Sports and exercise medicine

A sports medicine physician is a doctor trained to prevent, diagnose and treat injuries and health problems related to physical activity, in elite athletes as well as in weekend runners or people returning to exercise after 50. Patients also say sports doctor or, in Israel, rofe sport. The scope covers sprains, tendon problems, stress fractures, recurring muscle pain and concussion, but also exercise-induced asthma, fainting during exercise and the question of when it is safe to return to sport after illness or surgery. A visit starts with detailed questions about the activity (discipline, volume, intensity, recent changes in training load), a focused physical examination and often an ultrasound scan in the clinic. Depending on the findings, the sports physician orders imaging, prescribes physiotherapy, adjusts the training plan or performs a procedure such as an injection. In Israel the sports doctor is also the one who signs the fitness certificates required by the Sports Law for registered athletes and by some gyms.

• ✓Pain that comes back with every run or training session and lasts more than two or three weeks despite rest.
• ✓An ankle or knee sprain with swelling, instability or difficulty putting weight on the leg.
• ✓Pain in the shin, foot or hip during exercise that raises the possibility of a stress fracture, especially after a rapid increase in training volume.
• ✓A blow to the head during sport followed by headache, confusion, nausea or memory problems, even without loss of consciousness.
• ✓Unusual breathlessness, cough or chest tightness during exercise, to distinguish exercise-induced asthma from a heart problem.
• ✓Before returning to sport after a heart attack, surgery, pregnancy or a long break, to get a safe programme.
• ✓For the mandatory fitness certificate of a child or adult registered with a sports federation.
• ✓For unexplained loss of performance, persistent fatigue or missed periods in a female athlete (relative energy deficiency in sport).

In Israel, sports medicine (רפואת ספורט) is a specialty recognised by the Ministry of Health (משרד הבריאות): specialist in sports medicine (מומחה ברפואת ספורט) is a protected title, granted after a medical licence, an accredited specialty programme and the examinations of the Scientific Council of the Israel Medical Association. Many practitioners nevertheless practise sports medicine as orthopaedic surgeons, family doctors or rehabilitation physicians with additional training. To check, open the Ministry of Health public licence register and look at which specialty is actually recorded; the words « sports doctor » on a sign or a website are not a guarantee by themselves. Fitness tests required under the Sports Law (חוק הספורט) may only be certified by physicians and centres approved by the Ministry. For foreign qualifications: in the United Kingdom, sport and exercise medicine is a full specialty; in the United States it is a fellowship after another residency; in France it is an add-on training rather than a primary specialty. None of these converts automatically to the Israeli title; the Ministry reviews each file after recognising the basic medical degree. An osteopath, a physiotherapist or a strength coach specialised in sport is not a sports medicine physician.