Sport and Exercise Medicine

Sport and exercise medicine (SEM) is a relatively new National Health Service (NHS) specialty that was set up in 2005 in response to the growing need to manage musculoskeletal and exercise-related injury and illness. SEM consultants are trained in musculoskeletal medicine, exercise prescription and promotion and public health and as such provide a crucial solution to the medical problems associated with exercise-related and musculoskeletal injury, as well as physical activity.

SEM consultants aim to reduce NHS costs and improve musculoskeletal management by offering a service to individuals who do not require referral to orthopaedic care for surgery. Through primary care referral, this enables increased orthopaedic operating time and reduces waiting lists. SEM doctors also provide exercise prescription advice, assessing the cumulative risk for individuals with multiple pathologies and advising individuals to undertake safe levels of physical activity.

Key Points

• Running-related injuries are commonly seen in general practice;
• It is important to consider underlying biomechanical abnormalities when assessing individuals with musculoskeletal injury;
• A sudden change in training may precipitate musculoskeletal injury and must be addressed during management of such cases;
• Cautious fluid intake during endurance exercise will help prevent severe dilutional hyponatraemia; and
• Extreme volumes of exercise may result in adverse physical and psychological outcomes.

Further Information and Reading

Further information for individuals can be found at www.patient.c.uk, which offers user-friendly advice regarding each of the specific running-related conditions mentioned in this article. Another website, www.physioadvisor.com, provides a description of each running injury listed in this article, as well as a comprehensive list of rehabilitation exercises.

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Bruckner, P. & Khan, K. (2007) Clinical Sports Medicine. 3rd ed. London: McGraw-Hill.

Cowan, S.M., Bennett, K.L. & Hodges, P.W. (2002) Therapeutic Patella taping Changes in People with Patellofemoral Pain Syndrome. Clinical Journal of Sport Medicine. 12(6), pp.339-347.

Department of Health (2009) Let’s Get Moving. Commissioning Guidance. A New Physical Activity Care Pathway for the NHS. Available from World Wide Web: <http://www.dh.gov.uk/prod_consumdh/groups/dh_digitalassets/documents/digitalasset/dh_105944.pdf&gt; [Accessed: 26 April, 2013].

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Gunter, P. & Schwellnus, M.P. (2004) Local Corticosteroid Injection in Illiotibial Band Friction Syndrome in Runners: A Randomized Controlled Trial. British Journal of Sports Medicine. 38, pp.269-272.

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Kipps, C., Sharma, S. & Pedoe, D.T. (2011) The Incidence of Exercise-associated Hyponatraemia in the London Marathon. British Journal of Sports Medicine. 45, pp.14-19.

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Taunton, J.E., Ryan, M.B., Clement, D.B., McKenzie, D.C., Lloyd-Smith, D.R. & Zumbo, B.D. (2002) A Retrospective Case-control Analysis of 2002 Running Injuries. British Journal of Sports Medicine. 36, pp.95-101.