Sports physicians, also known as team physicians, treat patients who have sustained injuries to their musculoskeletal systems during the play or practice of an individual or team sporting event. Sports physicians also do preparticipation tests and physical exams. Some sports physicians create educational programs to help athletes prevent injury. Sports physicians work for schools, universities, hospitals, and private offices; some also travel and treat members of professional sports teams.
History of Sports Physician Career
The field of sports medicine, and nearly all the careers related to it, owes its foundation to experiments and studies conducted by Aristotle, Leonardo da Vinci, and Etienne Jules Marey. Aristotle’s treatise on the gaits of humans and animals established the beginning of biomechanics. In one experiment, he used the sun as a transducer to illustrate how a person, when walking in a straight line, actually throws a shadow that produces not a correspondingly straight line, but a zigzag line. Leonardo da Vinci’s forays into the range and type of human motion explored a number of questions, including grade locomotion, wind resistance on the body, the projection of the center of gravity onto a base of support, and stepping and standing studies.
However it was Marey, a French physiologist, who created much more advanced devices to study human motion. In fact, sports medicine and modern cinematography both claim him as the father of their respective fields. Marey built the first force platform, a device that was able to visualize the forces between the foot and the floor. Californian photographer Eadweard Muybridge’s serial photographs of a horse in motion inspired Marey’s invention of the chronophotograph. In contrast to Muybridge’s consecutive frames, taken by several cameras, Marey’s pictures with the chronophotograph superimposed the stages of action onto a single photograph; in essence, giving form to motion. By 1892, Marey had made primitive motion pictures, but his efforts were quickly eclipsed by those of film pioneers Louis and Auguste Lumiere.
Following both World Wars I and II, Marey’s and others scientists’ experiments with motion would combine with medicine’s need to heal and/or completely replace the limbs of war veterans. To provide an amputee with a prosthetic device that would come as close as possible to replicating the movement and functional value of a real limb, scientists and doctors began to work together at understanding the range of motion peculiar to the human body.
Sports can be categorized according to the kinds of movements used. Each individual sport uses a unique combination of basic motions, including walking, running, jumping, kicking, and throwing. These basic motions have all been rigidly defined for scientific study so that injuries related to these motions can be better understood and treated. For example, sports that place heavy demands on one part of an athlete’s body may overload that part and produce an injury, such as “tennis elbow” and “swimmer’s shoulder.” Baseball, on the other hand, is a throwing sport and certain injuries from overuse of the shoulder and elbow are expected. Athletes who play volleyball or golf also use some variation of the throwing motion, and therefore also sustain injuries to their shoulders and elbows.
Today, sports medicine concentrates on the treatment and prevention of injuries sustained while participating in sports. Sports medicine is not a single career but a group of careers that is concerned with the health of the athlete. For its specific purposes, the field of sports medicine defines athlete as both the amateur athlete who exercises for health and recreation, and the elite athlete who is involved in sports at the collegiate, Olympic, or professional level. Sports physicians treat people of all ages and abilities, including those with disabilities.
Among the professions in the field of sports medicine are the trainer, physical therapist, physiologist, biomechanical engineer, nutritionist, psychologist, and physician. In addition, the field of sports medicine also encompasses the work of those who conduct research to determine the causes of sports injuries. Discoveries made by researchers in sports medicine have spread from orthopedics to almost every branch of medicine.
Arthroscopic surgery falls into this category. It was developed by orthopedic surgeons to see and operate on skeletal joints without a large open incision. The arthroscope itself is a slender cylinder with a series of lenses that transmit the image from the joint to the eye. The lens system is surrounded by glass fibers designed to transfer light from an external source to the joint. Inserted into the joint through one small, dime- to quarter-sized incision, the arthroscope functions as the surgeon’s “eyes” to allow pinpoint accuracy when operating. The surgical elements, themselves, are inserted through other small incisions nearby. In the 1970s only a few surgeons used the techniques of arthroscopy and did so as an exploratory measure to determine whether or not traditional surgery had a good chance of succeeding. Today, arthroscopy is the most commonly performed orthopedic surgery performed in the United States; instead of being an exploratory procedure, 80 percent of all arthroscopic surgeries are performed to repair tissue damage.
The Job of Sports Physicians
Sports physicians treat the injuries and illnesses of both the amateur and elite athlete. They are often referred to as team physicians. Depending upon the level of athlete they are treating, sports physicians are usually either practitioners in family practice as medical doctors (M.D.’s) or orthopedic surgeons. More often than not, the individual who works as the team physician for a professional sports team is too busy tending to the health needs of the team to have time for a private practice as well.
Brent Rich, M.D., head team physician for Arizona State University and Team Physician for the Arizona Diamondbacks, agrees that there are some varieties of sports physicians: “Sports physicians come in two major varieties: primary care providers with training in nonsurgical sports medicine and orthopedic surgeons. The majority of sports physicians are in private practice. Each area has its rewards and downfalls. As a board-certified family physician, I deal with about 90 percent of what goes on in the sports medicine arena.”
At the scholastic level, the team physician is usually the school physician and is appointed by the school board. Athletic programs at the collegiate level are usually capable of supporting a staff of one or more physicians who cater to the needs of the athletic teams. The size of the school and athletic program also determines the number of full-time physicians; for example, a state university basketball team might have one physician, even an orthopedic surgeon, dedicated wholly to that team’s needs.
Professional teams, of course, have the necessary resources to employee both a full-time physician and an orthopedic surgeon. Generally, their presence is required at all practices and games. Often, professional teams have a sports medicine department to handle the various aspects of treatment, from training to nutrition to mental health. If they don’t have their own department, they take advantage of the specialists at university hospitals and private care facilities in the area.
To fully understand the nature of a particular sports injury, sports physicians study the athlete as well as the sport. The musculoskeletal system is a complex organization of muscle segments, each related to the function of others through connecting bones and articulations. Pathological states of the musculoskeletal system are reflected in deficits (weaknesses in key muscle segments) that may actually be quite distant from the site of the injury or trauma. The risk factors for any given sport can be assessed by comparing the performance demands that regularly produce characteristic injuries with the risk factors that might predispose an athlete to injury.
Strength and flexibility, for example, are requirements for nearly every sport. Stronger muscles improve an athlete’s performance, and deficits in strength can leave him or her prone to injury. Rehabilitation under the supervision of a sports physician focuses on rebuilding lost muscle strength. Likewise, an athlete who lacks flexibility may subject himself or herself to strains or pulls on his or her muscles. For this athlete, rehabilitation would center on warming and stretching the isolated muscles, as well as muscle groups, to reduce or alleviate such muscle strains. In both cases, it is the responsibility of the sports physician to analyze the potential for injury and work with other sports health professionals to prevent it, as well as to treat the injury after it happens. The goal of every sports physician is to keep athletes performing to the best of their ability and to rehabilitate them safely and quickly after they are injured.
To prevent injuries, as well as treat them, sports physicians administer or supervise physical examinations of the athletes under their care to determine the fitness level of each athlete prior to that athlete actively pursuing the sport. During the exams, sports physicians note any physical traits, defects, previous injuries, or weaknesses. They also check the player’s maturity, coordination, stamina, balance, strength, and emotional state. The physical examination accomplishes many different goals. To begin with, it quickly establishes the athlete’s state of health and allows the sports physician to determine whether that athlete is physically capable of playing his or her sport. On the basis of the physical exam, the sports physician advises the coach on the fitness level of the athlete, which in turn determines a great deal about the athlete’s position on the team. Furthermore, the exam alerts the sports physician to signs of injury, both old and new. Old or existing injuries can be noted and put under observation, and weaknesses can be detected early on so that coach and trainers can implement proper conditioning and training patterns.
Depending upon the results of their physical examinations, the sports physician may advise athletes to gain or lose weight, change their eating, drinking, and sleeping habits, or alter their training programs to include more strength or cardiovascular exercises. Routine physical checkups are also a common way of evaluating an athlete’s performance level throughout a season, and many sports physicians will administer several exams to gauge the effect of their advice, as well as to ensure that the athlete is making the suggested changes in habits or training.
Preventing injuries is the sports physician’s first goal and conditioning is probably the best way to accomplish that goal. Sports physicians are often responsible for developing and supervising the conditioning and training programs that other sports health professionals will implement. The sports physician may work with the coaching staff and athletic trainers to help athletes develop strength, cardiovascular fitness, and flexibility, or the sports physician may advise the coaching and training staff members of the overall safety of a practice program. For example, the sports physician may evaluate the drills and practice exercises that a football coach is using on a given day to make certain that the exercises won’t exacerbate old injuries or cause new ones. Sports physicians may even be involved in the selection of protective gear and equipment. The degree of their involvement, again, depends on the size of the team and the nature of the physicians’ skills or expertise, as well as on the number of other people on the staff. Large, professional teams tend to have equally large staffs on which one person alone is responsible for ordering and maintaining the protective gear.
Sports physicians are often in attendance at practices (or they are nearby, in case of an injury), but their presence at games is mandatory. If a player shows signs of undue fatigue, exhaustion, or injury, the sports physician needs to be there to remove the athlete from the competition. Dr. Rich says being at the games is one of the perks of his profession: “To see others accomplish what they desire gives me satisfaction. Another good part is covering sports events and feeling a part of the action on the sidelines, in the locker room, or in the heat of the battle.”
After an athlete is injured, the sports physician must be capable of immediately administering first aid or other procedures. He or she first examines the athlete to determine the gravity and extent of the injury. If the damage is extreme enough (or cannot be determined from a manual and visual exam), the sports physician may send the athlete to the hospital for X rays or other diagnostic examinations. Later, the team physician may perform surgery or recommend that the athlete undergo treatment or surgery by a specialist. Some of the most common types of injuries are stress fractures, knee injuries, back injuries, shoulder injuries, and elbow injuries.
The sports physician oversees the athlete’s recuperation and rehabilitation following an injury, including the nature and timing of physical therapy. The athlete’s return to practice and competition is determined by the sports physician’s analysis of the athlete’s progress. Frequent physical examinations allow the physician to judge whether or not the athlete is fit enough to return to full activity. The decision to allow an athlete to compete again following an injury is a responsibility that sports physicians take seriously; whether the athlete is an amateur or an elite professional, the future health and well-being of the athlete is at stake and cannot be risked, even for an important championship game.
A developing area of the sports physician’s responsibilities is the diagnosis and treatment of substanceabuse problems. Unfortunately, even as research on the field of sports medicine has produced new methods and medications that mask pain and decrease inflammation— which shortens recovery time and lengthens athletic careers—some also produce unnatural performance enhancement. Most notable of these are anabolic steroids—synthetic modifications of the male hormone, testosterone—which have become widely abused by athletes who use them to better their performances. When taken while on a high-protein diet and an intensive exercise regimen, these drugs can increase muscle bulk, which in turn can produce increased strength, speed, and stamina. The side effects of these drugs, however, include aggression, sterility, liver problems, premature closure of the growth plates of the long bones, and in women, male pattern baldness and facial hair. These side effects are usually irreversible and, as such, pose a significant health risk for young athletes.
Another method also banned from use in competition- level athletics is the withdrawal of an athlete’s blood several weeks prior to competition. The blood is stored and then, just before the athlete competes, the blood is transfused back into his or her bloodstream. This process, blood doping, also has serious, even fatal, side effects, including heart failure and death.
Finally, professional athletes sometimes develop substance- abuse problems, such as alcohol or drug abuse. Sports physicians are responsible for detecting all of these problems and helping the athlete return to a healthy lifestyle, which may or may not include competing in their sport.
In addition to the responsibilities and duties outlined above, many sports physicians also perform clinical studies and work with researchers to determine ways of improving sports medicine practices. Often, the results of such studies and research are published in medical journals and popular magazines.
Sports Physician Career Requirements
During high school, take as many health and sportsrelated classes as possible. Biology, chemistry, health, computers, and English are important core courses. High grades in high school are important for anyone aspiring to join the medical profession, because competition for acceptance into medical programs at colleges and universities is always tough.
Sports physicians have either an M.D. (medical doctor degree) or a D.O. (doctor of osteopathy degree). Each involves completing four years of college, followed by four years of medical school, study and internship at an accredited medical school, and up to six years of residency training in a medical specialty, such as surgery. Many physicians also complete a fellowship in sports medicine either during or after their residency.
During the first two years of medical school, medical students usually spend most of their time in classrooms learning anatomy, physiology, biology, and chemistry, among other subjects. In their last two years, they begin seeing patients in a clinic, observing and working with doctors to treat patients and develop their diagnostic skills. Some medical schools are beginning to alter this time-honored tradition by having medical students begin to work with patients much sooner than two years into their schooling, but this method of combining classroom and clinical experiences is not yet fully accepted or integrated into the curriculum.
After medical school, the new doctors spend a year in an internship program, followed by several years in a residency training program in their area of specialty. Most sports physicians complete this stage of their training by working in orthopedics or general practice.
The fellowship portion of a doctor’s training is essential if he or she has chosen to specialize. For example, the doctor specializing in general surgery and interested in sports medicine would probably seek an orthopedics fellowship providing further training in orthopedic surgery techniques.
Certification or Licensing
To become licensed, doctors must have completed the above training in accordance with the guidelines and rules of their chosen area or specialty. Beyond the formal requirements, this usually involves a qualifying written exam, followed by in-depth oral examinations designed to test the candidate’s knowledge and expertise.
To be a successful sports physician, you must be able to learn and remember all the many parts of the human body and how they function together. Knowledge of different sports and their demands on an athlete’s body is also important. Like all medical doctors, you need to be able to communicate clearly to your patients with compassion and understanding.
Exploring Sports Physician Career
High school students interested in becoming sports physicians should look into the possibility of working with the physician, coach, or athletic trainer for one of their school’s teams. Firsthand experience is the best way to gain fresh perspective into the role of the team physician. Later on, when applying for other paid or volunteer positions, it will help to have already had sports-related experience. Dr. Rich agrees, “Try to get experience with a physician who does what you think you want to do. Spending time in their offices, in surgery, or on the sidelines at high school games will give you exposure. As you learn more, you can do more.”
Most sports physicians are in private practice, so they work for themselves or with other medical doctors. Some sports physicians, however, may work for sports clinics, rehabilitation centers, hospitals, and college/university teaching hospitals. Still other sports physicians travel with professional baseball, basketball, football, hockey, and soccer teams to attend to those specific athletes. Sports physicians are employed all over the country.
You won’t become the team physician for a National Basketball Association team fresh out of medical school. Many sports physicians begin by joining an existing practice and volunteering with a local sports organization. After several years they may apply to the school board for consideration as a team physician for their local school district. Later, they may apply for a position with a college team until they ultimately seek a position with a national or international professional athletics team or organization. This gradual climb occurs while the individual also pursues a successful private practice and builds a strong, solid reputation. Often, the sports physician’s established reputation in an area of specialty draws the attention of coaches and management looking to hire a physician for their team. Others take a more aggressive and ambitious route and immediately begin applying for positions with various professional sports teams as an assistant team physician. As in any other field, contacts can prove to be extremely useful, as are previous experiences in the field. For example, a summer internship during high school or college with a professional hockey team might lead to a job possibility with that hockey team years later. Employment opportunities depend on the skill and ambitions of each job candidate.
Depending on the nature of an aspiring sports physician’s affiliation with athletic organizations (part time or full time), advancement paths will vary. For most sports physicians, advancement will accompany the successful development of their private practices. For those few sports physicians who are employed full time by professional athletic organizations, advancement from assistant to team physician is usually accompanied by increased responsibilities and a corresponding increase in salary.
The earnings of a sports physician vary depending upon his or her responsibilities and the size and nature of the team. The private sports physician of a professional individual athlete, such as a figure skater or long-distance runner, will most likely earn far less than the team physician for a professional football or basketball team, primarily because the earnings of the team are so much greater so the organization can afford to pay more for the physician’s services. On the other hand, the team physician for the professional basketball team probably wouldn’t have time for a private practice, although the sports physician for the figure skater or runner would, in all likelihood, also have a private practice or work for a sports health facility.
According to the U.S. Department of Labor, general practitioners and family practice physicians earn an annual net income of approximately $140,370 in 2005. Ten percent of these physicians earned less than $56,680 annually in that same year, and some earned significantly more. This general figure does not include the fees and other income sports physicians receive from the various athletic organizations for whom they work. Again, these fees will vary according to the size of the team, the location, and the level of the athletic organization (high school, college, or professional, being the most common). The income generated from these fees is far less than what they earn in their private practices. On the other hand, those team physicians who are employed full time by a professional organization will likely make more than their nonprofessional sports counterparts, even as much as $1 million or more.
Sports physicians must be ready for a variety of work conditions, from the sterile, well-lighted hospital operating room to the concrete bleachers at an outdoor municipal swimming pool. The work environment is as diverse as the sports in which athletes are involved. Although most of their day-to-day responsibilities will be carried out in clean, comfortable surroundings, on game day sports physicians are expected to be where the athletes are, and that might be a muddy field (football and soccer); a snow-covered forest (cross-country skiing); a hot, dusty track (track and field); or a steamy ring (boxing). Picture the playing field of any given sport and that is where you will find sports physicians. They are also expected to travel with the athletes whenever they go out of town. This means being away from their home and family, often for several days, depending on the nature, level, and location of the competition.
Sports Physician Career Outlook
After years of watching athletes close down the bars after a game, coaches and management now realize the benefits of good health and nutrition. Within the world of professional sports, the word is out: Proper nutrition, conditioning, and training prevent injuries to athletes, and preventing injuries is the key when those athletes are making their owners revenues in the billions of dollars. A top sports physician, then, is a worthwhile investment for any professional team. Thus, the outlook for sports physicians remains strong.
Even outside the realm of professional sports, amateur athletes require the skills and expertise of talented sports physicians to handle the aches and pains that come from pulling muscles and overtaxing aging knees. Athletes of all ages and abilities take their competitions seriously, and are as prone to injury as any professional athlete, if not more, because amateur athletes in general spend less time conditioning their bodies.