Year in, year out, when the most important sporting events are chasing each other, there is always (and often too often) talk of sports medicine and sports doctors. Who are these medical professionals? This question deserves a differentiated answer.
When the term “sports medicine” is mentioned, the interlocutor – especially if it is a doctor – shows surprise, often even disapproval. A sports doctor? Well, the medical advisor of some great from the sports world, a kind of personal physician who shares in the princely income of his patient. Or you think he’s the doctor who’s just waiting on the sidelines for his favorite to suffer an accident, then pounces on him and injects him to make him as fit as possible again so that he can continue playing – suffering and with his face contorted in pain – for the fans. Or even worse: a poorly informed interlocutor considers the sports doctor to be an unscrupulous individual who administers doping agents to the athlete so that he becomes “citius, fortius, altius”; possibly without even informing him. A bit simplistic, that description, isn’t it?
A bad image
A serious sports doctor is naturally annoyed by this thoroughly unfair and inaccurate image. Unfortunately, however, it has to be said that these views are by no means only the result of false information or coincidence. It cannot be argued away that such assessments of sports medicine are supported by numerous abuses or excesses that do indeed occur in competitive sports on a recurring basis. This fascinating field is often eaten away like a cancer by the large sums involved, but also by unscrupulous people. All they care about is adorning themselves with easily won laurels. There are a number of people in competitive sports whose upbringing and education do not meet the high ethical standards. Sports physicians, and logically all the medical specialties to which they are devoted, therefore fall prey to prejudices that are not easy to dispel.
It only works multidisciplinary
Unlike other medical specialties that deal with a specific organ or group of people, sports medicine seeks solutions to the medical problems of the active athlete, regardless of age, gender, or athletic performance level. It is by definition multidisciplinary. It combines the special knowledge from various branches of orthodox medicine with the knowledge from the world of sports (e.g. training theory and other sciences such as biomechanics) in the service of the active athlete: In this way, the athlete should be enabled to always realize maximum performance without putting his health at risk, ideally even by promoting it in the process. If he wants to achieve his goal, the sports physician must act before pathology comes into play. Its role is therefore strongly preventive and only therapeutic when in need.
A list of subject areas
Let’s not forget that sports medicine also has an important role to play in the treatment of a wide range of chronic diseases. Appropriate physical activity can be of great benefit to patients with such disorders. This is often forgotten, although this aspect is probably one of the most important of all – and will become increasingly important!
The list of subjects that the sports physician should know is therefore particularly long: biometry, biomechanics, training methods, knowledge of physiological processes during physical exertion, doping-related problems, functional anatomy, sports-related cardiology and pneumology, neuro- and muscle-physiological knowledge, sports hygiene, furthermore medical aspects as they come into play during sports activities and competitions, sports-related psychology, physiotherapy, indications and contraindications in sports, also taking into account sick and disabled people. Finally, the treatment of sports injuries, which, unfortunately, is most often required, as well as their prophylaxis.
The real sports doctor must therefore be able to perform a sports medicine test with classification of the athlete’s physical fitness and, immediately afterwards, treat a sports injury – in such a way that the athlete loses as little of his or her form as possible in the time needed for rehabilitation without jeopardizing healing. When using medications, it is always important to be aware of the boundary between legal pharmacological therapy and illegal doping. After that, the sports doctor may have to give dietary advice to a marathon runner or discuss with a patient what her options are for exercising during her pregnancy. In every situation, the sports physician must draw on knowledge that is rarely taught in the course of traditional medical training.
The training of sports physicians is therefore the real core problem. It is as essential in sports medicine as in any other discipline that the attending physician be aware of his or her responsibilities to the patient. After all, you don’t treat an athlete quite the same as an ordinary patient who doesn’t play sports.
Search for identity
Of course, the basic principles of any medical discipline remain unchanged in sports medicine, but the mental attitude under which they are applied is fundamentally different. An athlete knows his body, feels it and relies heavily on its strength and speed. This requires a special, active and dynamic attitude, even if it must remain conscientious and responsible. Such an attitude can be learned.
Sports medicine has long had to suffer from the inaccurate assessments of those who do not know exactly what it is, what it aims to do, and how complex it is. The unfortunate fact that it is not firmly anchored academically does not contribute much to this. This unsatisfactory situation has not disappeared to this day. For this reason, sports medicine is still searching for its own identity, and the situation of the sports physician who tries to practice it seriously is no less ambiguous. But his task is no less exciting and thrilling because of that. And even more future-oriented: Against the modern plague of inactivity, exercise is “medically” in demand. Who can prescribe these more competently than the trained sports physician?
FAMILY DOCTOR PRACTICE 2014, 9(1): 4-5
