Sports medicine for the internist

Because of increasing participation in leisure sports and exercise rehabilitation programs, many patients are developing nonsurgical, soft tissue overuse syndromes. Many of these musculoskeletal problems arise because of underlying biomechanical difficulties, training errors, or improper use of equipment. Epidemiologic observations reveal that these individuals frequently visit a general medical practitioner before seeking the advice of an orthopedic specialist. Prompt diagnosis simply requires an appreciation of anatomy and an analytic understanding of sports biomechanics. Although compulsive about their level of physical activity, many of those affected with overuse syndromes are highly motivated individuals who will predictably improve with the judicious use of NSAIDs, elimination of training errors, and the use of appropriate sports equipment and footwear. Simple orthotics may be needed for correction of biomechanical problems. For many of these localized musculoskeletal disorders, strict adherence to gradual physical rehabilitation activities is advisable.