What comes to mind when you hear the term “Sports Med­i­cine?” If you think a com­bi­na­tion of sports and sci­ence/med­i­cine work­ing with ath­letes, you are spot on. That is what drew me to this dy­nam­ic field.

In 2012, my favourite NBA play­er, Der­rick Rose, sus­tained a sea­son-end­ing knee in­jury dur­ing the play­offs, leav­ing the team and fans dev­as­tat­ed. NBA play­ers get in­jured quite of­ten, but I paid close at­ten­tion to this case and dis­cov­ered a world of med­i­cine that would lat­er be­come a pas­sion.

Rose was treat­ed, re­couped, and re­turned for the next sea­son, thanks to the care and ex­per­tise of sports spe­cial­ists, par­tic­u­lar­ly a sports doc­tor. I re­mem­ber think­ing how amaz­ing it would be to be in such a po­si­tion. I found out that the Uni­ver­si­ty of the West In­dies (UWI) of­fers a Sports Med­i­cine Mas­ter’s pro­gramme in Ja­maica. And so, my jour­ney be­gan.

I start­ed the MSc Sports Med­i­cine pro­gramme in the sum­mer of 2022. Ini­tial­ly, I had a gen­er­al un­der­stand­ing of the field, but I quick­ly dis­cov­ered that it goes much deep­er than I could imag­ine.

Sports med­i­cine is a spe­cial­ty of med­i­cine that deals with phys­i­cal fit­ness and treat­ing and pre­vent­ing in­juries re­lat­ed to sports and ex­er­cise. It is a broad field en­com­pass­ing as­pects of med­i­cine, bio­me­chan­ics, psy­chol­o­gy, nu­tri­tion, strength and con­di­tion­ing, in­jury iden­ti­fi­ca­tion, re­ha­bil­i­ta­tion, and so much more. Sports med­i­cine aims to op­ti­mise ath­let­ic per­for­mance and re­cov­ery; how­ev­er, it is not lim­it­ed to ath­letes. Any­one in­ter­est­ed in be­gin­ning an ex­er­cise pro­gramme, main­tain­ing their abil­i­ty to ex­er­cise, or re­cov­er­ing from in­jury can ben­e­fit from the field of Sports Med­i­cine, more broad­ly known as Sports and Ex­er­cise Med­i­cine.

As I con­tin­ued in the pro­gramme, I re­alised that the sports doc­tor plays an in­te­gral role in all as­pects of sports med­i­cine, but, as the po­et John Donne wrote, “No Man is an Is­land.”

When prepar­ing for train­ing or com­pe­ti­tion, a team of ded­i­cat­ed pro­fes­sion­als must get an ath­lete like Der­rick Rose in op­ti­mal shape. Each as­pect of sports med­i­cine has its spe­cial­ists. Apart from iden­ti­fy­ing and treat­ing in­juries, I learned about the pre-par­tic­i­pa­tion eval­u­a­tion. This is where the sports doc­tor/physi­cian in­ves­ti­gates the ath­lete’s or in­di­vid­ual’s med­ical his­to­ry, such as med­ical ill­ness­es (e.g., asth­ma, seizures/fits, low blood count), fam­i­ly his­to­ry (e.g., heart is­sues, his­to­ry of sud­den death), and pre­vi­ous in­juries. This ini­tial con­sul­ta­tion al­so dis­cussed sleep habits, sport or train­ing type, train­ing vol­ume, nu­tri­tion habits, and footwear.

Fol­low­ing this, with spe­cial­ly trained eyes, a de­tailed head-to-toe phys­i­cal ex­am­i­na­tion is per­formed, as­sess­ing the heart and lungs, po­si­tion­ing of the joints (neck, shoul­ders, hips, knees, an­kles, etc.), and over­all pos­ture, to name a few. If fur­ther in­ves­ti­ga­tion is need­ed, tests such as an elec­tro­car­dio­gram (heart test) or x-ray, among oth­ers, can be per­formed to iden­ti­fy any is­sues that could put the ath­lete or in­di­vid­ual at risk for in­jury or, worse, dur­ing ex­er­cise, train­ing, or com­pe­ti­tion.

Every doc­tor is trained to pre­scribe med­ica­tions and sup­ple­ments. When work­ing with ath­letes, how­ev­er, there are many fac­tors to con­sid­er apart from in­juries. I quick­ly dis­cov­ered that it was the re­spon­si­bil­i­ty of the sports doc­tor to en­sure that all pre­scribed med­ica­tion and sup­ple­ments com­plied with the World An­ti-Dop­ing Agency (WA­DA) and rel­e­vant lo­cal An­ti-Dop­ing Com­mis­sion reg­u­la­tions. Un­for­tu­nate­ly, some lo­cal and in­ter­na­tion­al ath­letes have been rep­ri­mand­ed for breach­ing these rules.

Pre­vi­ous re­search con­duct­ed by the Fac­ul­ty of Sport at UWI has shown a knowl­edge gap among gen­er­al med­ical prac­ti­tion­ers con­cern­ing WA­DA reg­u­la­tions. This top­ic is cov­ered in the Sports Med­i­cine cur­ricu­lum. Knowl­edge tru­ly is pow­er; the more we know, the bet­ter we can sup­port our tal­ent­ed ath­letes.

In ad­di­tion to clear­ly defin­ing the re­spon­si­bil­i­ties of a sports doc­tor, the pro­gramme in­te­grat­ed the per­spec­tives and roles of the oth­er spe­cial­ties, such as that of strength and con­di­tion­ing coach­es. These coach­es tact­ful­ly use ex­er­cis­es with­in a train­ing pro­gramme to in­crease or im­prove an ath­lete’s mus­cu­lar strength, ath­let­ic abil­i­ty, en­durance, speed, and abil­i­ty to re­sist in­jury. In the event of an in­jury, the ba­ton is passed to an­oth­er spe­cial­ist, a phys­io­ther­a­pist. In their ca­pa­ble hands, dif­fer­ent tech­niques are used to re­solve pain, re­store func­tion, strength­en weak mus­cles, and much more.

Most sports-re­lat­ed in­juries do not re­quire surgery to fix them. For those that do, or­thopaedic sur­geons are called up­on. Sports nu­tri­tion­ists, sports psy­chol­o­gists, and mas­sage ther­a­pists are es­sen­tial to man­ag­ing ath­letes.

When it comes to op­ti­mis­ing the health and per­for­mance of an ath­lete, it tru­ly takes a vil­lage. This col­lab­o­ra­tive ef­fort can take an in­di­vid­ual from good to great, each with the sup­port of the head and as­sis­tant coach­es and the full par­tic­i­pa­tion of the ath­lete.

The Caribbean is blessed to have tal­ent­ed ath­letes from mul­ti­ple sports and sports med­i­cine spe­cial­ists on our shores. The cadre of these spe­cial­ists has been in­creas­ing steadi­ly thanks to the grad­u­ate pro­grammes in Sport, Sport Med­i­cine, and Sport and Ex­er­cise Med­i­cine at The UWI. As peo­ple con­tin­ue to seek out and en­gage in spe­cial­i­sa­tion, our ca­pac­i­ty to pre­pare and pre­serve our ath­letes for out­stand­ing per­for­mances through­out their ca­reers can on­ly im­prove. Through ed­u­ca­tion and hands-on sup­port, I plan to make an im­pact.

Dr Hoshane White com­plet­ed his MSc. Sports Med­i­cine with the Fac­ul­ty of Sport in 2024