Sports medicine is a multi-faceted specialty that can address athletes of all levels with very varied problems and expectations. Certainly, the competitive athlete will regularly have recourse to sports medicine concerning his high training load and the sports accidents of which he may be a victim. The sports doctor can also play an important role with recreational athletes who can also greatly benefit from the varied skills of sports doctors which will be briefly described below. Indeed, some lesions of novice or beginner athletes are caused by errors in the equipment used or the programming of the training.

In addition to specific therapeutic management, the recommendations of the sports doctor will therefore prove to be particularly useful in terms of prevention. Finally, the sports doctor can be an important partner for the sedentary person who wishes to resume physical and sports activities. He will be able to estimate whether a medical check-up is necessary and, when necessary, accompany him medically during this recovery. Such support can be an important motivational factor, a guarantee of success when returning to a more active life.

We will also see below that this form of sports medicine sometimes referred to as “exercise medicine” is a new and growing area of ​​the specialty. the sports doctor can be an important partner for the sedentary person who wishes to resume physical and sports activities. He will be able to estimate whether a medical check-up is necessary and, when necessary, accompany him medically during this recovery. Such support can be an important motivational factor, a guarantee of success when returning to a more active life.

We will also see below that this form of sports medicine sometimes referred to as “exercise medicine” is a new and growing area of ​​the specialty. the sports doctor can be an important partner for the sedentary person who wishes to resume physical and sports activities. He will be able to estimate whether a medical check-up is necessary and, when necessary, accompany him medically during this recovery. Such support can be an important motivational factor, a guarantee of success when returning to a more active life.

We will also see below that this form of sports medicine sometimes referred to as “exercise medicine” is a new and growing area of ​​the specialty. guarantee of success when returning to a more active life. We will also see below that this form of sports medicine sometimes referred to as “exercise medicine” is a new and growing area of ​​the specialty. guarantee of success when returning to a more active life. We will also see below that this form of sports medicine sometimes referred to as “exercise medicine” is a new and growing area of ​​the specialty.

Sports traumatology is the best-known area of ​​sports medicine. Indeed, most of the work of sports physicians is dedicated to the diagnosis and therapeutic management of accidents and overload injuries in athletes. As part of the treatment of these lesions, rehabilitation occupies a privileged place. The sports doctor and the physiotherapist, therefore, work closely together to allow injured athletes to resume their training and competitions as quickly as possible.

How Does It Work?

Most sports injuries, and especially overload injuries, are non-surgical. The sports doctor-physiotherapist duo is therefore essential in sports medicine. Certain more serious lesions found in more traumatic sporting activities (“contact-collision” sports such as many teams or combat sports, alpine skiing, etc.) however require very specific surgery. These lesions must therefore be diagnosed without delay so that the athlete can benefit from adequate care without loss of time and without risking an aggravation of the initial lesions by continuing to practice sport with, for example, unrecognized or unrecognized ligament instability. properly processed.

The management of lesions of the musculoskeletal system of athletes requires good knowledge of general traumatology. However, quality care also requires specific knowledge because each sporting activity is characterized by its specific lesions and because some lesions are found practically only in athletes. This is, for example, the case of overload injuries such as the “windshield wiper syndrome” or even certain fatigue fractures of runners…

In sports traumatology, an important element to consider in the etiopathogenesis of sports injuries is the fact that the equipment (racket, shoes, skis, etc.) can contribute to the development of the injury, or even be its direct cause. Thus, an unsuitable or worn shoe can be the cause of Achilles tendinopathy or other overload injuries. Another example: is the appearance of new, more curved (“carved”) skis which sometimes contribute to the occurrence of a sprained knee…

The term “technopathy” designates this situation where the equipment used by the athlete has participated in the appearance of the lesion. A sports physician must therefore broaden his diagnostic evaluation by considering the equipment used. In the same perspective, the poor gestural technique can also induce excessive mechanical stress and therefore an overload injury. This is the case of the recreational tennis player whose backhand technique is imperfect and who will develop tendinopathy of the epicondylar muscles. In this case, in addition to the rest and rehabilitation traditionally prescribed, the treatment may also include some tennis lessons when returning to sport…

One of the delicate questions with which the sports doctor is systematically confronted is that of the moment of the resumption of sport. From when can a runner who has suffered a stress fracture, Achilles tendinopathy, or a tennis player who has suffered a muscular accident of the internal twin muscle of the calf… can they resume training and competition? The sports doctor must of course take care to respect the biology of the healing of the different tissues.

However, after stopping the practice of a specific activity, the resumption must always be done in a gradual and planned way. This gradual recovery phase is often referred to as “weatherization”. It corresponds to the moment when the traditional treatment in a physiotherapy practice ends, where the athlete will gradually get back on the field without however being able to participate from the start in competitions or practice all the gestures specific to his sport. The moment when the athlete can resume competition must be carefully chosen in close consultation between the physiotherapist and the sports doctor.

Although there are certain “guidelines” for the most frequent lesions, this decision is always difficult. It is indeed traditional to have to contain the ardor of athletes’ eagerness to resume their activity as soon as possible. Although there are certain “guidelines” for the most frequent lesions, this decision is always difficult. It is indeed traditional to have to contain the ardor of athletes’ eagerness to resume their activity as soon as possible. Although there are certain “guidelines” for the most frequent lesions, this decision is always difficult. It is indeed traditional to have to contain the ardor of athletes’ eagerness to resume their activity as soon as possible.

Sports medicine is not limited to sports traumatology, particularly in high-level athletes in whom intense practice can have a significant impact, sometimes positive, sometimes negative, on many systems. A generally positive example among the most studied is that of the “sportsman’s heart”. It is an adaptation of the heart pump resulting in a sometimes very significant improvement in its performance in endurance athletes.

But there are not only positive effects to large doses of sport… Thus, during the very intense practice of long-distance running, micro-traumas can in the long run lead to significant blood loss in the urinary and digestive tracts. When, in women, these blood losses are combined with the losses of menstruation, there is a risk of developing iron deficiency anemia leading to a drop in performance. This phenomenon must be researched and must not be confused with pseudo-anemia by hem dilution which is a normal physiological adaptation to the intense practice of endurance sport.

There are many other examples of the negative effects of excessive exercise. In adolescents or young women, the excessive practice of certain sports (running, dancing, gymnastics, etc.) can lead to depression of the hypothalamic-pituitary axis resulting in the “female athlete triad” characterized by the association of eating disorders (anorexia), amenorrhea and osteopenia (osteoporosis).

The peripheral vascular system can also be the seat of true overload lesions. This is the case of end fibrosis of the external iliac arteries of professional cyclists causing claudication of the thighs during intense effort.

Finally, the negative effects can be psychological: sporting “burn out”, sports addiction sometimes referred to across the Atlantic as “sport holism” …

Through these few examples relating sometimes to internal medicine, sometimes to vascular surgery, or even psychiatry, we see that sports medicine is far from being limited to ailments of the musculoskeletal system.

Some sports practices in particular risk environments require very specific skills on the part of the doctors who supervise these athletes. These are sports such as scuba diving, mountaineering, and aeronautics… There are therefore specific training courses covering in more depth the knowledge of hyperbaric and hypobaric physiology that the doctors who will follow these athletes must master. . These training courses also include the diagnosis and management of conditions specific to these disciplines.

The sports doctor can also be involved in the longitudinal follow-up of competitive athletes, which implies that he possesses or has access to skills as diverse as traumatology, exercise physiology, nutrition, etc. For the athlete’s level, he sometimes assumes the role of coordinator of the team of specialists involved in the support of the high-level athlete: orthopedic surgeon, physiotherapist, podiatrist, dietician, sports psychologist… He must also know the regulations very strict and regularly updated concerning the fight against doping.

The sports doctor may be involved in the medical coverage of sporting events in a variety of ways. It can be requested by an organization or a sports federation for the coverage of a competition. He may also be required to accompany a team or an individual athlete to a major sports competition or a preparatory course. This type of mission requires specific skills and preparation anticipating all the problems that may be encountered in this type of situation. Depending on the sport(s) concerned, the number of athletes involved, the weather conditions, and the place where the event takes place, the issues that the sports doctor will have to manage will be very diverse. In some more exceptional cases.

Final Words

A booming sector towards which some sports and rehabilitation physicians are turning consists of supporting non-athletic patients with various conditions (overweight, diabetes, high blood pressure, depression, anxiety, etc.) by offering them physical activity. physical and sports as therapeutic agents. This is called “exercise medicine”. Indeed, the practice of physical activities gradually and according to a program adapted to each case, can have a major positive impact on many of these conditions whose prevalence is constantly increasing and which constitute a major challenge in terms of health. the public in our industrialized countries.