Why are so-called "sports medicine doctors" in USA completely oblivious to the MPW a competitive distance runner doe

30mpw? OMG!!! wrote:

BRG/253 wrote:

"Sports medicine" for the most part is a primitive discipline and an overall joke populated by doctors who really want to be jocks.

What does it really mean if someone says they practice "sports medicine?"

According to about.com:

http://sportsmedicine.about.com/od/educationemployment/a/whats_sportsmed.htm

"Sports medicine is the study and practice of medical principles related to the science of sports, particularly in the areas of:

Sports Injury Diagnosis and Treatment

Sports Injury Prevention

Sports Training and Athletic Performance, including:

Exercises and Workouts

Sports Nutrition

Sports Psychology"

so if we assume they're supposed to have knowledge about exercises and workouts, what does that mean when it comes to running?

Its a fellowship (1-2 years) done after residency (3-7 years) and medical school (4 years)Very competitive.http://www.mima.com/sports_medicine.aspx

30mpw? OMG!!! wrote:

BRG/253 wrote:

"Sports medicine" for the most part is a primitive discipline and an overall joke populated by doctors who really want to be jocks.

What does it really mean if someone says they practice "sports medicine?"

According to about.com:

http://sportsmedicine.about.com/od/educationemployment/a/whats_sportsmed.htm

"Sports medicine is the study and practice of medical principles related to the science of sports, particularly in the areas of:

Sports Injury Diagnosis and Treatment

Sports Injury Prevention

Sports Training and Athletic Performance, including:

Exercises and Workouts

Sports Nutrition

Sports Psychology"

Dr Daniels has this chart showing that high mileage gives a tiny increase in performance for a LARGE increase in injury risk:

http://www.coacheseducation.com/images/jd-figure3.gif

Notice that Daniels has a line drawn at 60mpw. There's a reason for this...the curve to the right.

You have presented yourself at the doctor's admitting room with a training error. And while you are not paying him to be your coach, you ARE paying him to get you healthy and keep you out of the admitting room. Since you have not described yourself as a professional, elite, or post-collegiate (trying to accomplish professional of course), the MD probably sees you as a delusional/obsessive-compulsive type who is not likely to listen to him anyway, but he probably sees it as part of his job to try to talk some common sense into you.

You can either listen to the MD (or talk to a coach, but you probably know to much to listen to a coach, either) about how to stay healthy, or you can keep taking breaks in your training that you need time to recover from.

The key to long term improvement is consistent training over a period of at least a couple of years. You cannot improve if you keep visiting the admitting room with training errors...and that is the #1 thing obsessive, high-mileage freaks don't get (but I'll bet you doctor does).

I think you have a good point. There are less than 100 Americans for whom running 100mpw is logical. These are the people who have even a little chance of winning a competition that means anything (college division, local marathon, or elite races). If you're not going to win anything, then the massive increase in injury risk going from that 60mpw to 100mpw in order to get, say, 5 minutes faster in a marathon is just totally illogical from a medical perspective, even "sports medicine".

rsbones wrote:

I think you have a good point. There are less than 100 Americans for whom running 100mpw is logical. These are the people who have even a little chance of winning a competition that means anything (college division, local marathon, or elite races). If you're not going to win anything, then the massive increase in injury risk going from that 60mpw to 100mpw in order to get, say, 5 minutes faster in a marathon is just totally illogical from a medical perspective, even "sports medicine".

no can can decide that for you but you.

chinocochino wrote:

What?! Are you a doctor? Sports medicine fellowships are highly competitive since a lot of doctors want to work with athletes. I would LOVE to get a sports med fellowship.

This says nothing about the actual value of the current practice of sports medicine. Most doctors in the field are about sports, not medicine.

Running huge volume is outside of the experience of most physicians because they were all too busy going to good colleges and getting good grades instead of running DIII track or whatever.

rsbones wrote:

There are less than 100 Americans for whom running 100mpw is logical. These are the people who have even a little chance of winning a competition that means anything (college division, local marathon, or elite races). If you're not going to win anything, then the massive increase in injury risk going from that 60mpw to 100mpw in order to get, say, 5 minutes faster in a marathon is just totally illogical from a medical perspective, even "sports medicine".

That's bullsh*t. Even if you're a hobbyjogger trying to get to your personal summit, you need to ramp up the mileage (in an intelligent fashion of course). Whether this is worth it or not is up to you.

no bull son wrote:

That's bullsh*t. Even if you're a hobbyjogger trying to get to your personal summit, you need to ramp up the mileage (in an intelligent fashion of course). Whether this is worth it or not is up to you.

So what time improvement do you expect for a "hobbyjogger" who goes from 60mpw to 100mpw? If 100 hobbyjoggers did so, wouldn't so many of them be injured that their overall results would be terribly worse? This is the way logical people, like most in the medical profession, are going to look at things. Is the hobbyjogger in front of them likely to benefit from 100mpw and likely staying injured or going back to 60mpw and maybe not reaching his unreasonable personal goals, but at least staying healthy enough to finish the race?

High mileage does not cause injury. Too much intensity coupled with too little rest causes injury.

I'm a Doctor, and I run 90+ mpw; usually I chalk the recreational runner injuries up to the fact that they train too little. A typical conversation usually has them telling me that they run about 5 miles a day 3x/week...but they can't figure out why they can't run a half marathon without their calf muscles getting so sore, or their feet feeling numb. Or...that they have been training in their walmart shoes for the last 3 years.

hoss wrote:

I'm a Doctor, and I run 90+ mpw; usually I chalk the recreational runner injuries up to the fact that they train too little. A typical conversation usually has them telling me that they run about 5 miles a day 3x/week...but they can't figure out why they can't run a half marathon without their calf muscles getting so sore, or their feet feeling numb. Or...that they have been training in their walmart shoes for the last 3 years.

Nice! Where in US are you based out of? I want to see a doctor who can get me back!!!!

hoss wrote:

I'm a Doctor, and I run 90+ mpw; usually I chalk the recreational runner injuries up to the fact that they train too little. A typical conversation usually has them telling me that they run about 5 miles a day 3x/week...but they can't figure out why they can't run a half marathon without their calf muscles getting so sore, or their feet feeling numb. Or...that they have been training in their walmart shoes for the last 3 years.

Nice! Where in US are you based out of? I want to see a doctor who can get me back!!!!

hoss wrote:

I'm a Doctor, and I run 90+ mpw; usually I chalk the recreational runner injuries up to the fact that they train too little. A typical conversation usually has them telling me that they run about 5 miles a day 3x/week...but they can't figure out why they can't run a half marathon without their calf muscles getting so sore, or their feet feeling numb. Or...that they have been training in their walmart shoes for the last 3 years.

Nice! Where in US are you based out of? I want to see a doctor who can get me back!!!!

someone had to do it wrote:

High mileage does not cause injury. Too much intensity coupled with too little rest causes injury.

Agreed!

This thread is very encouraging to me as a medical student because:1) I was All-American in track.2) I'm pursuing orthopedic surgery.3) I plan on doing a sports medicine fellowship4) I still train.I always assumed (based on my own experiences) that I would be able to better relate to my runner patients because most docs have no clue about running. Seeing the frustrations in this thread has verified this assumption.

dumb wrote:

Running huge volume is outside of the experience of most physicians because they were all too busy going to good colleges and getting good grades instead of running DIII track or whatever.

MedSchoolRunnerPerson wrote:

This thread is very encouraging to me as a medical student because:

1) I was All-American in track.

2) I'm pursuing orthopedic surgery.

3) I plan on doing a sports medicine fellowship

4) I still train.

I always assumed (based on my own experiences) that I would be able to better relate to my runner patients because most docs have no clue about running. Seeing the frustrations in this thread has verified this assumption.

On the other hand I think as an elite athlete you are going to be pretty frustrated by the average sports medicine patient population.

You just had to burst my bubble, didn't you?

dumb wrote:

On the other hand I think as an elite athlete you are going to be pretty frustrated by the average sports medicine patient population.

rsbones wrote:

no bull son wrote:

That's bullsh*t. Even if you're a hobbyjogger trying to get to your personal summit, you need to ramp up the mileage (in an intelligent fashion of course). Whether this is worth it or not is up to you.

So what time improvement do you expect for a "hobbyjogger" who goes from 60mpw to 100mpw? If 100 hobbyjoggers did so, wouldn't so many of them be injured that their overall results would be terribly worse? This is the way logical people, like most in the medical profession, are going to look at things. Is the hobbyjogger in front of them likely to benefit from 100mpw and likely staying injured or going back to 60mpw and maybe not reaching his unreasonable personal goals, but at least staying healthy enough to finish the race?

Could be the difference between breaking 2:50 in a marathon and breaking 2:30 in a marathon. Plus it's fun to run higher mileage and just to run more in general - ever consider that?