What’s the difference between Medicine and Sports Medicine?

I was recently asked to talk to a group of students about high performance sport. We discussed all the “usual” topics: talent identification, sports science, elite coach development and sports medicine.

One of the students asked me, “Is there a difference between Medicine (as in general practice medicine) and Sports Medicine as it exists in high performance sport”?

Here’s what I replied:

1. Medicine in general practice is conservative in nature. Sports medicine / physiotherapy in high performance sport needs to be aggressive, goal orientated and time focused, i.e. better results in a shorter time. It is all about performance under pressure.
2. Medicine in general society is hierarchical. Sports medicine / physiotherapy in high performance sport is interdisciplinary and works best when professionals work as equals in problem solving, performance focused teams.
3. Medicine in society is in general 9 – 5pm and 5 days a week. Sports medicine / physiotherapy in high performance sport is 24 / 7, e.g. arranging for an athlete to have an MRI at 2 am Sunday morning so you can start treating them at 2:15 am Sunday morning.
4. Medicine in society is evidence based. Sports medicine / physiotherapy in high performance sport sometimes demands innovation, instinct and intelligent guess work (within ethical conventions).
5. Medicine in society generally follows a systematic process from assessment to treatment and recovery. Sports medicine / physiotherapy in high performance sport often needs to involve short cuts and respond to the needs of the situation, e.g. Grand Final week.
6. Medicine in society follows a medical practitioner driven model. Sports medicine / physiotherapy in high performance sport is a needs based, problem solving approach which may mean other practitioners and professionals may lead the treatment / recovery process at different times, e.g. strength and conditioning coach, sports massage therapist, sports psychologist.
7. Medicine in society depends on the patient following the practitioner’s advice. In professional sport, players may be required to follow medical advice including surgery as a contractual commitment.
8. Medicine in society usually means practitioners operating in silos as individual practitioners. Sports medicine / physiotherapy in high performance sport requires practitioners to work within a team which may include athletes, coaches, management, other medical practitioners, psychologists, nutritionists and others.
9. Medicine in society has to include a lot of public relations, customer relations and be business focused for survival. High performance sport is about performance – not making friends or growing a business.
10. Medicine in society is in general a long way behind cutting edge research and the latest thinking in the assessment and treatment of injury and illness owing to the need to be operating with a high level of clinical responsibility. High performance sport means sometimes making it up as you go along, i.e. 0.01 versus 0.50.

Wayne Goldsmith