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No matter what distance and level of triathlon you pursue, you’re likely putting your body through the wringer, day after day. While some myths (like running is bad for your knees) are exaggerated, training for a three-discipline endurance sport still stresses the joints and muscles used to propel you from start to finish.
Injury prevention techniques should be your first line of defense, but when bodily irritations and injuries crop up, it’s important not to let them fester—your overall health and season could depend on it. But knowing what type of medical professional to see for diagnosis, care, and rehab can be overwhelming and timely to research, so here’s a breakdown of who to see when.
Sports Medicine Doctor
Sports medicine doctors are clinicians who have attended medical school and are trained in diagnosing sports-related injuries and creating a care plan for athletes that can involve both non-operative (no surgery) and operative (surgery) solutions.
Emily Kraus M.D. is a cyclist and sports medicine doctor who practices at Stanford Children’s Sports Orthopedic Medicine in California.
“When I meet with a patient, I work with them to answer questions like: ‘What running shoes do they wear?’ or ‘When does their pain occur—during what activity?’ or ‘What are their goals for the season?’” said Dr. Kraus.
Sports medicine doctors work with patients to understand their athletic history, what’s bothering them currently, and how to craft a treatment plan that keeps them away from sport and life for as little time as possible.
As for the types of injuries a sports medicine doctor might see: “I do work with those who have acute injuries like ACL tears and patellar dislocations,” commented Dr. Kraus. “But I will generally refer those out to a surgical specialist.”
“What I do treat a lot are overuse injuries like tendonitis, bursitis, stress fractures, and low back pain,” said Dr. Kraus.
If you’re facing a nagging injury that has yet to be diagnosed, look up a local sports medicine doctor. After an initial consult, the sports medicine provider can work with the patient to determine if further treatment from a chiropractor, physical therapist, or orthopedic surgeon is needed.
Physical therapists often define themselves as “movement specialists,” meaning they work with athletes to help them move without dysfunction or pain. To become a physical therapist, one must have a four-year bachelor’s degree and then attend a three-year doctorate program, rounded out by needing to pass a board-certification exam.
Brenna David PT, DPT, CSCS, OCS is a physical therapist at Avant Physical Therapy in Seattle, Washington who specializes in working with athletes.
“My job as a physical therapist is to look at how someone moves, how their body is functioning, how it’s dysfunctioning, and then prescribe corrective and strengthening exercises to remedy that,” said Dr. David.
While some physical therapists may offer manual manipulations like musculoskeletal adjustments, most physical therapists will treat patients with a variety of rehabilitation-focused exercises and neuromuscular re-education (i.e. “retraining” the brain).
“Our goal is to get our patients active,” noted Dr. David. “If there’s a triathlete who has pain, a physical therapist’s job is to get that triathlete to an optimal state functionally so that the athlete can reach their goals.”
Dr. David suggests heading to a PT—most do not require a referral—if the athlete is experiencing joint or muscle pain, chronic aches or pain (or aches and pains that come and go), or an undefined pain isolated to one area of the body.
Chiropractors are generally thought of as “alignment specialists,” as their goal is to use hands-on manipulations of the body to realign a patient’s spine and other critical areas.
Chiropractors must also complete extensive training, including a four-year undergraduate degree followed by a four-year graduate program that includes mandatory internships and at least 900 hours of supervised work in a chiropractic setting.
Erika Bonilla DC, CCSP, SFG owns Elite Spine and Body Chiropractic in San Clemente, Ca. and has been a chiropractor for 11 years.
“I treat people as a whole. I don’t just treat where their pain is,” said Dr. Bonilla. “I look at them as a whole person.”
As Dr. Bonilla said, the nervous system is “the queen.” And when the queen is imbalanced, irritated, or out of sorts, isolated areas of pain can occur throughout the body.
“Spinal adjustments and a happy nervous system grant you pain-free movement,” said Dr. Bonilla. “Adjustments lead to improved range of motion, faster healing time, and reduced irritation of the nerves between the spinal vertebrae.”
Dr. Bonilla, who is a triathlete herself, noted that she wants to see athletes “before there is pain” so that she can help them stay aligned and prevent injury.
But, if you’re a triathlete who is experiencing frequent headaches, neck pain, hip pain, ankle pain, or other pain in that critical kinetic chain, a visit to the chiropractor can help not only realign the spine but regain a healthy range of motion in the irritated area.
Orthopedic surgeons help athletes attain pain-free movement through both nonoperative and surgical options.
Becoming an orthopedic surgeon requires a four-year undergraduate degree as well as completing medical school and residency (many orthopedic surgeons complete fellowships, as well).
Rachel Frank M.D. is an orthopedic surgeon who is currently an associate professor at the University of Colorado School of Medicine and the director of the Joint Preservation Program. She’s also an avid long-course triathlete.
Dr. Frank notes that her first line of defense for a patient are nonoperative options like physical therapy. If nonoperative methods aren’t providing the relief an athlete needs, Dr. Frank steps in to “definitively” treat musculoskeletal injuries through surgery.
However, Dr. Frank noted that one of the best parts about medicine is that it is multidisciplinary.
“In a field like sports medicine, having different experts available to deliver care is an incredible benefit to our patients,” commented Dr. Frank. “Both surgeons and nonoperative sports medicine specialists can serve as an athlete’s team of physicians and have vital roles. Often, we work together to provide the best care possible for our patients.”
A triathlete might consider heading to an orthopaedic surgeon for a consultation due to: ligament, tendon, or cartilage tears, fractures, previous injuries that still cause pain, or a second opinion when nonoperative methods have not provided the needed level of rehabilitation.
“My advice is to never be afraid to seek the opinion of an orthopedic surgeon,” said Dr. Frank. “Our goal is to keep you active, fit, and happy. Our goal is also to always try to avoid surgery if we can, so long as it’s safe to do so.”