Here are a Few Tools to Help you Expand your Athletic-Therapy Network

The Institut national du sport (INS) is a private, not-for-profit organization that supports all athletes involved in Olympic and Paralympic sports, along with high-level coaches in Québec. INS Québec is a key partner in sports systems throughout Québec and Canada. The organization is headquartered in Montréal’s Olympic Park and serves mainly elite athletes, but also runs several regional centres that were created to serve rural areas and facilitate transition in sport.

Since the INS began offering sports-medicine services to athletes, regional centres have been in charge of certifying practitioners to work with athletes who are known in their respective federations for embodying hope, transition, and top-caliber services. To join the organization’s list of practitioners, all certified athletic therapists must contact the regional centre nearest to their place of practice to learn about eligibility criteria and submit an application. The centre will evaluate whether new practitioners are needed in the area and if practitioners meet certain criteria. If you are accepted, you will be added to a list of practitioners that athletes may consult when they require treatment.

Please be aware that when applying as a practitioner, set preferential rates may be offered to athletes and normal rates for athletic therapy should be charged. This should be validated with the regional centre with whom you which you wish to work.

Please also be aware that all athletes who are certified by their respective federations hopeful, aspiring, or elite athletes may apply through their regional centres to obtain a life-insurance policy that covers athletic therapy (certain fees may apply).

Athletes may also contact the nearest regional centre to be added to the list of athletes and to apply for the insurance plan.

To see the list of regional centres across Québec

To learn more about the insurance plan

Catherine Martin, CAT (C)
Special collaboration

CTSQ Concussion Guidelines Updates - September 2016

The 2nd edition of the concussion management guidelines were developed to assist the CAT(C) provide the best evidence-based management strategies available. As our understanding of concussion continues to evolve, so must our evaluation and care. Certified athletic therapists are ideally positioned to act as front-line health care professionals in an inter-disciplinary concussion management protocol.

A concussion protocol involves a structured application and monitoring of the three phases of concussion management (resolution of symptoms, successful return-to-learn, and successful return to non-contact, high intensity physical activity).

There exists a real disconnect between ideal concussion management and real world implementation. There are just not enough physicians skilled in concussion management available to see every concussion. The standardization of care and availability of an inter-disciplinary management team to screen and refer to limited expert resources is a step in the right direction. Certified Athletic Therapists have an enormous role to play in this strategy.

The following is a synopsis of the level of care expected from a certified athletic therapist in the province of Quebec. Certification candidates need mentor supervision and must refer all concussions to a CAT(C) or other appropriate health care provider.

1. Acute assessments on the field of play or sideline must utilize appropriate assessment tools to screen for possible presence of a concussion.


2. Appropriate management strategies must be employed, especially for clinically unstable (red flag) presentations. All concussions (unstable or stable) should involve a referral to an appropriate health care professional.


3. Three categories of referral:
   a. Urgent Care
   An athlete with red flags present or symptom evolution should be sent urgently to an ER physician.
   b. Follow-up Care
   An athlete who is clinically stable with no red flags present does not need an urgent care consult but must still be monitored. Athlete should return for follow-up care in a few days, or referred out to another CAT(C) or health care professional with concussion management skills or to a concussion clinic.
   c. Post-Concussion Symptoms
   An athlete who was deemed clinically stable but still has residual symptoms lasting more than 10 days requires a post-concussion symptoms consult. This athlete needs to be seen by a physician (ideally one with experience in concussion management).


4. The best care for concussions usually involves an inter-disciplinary approach. Every professional involved has a role to play in one or more of the following: prevention, recognition, return to learn, return to play, rehabilitation.


5. CAT(C) should continue to develop skill sets that enhance their capabilities to perform baseline testing, acute assessment, and management strategies. In addition, they need to identify the primary lesion type (eg: vestibular, cognitive, oculomotor, cervigogenic) in order to provide appropriate rehabilitation and /or referral when appropriate. Slow to resolve cases usually require an inter-disciplinary approach.


6. It is important that age-appropriate return to learn (R2L) and return to play (RTP) procedures are followed in order to obtain an optimal recovery.


7. Non-school and summer programs may have less monitoring and consideration for R2L component of recovery. A signed consent form (parents and therapist) must be provided to the coach/organization before RTP may be commenced. This provides both educational and medico-legal assurance of RTP readiness.

These guidelines are to serve as a standard of care and the “reasonable knowledge and skill” expected from a certified athletic therapist in Quebec.

John Boulay, CAT (C), Concussion Committee Chair
Special collaboration