People who lead physical lifestyles or participate in sport are susceptible to developing various injuries due to the increased strain put on their bodies. Suffering a sports-related injury can hamper performance, cause grave discomfort and force us to put our health goals on hold, so it’s important to address any issues as soon as possible. And, to take preventative measures to stop the issues occurring in the first place.
Sports and Exercise Medicine (SEM) is a holistic approach to addressing injuries and other medical conditions in people who are physically active and take part in sport. While sports medicine has in fact been practised for centuries, SEM only received speciality recognition in the UK in around 2005. Since then, it has become a fundamental branch of medicine, and something pioneered by consultants at Wimbledon Clinics, one of whom is Dr Peter Thomson.
“SEM essentially fills the gap in musculoskeletal, between orthopaedics and rheumatology and performance medicine,” explains Dr Thomson.
“Many patients used to be referred to, for instance, orthopaedics when in fact the nature of their injury didn’t require a surgical opinion. There was the need for an ‘intermediate medical discipline’ that could offer effective treatment to patients with non-surgical needs, at the same time relieving the pressure on surgical specialists. And that’s where SEM comes in.”
- Effective, holistic treatment of musculoskeletal conditions and injuries.
- Assessing the cause of injury and its effect on function and performance.
- Promotion of health and wellbeing through increased uptake of physical activity.
- Assessment and guidance on injury prevention and treatment, rehabilitation, exercise, training and nutrition.
Inter-cooperation is key
Rather than exist as its own entity, SEM works alongside other clinical specialists in deciding and delivering what’s best for each patient.
As Dr Thomson explains: “Within Wimbledon Clinics, patients’ care is shared with our physiotherapy, podiatry or orthopaedics colleagues; SEM may be the most suitable expert, or alternatively patients may be referred on to one of our other specialist teams for help and advice. Satisfying our patients’ needs and finding the clinician at Wimbledon Clinics best placed to deliver this is of paramount importance.
“For instance, I’ll work with one of our specialist physiotherapy consultants to assess a patient’s pain or injury. For example, with anterior knee pain my job would be to understand the story of their condition, examine them and look for structural issues using imaging such as ultrasound or MRI. Together we might then decide if they need to see an orthopaedic surgeon, or require treatment for pain by guided injection from a musculoskeletal specialist like myself, before being further advised by the physiotherapy consultant using an in-depth functional assessment and a course of exercises.
“Equally, this would apply to back conditions, shoulder problems and lower leg pain, for example.”
What are the benefits of SEM for patients?
- Faster time to recovery. Around 80% of injuries don’t require surgery. As operations typically have longer recovery times, SEM can advise on the optimal evidence-based pathway to recovery , helping patients to get back to the shape they were as quickly as possible, in the safest way.
- Specialised care. Consultants are experts in injuries borne from an extensive range of sports and activities and will use their knowledge to devise tailored treatment plans, corresponding to the individual’s unique needs.
- Effective treatment plans. Additional functional assessments conducted, which inform treatment plans. For instance, Dr Thomson uses a treadmill and iPad to record and assess runners – using slow-motion video aids the identification of possible causes of running injuries.
- Innovative treatment and techniques. Cutting-edge tools and treatment methods are used in SEM. Dr Thomson incorporates diagnostic musculoskeletal ultrasound into his clinical practice and can offer the additional facility of guided targeted injection.
How GPs can benefit
We all know how stretched GPs currently are. There is large area of musculoskeletal medicine that is undertreated in primary care partly due to time constraints. Patients may be appropriately treated for musculoskeletal conditions with anti-inflammatory medication or by referral directly to a physiotherapist; however, where SEM can help may be in understanding structure and function, resulting in more targeted treatment and providing an understanding of long-term injury prevention.
SEM teams can relieve the burden for GPs and work hand-in-hand with them to provide effective care for patients.
“If GPs feel like they are unable to manage a patient’s need alone, this is where we can step in,” states Dr Thomson. “We clinically assess their injury or condition, decide whether to take a surgical or non-surgical pathway and, if necessary, put together a management plan. This will save both the GP and patient time, with the patient receiving an accurate diagnosis and enabling them to kick-start treatment.”
Wider uses of SEM
SEM has proven to be hugely successful in the assessment, diagnosis and treatment of athletes and sports people, at recreational all the way up to elite level. But it also has wider implications, and could potentially be used for the treatment of people who lead inactive lifestyles.
“We’ve only just begun to uncover the tip of the ‘public health’ iceberg with SEM,” concludes Dr Thomson. “I envisage SEM being used in wider healthcare in the future – in the treatment of people with conditions such as type 2 diabetes and pre-diabetes. We could have a referral system where we offer tailored exercise programmes for patients who are inactive, overweight or obese who are particularly at risk of type 2 diabetes. It could have huge benefits for the public, encouraging a healthier lifestyle and reducing the increasing strain on our healthcare system.”
If you’re a GP or patient wanting to find out more about SEM and its benefits, call us on 020 3962 1279.