What is a Sports Physician? Sports doctors fill the gap between general practitioners and orthopaedic surgeons. They diagnose and treat musculoskeletal injuries and conditions that do not require surgery, including muscle, ligament, tendon and minor bone injuries. They manage not only elite athletes but also musculoskeletal injuries in the non-sporting population. Sports Physicians also manage regular medical conditions in athletes like asthma and diabetes and promote the “exercise is medicine” approach to treat chronic illnesses.
Common conditions seen include ankle sprains, muscle tears, tennis elbow (lateral epicondylitis), rotator cuff syndrome, jumpers knee, runners knee, plantar fasciitis and many more. Most of our patients with tennis elbow don’t play tennis!
General Practice: Dr Donna Dowson is also a general practitioner. She is a family doctor and has a soft spot for children and is comfortable attending to paediatric patients. Minor surgical procedures are also performed in the rooms under local anaesthetic, for example excisions of moles and cysts. Treatment and monitoring of chronic illnesses like high blood pressure and diabetes is also offered, along with treatment of acute illnesses.
• Treatment of Facial Veins/Telangiectasia: Electrocautery is a safe and effective way to treat small facial veins medically known as telangiectasia.
The vein is cauterized by repeated applications of the tip of a hand held cautery over the entire length of the vessel. The procedure does not require local anaesthesia and it is generally well tolerated. In most cases (88%) a single session is enough to remove the telangiectatic vessel, however, in some occasions, 2 or 3 consecutive sessions are necessary, done 3 weeks apart.
Figure: a) Telangiectasia before treatment. B) After treatment
(image from: E Liapakis I, Englander M, Sinani R, I Paschalis E. Management of Facial Telangiectasias with Hand Cautery. World J Plast Surg. 2015;4(2):127-133.)
• Special Interest in skin Cancer: Dr Donna Dowson has a special interest in diagnosing and treating skin cancers. She has completed extra training in this field and uses a dermatoscope to analyse lesions. Suspicious lesions are excised in the rooms under local anaesthetic. Benign skin lesions are also treated, for example seborrheic keratosis and strawberry naevi/haemangiomas are effectively treated with electrocautery.
• Platelet Rich Plasma Injections: With PRP injections we inject the platelets and their growth factors right where they are needed, in the site of injury; often under ultrasound guidance. This aids in a faster recovery. As a standard protocol, three injections are usually done a week apart. PRP can be used to treat a variety of conditions. The injuries most commonly treated include: Tennis elbow, golfers elbow, muscle tears, tendon tears, ligament tears in the ankle and the knee (MCL). PRP injections can also help relieve pain in osteoarthritis of the knee.
• Hyaluronic Acid Injections: Hyaluronic acid is a naturally occurring substance found in the synovial (joint) fluid. It acts as a lubricant and shock absorber for joint loads. Suplasyn injections may be a therapeutic option for individuals with osteoarthritis of the knee.
• Cortisone Injections: Cortisone injections are done into painful and inflamed joints, including the shoulder, knee and ankle joint amongst others. It can also be done into tendon sheaths to relieve inflamed tendons. The cortisone is mixed with a local anesthetic to make the procedure less painful and results in immediate pain relief of the inflamed joint. Cortisone injections are usually done in conjunction with a rehabilitation program to correct and treat underlying abnormalities and injuries.
• Shockwave therapy: Shockwave is used mainly to treat tendinopathies (painful tendons from overuse). Common sites include Achilles tendons, gluteal tendons, patella tendons and golfers elbow. It is also useful in treating plantar fasciitis. The shock waves help with pain relief and also stimulate tenocytes to promote healing. Three shockwave sessions are usually done a week apart.
• MSK Ultrasound: Ultrasound is used in the consulting room to diagnose simple injuries like ligament and muscle tears and is also used for ultrasound-guided procedures like platelet rich plasma injections directly into muscle or tendon tears. Dr Dowson obtained certificates in basic and advanced MSK Ultrasound through a Phillips training course.
• Dr Donna Dowson grew up in the west of Gauteng and attended Krugersdorp high school. She is a sporting enthusiast herself and excelled in athletics, representing South Africa in various international sporting events as a junior springbok sprinter.
• She completed her MBBCh (Bachelor of Medicine and Bachelor of Surgery) in 2006 at the University of the Witwatersrand. Dr Dowson completed a two-year internship at Witbank Hospital and completed her one-year community service at South Rand Hospital. She then went on to open her own GP practice in Brackenhurst and now expanded her scope as a Sports Physician after completing her Masters in Sports Medicine at the University of Pretoria.
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