Think of ‘sports medicine’ and, for many of us, an image is conjured up of elite athletes receiving the kind of treatment reserved only for those occupying the higher echelons of the sporting world. However, the reality is quite different, with the same treatment processes also on offer to all patients visiting London, regardless of their athletic ability or lifestyle.
“The term ‘sports medicine’ is a slight misnomer, as we are not only treating athletes, but also regular people with problems such as back pain or chronic knee arthritis,” explains Dr Natasha Beach, a consultant in sports and musculoskeletal medicine at OneWelbeck Orthopaedics. “For this reason, we are trying to change refer to ‘sports and musculoskeletal medicine’, because of the common misconception that we only treat athletes.
“I’ve heard patients say, ‘Oh, I’m not an athlete, am I in the right place?’, but yes, they are! We treat everybody in the same way as an elite athlete, using all the same principles that we use with professional sportspeople. If you’re an elite tennis player and you’ve got tennis elbow, the injury is no different to that of a new mother who is suffering elbow pain after lifting her baby up all the time.”
Dr Beach’s patients are mostly referred by physiotherapists with some experience of sports medicine, although patients may also approach the clinic directly. “We might be the third or fourth port of call for many patients, who are visiting us with an ongoing problem that hasn’t been solved by their previous treatment. At that point, people are starting to get almost desperate.”
When patients arrive at the clinic, the focus is on finding out the cause of an injury. “We take a holistic approach in sports medicine,” says Dr Beach. “For example, if somebody is suffering from knee pain then we are not just interested in what the problem is, but also why it has happened. Are they overtraining, are they wearing the wrong shoes, or are they running up and down a hill with an unusual camber? If we can identify and fix what caused the injury in the first place, that goes a long way towards making the patient better.”
Following an initial consultation, which will also consider any reports from previous diagnostic scans taken elsewhere, patients are provided with the appropriate imaging – which includes ultrasound, magnetic resonance imaging and X-ray – to ascertain their injury. “We’re fortunate at OneWelbeck that we are able to perform diagnostic imaging on-site, which means that we can often do a consultation and then carry out an MRI scan the same day,” says Dr Beach. “I can then see the results without having to call another hospital or clinic.”
After the imaging results have been received, most patients will move on to a course of physiotherapy, but others may require additional treatments, such as steroid injections or pain relief. “The time frame for rehabilitation depends on the severity of the injury,” advises Dr Beach. “For many people, rehab will take six to eight weeks, but for some it will be faster and for others it will take considerably longer. For instance, someone with a stress fracture will be on crutches or wearing a protective boot for six weeks before they can start their rehab.”
Dr Beach’s expertise in the field of sports medicine means that she spends much of her working week with elite athletes at the Lawn Tennis Association, which oversees the sport in Great Britain, as well as working with national organisations for athletics, triathlon and hockey. Her practice at OneWelbeck also brings her into contact with non-professional sportspeople, whose training regimes are often comparable to those of the elite, as well as recreational athletes.
Dr Beach’s caseload, and many of the injuries that are presented, varies in line with the sporting seasons. “In the autumn, we’ll see more traumatic injuries associated with rugby, such as fractures and concussions,” she says. “In the spring, we tend to see a variety of injuries from skiing, so anterior cruciate ligament ruptures, nasty knee injuries and problems as a result of falls on the slopes.” Mass-participation events, such as the London Marathon, also bring their fair share of complications, including stress fractures and tendon injuries.
Working in a modern facility such as OneWelbeck, where there are departments dedicated to numerous medical disciplines, can also be helpful when patients arrive with issues that are more difficult to diagnose, or which may have previously been mistaken for a different problem. “One surgeon I work with is often referred patients who potentially have a hernia, but his examination reveals that it is actually a hip problem, so he can then refer them to me,” explains Dr Beach. “Likewise, I’ve had patients referred with a potential hip injury, but I’ve then realised that it may be a different issue and have referred them to my colleague.”
Inevitably, the pandemic brought about necessary changes to how patient appointments were carried out, with many consultations taking place online. Such innovations have continued and have been of particular benefit to those visiting London from abroad for their treatment.
“Since the start of the pandemic we’ve offered remote video consultations, which have been very popular among patients who require follow-ups and are unable to travel for an in-person appointment,” says Dr Beach. “I think these consultations work brilliantly – patients like the fact that I can follow them up with them on a Zoom call, having seen them face to face and carried out all their imaging. Pre-Covid, we’d have never thought to do that, but now around 80% of my patients choose these remote consultations, particularly my international patients.”
For more information on sports medicine services at OneWelbeck, visit onewelbeck.com/orthopaedics/
