Is consulting a sports medicine doctor reserved for athletes?

Sports medicine is often associated with high-level athletes. Yet it is equally relevant for people who engage in regular or occasional physical activity, as well as those who do not exercise at all. Dr Régis Coudert sheds light on a specialty he has been practising for over ten years, which extends far beyond the sporting context. MonacoSanté keeps you informed.

Its role and specialty

Contrary to popular belief, patients who consult a sports medicine doctor have highly varied profiles. Emerging in the 1950s, this medical specialty focuses on the musculoskeletal system as a whole, and more particularly on osteoarticular structures. A specialist in sports medicine Dr Régis Coudert also holds qualifications in musculoskeletal ultrasound, manual medicine osteopathy and mesotherapy. In the Principality, he works with young footballers at AS Monaco Academy and practises at IM2S, the Monaco Institute of Sports Medicine and Surgery, the sports clinic. "People often think you only consult a sports medicine doctor after being injured during physical activity. While we are indeed trained to treat athletes subjected to specific muscular, tendon and joint stresses, a large proportion of the patients I see at IM2S do not come following a sporting accident. We sit midway between the general practitioner and the orthopaedic surgeon", explains Dr Coudert. Reasons for consultation relate to bones joints, muscles and tendons alike. Many patients come with chronic or acute pain, whether traumatic in origin or not. Back, hips, knees, ankles, shoulders: the entire body may be affected. "These consultations also follow domestic or workplace accidents, particularly among manual workers for example," he continues. "They are then seeking solutions adapted to their professional practices, their physical activity, but also to pain related to daily life".

Prevention, health and wellbeing

For amateur athletes, beginners and non-practitioners, consulting a sports medicine doctor can prove particularly valuable. They have access to a wide range of treatments and care approaches enabling people to begin or continue physical activity in a progressive, adapted and safe manner. "During the clinical examination, I perform tests specific to the painful area, but also an overall assessment of the person, both postural and muscular. The sports medicine doctor's perspective is essential for identifying any morphological abnormalities, detecting strength deficits or imbalances as well as postural problems". An ultrasound examination can be performed during consultations to allow more precise visualisation of tissues, particularly muscles, tendons and ligaments. Through targeted adaptations and muscle strengthening, Dr Régis Coudert encourages patients not to give up physical activity. "I provide personalised guidance: for resuming sport, muscle strengthening work, and how to stabilise and relieve a joint. The objective being to maintain adapted activity while limiting new joint stresses". Prevention also occupies a central place. "You can consult even before starting a sporting activity, as injuries often occur when resuming exercise", he warns. Physical activity is moreover strongly recommended in the fight against cancer, obesity, chronic or cardiovascular conditions. "Very often, patients do not know how to go about it. The consultation precisely allows us to guide them", he emphasises.

From young children to the elderly

Beyond high-level athletes and amateur sportspeople, his patient base can begin from the age of 5. Consultations then most often concern pain or growth-related conditions. "Such as traction on a bone that is not yet fully mature and solid. These manifest as bone pain related to activity, walking or sporting practice, at the Achilles heel or knees for example. Children may also present with tendinitis, ligament or muscle injuries". Beyond children and adolescents, the sports medicine doctor also treats elderly patients with the objective of maintaining physical activity for as long as possible. "Before considering surgery, we attempt as many treatments and therapeutic solutions as possible. Where the rheumatologist focuses more on chronic inflammatory conditions, the sports medicine doctor primarily treats mechanical ones. This notably includes osteoarthritis, linked to progressive cartilage wear, as well as other degenerative conditions". The doctor can also refer elderly patients to physiotherapists, in order to rehabilitate, strengthen and maintain sufficient muscle levels.

Injuries, recovery and resumption

While clinical examination constitutes the first step in identifying and understanding a condition, Dr Régis Coudert relies on a complementary therapeutic range. He also uses mesotherapy, which consists of cutaneous injections of anti-inflammatories on painful areas, as well as manual medicine osteopathy. A focused shockwave machine is a sometimes necessary tool for treating tendon or bone conditions. In certain cases of tendon or cartilage lesions, related to osteoarthritis for example, sports medicine doctors may also use platelet-rich plasma (PRP) or hyaluronic acid infiltrations. After an injury, support for resuming physical activity is paramount. Criteria vary depending on the condition. "We are cautious and progressive. If an injury has occurred, it is often because there was a strength deficit or stresses that the muscle was not able to withstand. We must therefore ensure that the patient has regained power at least equivalent to, or even greater than, that before the injury, in order to be able to withstand muscular stresses again". This recovery is validated by clinical examination, medical imaging orstrength tests. "At the clinic, we notably have an isokinetic testing machine, which allows precise measurement of muscle strength in the thighs, shoulders or back". Whether you are an experienced athlete, occasional amateur or non-practitioner, consulting a sports medicine doctor primarily allows you to receive optimal diagnostic and therapeutic care. A comprehensive and cross-disciplinary approach, accessible at all ages, to prevent injuries, relieve pain and continue moving sustainably.