System | Musculoskeletal, cardiovascular |
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Focus | Sports especially athletics |
Significant diseases | |
Significant tests | Musculoskeletal tests |
Specialist | Sports physician |
Glossary | Glossary of medicine |
Occupation | |
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Names |
|
Occupation type | Specialty |
Activity sectors | Medicine |
Description | |
Competencies | Exercise prescription, Therapeutic injections |
Education required |
|
Fields of employment | Hospitals, Clinics, Professional sports, College athletics, university |
Sports medicine is a branch of medicine that deals with physical fitness and the treatment and prevention of injuries related to sports and exercise. Although most sports teams have employed team physicians for many years, it is only since the late 20th century that sports medicine emerged as a distinct field of health care. In many countries, now over 50, sports medicine (or sport and exercise medicine) is a recognized medical specialty (with similar training and standards to other medical specialties or sub-specialties). In the majority of countries where sports medicine is recognized and practiced, it is a physician (non-surgical) specialty, but in some (such as the USA), it can equally be a surgical or non-surgical medical specialty, and also a specialty field within primary care. In other contexts, the field of sports medicine encompasses the scope of both medical specialists as well as allied health practitioners who work in the field of sport, such as physiotherapists, athletic trainers, podiatrists and exercise physiologists. [1]
Sports medicine can refer to the specific medical specialty or subspecialty of several medical and research disciplines in sports. Sports medicine may be called Sport and Exercise medicine (SEM), which is now well established in many countries. It can broadly also refer to physicians, scientists, trainers, and other paramedical practitioners who work in a broad setting. Sports medicine specialists include a broad range of professions. All sports medicine specialists have one main goal in mind, and that is preventing future injuries and to improve the function of that area to return to everyday life. They work with all different types of people, and not just athletes. [2] The various sports medicine experts often work together as a team to ensure the best recovery plan for the individual. Team members can include orthopedic surgeons, certified athletic trainers, sports physical therapists, physical medicine and rehabilitation specialists, and specialty SEM physicians. [3]
Specializing in the treatment of athletes and other physically active individuals, SEM physicians have extensive education in musculoskeletal medicine. SEM doctors treat injuries such as muscle, ligament, tendon and bone problems, but may also treat chronic illnesses that can affect physical performance, such as asthma and diabetes. SEM doctors also advise on managing and preventing injuries. [4]
European templates for SEM specialization generally recommend four years of experience in: [5]
Although sports medicine was only established formally as a specialty in the 20th Century, the history of doctors having involvement in treating athletes goes back to ancient times in Greek, Roman and Egyptian societies. [6] [7] [8] [9] [10]
Continental European countries were the first to establish medical groups with a focus on sport in the earliest part of the 20th Century. Possibly the earliest establishment of a society of Sports Medicine was the DGSP in Germany in 1912. [11] The Italian version of this page Medicina dello sport states that Sports Medicine societies were first established in Switzerland (1922) followed by France (1929) and Italy (1929) (Italian Sports Medicine Federation). In Germany in the 1920s, an attempt was made to upskill thousands of doctors and other health professionals in sport and exercise medicine, without establishing it as a distinct specialty at that stage, but it failed due to lack of funding in the Depression. [12] Sports medicine was established as a distinct specialty in Italy, the first country to do so, in 1958. The European Union of Medical Specialists has defined necessary training requirements for the establishment of the specialty of Sports Medicine in a given European country. [3] In May 2024, the EU approved cross recognition of sports medicine qualifications between 11 different countries. [13] It is a goal of the European Federation of Sports Medicine Associations to eventually establish Sports Medicine as a specialty in all European countries. [14]
In Australia and New Zealand, Sport and Exercise Medicine (SEM) is a stand-alone medical specialty, with the Australasian College of Sport and Exercise Physicians being one of Australia's 15 recognized medical specialty Colleges. [15] Australia, New Zealand and the UK have been cited as pioneer countries in the establishment of SEM as a stand-alone specialty. [16]
The USA (and many other countries) follow the model of recognizing Sports Medicine as an official subspecialty of multiple other primary medical specialties. The most common primary specialties prior to a sports medicine subspecialty in the USA are family practice, orthopedics and physiatry. [17]
Country | Specialist sports physician association | Fully recognized specialty? (Year) | Training requirements | General sports medicine association |
---|---|---|---|---|
Argentina | Yes [18] | 2-year training program | ||
Australia | Australasian College of Sport and Exercise Physicians | Yes (2009) | 4-year training program | Sports Medicine Australia |
Austria | Austrian Society of Sports Medicine (OSMV) | Subspecialty [19] | 3-year Diploma | |
Belarus | Belarus Sports Medicine Association | Yes [20] | ||
Belgium | The Belgian Federation of Sport and Exercise Medicine | Subspecialty [20] | 1 year | |
Bosnia Herzegovina | Sports Medicine Association Bosnia Herzegovina | Yes [20] | 5 years | |
Brazil | Brazilian Society of Exercise and Sports Medicine | Yes [21] [22] | 3 years | |
Bulgaria | Bulgarian Scientific Society of Sports Medicine and Kinesitherapy | Yes [20] | 4 years | |
Canada | Canadian Academy of Sport and Exercise Medicine | Subspecialty | ||
China | Chinese Association of Sports Medicine | Yes [23] [24] [25] | ||
Croatia | Croatian Sports Medicine Society | Yes [26] | ||
Cuba | Yes [27] | |||
Czech Republic | Czech Society of Sports Medicine | Yes [20] | 5 years | |
Denmark | No [26] | Danish Association of Sports Medicine | ||
Estonia | Yes [26] | |||
Finland | Finnish Society of Sports Medicine | Yes [20] | 5 years | |
France | Sport and Exercise Medicine French Association (SFMES) | Yes [19] | ||
Georgia | Georgian Association of Sports Medicine | Yes [20] | ||
Germany | German Federation for Sports Medicine (DGSM) | Subspecialty [19] | ||
Hungary | National Institute for Sports Medicine [28] | Subspecialty [20] | ||
India | Indian Society of Sports and Exercise Medicine (ISSEM) [29] | Yes (1987 for PG Diploma & 2013 for MD) [30] | 2 [31] & 3 years [32] | Indian Association of Sports Medicine & Indian Federation of Sports Medicine |
Indonesia | Indonesia Sports Medicine Association (PDSKO) [33] | Yes [34] | 3,5 years [34] | Indonesian Sports Health Supervisory Association |
Ireland | Faculty of Sports and Exercise Medicine | Yes [35] (2017) | ||
Israel | Israel Society of Sports Medicine | Yes [36] | ||
Italy | Federazione Medico Sportiva Italiana (FMSI) | Yes [19] (1958) | 5 years | |
Japan | Japan Medical Association Certified Sports Health Medical System | Yes (1994) [37] | The Japanese Federation of Physical Fitness & Sports Medicine | |
Latvia | Latvian Sports Medicine Association | Yes [20] | 4 years | |
Lithuania | Yes | |||
Malaysia | College of others (Sports Physician), Academic of Medicine of Malaysia, National Specialist Registrar (NSR) [38] | Yes [39] | 4 years | Malaysian Association of Sports Medicine [40] |
Malta | Yes | |||
Mexico | Yes [27] | |||
Netherlands | Netherlands Association of Sports Medicine NASM – VSG | Yes [20] (2014) | 4 years | |
New Zealand | Australasian College of Sport and Exercise Physicians | Yes (1998) | 4 years | Sports Medicine New Zealand |
Norway | No | Norwegian Sports Medicine Association | ||
Poland | Yes [41] | |||
Portugal | Sociedade Portuguesa de Medicina Desportiva | Yes [20] | ||
Qatar | ASPETAR | Yes | ||
Romania | Yes | |||
Russia | Russian Association of Sports Medicine and Rehabilitation of Patients and the Disabled | Yes [20] | 2 years | |
Serbia | Sport Medicine Association of Serbia | Yes | 3 years | |
Singapore | Yes (subspecialty) [42] (2011) | 3 years (after primary specialty training) [43] | Sports Medicine Association Singapore (SMAS) | |
Slovakia | Slovak Society of Sports Medicine | Subspecialty | (6 years) | |
Slovenia | Slovenian Sports Medicine Association | Yes [20] | ||
South Africa | College of Sport and Exercise Medicine of South Africa | Yes (2022) [44] | South Africa Sports Medicine Association (SASMA) | |
South Korea | Subspecialty [45] | Korean Society of Sports Medicine (KSSM) | ||
Spain | SMD (Sociedad Española de Medicina del Deporte) | Yes | 3 years | |
Sri Lanka | Sri Lanka Sports Medicine Association | Yes [46] | 3 years | |
Sweden | No [26] | Swedish Society for Physical Activity and Sports Medicine | ||
Switzerland | Swiss Society for Sports Medicine (SGSM) | Subspecialty [20] | ||
Turkey | Turkish Sports Medicine Association | Yes [20] | ||
Ukraine | Ukrainian Sport Medicine and Physical Exercises Specialists Association (USMPESA) | Yes [20] | ||
United Kingdom | Faculty of Sport and Exercise Medicine UK | Yes (2006) [47] | 4 years | British Association of Sport and Exercise Medicine |
United States of America |
| Subspeciality (1994) of:
| 1–2-year Fellowships | American College of Sports Medicine |
Uruguay | Yes [27] | |||
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. [48]
Common sports injuries that can result in seeing a sports medicine specialist are knee and shoulder injuries, fractures, ankle sprains, concussions, cartilage injuries, and more. [49] A sports medicine specialist can also be seen for advice in other areas of health, like nutrition, exercise, supplements, and how to prevent injuries before they occur. A sports medicine specialist works to help make the performance of the athlete more advanced, as well as ensuring their safety while performing the activity. [50] Sports injuries generally affect soft tissue or bones within the body and are commonly treated without surgery. [51]
Different types of sports injuries require different treatments and major injuries involve surgery, but most do not. Common treatments include medication, such as pain relievers or anti-inflammatory medication, icing, physical therapy, and/or immobilization of the injured area. [52] Physical therapy is used to get the injured area back into regular movements and to reduce the discomfort of the affected area. PRICE is an acronym that is used for the common treatment of these injuries. It stands for protection, rest, ice, compression, and elevation. [51]
The management of concussion in sport has been extremely controversial over the past 20 years due to the discovery and reporting of Chronic traumatic encephalopathy as a disease that is common in ex-athletes, particularly footballers. Sporting codes have been accused of being complicit in understating the long-term damage caused by concussions by allowing too many head impacts to occur and for the players to be able to return to play too quickly after received concussions. A seminal series of consensus papers has been the international guidelines on the management of concussion in sport. [53] [54] [55] These consensus statements have been seen on the positive side as being sports medicine leaders moving the management of concussion in a more conservative direction over time and encouraging a standard set of tests and assessments. On the negative side, they have been seen as conflicted and allowing return to play too rapidly.[ citation needed ]
Whether male-to-female transgender athletes can safely and fairly participate in women's sport at the elite and community levels is a highly charged and controversial topic. The sports medicine world is not united in its views and although this debate well and truly involves medical input, it is as much a social controversy as it is a medical one. [56] [57]
Doping in sport has a long history with doctors in the sports medicine world being both heroes and villains on different occasions.[ tone ] The presence of trained sports medicine professionals at elite sporting events has been critical in the fight against doping, but sometimes doctors become the enablers of doping and are part of the scandal themselves. [58]
Major scandals where doctors were prominent include: [59]
Different medical professionals for sports injuries require different forms of training, but for sports injuries, they mainly all work with the diagnosis and treatment of these injuries. All sports medicine professionals work with people of all age ranges, professional athletes, or even adolescents playing any sport. The main two allied health professions for sports injuries are athletic trainers (in the USA) and physical therapists (physiotherapists) in most other countries. [2]
Athletic trainers are typically part of a sports medicine team in the US in particular, providing primary care, injury and illness prevention, wellness promotion, emergency care, therapeutic intervention and rehabilitation to injuries. [60] When an athlete is injured, an athletic trainer is key to treatment and rehabilitation working closely with the athlete throughout rehabilitation. [61] Athletic trainers are often the ones who assess the injury first and provide initial care.
Physiotherapists are a primary sports medicine team member in most countries of the world. Physiotherapists can specialize in many areas with sports physiotherapy as a major subspecialty. Physiotherapists are a main factor in the recovery stage of an injury as they set up an individualized recovery plan. [62] Physiotherapy is underfunded within most health systems so that it is generally much more accessible in higher-income countries and, even within these countries, is much more accessible to higher-income earners. In countries like Denmark and Australia there are many more physiotherapists than in lower-income countries. [63]
Podiatrists treat issues related to the foot or ankle, which is a common area where athletes get injuries. They specialize in the diagnosis and treatment of foot-related issues by performing tests and referring physical therapists. Podiatrists can also perform surgeries or prescribe medication as forms of treatment. [62]
All of Exercise physiologists, Strength and conditioning coaches, personal trainers, Chiropractors, Osteopaths, Sports psychologists and Sports nutritionists/dietitians can be part of the Sport and Exercise Medicine team.
Journal | Established | Scimago Ranking [64] | Region/country | Publisher |
---|---|---|---|---|
British Journal of Sports Medicine | 1964 | 4.329 | United Kingdom | BMJ Group |
American Journal of Sports Medicine | 1972 | 3.021 | United States | SAGE Publishing |
Knee Surgery, Sports Traumatology, Arthroscopy | 1992 | 1.806 | Germany; Europe | Springer Science+Business Media |
Medicine & Science in Sports & Exercise | 1969 | 1.703 | United States | Lippincott Williams & Wilkins |
Clinical Journal of Sport Medicine | 1990 | 0.990 | Canada | Lippincott Williams & Wilkins |
Journal of Science and Medicine in Sport | 1984 | 1.724 | Australia | Elsevier |
The Physician and Sportsmedicine | 1973 | 0.651 | United States | Informa Healthcare |
Research in Sports Medicine | 1988 | 1.397 | Routledge | |
Sports Health | 2009 | 1.212 | United States | SAGE Publications |
Exercise and Sport Sciences Reviews | 2000 | 1.945 | United States | Lippincott Williams & Wilkins |
The Journal of Strength and Conditioning Research | 1987 | 1.569 | United States | Lippincott Williams & Wilkins |
Physical therapy (PT), also known as physiotherapy, is a healthcare profession, as well as the care provided by physical therapists who promote, maintain, or restore health through patient education, physical intervention, disease prevention, and health promotion. Physical therapist is the term used for such professionals in the United States, and physiotherapist is the term used in many other countries.
Internal medicine, also known as general internal medicine in Commonwealth nations, is a medical specialty for medical doctors focused on the prevention, diagnosis, and treatment of internal diseases in adults. Medical practitioners of internal medicine are referred to as internists, or physicians in Commonwealth nations. Internists possess specialized skills in managing patients with undifferentiated or multi-system disease processes. They provide care to both hospitalized (inpatient) and ambulatory (outpatient) patients and often contribute significantly to teaching and research. Internists are qualified physicians who have undergone postgraduate training in internal medicine, and should not be confused with "interns", a term commonly used for a medical doctor who has obtained a medical degree but does not yet have a license to practice medicine unsupervised.
A concussion, also known as a mild traumatic brain injury (mTBI), is a head injury that temporarily affects brain functioning. Symptoms may include loss of consciousness; memory loss; headaches; difficulty with thinking, concentration, or balance; nausea; blurred vision; dizziness; sleep disturbances, and mood changes. Any of these symptoms may begin immediately, or appear days after the injury. Concussion should be suspected if a person indirectly or directly hits their head and experiences any of the symptoms of concussion. Symptoms of a concussion may be delayed by 1–2 days after the accident. It is not unusual for symptoms to last 2 weeks in adults and 4 weeks in children. Fewer than 10% of sports-related concussions among children are associated with loss of consciousness.
Kinesiology is the scientific study of human body movement. Kinesiology addresses physiological, anatomical, biomechanical, pathological, neuropsychological principles and mechanisms of movement. Applications of kinesiology to human health include biomechanics and orthopedics; strength and conditioning; sport psychology; motor control; skill acquisition and motor learning; methods of rehabilitation, such as physical and occupational therapy; and sport and exercise physiology. Studies of human and animal motion include measures from motion tracking systems, electrophysiology of muscle and brain activity, various methods for monitoring physiological function, and other behavioral and cognitive research techniques.
Patellar tendinitis, also known as jumper's knee, is an overuse injury of the tendon that straightens the knee. Symptoms include pain in the front of the knee. Typically the pain and tenderness is at the lower part of the kneecap, though the upper part may also be affected. Generally there is no pain when the person is at rest. Complications may include patellar tendon rupture.
An anterior cruciate ligament injury occurs when the anterior cruciate ligament (ACL) is either stretched, partially torn, or completely torn. The most common injury is a complete tear. Symptoms include pain, an audible cracking sound during injury, instability of the knee, and joint swelling. Swelling generally appears within a couple of hours. In approximately 50% of cases, other structures of the knee such as surrounding ligaments, cartilage, or meniscus are damaged.
Jane S. Thornton is a Canadian Clinician Scientist, Olympic rower and international advocate for physical activity. She is the Canada Research Chair in Injury Prevention and Physical Activity for Health at the University of Western Ontario. She was born in Fredericton, New Brunswick.
The British Journal of Sports Medicine is a twice-monthly peer-reviewed medical journal covering sports science and sports medicine including sport physiotherapy. It is published by the BMJ Group. It was established in 1964 and the editor-in-chief from 2008 to 2020 was Karim M. Khan. Jonathan Drezner has been editor-in-chief since January 1, 2021.
The Clinical Journal of Sport Medicine (CJSM) is a peer-reviewed medical journal in the sports medicine field. It is published by Lippincott Williams & Wilkins. It was established in 1990 by the Canadian Academy of Sport and Exercise Medicine with Gordon Matheson as the founding editor. It is also the official journal of the Australasian College of Sport and Exercise Physicians, the American Medical Society for Sports Medicine (AMSSM) and American Osteopathic Academy of Sports Medicine. It is the pre-eminent non-surgical sports medicine journal of North America. In North America, sports medicine is a subspecialty field of medicine with an even split between surgical and non-surgical subspecialties. The surgical branch of sports medicine is a subspecialty field of orthopedics, whereas the non-surgical branch draws from specialties including family practice, physiatry, pediatrics, internal medicine and emergency medicine. The journal editor-in-chief is Christopher Hughes. There are active associated CJSM Blog and Podcast sites which are edited by Deputy Editor James MacDonald.
Concussion, a type of mild traumatic brain injury that is caused by a direct or indirect hit to the head, body, or face is a common injury associated with sports and can affect people of all ages. A concussion is defined as a "complex pathophysiological process affecting the brain, induced by biomechanical forces". A concussion should be suspected in any person who falls or has a hit to their face or their body and has a visible sign/clue that they may have a concussion or experiences any symptoms of concussion. The Concussion Recognition Tool 6 (CRT6) can be used to help non-medically trained people manage sport related concussion on the sideline to ensure that they are directed to the appropriate care. Symptoms of concussion can be felt right away or appear over the first 1-2 days after an accident. If an athlete has a suspected sport-related concussion they should not return to play that day, not be left alone for the first three hours after their injury, not drive until cleared by a medical professional, and not return to any activity that has a risk of hitting their head or falling until they have a medical assessment. If the person has worsening symptoms or any 'red flag symptoms', they need immediate medical attention. Concussions cannot be seen on X-rays or CT scans.
Caroline Finch AO is an Australian sports injury epidemiologist and sports injury prevention researcher. Her research has been adopted and used to directly inform safety policy by Government Departments of Sport and Health, health promotion and injury prevention agencies, and peak sports bodies both within Australia and internationally. Her injury prevention research has been applied to falls in older people, road safety, workplace safety and injuries in children.
The Australasian College of Sport and Exercise Physicians (ACSEP) is a not-for-profit professional organisation responsible for training, educating, and representing over 350 doctors in Australia and New Zealand. These doctors practise medicine in the specialty of sport and exercise medicine (SEM). The ACSEP is the smallest of the 15 recognised specialist medical Colleges in Australia with approximately 260 Fellows and Registrars in 2020. Australia and New Zealand, along with the UK, have been cited as pioneer countries in the establishment of SEM as a stand-alone specialty.
The Faculty of Sport and Exercise Medicine (UK) (FSEM) is a not-for-profit professional organisation responsible for training, educating and representing over 500 doctors in the United Kingdom. These doctors practise in the speciality of sport and exercise medicine (SEM). The FSEM is housed in the Royal College of Surgeons Edinburgh, but is an intercollegiate faculty of the Royal Colleges of Physicians and RCSEd
Sports cardiology is an emerging subspecialty field of Cardiology. It may also be considered a subspecialty field of Sports medicine, or alternatively a hybrid subspecialty that spans cardiology and sports medicine. Emergency medicine is another medical specialty that has some overlap with Sports Cardiology. Sports cardiology is now considered to be a distinct subspecialty in Europe and the USA, with a core curriculum developed in both regions. In Europe it has traditionally been grouped under Preventive Cardiology, but the subspecialty of Sports Cardiology is now considered a distinct field. In the USA, it has developed from being a special interest area to a distinct subspecialty as well.
John Orchard FACSEP is an Australian sport and exercise medicine physician, notable for advocating for rule changes in sport to improve player safety. In 2020 he was awarded a Member of the Order of the Order of Australia for significant service to sports medicine, particularly cricket. He was a member of the Australian government advisory group for sport responding to COVID, representing professional sport as the Chief Medical Officer for Cricket Australia and was instrumental in cricket's response to COVID. During 2023, he worked as the General Medical Officer for Australia at the FIFA Women's World Cup.
Jonathan A. Drezner is an American sport and exercise medicine physician, currently editor in chief of the British Journal of Sports Medicine. In both clinical practice and research he has a strong interest in sports cardiology. He is a first author for the International Guidelines for Electrocardiography (ECG) Interpretation in athletes and was the 19th President of the American Medical Society for Sports Medicine (AMSSM) in 2012.
The American Medical Society for Sports Medicine (AMSSM) is a large sports medicine membership organization, representing over 3000 physicians in the United States, established in 1991. AMSSM includes members who serve as team physicians at the youth level, NCAA, NFL, MLB, NBA, WNBA, MLS, and NHL, as well as with Olympic and Paralympic teams.
A pediatric concussion, also known as pediatric mild traumatic brain injury (mTBI), is a head trauma that impacts the brain capacity. Concussion can affect functional, emotional, cognitive and physical factors and can occur in people of all ages. Symptoms following after the concussion vary and may include confusion, disorientation, lightheadedness, nausea, vomiting, blurred vision, loss of consciousness (LOC) and environment sensitivity. Concussion symptoms may vary based on the type, severity and location of the head injury. Concussion symptoms in infants, children, and adolescents often appear immediately after the injury, however, some symptoms may arise multiple days following the injury leading to a concussion. The majority of pediatric patients recover from the symptoms within one month following the injury. 10-30% of children and adolescents have a higher risk of a delayed recovery or of experiencing concussion symptoms that are persisting.
Exercise medicine is a branch of medicine that deals with physical fitness and the prevention and treatment of injuries and illness with exercise. In some countries, Sport and Exercise Medicine (SEM) is a recognized medical specialty. Exercise medicine is therefore an emerging physician (non-surgical) specialty, but there is also a belief that exercise is treatment of such fundamental benefit that it should be incorporated into all medical specialties. Allied health practitioners also can specialize in exercise such as exercise physiologists, physiotherapists, athletic trainers and podiatrists.
Cathie Sherrington FAHMS is an Australian physiotherapist who is an expert in fall prevention and physical activity promotion. She is the deputy director of the Institute for Musculoskeletal Health, a research collaboration between the University of Sydney and Sydney Local Health District, where she is the lead researcher of the Physical Activity, Ageing and Disability Research stream, co-leader of the Global Fragility Fracture and an National Health and Medical Research Council Leadership Fellow. She is a professor at the University of Sydney School of Public Health in the Faculty of Medicine and Health and president of the Australia and New Zealand Fall Prevention Society and leads the Centre of Research Excellence in the Prevention of Fall-related Injuries.