Information for Medical Staff

These Guidelines have been prepared by the FIBA Medical Commission, which was formed in 1977 and comprises membership from the five FIBA Zones. It has the responsibility of advising FIBA on medical and anti-doping matters.

Introduction

Being a member of the medical staff of a basketball team is a rewarding and unique experience from a personal and professional perspective. It is a game with its own particular healthcare issues. It is a team sport played to the highest elite and professional levels.

Basketball has a wide international context which means that all levels of the game have the opportunity to travel, competition and share friendships all over the world.
There are many opportunities for physicians, physiotherapists, massage therapists, dieticians and trainers in the game. Alongside these opportunities are professional and ethical obligations.

This page scope the responsibilities of basketball support medical staff.

Illness
As you would expect with any group of people basketball medical personnel will encounter many varied illnesses but primarily infections. This is particularly true if you are traveling to foreign countries for competition. An understanding of the range of these conditions and knowledge of their management, including management in the context of playing and training, requires knowledge, experience and preparation. Medical support staff must have the capability of managing emergency medical situations (e.g. advanced life support such as CPR) and acute trauma (e.g. concussion).

Travel illnesses and vaccinations - Live Well - NHS Choices

Injury
In looking after a basketball team, medical personnel will encounter a similar range of musculoskeletal conditions that you would expect in any group of competing athletes. It also has certain conditions that are more common and reflect the physical demands of the sport. Such conditions include ankle and knee sprains, chronic back pain and overuse tendon and bone injuries.

While concussion is not common it is important that medical staff are familiar with contemporary concussion management guidelines.

Common basketball injuries:

Concussion:

Medical fitness
The determination of a player’s ‘medical fitness’ to participate in basketball competition and training has an important role. This may relate to a medical or musculoskeletal condition. Such decisions are not always easy to take and may require input from all members of a multi-disciplinary medical team, as well as external specialist consultants.

If there are any doubts, accountability for ‘medical fitness’ should ultimately reside with the team physician after wide consultation and input from the player and coach. It is the aim of a team’s medical personnel to ensure the safe participation of a player in a competition.
It is the responsibility of the medical personnel to fully inform players and officials if participation poses a risk to a player or is contraindicated.

Prevention
Prevention of illness and injury is an essential aspect of athlete's healthcare.     A comprehensive prevention program will usually include general medical and basketball specific pre-participation screening (including a cardiac assessment), player healthcare monitoring, vaccinations, assessment of environmental conditions and travel preparation where player-care is provided alongside international travels.

It is a FIBA requirement that all players have a pre-participation medical screen prior to a FIBA controlled competition. This includes a mandatory requirement of a cardiac assessment which includes specific questionnaire, physical examination and ECG.

An Echo is not considered mandatory. It is strongly recommended that cardiac screening is undertaken by appropriately qualified practitioners with experience in team-care, medical screening and cardiac examination. Abnormal findings should be assessed and investigated by a cardiologist with experience in the management of athletes.

IOC Medical Commission

Professional and Ethical Standards
Team medical staff must have the appropriate qualifications for their professional position and apply the highest ethical standards relevant to their discipline. Team physicians must have an appropriate medical degree, ideally post graduate sports medicine training, medical registration and professional indemnity insurance.  It is expected that the care of players be evidence based, safe and consistent with FIBA Regulations.

Professional ethical standards include confidentiality, player consent (a player has the right to be fully informed regarding a medical condition and its’ treatment) and medical record keeping.

Code of Ethics | FIMS - International Federation of Sports Medicine

Confidentiality
The maintenance of confidentiality in the context of a sporting team is complex. While there is an obligation to communicate with the coach on healthcare matters that impact the team, this needs to be undertaken in the broader restrictive context of patient confidentiality.

As a general rule confidentiality should be maintained where the health information has no bearing on player or team performance or is personal and sensitive in nature. It is important that this issue is discussed with players and officials as a group so there is a clear understanding of what is reasonable and expected. Confidentiality is particularly difficult where there is media coverage of a player, team or event.

As a general rule team medical support staff should not release player or team medical or injury information to the media without the consent of all parties. This issue should be discussed with team management preferably prior to an event or competition.

Team Physician Consensus Statement

FIBA ‘Medical’ Rules and Regulations
FIBA Regulations include a number of Articles that dictate medical support such as active bleeding, prosthesis use, access to the court during competition and anti-doping. Team medical personnel should be fully familiar with FIBA regulations including those rules (Articles 4.2.1 [access to bench], 4.4 [equipment rules], 5 [injured player during a game] and 19.3.8 [substitution of an injured free throw player]) that impact health care in the context of the game.

Anti-Doping
Members of a basketball team’s medical staff are expected to be familiar with the FIBA Anti-Doping regulations, the WADA Code, WADA Prohibited List and drug test procedures. Other responsibilities are player and officials’ anti-doping and illicit drug education, support of players during drug testing, management of player Therapeutic Use Exemptions (TUEs) and the clearance of medicines and supplements for use by a team.

Therapeutic Use Exemptions can be sought for the reasonable treatment of a medical condition by a WADA prohibited drug if other permitted drugs have been tried or none are available. For an international level athlete TUEs should be sought from the FIBA TUE Committee (TUEC). All other TUEs should be sought from the National TUEC. If a player has a national TUE and is progressing to international competition at a FIBA tournament, a TUE application should be made to the FIBA TUEC with a copy of the national approval and supporting medical documentation. The national TUE will be evaluated according to WADA Guidelines.

Nutritional supplements that contain a WADA prohibited substances is a common problem and poses a serious threat to athletes subject to drug testing. Supporting players in the wise selection of any supplement is an integral role of the support medical staff of the team. Firstly, consideration should always be given to promoting a well-balanced diet as the starting point of any selection of a supplement. In selecting a supplement a physician should consider the published evidence, safety, WADA Prohibited List compliance, reliability of the manufacturing, certified batch testing of the product and any extravagant claims by the supplier.