Sport & Exercise Medicine: Working with Professional Tennis Players & Athletes


Prof Mark Batt is a Consultant of Sport and Exercise Medicine working at Nottingham University Hospitals NHS Trust and The BMI Park Hospital. He also spends his time working with professional athletes and tournaments such as Wimbledon and the London 2012 Olympics.

We caught up with him to find out more about his exciting roles:

How did you get into the medical profession?

I got into medicine because I was always interested in sciences at school, I’m from a very medical family, I’m the 10th doctor in direct generations, and we go back to the middle 1700s. Thus I guess part of my love of medicine was in my genes.

Growing up I always loved sports and I was always looking for a fusion of medicine and sport, making sports medicine a very natural choice for me. That having been said, training in sports medicine was really difficult because there were no specialist training schemes when I qualified in 1984.

Prof Mark Batt

Prof Mark Batt

Consultant in Sport and Exercise Medicine

BSc MB BChir DRCOG DM  FRCP FFSEM(UK)


What is a Consultant of Sport and Exercise Medicine, and what does your role entail?

My role is split between clinical work, research and teaching. My clinical work is with NHS patients at Nottingham University Hospital NHS Trust, and here at The BMI Park Hospital. I see patients with musculoskeletal problems that have come about through exercise, physical activity and sport. Whilst some of my work involves working with higher-level athletes, actually I’m interested in all athletes and exercisers. I see patient of all ages, including children and adolescents. One of my mantras is that all my patients are ‘athletes to a greater or lesser extent’.

As well as my clinical work, I am also a researcher and the Director of The Arthritis Research UK Centre for Sport and Exercise and

Osteoarthritis. This is a large consortium of universities including Nottingham, Oxford, Southampton, Bath, Loughborough, UCL and Leeds, with several international partners looking specifically at Osteoarthritis, sport, exercise and injury.

I teach widely in Nottingham, nationally and internationally, and have asked to examine PhD theses from around the world. In addition I have advocacy roles with physical activity, have and worked with the Department of Health on their Physical Activity guidelines. Thus I wear a number of different hats, and each of them is important and I love the opportunity to move between the varied roles.

You are an Honorary Professor of Sports Medicine at Nottingham University: Is this an area that is growing in popularity?

At the University of Nottingham we’ve had a Sport and Exercise Medicine Masters for over 20 years. We take a variety of students on to the course from backgrounds including Medicine, Sports Science, Physiotherapy and other disciplines.

Medical students and young doctors are becoming increasingly interested in the specialty and it’s now much easier to train to be a specialist in Sports Medicine than it was some years ago as we now

have specialty training available. This is a 4 year training programme which begins after Foundation years and basic medical training.

One of the hats that I wore previously was in 2004/5, when I chaired the committee that wrote the papers for Government to have Sport and Exercise Medicine accredited as a speciality of Medicine. That happened in 2006, with the subsequent formation of the Faculty of Sport and Exercise Medicine, that I was President of until the end of 2012.

With the broad array of roles you have, what does a usual week entail for you?

I spend 50% of my time doing research through Arthritis UK Centre, and the remaining 50% is spent with patients either at my private practice at BMI The Park Hospital on a Wednesday or my two

NHS clinic days in Sport and Exercise Medicine at Nottingham University Hospitals.

You work as a Sports Doctor for many sporting events and tournaments in the UK, can you tell us which ones and briefly what your role is at each?

Formerly I worked with The England and Wales Cricket board on their advisory group to help manage players, and I have held a similar role with The Rugby Football League. I had a more hands on role with British Gymnastics including travelling to world championships and also providing local services to gymnasts training in Nottingham - we have a big gymnastics training centre and we see a number of their gymnasts.

I was one of the first doctors working as a sports physician for The English Institute of Sport looking after England’s elite athletes in a number of different sports. And finally is tennis, which is what I do most of now. I’ve been at Wimbledon for 16 years and for the last few years I’ve worked with the ATP at the World Tour Finals, which is held at the O2 arena.

Tell us more about your role at Wimbledon?

Along with my colleagues Doctors Phillip Bell, Ian McCurdie and Jane Allen, we provide services for tennis players who come to Wimbledon. We start during qualification week and run all the way through to the finals. We support players who typically are not travelling with their own doctors, so they rely on us to provide their medical services along with the in house team at The All England Lawn Tennis Club.

We provide musculoskeletal care, and Doctor Jane Allen, the club doctor, who’s a GP in Wimbledon, oversees primary care for the players.

Tennis

From a medical perspective, do you treat the professional athlete’s injuries differently to how you would someone in the hospital?

Understanding the context of the injury is important for players, such as the time in their competitive season and career. So, the basic approach is the same it’s just the context that is different NHS clinic

days in Sport and Exercise Medicine at Nottingham University Hospitals.

Comparing different tennis tournaments, are the injuries and treatments different due to a different playing surface: grass, hard and clay?

Yes to an extent, but I think the more interesting factor is probably the change of playing surface. We do see interesting patterns of injury that vary somewhat between surfaces, which reflects the

ball bounce and player movement patterns. For athletes it’s often the change of surface, environment and location that’s the really demanding.

What are some of the difficulties you face?

Time is an issue. For the player, as injury will adversely effect their season, thus rapid return to play is key. Time is also important when evaluating injuries on court where there are time specific pressures for medical evaluations. Other challenges are variable dependent upon tournament: many venues are complicated so your need to understand the geography of the site, your team and establish great communications.

At Wimbledon we’re typically seeing players in the medical rooms, which are effectively underneath Centre Court. If you get a call to a specific court you need to know where this is and the quickest way of getting there. There’s a huge difference between walking to courts when the site is spectator free and trying to get there when the ground is full.

What was your role at the 2012 London Olympics?

Wimbledon was one of a few venues that were described as ‘complex venues’ for London 2012, so with the Olympic tennis being held at the All England Lawn Tennis Club they tried to get a team who were familiar with the site and facilities. Doctors Phillip Bell, Jane Allen and I provided care at the London Olympic Games; it was really quite similar to The Wimbledon Championships.

However, it certainly felt different as the colours changed with the logos and livery of London 2012. Many of the players had their own Olympic medical teams, which is typically for an Olympic event, and is not typically the case for Grand Slams. We had fewer players as it was a smaller draw for the Olympic Games than for the Championships.

From your experience of working at the London 2012 Olympics do you think it provided the lasting legacy of boosting interest in sport?

Looking at the evidence, the answer to that question at this stage is no. Indeed if you look at the historical evidence that the Olympic Games stimulate more people to be more active, the evidence is thin. However, I think the Olympics did other things. It allowed for regeneration, particularly in East London, an area that has benefited massively. It has created some fantastic new sports facilities and a National Centre for Sport & Exercise Medicine.

Team GB did fantastically well at the Games and from a medical perspective were very well led and looked after. The Games also served to remind us that Great Britain is fantastically good at staging large events!

Athletes

Do you see a difference between the types of injuries in the professional sports players compared to general public?

You need training in both, as they are subtlety different. There are also some sport specific injuries that you may see at a higher level of competition, but overall it’s pretty similar. It has created some fantastic new sports facilities and a National Centre for Sport &

Exercise Medicine. Team GB did fantastically well at the Games and from a medical perspective were very well led and looked after. The Games also served to remind us that Great Britain is fantastically good at staging large events!

In terms of severity, is it generally more severe in professional athletes because they are playing at a higher intensity and general injuries will just be small niggles and pains?

Not necessarily, I think the severity is often the same. In fact the opposite may be true whereby elite athletes, surrounded by a care system of strength and conditioning, nutrition, physiotherapy, and massage therapy, have their niggles and illnesses identified earlier.

In terms of an ankle or knee injury there really isn’t a significant difference between types and severity of injuries sustained in village football or The Premiership.

What can we do to avoid and treat sports injuries ourselves?

Importantly, we need to encourage more people to become more active more of the time. Linked to that making sensible choices about what you choose to eat and drink. Helping the whole population, from young people all the way through to the elderly, to stay fit and active and specifically not to have prolonged sedentary

periods is vital. In terms of injury prevention, the vast majority of injuries occur through overuse and because of training errors, often doing too much, too soon. So specific advice around training and technique is important.

Ok, so what about warming up properly, warming down?

Interestingly, the evidence around warming up is not particularly strong, many people assume they need to stretch or do flexibility work prior to exercise to prevent injury but the evidence is not very strong. You see people getting straight out of the car trying to stretch before they then run on to the football pitch: in reality they should warm up through walking, then jogging to get the tissues warm, then do some flexibility work, prior to playing sport. The most important thing is the post activity stretch; the concept of warming down and stretching out muscles is good. Avoiding injury is more about listening to your body, cross training, giving your body different activities to do, and ensuring you have time to rest and catch up between activities.

Runner

Is there any particular advice you can give to people who may not lead particularly active lifestyles in terms of what they can be doing?

I would encourage sensible physical activity, which doesn’t need to be sport or vigorous activity. Sport is one aspect of physical activity, but using the stairs rather than the lift, walking more, dancing, dog walking, gardening, housework, all count as physical activity. People

need to be more active and less sedentary on a daily basis. Working to the Government’s Physical Activity guidelines is a great start, and way to maintain health.

Do you have any other particular interests outside of work?

I have a lot of interests; I play a number of different sports (all pretty badly!). I’m a keen on the outdoors and a gardener. .

I run, cycle, play tennis, play golf, ski (particularly cross country skiing). Anything really - I’m happy to give most things a go

Do you find with all your knowledge then you get fewer injuries?

No less than everyone else I’m afraid.

And why do you think that is?

Probably because I don’t listen to my own advice!


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