Sports medicine or sport medicine is an interdisciplinary subspecialty of medicine which deals with the treatment and preventive care of athletes, both amateur and professional. The team includes specialty physicians and surgeons, athletic trainers, physical therapists, coaches, other personnel, and, of course, the athlete.

History

The origins of Sports Medicine lie in 5th century BC ancient Greece and ancient Rome where physical education was a necessary aspect of youth – training and athletic contests first became a part of everyday life during these times. However, it was not until in 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. They were trainer-coaches and were considered to be experts on diet, physical therapy, and hygiene as well as on sport-specific techniques. The first use of therapeutic exercise is credited to Herodicus, who is thought to have been one of Hippocrates' teachers. Until the 2nd century AD, when the first "team doctor", Galen, was appointed to the gladiators, the physician only became involved if there was an injury. Whether or not there was good communication or rapport between the trainer-coaches and the team physician back then is a matter of speculation. What is clear however, is that from its beginnings, Sport Medicine has been multidisciplinary with the obligation not only to treat injuries but also to instruct and prepare athletes. This link with physical education has remained in place throughout its evolution.

Sports Medicine Today

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 also preventative, which may actually be the most important one of all. 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 - cardiology, orthopaedic surgery, biomechanics, traumatology, etc. For example, heat, cold or altitude during training and competition can alter performance or may even be life threatening. What about the female triad of disordered eating, menstrual and bone density problems, and the pregnant or the aging athlete? In addition, the management of dermatological and endocrinological diseases and other such problems in the athlete demands 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. Then there are the particular problems associated with international sporting events, such as the effects of travel, acclimatization and the attempt to balance an athlete's participation and her or his health. Much of this represents new fields of study where extensive clinical and basic science research is burgeoning. Finally, prevention is an area of increasingly specialized knowledge, interest and expertise.

United States

The Sports Medicine Specialist is a leader of the sports medicine team, which also includes specialty physicians and surgeons, athletic trainers, physical therapists, coaches, other personnel, and, of course, the athlete.

They are physicians with a primary specialty in Family Practice, Internal Medicine, Emergency Medicine, Pediatrics, or Physical Medicine and Rehabilitation, most of whom obtain 1-2 years of additional training in sports medicine through accredited fellowship (subspecialty) programs in Sports Medicine. Physicians, who are board certified in Family Practice, Internal Medicine, Emergency Medicine, or Pediatrics, 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 by the American Board of Medical Specialties since 1989. Currently there are more than 70 Sports Medicine fellowships and approximately one thousand certified Sports Medicine Specialists in the United States.

First Olympic Sports Medicine Team

While watching his daughter Louise swim at the 1968 Summer Olympics in Mexico City, Dr. J C Kennedy, a doctor based in London, Ontario in Canada concluded for a variety of reasons that competing athletic teams from Canada should be accompanied by qualified and well organized medical care. This belief led him to be a founding father of the Canadian Academy of Sport Medicine. One of the primary mandates of this society was to provide expert care to Canadian athletes, and in 1972 he was appointed chief medical officer of the first "true" medical team at the 1972 Summer Olympics in Munich, Germany. Other countries soon followed this example and assigned medical teams to Olympic athletes. Dr. Kennedy's vision was not limited to travelling Canadian athletes. At a time when Sport Medicine clinics were unheard of in Canada, he convinced his university's administration to convert a former wrestling "combatives" room into The Athletic Injuries Clinic that officially opened in 1972. The first Nautilus equipment in Canada was purchased from funds raised to outfit this clinic. Dr. Kennedy inspired and fostered an interest in research in Sport Medicine, for which the University of Western Ontario (UWO) and London, Ontario have become known.

The Future of Sports Medicine

Many believe that Sports Medicine will make its most significant future contributions in the area of prevention. According to Dr. David Janda, orthopaedic surgeon and director of The Institute for Preventative Medicine 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 outcomes of meaningful research have shown that it can be lowered. One rapidly advancing field with great potential for applications in prevention is the study of the body's neuromuscular adaptations. For example, a study of specific preseason neuromuscular training in soccer players demonstrated a significant decrease in the incidence of anterior cruciate ligament tears. In another investigation by Janda et al., serious injuries in recreational softball were reduced by 98% when breakaway bases were used.

Participation in all forms of physical activity at all levels is a huge part of everyday modern life and its benefits to health and quality of life are clear. Sports Medicine will continue to grow and develop so that these benefits can be fully and safely realized.

References

• Fowler, PJ, Sport Medicine (http://www.med.uwo.ca/UME/Diane/Year2Postings2004-2005/Trimester%202/MSK/SportMedicineDrFowler.pdf)
  • Article originally written by P. J. Fowler, MD and released into the public domain on 5 Jan 2005

External links

• American College of Sports Medicine (http://www.acsm.org) advances and integrates scientific research to provide educational and practical applications of exercise science and sports medicine.
• American Medical Society for Sports Medicine (http://www.amssm.org/) to foster a collegial relationship among dedicated, competent sports medicine specialists, to provide a quality educational resource for AMSSM members, other sports medicine professionals, and the general public.
• Canadian Academy of Sport Medicine (http://www.casm-acms.org/) advance the art and science of sport medicine, including health promotion and disease prevention, for the benefit of all Canadians through programs of education, research and service.
• The Fédération Internationale de Médecine du Sport (FIMS)/International Federation of Sports Medicine (http://www.fims.org) is an international organisation with a common involvement with sports medicine on all continents. FIMS aims primarily to promote the study and development of sports medicine throughout the world, and to assist athletes in achieving optimal performance by maximising their genetic potential, health, nutrition, and high-quality medical care and training.