IBFCSM CPSO cheat sheet

VO2max (mL/kg/min) = cardiac output (L/min) × a-vO2 difference (mL O2 per 100 mL blood) × 10; Fick principle underlies all aerobic capacity testing.

Maximal heart rate estimate: 220 − age (±10-12 bpm SD); Tanaka formula 208 − (0.7 × age) is more accurate in adults over 40.

Karvonen target HR = ((HRmax − HRrest) × %intensity) + HRrest; use %HRR rather than %HRmax for training prescription.

ATP-PCr system: ~10 s maximal effort, no oxygen, no lactate; glycolytic system ~10 s to 2 min with lactate accumulation; oxidative system dominates beyond ~2-3 min.

Lactate threshold in trained endurance athletes occurs at 70-80% VO2max; untrained at 50-60%; OBLA (4 mmol/L) is a common fixed reference.

Blood lactate clearance is accelerated by active recovery at 30-60% VO2max; passive recovery clears lactate more slowly.

Eccentric contractions generate higher force at lower metabolic cost but cause delayed-onset muscle soreness peaking 24-72 h post-exercise.

Cardiac output at rest ≈ 5 L/min; during maximal exercise in trained athletes 35-40 L/min; stroke volume plateaus near 40-50% of maximal intensity.

Respiratory exchange ratio (RER) >1.10 at exhaustion indicates maximal effort; RER 0.7 ≈ fat oxidation, 1.0 ≈ carbohydrate oxidation.

FIFA 11+ warm-up program reduces lower-limb injury rates in amateur football by roughly 30-40% when performed at least twice weekly.

Neuromuscular training programs with plyometrics, balance, and strengthening reduce ACL injury risk in female athletes by up to 50-70%.

Progressive overload principle: load must increase gradually; a common guideline is ≤10% weekly increase in training volume to limit overuse injury.

Acute:chronic workload ratio >1.5 is associated with increased injury risk; ratios between 0.8 and 1.3 are considered the safer training zone.

Static stretching before explosive activity can transiently reduce power output; dynamic warm-up is preferred pre-competition.

Eccentric hamstring strengthening (e.g., Nordic hamstring exercise) reduces hamstring strain injury incidence in soccer by approximately 50%.

Return-to-sport criteria after ACL reconstruction include limb symmetry index ≥90% on strength and hop tests, plus psychological readiness.

The 'weekend warrior' pattern (high acute load with low chronic base) is a recognized risk factor for musculoskeletal injury.

Ottawa Ankle Rules: X-ray indicated if pain in malleolar zone plus bone tenderness at posterior edge of lateral or medial malleolus, or inability to bear weight 4 steps.

Ottawa Knee Rules: X-ray if age ≥55, isolated patellar tenderness, fibular head tenderness, inability to flex knee to 90°, or inability to bear weight 4 steps.

Lachman test is the most sensitive clinical test for ACL rupture (sensitivity ~85-95%); pivot shift is more specific but less sensitive.

McMurray test for meniscal tear has limited sensitivity (~50-70%) but higher specificity; a negative test does not exclude a tear.

Anterior drawer test for ankle sprain evaluates the anterior talofibular ligament; the squeeze test evaluates syndesmotic (high ankle) injury.

NEXUS criteria for cervical spine imaging: no posterior midline tenderness, no focal neurologic deficit, normal alertness, no intoxication, no distracting injury.

Concussion assessment includes SCAT6 symptom checklist, SAC (Standardized Assessment of Concussion), and VOMS; no single test confirms diagnosis.

Phalen and Tinel tests screen for carpal tunnel syndrome; Phalen sensitivity ~68%, specificity ~73%.

RICE has largely been superseded by PEACE & LOVE (Protection, Elevation, Avoid anti-inflammatories, Compression, Education; Load, Optimism, Vascularisation, Exercise).

Early controlled mobilization after acute soft-tissue injury outperforms prolonged immobilization for restoring range of motion and function.

Cryotherapy reduces tissue temperature and pain but should be limited to ~15-20 min per application to avoid cold-induced nerve injury.

Progressive tendon loading (isometric → eccentric → concentric/plyometric) is the cornerstone of tendinopathy rehabilitation.

Rehabilitation phases: acute (protection), subacute (mobility), strengthening, return-to-sport; each phase requires objective criteria before progression.

Proprioceptive and balance training after ankle sprain reduces recurrence risk by approximately 50%.

Blood flow restriction training at 20-40% 1RM with 40-80% arterial occlusion can increase strength and hypertrophy comparable to higher-load training.

Manual therapy and joint mobilization provide short-term pain and ROM benefits; evidence favors combining them with active exercise.

Adult CPR: compressions at 100-120/min, depth 5-6 cm, ratio 30:2 with ventilations; use AED as soon as available.

Commotio cordis occurs from blunt chest impact during the vulnerable repolarization window (T-wave upstroke) and requires immediate defibrillation.

Suspected cervical spine injury: maintain manual in-line stabilization; do not remove helmet or shoulder pads unless airway cannot be maintained.

Exertional heat stroke: core temperature >40°C with CNS dysfunction; treat with immediate cold-water immersion and cool to <39°C.

Exertional hyponatremia presents with confusion, seizures, or collapse; treat with hypertonic saline, not free water.

Anaphylaxis in athletes: intramuscular epinephrine 0.3-0.5 mg (1:1000) into the anterolateral thigh; repeat every 5-15 min as needed.

Concussion: remove from play immediately; no same-day return to sport; graduated return-to-learn precedes return-to-sport.

Sickle cell trait exertional collapse: maintain hydration, avoid extreme conditioning in heat, and treat collapse with oxygen and cooling.

Carbohydrate loading: 8-12 g/kg/day for 36-48 h before endurance events >90 min; increases muscle glycogen 1.5-2×.

Pre-exercise carbohydrate: 1-4 g/kg 1-4 h before exercise; during exercise 30-60 g/h for events 1-2.5 h, up to 90 g/h for >2.5 h with multiple transportable carbohydrates.

Protein: 1.2-2.0 g/kg/day for athletes; 20-40 g per dose post-exercise supports muscle protein synthesis.

Hydration: 2% body-mass loss impairs performance; replace 1.25-1.5 L fluid per kg body mass lost.

Creatine monohydrate: 3-5 g/day maintenance; loading 20 g/day divided into 4 doses for 5-7 days; ergogenic for short-duration high-intensity efforts.

Caffeine: 3-6 mg/kg improves endurance performance; avoid within 8 h of sleep.

WADA Prohibited List categories include anabolic agents, peptide hormones, beta-2 agonists, hormone modulators, diuretics, and masking agents.

Therapeutic Use Exemption (TUE) must be obtained before competition for prohibited substances required for legitimate medical treatment.

Beta-2 agonists: inhaled salbutamol permitted up to 1600 µg/24 h; formoterol up to 54 µg/24 h.

Yerkes-Dodson law: performance peaks at moderate arousal; optimal arousal level decreases as task complexity increases.

Self-Determination Theory: intrinsic motivation is supported by autonomy, competence, and relatedness.

Goal-setting theory (Locke & Latham): specific, measurable, moderately difficult goals outperform vague 'do your best' goals.

Imagery (mental rehearsal) activates similar cortical and autonomic pathways as physical practice; best used as an adjunct, not a replacement.

Overtraining syndrome: performance decrement, mood disturbance, sleep disruption, and elevated resting HR persisting >2 weeks despite rest.

Relative Energy Deficiency in Sport (RED-S) affects metabolic rate, menstrual function, bone health, immunity, and psychological state.

Psychological readiness to return to sport (e.g., ACL-RSI) predicts reinjury and return-to-sport success as much as physical measures.

Athlete burnout comprises emotional exhaustion, reduced sense of accomplishment, and sport devaluation; early signs include loss of enjoyment.

Scope of practice: provide care only within documented training, licensure, and jurisdictional law; refer outside scope.

Informed consent requires disclosure of risks, benefits, alternatives, and the right to refuse; document the discussion.

Confidentiality: protected health information may be shared only with consent, for treatment coordination, or as required by law.

Mandatory reporting obligations include suspected abuse, certain communicable diseases, and impaired colleagues, per jurisdiction.

Documentation should be contemporaneous, objective, and include subjective, objective, assessment, plan (SOAP) components.

Conflict of interest: disclose financial or personal interests that could influence clinical decisions or research reporting.

Emergency action plan (EAP): written, rehearsed, with defined roles, access to AED, and activation of EMS; rehearse at least annually.

Infection control: standard precautions apply to all athletes; blood-borne pathogen exposure requires immediate post-exposure evaluation.

VO2max is limited primarily by central (cardiac output) factors in healthy trained individuals; peripheral factors dominate in untrained or patient populations.

Anaerobic power tests: Wingate 30 s peak power and mean power; typical peak 8-12 W/kg for trained adults.

Blood pressure response to exercise: systolic rises with workload; diastolic should remain stable or fall slightly; exaggerated response >210/110 mmHg in men warrants follow-up.

Overtraining markers: decreased performance, elevated resting HR, elevated CK, altered HRV, and mood disturbance.

Heat acclimatization requires 7-14 days; plasma volume expands, sweat rate increases, and sweat sodium concentration decreases.

Altitude: VO2max declines ~1% per 100 m above 1500 m; acclimatization requires 2-3 weeks; live-high train-low is a common strategy.

Periodization: preparatory, competitive, and transition phases; volume peaks in preparatory, intensity peaks in competitive.

Strength training in youth is safe and effective when supervised, with technique emphasized and load progressed gradually.

Static stretching held 30-60 s improves flexibility; perform after activity or in a separate session to avoid pre-event power decrement.

Ankle taping and bracing reduce recurrent sprain risk but do not replace balance and strengthening programs.

Mouthguards reduce dental injury and may reduce concussion risk in collision sports.

Load monitoring tools include session-RPE (RPE × duration), GPS metrics, and wellness questionnaires; combine subjective and objective data.

Special tests should be interpreted with pretest probability; a highly sensitive test is most useful when negative (rules out), a highly specific test when positive (rules in).

Glasgow Coma Scale: eye (4), verbal (5), motor (6); score ≤8 generally indicates need for airway protection.

VOMS (Vestibular/Ocular Motor Screening) includes smooth pursuits, saccades, convergence, VOR, and visual motion sensitivity; symptom provocation ≥2 points is abnormal.

Balance testing: BESS and tandem gait are commonly used post-concussion; compare to baseline when available.

Functional movement screen scores are not validated to predict injury in isolation; use as one component of assessment.

Neurovascular assessment after fracture: 5 P's - pain, pallor, pulselessness, paresthesia, paralysis.

Pain-guided rehabilitation: use pain-monitoring model; pain ≤3/10 during activity and resolving within 24 h is acceptable to progress load.

Strength testing: 1RM testing is safe in trained individuals; use estimated 1RM from submaximal loads in clinical populations.

Range of motion: goniometry is the standard; measure both sides and record position and landmark used for reliability.

Return-to-run criteria after lower-limb injury: pain-free walking, full ROM, symmetrical strength, and no swelling after load.

Taping and bracing support but do not replace neuromuscular training; combine with exercise for best outcomes.

Aquatic therapy reduces joint loading and is useful for early rehabilitation of weight-bearing injuries.

Primary survey: airway, breathing, circulation, disability, exposure (ABCDE); reassess after any intervention.

Spinal motion restriction: use backboard or vacuum mattress only when indicated; prolonged immobilization increases pressure injury risk.

Fracture management: immobilize in position found, assess distal pulses and sensation before and after splinting.

Hypothermia: remove wet clothing, insulate, and use active rewarming for core temperature <35°C; avoid rough handling of the extremities.

Lightning safety: 30-30 rule - seek shelter when flash-to-thunder <30 s, wait 30 min after last thunder.

Emergency action plan rehearsal should include venue access, AED location, EMS communication, and role assignment for each staff member.

Iron: athletes, especially endurance and female athletes, are at risk for iron deficiency; screen ferritin and treat with oral iron plus vitamin C.

Vitamin D: 600-800 IU/day general; athletes with deficiency may need higher doses; test 25(OH)D.

NSAIDs: short-term use for acute injury; chronic use impairs tendon and bone healing and increases GI and renal risk.

Glucocorticoid injections provide short-term pain relief but repeated injections may impair tendon quality; observe local restrictions.

Doping control: athletes are responsible for any substance found in their sample; check every product against the WADA Prohibited List.

Alcohol and cannabis impair recovery, sleep, and reaction time; both are on the WADA monitoring or prohibited lists depending on context.

Pre-performance routine: consistent sequence of behaviors before skill execution improves attention and reduces anxiety.

Self-talk: instructional self-talk benefits fine motor tasks; motivational self-talk benefits gross motor and endurance tasks.

Arousal regulation techniques include breathing, progressive muscle relaxation, and imagery; match technique to the athlete's optimal zone.

Screening tools: PHQ-9 for depression, GAD-7 for anxiety; positive screens warrant referral, not diagnosis by the sports practitioner.

Mental health emergency: any expression of suicidal ideation requires immediate safety assessment and referral to emergency services.

Team culture and coach behavior strongly influence athlete well-being; psychological safety is associated with lower burnout.

Consent for minors: obtain from parent or guardian unless emergency doctrine applies; assent from the minor when developmentally appropriate.

Record retention: follow jurisdictional requirements; retain records for the period specified by law or institutional policy.

Telehealth: verify identity, location, and licensure jurisdiction; document the modality and any limitations.

Cultural competence: adapt communication and care to the athlete's language, beliefs, and background; use interpreters when needed.

Research ethics: IRB approval, informed consent, and data protection apply to athlete research; report conflicts and adverse events.

Patient safety event reporting: report near-misses and adverse events through the institutional system; do not alter records after an event.

Cardiac output = HR × stroke volume; stroke volume increases with training via increased end-diastolic volume and contractility.

Muscle fiber types: type I slow oxidative (fatigue-resistant), type IIa fast oxidative-glycolytic, type IIx fast glycolytic (fatigable).

Oxygen deficit at exercise onset is repaid post-exercise as excess post-exercise oxygen consumption (EPOC).

Ventilatory threshold occurs before lactate threshold in most individuals; both are used to set training zones.

Training zones: zone 1 (<55% HRmax), zone 2 (55-75%), zone 3 (75-90%), zone 4 (>90%) for endurance prescription.

Warm-up should include general aerobic activity, dynamic mobility, and sport-specific movements; total 10-20 min.

Cool-down includes light activity and static stretching; does not prevent injury but supports recovery and ROM.

Core stability training reduces low back pain incidence in athletes when combined with general conditioning.

Footwear and surface selection affect load distribution; change running shoes every 500-800 km.

Concussion prevention: rule changes, equipment standards, and technique coaching reduce risk; no helmet eliminates concussion risk.

Screening for prior injury is the strongest predictor of future injury; address prior deficits in preseason.

Sensitivity = true positives / (true positives + false negatives); specificity = true negatives / (true negatives + false positives).

Likelihood ratio positive = sensitivity / (1 − specificity); LR+ >10 is strong, 5-10 moderate; LR− <0.1 strong.

Differential diagnosis for anterior knee pain includes patellofemoral pain, patellar tendinopathy, and Osgood-Schlatter in adolescents.

Shoulder impingement tests: Neer, Hawkins-Kennedy, and painful arc; none is diagnostic alone.

Hip pathology: FADIR test for femoroacetabular impingement; Trendelenburg sign for gluteus medius weakness.

Red flags: night pain, unexplained weight loss, fever, neurologic deficit, and history of cancer warrant urgent referral.

Manual therapy techniques include joint mobilization, manipulation, soft tissue mobilization, and massage; use as adjuncts to exercise.

Neuromuscular electrical stimulation (NMES) can reduce quadriceps strength loss after ACL reconstruction when used early.

Plyometric progression: land → jump → hop → bound; ensure adequate strength and control before advancing.

Return-to-sport testing should include strength, power, agility, endurance, and sport-specific skills, plus psychological readiness.

Patient education and self-management improve adherence; use teach-back to confirm understanding.

Rehabilitation dosage: strength 2-3 sessions/week, 2-4 sets, 6-12 reps at 60-85% 1RM for hypertrophy and strength.

AED use: apply pads to bare chest, follow voice prompts, deliver shock if advised, resume CPR immediately after shock.

Airway management: use head-tilt chin-lift for no suspected spine injury; jaw thrust if spine injury suspected.

Bleeding control: direct pressure, pressure dressing, and tourniquet for life-threatening extremity hemorrhage.

Burn management: cool with running water for 20 min, cover with sterile non-adherent dressing, avoid ice.

Diabetic emergency: if conscious and able to swallow, give fast-acting carbohydrate; if unconscious, call EMS and do not give oral fluids.

Seizure: protect from injury, do not restrain, time the event; call EMS if >5 min or first seizure.

Energy availability: low energy availability (LEA) is defined as <30 kcal/kg fat-free mass/day; a driver of RED-S.

Female athlete triad: low energy availability, menstrual dysfunction, and low bone mineral density; screen at-risk athletes.

Supplement regulation: products are not pre-approved for safety or efficacy; third-party testing (e.g., Informed Sport) reduces contamination risk.

Nitrate (beetroot juice): 300-600 mg nitrate 2-3 h pre-exercise may improve endurance performance.

Beta-alanine: 3.2-6.4 g/day for 4-12 weeks increases muscle carnosine and benefits 1-4 min high-intensity efforts.

Alcohol: impairs protein synthesis, sleep, and hydration; avoid post-exercise for recovery.

Attribution theory: attributing success to internal, stable, controllable factors supports motivation; attributing failure to external, unstable factors can protect self-esteem short-term.

Flow state: complete absorption in task, clear goals, immediate feedback, and balance between challenge and skill.

Team cohesion: task cohesion (shared goals) and social cohesion (interpersonal bonds); both relate to performance.

Psychological skills training (PST) includes goal setting, imagery, self-talk, arousal regulation, and concentration training.

Injury psychology: grief, identity loss, and fear of reinjury are common; screen and refer when symptoms persist.

Sleep: athletes need 7-9 h; sleep extension improves reaction time and sprint performance.

Duty of care: act in the athlete's best interest, including removal from play when medically indicated.

Shared decision-making: present options, discuss risks and benefits, and respect the athlete's values and preferences.

Advertising and endorsement: disclose financial relationships; do not make false or misleading claims.

Competence: maintain certification, complete continuing education, and practice within current evidence.

Whistleblowing: report unsafe practice or unethical behavior through appropriate channels; protect confidentiality where possible.

Data security: protect electronic health records with strong passwords, encryption, and access controls.

Cardiorespiratory fitness is inversely associated with all-cause mortality; each 1-MET increase is associated with ~10-25% lower mortality risk in observational studies.

Exercise prescription for health: 150 min/week moderate or 75 min/week vigorous aerobic activity plus 2 days/week resistance training.

Rating of perceived exertion (Borg 6-20) correlates with HR: RPE × 10 ≈ HR; use for prescribing intensity when HR monitoring is unavailable.

Detraining: VO2max declines ~5-10% within 2-4 weeks of inactivity; stroke volume and oxidative enzymes decrease first.

Menstrual cycle: performance effects are individual; track symptoms and adjust training rather than assuming a universal pattern.

Overuse injury results from repetitive load without adequate recovery; address training errors, equipment, and biomechanics.

Bone stress injury: relative energy deficiency, low BMI, and rapid load increases are risk factors; early MRI is more sensitive than X-ray.

Concussion prevention in sport includes rule changes, technique coaching, and neck strengthening; helmets reduce skull fracture but not all concussion risk.

Return-to-play after illness: fever, systemic symptoms, or myocarditis concern warrant medical clearance before resumption.

Heat illness prevention: acclimatize, hydrate, schedule around peak heat, and use wet-bulb globe temperature (WBGT) to guide activity.

Tendinopathy prevention: progressive loading, adequate recovery, and addressing contributing factors such as footwear and training surface.

History components: mechanism of injury, onset, location, quality, severity, aggravating and relieving factors, prior injury, and medications.

Observation: symmetry, alignment, swelling, deformity, and gait; compare bilaterally.

Palpation: bony landmarks, joints, and soft tissues; identify point of maximal tenderness.

Range of motion: active then passive; note end-feel (hard, firm, soft, empty).

Strength testing: manual muscle testing 0-5 scale; resisted testing reproduces pain in tendinopathy.

Neurologic screening: dermatomes, myotomes, and reflexes; document findings and compare sides.

Manual therapy dosing: joint mobilization grades I-II for pain, III-IV for ROM; reassess after each session.

Modalities: ultrasound evidence is weak; TENS may reduce pain short-term; use as adjuncts not primary treatment.

Progressive loading for bone stress injury: non-weight-bearing → partial → full weight-bearing → impact → return to sport.

Return-to-sport after hamstring strain: pain-free sprinting at full speed and symmetrical strength before full return.

Rehabilitation after concussion: sub-symptom threshold aerobic exercise may speed recovery; avoid complete rest beyond 24-48 h.

Outcome measures: use validated tools (e.g., DASH, KOOS, VISA-A) at baseline and discharge to document progress.

Scene safety first: assess for hazards before approaching an injured athlete.

Call for help early; assign someone to meet EMS and direct them to the field.

CPR quality: minimize interruptions, allow full chest recoil, and rotate compressors every 2 min.

AED pads: anterolateral placement; dry the chest if wet; remove transdermal patches.

Suspected fracture with deformity: splint in position found; do not attempt to reduce unless circulation is compromised.

Documentation of emergency care: time of injury, interventions, response, and transfer of care.

Protein timing: total daily intake matters more than timing; distribute 0.25-0.4 g/kg per meal.

Fat intake: 20-35% of energy; emphasize unsaturated fats; adequate fat supports hormone production.

Micronutrients: calcium 1000-1300 mg/day, vitamin D 600-800 IU/day; iron and B12 for vegetarian athletes.

Hydration assessment: monitor urine color and body mass change; pale yellow urine suggests adequate hydration.

Ergogenic aids with evidence: caffeine, creatine, nitrate, beta-alanine, bicarbonate; others have limited or no evidence.

Anti-doping: check medications and supplements against the WADA Prohibited List; keep records of TUEs.

Anxiety: cognitive anxiety (worry) and somatic anxiety (physical symptoms); interventions differ.

Choking under pressure: occurs when explicit monitoring disrupts automated skills; practice under pressure and use pre-performance routines.

Motivation: intrinsic vs extrinsic; extrinsic rewards can undermine intrinsic motivation if perceived as controlling.

Team communication: clear roles, constructive feedback, and conflict resolution support performance and well-being.

Athlete identity: strong exclusive athletic identity increases distress after injury; encourage diversified identity.

Referral: when symptoms interfere with daily function or persist >2 weeks, refer to a mental health professional.

Informed consent for research: voluntary, documented, and revocable; special protections for vulnerable populations.

Conflict of interest in team settings: the practitioner's duty is to the athlete, not the team's competitive interest.

Documentation errors: use a single-line strike-through, date, and initial; never obliterate or backdate entries.

Social media: avoid posting identifiable athlete information; maintain professional boundaries.

Continuing education: track credits and renew certifications before expiration.

Insurance and liability: maintain professional liability coverage and understand its scope.

Cardiac output during exercise increases linearly with workload until VO2max; stroke volume plateaus while HR continues to rise.

Blood pressure during resistance exercise can exceed 200/150 mmHg; avoid Valsalva in hypertensive or cardiac patients.

Exercise-induced bronchoconstriction: diagnose with bronchoprovocation testing; treat with warm-up and inhaled bronchodilator as prescribed.

Exercise in heat: core temperature rises; acclimatization and hydration reduce risk; monitor for heat illness signs.

Exercise in cold: risk of hypothermia and frostbite; layer clothing and monitor duration.

Preseason screening should include prior injury, strength, flexibility, balance, and sport-specific movement quality.

Training load should be periodized; avoid sudden spikes after breaks.

Recovery: sleep 7-9 h, nutrition, and active recovery support adaptation; recovery days are part of the program.

Protective equipment: fit and condition checked regularly; replace damaged equipment.

Youth athletes: avoid early specialization and excessive competition volume; monitor growth and maturation.

Environmental: adjust training for heat, cold, altitude, and air quality.

Differential diagnosis should consider referred pain from the spine, viscera, and vascular sources.

Imaging: X-ray for fracture, MRI for soft tissue, ultrasound for dynamic assessment; order based on clinical question.

Laboratory: CBC, ferritin, vitamin D, and thyroid function when indicated; interpret in context.

Concussion: diagnosis is clinical; imaging is not routinely indicated unless red flags are present.

Cardiac screening: history and physical; ECG screening policies vary by organization and jurisdiction.

Documentation: record findings, interpretation, and plan; include patient education and follow-up.

Rehabilitation should be individualized based on injury, sport, and athlete goals.

Pain science education can reduce fear-avoidance and improve outcomes in persistent pain.

Strengthening should progress from isometric to eccentric to concentric to plyometric as tolerated.

Balance and proprioception training should be included after lower-limb injury.

Cardiovascular conditioning should be maintained during rehabilitation using alternative modes.

Return-to-sport decisions should be shared with the athlete, coach, and medical team.

Emergency action plan should be venue-specific and rehearsed.

Communication: designate a caller, a responder, and a greeter for EMS.

Equipment: AED, first aid kit, splints, and oxygen should be accessible and checked regularly.

Triage: prioritize life-threatening conditions over musculoskeletal injuries.

Transport: decide on EMS transport vs. self-transport based on injury severity and level of consciousness.

Follow-up: document and communicate the plan to the athlete and family.

Nutrition assessment: diet history, body composition, and laboratory markers when indicated.

Weight management: gradual changes (0.5-1 kg/week) preserve lean mass and performance.

Eating disorders: screen with validated tools; refer to a multidisciplinary team.

Supplements: recommend only when evidence supports and diet is inadequate.

Medication review: check for prohibited substances and interactions with exercise.

Hydration: individualize based on sweat rate and environmental conditions.

Goal setting: process goals, performance goals, and outcome goals; emphasize process.

Imagery: use multisensory, first-person perspective for skill acquisition.

Self-talk: use positive, instructional, and motivational statements; practice regularly.

Arousal regulation: breathing, relaxation, and music can modulate arousal.

Team building: shared goals, roles, and communication improve cohesion.

Referral: use a multidisciplinary network for mental health concerns.

Scope of practice: know jurisdictional laws and institutional policies.

Informed consent: document discussions and decisions.

Confidentiality: protect athlete information and share only as needed.

Mandatory reporting: follow legal requirements for abuse and public health.

Documentation: contemporaneous, objective, and complete.

Conflict of interest: disclose and manage appropriately.

VO2max is expressed in L/min (absolute) or mL/kg/min (relative); relative values allow comparison across body sizes.

Exercise economy: oxygen cost at a given speed; improves with training and technique.

Anaerobic threshold: intensity above which lactate accumulates faster than it is cleared.

Heart rate variability (HRV): reflects autonomic balance; used to guide training load.

Training intensity distribution: polarized (80% low, 20% high) vs. threshold models; individualize.

Strength training: 2-3 sessions/week, 2-4 sets, 6-12 reps; progress load gradually.

Plyometrics: 2-3 sessions/week, 80-120 ground contacts; ensure adequate strength base.

Speed and agility: 2 sessions/week; include acceleration, deceleration, and change of direction.

Endurance: 3-5 sessions/week, 20-60 min at moderate intensity.

Flexibility: 2-3 sessions/week, hold 30-60 s.

Recovery: include rest days and sleep hygiene.

Subjective: history of present illness, past medical history, medications, and social history.

Objective: observation, palpation, ROM, strength, and special tests.

Assessment: differential diagnosis and clinical impression.

Plan: further testing, treatment, referral, and follow-up.

Reassessment: document changes and adjust plan.

Communication: explain findings in plain language.

Acute phase: protect, reduce pain, maintain ROM.

Subacute phase: restore ROM, strength, and proprioception.

Strengthening phase: progressive loading and functional exercises.

Return-to-sport phase: sport-specific drills and testing.

Criteria-based progression: use objective measures at each phase.

Documentation: record interventions and response.

Primary survey: ABCDE.

Secondary survey: head-to-toe examination.

Splinting: immobilize and reassess neurovascular status.

Wound care: clean, cover, and refer as needed.

Pain management: use appropriate analgesia per protocol.

Documentation: record findings and interventions.

Macronutrients: carbohydrate, protein, fat; balance based on training demands.

Micronutrients: vitamins and minerals; address deficiencies.

Hydration: monitor and replace losses.

Supplements: evidence-based and third-party tested.

Medications: check for prohibited substances.

Education: teach athletes to read labels.

Psychological skills: goal setting, imagery, self-talk, arousal regulation, and concentration.

Mental health screening: use validated tools and refer when indicated.

Injury psychology: address fear of reinjury and identity.

Team culture: promote psychological safety.

Sleep: 7-9 h for athletes.

Referral: multidisciplinary network.

Scope of practice: know laws and policies.

Informed consent: document.

Confidentiality: protect information.

Mandatory reporting: follow law.

Documentation: contemporaneous and objective.

Conflict of interest: disclose.

Energy systems: ATP-PCr, glycolytic, oxidative; all contribute, with dominance depending on intensity and duration.

VO2max testing: use graded exercise test with ECG monitoring for at-risk individuals.

Lactate testing: incremental protocol; identify thresholds for training zones.

Field tests: 20 m shuttle, 1.5-mile run, and Cooper test estimate VO2max.

Training load: session-RPE and heart rate monitoring.

Recovery: sleep, nutrition, and active recovery.

Injury prevention programs: neuromuscular training, balance, and strengthening.

Load management: avoid sudden increases; monitor acute:chronic ratio.

Equipment: fit and condition.

Environment: heat, cold, altitude, and air quality.

Youth: avoid early specialization.

Screening: prior injury and deficits.

History: mechanism, onset, and symptoms.

Observation: symmetry and gait.

Palpation: point of tenderness.

ROM: active and passive.

Strength: manual muscle testing.

Special tests: interpret with pretest probability.

Pain-guided rehabilitation: monitor pain during and after activity.

Progressive loading: isometric → eccentric → concentric → plyometric.

Balance and proprioception: include after lower-limb injury.

Cardiovascular conditioning: maintain with alternative modes.

Return-to-sport: criteria-based and shared decision.

Outcome measures: validated tools.

Scene safety: assess hazards.

Call for help: early and assign roles.

CPR: high-quality compressions.

AED: apply and follow prompts.

Splinting: immobilize and reassess.

Documentation: record and communicate.

Energy availability: avoid low energy availability.

Carbohydrate: 3-10 g/kg/day depending on training.

Protein: 1.2-2.0 g/kg/day.

Fat: 20-35% of energy.

Hydration: individualize.

Supplements: evidence-based and third-party tested.

Goal setting: specific, measurable, and process-oriented.

Imagery: multisensory and practiced.

Self-talk: positive and instructional.

Arousal regulation: breathing and relaxation.

Team cohesion: shared goals and roles.

Referral: when symptoms impair function.

Scope: know laws and policies.

Consent: document.

Confidentiality: protect information.

Reporting: follow law.

Documentation: contemporaneous and objective.

Conflict of interest: disclose.