sports medicine

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Sports medicine is a branch of medicine that deals with physical fitness, treatment and prevention of injuries related to sports and exercise. Although sports teams have employed Team physicians for many years, it is only since the late 20th century that Sport and Exercise Medicine has emerged as a distinct entity in health care.

Domains

1. Prevention
2. Clinical education & diagnostic
3. Immediate care
4. Treatment, rehab & reconditioning
5. Organizations & admin
6. Professional responsibility (education & counselling)

Recent History

In recent years Western society has increasingly recognized the dangers of Physical inactivity, and significant efforts have been made within the Public Health community to encourage the nation to become more physically active. To reflect this paradigm shift BASM has renamed itself BASEM (British Association of Sport and Exercise Medicine) and the speciality itself has rebranded from Sports Medicine to Sport & Exercise Medicine.^[1] Since 2007 several deaneries across the UK have established training programmes in SEM, and recurrent funding for 50 National Training Numbers (NTN’s) is available.

Qualification in Sport & Exercise Medicine

In the past SEM has largely been a special interest among General Practitioners. The minimal level of qualification is a Diploma available from FSEM (Faculty of Sport and Exercise Medicine), or MSc (with submission of research project) from,^[2][3][4][5],,,^[6][7] and.^[8] Provided a Medical Doctor (usually a GP, or specialist in A&E, Orthopaedic, Rheumatology or Musculoskeletal Radiology) can provide evidence of active involvement in SEM, they will be granted Membership of FSEM ^[9]

Fellowship of the Faculty ^[10] is only granted to senior sports physicians, or new entrants to the.^[11] The highest level of qualification in SEM is entry to the GMC Specialist Register. This is achieved through approval of prior qualification and experience, leading to a Certificate of Eligibility for Specialist Registration ^[12] or through completion of an approved NHS,^[13] leading to a Certificate of Completion of Training.^[14] Only doctors on the GMC’s Specialist Register may hold substantive NHS Consultant posts, and although the title “Consultant” is not protected by law, the term is generally reserved for full NHS Consultants. In addition many private medical insurers ^[15] will only grant specialist recognition and practice privileges to doctors entered on to the GMC specialist register."

Sports Medicine Team

Certified Athletic Trainer (ATC); Certified Athletic Therapist CAT(C) (Canada)

Athletic Trainers/Therapists (ATs) are highly skilled professional specializing in the health care of physical activity. They are responsible for care & prevention of athletic injury/illness and serve as a liaison between the team physician, coach, parent, and athlete.

Responsibilities include:

1. Immediate on-field emergency injury assessment and management
2. Making appropriate and unbiased sideline decisions regarding athletes returning to full participation
3. Thorough assessment and appropriate management of sport related emergencies such as, but not limited to: concussions, heat-related emergencies, sudden cardiac death, and MRSA
4. Clinical assessment of injury
5. Design & implementation of contemporary rehab protocols
6. Sport equipment fitting, maintenance, and emergency removal
7. Applying protective/supportive techniques that allow the athlete to regain physically active lifestyle
8. Inventory and purchasing of supplies
9. Completing medical/accidental record form

Team Physician

Promotes the success of the AT program, “cornerstone” of the medical team, available for emergencies.

Duties

1. Supervising pre-participation physical & medical history
2. Clearing of players for return to play after injury
3. Work with AT and student athletic trainers/therapist in further development of AT program

Athletes

Duties

1. Maintain good physical condition
2. Selecting, fitting, and maintaining protective equipment
3. Play by the rules
4. Follow the instruction of the coaches and the ATC

Parents Can assist by keeping the child healthy, if kept updated on the injury Should be informed of recommended treatment at home for injury or if they are hurt

Officials Duties

1. enforcing fair rules
2. Monitoring playing conditions
3. Cooperating with ATC & physician when injury occur & when environmental hazards exist

Coaches

Duties

1. Plan practice including: conditioning & training of the athlete & teach techniques /rules of sport
2. Selecting,fitting & maintaining protective things
3. Supervision of practice/ game facilities
4. Update education by attending clinics that review rule changes, skill development, CPR/FA

ATS’s (athletic training students) Duties

1. Assisted by the ATC to develop skills in immediate care of injury, preventative techniques and basic treatment protocol
2. Maintain clean facility
3. Inventory control: keeping track of supplies and equipment
4. Packing FA kits
5. Taping, wrapping, change dressings, minor treatment, FA procedures

Sports Medicine Organizations

American College of Sports Medicine (ACSM)
Founded in 1954, the American College of Sports Medicine is the largest and most prominent sports medicine and exercise science organization in the world. ACSM has more than 20,000 International, National and Regional Chapter members. Since its founding ACSM members have applied their knowledge, training and dedication in sports medicine and exercise science to promote healthier lifestyles for people around the globe.
American College of Sports Medicine

Canadian Academy of Sport and Exercise Medicine The Canadian Academy of Sport and Exercise Medicine (CASEM) is an organization of physicians committed to excellence in the practice of medicine as it applies to all aspects of physical activity.
Our mission is to forge a strong, collective voice for sport medicine; to be a leader in advancing the art and science of sport medicine, including health promotion and disease prevention, for the benefit of all Canadians through advocacy, education, research and service.

http://www.casm-acms.org/

American Medical Society for Sports Medicine (AMSSM)
Founded in 1991, AMSSM is a multi-disciplinary organization of physicians whose members are dedicated to education, research, collaboration and fellowship within the field of Sports Medicine. It now comprises over 1500 Sports Medicine Physicians whose goal is to provide a link between the rapidly expanding core of knowledge related to sports medicine and its application to patients in a clinical setting. American Medical Society for Sports Medicine
National Athletic Trainers' Association(NATA)
Founded in the year 1950
The mission of the National Athletic Trainers’ Association is to enhance the quality of health care provided by certified athletic trainers and to advance the athletic training profession.
National Athletic Trainers' Association

Canadian Athletic Therapists' Association(CATA)
Founded in the year 1965.^[16]
The Canadian Athletic Therapist Association (CATA) is an organization devoted to the comprehensive health care of an individual at any level of physical ability by Certified Athletic Therapists.
Canadian Athletic Therapists Association
http://www.athletictherapy.org/en/index.aspx

American Medical Association(AMA)
Recognized Athletic Training(AT) as an allied health profession in 1990
American Medical Association
American Osteopathic Academy of Sports Medicine (AOASM) http://aoasm.org/

SPARRC INSTITUTE - INDIA
Sports Performance Assessment Rehabilitation Research Counselling Institute
Founded by Dr Kannan Pugazhendi
http://www.sparrcinstitute.com/

Future Challenges

The challenge remains for SEM to establish itself within the UK medical community, particularly the NHS. SEM is the first medical speciality to be created ex nihilo, ‘out of nothing’. Whereas other medical specialities have emerged from others, i.e. Cardiology emerged when practicing general physicians decided to concentrate on, Heart conditions, SEM has not emerged from any other speciality, and therefore most of its practitioners do not practice within the NHS. Instead most SEM specialists work for Sports teams or Private Clinics.

In September 2009, the UK Department of Health took an SEM specialist, Dr Leon Creaney, on secondment from the London Deanery to tackle this specific issue. The specific projects include developing a business case to clearly elucidate the advantages of SEM services for the NHS, and the development of a National Centre of Excellence in Sport & Exercise Medicine.

National Centre

The development of a ^[17] was a specific Olympic legacy commitment made to ^[18] in February 2005 as part of the.^[19]

Chief Medical Officer Sir Liam Donaldson

To date a National Centre has not emerged, though the Department of Health continues to pursue the project.

Scope of the Speciality

Specialists in SEM will diagnose and treat any medical conditions which regular exercisers or sports persons encounter. The majority of an SEM Physicians time is therefore spent treating musculoskeletal injuries, however other conditions include Female athlete triad, Unexplained Underperformance Syndrome, Exercise-induced asthma, screening for Cardiac Abnormalities, Diabetes in Sport. In addition Team Physicians working in Elite Sport often play a role in performance medicine, whereby an athletes’ physiology is monitored, and aberrations corrected, in order to achieve peak physical performance.

Exercise Medicine

The Foresight Report^[20] issued by the Government Office for Science, 17 October 2007, highlighted the unsustainable health and economic costs of a nation that continues to be largely sedentary. It forecasts that the incremental costs of this inactivity will be £10 billion per year by 2050 and the wider costs to society and businesses £49.9billion. Physical inactivity inevitably leads to ill-health and it forecasts the cost of paying for this impact will be unsustainable in the future. No existing group of medical specialists is equipped with the skills and training to deal with this challenge.

The concept of Exercise as Health tool or ^[21] is becoming increasingly important. SEM Physicians are able to evaluate medical patients co-morbidities, perform exercise testing and provide an exercise prescription, together with a motivational programme and exercise classes.

Public Health

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. An example of published work includes the Royal College of ^[22] publication – ^[23]

Common Sports Injuries

Concussion- caused by severe head trauma where the brain moves violently within the skull so that brain cells all fire at once, much like a seizure

Muscle Cramps- a sudden tight, intense pain caused by a muscle locked in spasm. Muscle cramps are also recognized as an involuntary and forcibly contracted muscle that does not relax

ACL Sprains- The anterior cruciate ligament (ACL) is a ligament involved in knee stabilization. An ACL rupture can occur when the foot is planted and the knee twists to change direction.

Ankle Sprain- The ligaments that hold the ankle bones in place can easily be overstretched.

Shin Splints- The tissue that attaches the muscles of your lower leg to the shin bone may be pulling away from the bone, or it may be inflamed from overuse. ^[24]

See also

References