Sports Physicians - what you need to know

So I’m Injured: Should I just ask Facebook….or go an see an expert??

Around 65% of runners suffer a running injury in any given year. Injuries are particularly common in people new to the sport. Even seasoned athletes such as many of us Wild Things are at risk due to the high hours of participation and a tendency to push the limits when it comes to distance and terrain 

It has been suggested that 5-10% of intended running workouts do not get completed due to injury. As many of 50% of these are lost due to recurrent injuries.

Injury prevention strategies are important. Despite our best efforts though, many of us will end up in the hurt box at some point in our trail running journey. This will commonly be through overuse type injuries or trauma suffered on technical terrain. For many strains and sprains, assessment and treatment by a health care professional such as a physiotherapist along with time and training modifications lead to resolution of the injury.

But some injuries are serious, recurrent, not resolving, pain without a diagnosis or  time sensitive.

In these cases, seeking specialist medical advice may give you the best chance of returning to running as soon and as safely as possible. Fortunately there exists a species of Doctor that is especially interested and highly trained in the treatment of sick or injured athletes and exercisers.

Even better, if your problem is an injury accepted by ACC, the cost of accessing these experts, and any tests they may order, is largely funded under the ACC system (mostly it doesn’t cost you anything.)

 What is a Sports and Exercise Physician (Sports Medicine Doctor)?

A Sport and Exercise Physician is a Specialist Medical Doctor who has completed a medical degree and  a 4-year training program in Sport and Exercise Medicine. In New Zealand they are known as a Fellow of the Australasian College of Sport and Exercise Physicians (ACSEP). They are trained in:

1.     Diagnosis and assessment of musculoskeletal injuries in exercising individuals

2.     Diagnosis and management of medical problems in the context of exercise. (Such as anemia/ low ferritin, diabetes, athsma)

3.     Assisting specific groups with sport and exercise goals (Such as exercise in pregnancy, disabled sports).

4.     Medical issues in a sporting setting (such as medical screening, anti-doping compliance, medical care at events).

5.     They are involved with high level sports teams and athletes during training and in their practice.

6.     They can order  and interpret ALL the possible investigations that may be necessary. This includes X-ray, CT, MRI and other special imaging. They can order, and in some cases have access to, on-site ultrasonography for assessing injuries. In the case of medical issues they can order and interpret blood tests, ECGs, and refer as appropriate to other medical specialists. They also have access to specialised treatment modalities such as pulsed ultrasound to treat stress fractures.

7.     They all participate in Continuing Medical Education (CME) programs examining the latest findings on care of the injured athlete.

How can I find one in my region?

There are Specialist Sports and Exercise Physicians in Auckland, Hamilton, Tauranga, Palmerston North, Wellington, Christchurch, Queenstown and Dunedin.

On the ACSEP website www.acsep.org.au scroll down to the “Find a Sport and Exercise Physician” bar half way down the page and search by region.

Do I need a referral and how much will it cost? 

Yes. Sports Physicians are Specialists require a referral. This is most commonly provided by a GP or a physiotherapist and the Sports Physician will then work with them to plan your management. However any ACC provider (including Chiropractors, Osteopaths etc) who can fill out an ACC form are able to provide a referral. If you have an ACC number (your problem is due to an injury), then ACC will pay the cost of the specialist consultations and most if not all of the cost of any investigations that may be necessary (such as MRI scans).

If you have a medical problem not covered by ACC, then a Specialist fee will apply. This can be determined by phoning the individual practice. This may be covered by some types of comprehensive medical insurance plans but you would need to check with the individual insurance company.

Consultations with Sports Physicians cannot be accessed via the public health system.

What if I don’t live in a major centre?

GPs can undertake Diploma Level courses in Sports Medicine and there may well be GPs in your town or area who have an interest and/or qualifications in this field. Your own GP or Physio will probably know who they are.

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Terri Bidwell has extensive experience as an endurance athlete. She has run over 50 marathons and many Ultramarathons, including the legendary Marathon des Sables stage race. She has raced paddle boards, taken part in marathon open water swimming events and is a 4x Ironman Triathlete (and two-time Kona qualifier.) She holds Science & Medicine degrees (BHB, MBChB 1996 Auckland ) and has been in specialist practice as an orthopaedic surgeon for 10 years. She has twice been Race Doctor at Ironman Hawaii and is a regular on the medical team for the Tarawera Ultramarathon. 

Terri will be contributing a series of articles on medical/injury matters for Wild Things. Thanks Terri!