Why I Don't Do Sports Medicine (February 28, 2017)

I’m going to tell you right off why I don’t do sports medicine and never found the prospect even remotely appealing. That is violating one of the rules of good writing. Ideally I should trail you along for a while first. But nobody’s perfect, are they. So -- the reason I don’t do sports medicine is because, as a doctor, I consider sports to be bad for you, and I wouldn't want a career enabling those who indulge in them. 

Several of you just fainted -- I heard your heads hit the floor. Yes, this IS a minority viewpoint, both in and out of the health professions. The media and people in general hold athletes up not just as role models, but as paragons of health. The role model thing, well, I won’t begin to get into that here. But the paragon of health thing, I will – and say that that’s just plain ridiculous. Athletes – especially former athletes – are rarely really healthy people.

In any sport, some muscles are overtrained, and some joints are overused. The participants often play regularly beyond the point of exhaustion, and with pain and injuries. Any physical advantage such people might derive from their level of fitness is usually offset by persistent pain and disability, often in the present time but especially down the road. 

Children’s sports I consider to be particularly evil. I can’t tell you how many men there are out there suffering with persistent football and wrestling injuries from college or even earlier in their lives. If some idiot in their 30s decides s/he needs to do triathlon training, that's fine. But brainwashing children into activities that leave them with persistent problems for life is just plain criminal.

Exercise and physical activity are crucial for good health. But sports and athletics are not. In fact, they are the antithesis of good health. Exercise is to sports what bingo is to Russian roulette.

Now I did do some actual research into this subject and, at first blush, it looks like the evidence contradicts me. ‘Elite athletes’ are thought to probably live four to eight years longer than their compatriots. But if you dig into this data a bit, you find something interesting – said athletes are usually being compared to PEOPLE THEIR OWN AGE. In other words, a 38-year-old Olympic triathlete is being compared to an average 38-year-old in the general population.

Well, I'd take that bet. Considering the poor level of health and fitness of the general population, of course an athlete has a better chance of living a bit longer. But I wager that, if you could compare the general health and longevity of an athlete to a fit person of the same age, you'd see something quite different.

Plus, that “elite” thing. If you’re competing successfully at a professional level, any chronic physical problem or pain that you have must be quite manageable. Were it not, you couldn't compete successfully. Your basic legal assistant running local triathlons has no such requirement. S/he can continue to train with some rather nasty problems - worsening them all the while. 

And that is the raison d'etre for the existence of sports medicine. It “focuses on helping people improve their athletic performance, recover from injury and prevent future injuries”.  I don't see jack squat in that definition about maximizing HEALTH.

That's not to rag on sports medicine specialists. They are smart and know a lot of stuff. Outside the whole athletics thing, they are frequently great at a problem in the general population that is very similar to many sports injuries. That is the problem of overuse, which is just what it sounds like.

It’s easy to understand that a runner may develop an overuse problem with his or her feet. It’s less intuitive to realize that the problems that hairdressers have with their shoulders (because of keeping the hands and elbows slightly elevated all day) or that a keyboardist has with their hands is the same kind of problem. You’ve got muscles (usually little ones) and joints (likewise) that were never meant to be used as long or as hard as they are being used, and after a while they cry "uncle". If you are one of those people and you can find a sports medicine specialist that isn't too busy keeping half-crippled athletes on the playing field for just one more season, you can often get some pretty good help there.

Full disclosure – despite my attitude about all this, there is some activity in my own past that could be characterized as athletic. Feel free to call me a hypocrite. But that doesn't detract from the validity of the point I'm trying to make here.

Sports can be fun. Young people in particular have a lot of energy that has to go somewhere, and sports are a better outlet, if you need one, than excessive drug use, violent crime or war. If you look at sports activities for the average person this way, then yeah, go team. But you'll never get to health heaven that way.

--dr. diane holmes
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