Primary care sports medicine: The osteopathic approach

The day’s first patient is a professional ballet dancer whose shoulder pain is interfering with her dancing. The second is a retiree with diabetes who’s determined to get more exercise. This patient mix typifies primary care sports medicine, which addresses musculoskeletal injuries as well as primary care issues.

“We’re not necessarily treating just athletes, but people who want to get healthy through lifestyle changes and are in need of exercise and nutritional advice,” says Andrew T. Martin, DO, MBA, the director of sports medicine at Campbell University in Buies Creek, North Carolina.

Musculoskeletal experts

DOs’ in-depth training in the musculoskeletal system can help them assess the root cause of an injury, says Per Gunnar Brolinson, DO, the head team physician for Virginia Tech’s football team. To illustrate, Dr. Brolinson describes treating a baseball pitcher who has a sore shoulder or elbow.

“Typically, you might focus attention on just the elbow or shoulder, but osteopathic physicians are trained to look at other areas in the kinetic chain that are leading to the overload on those joints,” he explains. In the case of the pitcher, Dr. Brolinson says, elbow or shoulder pain could stem from tightness in the low back or hip that’s compromising the athlete’s throwing form.

For Rebeccah R. Rodriguez, DO, the hands-on approach of osteopathic training echoed the 12 years she spent as a professional dancer before becoming a physician. “As a dancer, you become very aware of correct body positioning and you can feel when something is off,” says Dr. Rodriguez, who serves as company physician for several San Diego performing arts groups and was appointed last year to the President’s Council on Fitness, Sports and Nutrition Science Board. “It’s the same with osteopathic training—you learn the feel of the body and how joints and tissues can feel when they’re overused or strained.”

‘A lot on the line’

The pressures of being an elite athlete can trigger mental health issues like depression or anxiety, particularly for people who experience an injury. Dr. Martin has seen this dynamic firsthand—he’s also the head team physician at Campbell University, which is an NCAA Division I school for athletics.

“Playing sports at a high level has been a lifelong dream for these kids, so there can be a lot on the line,” he says. “When someone who’s used to being active all the time has a season-ending injury, it can have a significant psychological impact.”

Athletes who’ve suffered a severe injury such as a concussion can benefit from talking with their physician about the need for rest and the estimated timeline of their recovery, Dr. Martin says. For athletes who’ve suffered nonsevere injuries, Dr. Rodriguez recommends developing workout modifications that will allow the patient to remain somewhat active while decreasing the impact around the injured area.

Osteopathic manipulative treatment

Dr. Martin frequently uses osteopathic manual medicine (OMM) when treating student athletes. “Sports medicine is very musculoskeletal and orthopedic-focused, so OMM is a good treatment modality for many of these ailments,” he explains.

Many athletes request osteopathic manipulative treatment (OMT) before a competition because they feel it boosts their performance, says Dr. Brolinson. Because it doesn’t involve medication, OMT can also be an attractive pain relief option for athletes facing strict drug testing protocols.

Editor’s note: This story was updated on Jan. 7, 2015, to reflect Virginia Tech’s preferred style for the university’s name. A previous version of this story referred to the school as Virginia Tech University.