Sports-related Medicine Question

[ralphlaurenfan]

Hi,

I have a few questions:

1. I was wondering if there is any way to do surgical-type of techniques in sports-medicine without doing a orthopedic surgery residency. Although I think Ortho would be awesome, I know it's not realistic to assume you'll get it, so is there any other way to do surgical-type procedures without doing orthopedic surgery first?

2. If surgery isn't possible without orthopedics, what is the best residency that will allow you to get into this field? I've heard of internal meds, PM&R, emergency meds and then fellowship are relatively common, but what about anesthesia or rheumatology?

3. I'm not sure if this is the best sub-section to ask this, but can rheumatologists help treat a lot of sports-related problems? I was thinking since a lot of athletes injure muscles, this might be something they can deal with, but I don't want to make assumptions and was wondering if I could have a more educated opinion.

thanks

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[hokiedo2012]

From my experience working in a rheumatology office, rheumatologists treat few sports-related problems. The majority of the cases are pain-associated disorders, not injuries: rheumatoid arthritis, osteoarthritis, gout, lupus, etc...

 

[Instatewaiter]

Hi,

I have a few questions:

1. I was wondering if there is any way to do surgical-type of techniques in sports-medicine without doing a orthopedic surgery residency. Although I think Ortho would be awesome, I know it's not realistic to assume you'll get it, so is there any other way to do surgical-type procedures without doing orthopedic surgery first?

2. If surgery isn't possible without orthopedics, what is the best residency that will allow you to get into this field? I've heard of internal meds, PM&R, emergency meds and then fellowship are relatively common, but what about anesthesia or rheumatology?

3. I'm not sure if this is the best sub-section to ask this, but can rheumatologists help treat a lot of sports-related problems? I was thinking since a lot of athletes injure muscles, this might be something they can deal with, but I don't want to make assumptions and was wondering if I could have a more educated opinion.

thanks

1) If you want to do sports related surgery you have to either do an ortho residency or a gen surg residency and then a fellowship. Sports med is generally a fellowship after family medicine which does not have a whole bunch of surgery involved.

2) The best residency to get into ortho is to do an ortho residency. Without going the surgery route, PM&R and family med+sports med fellowship are options if you want to deal with sports related issues.

3) I think the specialties you are looking for include PM&R which does the rehab after a sports injury (kinda like a physical therapist), sports medicine which is more diagnostic and less like a physical therapist or ortho who does repairs.

 

[Taus]

1) If you want to do sports related surgery you have to either do an ortho residency or a gen surg residency and then a fellowship. Sports med is generally a fellowship after family medicine which does not have a whole bunch of surgery involved.

2) The best residency to get into Ortho is to do an ortho residency. Without going the surgery route, PM&R and family med+sports med fellowship are options if you want to deal with sports related issues.

3) I think the specialties you are looking for include PM&R which does the rehab after a sports injury (kinda like a physical therapist), sports medicine which is more diagnostic and less like a physical therapist or ortho who does repairs.

PM&R does not "do" the rehab after a sports injury and is not like physical therapy, despite both groups of professionals working towards the same goals of increasing function and decreasing pain and disability. The day to day practice of both have very little in common.

Regarding the OP's questions:

1. To do surgery on sports injurys ortho is the way to go. Other fields like PM&R and Anesthesia train you to do "interventional procedures" and EMG's (PM&R & Neurology only), but not open surgeries. This is in a manner similar to GI vs. Colo-Rectal Surgery or Cardiology vs. Cardio-thoracic surgery.

2. All of those fields (though predominately FP and PM&R) allow you do enter the field of sports medicine, but the daily practice and setting can be very different between them. You have to decide what area of sports medicine most interests you, as it is a broad term. Anesthesia can lead to Pain Medicine, though they don't usually deal with acute to sub-acute sports injuries.

3. I guess in theory Rheum could, but they generally don't.

 

[medking]

PM&R does not "do" the rehab after a sports injury and is not like physical therapy, despite both groups of professionals working towards the same goals of increasing function and decreasing pain and disability. The day to day practice of both have very little in common.

Regarding the OP's questions:

1. To do surgery on sports injurys ortho is the way to go. Other fields like PM&R and Anesthesia train you to do "procedures", but not open surgeries.

2. All of those fields (though predominately FP and PM&R) allow you do enter the field of sports medicine, but the daily practice and setting can be very different between them. You have to decide what area of sports medicine most interests you, as it is a broad term. Anesthesia can lead to Pain Medicine, though they don't usually deal with acute to sub-acute sports injuries.

3. I guess in theory Rheum could, but they generally don't.

Can you explain the difference between a physiatrist and a physical therapist?

Thanks!

 

[fozzy40]

I saw this oldie but goodie and had to answer it

The common misconception of physiatrists are that we are the ones who are actually performing the therapies. Physical therapists are trained on the clinical features of common musculoskeletal pathology, musculoskeletal examination, developing a treatment plan utilizing stretching, biomechanics, kinesiology, exercise prescription, and use of physical modalities (including heat, cold, TENS.) This is a very general description of physical therapy.
The role of the physiatrist is to medically manage the patient as they participate through the rehabilitation process. Our role in the inpatient setting is to assess the patient and reassure that the patient is medically stable to participate in therapies. Our job is to identify how disease affects the patient's ability to move in their day to day life. We do not perform the actual physical therapy but we do determine what therapies are appropriate for our patients and treat medical issues that directly effect their ability to perform in therapies. Medical issues specific to rehabilitation include pain management, neurogenic bowel and bladder, spasticity management, and disease education. I am often called by the therapists during a therapy session to evaluate new muscular or joint pain, extremity swelling, syncope, chest pain, heart palpitations, shortness of breath, agitation, mental status changes, seizure evaluation. So what I think it's interesting because I get to evaluate medical problems during functional activities that your typical internist or surgeons might not see. This is not to mention that we are managing pre-morbid comorbidities i.e. HTN, diabetes, chronic obstructive pulmonary disease, etc.

 

[cabinbuilder]

I do a lot of sports injury types of things in family practice as well. Not surgery per se but if you get good at joint injections and casting that a lot of income you are not sending out the door.

In any given week I do:

Knee injections
Shoulder injections
Trigger points in the back
Plantar Fasciitis injections
DeQuervain's Tenosynovitis
Tennis Elbow
Golfer's Elbow
Casts/splints/ braces
Trigger fingers
Trochanteric Bursitis
Ganglion Cyst drainage.

And of course all the biopsies of skin, mole removal, toenail, I&D of abcess, etc. Heck, did a inner labia biopsy last week since no one else would do it. Have your suture ready always.

I did a lot of surgery rotations in Residency to learn how to do these procedures since I knew I would be in rural places. Even now doing indigent care its good to know since most specialists wont take medicaid patients since there is no reimbursement for them so I do most of the care myself if I can swing it.