With spring approaching and temperatures rising, sports and exercising are once again seeing an annual resurgence in popularity among Shanghai residents. But after months of hibernation during the cold winter, suddenly leaping onto a basketball court or running along Suzhou Creek could result in physical injuries.

Indeed, at hospitals across Shanghai the long queues of patients has segued from sickly children to hamstrung adults, now making orthopedic doctors rather than pediatricians the city's most in-demand. But according to some medical experts, Chinese orthopedics is not nearly as specialized as in Western countries.

"When a doctor gives his diagnosis, he needs to know a lot about sports. Someone who came here with an injury of running is completely different from someone who injured his knee," Dr. Derk Rietveld, an orthopedic surgeon and sports medicine specialist with Parkway Health Medical Center in Shanghai, told the Global Times.

"Soccer, for example, is completely different from playing basketball or running. You have to know which movement they make, whether they run straight or take a turn, which muscles are used more than others and whether they are trained in strength, coordination, or speed," he added.

Lack of preventative measures

Rehabilitation is also a concern among sports players in China, with many saying that the local physical therapy (PT) industry lacks modern methods. "Chinese rehab is more into TCM and massaging," said Dr. Rietveld, who confirmed the overall lack of PT specialists in Shanghai. An anonymous physician of a large hospital in Shanghai also told the Global Times that while there are many rehab professionals in Shanghai, most of them have limited skills and training.

"Sports medicine is not only orthopedics, you have to coordinate the rehab and see how the patients can go back to his sport, talking to the trainer or coaches. It also depends on what sport it is," he added.

"There's a lack of public awareness of prevention, leading to more and more injuries," the anonymous physician told the Global Times.

"People in China don't do a lot of prevention before sports. In Holland, for example, if you want to run a marathon, you have to be tested first. Here, people wear jeans or non-sports shoes in marathons. They're not prepared," said Dr. Rietveld.

International clinics and general hospitals in Shanghai do not offer sports testing or even give advice to amateur athletes. "People can do medical checks in hospitals, but no expert explains to them what is on their medical check reports or tells them how to improve their health conditions," Dr. Rietveld added.

Minimum amount of moving

Dr. Rietveld believes that one of the primary reasons behind these discrepancies is that Chinese and Western people see exercise as having different purposes.

"As the world's population has become more sedentary, the rates of obesity and diabetes have sharply increased," said Dr. Ashwin Deshmukh, Chief of Orthopedic & Sports Medicine of Shanghai United Family Hospital and Clinics. "There are many ancient and excellent health and fitness practices in China - tai chi and group dancing in public parks for example - that are becoming increasingly popular around the world."

Fitness for people in China means getting fit by losing weight or gaining muscles, while for Westerners being overall healthy and feeling good hold a priority over appearance, said Dr. Rietveld.

"The main difference between the two regions is in the popularity of sports at the amateur/recreational level," said Dr. Deshmukh. In many other countries, amateur and recreational leagues are highly developed and playing fields and basketball courts are available in most neighborhoods."

Remarkably insufficient

According to the anonymous physician, Chinese sport medicine practitioners are not well trained and do not keep up with cutting-edge methods. Many doctors also have to give up clinical training or fail to observe medical guidelines in order to cope with large numbers of patients and to meet the thesis evaluation and revenue requirements of the hospitals.

The same applies to the situation of orthopedics trauma treatment. Low pricing of medicine as well as the low salaries of doctors have led to a significant decrease of orthopedics trauma professionals in China, "with local rehab expertise remarkably insufficient," the physician said.

"We have good medicine and methods in our traditional treatment, such as Yunnan Baiyao (an ancient herbal remedy to reduce post-operative bleeding) which has good efficacy against some acute trauma and inflammation. But compared to the Western system, orthopedic and sport injury treatment in China are less developed," the physician told the Global Times.

 

 

(From above) Dr. Ashwin Deshmukh and Dr. Derk Rietveld with patients

Photos: Courtesy of the interviewees

 
Newspaper headline: Ill-equipped