Written by:
Dan Wathen - Youngstown State University, Ohio, USA

The term Sports Medicine is widely used and has numerous meanings. Many feel that anyone who has anything to do with health education, illness and injury prevention, treatment and rehabilitation, and basic and applied research of active (sports and general fitness) populations is involved with Sports Medicine. Certainly within this broad context the Strength and Conditioning Specialist can be found. Generally these members of the Sports Medicine team work with healthy populations but they can also serve to supply the link between formal physiotherapy and return to active participation for injured athletes and fitness enthusiasts. Their main contribution to the athletic individual is improved performance however their main function to the Sports Medical team is in the area of injury prevention.

Most members of the sports medicine team are aware of the benefits of strength and conditioning on the physiology and psychology of the athlete. Stronger bones, muscles, tendons, and ligaments are more difficult to disrupt than weaker ones (1,2,3,6,7,8). Strong athletes have greater self confidence and esteem (1). A fit athlete will fatigue less easily and maintain their concentration for longer periods of time (9). Energy demands and oxygen transport are better met by fitter individuals. Recent studies (5) indicate that appropriate physical training can reduce specific injuries such as anterior cruciate ligament sprains in women athletes.

The Strength and Conditioning Specialist begins their contributions to the Sports Medical team by evaluating the individuals strengths and deficiencies in a battery of sports/activity specific fitness tests. These tests assess the strength, power, speed, endurance, flexibility, and body composition of the athlete. The tests are specific to the fitness demands of the activity. For example power is very important in volleyball, throwing events, baseball, basketball, hockey, tennis, American football, sprint running and swimming. Endurance should be measured according to the metabolic demands of the activity. Soccer players run for longer periods of time than baseball players and must be evaluated accordingly. Upper body strength is more important to wrestlers than distance runners. By determining the strengths and weaknesses of a player a program can be devised to correct imbalances and deficiencies which may lead to injury (1,2,3,4,7,8).

Next the Strength and Conditioning Specialist can design a program to address the specific fitness needs of the activity and the individual. This program is determined by the biomechanical nature and metabolic needs of the activity along with the individuals strengths and weaknesses. The medical history of the individual should be discussed in order to determine if previous injuries remain incompletely rehabilitated or will require program modifications. This area may require consultation with other members of the sports medical team. Activities that are specific to the demands of the sport are included. These include strength training, plyometric drills, flexibility exercises, agility drills, and a variety of sport specific endurance activities. The program should be Periodized to bring the athlete to peak condition at the most important events and to avoid overtraining that can lead to injury. This requires regular variation in exercises, exercise intensity ( average load ) and volume (total load ). The program will be cyclic in nature and have goals for the off-season ( general preparatory), pre-season (specific preparatory), in-season (competitive) and included rest periods (transitional) at various intervals during the cycles. This type of programming allows for peaks in fitness that aid performance. It also addresses weaknesses that may contribute to injury. The performer gains added self confidence from improved fitness which translates to injury reduction.(1)

The Strength and Conditioning Specialist can be employed to take the injured competitor, after a suitable period of physiotherapy, and recondition them so they have a reduced risk of re-injury. Many times an athlete will return to participation before they have regained the necessary strength, power, and endurance they had pre-injury to effectively compete. The Strength and Conditioning Specialist can serve as the link between the physiotherapist and skill/sport coach. This alone makes them a valuable member of a sports medical team.

Finally they should be looked upon and a resource by other members of the sports medical team in the areas of exercise for not only performance improvement but injury prevention. They can help dispel many myths and misconceptions about physical training and guide other members of the team in this area. By working in concert with physicians, coaches, trainers, physiotherapists, nutritionists, sports scientists, and psychologists the strength and conditioning specialist can fill an important block in the structure of the sports medicine team.