Sports Medicine Practitioners

At one time, sports medicine was made up of two basic types of practitioners—those in mainstream medicine, who were mostly medical doctors and osteopaths, and those in complementary medicine who used so-called alternative therapies. More recently, sports medicine—a general term for all those healthcare practitioners who treat athletes—has evolved and transformed itself. Two significant changes have occurred:

Complementary medicine with its many therapies has gained a high level of acceptance. Many of these approaches are used to varying degrees by all types of practitioners, from chiropractors and osteopaths to physical therapists, acupuncturists, and massage therapists. These include biofeedback, diet and nutrition, acupuncture, manipulation (of the cranium, spine, and other joints), homeopathy, and others.

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A second change is that many mainstream medical doctors now use one or more of these same alternative or complementary therapies in their practices.

Unfortunately, many practitioners are considered sports medicine therapists simply because many of their patients are athletes, not because they are personally well acquainted with endurance training and racing.

At the risk of sounding too general and leaving out many other types of sports medicine therapies, I’d like to discuss some types of therapies used in sports medicine, beginning with the four general categories of sports medicine practitioners.

The first category consists of practitioners who predominantly provide hands-on care. These include chiropractors, traditional osteopaths, physical therapists, massage therapists, and those employing different manual therapies. Many of these practitioners use forms of manual muscle testing, which can best be described generally as biofeedback.

The second category includes those professionals who deal with lifestyle factors, especially the chemical and mental or emotional aspects of an athlete. These professionals offer dietary and nutritional advice, and dispense other types of non-drug supplements such as dietary supplements, homeopathic remedies, and herbs. With its reliance on imagery and “mental training,” sport psychology falls within this category.

The third category includes professionals who incorporate most if not all of the methods mentioned above into one approach, using both hands-on techniques and addressing lifestyle factors such as diet and nutrition, stress management, and herbal and other types of non-drug supplementation. The three predominant groups within this category are Chinese medicine, applied kinesiology, and naturopathy. While many people are not familiar with these professions, most are familiar with some of their individual elements. Chinese medicine was the first holistic approach, using a combination of acupuncture, herbology, manipulation, nutrition and diet, music and color therapy, and other individual techniques. Applied kinesiology employs much of the same and is a Westernized version of Chinese medicine. Naturopathy involves a similar approach with more emphasis on lifestyle factors.

A fourth group are specialists who address more serious conditions. These include surgeons, neurologists, cardiologists, and those who use primarily surgery and medication. They tend to perform emergency care or often use more extreme therapy as a “last resort” approach after other therapies have not succeeded. These will not be discussed here. While their services are sometimes necessary, they treat the minority of sports problems.

There is a fifth group comprised of sports trainers. These individuals work with athletes by providing specific training schedules. While many are former athletes, others are physiologists, athletic trainers, and certified trainers, and they typically don’t provide a particular therapy.