Tuesday, February 1, 2000

Building a Sports Doctor Network - It's Time

by Dr. Tim Maggs, © February 2000

"Dr. Maggs, do you know of a good sports doctor in Toledo, Ohio who could help me with my knee problem?"

"Hey, Running Dr. Do you happen to know who you could refer me to in Boise, Idaho who could help me with my calf problems?"

"Hey doc, do you know anyone anywhere who could help?"

When asked this question time and time again, the sad truth is, I don't know anyone. Heck, I'm afraid to send people to docs in my own hometown who I've known for 20 years. The doctor-patient relationship is a fragile piece of business, like a boyfriend-girlfriend, or even husband-wife. I introduced a couple once in my life, and they ended up in divorce. I'm willing to quit at 0 for 1.

But, beyond these personal idiosyncrasies, a much larger problem looms out there. The Internet, websites and e-mail have given people the tremendous opportunity to reach out and locate experts and information that 10 years ago was impossible. Sometimes finding the good information solves one problem but creates a much bigger one--how to take advantage of it. That's not always so easy.

It's become increasingly difficult for many runners to find the perfect sports doctor in their own town who can answer their needs. Managed Care directs many runners to their primary care providers, who will be the first to admit they don't know how to treat many of these common running injuries. They may refer them to another specialist or two, run some tests that don't show anything, and then suggest the patient should maybe stop running. The patient who gets caught on this medical treadmill very often jumps off out of frustration before ever getting the help they need.

The average doctor, whether they're a medical doctor, osteopath or chiropractor, is usually not skilled enough to accurately diagnose biomechanical injuries and develop successful rehabilitative programs. And as much as some people don't want to believe that, you better start believing there's a whole lot more to sportsmedicine than anti-inflammatories, injections of cortisone and the "Final Kahuna" recommendation--stop running.

Sportsmedicine Online

In the many e-mails I receive, most are asking for help, but many are also asking for referrals. A lot of these runners get excited when they come upon some useful and relevant information, whether it be on my site or someone else's. Unfortunately, it's like building Noah's Ark in the basement. They have no doctor who works local to them who understands the psychoses of us runners and how to diagnose and treat the many maladies we suffer with. Someone must give of themselves (by leading the charge to build this network) for the sanity of us all. It's time.

Now, if I were in charge, I'd want to begin with a network of docs and therapists who specialize in biomechanics. Most running injuries are due to repetitive motion and biomechanical defects. This network would address the largest percentage of injuries out there. Following this network, others might include a podiatric network, a network for internal problems and infectious diseases and a network for psychological problems. But I believe the biomechanical network is Goal #1.

High Standards

The most important issue in developing this network must be the standards needed to qualify as a provider. Today, with the popularity of sportsmedicine, many doctors and therapists promote themselves as sports experts, but in reality, they are using this for marketing purposes. They're not really qualified to address runner's problems.

The providers who qualify must understand biomechanics. Their exams must involve the detection of normal and abnormal joint motion in all joints of the body, muscle strength, flexibility and balance, leg length differences, spinal alignment, spinal curvature, an understanding of the arches of the feet and the role they play, as well as the ability to interpret x-ray findings. Communication skills (to explain the details to the patient), good management skills (to manage the patient through the necessary corrections) and the ability to understand the different psychological profiles, will only help the treating doctor get good results.

There are a variety of ways to reach out to find these doctors, and some of these doctors may need some guidance and teaching from more experienced sports biomechanics docs to become fully qualified. But the movement must begin. This program would probably be most effective if it were done regionally to start. Any docs out there who have an interest should be willing to go through an evaluation of their knowledge and willingness to do a good job, and any patients out there should encourage their doctor, if they have a good one, to become a part of this network.

As to who will provide the classes, who will organize the search and conquer program and all the other tasks that go along with this idea, I don't know. My job today is simply to propose the concept, and see if my simple idea can lead to an ultimate sportsmedicine biomechanics network so that every runner in the U.S. will have a qualified sports doctor in their hometown to diagnose and treat most of their running injuries.

Hey, don't blame me, I'm an optimist.

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