The Sports Medicine Department, in conjunction with Health Services has established "Resources, Guidelines, and Protocols for the Care of the Student Athlete". The handbook is a guide for helping a student athlete with health-related problems and concerns while competing as an athlete at Middlebury College. The information in the handbook shall serve as a basic reference for referral to health professionals on campus. This is a preliminary effort to equip coaches with necessary guidelines to assure proper care of your student athletes.
Please read the information, make notes and feel free to ask questions about what is presented in the handbook. Additional information will be distributed as needed.
Encourage your assistant coaches to become familiar with the protocols and guidelines to make this a collaborative effort for the well being of the student athletes.
Thank you for your time and consideration.
David P. Matthews, MA, ATC
Director, Middlebury College
No communication between the counselors, physicians, athletic trainers and the student athletes will be released beyond the health services except in cases of immediate danger or serious harm to someone, or when the student has provided written permission to release information.
When a student athlete discloses information regarding a medical situation, the information should be considered confidential and not discussed with people other than medical professionals. No information should be discussed with team members regarding why a student athlete is not participating, unless the student athlete decides that they are willing to tell the team.
Coaches should notify the certified athletic trainer responsible for their team with any concerns regarding the status of one of their student athletes.
Some guidelines for Communication
1.Express your concern in a caring, non-judgmental way by sharing your feelings. Use "I" statements, such as:
"I am worried about you because you seem tense and unhappy."
"I am concerned about you. You seem to worry so much about _________."
"It looks like you've been having a hard time, I'd like to try to help."
- Don't diagnose or label. It is better to say, "I think you have a problem", not "you have an eating disorder, or depression".
- Invite the person to share his/her feelings with you.
"Would you like to talk about it?"
"I often feel better after I talk something out with a friend, if you wanted to, I would be glad to listen."
- Be supportive. Show the person you believe in him/her. Let the person know that the conversation is confidential.
- Be specific about the behaviors that concern you, without condemning the person.
"I've notice that you are not taking an active part in the team outside of practices and games."
"I've heard you crying/being sick, etc."
- If the student athlete declines to talk about it, don't push. But do check back later.
"I could be wrong, I just want you to know that I do care and am interested. If you ever want to talk, I'm available."
- After that continue to treat the person in a normal, friendly way. In a few days/weeks ask later.
- Give the person time. But, if nothing happens and you are still concerned, it may help to talk to a professional about what to do next.
- If the student athlete does confide in you, let him/her know you are glad.
"I'm glad you told me."
"I'd like to help however I can."
- Don't be a watchdog. Watching the person eat or telling the person what to do is not helpful. It's best to ask the person how he/she would like you to help.
What to take into consideration beforehand:
- Think through whom is the best person to do the talking.
- Feel free to consult with someone about how best to approach a student (options for consulting include: certified athletic trainers, health service staff, women's health, counseling, primary care and nutritionist).
- Pick a time to talk when you are feeling calm.
- Pick a time and place to talk when you know you won't be interrupted, and where the person you are speaking to will be comfortable.
- Carefully consider what you want to say ahead of time. Consult with a knowledgeable person for support and assistance. Practice what you will say to the person. A well-planned discussion will have a better impact and increase the likelihood that the person will respond positively.
- Give some thought to the following points in order to be clear about what you are saying:
- What is worrying you about this student athlete?
- How do you feel about his/her behavior?
- What are your goals in talking to the student athlete? Are they realistic?
- Keep in mind that you can stop the conversation if it starts to get out of control, and continue at a later date.
Management of Orthopedic Injury
Orthopedic injuries are injuries that result from sports related or overused activities. Some examples of orthopedic injuries may include: sprains, strains, contusions, lacerations, concussions, fractures, dislocations, tendonitis and surgical repairs.
Each team is assigned a certified athletic trainer to provide sports medicine for the team. The student athletes can have an initial injury evaluation by a certified athletic trainer. The certified athletic trainer has the ability to make referrals into Champlain Valley Orthopedics.
Rehabilitation and treatment plans should be designed and implemented by the assigned ATC. Coaches should contact their ATC directly regarding their student athlete participation.
Certified Athletic Trainers
David Matthews Football, men's ice hockey, baseball, softball, m/w golf
Sue Murphy Men's soccer, m/w x-c, women's swim, women's track
Kelly Cray Women's soccer, m/w tennis, men's basketball, men's swim, men's lacrosse
Rachel Eldredge Field hockey, volleyball, women's squash, women's ice hockey, w lacrosse, m track.
Club sports of crew and rugby will not be assigned a certified, but will be provided care by whom ever is free to do so according to established protocol.
Management of Sports Nutrition
Sports Nutrition is a necessary part of the well being of student athletes. Knowing the basics for balanced nutrition for a physically active person can help to enhance sports performance and establish good eating habits for life. Poor nutrition can lead to injury and disordered eating habits. An eating disorder is described as a disturbance in eating behavior that jeopardizes a person's physical or psychological well-being. Eating disorders are prevalent among college students. The types of disorders range from bulimia and anorexia to binge eating disorders. Student athletes are at risk of developing eating disorders that can affect sports performance, general and psychological health. Eating disorders are treatable but often require professional intervention. Helping the student athlete recognize the condition and receive help is necessary for recovery from the disease.
Identifying the athlete with an eating disorder:
·Social isolation and withdrawal from friends
·Lack of confidence in athletic ability
·Ritualistic eating behaviors
·Obsession with counting calories
·Obsession with constantly exercising, especially just before meals
·Obsession with weighing self
·Overestimation of body size
·Patterns of leaving the table directly after eating to go into the restroom
·Problems related to eating disorders (malnutrition, menstrual irregularities or chronic fatigue)
·Family history of eating disorders
Indications for referrals:
·When a student athlete needs help managing food behaviors such as maintaining a healthy weight, fad dieting, over exercising, poor planning for meals.
·Advice on healthy weight loss/gain options
·Information on nutrition
·Another student athlete has a concern for a teammate and needs help with confronting the individuals with an eating disorder
·Displaying signs and symptoms of eating disorders
·Signs and Symptoms of alcohol use/abuse
Making a Nutritional Referral:
·Contact the Team Athletic Trainer at Zug Sports Medicine Facility
·Health Services at ext. 5135
·Counseling Office at ext. 5141
·Dr. Mark Peluso at ext. 5249 (Sports Medicine), ext. 5135 (Health Center)
Food and Nutrition Information Center http://fnic.nal.usda.gov/
Eating Disorders http://www.mirror-mirror.org/eatdis.htm
American Dietetics Association http://www.eatright.org/
American Heart Association Diet http://amhrt.org
Ask the Dietician http://www.dietitian.com
Nutrition Pages http://www.nutrition.about.com
Food Fit http://www.foodfit.com
Something Fishy http://www.somethingfishy.org
Management of Mental Health and Psychological Needs
Mental health and psychological needs may include disorders such as but not limited to depression, anxiety, panic attacks, chronic fatigue syndrome and substance abuse. These issues may affect an individual as well as a team. Intervention by a medical and/or licensed mental health care professional is necessary to ensure the proper care of the student athlete's needs. There are certain signs and symptoms that may allow a coach or teammate to determine the need for intervention.
Signs and Symptoms:
·Normal emotions that are displayed to an extreme degree or for a prolonged period of time (e.g., tearfulness, nervousness)
·Marked changes in personality or mood and/or significant mood swings
·Listlessness, lack of energy
·Inability to make decisions or to concentrate on classes or other activities
·High levels of irritability, including unruly, aggressive, violent or abrasive behavior
·Use of alcohol or other drugs that leads to recklessness, impairment, loss of control or if it represents a change in use
·Thought or desire to take drastic action or make impulse decisions (e.g., dropping out of school in response to a fear that a test may not go well)
·Withdrawal, excessive sleeping, and procrastination
·Increase in self-critical thoughts with a voice in one's mind providing a constant barrage of harsh, negative statements
·Sleep disturbance or unable to fall back to sleep
·Decrease in appetite or food loses its taste: significant weight loss or gain
·Feelings of guilt, helplessness and/or hopelessness
·Thoughts of suicide, self-mutilation, homicide
·It is also not unusual to have no reaction at all
·Extreme difficulty or reluctance to discuss a significant loss
·Compulsive exercise beyond team requirements
The Center for Counseling and Human Relations is staffed by psychologists, psychiatrists, social workers and certified athletic trainers who are available to meet with students. To confidentially discuss any students you are worried about, feel free to contact any of the counseling staff.
Students who want to talk about concerns for themselves or a friend are encouraged to contact Counseling at (802) 443-5141. A Counselor on-call is available for emergencies 24 hours every day.
Management of Health Issues for Female Student Athletes
The Parton Health Center at Centeno House is available for first-line assessment of the female student athlete. Women's health issues may include the following:
Gynecologic Issues (not just pap smears/annuals)
Irregular or absent periods, pelvic pain, painful periods, vulvar/vaginal problems, urinary tract/bladder infection problems, hormone problems, sex issues.
All body systems except acute orthopedic injuries
Mental health, nutrition, sleep disturbances, musculo-skeletal, skin, lung, gastro-intestinal, cardiology, substance abuse, headaches.
Women's Health providers will facilitate and coordinate the athlete's overall care, arrange referrals to other specialists and specialty areas.
Parton Health Center
American College of Obstetrics and Gynecology www.acog.org
The Universe of Women's Health (search "athletics) www.obgyn.net
Management of Primary Care Issues for Student Athletes
Primary Care at Parton Health Services will do primary evaluation, treatment, initiate referrals to specialists and oversee coordination of care. Services may include diagnostic exams, labs, x-rays and prescriptions.
The following list of common ailments and concerns are reasons for sending an athlete for evaluation by Health Services:
Headaches, dizziness, vision/eye, hearing, gait, hand-eye coordination, sensation
Breathing, chest pain, asthma, colds, flu, bronchitis
Heart palpitations, fast or slow heart rate, heart or circulation problems
Rashes, itching, lesions, bumps, sores
Stomach problems, bowel problems, abdominal pain, abdominal pressure, gas
Genital injuries, problems, rashes, sexual problems, diseases
Ø Urinary Tract
Bladder problems, kidney problems
Hormone problems (diabetes, thyroid, other "glands")
Ø Nutrition Issues
Ø Alcohol/substance abuse issues
Parton Health Center
Mayo Clinic Sports Medicine http://www.mayoclinic.org/sportsmedcenter-rst/