Dr Akshai Mansingh/Contributor
IN OUR first Sport Pulse column, we made mention of the Faculty of Sport at The University of the West Indies raising the level of academic offerings in sport, along with coordinating the university sporting teams and social outreach and support programmes.
The Mona campus had been involved in advancing the specialty of sports medicine long before the faculty was established in 2017.
In 2006, an MSc Sports Medicine programme for physicians was initiated to introduce a specialty of sports medicine to the region. A few years later, the MSc Sports and Exercise Medicine-Physiotherapy became the first postgraduate physiotherapy programme offered by the university, thereby producing sport physiotherapists.
As advances in sport have been based on greater attention to science and technology, the support staff has also had to upskill and specialise. Coaches not versed with the basics of biomechanics, data and video analysis, and a general appreciation of sports medicine, are disadvantaged and often disqualified from top jobs.
Traditionally, a cricket team travelled with only a manager, and a tennis player with their coach. It is now commonplace for the support staff to exceed the number of coaches. This is because optimal performance requires input from highly specialised support staff.
The specialty of sports medicine encompasses an in-depth knowledge of sports nutrition, sports psychology, biomechanics, sports physiology, injury management and rehabilitation, as well as the intricacies of anti-doping policies. The sports medicine doctor and physiotherapist can guide athletes in fitness analysis specific to a sport, as well as advising on individualised programmes for each athlete. The other arm of sports medicine is the use of exercise in controlling non-communicable diseases such as hypertension, diabetes, osteoporosis, and many others that afflict the region. The ability of the sports physician or sports physiotherapist to set up individualised exercise prescriptions, inclusive of guidance on sports nutrition, has seen a reduction in the dependency on medication and its associated costs.
The field of medicine is traditionally based on a vertical ladder whereby 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 garnered by the specialist.
The sports medicine model is more of a wheel and spoke whereby the athlete is in the centre and all the interconnected spokes of the wheel lead to the betterment of the athlete. This includes coaches, sports medicine physicians and physiotherapists, families and all other support structures. Any of these can interact with and refer to each other. If further specialists are needed, then one can integrate the sports psychologists, sports nutritionists, sports physiologists, etc.
The sports physician has a responsibility to integrate the medical management, inclusive of injuries. Most sports physicians are versed in ultrasound investigation and are versed with indications for when to order more in-depth investigation. The prevailing view that all injuries must be investigated with an MRI scan is erroneous and highly expensive. Many injuries are over-investigated or wrongly investigated. In countries like Australia, the government will subsidise an MRI investigation ordered by an orthopaedic surgeon or sports medicine physician, but the cost of referral from all others must be borne by the patient fully.
Another misconception is that sports medicine applies only to elite athletes. In fact, sports medicine specialists also tend to recreational and competitive athletes. In other sportingly advanced countries, sports physicians and sports physiotherapists are engaged to care for high school and college athletes, sports clubs and teams as well as elite sports.
That concept has not caught on in Jamaica where it is still commonplace to have a general doctor or physiotherapist, or a specialist in a completely different field of medicine, look after athletes. The culture of relying on gratis services rather than specialist services has cost many young athletes their sporting careers, as injuries are either misdiagnosed, mismanaged, or athletic potential is not unearthed.
This culture of utilising anyone who would provide the service for free has had its consequences. Whereas we bask in producing the Usain Bolt, Shelly-Ann Fraser-Pryce, Elaine Thompson Herah and the likes, one shudders to think how many similar athletes have been lost by the wayside because of improper intervention by the non-specialists.
It literally is asking a skin specialist to deliver your baby or remove your kidney stones.
Since inception, the sports medicine division has produced graduates that have served as sports physicians and physiotherapists for Jamaica, Antigua, Bahamas, Barbados, Cayman Islands, Guyana, St Vincent and the Grenadines, and Trinidad and Tobago.
There is also a dearth of sports medicine centres operated by fully qualified sport specialists in Jamaica. The UWI Sports Medicine Centre 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 expansion of this as a Jamaica 60 legacy project shows their commitment to providing sports specialist services to all.
Sport Pulse and Sport Matters are fortnightly columns highlighting advances that impact sport. We look forward to your continued readership.
Dr Akshai Mansingh is Dean, Faculty of Sport, UWI. He can be reached at akshai.mansingh@uwi.edu [2]