What is sports medicine?
Sports medicine is the medical care of athletes and treatment of sports injuries. In addition to medical doctors, it involves physiotherapists, podiatrists, massage therapists, nutritionists, first-aid practitioners, sports scientists and coaches. In New Zealand most of the cost of treatment for sports injuries from accidents is covered by the Accident Compensation Corporation (ACC). ACC does not cover sports injuries that result from gradual processes rather than accidents.
The high price of sports injuries
The following five sports were the most expensive for injury payouts by ACC between July 2010 and June 2011:
Rugby union, $56,188,339
Rugby league, $14,918,982.
Sports Medicine New Zealand
New Zealander Arthur Porritt, a doctor and former Olympic sprint medallist, was a foundation member of the British Association of Sports and Medicine in 1953. Porritt encouraged Dunedin radiologist Norrie Jefferson to set up the New Zealand Federation of Sports Medicine (NZFSM) in 1963. The NZFSM worked to standardise sports injury treatment and establish training in sports medicine. The federation was renamed Sports Medicine New Zealand and by 2013 had 12 regional branches, with a national office in Dunedin. New Zealand has specialised courses in sports medicine at the Otago and Auckland medical schools.
Most injured athletes go first to a general practitioner or a physiotherapist. Sometimes athletes will then be referred on to a sports physician – a specialist in sports and exercise medicine. A large part of sports physicians’ work deals with musculoskeletal injuries. They also provide medical screenings, monitor athletes’ health concerns and check any medications athletes are taking. Some medications are banned in sport, unless the athlete gets a therapeutic use exemption.
At the 2008 Beijing Olympics New Zealand rower Mahé Drysdale came down with a severe bout of gastroenteritis just days before he was to compete. The normal treatment was intravenous fluid resuscitation, but before this could be administered the medical team had to obtain a therapeutic use exemption from the games authorities. The use of intravenous fluids was severely regulated at the Beijing games to reduce any opportunities for doping.
Sports physicians also carry out impairment assessments for injured athletes who are making claims to ACC. Sports physicians are in demand to act as team doctors for high-level sports teams such as the All Blacks (rugby), the Silver Ferns (netball) and New Zealand’s Olympic and Commonwealth games teams.
Many sports involve the risk of damage to tendons, bones or joints, with some injuries requiring orthopaedic surgery. Rugby player Michael Jones needed immediate orthopaedic surgery after severely damaging a knee during the 1989 test against Argentina in Auckland. Fellow All Black Dan Carter had to undergo ankle surgery in 2010 and a tendon operation in 2011. Cricketer Martin Crowe had a persistent knee injury throughout his career, and finally had the bone repositioned through major orthopaedic surgery.
Physiotherapists use a range of techniques, including exercise and massage, to identify and treat athletes’ health problems. They devise treatment programmes to enable rehabilitation from injuries and to help prevent future injuries. The importance of physiotherapists in modern sport was illustrated at the 2012 London Olympics, where the 31-strong health team accompanying New Zealand’s Olympic squad included 13 physiotherapists.
Massage therapy helps athletes recover from injuries. Massage promotes muscle relaxation, lowers the heart rate and blood pressure, and provides general stress relief. It is particularly useful for athletes in high-energy sports such as rugby, netball, cycling and athletics.
Sports nutritionists or dieticians design nutrition plans for athletes to help them maintain good health and maximum performance. Advice on vitamin and mineral supplement use has also become a major part of sports nutrition. Nutritional planning is particularly important when athletes are travelling overseas, where they are likely to encounter different conditions and foods. Nutritionist Christel Dunshea-Mooij devised high-carbohydrate diets for New Zealand rowers to enable maximum performance at the 2010 World Rowing Championships at Karapiro and at the 2012 Olympics in London.