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I see that the recent House of Lords Science and Technology Select Committee has released its report on complimentary and alternative medicine (CAM).1 For almost two years this committee considered the submissions put to it, examined the evidence, and took expert advice. The report ultimately had something for everyone. Not surprisingly they found that CAM requires more detailed study, that CAM practitioners need to be regulated, their training scrutinised, and that CAM should be integrated into mainstream health care.
In sports medicine, we increasingly are embracing CAM techniques. Perhaps due to the long history in many countries of musculoskeletal medicine, a tradition of manual medicine has developed and is used by many sports medicos. In addition, dry needling techniques for pain or muscle spasm bear curious similarities to acupuncture. Our close involvement with physiotherapists, soft tissue therapists, osteopaths, chiropractors, podiatrists, and the like means that we have a constant exposure to some of manual therapy disciplines. While not embracing all of the CAM disciplines, such as Bach flower therapy, nevertheless I suspect sports medicine is actually well placed in assist in developing the understanding of the overlap between CAM and mainstream medicine.
Part of our use of these therapies in the past has been driven by need. To enable an athlete with an acute injury to perform well at a competition we often resort to needling, muscle energy, and other remedies. Athletes are not interested in acquiring a detailed understanding of the pros and cons of therapy but rather want to do “whatever it takes” to get on the field.
Having had this practical experience, it is the challenge of sports medicine to take the next step. To perform scientifically credible studies to prove or disprove the effectiveness of what we do. Sports medicine occupies a unique position within this area, straddling the divide between mainstream and alternative medicine. We can bring the scientific rigour needed for studies to proceed and answer these important questions. Sports medicine clinicians should consider applying for the research funding suggested by the House of Lord's Committee and expand the evidence base of our discipline.
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