Sports medicine

• 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

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.[6][7][8][9][10]

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.[11] 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.[3] It is a goal of the European Federation of Sports Medicine Associations to eventually establish Sports Medicine as a specialty in all European countries.[12]

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.[13] Australia, New Zealand and the UK have been cited as pioneer countries in the establishment of SEM as a stand-alone specialty.[14]

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

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.[47][48][49] 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.

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.

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.

Major scandals where doctors were prominent include:[50]

• Bloodgate
• USA Gymnastics sex abuse scandal
• Operación Puerto doping case
• Biogenesis scandal
• Eva Carneiro scandal, involving Chelsea F.C. and José Mourinho

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.[51] When an athlete is injured, an athletic trainer is key to treatment and rehabilitation working closely with the athlete throughout rehabilitation.[52] Athletic trainers are often the ones who assess the injury first and provide initial care.

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.[53] 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.[54]

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.[53]

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.