Friday, May 7, 2010
What is Sports Medicine?
The sports medicine approach to injuries, athletic or not, can be very different from general podiatric or orthopedic approaches. Sports Medicine evolved from the professional and college teams needing to get their players safely, but as quickly as possible, back onto the playing fields. It evolved away from the surgical treatment of injuries as the mainstay of treatment. Was there another way to treat an injury, besides surgery that led to the same results without the surgical scar and without the time off required for surgery? Was there another way to treat an injury without prolonged casting/immobilization of the body part?
The sports medicine approach is a switch from “Doctor please heal me!” to “What can I do to help myself get better?” The sports medicine approach is a switch from pills and shots and casts to ice, soaking, alternative exercise, home exercise programs, braces, etc.
Sports medicine doctors will use surgery when needed, shots when needed, casts when needed, and medicine when needed. The doctor’s orientation to an injury is less doctor focused, and more physical therapy focused, and more patient involvement. Treating a patient with a sports medicine approach is truly an attitude difference. Hopefully, the various posts on this blog will infuse the reader with this attitude.
A sports medicine approach is in its purest sense a team approach---patient, therapist, doctor, other specialists (acupuncture, trainers, dieticians, coaches, etc.) Everyone’s input is vital, looking at the same injury from different perspectives. The patient’s subjective view, but experiencing the problem first-hand, is balanced by others sometimes more objective views. Having treated many athletes and non-athletes, I realize patients can be very objective about their injuries, or not at all. Most importantly, no one should advise anything that potently harms the patient (patients have a way of doing that to themselves too much already).
From 1975 to 2000, sports medicine explosion happened. Prior to 1975, there were sporadic sports medicine centers across the country, now they dominate the health care world. Everyone wants to use the word sports medicine in their practices, but do they practice sports medicine?
The consumer needs to find the sports medicine doctors and therapists in their areas by talking to fellow athletes, the running shoe shops, the cycling stores, the athletic clubs, and online services like Yelp.com. They need to shop around if there initial treatment plan is lacking in patient home programs, physical therapy programs, alternative exercise programs, and other signs that this doctor practices sports medicine.
I personally do not think the doctor or therapist needs to play sports to be good at sports medicine, but it helps immensely. Does the doctor/therapist understand your need to get back to exercise quickly? A typical proactive program contains a minimum to 4 and sometimes 7-8 activities for the patient to do between office visits to get better. Some sports medicine physicians do leave this to the therapist, but I prefer some individualization from the doctor.
1. What stretching can be done?
2. What strengthening can be done?
3. How often do I ice the area, or should I soak it?
4. What does physical therapy have to offer?
5. Would alternative exercises (for example, biking if it is an injured runner) help and what kinds?
6. Should I take medicine? And when?
7. Should I wear a brace, splint, or do some form to taping?
8. Should I change something about my shoe gear, equipment (for example, have my bike pedals adjusted), lacing, shoe inserts?
9. Should my training be different?
10. Will I need any tests, and how it that decided?
These are such basic questions that must be answered within the first 2 visits of a typical sports medicine visit.
Since 99% of all sports medicine injuries are non-surgical, the sports medicine specialist or his/her team should be the expert in rehabilitation. It is so important for our bodies to get the best and safest treatments. We need these bodies to be fully functional for hopefully a long time.
Every health care profession has a sports medicine division. That can be a good place to look for a specialist in your area. For podiatry, the American Academy of Podiatric Sports Medicine www.aapsm.org is the appropriate starting place. But, I have found that no matter how you label yourself, the patient must evaluate whether or not you really have the sports medicine attitude.