Table 6. Treatment recommendations (%) Total population (n = 233) Sports medical advice Physiotherapy/manual therapy/exercisaes Referral (orthopedic) surgeon Medication ESWT Brace/insole/bandage Referral to other medical specialist Injection of corticosteroids 22.7 54.4 19.2 10.0 10.0 9.6 5.6 1.3 Abbreviations: ESWT, extracorporeal shockwave therapy; GP, general practitioner. Self-referrers 31.5 46.0 14.6 12.2 10.1 7.9 4.4 0.4 Referredby GP 15.5 62.5 22.7 8.2 5.2 13.4 6.2 0.4 Referred byphysiotherapist/paramedic 17.9 50.0 17.8 14.3 21.4 7.1 0 0.4 Referred bymedical specialist 13.3 60.0 26.7 0 20.0 0 20.0 0 The patients in the present study corresponded regarding age, gender, and sports performance with demographic data on sport injuries reported by the Dutch National Institute for Health and Environment and by others examining the prevalence of sport injuries in general practice.3–6 Therefore, our study population seems to be representative of patients with sport-related injuries in The Netherlands. Soccer and running (the most commonly practiced sports) were responsible for the greatest amount of injuries, and men reported more sports-related injuries than women. Most patients in this study visited a sports physician with lower limb complaints, mainly involving the ankles and knees. Patients referred by a general practitioner to a sports physician suffered mainly from patellofemoral pain syndrome, whereas self-referrers suffered mainly from intra-articular knee pathology. Apart from that, the overall picture of sports-related injuries was similar between the four groups and corresponds with data from the National Compass Public Health 2009.7–16 all patients with sports-related problems in The Netherlands. Some of the self-referred patients may have consulted their general practitioners, team physicians, or other therapists in the past, which may have affected the outcome of our study. Unfortunately, we cannot compare our data on diagnoses with other data on the prevalence of sports-related injuries in general practice because only non-diagnosis-specific registration was made in the previous studies.3,6 Our study did not monitor the severity or follow-up of sport-related injuries. Our study group consisted of patients consulting sports physicians at the University Sports Medical Center during September. The specific setting and season may have influenced patient characteristics, in which case this population may not be representative of Conclusion Self-referrers represent an important proportion (39.3% in this study) of a growing patient population with sportsrelated injuries consulting sports physicians in The Netherlands. In our study, although the baseline characteristics of self-referrers were similar, their profiles differed from those of patients who were referred to a sports physician. Self-referrers can be broadly characterized as having relatively new complaints and more frequently engaging in individual sports. Their reasons for bypassing the general practitioner to consult a sports physician directly remain unclear. More knowledge on these motives might answer the question whether, in the case of sports-related injuries, a direct specific evaluation by a sports physician has additional value, or whether the general practitioner could filter sports-related problems in the first instance, with the sports physician in the background as a secondline clinical specialist. Acknowledgment This study was funded by the Department of General Practice, University Medical Center Groningen, The Netherlands. nummer 1 | maart 2013 | Sport & Geneeskunde 31 Pagina 30
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