unavailable, the Head Athletic Trainer, or, if unavailable, the Sports Medicine Physician. When situations arise that are not covered by Athletics medical insurance (e. g., illness), the following guidelines will assist:

Encourage all students to carry their insurance information with them.
Upon request, the Senior Secretary, Insurance can provide the insurance numbers of your team members (those who have returned cards) and you can carry this information.
Attempt to acquire medical advice/attention through the host institution.
Contact the parents to alert them to the situation, including the financial responsibility at the earliest opportunity. NOTE: HIPPA and FERPA regulations define anyone 18 years of age or older as an adult who must give permission to contact his/her parents.
Have the student provide all necessary information, preferably provide insurance information, or request billing and give parents/guardians address, telephone number, etc. at the medical facility. The student, not the coach should make all financial/billing arrangements.
Have the student contact the Sports Medicine Clinic immediately upon return to campus to apprise them of the situation.
All billing, just as for injuries that are covered by Athletics medical insurance, is to go to the student-athlete or his/her parents/guardians, not to Athletics, nor to the coach.

17. Student-athletes who have been diagnosed by their personal physician, by the University of Delaware's Sports Medicine Physician or by a consultant physician as having a potentially "life threatening" medical condition, shall be precluded from participation in the intercollegiate athletics program. See "Life Threatening Condition" for further information.

2. ORTHOPAEDIC POLICY

UD Sports Medicine Orthopaedic Consultant Referral Policy

Per Athletics Policy Manual DDD. 2: The referral of athletes for specialized consultation (i.e.orthopedics, neurology, etc.), physical therapy, and diagnostic testing (laboratory, X-ray, etc.) will be arranged only by the Sports Medicine Physicians and their office staff.
Per Athletics Policy Manual DDD. 3: Any athlete who, by personal choice, receives the above mentioned care without such referral by a University of Delaware Sports Medicine Physician must be cleared by a University Sports Medicine Physician prior to resuming participation in any University of Delaware sponsored conditioning, practices or, games.

Per Athletics Policy Manual DDD.6: The coach plays a vital role in Sports Medicine and shall . . . . Be prohibited from making referral of students to external physicians, therapy services or laboratory evaluations.

All Orthopaedic Consultants must be Board Certified by the American Board of Orthopedic Surgery or American Osteopathic Board of Orthopedic Surgeons. Board eligibility is not a sufficient level of credentialing for this consideration.
All Orthopaedic Consultants must hold a current licensure to practice medicine in the state of Delaware.
To be considered as a Sideline Consultant, an Orthopedic Surgeon must:

Have completed a Sports Medicine Fellowship
Complete the University of Delaware Student Health Service Credentialing process

It is the expectation of the Sports Medicine Clinic at the University of Delaware that all Orthopedic Consultants will:

Communicate either in writing or by verbal communication their findings and plan of care within 24 hours of seeing a University of Delaware Student Athlete.

It is understood that circumstances may exist that may make this request difficult at times but every effort should be made to meet this 24 hour request.

Refer the University of Delaware Student Athlete back to the Sports Medicine Clinic to obtain proper referral prior to pursuing the following (Emergency situations will make this request obsolete):

Additional Studies

Radiologic Studies
Laboratory Work

Physical Therapy Referrals
Filling of Prescriptions
Referral to other consultants

Understand that at times, it will be necessary for a second opinion to be obtained.

This second opinion will be regional in nature and no local (Defined as main office located within the borders of New Castle County, Delaware) second opinions will be supported by the University of Delaware.

All approved Orthopedic Consultants will be used at the discretion of the University of Delaware Sports Medicine Physicians under the Supervision of the Student Health Services.

Any questioning of decisions regarding level or frequency of referral will be grounds for removal from the list of approved consultants.
Consultants are expected to respect the members of the UD Sports Medicine Staff and other Orthopaedic Consultants at all times. Differing opinions regarding prior treatment techniques should not be aired in front of the student athlete, their parent or legal guardian but discussed with the Sports Medicine Staff following the evaluation session. Disrespect will not be tolerated.

Every effort will be made to maintain patient-physician relationships with prior Orthopedic Surgeons whether or not they are approved consultants.
To assure appropriate insurance coverage and fiscal responsibility.

Per Athletics Policy Manual GG.2.e.: Medical treatment by non-University of Delaware personnel must be authorized by the Sports Medicine Physician or his/her appointee.
Per Athletics Policy Manual GG.2.f.: Unauthorized medical treatment is the sole responsibility of the athlete and/or his/her parents/guardians.

3. PHYSICAL THERAPY POLICY

Per standing Athletic Department Policy:

The referral of athletes for specialized consultation (i.e.orthopedics, neurology, etc.), physical therapy, and diagnostic testing (laboratory, X-ray, etc.) will be arranged only by the Sports Medicine Physicians and their office staff. (CCC.2.)
The administration of the Athletic Training Room is the responsibility of the Head Athletic Trainer. The Associate, Assistant, Graduate Assistant and students are responsible to that person in all matters pertaining to Athletic Training. (CCC.10.)

Athletes with minor sprains, strains and contusions who have not been evaluated by the Sports Medicine Physician will be carefully monitored by the Athletic Training Room. Athletes who do not show continued improvements within a reasonable time (4 days) shall be referred to the Sports Medicine Physician. Athletes with more serious injuries shall be restricted from practices and/or competition until they have been evaluated and cleared by the Sports Medicine Physician or his/her designee.
Physical Therapy services will only be provided by direct referral (written or verbal) by the Sports Medicine Physician.

When Physical Therapy Services, above and beyond the rehabilitation services already being provided by the Athletic Training services, are deemed to be necessary by the Sports Medicine Physicians:

A referral will be generated by a Sports Medicine Physician
The University of Delaware Physical Therapy Department will serve as the preferred site of first referral. Outside services will be sought only under the following conditions.

Patient has had a prior interaction with a provider of Physical Therapy Services and wishes to return to that location.
An outside consultant specifically requests that a particular provider of Physical Therapy is used and has justification for that request
The student athlete fails to progress towards return to function appropriately while receiving Physical Therapy at UD and it is felt that another Physical Therapist may be able to achieve this goal by using different therapeutic techniques.

The Athletic Trainer responsible for the care of the athlete will be notified by the Sports Medicine Physician that a referral for PT services has been processed.

An initial evaluation will be sent back to the referring Sports Medicine Physician by the Physical Therapist who has evaluated the student athlete.

Once reviewed by the Sports Medicine Physician responsible for the care of that particular Student Athlete it will then be distributed to the Athletic Trainer responsible for their care.
The Sports Medicine Physician will delineate which services are to be provided in the athletic training room and which will provided at the Physical Therapy setting.

The Athletic Trainer and the Physical Therapist are encouraged to communicate on a regular basis to improve and integrate the care being provided to the student athlete.

Weekly update notes will be created by the Provider of Physical Therapy Services to maintain an appropriate level of communication between the caregivers to the University of Delaware Student Athlete

These update notes will be reviewed by the Sports Medicine Physician responsible for the care of that particular Student Athlete then distributed to the Athletic Trainer responsible for their care.
Communication of ongoing plans is encouraged and should also include the Strength and Conditioning Coaches once appropriate.

A weekly Physical Therapy “Brain-storming” evaluation will occur each week of the academic year under the supervision of the Head Athletic Trainer

Selected student athletes will be evaluated by a physical therapist associated with the UD PT department to provide further insight into potential therapeutic treatment options that may hasten their recovery from an injury.
All athletes selected for this evaluation must have previously seen a Sports Medicine Physician at the UD Sports Medicine Clinic.
No athlete may be evaluated by the consulting physical therapist without the presence of a member of the UD Athletic Training staff.
The visit and its subsequent rehabilitation recommendations will be recorded into the athletic training room documentation system using a prescribed evaluation form. (See addendum A) This form will be completed by the consulting Physical Therapist prior to leaving the Athletic Training Facility.
This service will be open to all athletes who are eligible for care in the athletic training room.
No fee will be charged to the student athlete for this additional service
The Physical Therapists used for purposes of this consultation must be part of the faculty (or adjunct faculty) in the University of Delaware Physical Therapy Program.
All consultants should respect the members of the treatment team at all times. Differing opinions regarding prior treatment techniques should not be aired in front of the student athlete, their parent or legal guardian, but discussed with the Sports Medicine Staff following the evaluation session. Disrespect will not be tolerated.
If a Physical Therapy consultant is not able to make a scheduled evaluation session, they must notify the Head Athletic Trainer so that alternative plans can be arranged.

Failure to be present at 3 scheduled sessions in a given academic year will preclude future consideration for this service
No substitutes will be accepted without prior approval of the head athletic trainer and the UD Physical Therapy Department.

The schedule for these consultations will be created by the Head Athletic Trainer in conjunction with the Assistant Athletic Director, Sports Medicine, and UD Physical Therapy.