Sports Medicine in Medical Tourism

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Sports medicine is defined as the branch of medicine concerned with the treatment of injuries or illness resulting from athletic activities. While this has a wide range of connotations generally sports medicine in the realm of medical tourism usually refers to injured or impaired athletes traveling to obtain the best surgical treatment that will enable them to return to their sport. Sports medicine can also encompass areas of physiologic or metabolic management to optimize athletes performance but gener ally this is something that only elite athletes would travel for and this type of medical care requires long-term management.


The branch of orthopedic surgery termed sports medicine generally refers to a surgical subspecialist who treats the majority of athletic injuries with the use of arthroscopic or minimally invasive surgery.


This requires inserting fiberoptic instrumentation in the joint and identifying the injured structure that in this case is hampering athletic performance or was directly injured as a result of a traumatic injury during a sport. While this may be indicated for the pathology athletic injuries can fall within the area of spine surgery foot and ankle or hand/wrist.


Due to their specific needs both elite and weekend warrior athletes will often seek the best practitioner to perform this surgery.This really embodies the concept of medical tourism because impaired athletes often use different information resources to identify the most qualified specialist to take care of their sports injury.


This is logically the case because most athletes are passionate about their sport and their main goal is the fastest and most optimal recovery possible. To do this they need to seek out the best specialist. While cost may be a factor athletes at all levels will make great sacrifices in order to be able to return to their athletic endeavor.


Therefore sports medicine often embodies the ideal indication for the practice of medical tourism.While the injured athlete is often willing to travel specifically for medical evaluation and treatment these patients typically require significant after care which will consist not only of physical or occupational therapy but also working with an athletic trainer and coach to return them to their pre-morbid level of athletic skill and ability.


Ongoing communication between the treating surgeon and the rehabilitation team is critical to an optimal result. This is a procedure-specific concept as orthopedic surgery has become extremely specialized and so the athlete will need to find not only the appropriate type of orthopedic subspecialist but also the person who treats this specific type of injury or performs a particular surgical intervention.


For example James Andrews a renowned sports medicine surgeon in Alabama and Florida frequently sees athletes who require reconstruction of the critical medial collateral ligament of the elbow the part of the body that enables them to pitch a baseball throw a football or hurl a javelin.


Dr. Pinczewski from Sydney Australia is world-renowned for mainly performing anterior cruciate ligament reconstruction on athletes. Soccer players from Europe or South America may travel way down under just to have this one specific surgery.

International Society for Sport Traumatology of the Hand

In my specialty surgery of the hand and upper extremities the need for sports specific injury management led to the creation of the International Society for Sport Traumatology of the Hand (ISSPORTH). This society was founded in Europe and now has members from more than 50 countries in six continents.


While the United States is actually underrepresented I am the current worldwide president and my goal is not only to educate other medical colleagues about the importance of hand surgery involvement in those specific sports injuries but also to educate athletes and trainers alike about the importance of having hand surgeons involved in their treatment.


Furthermore ISSPORTH embodies the concept of medical tourism because we are actually encouraging athletes to seek out the appropriate specialist so that they can have the surgery performed in the location of their tournament and then return to their home country to continue training. In order to reach such a goal ISSPORTH created an iPhone app that allows a coach trainer or athlete to easily find the nearest ISSPORTH member hand surgeon in order to treat their specific problem.


For example I have been treating professional tennis players for upper limb injuries for many years often seeing them during the Sony Ericsson tournament where their trainers schedule a consultation and players frequently return to have wrist or elbow surgery with me in Miami.


A simple click on their smartphone will dial my office number send an email or bring up a map of our center. This can easily be done from anywhere like if they are competing in Latvia Brazil or South Africa where they will be seeking the closest appropriate hand specialist.

Sports medicine for all skill levels

While sports medicine is often thought of for elite athletes such as professional or Olympic competitors sports medicine in its broadest sense actually entails treatment of the everyday competitor who happens to be passionate about golf tennis or any multitude of sporting endeavors.


When either degenerative problems overuse syndromes or even acute injury impairs players ability to compete in their sports activity they will often seek the best practitioner they can find to return them to their sport.


In many cases the everyday athlete possesses the financial means to afford travel as patients with less financial resources are not typically members of golf clubs or tennis academies in their home country.


Because the ability to dedicate time to a sporting activity generally requires the financial means these are the very same patients that will often travel to great lengths to seek appropriate care. Therefore sports medicine is actually an ideal avenue to promote the overall concept of medical tourism.


Once that patient travels to have a wrist arthroscopy he or she may decide to travel again in the future to have coronary bypass surgery or an elective hernia operation.The treatment of high caliber athletes can often inspire less competitive athletes to seek the same quality of care.


We all remember the slogan idolizing Michael Jordan namely Be Like Mike. In other words we not only want to wear the athletes chosen sneaker brand but we also may want to be treated in the same world-renowned clinic or by the same famous sports medicine surgeon.


Recently I had the opportunity to evaluate and then perform arthroscopic shoulder surgery on Karen Meakins a world-class female squash player from Barbados who has been a Caribbean champion and a silver medalist in world masters championship.


The patient was referred to me by another orthopedic surgeon because in her country arthroscopic surgery of the shoulder is still in its infancy. It was clear that this patient needed a rotator cuff repair but her goal was not only to be able to achieve the optimal result but to do this in record time she had her eye on the Barbados National Championship occurring within six months of the time of her planned surgery.


This athlete not only had an excellent outcome but she also successfully defended her title to win her 13th Barbados national title. This case as well as operating on the shoulders of a world-class MMA fighter an Olympic swimmer and a rugby player has ultimately led arthroscopic shoulder surgery to surpass endoscopic carpal tunnel release as the most common procedure I perform on the international patient.


I fully attribute this to the stark visibility that sports injuries provide the public in understanding what recovery is possible after an orthopedic ambulatory procedure. It inspires confidence.

Coordinating with the international facilitator

The traveling athlete does require particular attention in facilitating their care abroad. Early discussion of treatment options often with the coach or trainer must be done before they make the commitment to travel. This requires evaluation of studies such as radiographs MRIs and nerve studies as well as meticulous review of the current treatment regimen without being critical as collaboration with local health professionals is vital to achieving the desired result in return to play.


An international patient coordinator or facilitator is particularly helpful in assembling this data scheduling the travel and local stay even finding athletic or gym facilities so that the athlete can maintain their conditioning level.


In our center all of the diagnostic equipment including fluoroscopy MRI imaging and electrodiagnostic instruments are available onsite to utilize on the very first consultation. Most importantly the surgical team is safe and experienced with a cardiac anesthesiologist leading the unit and performing virtually all surgeries under regional block anesthesia followed by indwelling pain pump catheters allowing a virtually pain-free post-operative course.


The surgical center is onsite as well as the rehab unit as close communication with the physiotherapist is particularly crucial in guiding the athlete through the recovery process.


Conclusion

It is clear that sports medicine is a topic that captures the interest and imagination of the lay public particularly in those of us passionate about sports whether watching them or participating in them at any level. Consequently an injured athlete may travel a great distance to seek the appropriate care. The advancement of medical tourism can certainly benefit from this simple fact.

About the Author:

Alejandro Badia M.D. F.A.C.S. Alejandro Badia MD FACS is a hand and upper extremity surgeon at Badia Hand to Shoulder Center in Doral Florida. Dr. Badia studied physiology at Cornell University and obtained his medical degree at NYU where he also trained in orthopedics. A hand fellowship at Alleghany General Hospital in Pittsburgh was followed by an AO trauma fellowship in Freiburg Germany.


In 2008 he completed the Badia Hand to Shoulder Center a fully integrated clinical facility for the upper limb also encompassing the Surgery Center at Doral Integra Rehabilitation and an MRI imaging facility.


More recently Dr. Badia inaugurated OrthoNOW the first immediate orthopedic care center in south Florida which is staffed by surgeons from the International Orthopedic Group (IOG) a group of surgeons from lower extremity upper limb and spine subspecialties who also treat elective orthopedic problems in international patients.


He can be reached via
www.drbadia.com a patient education portal and website for hand surgeon academic exchange or via (305) 227-HAND at the Badia Hand to Shoulder Center or at OrthoNOW (305) 537-7272.