Sports and exercise medicine—specialists or snake oil salesmen?

There is a belief that Sports and Exercise Medicine (SEM) is a unique aspect of medical practice because sports physicians care for elite athletes, and athletes are different. This situation can result in the use of unproven therapies which are then justified on the basis that elite athletes need to be at the “cutting edge” of medical treatment in order to return to play as rapidly as possible. In more established fields of medicine, the use of such unproven therapy would lead to considerable professional criticism.1 The concept that “cutting edge” treatment means the integration of anecdotal treatments into conventional sports medicine needs to be addressed urgently. We argue that not only is this approach flawed but that it will limit the development of an evidence base in SEM, is ethically questionable and will ultimately undermine the credibility of the specialty.2 3 Evidence-based medicine, with all its limitations, is a vital component of good clinical practice and enhances patient confidence in medicine. Good clinical practice demands that we search for, and develop, evidence for benefit and safety and then select treatment options according to the best evidence available. For the speciality of SEM, to ignore established evidence-based approaches to medical practice is simply unacceptable in the modern era. A recent editorial in the Journal by a group of experienced clinicians argued that an unproven injection therapy for acute muscle strains should be considered “an important …