Sports orthopaedics is part of sports medicine and orthopaedics, which in turn are part of human medicine. In both areas, sports orthopaedics is not clearly defined and is not considered a separate and independent field.
Sports orthopaedists have a wide range of tasks:
- Diagnosis and treatment of sports injuries and degenerative diseases
- prevention
- Care of top athletes and ambitious amateurs
It doesn't always have to be bone fractures, meniscus tears or cruciate ligament ruptures: Tense muscles in the shoulders and neck, bruises, tennis elbows or sprains also fall into the field of sports orthopaedics.
Sports orthopaedics often deals with large joints such as the shoulder, knee, ankle or elbow.
This involves not only bones and joints, but also tendons, muscles and ligaments.
In Germany, the most common sports injuries occur in soccer, but jogging, tennis and other ball sports also keep orthopaedists busy.
This is because typical injuries and complaints often arise in one sport:
- Soccer: knee and ankle injuries due to twisting and bruising
- Jogging: Runner's knee and ankle injuries
- Cyclists: back pain and neck pain
- Skiing: bruises, fractures, "ski thumb"
- Tennis: tennis elbow, tendinitis, knee and ankle injuries
.jpg "Fußgelenkverletzung beim Joggen")
Ankle injuries often happen to joggers when they twist their ankle while running @ Jo Panuwat D /AdobeStock
The therapies are just as varied as the injuries and complaints that orthopaedists treat. The PECH rule has established itself as an effective immediate measure:
- Rest
- ice
- Compression and
- elevation
These measures help to minimize the damage caused by muscle and joint injuries. Sports orthopaedists also treat patients with pain-relieving medication in the form of ointments, injections or tablets.
Occasionally, other medications are also used, for example as part of infiltration therapy. Sports orthopaedists use injection therapy to support the regeneration and healing of muscles or cartilage.
Chronic complaints can often be alleviated by physiotherapy, physical therapy or remedial gymnastics. These therapy methods are often also part of rehabilitation measures after an operation.
This is because they help to restore the mobility of joints and muscles and to increase the load sensibly. Kinesiology taping or shock wave therapy are also an integral part of the orthopaedic surgeon's "toolbox" and help with mild to moderate complaints.
For serious injuries, however, surgical treatment is often the only option. Joints are increasingly being treated arthroscopically. This means that they are diagnosed and treated using an endoscope.
With this minimally invasive procedure, doctors avoid having to open the joint completely and treat the patient much more gently.
An essential part of physiotherapy practice is orthopaedic treatment of acute to chronic pain @ Louis-Photo /AdobeStock
As in any medical field, the diagnosis in sports orthopaedics begins with a detailed medical history. This is because two pieces of information are important for the further examination:
- how the injury occurred and
- what symptoms the patient is suffering from
In some cases, palpation and movement of the body part are sufficient for further diagnosis. For a reliable diagnosis of more serious injuries or complaints, the doctor also needs an imaging procedure as support.
A sports orthopaedist uses X-rays to diagnose bone fractures and bone scans to analyze the density of the bones.
Computed tomography (CT) and magnetic resonance imaging (MRI) are indispensable in sports orthopaedics. MRI in particular makes it possible to diagnose ligaments, tendons, meniscus or muscles very precisely from the outside.
In many cases, it is the diagnostic tool of choice because it provides detailed images. The only disadvantage is that it is not conclusive enough in the case of a fresh injury with severe swelling.
CT helps in the diagnosis of bony injuries or damage to soft tissue.
Orthopaedic surgeons are increasingly turning to ultrasound for acute injuries. It enables them to assess the severity of muscle and ligament injuries.
A major advantage is the dynamic examination, which enables the orthopaedic surgeon to assess the function of injured ligaments. More and more sports physicians are rediscovering sonography because it enables a much better assessment of further therapy.
For runners or athletes with foot problems, computer-aided foot pressure measurement opens up new diagnostic possibilities. With a pedoscan of this kind, the doctor can see exactly where problems and imbalances are.
This enables them to recommend specific insoles or surgical interventions. And every runner is probably familiar with treadmill analysis, which can be used to analyze running style and foot misalignments.
The electronic foot pressure measurement makes orthopaedic foot problems visible and helps the specialist to make a diagnosis @ Lubo Ivanko /AdobeStock
Sports orthopaedists are highly specialized and, in larger cities, join forces with colleagues in group practices or centers.
Sports orthopaedics is much more frequently a sub-area of orthopaedics in orthopaedic practices because an orthopaedist has undergone appropriate further training.
This makes sense because orthopaedists in practices often diagnose and treat sports injuries. In-depth knowledge is valuable in their day-to-day work.
To be able to call yourself a sports orthopaedist, two steps are necessary.
- The first step is training as an orthopaedic specialist
- Then there is additional specialization
How complex this is depends on the society that carries it out.
At the German Society for Sport and Prevention, prospective sports physicians need around 240 hours of further training per course.
In addition, they have to accompany a sports club for 120 hours as a sports physician. Doctors can also specialize further.
To obtain a certificate as a GOTS sports physician, four two-day modules and a passed test are required in addition to the sports orthopaedic activity.
If patients want to find experts in sports medicine, completed further training and certificates are a good indication.
Sports orthopaedists often do not work in isolation, but instead join forces with experts from other disciplines. In sports medicine centers, doctors can then advise and treat athletes from different perspectives.
They offer a good combination of expert knowledge, especially for top athletes and recreational athletes with chronic complaints.
Sports orthopaedists also work in hospitals and clinics. Sports orthopaedics is firmly established in university hospitals in particular.
Here you will find specialists who are often well versed in the subject and up to date. This is because they conduct research in their subject area, carry out studies and exchange information intensively with colleagues.
Of course, a large part of their work also involves the surgical treatment of sports injuries.
