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The Role of Sports Medicine in Officer Safety and Wellness


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Title: The Role of Sports Medicine in Officer Safety and Wellness

The Role of Sports Medicine in Officer Safety and
  • Nancy C. Burke, MS, VATL, ATC

    Athletic Trainer
  • Fairfax County Police Department,
  • Fairfax Virginia
  • Major Edwin C. Roessler Jr., Director
  • Fairfax County Criminal Justice Academy
  • Fairfax County Police Department

IACP Annual Conference Denver, CO October 5, 2009
Learning Goals
  • Understand what an Athletic Trainer is
  • Explore how the idea was put into action at the
    Fairfax County Criminal Justice Academy
  • Discuss how the program was incorporated with
    business flows
  • Learn about successes challenges
  • Explore future strategic goals
  • PLEASE ask questions often!

Overview of the FCPD
  • County is 399 square miles
  • Population in excess of 1 million
  • Department comprised of over 1,700 sworn and
    civilian personnel
  • Serves an urban diverse community
  • Recruit and in-service training is conducted at
    the Fairfax County Criminal Justice Academy

Pre-Athletic Trainer Program/Policies in the FCPD
  • General Order 331
  • First report of injury by supervisor
  • Authorized Physician Panel list
  • Risk Managements old philosophy
  • Old system Little to no advocate

  • The meeting
  • Project plan developed
  • Funding
  • Space
  • Equipment
  • Stakeholders
  • Risk Management
  • Occupational Health Center
  • Fire Department
  • Sheriffs Office

The Pilot
  • Mission Statement
  • Maintain and improve general overall wellness
    provide for care and prevention of injury and
  • Housed at CJA
  • Recruit class as the control group
  • Prior tracking of dismissals due to injuries
  • Ability to closely monitor
  • Diverse group from Academy member agencies
  • Initial Start Up at the CJA
  • Trust fear of reporting injuries (dismissal
  • Rapport building
  • Word of mouth
  • Tracking successes
  • Wellness Advisory group meetings

Imbedding the Program
  • Position description created as limited term
  • Not merit position
  • Must take break in 11 month
  • Placement in the organizational chart
  • Housed at the Academy
  • Reports in chain of command (Academy)
  • Direct report to Risk Management and OHC
  • Joined with Academy Wellness Program
  • Networks with Incident Support Services
  • Advisor to specialized training efforts (i.e.
    SWAT school)
  • Contributor to Departments Training Bulletin
  • Network with other local academies
  • HIPAA applies
  • Line item on Departments budget

Background Information
What is a Certified Athletic Trainer?
  • Athletic Trainers are medical professionals who
    are experts in injury prevention, assessment,
    treatment and rehabilitation of injuries and
    illnesses that occur to athletes and the
    physically active.
  • Athletic trainers deliver rehabilitation services
    under a physicians guidelines. 

  • Athletic Trainers are NOT personal trainers.
  • An Athletic Trainer meets the qualifications set
    by a state licensure and/or the Board of
    Certification, Inc. and practices athletic
    training under the direction of a physician.
  • A personal trainer prescribes, monitors and
    changes an individuals specific exercise program
    in a fitness or sports setting.

  • Athletic Training is an allied healthcare
  • recognized by the American Medical Association
  • Other allied healthcare professions include, but
    are not
  • limited to audiologists, nurses, cardiovascular
  • technologist, medical technologist,
  • dentist, physical therapist, physicians
  • physician, psychologist.

  • Athletic Trainers are regulated and licensed
    health care workers.
  • Athletic Trainers know and practice health care
    at the highest professional, ethical and quality
    standards in order to protect the public.
  • Athletic Trainers specialize in patient
    education to prevent injury and re-injury and
    reduce rehabilitative and other health care

Differences Athletic Trainer / Physical
Athletic Trainer Physical
Therapist Rehabilitates injuries of a
mostly Rehabilitates injuries and illness
orthopedic nature in the active of many
different patient population populations Res
ponsible for the prevention of Work with
orthopedic patients, as well as and immediate
care of injury patients with unique medical
conditions and/or illness Traditional
setting is on-site at the Traditional setting
is a clinic. time of injury. Provides
immediate Clinical treatments only. treatment
and continues care. Provides care following
physician Provides care following
physician guidelines guidelines Physical
performance test specific to Law enforcement.
Practice Domains
  • Prevention
  • Clinical Evaluation and Diagnosis
  • Immediate Care
  • Treatment, Rehabilitation and Reconditioning
  • Organization and Administration
  • Professional Responsibility

Where Do Athletic Trainers Practice?
Secondary Schools Corporate Health
Programs Performing Arts Sports Medicine
Practices Physician Clinics Physical Therapy
Clinics Military Colleges and Universities Law
Enforcement Industrial Health Care Professional
Sports Medicine and Occupational Health
Sports Medicine is the practice of treating
individuals who have been injured in physical
activity. Began as a specialty working with
sport specific athletes and has branched out into
the general active person.
Sports Medicine
Athletic Model Law Enforcement
Model Team Physician Workers
Compensation Panel Physician / Personal
Physician Coach
Supervisor Athletic Trainer Athletic
Sports Medicine Team
Sports Medicine Principles
  • Prevention / Education
  • Fitness / Wellness
  • Early Intervention / Immediate Care
  • Biomechanics / Ergonomics
  • On-Site Rehabilitation
  • Functional or Work Specific Training

Early Intervention is KEY !
  • Injured workers treated within the first 24
    hours were more likely to be out of work a week
    or less, more satisfied with their medical care,
    physician and employer, and less likely to
    contact an attorney.
  • (Zigenfus, G, Physical Therapy)
  • Fewer physician visits, decreased lost time
  • Early intervention can give the opportunity to
    set an expectation of recovery.

  • Athlete - A person possessing the natural or
    acquired traits, such as strength, agility, and
    endurance, that are necessary for physical
    exercise or sports, especially those performed in
    competitive contests.
  • Tactical Athlete - any public safety officer
    who engages in high risk operations. Such
    operations require high levels of strength,
    speed, power, and agility. This includes
    aerobic and anaerobic fitness.

Benefits of the Sports Medicine Model in Law
Enforcement Settings
  • Improved Employee Morale
  • Increased Productivity
  • Decreased Incident and Severity of Injury
  • Decrease in Workers Compensation Costs
  • Quality of Care

Principles of Sports Medicine Care
  • Team approach inclusive of physicians, athletic
    trainer, patient, supervisor
  • Early intervention
  • Expectation of recovery
  • Function- oriented treatment

Medical Care Costs
  • Medical care costs are a combination of
  • Actual medical services delivered
  • Estimated 80 of the cost from lost
  • work time, indemnity, wage replacement,
    administrative costs.

General Program Overview
Sports Medicine Occupational Model of Care
Allivato, J The Sports Medicine Model of Care
for your Occupational Athlete, 2003
Care for Injured Officers
  • The time is long overdue to provide
  • first class treatment and support.
  • Officers not back on duty within 90 days
  • of an injury (light duty or full duty) have
  • only a 20 chance of returning to duty.
  • (Mathis and Schreuder, Workers Compensation

Fairfax County Police Department Injury Care
and Prevention Program
Mission Statement
  • Mission Statement
  • Maintain and improve general overall wellness
    provide for care and prevention of injury and

Goals of the Athletic Trainer
  • Prompt access to physicians
  • Enhance the delivery of medical care
  • Rehabilitation
  • Liaison to Third Party Administrators and
  • Dedicated educational resource center

Medical Supervisor
  • Licensed Physician
  • Required by NATA Board of Certification and
    state Board of Medicine

What can the Athletic Trainer Do?
  • Provide primary injury evaluation and immediate
  • Make referrals to the appropriate workers
    compensation physician, private physician or
    healthcare provider
  • Expedite many physician visits

  • Develop a medical care plan with the physician
    and/or healthcare provider
  • Administer the medical care plan
  • Monitor the progress of the officer
  • Administer physical performance tests to advise
    physicians on duty status.

Therapy Provided by the Athletic Trainer
  • Therapy may be provided for both work and
    non-work related conditions.
  • Immediate evaluation and general medical care
  • Cryo-therapy
  • Thermo-therapy
  • Ultrasound
  • Electrical Stimulation
  • Cold Laser and Photo-therapy
  • Prescriptive Exercise Program
  • Recommendations for appropriate braces
  • And much more.

Athletic Trainer Schedule
  • 40-hour work week
  • Flex schedule to meet workload demands
  • 24/7 access by County cell phone (rolled into
    Incident Support Services)

  • Whether there is a need to see the physician or
  • not, the Athletic Trainer can begin
    rehabilitation ASAP.
  • Multiple studies support early rehabilitation
  • treatment resulting in faster healing.

Clinic Appointments
  • Rehabilitation may be completed every day.
  • Scheduled appointments are made OR
  • walk-ins freely accepted.
  • Walk-in appointments allow for shift changes,
    delays at court, weather adjustments, etc.

  • The Athletic Trainer follows the physicians
    guidelines for rehabilitation and treatment is
    compliant with HIPAA regulations.
  • Patient progress notification to the treating
  • physician is made on a timely basis through
  • email, telephone calls and fax reports.

  • The Athletic Trainer CANNOT sign the Medical
    Status Form to return an officer to full duty.
  • The Athletic Trainer keeps the physician
    informed of the employees progress for the
    Medical Status Form.

Work Injury Scenario Comparison
Post AT Urgent Care AT clinical
diagnosis Orthopedist 5 days
Orthopedist 1-2 days Therapy - 7 to 10 days
Therapy-Immediate Lost time Before
Treatment 5 7 days 0 Return to Full
Duty Status 4 5 weeks 2 3 weeks
Ruptured Achilles/Fractured Foot   Pre-AT Post
AT Urgent Care AT Clinical Diagnosis Specialis
t 2-4 days Specialist - same day Surgery
8-10 days Surgery 3-5 days Therapy Begun 2
weeks Therapy Begun 4 days  Recovery to Full
Duty 9 months 6 months Fully capable of
performing duties
In athletic training, we offer much quicker
access and entry into the healthcare system.
Physician Status
Workers Compensation Panel physicians have
agreed to see FCPD employees within 24 48 hours
of the event. Physicians have agreed to have
rehabilitation done by the Athletic Trainer.
  • Rehabilitation occurs in two fashions
  • 1. The Athletic Trainer works in conjunction
    with a
  • physical therapist to provide daily care
  • The Athletic Trainer provides all the
    rehabilitative care on a daily basis
  • The treating physician is kept apprised of the
    employees progress.

Program Development
Wellness Clinic
  • Established at the Fairfax County Criminal
    Justice Academy
  • Fully equipped with rehabilitation and therapy
    equipment and materials
  • Assessment and treatment for FCPD employees and
    Academy recruits

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Weight and Conditioning Facility
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  • The Safe Shield Project primary goal is to
    accept no less than zero officers injured or
    killed while protecting the safety of citizens.
  • Begun as a long-term project to look at current
    and cutting-edge technology of personal
    protective systems for police officers.

  • In 2002, the Southern Association Chiefs Of
    Police (SACOP) produced a survey to determine the
    types of injuries officers sustain, the severity
    and frequency of those injuries.

SACOP Survey Results
FCPD Trends
  • In 2002, SACOP produced a survey to determine
    the types of injuries officers sustain, the
    severity and frequency of those injuries.

Top 12 Body Parts Injured FY 03 FY 09
Top 10 Injury Types FY 03 FY 09
  • Work Non-Work Total
  • FY 06 344 311 655
  • FY 07 1,320 1,188 2,508
  • FY 08 3,596 2,974 6,570
  • FY 09 2,689 3,821 6,512

556,489.00 in Savings -Therapy Costs
  • Work Non-Work Total
  • FY 06 17,824.00 15,355.00 33,179.00
  • FY 07 47,809.00 43,935.00 91,744.00
  • FY 08 115,450.00 99,603.00 215,053.00
  • FY 09 90,100.00 126,278.00 216,513.00

These costs are not billed to the agency nor the
Recognized Savings
  • Comparing 3 years pre-Athletic Trainer and 3
    years post-Athletic Trainer
  • Reduced By
  • Overall Medical Costs 49.5
  • Musculoskeletal Medical Costs 86.3

  • Recognized Savings
  • Comparing 3 years pre-Athletic Trainer and 3
    years post-Athletic Trainer
  • Reduced by
  • Overall Medical Costs 22.05
  • Musculoskeletal Costs 21.2

  • We have seen since the inception of the Athletic
  • program, a number of police officers who have
    been injured and
  • likely out for a long period of time - werent -
    due to the
  • commitment of the Departments athletic trainer.
    This has truly
  • been a success story as well as a key element
    to aggressively
  • managing injury prevention - key elements of a
  • compensation case and providing  successful
  • The high standard for care and treatment is
    deserving of the
  • Departments police officers.  Bringing together
    a new and
  • innovative way to provide immediate care and
  • while reducing costs involved with potential
  • injuries is a WIN/WIN and a golden opportunity
    for all of
  • us, as a stakeholders in this process - Ms. Teri
    Flynn, Risk Manager,
  • Fairfax County, VA

Satisfaction Survey
  • Male and female Department employees of varying
    race, rank, shift and assignment who had been
    evaluated and/or treated by the Athletic Trainer
    were surveyed.
  • 403 requests sent out
  • 207 returned for a 51.4 return rate

Survey Results
  • 96 are satisfied with the Athletic Trainer
  • 95 are satisfied with Treatment
  • 94.5 are satisfied with the Clinic

Patient Comments
  • I received more information on my type of injury
    from the trainer than I did from my primary care
  • She quickly assessed my soft tissue injury and
    provided treatment that both relieved the pain
    and expedited the healing process. I am positive
    that her knowledge and skills helped me return to
    work more promptly and in the best condition
    possible. I would definitely use her services
    again and encourage my co-workers do the same.

  • Employee comments on the survey demonstrated
    they view the Athletic Trainer as an employee
    and a great recruitment tool for potential

  • During a recent injury, the athletic trainer
    contacted me and coordinated treatment, resulting
    in a very short turnaround to receiving required
    surgery and therapy. This went far in reducing
    my worries/fears about my career and possible
  • The athletic trainer has demonstrated the unique
    skill of relating to police officers needs and
    concerns in such a manner that we do not feel
    threatened to share and give her complete and
    honest answers regarding status of injuries.

  • The Athletic Trainer is an educational resource
    for a variety of law enforcement related

Health Bulletins
Strengthening Programs Designed Specifically for
Law Enforcement
Grip Strength Exercises and Materials Dumbbell/Ba
nd Exercises. Repeat 12 times per set, 3 sets
daily. Forearm Curls. With palm up, weight in
hand, bend wrist up. Return slowly.
Duty Belt Information
Additional Activities
  • Specialty Unit Advisor
  • Safety Officer Program
  • Presentations to FCPD staff on stress management
    and fitness activities
  • Assisted in the development of the FCPD Family
    Leave Manual
  • Assist with finding pediatricians, family
    practice physicians and other medical specialists
    for new employees
  • Case management for all employees on restricted
  • Advise on prevention of heat stress and other
    environmental training issues
  • Advise on shoes, shoe inserts, ergonomics
    related to car seats and computer work stations

  • Health education resource for nutrition, high
    blood pressure, Lyme disease, sleep apnea, return
    to fitness after childbirth or other
    extraordinary life event, diabetes, etc.
  • MRSA education
  • Onsite blood pressure checks
  • Work with the wellness, defensive tactics and
    physical training staffs to determine trends in
    recruit/employee injury in training and how to
    work toward injury free training.

The Athletic Trainer provides quick access to a
healthcare professional for care and prevention
of injury and illness.
Outcomes of the Entry of Sports Medicine into
Public Safety
  • Graduate students taking on research topics for
    public safety regarding injury, illness and other
    health related concerns
  • Current and applicable sports medicine
    strategies, training, information is more
    frequently being offered and received by tactical
  • Sports medicine physicians recognized as better
    versed to treat tactical athletes
  • Development of the Public Safety Athletic
    Trainers Society for two-way information
    regarding athletic trainers and public safety
    opportunities, as well as future grant
    opportunities furthering study in public safety
    healthcare issues.

Future Goals
  • Merit position(s)
  • Expand services Fire and Rescue, Sheriffs
    Office, Public Works
  • Increase technology
  • Partnerships with County Public Safety
  • Market successes

Surviving the Economic Crisis
  • Tracking cost savings and successes
  • Defended program/position reductions

Review Discussions
  • Concept
  • Planning for pilot
  • Imbedding the Athletic Trainer program
  • Tracking program costs successes
  • Future goals

  • Organizations
  • National Athletic Trainers Association
  • Public Safety Athletic Trainers Society

  • Individuals
  • Major Edwin C. Roessler Jr., Director
  • Fairfax County Criminal Justice Academy
  • 703-449-7272
  • Nancy Burke, ATC, Athletic Trainer
  • Fairfax County Police Department
  • 703-449-7241

  • Articles
  • The Facts about Athletic Trainers (NATA)
  • Athletic Training Education Overview (NATA)
  • Athletic trainers Providing healthcare for
    athletes of all kinds , C. Brett Lockard
    Occupational Outlook Quarterly, Spring 2005
  • Athletic Trainers Workplace Remedies, Tyler,
    K, HR Magazine, Dec. 2008

  • The Sports Medicine Model of Care for Your
    Occupational Athlete, Alliva, J, July 2003,
  • Certified Athletic Trainers On-site training
    for industrial athletes helps employers control
    losses, Monteiro, M, MS, ATC, CSCS

  • Pamphlets / Brochures
  • Athletic Trainers Get Results with Occupational
  • Unique Health Care Providers
  • Athletic Trainers not personal trainers