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Sports medicine:
Sports 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 a well 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, physiologists, 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 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.
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.*
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*Wikipedia |