sports medicine

Sports medicine can refer to the specific medical specialty or subspecialty of several medical and research disciplines in sports. Sports medicine may be called Sport and Exercise medicine (SEM), which is now well established in many countries. It can broadly also refer to physicians, scientists, trainers, and other paramedical practitioners who work in a broad setting. Sports medicine specialists include a broad range of professions. All sports medicine specialists have one main goal in mind, and that is preventing future injuries and to improve the function of that area to return to everyday life. They work with all different types of people, and not just athletes.{{Cite web |title=What Is Sports Medicine – Health Encyclopedia – University of Rochester Medical Center |url=https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=160&contentid=19 |access-date=2022-04-02 |website=www.urmc.rochester.edu}} The various sports medicine experts often work together as a team to ensure the best recovery plan for the individual. Team members can include orthopedic surgeons, certified athletic trainers, sports physical therapists, physical medicine and rehabilitation specialists, and specialty SEM physicians.

Specializing in the treatment of athletes and other physically active individuals, SEM physicians have extensive education in musculoskeletal medicine. SEM doctors treat injuries such as muscle, ligament, tendon and bone problems, but may also treat chronic illnesses that can affect physical performance, such as asthma and diabetes. SEM doctors also advise on managing and preventing injuries.{{cite journal |last1=Gamage |first1=PJ |last2=Seker |first2=S |last3=Orchard |first3=J |last4=Humphries |first4=D |last5=Fitzgerald |first5=K |last6=Fitzpatrick |first6=J |title=Insights into the complexity of presentation and management of patients: the Sport and Exercise Physician's perspective. |journal=BMJ Open Sport & Exercise Medicine |date=2021 |volume=7 |issue=4 |pages=e001228 |doi=10.1136/bmjsem-2021-001228 |pmid=34925878|pmc=8628332 }}

European templates for SEM specialization generally recommend four years of experience in:{{cite web|url=https://www.uems.eu/__data/assets/pdf_file/0014/110372/ETR-Sports-Medicine.pdf|title= Training Requirements for the Specialty of Sports Medicine|publisher=European Union of Medical Specialists|accessdate=25 March 2022}}

• internal medicine with special emphasis on cardiology, emergency medicine and clinical nutrition
• orthopedics and traumatology
• physical and rehabilitation medicine
• fellowship at a recognized sports medicine centre.

• Exercise medicine
• Podiatry
• Sports cardiology
• Emergency medicine
• Lifestyle medicine
• General practice
• Adolescent medicine
• Physical medicine and rehabilitation
• Rheumatology
• Orthopaedic sports medicine
• Pediatrics
• Occupational medicine

Although sports medicine was only established formally as a specialty in the 20th Century, the history of doctors having involvement in treating athletes goes back to ancient times in Greek, Roman and Egyptian societies.{{cite journal |last1=Ergen |first1=Emin |title=The origins of sports medicine |journal=Aspetar Sports Medicine Journal |date=2016 |volume=5 |issue=2 |pages=342–348 |url=https://www.aspetar.com/journal/viewarticle.aspx?id=322 |access-date=2 July 2022}}{{cite journal |last1=Appelboom |first1=T |last2=Rouffin |first2=C |last3=Fierens |first3=E |title=Sport and medicine in ancient Greece. |journal=The American Journal of Sports Medicine |date=November 1988 |volume=16 |issue=6 |pages=594–6 |doi=10.1177/036354658801600607 |pmid=3071150|s2cid=27540215 }}{{cite journal |last1=Masterson |first1=DW |title=The ancient Greek origins of sports medicine. |journal=British Journal of Sports Medicine |date=December 1976 |volume=10 |issue=4 |pages=196–202 |doi=10.1136/bjsm.10.4.196 |pmid=795492|pmc=1859519 }}{{cite journal |last1=Burke |first1=DT |last2=Al-Adawi |first2=S |last3=Lee |first3=YT |last4=Audette |first4=J |title=Martial arts as sport and therapy. |journal=The Journal of Sports Medicine and Physical Fitness |date=March 2007 |volume=47 |issue=1 |pages=96–102 |pmid=17369805}}{{cite journal |last1=Ergen |first1=Emin |title=Roots of Sports Medicine |journal=Arch Med Deporte |date=2014 |volume=31 |issue=4 |pages=263–267 |url=http://femede.es/documentos/rev01_162.pdf}}

Continental European countries were the first to establish medical groups with a focus on sport in the earliest part of the 20th Century. Possibly the earliest establishment of a society of Sports Medicine was the DGSP in Germany in 1912.{{cite web |title=DGSP • Deutsche Gesellschaft für Sportmedizin und Prävention e.V. - Satzung |url=https://www.dgsp.de/seite/374947/satzung.html |website=www.dgsp.de |access-date=28 October 2024 |language=de}} The Italian version of this page Medicina dello sport states that Sports Medicine societies were first established in Switzerland (1922) followed by France (1929) and Italy (1929) (Italian Sports Medicine Federation). In Germany in the 1920s, an attempt was made to upskill thousands of doctors and other health professionals in sport and exercise medicine, without establishing it as a distinct specialty at that stage, but it failed due to lack of funding in the Depression.{{cite journal |last1=Pfister |first1=Gertrud |title="Sports" Medicine in Germany and Its Struggle for Professional Status |journal=Canadian Bulletin of Medical History |date=October 2011 |volume=28 |issue=2 |pages=271–292 |doi=10.3138/cbmh.28.2.271 |pmid=22164597 |language=en |issn=0823-2105|doi-access=free }} Sports medicine was established as a distinct specialty in Italy, the first country to do so, in 1958. The European Union of Medical Specialists has defined necessary training requirements for the establishment of the specialty of Sports Medicine in a given European country.{{cite web |title=Training Requirements for the Specialty of Sports Medicine |url=https://www.uems.eu/__data/assets/pdf_file/0014/110372/ETR-Sports-Medicine.pdf |website=European Standards of Postgraduate Medical Specialist Training |publisher=UEMS}} In May 2024, the EU approved cross recognition of sports medicine qualifications between 11 different countries.{{cite news |title=Sports medicine recognised as medical specialty |url=https://www.uems.eu/blog/uems-news-2/sports-medicine-recognised-as-medical-specialty-58 |work=uems.eu |date=3 June 2024}} It is a goal of the European Federation of Sports Medicine Associations to eventually establish Sports Medicine as a specialty in all European countries.{{cite web |title=Main Goal |url=https://www.efsma.eu/sports-medicine/main-goal.html#:~:text=Sports%20Medicine%20is%20a%20multidisciplinary,takes%20part%20in%20all%20sports. |website=www.efsma.eu |publisher=EFSMA}}

In Australia and New Zealand, Sport and Exercise Medicine (SEM) is a stand-alone medical specialty, with the Australasian College of Sport and Exercise Physicians being one of Australia's 15 recognized medical specialty Colleges.{{Cite web|url=https://cpmc.edu.au/|title=Council of Presidents of Medical Colleges}} Australia, New Zealand and the UK have been cited as pioneer countries in the establishment of SEM as a stand-alone specialty.{{Cite journal |last1=Carrard |first1=Justin |last2=Azevedo |first2=Ana Morais |last3=Gojanovic |first3=Boris |last4=Edouard |first4=Pascal |last5=Pandya |first5=Tej |last6=Robinson |first6=Diana Gai |last7=Dönmez |first7=Gürhan |last8=Ušacka |first8=Laila |last9=Stenger |first9=Rodrigo A. Martínez |last10=Mendonça |first10=Luciana De Michelis |last11=Thornton |first11=Jane |last12=Silva |first12=Miguel Reis e |last13=Schneider |first13=Isabel |last14=Zwerver |first14=Johannes |last15=Jederström |first15=Moa |date=2023-03-01 |title=Sport and exercise medicine around the world: global challenges for a unique healthcare discipline |url=https://bmjopensem.bmj.com/content/9/1/e001603 |journal=BMJ Open Sport & Exercise Medicine |language=en |volume=9 |issue=1 |pages=e001603 |doi=10.1136/bmjsem-2023-001603 |pmid=37020535 |pmc=10069566 |issn=2055-7647}}

The USA (and many other countries) follow the model of recognizing Sports Medicine as an official subspecialty of multiple other primary medical specialties. The most common primary specialties prior to a sports medicine subspecialty in the USA are family practice, orthopedics and physiatry.{{cite web |title=So You Want to Be a Sports Medicine Doctor |url=https://medschoolinsiders.com/medical-student/so-you-want-to-be-a-sports-medicine-doctor/ |website=Med School Insiders |access-date=28 October 2024 |language=en |date=13 September 2020}}

SEM physicians are frequently involved in promoting the therapeutic benefits of physical activity, exercise and sport for the individuals and communities. SEM Physicians in the UK spend a period of their training in public health, and advise public health physicians on matters relating to physical activity promotion.{{cite web | url=https://medinmotion.com/about-sports-medicine/| title=What is Sports Medicine? | accessdate=2020-03-09 | publisher=Medinmotion.com|date=2023-01-19|language=english|author=Ashish SIngh}}

{{Main|Sports injury}}

File:Anterior Cruciate Ligament Tear.jpg

Common sports injuries that can result in seeing a sports medicine specialist are knee and shoulder injuries, fractures, ankle sprains, concussions, cartilage injuries, and more.{{Cite book |last=Levy |first=Allan M. |url=https://books.google.com/books?id=Ro3uEAAAQBAJ&dq=Common+sports+injuries+that+can+result+in+seeing+a+sports+medicine+specialist+are+knee+and+shoulder+injuries,+fractures,+ankle+sprains,+concussions,+cartilage+injuries,+and+more&pg=PT9 |title=Sports Injury Handbook: Professional Advice for Amateur Athletes |date=1993-06-01 |publisher=Turner Publishing Company |isbn=978-1-62045-952-2 |language=en}} A sports medicine specialist can also be seen for advice in other areas of health, like nutrition, exercise, supplements, and how to prevent injuries before they occur. A sports medicine specialist works to help make the performance of the athlete more advanced, as well as ensuring their safety while performing the activity.{{Cite web|url=https://www.stanfordchildrens.org/en/topic/default?id=what-is-sports-medicine-160-19|title=default – Stanford Children's Health|website=www.stanfordchildrens.org|access-date=2019-11-21}} Sports injuries generally affect soft tissue or bones within the body and are commonly treated without surgery.{{Cite web |date=2021-01-11 |title=An Overview of Sports Medicine |url=https://integrityspineortho.com/an-overview-of-sports-medicine/ |access-date=2022-04-02 |website=Integrity Spine |language=en-US}}

Different types of sports injuries require different treatments and major injuries involve surgery, but most do not. Common treatments include medication, such as pain relievers or anti-inflammatory medication, icing, physical therapy, and/or immobilization of the injured area.{{Cite web |date=2004 |title=Sports Injuries |url=https://www.betterhealth.vic.gov.au/health/healthyliving/sports-injuries |website=Better Help}} Physical therapy is used to get the injured area back into regular movements and to reduce the discomfort of the affected area. PRICE is an acronym that is used for the common treatment of these injuries. It stands for protection, rest, ice, compression, and elevation.

{{Main|Concussions in sport}}

The management of concussion in sport has been extremely controversial over the past 20 years due to the discovery and reporting of Chronic traumatic encephalopathy as a disease that is common in ex-athletes, particularly footballers. Sporting codes have been accused of being complicit in understating the long-term damage caused by concussions by allowing too many head impacts to occur and for the players to be able to return to play too quickly after received concussions. A seminal series of consensus papers has been the international guidelines on the management of concussion in sport.{{cite journal |last1=McCrory |first1=P |last2=Meeuwisse |first2=W |last3=Dvořák |first3=J |last4=Aubry |first4=M |last5=Bailes |first5=J |last6=Broglio |first6=S |last7=Cantu |first7=RC |last8=Cassidy |first8=D |last9=Echemendia |first9=RJ |last10=Castellani |first10=RJ |last11=Davis |first11=GA |last12=Ellenbogen |first12=R |last13=Emery |first13=C |last14=Engebretsen |first14=L |last15=Feddermann-Demont |first15=N |last16=Giza |first16=CC |last17=Guskiewicz |first17=KM |last18=Herring |first18=S |last19=Iverson |first19=GL |last20=Johnston |first20=KM |last21=Kissick |first21=J |last22=Kutcher |first22=J |last23=Leddy |first23=JJ |last24=Maddocks |first24=D |last25=Makdissi |first25=M |last26=Manley |first26=GT |last27=McCrea |first27=M |last28=Meehan |first28=WP |last29=Nagahiro |first29=S |last30=Patricios |first30=J |last31=Putukian |first31=M |last32=Schneider |first32=KJ |last33=Sills |first33=A |last34=Tator |first34=CH |last35=Turner |first35=M |last36=Vos |first36=PE |title=Consensus statement on concussion in sport-the 5th international conference on concussion in sport held in Berlin, October 2016. |journal=British Journal of Sports Medicine |date=June 2017 |volume=51 |issue=11 |pages=838–847 |doi=10.1136/bjsports-2017-097699 |pmid=28446457|s2cid=42329667 |doi-access=free |hdl=2263/61384 |hdl-access=free }}{{cite journal |last1=McCrory |first1=P |last2=Meeuwisse |first2=WH |last3=Aubry |first3=M |last4=Cantu |first4=B |last5=Dvorák |first5=J |last6=Echemendia |first6=RJ |last7=Engebretsen |first7=L |last8=Johnston |first8=K |last9=Kutcher |first9=JS |last10=Raftery |first10=M |last11=Sills |first11=A |last12=Benson |first12=BW |last13=Davis |first13=GA |last14=Ellenbogen |first14=RG |last15=Guskiewicz |first15=K |last16=Herring |first16=SA |last17=Iverson |first17=GL |last18=Jordan |first18=BD |last19=Kissick |first19=J |last20=McCrea |first20=M |last21=McIntosh |first21=AS |last22=Maddocks |first22=D |last23=Makdissi |first23=M |last24=Purcell |first24=L |last25=Putukian |first25=M |last26=Schneider |first26=K |last27=Tator |first27=CH |last28=Turner |first28=M |title=Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012. |journal=British Journal of Sports Medicine |date=April 2013 |volume=47 |issue=5 |pages=250–8 |doi=10.1136/bjsports-2013-092313 |pmid=23479479|s2cid=33863105 |doi-access=free |hdl=11250/171236 |hdl-access=free }}{{cite journal |last1=McCrory |first1=P |last2=Meeuwisse |first2=W |last3=Johnston |first3=K |last4=Dvorak |first4=J |last5=Aubry |first5=M |last6=Molloy |first6=M |last7=Cantu |first7=R |title=Consensus statement on concussion in sport – the Third International Conference on Concussion in Sport held in Zurich, November 2008. |journal=The Physician and Sportsmedicine |date=June 2009 |volume=37 |issue=2 |pages=141–59 |doi=10.3810/psm.2009.06.1721 |pmid=20048521|s2cid=42974527 }} These consensus statements have been seen on the positive side as being sports medicine leaders moving the management of concussion in a more conservative direction over time and encouraging a standard set of tests and assessments. On the negative side, they have been seen as conflicted and allowing return to play too rapidly.{{citation needed|date=November 2023}}

{{Main|Transgender people in sport}}

Whether male-to-female transgender athletes can safely and fairly participate in women's sport at the elite and community levels is a highly charged and controversial topic. The sports medicine world is not united in its views and although this debate well and truly involves medical input, it is as much a social controversy as it is a medical one.{{Cite journal |last=Birnbaum |first=Amy |date=2023 |title=Musculoskeletal health considerations for the transgender athlete |journal=The Physician and Sportsmedicine |volume=51 |issue=5 |pages=387–393 |doi=10.1080/00913847.2022.2057787 |pmid=35373697 |s2cid=247937768 |url=https://www.tandfonline.com/doi/abs/10.1080/00913847.2022.2057787|url-access=subscription }}{{Cite journal |last1=Hilton |first1=Emma |last2=Lundberg |first2=Tommy |date=December 8, 2020 |title=Transgender Women in the Female Category of Sport: Perspectives on Testosterone Suppression and Performance Advantage |journal=Sports Medicine |volume=51 |issue=2 |pages=199–214 |doi=10.1007/s40279-020-01389-3 |pmid=33289906 |pmc=7846503 }}

{{Main|Doping in sport}}

Doping in sport has a long history with doctors in the sports medicine world being both heroes and villains on different occasions.{{tone inline|date=July 2022}} The presence of trained sports medicine professionals at elite sporting events has been critical in the fight against doping, but sometimes doctors become the enablers of doping and are part of the scandal themselves.{{Cite journal |last=Segura |first=Jordi |date=August 1996 |title=Doping Control in Sports Medicine |journal=Therapeutic Drug Monitoring |volume=18 |issue=4 |pages=471–476 |doi=10.1097/00007691-199608000-00028 |pmid=8857571 |url=https://journals.lww.com/drug-monitoring/abstract/1996/08000/doping_control_in_sports_medicine.28.aspx|url-access=subscription }}

{{Main|List of sporting scandals}}

Major scandals where doctors were prominent include:{{Cite journal |last1=Orchard |first1=Jessica J. |last2=Maddocks |first2=David |last3=Carneiro |first3=Eva |last4=Orchard |first4=John W. |date=2022-05-01 |title=A Review of Legal, Ethical, and Governance Issues for Team Doctors |url=https://pubmed.ncbi.nlm.nih.gov/34759177 |journal=Clinical Journal of Sport Medicine|volume=32 |issue=3 |pages=248–255 |doi=10.1097/JSM.0000000000000986 |issn=1536-3724 |pmid=34759177|s2cid=243987808 }}

• Bloodgate
• USA Gymnastics sex abuse scandal
• Operación Puerto doping case
• Biogenesis scandal
• Eva Carneiro scandal, involving Chelsea F.C. and José Mourinho

Different medical professionals for sports injuries require different forms of training, but for sports injuries, they mainly all work with the diagnosis and treatment of these injuries. All sports medicine professionals work with people of all age ranges, professional athletes, or even adolescents playing any sport. The main two allied health professions for sports injuries are athletic trainers (in the USA) and physical therapists (physiotherapists) in most other countries.

Athletic trainers are typically part of a sports medicine team in the US in particular, providing primary care, injury and illness prevention, wellness promotion, emergency care, therapeutic intervention and rehabilitation to injuries.{{Cite web | url=https://www.nata.org/about/athletic-training |title = Athletic Training|publisher=National Athletic Trainers' Association|date = 19 March 2015}} When an athlete is injured, an athletic trainer is key to treatment and rehabilitation working closely with the athlete throughout rehabilitation.{{Cite web | author=Lee Witbeck|url=https://dailybruin.com/2010/11/03/trainers_and_athletes_build_relationships_for_rehabilitation/ |title = Trainers and athletes build relationships for rehabilitation|publisher=Daily Bruin, UCLA|date=3 November 2010}} Athletic trainers are often the ones who assess the injury first and provide initial care.

Physiotherapists are a primary sports medicine team member in most countries of the world. Physiotherapists can specialize in many areas with sports physiotherapy as a major subspecialty. Physiotherapists are a main factor in the recovery stage of an injury as they set up an individualized recovery plan.{{Cite web |title=Sports Medicine Professionals |url=https://www.healthychildren.org/English/family-life/health-management/pediatric-specialists/Pages/Sports-Medicine-Professionals.aspx |access-date=2022-04-02 |website=HealthyChildren.org|date=21 November 2015 }} Physiotherapy is underfunded within most health systems so that it is generally much more accessible in higher-income countries and, even within these countries, is much more accessible to higher-income earners. In countries like Denmark and Australia there are many more physiotherapists than in lower-income countries.{{cite journal |last1=Kemp |first1=Joanne |last2=Mendonça |first2=Luciana De Michelis |last3=Mosler |first3=Andrea Britt |last4=Bizzini |first4=Mario |last5=Thorborg |first5=Kristian |last6=Wilson |first6=Fiona |last7=Surdyka |first7=Nicole |last8=Ahmed |first8=Osman Hassan |last9=Mkumbuzi |first9=Nonhlanhla Sharon |title=Sports physiotherapists' contribution to the sports and exercise medicine team: moving forward, together |journal=British Journal of Sports Medicine |date=1 January 2023 |volume=57 |issue=2 |pages=74–75 |doi=10.1136/bjsports-2022-106404 |pmid=36344213 |s2cid=253395665 |url=https://bjsm.bmj.com/content/57/2/74 |language=en |issn=0306-3674|doi-access=free }}

Podiatrists treat issues related to the foot or ankle, which is a common area where athletes get injuries. They specialize in the diagnosis and treatment of foot-related issues by performing tests and referring physical therapists. Podiatrists can also perform surgeries or prescribe medication as forms of treatment.

All of Exercise physiologists, Strength and conditioning coaches, personal trainers, Chiropractors, Osteopaths, Sports psychologists, Sekkotsu, and Sports nutritionists/dietitians can be part of the Sport and Exercise Medicine team.

• Exercise physiology
• Physical therapy
• Sports injuries
• Infectious diseases (athletes)

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Category:Orthopedic surgical procedures