Sports medicine

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Sports medicine specializes in preventing, diagnosing and treating injuries related to participating in sports and/or exercise, specifically the rotation or deformation of joints or muscles caused by engaging in such physical activities. The sports medicine "team" includes specialty physicians and surgeons, athletic trainers, physical therapists, coaches, other personnel, as well as the athlete himself/herself. Because of the competitive nature of sports, a primary focus of sports medicine is the rapid recovery of patients, which drives many innovations in the field.

Sports medicine has always been difficult to define because it is not a single specialty, but an area that involves health care professionals, researchers and educators from a wide variety of disciplines. Its function is not only curative and rehabilitative, but especially preventive.

Despite this wide scope, there has been a tendency for many to assume that sport-related problems are by default musculoskeletal and that sports medicine is an orthopaedic specialty. There is much more to sports medicine than just musculoskeletal diagnosis and treatment. Illness or injury in sport can be caused by many factors – from environmental to physiological and psychological. Consequently, sports medicine can encompass an array of specialties, including cardiology, pulmonology, rehabilitation medicine, orthopaedic surgery, nutrition, dentistry, opthamology, exercise physiology, biomechanics, and traumatology. For example, heat, cold or altitude during training and competition can alter performance or may even be life threatening. The female athlete triad of disordered eating, menstrual disturbances, and bone density problems, and the problems of pregnant or aging athletes demand knowledge from many diverse fields. In addition, the management of endocrinological diseases and other such problems in the athlete demands both medical expertise and sport-specific knowledge.

The use of supplements, pharmacological or otherwise, and the topics of doping control and gender verification present complex moral, legal and health-related difficulties. Further unique problems are associated with international sporting events, such as the effects of travel and acclimatization, and the attempt to balance an athlete's participation with his or her health. Much of this draws on new fields of study, in which extensive clinical and basic science research is burgeoning.

Contents 1 Sports medicine in the United States 2 Pediatric orthopedic issues 3 History 4 The future of sports medicine 5 Further reading 6 See also 7 References

[edit] Sports medicine in the United States

The Sports Medicine specialist, either an orthopedist or a primary care sports medicine specialist, is usually the leader of the sports medicine team, which also may include physician and surgeon specialists, physiologists, athletic trainers, physical therapists, coaches, other personnel, and -- not least of all -- the athlete.

For primary care sports medicine, doctors who specialize begin with a primary residency program in family practice, internal medicine, emergency medicine, pediatrics, or physical medicine and rehabilitation. They generally obtain one or two years of additional training through accredited fellowship (subspecialty) program in sports medicine. Physicians who are board-certified in one of these displines are then eligible to take a subspecialty qualification examination in sports medicine. Additional forums, which add to the expertise of a Sports Medicine Specialist, include continuing education in sports medicine, and membership and participation in sports medicine societies.

Sports medicine has been a recognized subspecialty of the American Board of Medical Specialties since 1989. Currently there are more than 80 sports medicine fellowships and approximately 1,000 certified Sports Medicine Specialists in the United States.

[edit] Pediatric orthopedic issues

Shoulder dislocations: Active teenagers often suffer shoulder dislocations, most of which are caused by traumatic injury. Though some dislocations need to be reduced -- put back into place -- in the emergency room, some dislocations will spontaneously reduce without medical treatment. Young women can suffer from a form of instability where the shoulder slides in and out of place with no trauma or injury. This is termed multi-directional instability.

Scientific literature^[1] indicates that if the arm is immobilized in 20 or 30 degrees of external rotation (following an initial traumatic dislocation) for three weeks, the risk of a repeat dislocation is dramatically reduced.

Rotator cuff injuries: Children almost never suffer from rotator cuff problems; stress fractures or stress reactions of the growth plate (from overhead sports or throwing) are far more common, along with repetitive stress injuries to ligaments in the shoulder. Instability caused by these ligament injuries can be very subtle and can lead to subluxation of the joint.

ACL tears: Children -- especially young girls -- are experiencing ACL tears and injuries more often, and these injuries cause a dilemma for parents. Without an ACL repair, most children will be unable to participate in sports that involve cutting, pivoting, and twisting. With adults, the preferred solution is often surgical reconstruction. That is sometimes the preferred treatment for children, but the risks associated with ACL reconstruction in children are far more significant.

Prevention and preparation: Though coaches and parents are warned to not allow kids to pitch or throw too much, many kids are out there throwing 100+ pitches every week. Most of the strength of the pitch originates below the navel -- a strong pitch comes from the unwinding of the entire kinetic chain. In order to coil and release through the pelvis and hips, a child must have phenomenal CORE strength and balance. Squats, lunges, rotational exercises, and CORE strengthening should be performed for months prior to the season to properly prepare kids for the physical demands of an overhead sport.

[edit] History

The origins of sports medicine lie in ancient Greece and ancient Rome where physical education was a necessary and valued aspect of youth – training and athletic contests first became a part of everyday life during these times.

In the Modern Age, the first book on sports medicine was De Arte Gymnastica, by Girolamo Mercuriale from Forlì (Italy).

However, it was not until 1928 at the Olympics in St. Moritz, when a committee came together to plan the First International Congress of Sports Medicine, that the term itself was coined. In the 5th century, however, the care of athletes was primarily the responsibility of specialists. These were trainer-coaches who were considered to be experts on diet, physical therapy, hygiene, and sport-specific techniques.

[edit] The future of sports medicine

According to the director of The Institute for Preventive Medicine ^[2] in Michigan, prevention is sports medicine's final frontier. The risk of injury will never be entirely eliminated, but modifications in training techniques, equipment, sports venues and rules -- based on meaningful research -- have shown that risks can be lowered.

One rapidly advancing field with great potential for applications in prevention is the study of the body's neuromuscular adaptations. A study of specific pre-season neuromuscular training for soccer players demonstrated a significant decrease in the incidence of anterior cruciate ligament (ACL) tears.

In another investigation by Janda et al., serious injuries in recreational softball were reduced by 98 percent when breakaway bases were used.

Participation in all forms of physical activity at all levels is a huge part of everyday life, and the benefits of this are clear. Sports medicine's continued growth and development may help the benefits of physical activity to be fully and safely realized.

[edit] Further reading

• Sport and Exercise Science: Essays in the History of Sports Medicine (Sport and Society), ed. by Jack W. Berryman and Roberta J. Park, University of Illinois Press, 2000

[edit] See also

• Arthroscopy
• Athletic trainer
• Augustus Thorndike
• Exercise
• Nutrition
• Overtraining
• Sports injuries
• Sports nutrition
• Sports training

[edit] References