Sport and Exercise Medicine


By Dr. Jake Fisher

This is a discipline that focuses on the management of the medical problems of exercising individuals at all ages and all levels of participation. We evaluate, diagnose, and treat injuries sustained during activity, exercise, or sport. We utilize the use of exercise and therapeutic modalities in the treatment and prevention of musculoskeletal disease. Everyone’s goals and activity levels are different, and we strive to get the individual back to their desired function.

How Injuries Occur
Injuries can happen due to trauma, overuse, or deconditioning. Accidental or trauma injuries are unpredictable and hard to control for. Overuse injuries happen when someone does too much, too fast, with little recovery or rest. Deconditioned injuries can happen because the body is not prepared for the stress or load about to be placed on the tissues. They can be acute, and if not managed correctly through rehab, can become chronic.

Bridging The Gap Between Rehab And Performance
Most rehabilitation fails due to cookie-cutter programming where you get a piece of paper with a few exercises on it, come in twice a week for 6-8 weeks, and complete the standard three sets of ten repetitions. I commonly see three things unfold with failed rehabilitation. First, the person was not consistent and stopped early in the rehabilitation process because they thought they were not improving. It takes time for soft tissue to adapt, and progress can be slower than anticipated. Second, the intensity, load, or resistance was not high enough to create adaptations. And lastly, after the desired results of rehabilitation they did not continue to a general strength training routine. Bridging the gap between rehab and performance is a must to minimize re-injury risk.

Rehab Like An Athlete
The selection of exercise is important, however, to get the targeted adaptations, other components of training play crucial role in the process. The number of sets, repetitions, intensity, tempo, rest, and frequency matters the most and must be individualized. This is often neglected in the rehab process. We integrate evidence-based return to play protocols while applying strength and conditioning principles to excel adaptations and recovery times with our patients. Rehab like an athlete is my philosophy. Exercise and sports injuries are very common in athletes and the general population. Applying the same standard of care, we treat everyone like they are an athlete about to compete in the biggest competition of their lifetime.

Injury Prevention
Everyone should have a full musculoskeletal joint assessment yearly to get baseline data on where you are. These types of comprehensive orthopedic examinations include range of motion testing, movement screens, orthopedic special testing on the major joints, and strength metrics with the purpose of injury prevention. Most everyone gets their yearly physical and blood work done so why not get your musculoskeletal system analyzed as well?

Performance Therapy
Performance therapy is an intervention prior to working out, or participating in sporting practice, or competition. The goal of performance therapy is to improve a person or athlete’s movement quality and motor pattern prior to activity. The purpose is to accomplish incremental gains in movement efficiency. This is accomplished through manual therapy, manipulative therapy, and muscle energy techniques. Utilizing these modalities causes a transient increase in joint range of motion, soft tissue extensibility, and can decrease pain. Taking golf as an example, we see many golfers who lack trunk rotation and hip and shoulder mobility. Applying performance therapy right before your tee time will help improve range of motion and movement quality so you can enhance your performance and decrease the likelihood of injuring yourself.