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Sports Medicine As Preventive Medicine



Dr. James Ting

Most of us think of sports medicine after we’ve been injured. While that is certainly a good way to speed up recovery, these types of professionals can take a proactive role too.

About.com caught up with James Ting, MD, FAAFP, CAQSM, of the Hoag Orthopedic Institute to discuss different ways sports medicine professionals can help prevent injuries. Dr. Ting believes sports medicine professionals play a key and proactive role in preventing injuries on several levels.

Patient Education
Sports medicine professionals additionally have training and expertise in issues related to nutrition, strength and conditioning, which in combination with their knowledge of musculoskeletal medicine, allows them to serve as effective counselors and educators in regards to injury prevention.       

Patient education is “extremely important,” remarked Dr. Ting.

“The more aware and informed patients are in regards to potential risk factors for injury, the importance of proper training and conditioning, as well as the demands of their individual sport, the more effective sports medicine professionals and patients themselves can be in preventing injuries,” he elaborated.

Cyclists can be proactive with injury prevention by not only paying attention to general issues affecting all athletes, such as nutrition and conditioning, but also by paying particular attention to the quality and fit of their equipment, Dr. Ting commented. This includes, but is not limited to, their helmet, bike, seat, pedals, and shoes.
Preventing Common Cycling Injuries
There are many different injuries that can occur in cycling. They can be broadly categorized as either traumatic, or secondary to overuse. 

While not an exhaustive list, Dr. Ting noted some of the most common injuries that occur in cycling are fracture of the clavicle (collarbone), fracture of the scaphoid (specific carpal bone that is located on the thumb side of the wrist), Achilles tendonitis, patellar tendonitis, low back pain, neck pain and saddle sores. 

“Unfortunately, traumatic injuries, such as a clavicle fracture or a scaphoid fracture can't be easily predicted or prevented. These fractures typically occur during a crash when a rider reaches out with his/her outstretched hand to break the fall. While it may not be instinctive or easy to remember, holding onto the handlebars during a fall to allow your entire body to absorb the force of the impact, rather than reaching out with your hand, may help to prevent these specific injuries,” he advised.

Achilles tendonitis, patellar tendonitis, low back pain, neck pain and saddle sores are considered overuse injuries. Taking care to ensure a proper bike fit can be helpful in preventing all of these injuries. 

Items that can be adjusted in order to prevent or reduce excessive strain and thus prevent injuries to these specific areas of the body include, but are not limited to seat, pedal and handlebar position. 

“Consider a professional bike fitting for help with this. While improper bike fit can be a cause of both Achilles and patellar tendonitis, be mindful as well of over-training, as this is also a common culprit,” suggested Dr. Ting. In addition to a proper fitting, a core-strengthening program can be helpful to prevent low back pain, while strengthening of the neck and shoulder muscles can help to prevent neck pain. 

The prevention of saddle sores can be accomplished through both proper seat positioning as well as the use of newer, well cushioned cycling shorts, and avoiding ones that are old and potentially worn out. The use of chamois creams to reduce friction can also be a helpful preventive measure as well.

Seeking Out Care
Dr. Ting advises cyclists to seek care from a physician whenever pain or an injury is recurrent or persistent, and otherwise if there is any question or concern regarding the severity of an injury, its proper rehabilitation, or when it is safe to return to activity. 

“In the event of traumatic injuries, such as a clavicle or a scaphoid fracture, care from a physician should be sought immediately. Taking the example specifically of a scaphoid fracture, delayed or improper treatment can have a significant impact on healing, which in turn can potentially result in unfortunate long-term consequences such as pain and arthritis,” he said.

Dr. Ting urges cyclists to also see a physician prior to starting a new exercise regimen or program to ensure that it is safe to do so. 

“Injury prevention after all, is key!” he concluded.

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