Having had the personal experience of visiting several human sports medicine practices over the last several years, I am always interested to see how human and veterinary sports medicine and rehabilitation services might compare. However, I continue to be amazed when I ask the sports medicine physician or orthopaedic surgeon what area or aspects of sports medicine that they work with and they respond "knees" or "shoulders." I am quite sure that I would have a hard time focusing on the treatment and surgical repair of a single articulation for my entire career, but it does illustrate how specialized some of our human colleagues have become. But it also emphasizes the critical need for collaborative efforts between human physical therapists, physiatrists, coaches, athletic trainers, chiropractors, massage therapists, and whomever else might be included in an individual's sports medicine team.

As a diplomate in veterinary sports medicine and rehabilitation, all of the above responsibilities and expectations might unfortunately fall upon a single individual in a practice, which can make it quite difficult to have the needed skill sets and to be proficient enough in all areas required to meet an animal athlete's specific needs. As our specialty continues to develop and become more refined, it is expected that each of us will become more focused in specific aspects of sports medicine or rehabilitation as we create a team of specialists to provide the full spectrum of services needed to serve our patients and to help meet their owners' expectations.

During a recent conversation, one of our board members stated that equine rehabilitation is not defined by providing stall rest and hand walking. Unfortunately, for many equine practitioners we have not progressed much beyond this very basic level of care. In addition, as a horse becomes sound and is no longer lame, then they are often immediately returned to a previous level of ridden exercise without any consideration of intermediary stages of rehabilitation. For most sport horse injuries, in-depth conversations are needed on how to address chronic pain mechanisms, methods to improve proprioception and flexibility, and therapeutic exercises that are focused on specific rehabilitation issues and staged to the current phase of injury or healing. While specific aspects of equine sports medicine are more fully established (e.g., lameness diagnosis and treatment), there is a concurrent need to fully integrate and implement equine rehabilitation principles and practices in sports medicine. We can do so much more than the age-old remedies of pasture turnout, stall confinement or hand walking for our equine patients.

Conversely, canine rehabilitation has become a great practice builder with the installation of underwater treadmills, the increased use of laser therapy for a multitude of ailments, and the wide array of tools and toys used to improve balance, coordination, core stability, strength and endurance for dogs with orthopaedic and neurologic disabilities. However, the field of canine sports medicine often lags far behind for many small animal practitioners. Borrowing from equine sports medicine practice, there has been a growing interest in the use of musculoskeletal ultrasound, intra-articular medications, biological therapies, and video analysis of subtle performance or lameness issues in our canine athletes. Many of the skills needed to support the development of canine sports medicine have been relinquished to dog trainers and have not been well established within veterinary training programs. Examples of some of these include dogs involved in military duties, drug detection, search and rescue, agility training and competition, and service animals for seizure or cancer detection. Aspects of sports medicine could benefit dogs involved in all of the above activities.

Veterinary sports medicine and rehabilitation is also not limited to dogs and horses. Cattle or small ruminants may have orthopaedic or neurologic disorders that are amendable to rehabilitation. Cats and many of the pocket pets seen in small animal or exotic practices also are often in need of rehabilitative care. Over the last 5 years I have consulted with a team of veterinarians and zoo keepers focused on the successful rehabilitation of a giraffe with torticollis, an elephant with knee osteoarthritis and patellar luxation, and a tiger with a suspected hip injury that was exacerbated by poor stair design in the enclosure that was too steep and had too short of treads which prevented normal limb placement during descent. Wildlife rehabilitation centers have been in existence for decades, but many may not include regular veterinary staffing or consultation with animal rehabilitation specialists. In some parts of the world, professional camel racing is common and could benefit from insights provided by a veterinary sports medicine specialist.

As we continue to define and expand the roles of veterinary sports medicine and rehabilitation, we need to educate our clientele and colleagues that sports medicine is not delineated by a single surgical procedure for addressing cranial cruciate ligament injures in dogs and that running horses through set underwater treadmill exercise routines without consideration of specific rehabilitation issues or disabilities of the individual patient is not rehabilitation.

As always, if you have any questions or concerns please let me know or contact one of the ACVSMR board or committee members.