Dr Akshai Mansingh/Contributor
In our first Sport Pulse column, we mentioned the Faculty of Sport at the University of the West Indies raising the level of academic offerings in sport, along with co-ordinating university sports teams and outreach and social support programmes.
The Mona campus was involved in the advancement of the specialty of sports medicine long before the faculty was founded in 2017.
In 2006, an MSc program in Sports Medicine for physicians was launched to introduce a sports medicine specialty to the region. A few years later, the MSc Sports and Exercise Medicine-Physiotherapy became the first postgraduate physiotherapy program offered by the university, thus producing sports physiotherapists.
As advances in sports have been based on greater attention to science and technology, the support staff also needs to be upgraded and specialized. Trainers who are not proficient in the basics of biomechanics, data and video analysis, and a general appreciation of sports medicine are at a disadvantage and are often disqualified from top jobs.
Traditionally, a cricket team traveled with only one manager and one tennis player with their coach. It is now common for the support staff to outnumber the coaches. This is because optimal performance requires input from highly specialized support staff.
The specialty of sports medicine includes an in-depth knowledge of sports nutrition, sports psychology, biomechanics, sports physiology, injury management and rehabilitation, and the intricacies of anti-doping policies. The sports medicine doctor and physiotherapist can guide athletes in sport-specific fitness analysis, as well as advise on individualized programs for each athlete. The other branch of sports medicine is the use of exercise in the control of non-communicable diseases such as hypertension, diabetes, osteoporosis and many others that affect the region. The ability of the sports physician or sports physiotherapist to establish individualized exercise prescriptions, including sports nutrition guidelines, has seen a reduction in medication dependency and associated costs.
The field of medicine is traditionally based on a vertical ladder where a patient presents to a general practitioner who treats most patients but would refer complicated cases to the relevant specialist. Support from physiotherapists and other paramedical specialties is usually provided by the specialist.
The sports medicine model is more of a wheel and spokes where the athlete is at the center and all the interconnected spokes of the wheel lead to the improvement of the athlete. This includes coaches, sports medicine doctors and physiotherapists, families and all other support structures. Each of them can interact and refer to each other. If further specialists are needed, then sports psychologists, sports nutritionists, sports physiologists, etc. can be integrated.
The sports physician has the responsibility to integrate medical management, including injuries. Most sports physicians are skilled in ultrasound examination and are prepared with the indications of when to order a more in-depth examination. The prevailing view that all injuries should be investigated with an MRI scan is wrong and very expensive. Many injuries are over-investigated or mis-investigated. In countries such as Australia, the government will subsidize an MRI investigation ordered by an orthopedic surgeon or sports medicine physician, but the cost of a referral from anyone else must be borne entirely by the patient.
Another misconception is that sports medicine only applies to elite athletes. In fact, sports medicine specialists tend to both recreational and competitive athletes. In other sportingly advanced countries, sports doctors and sports physiotherapists are engaged in caring for high school and college athletes, club and team sports, and elite sports.
This concept has not been implemented in Jamaica, where it is still common for a general practitioner or physiotherapist, or a specialist in a completely different field of medicine, to care for athletes. The culture of relying on free services rather than specialist services has cost many young athletes their sporting careers, as injuries are either misdiagnosed, mismanaged or athletic potential is not discovered.
This culture of exploiting anyone who would offer free service has had its consequences. As we bask in the production of Usain Bolt, Shelly-Ann Fraser-Pryce, Elaine Thompson Herah and the like, one shudders to think how many similar athletes have been lost along the way due to improper intervention by non-specialists.
It’s literally asking a skin specialist to deliver your baby or remove your kidney stones.
Since its inception, the sports medicine division has produced graduates who have served as sports physicians and physical therapists for Jamaica, Antigua, Bahamas, Barbados, Cayman Islands, Guyana, Saint Vincent and the Grenadines, and Trinidad and Tobago.
There is also a lack of sports medicine centers operated by fully qualified sports specialists in Jamaica. The UWI Sports Medicine Center is perhaps the only one with such an integrated service. This has provided services to all athletes in the region since 2008. The fact that the government has announced the expansion of this project as a Jamaica 60 heritage project shows their commitment to providing specialist sports services for all.
Sport Pulse and Sport Matters are bi-weekly columns highlighting developments affecting sports. We look forward to your continued readers.
Dr Akshai Mansingh is Dean, Faculty of Sport, UWI. He can be reached at [email protected]
