It is the start of soccer season and Sarah is playing in her second game; she fakes to the right and tries to outrun her opponent when she is suddenly hit in the knee, immediately experiencing pain. She is helped off the field, but now what?
Many of you, just like Sarah, may experience your first sports injury and wonder who do I go see first? What are my options? Who should I trust?
The main players that may come to mind are athletic trainers, urgent cares/emergency rooms, family practice physicians and orthopedic surgeons. We are here to discuss all these options, so you feel confident in seeking the right care after a sports injury.
First stop is your school’s athletic trainer (AT); he or she works with athletes of all ages and skill levels to prevent and treat injuries that occur during practices or games. They are board certified and have completed a bachelor degree program in their field, participating in countless hours of hands-on training before graduation. The duties of an athletic trainer are to evaluate injuries and provide first-aid to student athletes. When you think of an AT, think first line responder. These professionals can assess the situation and make decisions such as whether your ankle may just need some ice and taping or it requires them to pull you from playing. Not only can they start treatment for your injury, they can help to facilitate you receiving further, more specialized treatment when needed by your local orthopedic surgeon.
After consulting your athletic trainer, if they are unable to provide adequate treatment for the severity of your injury, you may seek care in the emergency department (ED) or an urgent care facility. These places offer diagnostic imaging and skilled healthcare professionals who are trained to treat emergent injuries. The ED or urgent care is an appropriate choice when there is suspicion for an acute fracture, loss of consciousness or your shoulder is dislocated and remains out of place. You will receive the care you need to safely return home and you may be referred to an orthopedic surgeon for further follow up treatment once discharged.
What if your sports injury is not acute? You may have had nonspecific knee or ankle pain for the last few months and are wondering where to start. As we discussed previously, athletic trainers are always a great first line. They may be able to work with you to provide therapeutic exercises, kinetic taping, or a wide range of modalities to get you back to playing. If you do not have an AT available and are experiencing chronic pain, you may see your family practice physician. These are doctors who have gone through medical school and a three-year residency focusing on the general care of patients of all ages. They are experts at managing common complaints. It varies from practice to practice whether imaging services are available, but these physicians can offer the start to treatment and diagnosis of sports or activity related ailments. If the injury does not resolve or requires specialized testing, family practice physicians have the ability to refer patients to an orthopedic surgery practice for a higher level of care.
We keep mentioning orthopedic surgeons, so who are they?
An orthopedic sports medicine surgeon is a doctor who has gone through medical school, a five-year orthopedic surgery residency, and an additional year fellowship to specialize in sports medicine. Think of orthopedic surgeons as your number one “go to” for sports related injuries. A great way to highlight their experience is through Malcom Gladwell’s book, Outliers, the story of success, and anyone familiar with it knows about the 10,000-hour rule. According to his research, it takes 10,000 hours of focused experience in a certain area to develop technical expertise. When you visit an orthopedic surgeon, you are being treated by a physician who has concentrated expertise in treating your injury and who is able to give you the most experienced and informed treatment. They are there to be part of your journey from evaluating your complaint, to obtaining necessary diagnostics, to discerning the most appropriate treatment, and working with their team to get you back to play. From acute injuries such as muscle strains, knee and shoulder injuries and fractures to overuse injuries like tendonitis, a sports medicine orthopedic surgeon can handle it. And although “surgeon” is in their title, it is necessary to note that not every condition requires surgery. They are experts who can help make the right decision on treatment for you and your injury, whether it be conservative treatment with bracing, physical therapy or injections or if your injury is severe enough to require surgery.
Now let's think back to Sarah and her new onset knee pain following an injury at her soccer game. With our new information, do we know who she should see? If you are thinking the athletic trainer, our first line responder, then you are correct. She should be evaluated first by the AT to assess the injury and receive immediate care. From there, if the AT has suspicion of a serious injury such as swelling and inability to bear weight on the leg, he or she will likely refer Sarah to an orthopedic surgeon for further specialized care she can trust.