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 Sports And Injuries

august 2012

Is Sports Medicine Your Forte?

Dr S Bakhtiar Choudhary
Sport and physical activity make a substantial contribution to the wellbeing of people. Exercise, physical activity and sports have long been used in the treatment and rehabilitation of communicable and non-communicable diseases. Physical health is directly related to mental health and physical activity is a strong means for prevention of diseases.

What Is Sports Medicine?

Sports medicine is an area of health and special services that apply medical and scientific knowledge to prevent, recognize, manage, and rehabilitate injuries related to sport, exercise, or recreational activities.

Sports medicine includes subjects like exercise physiology, internal medicine, orthopaedics, nutrition, injury evaluation and management, psychology and counselling.

It all began in East Germany to improve human performance in sports. They started working on children and developed many methods to identify the indicators of performance. Later, other western countries and the rest of the world came up with their own methods.

Professionals In Sports Medicine

Sports medicine is a super specialty field like cardiology; there are two streams - sports medicine and sports rehabilitation. Sports medicine is essentially for a medical graduate and rehabilitation is for a physiotherapist. Also, we may safely say that mere theoretical education in sports medicine without adequate practical experience is no help when attending to sportspersons.

In India, a medical graduate can pursue a diploma course in sports medicine at the National Institute of Sports located in Patiala, Punjab. Countries like the UK, Germany and Australia offer MS, MD and post doctoral degrees both as part-time and fulltime courses. Physiotherapists can study sports physiotherapy, kinesiology, biomechanics, sports trauma and orthopaedics.

Sports medicine can be classified into specialties like sports traumatologists, sports physiologists, sports nutritionists, sports physicians and sports biomechanists.

Current Issues
A one-off attendance on an injured sports person does not make a doctor an expert in sports medicine!
An athlete puts in at least 7-10 years of hard work, sacrifice and energy in the face of politics and trouble before reaching the state/national level. Even a small injury can put the work of many years and a career at risk. A doctor attending to a sportsperson must therefore understand the years of training, intensity of training, performance audit and nutritional status of the patient.

The Scope In Practice

Players or teams don’t keep you busy or in demand always. Even if the situation is otherwise, sports medicine specialists have a responsibility towards the non-sports population.

Their area of expertise and knowledge puts them much ahead of other professionals in the management of non-surgical and musculo-skeletal diseases like degenerative arthritis and muscle imbalances. Spine related conditions that are manifest in urban areas today can be handled with great ease by doctors of sports medicine; ergonomics and posture corrections are a crucial part of their assessment.

The opportunities are plenty for doctors of sports medicine, if they care capable of planning innovatively. The fields include paediatric, cardiac, geriatric, and cancer rehabilitation, immunonutrition, ergonomics and work place management, fitness management, body weight management, preventive rehabilitation for musculo-skeletal disorders, exercise prescription for stress related diseases like diabetes and the entire area of childhood obesity.

How Does Sports Medicine Help In Talent Spotting?
It is important to understand that people exist in two muscle fibre types - fast and slow.
  • Fast Muscle Fibre: People with fast twitch muscle fibre respond to speed and strength better but cannot perform long distance activities.
  • Slow Muscle Fibre: People with slow muscle fibres have better performance in long distance activities but fail to perform in sprints.
  • This is the reason why most sprinters come from one area and there is a geographical relation to performance as observed during major world sporting events like the Olympics. As we understand, a slow person cannot run faster and this is the foundation for talent spotting. It is important to identify and train faster athletes early in life, as speed quality deteriorates with age. Batteries of tests have been developed to assess the motor qualities of young trainees based on what can decide the correct sports discipline for an individual trainee. In India, we are yet to reap the benefits of this knowledge and advances therein.
  • Psychology Of An Injured Athlete: A large number of players leave their sport because of serious injury. It has a lot to do with psychology too. Even after complete rehabilitation, many players continue to think that they have not recovered completely. An audit of treatment protocol will help in avoiding such situations. It involves factors like advice on appropriate rest and alternative training methods, counselling the athlete with the assurance of his/her complete recovery and modification of the training programme to suit the returning player.
Dr S Bakhtiar Choudhary is Senior Consultant Sports Medicine, Ergonomics and Obesity, Hyderabad Spine Clinics, Hyderabad.