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The Role of a Sports Medicine Doctor
Submitted by Thomas J. Duhig, MD, Orthopedic & Sports Enhancement Center
hether you are a competitive athlete or a sports-minded adult, sports-related injuries can be painful and frustrating. Disease or injury to the musculoskeletal can adversely affect athletic performance and even the ability to perform daily activities. Athletic trainers, physical therapists, and orthopedic surgeons may all have a role in treating these injuries. However, a sports medicine doctor has specialized training in the fields of medicine that deal with sport or exercise-related injuries and may be able to best manage and coordinate treatment. Primary care sports medicine is a relatively new specialty. The primary focus is on the diagnosis, treatment, and prevention of injuries that occur during sports and other physical activity. Sports medicine doctors can come from a variety of fields including internal medicine and pediatrics, but most choose family medicine as their baseline training. This means that after medical school, they complete three years of family medicine residency and then an additional one or two year sports medicine fellowship program. During fellowship training, a great deal of time is spent learning more about sport specific injuries as well as additional training in techniques such as prolotherapy, platelet rich plasma therapy, concussion evaluation, and evidence based return-to-play decision making. Time is also spent working closely with multiple specialized orthopedic surgeons and assisting in shared patient orthopedic surgery. Another important aspect of a sports medicine fellowship involves being a team doctor for a local high school, college, and often professional athletic organization. Primary Care Sports Medicine vs. Orthopedic Sports Medicine There are two types of sports medicine doctors: orthopedic surgeons and non-surgical primary care sports medicine doctors. Primary sports medicine physicians specialize in the non-surgical medical treatment of musculoskeletal sports conditions, therapy, radiographic evaluation, and evidence based return-to-play decisions. Both are well trained in treating musculoskeletal problems, which commonly include: • Acute injuries such as ankle sprains, muscle strains, knee and shoulder injuries, and fractures
Page 6 — Healthy Cells Magazine — Bloomington — April 2013

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Overuse injuries such as tendonitis and stress fractures Return-to-play decisions in the sick or injured athlete Strength training and conditioning Healthy lifestyle promotion

Sports medicine is more than just orthopedics. The primary care sports medicine fellowship includes continued training in the doctor's original specialty so that they do not lose touch with their baseline training, be it family medicine, internal medicine, pediatrics, etc. They become efficient at musculoskeletal/orthopedic injuries, but also remain well trained in more traditional medical problems such as asthma, hypertension, and diabetes, with an emphasis on the unique management of these problems in athletes and the effects on their performance. In general, the responsibilities of a sports medicine doctor are to: • Coordinate pre-participation screening, examination, and evaluation • Educate and counsel athletes regarding nutrition, strength and conditioning, external influences to enhance performance, substance abuse • Handle assessment, triage, and injury management on the playing field • Provide for medical management of injury and illness • Provide for proper preparation for safe return to participation after an illness or injury • Maintain clear lines of communication with the family physician, parents, coaches and support personnel of the athlete • Prevent acute injuries with pre-season physical conditioning, proper warm-up and cool-down.

• Prevent overuse injuries by evaluating risk factors such as previous injuries, poor conditioning, muscle imbalances, anatomical abnormalities and poor nutrition along with factors such as inappropriate workout structure and training errors (abrupt increases in intensity, duration, or frequency) • Ensure safe playing conditions such as recommending the use of appropriate safety equipment and modifying training during extreme temperatures reducing potential for hot and cold weather injury prevention. Traditionally, orthopedic surgeons have been both the team physician and sports medicine doctor. However, approximately 90 percent of all sports injuries are non-surgical. It is important to note that non-surgical treatment does not mean there is no treatment. Sports medicine physicians can expedite referral to an orthopedic surgeon when indicated, and can integrate medical expertise with other health care providers, including medical specialists, athletic trainers, physical therapists, and any other supportive services that may be needed. The added benefit is that they can also treat non-injury problems such as skin infections, upper respiratory tract infections, exercise-induced asthma, endocrine abnormalities, cardio respiratory, and gastrointestinal symptoms as well as sports psychology. This team approach helps everyone work together so that the athlete can return to action as soon as possible. For more information, you may contact Orthopedic & Sports Enhancement Center, 309-663-9300. They are located at 2406 East Empire in Bloomington.

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April 2013 — Bloomington — Healthy Cells Magazine — Page 7

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