10 most pressing issues in sports medicine

Orthopedic Sports Medicine

Sports medicine can be equally rewarding for athletes and sports medicine providers, but it is not without its challenges. From dealing with the media, to dealing with the team, to treating an injured athlete who could possibly rush recovery, sports medicine providers have a series of hurdles to overcome.

Here are 10 of the most pressing issues in sports medicine.

1. Brain trauma: The most pressing issue in sports medicine is brain trauma. Affecting all sports, the full effect of brain trauma is still making its long-term consequences felt. Congressional hearings have been called surrounding concussions, along with several investigations into the concussion issue with seemingly little to no progress made.

As for the players, chronic traumatic encephalopathy and the fact that it is difficult to diagnose continues to devastate the ranks of retired players. The neurodegenerative disease, linked to repetitive head impacts, causes cognitive dysfunction as well as mood and behavior disorders, according to a study in Brain.

2. Torn UCLs in MLB: Ulnar collateral ligament tears have devastated all levels of baseball. From youth athletics to the MLB, tearing a UCL continues to derail careers with no solution in sight. Although for partial UCL tears, primary care is emerging as a viable alternative to Tommy John, cutting rehabilitation times in half. A full tear requires a year-long recovery process and a scar that lasts a lifetime.

3. Torn ACLs in the NFL: Anterior cruciate ligament tears are as devastating for the NFL and youth football as UCL tears are for MLB. Although they take a backseat to concussions and head trauma, the San-Diego Union-Tribune is calling the steady and consistent rash of ACL injuries an unpreventable epidemic.

4. Overuse in youth athletics: The allure of playing sports professionally can cause young athletes to want to play a sport year round, putting their health at risk. The American Medical Society for Sports Medicine has adopted the stance that no child should be in one sport year round, and it urged parents to implement and enforce mandatory periods of rest or to encourage second sport specialization to greatly reduce the injury risk single-sport specialization carries.

5. Stem cells and regenerative medicine: Misusing regenerative medicine continues to be a problem in the sports medicine industry. In August 2017, the FDA released a statement announcing its intent to increase oversight of stem cell use, after several "unscrupulous actors" were marketing and performing regenerative medicine treatments for indications they had not yet been approved for. The FDA is attempting to protect the public and sports medicine patients from treatments that have yet to be proved safe or effective.

6. Opioid alternatives: Sports medicine is not immune to the opioid crisis. While representing only 4.6 percent of the world’s population, Americans consume 80 percent of the worldwide opioid supply. A recent CDC study shows with an initial 10-day prescription, about 20 percent of individuals become long term opioid users. In a Becker's Spine Review piece, Huaiyu Tan, MD, PhD, of Gulf Breeze, Fla.-based Andrews Institute for Orthopaedics & Sports Medicine, attempts to use opioids as a last resort. To do this, Dr. Tan is brought into the treatment plan at an early stage, where he warns patients of the risk of opioids and then works with them to develop a treatment plan that will help them recover without opioids.

7. Playing through injuries: The glorification of athletes playing while injured in sports media is one of the most troubling issues in the sports medicine arena. Players are lauded by the media and the fans for playing injured, when all they're doing is putting themselves at further risk for injury. For example, Detroit Tigers 1B Miguel Cabrera recently made headlines after saying, "He was done playing hurt." MLive criticized Mr. Cabrera's actions saying it was "unfair to Tiger fans who've supported him."

8. Patient confidentiality: Sports medicine physicians, who treat professional athletes and serve as official team physicians, differ from other orthopedic surgeons with regard to the privacy and ethical ramifications that come with the job. According to a study, published in The American Journal of Bioethics, team physicians have multiple factors to consider when delivering care. They must keep the best interests of the team in mind, while still providing top-notch care. Then they must respect their patient's privacy wishes despite the prying sports media.

9. Work-life balance: While only 34 percent of orthopedic physicians report feeling burnt out, Naples, Fla.-based Bluetail Medical Group's Luga Podesta, MD, offered advice to new sports medicine physicians about managing the time commitment of sports medicine. In a Becker's Spine Review piece, he said the profession requires you to be available for games and for the players, trainers and coaches whenever needed. He urged all new physicians to make sure they have the drive to be part of team.

10. Burnout: The demands of sports medicine can be particularly taxing because the intense sports season increases the potential for burnout. Andrews Institute for Orthopaedics & Sports Medicine's Juliet DeCampos, MD, offered advice to combat this, saying sports medicine providers need a passion for the sport. She said, "Be a student of sports — not just football and baseball, but all sports possible. Be passionate about sports. Read Sports Illustrated and ESPN Magazine, watch obscure sports and read the sports pages. My time as a sports journalist helped me to "talk the talk" with athletes so I had more credibility as a sports physician. Understanding sports training and mechanics allowed me to be more focused on helping the athletes go back to their specific skills and game."

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