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 some countries, sports medicine (or sport and exercise medicine) is a recognized medical specialty (with similar training and standards to other medical 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.

Scope

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. 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.

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.

European templates for SEM specialization generally recommend four years of experience in:

 internal medicine with special emphasis on cardiology, emergency medicine and clinical nutrition
 orthopedics and traumatology
 physical and rehabilitation medicine
 fellowship at a recognized sports medicine centre.

Related medical specialties

 Exercise medicine
 Podiatric Medicine & Surgery
 Sports cardiology
 Emergency medicine
 Lifestyle medicine
 General practice
 Adolescent medicine
 Physical medicine and rehabilitation
 Rheumatology
 Orthopaedic sports medicine
 Pediatrics
 Occupational medicine

Establishment as a medical specialty

Historical roots of sports medicine
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.

Modern establishment of the specialty
The Italian version of this page Medicina dello sport states that Sports Medicine societies were first established in Switzerland (1922) followed by: Germany (1924), 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. Sports medicine was established as a 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. It is a goal of the European Federation of Sports Medicine Associations to eventually establish Sports Medicine as a specialty in all European countries.

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. Australia, New Zealand and the UK have been cited as pioneer countries in the establishment of SEM as a stand-alone specialty.

The USA (and many other countries) follow the model of recognizing Sports Medicine as an official subspecialty of multiple other primary medical specialties.

Public health
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.

Common sports injuries

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. 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. Sports injuries generally affect soft tissue or bones within the body and are commonly treated without surgery.

Treatment for sports injuries 
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. 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.

Controversies in sports medicine

Concussion in sport

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. 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.

Transgender people in sport

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.

Drugs in sport

Doping in sport has a long history with doctors in the sports medicine world being both heroes and villains on different occasions. 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.

Sports scandals involving medicine

Major scandals where doctors were prominent include:
 Bloodgate
 USA Gymnastics sex abuse scandal
 Operación Puerto doping case
 Biogenesis scandal
 Eva Carneiro scandal, involving Chelsea F.C. and José Mourinho

Allied health team members

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.

Athletic trainer
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. When an athlete is injured, an athletic trainer is key to treatment and rehabilitation working closely with the athlete throughout rehabilitation. Athletic trainers are often the ones who assess the injury first and provide initial care.

Physiotherapist
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. 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.

Podiatrist 
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.

Other practitioners 
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.

Journals

See also

 Exercise physiology
 Physical therapy
 Sports injuries

References

Further reading 
 

 
Orthopedic surgical procedures
스포츠 의학()은 스포츠 선수의 신체 능력의 강화, 좋은 성적을 내기 위한 신체의 사용법, 재활 치료 등을 취급하는 종합적인 전문 의학 분야이다. 스포츠 의학은 선수 본인을 중심으로 내과 의사, 외과 의사, 물리 치료사, 코치 등이 팀을 구성하고있다.

정의 
일반적으로 스포츠의학은 전문 운동선수의 경기력을 향상시키며, 경기 중이나 훈련 중에 발생한 손상 치료 및 재활 그리고 예방과 같이 선수를 관리하고 연구하는 스포츠 전문 의학 분야라고 알려져 있다.하지만 최근에는 스포츠 관련 외상의 치료와 예방은 물론이고 일반인을 위한 올바른 운동 방법, 만성 질환자의 치료를 위한 운동법까지도 다루고 있다. 뿐만 아니라 스포츠를 즐기고, 삶의 질을 향상시키며 노화나 질병, 그리고 외상 등으로 인해 저하된 신체능력을 회 복시켜 일상생활을 무리 없이 수행할 수 있도록 체력을 증진 시키는 것과 같은 광범위한 분야까지도 포함하고 있는 의학 적 학문의 집합체라고 할 수가 있다. 이처럼 다양한 분야 들이 있지만 현대적인 개념을 기초로 크게 분류 한다면 다음 과 같은 세가지 영역으로 분류할 수 있을 것이다. 첫째, 스포 츠 손상의 의학적 관리, 둘째, 성인병의 운동을 통한 치료적 관리, 셋째, 만성 퇴행성 질환의 예방이 그것이다.

스포츠 의학의 역사 
스포츠의학의 원조라고 할 수 있는 사람은 고대 로마 시대의 의사이자 해부학자인 클라우디오스 갈레노스이다. 그는 소아시아의 페르가몬에서 태어나 200년 사망할 때까지 해부학과 생리학 등에 수많은 의학적 공헌을 남겼다. 또한 당시 전사들의 주치의로 임명되어 스포츠 외상의 처치법을 개발하고 건강관리를 하여 현대 스포츠에 존재하는 팀닥터의 시조라고 할 수 있다. 19세기 후반부터는 과학문명이 급속도로 발달함에 따라 스포츠의학도 이러한 과학적 발판 위에서 연구되기 시작하였고, 특히 근육의 생리학적 연가 활발해졌다. 1910년에는 지그프리드 바이스바인이 베를린에서 『스포츠 위생』이라는 책을 발간하였는데 이것이 과학적 스포츠 의학의 탄생으로 받아들여지고 있다.
또한 제1차 세계대전 후에는 스포츠의 의학적 연구가 세계 각지에서 본격적인 활동을 개시하였다. 1928년에는 스위스 남동부의 스키장인 장크트 모리츠에서 개최된 제2회 올림픽 동계대회를 계기로 국제스포츠의학연맹(FIMS: fédération internationalede medicin sportive)이 결성되었으며, 같은 해에 암스테르담 올림픽대회에서 제1회 국제스포츠의학회가 개최되어 이때부터 스포츠의학의 연구는 국제적 규모로 변모하였고, 이 시기가 현대 스포츠의학연구의 시발점이라고도 할 수 있다.

스포츠 의학의 미래 
생활수준의 향상과 주 5일제에 따른 여가시간의 증가와 더불어 의학기술이 발달됨에 따라 평균수명 연장 그리고 삶 의 질을 향상시키기 위한 방법 등에 있어서 운동은 빠질 수 없는 조건이기 때문에 미래의 스포츠의학이 건강산업의 주 도적인 자리를 차지할 것이라는 것은 쉽게 예상할 수 있다. 이처럼 스포츠의학이 운동선수뿐만 아니라 스포츠를 즐기는 대중으로 시야를 넓히게 된 현 시점에서 그 관심은 재활 치료를 넘어 지역사회의 건강사업 등과 관련한 예방의학적 역할에 점점 더 비중이 커지며 집중될 것이다. 즉, 각종 성인 병과 만성퇴행성 질환의 조절과 관리뿐만 아니라 운동을 통 해 미리 질병을 예방하는 일, 그리고 현재의 건강을 유지하 고 보다 증진하는 일 등이 스포츠의학의 주요 관심사로 대두 될 것이다.

주요 용어 
웨이트트레이닝(weight training)
근육 발달을 통해 강한 체력을 기르기 위한 저항 훈련을 말한다. 자기 체중을 이용하여 하는 운동을 비롯하여 익스팬더, 아령, 바벨 또는 모래주머니처럼 간단하게 만들 수 있는 중량물 등 스프링이나 중량으로 저항 부하(負荷)를 걸어서 하는 훈련방법을 가리킨다.

트림운동(trimm aktion)
건강증진과 체력저하를 방지하기 위해서 가볍게 달리기·수영 등 간단한 스포츠를 지속적으로 하는 운동을 말한다. 트림이란 본래 신체의 균형을 잡는다는 뜻의 노르웨이어인데, 전화(轉化)하여 ‘신체의 균형을 잡는다’, ‘신체를 단련한다’는 뜻으로 사용된다.

운동처방(exercise prescription)
신체적 훈련에 의한 질환치료, 체력향상이나 건강증진을 꾀하는 경우에 기초가 되는 운동양식, 부하강도, 부하시간, 부하빈도 및 운동프로그램 진행속도 등을 대상자의 상황에 맞게 안전성과 유효성을 고려하여 주는 일련의 계획을 말한다. 처방 목적으로도 실시하지만 대상자의 연령, 성별, 운동능력과 습관 정도, 여러 가지 건강지표치 등 현재적·잠재적 건강 상황에 근거하여 개인별로 계획되는 것이 보통이다. 또한 대상자의 일상생활의 환경이나 기호 등의 인자도 고려되는 경우가 많다.

운동부하 검사(exercise test)
운동을 부하함으로써 심 기능과 폐 기능의 평가하고 이러한 질환의 진단과 중증도 판정을 행한다. 특히 허혈성 심질환일 때에 행하는 운동부하심전도시험에는 마스타 2단계 부하시험, 트레드밀, 작업계, 핸드글립 등의 방법이 있다. 안정시의 심전도에서는 이상소견이 없는 경우라도 운동부하시험을 하면 심근허혈을 나타내는 ST저하가 나타나는 수가 있어 허혈성 심질환의 진단에 이용된다.

관련 직업 
가정의학 전문의,
스포츠의학전문가,
피트니스센터 개원,
의학 관련 연구원

주요 검사 
스포츠의학의 주요 검사에는 예진을 포함하여 체성분 검사, 유연성/신체측정 검사, 체형분석 검사, 발란스 기능 검사, 근관절 기능 검사, 운동부하 검사, 요추부 근 기능 검사 등이 있다.

각주