To the average person, the term sports medicine may evoke images of professional athletes-or at least weekend warriors-seeking treatment for complex injuries suffered on the playing fields, ski slopes, or bicycle paths. But at Hospital for Special Surgery (HSS) this interdisciplinary medical specialty provides care for a wide range of patients, both athletes and non-athletes, young and old, with a variety of musculoskeletal injuries of the knee, shoulder and other joints. Both the nature of these injuries and the diverse population who are seeking care make the interdisciplinary model particularly useful. In addition to being seen by an orthopaedic surgeon, patients may consult with a primary care physician, an internist, a physiatrist, or a pediatrician.
For all patients, the treatment goals are the same: To address the injury or condition that has prompted the patient to seek medical attention and, whenever possible, to help the patient return to pre-injury activities or level of play. In addition, everything is done to help patients remain as active as possible, for as long as possible.
Interestingly, while Sports Medicine has evolved as a specialty in part due to special demands placed on professional athletes, the injuries experienced by these individuals and by non-athletes do not differ significantly from one another, according to Thomas Wickiewicz, MD, Attending Orthopedic Surgeon at HSS. "Nor does their ability to recover. The difference physicians may see between the athlete and the non-athlete is more likely to be stronger motivation in the athlete to return to competition when it is medically safe to do so, even if they are still experiencing pain in the affected joint." Despite the financial incentive to return to play, professional athletes may have a better understanding of the importance of an adequate healing and rehabilitation period. Young, amateur athletes may be more likely to push for rapid results.
Both athlete and non-athlete benefit from technological advances that are used frequently in the Sports Medicine Service. These include the use of arthroscopic techniques for knee injuries such as a torn ACL (anterior cruciate ligament)-surgery in which a combination of fiber optics, small incisions, and small instruments are used in place of more invasive operations. Same-day surgeries and the use of local or regional anesthesia are also available in many cases.
Once the injury or problem has been addressed, prevention of re-injury becomes a primary focus for patient and physician. In some cases, activity modification may be recommended. These changes may be as modest as the use of different shoes or running surfaces or as extensive as restricting or eliminating certain recreational activities. Some individuals may need to undergo a psychological adjustment as a well as a physical change. Those who relieve stress by running or jogging, for example, may be particularly reluctant to give up their favorite activity. Based on their experience with large numbers of athletes, physicians trained in sports medicine can be particularly adept at helping these individuals find a safe, alternate athletic activity that confers the same benefits with less risk of injury.
In addition to providing clinical care to patients, many members of the Sports Medicine team are involved in educational activities, including providing information to coaches and athletes-at the secondary school, collegiate and professional level, and speaking to groups with relevant concerns. The service also provides educational opportunities for physicians who are training to become sports medicine specialists.
The Sports Medicine clinicians at HSS are involved in numerous research projects, with much of their effort focused on soft tissue reconstruction and cartilage repair and regeneration. Any advances this research yields promises to benefit all patients with musculoskeletal injuries or disease.
Summary Prepared by Nancy Novick