Whether a sports medicine doctor performs surgery depends on their fundamental medical training. Sports medicine is a broad field focusing on physical fitness, injury prevention, and the treatment of musculoskeletal injuries. It is not a standalone primary medical specialty but a specialized qualification earned after completing a residency in another area. This distinction separates sports medicine physicians into two primary groups: those specializing in non-operative care and those specializing in surgical intervention.
The Non-Surgical Sports Medicine Specialist
Physicians who specialize in non-surgical sports medicine complete a residency in a primary care field, such as Family Medicine, Internal Medicine, Pediatrics, or Physical Medicine and Rehabilitation (PM&R). They then complete a one- to two-year fellowship in Sports Medicine to gain a Certificate of Added Qualification (CAQ). This training prepares them to handle approximately 90% of all sports-related injuries, which do not require an operation.
Their practice focuses on the non-operative management of acute injuries like sprains, strains, and non-displaced fractures, as well as chronic conditions like tendonitis. They use therapeutic techniques to restore function and manage pain. These methods include prescribing physical therapy, utilizing bracing and splinting, and administering short-term medications.
A significant part of their work involves performing diagnostic procedures, such as musculoskeletal ultrasound, to visualize soft tissues and guide treatment. They frequently use therapeutic injections, including corticosteroids for inflammation and viscosupplementation for joint lubrication. Some specialists also utilize regenerative treatments like Platelet-Rich Plasma (PRP) therapy to promote healing. They are also responsible for concussion management and making complex “return-to-play” decisions for athletes.
The Sports Medicine Surgeon (Orthopedic Focus)
The doctors who perform surgery in sports medicine are Orthopedic Surgeons. These physicians complete a rigorous five-year residency in Orthopedic Surgery after medical school, providing extensive training in surgical techniques for the entire musculoskeletal system. Their ability to operate stems from this foundational surgical residency.
Following their orthopedic residency, they undertake a one- to two-year surgical Sports Medicine fellowship. This specialized fellowship focuses on the operative management of injuries common among active individuals and athletes. Their responsibilities center on repairing or reconstructing damaged joints, ligaments, tendons, and cartilage.
Common surgical procedures include knee operations like Anterior Cruciate Ligament (ACL) reconstruction and meniscal repair. They also manage shoulder injuries, performing arthroscopic procedures for rotator cuff repair and stabilization following dislocations. This expertise allows them to treat complex trauma and acute injuries not resolved through non-operative methods.
The Referral Process: Deciding on Surgery
The two types of sports medicine specialists frequently work together in a collaborative care model. The non-surgical specialist often serves as the initial point of contact for a musculoskeletal injury, maximizing all non-operative options first. This approach is logical, as the vast majority of sports injuries are treated without an operation.
A patient is referred to a sports medicine surgeon when non-operative treatment fails to resolve the pain or restore function, or if the injury presents a clear surgical need. Injuries that necessitate immediate surgical consultation include complete ligament tears, such as a full ACL rupture, or certain unstable or displaced fractures. Chronic instability in a joint, like a repeatedly dislocating shoulder, is also a common criterion for referral.
When a non-surgical physician refers a patient for a surgical consultation, the two specialists often agree on the need for an operation. Studies have shown that when referrals are made by sports medicine physicians, a high percentage of those patients are ultimately recommended for surgery. This collaboration helps streamline the process, ensuring patients with non-surgical issues receive prompt conservative care while those who require an operation are quickly transitioned to a surgeon.