The American College of Sports Medicine (ACSM) is proud to feature Tyler Wadsworth, MD, in this issue’s Clinician Profile. Dr. Wadsworth has been practicing Sports and Musculoskeletal Medicine in the St. Louis area for almost 20 years. He is certified by the American Board of Medical Specialties in Family Medicine and Sports Medicine. He completed a postgraduate fellowship in Sports Medicine at Hennepin County Medical Center in Minneapolis, MN, in 1990. He has written chapters in sports medicine textbooks and articles in a number of scientific journals about a variety of sports medicine topics. Dr. Wadsworth has lectured at numerous local, national, and international sports medicine conferences. He is cochair of ACSM’s Team Physician Course and serves on the ACSM Medical Education Committee. He is the medical director for the Athletic Training Education Program at Saint Louis University. Dr. Wadsworth serves as team physician for Saint Louis University, Webster University, and University City High School and team consultant for the Pittsburgh Pirates. He has been selected by his peers for inclusion in the Best Doctors in America® list.
You Have Been an ACSM Member since 1990, How Has ACSM Grown and Changed since You Became a Member?
The power of ACSM comes from its diverse and accomplished membership. The growth of the organization has been remarkable, which is most apparent at the Annual Meeting. We consistently have presentations at the Annual Meeting by experts from around the world. I really enjoy meeting members from diverse backgrounds and professions and seeing issues presented from perspectives that are different from mine as a primary care sports medicine physician in the United States. The contributions from international members and the growth of ACSM as a world leader in sports medicine have been astounding. As ACSM has grown and become such an important organization in sports medicine, we have been able to influence sports and exercise medicine policy. The vast expertise and energy of our membership are changing the way the United States and the world view exercise.
A major positive change has been the increasing presence of my subspecialty of primary care sports medicine physicians within ACSM. There were few of us around back in those days, and it is rewarding to see the broad contributions of many colleagues to the advancement of sports and exercise science and to the service of ACSM.
What Was It Like to Be a Clinician a Decade or Two ago Compared to Today?
One of the most important differences is the growth of the primary care sports medicine subspecialty. There were a handful of experts in this area around the country when I started out more than 20 years ago; now there are multiple fellowship-trained primary care sports medicine fellowship physicians in most major metropolitan areas. This growth has provided greater access to expert care for athletes and improved the training in sports medicine in primary care residencies.
Our understanding of the disease processes and injuries that we see in sports medicine has progressed, as have the tools we have to treat these conditions. The science of sports medicine has advanced considerably, and ACSM and its members have been great contributors to that fund of knowledge. Prevention of anterior cruciate ligament injuries in female athletes is a great example. When I started practice, we were just becoming aware of differing injury patterns in male and female athletes. It has been fascinating to see our understanding grow from identifying the problem to finding associated risk factors, learning to address those risk factors, and showing that injury rates decrease as those risks are addressed.
We certainly have wider availability of advanced imaging modalities such as magnetic resonance imaging and office-based ultrasound, so sometimes there is a little less guesswork with difficult or challenging cases. Advances in imaging modalities have in some cases led to better understanding of underlying pathophysiology and improvement in care. The emergence of office-based musculoskeletal ultrasound has improved my diagnostic accuracy. As it turns out, you CAN teach an old dog new tricks! We are able to diagnose and treat tendinopathies and other soft tissue injuries more precisely. I have seen fewer patients require open surgical procedures to successfully treat these injuries, which I believe reflects improvement in our nonsurgical treatment options.
How Has Membership in ACSM Influenced Your Career?
ACSM has influenced me in many ways. Most importantly, I have connected with bright, energetic, and talented sports medicine professionals who have taught me a great deal about sports medicine and about how to contribute to our field. I have been able to collaborate with colleagues from around the country on projects to improve sports medicine education. These are things that just cannot be accomplished alone.
ACSM journals are among the most important publications in the field of sports medicine, and there have been countless times that I have changed the way I approach clinical problems because of an improvement in understanding of an injury or condition that I treat because of something I have read in Current Sports Medicine Reports, Medicine & Science in Sports & Exercise®, or one of our other journals. I have learned new rehabilitation techniques, diagnostic strategies, and developed new skills to improve the care of athletes and patients. Reading member journals and attending the Annual Meeting and other educational offerings allows me to remain current in the treatments I can offer to my patients.
I have met many of the great leaders in sports medicine through ACSM. Getting an opportunity to sit and chat with pioneers in the field was priceless to a new physician all those years ago. I have been mentored by several of the primary care sports medicine physicians who established the credibility of medical physicians as valuable members of the sports medicine team. I learned how to mix a private practice with the demands of team sports coverage and the need for academic contributions from a wide variety of sports medicine specialists. I learned to find a place in this wonderful profession that would allow me to contribute in some small ways to the advancement of science and to the education of future sports medicine professionals.
The multidisciplinary nature of ACSM has been of particular influence on me. I have learned a great deal from other professions within the broad scope of sports medicine: athletic trainers, physical therapists, exercise physiologists, and others in the field. Friendships and collaborations with these dedicated colleagues have been professionally and personally rewarding and have enriched my career immensely.
How Do You Use the ACSM Network in Your Daily Work?
It is not uncommon to send an e-mail or place a quick phone call to run an unusual or interesting case by a colleague. I access member journals frequently to try to keep my practice up to speed. The most credible exercise science professionals in the world are members of ACSM, and I have learned a great deal from them at the Annual Meeting. I have had the privilege of interacting with world experts in a variety of areas within sports medicine and have been able to establish rich and rewarding friendships with some incredibly bright leaders in the field of sports medicine.
What Is Your Best Advice to Other Sports Medicine Clinicians?
Work hard to make sure your skills are sharp. Maintain membership in ACSM and your professional organizations, serve on committees, participate in ACSM’s Annual Meeting, and grow your contacts in sports medicine. Read and keep up with the sports medicine literature to expand your knowledge base and deepen your experience. Expand your network while enhancing your knowledge by attending ACSM meetings and getting to know some of the faculty and attendees outside of your regular sphere of colleagues. Volunteer at local high schools, health-related and other charities, ACSM, and other organizations where you can use your skills in settings other than a medical office. Doing something for the greater good gives immense satisfaction and makes the world a better place.
Where Do You See ACSM Heading in the Future?
Several developments excite me about ACSM. I really love the Exercise is Medicine® program, and I think that the translation of this incredible body of information we are developing into action with the American public and the world has the potential for huge impact on the public’s health and well-being.
ACSM is partnering with other organizations such as the American Medical Society for Sports Medicine and the American Orthopedic Society for Sports Medicine to sponsor the Advanced Team Physician Course, one of the top sports medicine continuing medical education events in the world. ACSM partners with the National Athletic Trainers Association, Federation Internationale de Medecine du Sport, British Association of Sport and Exercise Medicine, European College of Sport Science, Pan American Confederation of Sports Medicine, International Council of Sport Science and Physical Education, and other organizations to provide educational courses around the globe. Our growth as an internationally prominent sports medicine organization will continue to spread and advance the science of sports medicine the world over.
But it is the growing support for high-quality sports medicine research that excites me most about ACSM. There are more questions than answers about the conditions that affect athletes and active people, and quality research leads to improved care for our athletes and patients. The ACSM Foundation is providing currently more than $100,000 in direct financial support for sports medicine researchers, and this number continues to grow. Without research, neither the science nor the clinical practice advances.