Popular culture often pushes the stereotype of athletes as young, lean and heavily muscled.The fact is, most anyone who participates in sports or is active can be called an athlete. Whether you make a living…
Popular culture often pushes the stereotype of athletes as young, lean and heavily muscled.The fact is, most anyone who participates in sports or is active can be called an athlete. Whether you make a living off participating in sports or just enjoy jogging for fitness, everyone from kids to older adults can be considered athletes.
Across this broad spectrum of sports lovers, injuries can be quite common, and the best doctor to help you recover from an injury or physical problem is the sports medicine physician. Sports medicine is a subspecialty of several medical specialty fields, including emergency medicine, internal medicine, family medicine, pediatrics, orthopedic surgery and physical medicine and rehabilitation.
Sports medicine doctors “provide care to athletes on the field, in the operating room, in the training room, on a bus, on a plane, in hotel rooms” and other locations, says Dr. Daryl C. Osbahr, an orthopedic sports medicine surgeon and chief of sports medicine for Orlando Health. “As you can imagine, a sports medicine provider truly needs to be someone who’s very comfortable with providing care for people on multiple levels, from high level athletes all the way to low level and pediatric athletes. It’s truly an opportunity for a physician to really engage in a patient interaction in many different avenues.”
To become a sports medicine specialist, a doctor completes medical school and a residency in one of the specialties above, and then goes on to complete a fellowship year in the subspecialty area of sports medicine. Osbahr says sports medicine subspecialists most commonly come from family medicine, orthopedic surgery and pediatrics.
Within the field of sports medicine, “the main delineation is surgical or non-surgical. We have a primary care sports medicine track,” in which doctors see a variety of conditions and injuries and treat patients with non-surgical means, Osbahr says. “And then we have the orthopedic sports medicine track,” where physicians use surgery to treat sports injuries after non-surgical means have failed.
Dr. Bryant Walrod, a family medicine physician with a focus on sports medicine at the Ohio State University Wexner Medical Center, is a primary care sports medicine physician. In his practice, he sees a lot of overuse injuries related to improper form when exercising or acute injuries like tears to knee ligaments, tendon strains, tendonitis and muscle tears. He also sees a lot of arthritis-related issues among his older patients. “I know it’s sports medicine, but we still see a lot of patients with degenerative joint conditions, whether it be hip, shoulder or knee wear-and-tear over time.” He says many of these problems result from years of imperfect form or biomechanics that place too much stress on a joint or other body part. “If the biomechanics are sound, you have less chance of wear-and-tear. But if someone has an angled knee, for example, they’re going to wear out the cartilage quicker than someone who has neutral biomechanics.”
Walrod also sees some sport-specific problems. “I take care of a lot of wrestlers, so I see a lot of skin rashes.” Head trauma and concussions are also common among athletes in contact sports like football. Sports medicine physicians, and more specifically sports psychologists, may be able to help athletes with mental health issues such as mood disorders, depression or anxiety, especially as these problems relate to sports performance.
Osbahr says no matter what sends an athlete to a sports medicine physician for care, “the goal is to determine what the injury is, how to treat it best and how to get that athlete back to sport as quickly and safely as possible.”
“If you’re a runner, my goal is not to say, ‘don’t run,’ Walrod says. “My goal is to get you back running safely. Maybe we need to change the frequency, intensity or the distance of your run or whatever activity you’re doing. But my goal is to really work with you to get you back and get you better.”
Both Osbahr and Walrod say starting with conservative treatments such as rest, ice and anti-inflammatories is typically the best approach. Most physicians will only move on to more invasive or surgical treatment options once nonsurgical options have been exhausted. “The goal for any sports medicine physician should be to get athletes back to [their] sport as safely and effectively as possible with the most conservative amount of care,” Osbahr says.
By their very nature, many sports medicine problems are urgent, and it may be important to be seen by a doctor quickly. This could mean patients don’t have much time to find a physician or compare options. Nevertheless, Osbahr recommends doing some research before making an appointment. “Word of mouth is always a good way to find someone who’s providing quality care to other people. And research the practitioner before you come in to make sure you have the right person.”
Walrod says looking for a practitioner who has a background or interest in the same sport you play may help you find a good fit, “because then they know the nuances of the sport.”
Once you’re in the room with the physician, Osbahr says “you should be gauging your trust level with that physician.” Consider whether the doctor makes you feel comfortable and whether you feel like your doctor understands your condition. And if you’re surprised by your diagnosis, don’t hesitate to get a second opinion, but “make sure that second opinion is from someone who has a lot of experience in that field as well.”
In determining whether a particular doctor is right for you, Osbahr cites the “three As of care — availability, affability and ability.” First among these is availability, he says. “The sports medicine physician needs to be available to see patients quickly.” Once that happens, the doctor should be affable and able to communicate effectively. Some sports injuries can be quite serious, and compliance with treatment protocols is critical. Lastly, Osbahr says the doctor’s ability in solving the problem should seal the deal and get you back to play quickly.
In achieving that goal, Walrod says he wishes patients realized they have a big role to play in whether or not their visit with a sports physician will have a successful outcome, but that it may not come easily. “When my patients get better after prolonged physical therapy, I usually tell them ‘thanks for buying into the plan.'” He says getting an injection or taking medication is easy, but those measures are often provided not as the cure, but to help ease patients’ pain so they can commence physical therapy to rebuild from an injury. “The real work comes after the visit or after that surgery with the rehab and really sticking with the plan. That’s the hard stuff.”
But, you might be able to avoid seeing a sports medicine physician altogether, Walrod says, by having a technique review or gait analysis by a trained coach, physical therapist or sports medicine practitioner before an injury occurs. Have your technique checked for biomechanical flaws that could set you up for a problem down the line and learn how to correct your form. You might even consider doing certain exercises to strengthen important muscles, which could lead to better performance and fewer injuries.