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Let the Games begin

gamespan-am.jpgThe bleachers and box suites at major games are occupied by thousands of enthusiastic and excited spectators. Those fun-filled moments are the realization of a process, the evolution of a final product, so-to-speak. Athletes have spent countless hours honing their skills for the competition. Likewise, for every group of fans taking in the sights and sounds of the spectacle, there is a large number of people who have helped organize the occasion and support it while it is happening.

February 18, 2014  By Jonathan Maister

It could be argued that a major game resembles a large rock band
concert, but on a far grander scale. At such an event there are travel
consultants and equipment movers. Often, construction is involved, and
stage managers, medical people, officials and volunteers are present.

Pan Am and Parapan Am Games bearing down on Toronto in 2015 will be
such an event — perhaps second in size only to the Summer Olympics. In
fact, sport venues stretch across Ontario’s Golden Horseshoe — from
Welland to Oshawa and from the downtown area up to Lake Simcoe.

Pan Am Games — to be held July 10 to 26, 2015 — and Parapan Am Games —
to be held Aug. 7 to 14, 2015 — will include countries from North,
Central and South America, as well as the Caribbean. Some 41 national
teams, totalling close to 7,000 athletes, will be participating.
Competitors will represent their countries in 36 sports and 15 sports in
the Pan Am and Parapan Am Games, respectively.. Around 20,000
volunteers are needed to make these events a seamless and outstanding
success for .

An event of this magnitude requires medical
personnel of all stripes — emergency medical personnel, athletic
therapists, massage therapists with a sport massage background, sport
physiotherapists, sport chiropractors, sport physicians, orthopaedic


Prior to participation, all must receive
accreditation, which often involves a police check to determine that the
prospective participant does not have a criminal record.

are briefed on a number of topics — some obvious and others less
typical. Athletes must be a ware of cultural considerations with
different athletes, health issues with participants (Think Special
Olympics where participants have special needs), equipment issues
(depending on the sports, wheelchairs, helmets). Cooperation protocols
for different professionals must be established so everyone knows what
his or her role is in the team.

Participants in medical teams
have indicated that at special events, recognition and respect for the
skills of different professionals is far better than in the regular
medical system. It is a common lament that, if only the daily medical
system mirrored sport events, patients would have superior and faster
medical care.

Preparing medical coverage is multifaceted. The
logistics of various locations are important. Depending on the size of
the contingent competing at that location, more personnel will be
required. Who staffs that location also depends on how far it is from a
major hospital and what events are taking place. Motor cross and skiing
events may be farther from a major hospital compared to, say, track and
field events, and might need a more comprehensive medical presence.
Injuries are more likely to occur with certain sports hence,
professionals trained in emergency care will be more of a presence in
events with higher risks of injury, like rugby. On the other hand
certain events, such as swimming, are more likely to require massage.
Hence, the profile of the medical professionals present depends on the
sport and location.

Larger foreign teams do come with their own
medical team.  The insurance of their medical staff indicates they may
work with their own athletes even though they are in Canada — which to
them is a foreign country where their insurance usually does not apply.
The corollary is that the Canadian host medical team may work with all
athletes — foreign and Canadian — so long as contact occurs in Canada.
Foreign medical doctors may assess their own athletes and suggest
treatment or medication, but their Canadian doctor counterparts will
then have to prescribe the appropriate medication.

when a variety of languages are spoken, translation services will be
required. The Pan Am Games will most likely have English as a
predominant language. However, French and Spanish will also be official
languages of the event. Volunteers are asked, if possible, to brush up
on their Spanish and French.

Medical personnel at major games can
be divided into three groups. Individual teams from all countries,
including Canada, may have their own dedicated team therapist. This is
usually someone who is very familiar with the sport and who has worked
extensively with the team previously. Often, that therapist has
themselves been an athlete in that particular sport.

foreign contingents will also have a core medical team who serve their
athletes in general. There is also a host medical team provided by the
home country, which is usually based somewhere central as well as in
satellite clinics close to event locations. The host medical team serves
all athletes — the host country’s athletes, as well as foreign
athletes. Smaller foreign contingents with little or no medical staff of
their own will rely more heavily on the host country’s host medical

Head therapists and physicians often have a cell phone
dedicated to the event, enabling other staff to reach them at all times.
In truth nowadays, it is realistic that everyone on the medical team
will be equipped with a mobile communication device such as a cell
phone. Health forms,record keeping and consent protocols must be
organized. An emergency action plan (EAP) must be established with all
involved personnel knowing exactly what to do in this eventuality.
Equipment (stretchers, spinal boards, treatment tables, modalities), and
supplies (tape, tensors, ice etc), as well as sanitizers for the
equipment and hands must be available and paid for — hence, the value of
sponsors. If concussions are likely in the sport, SCAT forms (sport
concussion assessment tools) must be available. 

Massage therapy
at major sporting events will focus on sport massage and when
necessary, soft tissue work to treat injuries. Participating therapists
would be wise to take a sport massage course to bone up their skills.
This type of preparation is often a requirement by organizers to ensure
that all therapists providing massage to athletes are fully equipped to
deliver the best possible care.

Canada prides itself on the
quality of care of its sport medicine professionals. Physiotherapy has a
sport medicine designation (Sport Physiotherapist), much like 
Chiropractors and MDs have sport medicine fellowships. Their presence
will be reflected in the volunteer schedule.

Aside from the
resume building and networking opportunity — which is substantial —
participants report being part of such an event is as exciting as it is
rewarding. Such an international sporting event comes only rarely to
Toronto. This is absolutely an opportunity to be embraced.

All interested therapists are welcome to examine the event website for further information:

interested in sport massage or participating in a sport event should
start getting involved through their neighbourhood sport events. Year
round, events are happening at the local and national level. Volunteers
will gain experience in sport medicine, make contacts and improve their

Information about a number of sporting events are
available on the Internet. Sport massage courses recognized by the
Canadian Sport Massage Therapists Association are held at regular
intervals and are strongly recommended for therapists who wish to become
involved with sporting events.

Jonathan Maister is a Canadian trained Athletic Therapist, Massage Therapist and Sport Massage Therapist. He is in private practice in the Markham, Ont., area and has lectured on a number of sport massage and sport medicine topics across Canada. He has authored articles that have appeared in various associated journals across North America. He can be contacted at or 905-477-8900.

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