Sports Medicine is a relatively new science which has grown with the increasing professionalism of sport.  The science of sport is making rapid gains in performance but at the cost of increasing injuries.  Although this relates to the professional elite sports person, the majority of those participating in sport are not professional but rather recreational.  The issue is that this population is at an even greater risk of injury because they are not as prepared for the demands placed upon them by the sport that they participate in. 

This is what makes sporting injuries unique.  That is, the relationship between the sporting event and the occurrence of injury.  Injuries that occur as a direct result of sporting participation can be divided into two basic groups, which include injuries that result from;

1. A large force transmitted through a specific structure, either resulting from direct trauma or a particular event.
2. A small force that occurs repetitively during the course of the game or event.

The first scenario describes injuries such as concussion or fractures, as may occur in games such as boxing and all forms of rugby.  However, in addition it also includes events such as side-stepping and twisting on the weight-bearing leg causing a rupture of the Anterior Cruciate Ligament or as occurs when an opponent falls on the player trapping the foot underneath in a twisted position causing a tear of the distal tibiofibular syndesmosis. Appreciating the mechanism of injury is crucial in determining the potential structures injured.

The second group is those who present with, generally, a gradual onset of pain related to an injured structure due to repetitive activity.  The most common structure injured in this scenario is tendons.  In effect, the repetitive stress/force causes fatigue of the strained structure, ultimately leading to failure.  This is manifested as either a tear of the tendon, ligament, muscle, or a fracture of bone.  In this case, an intimate knowledge of the biomechanical forces associated with the particular sport is vital.  This is important, not only in evaluating which structure is likely to be injured but also in planning rehabilitation.

Although, determining the diagnosis of the injury is interesting and rewarding the greater challenge is in the rehabilitation of the athlete.  The aim is in returning them to their pre-injury level of performance.  This initially involves a graduated strengthening and stretching program which over time evolves to incorporate functional retraining.  This aims to prepare the athlete for their return to sport.  This process is best supervised by a physiotherapist with expertise in the management of sporting injuries.

In elite sports, there are often extra pressures upon the athlete to return to sport as quickly as possible.  The role of the treating physician often involves co-ordinating this process, as the leader of the multidisciplinary team including the coach, physiotherapist, and other allied health professionals.  The situation often presents itself when the doctor must assume the role of advocate for the athlete’s well being against the many, often powerful, competing influences to their return to sport.

A further important aspect to the management of sporting injuries is the recognition and treatment of the psychological consequences of the injury upon the athlete.  This may range from denial and unrealistic expectations, through anxiety, to depression in certain cases.