How did you first start in sports medicine?
Before I became a GP I worked as a medic in the Navy. One of my colleagues, who was the Navy rugby team physio, asked me to cover a game because the usual doctor had been deployed elsewhere. The Navy later sponsored me to do a distance learning sports and exercise diploma at Bath University.
After leaving the Navy, I continued to work in rugby alongside general practice, as one of the match doctors with Plymouth Albion.
I currently work in Devon, covering about half a dozen rugby matches a year during the county championships. As part of that work, I do an annual pitch-side trauma course for training in high-impact injuries.
How did you become involved in wheelchair rugby and what does your role involve?
A couple of years ago I was approached by someone from Navy rugby who said that Team GB wheelchair rugby needed a GP.
This year, I did about 40 days with the wheelchair rugby team because of the Paralympics, but next year it will probably only be 10 or 12 days.
A lot of what I do is looking after renal problems, pressure areas and any number of things that pertain to players' injuries. A lot of it is distance working - for example, I might need to generate a referral to a consultant, or liaise with a player's consultant or specialist nurse in the spinal clinic.
If I go to training camp with the team for two or three days at Stoke Mandeville or in Norfolk, I can sort out some of the team members' longer-term problems.
While I'm there with the team, I might have nothing to do for most of the day, but this is really about building a relationship with the team and being supportive. I'm not their GP and most of their GPs are fantastic.
Watch the team in action
You went to the Paralympics with the wheelchair rugby team. What was that like?
It was the most amazing thing; it was a surreal experience. It was a real rollercoaster of emotions, especially for the members of the team. They would go into the Olympic Park and they'd be mobbed by enthusiastic spectators.
On the first day of training, the team left the arena and as soon as they got into the Olympic Park, people started to realise they were a British team. Everyone was turning around to look at them and then suddenly people started clapping. Just to be associated with something like that, to witness something like that, is amazing. Some of the younger members of the team couldn't quite believe it.
For me, a lot of my work was done before the Games started, because I was working on classifications.
Classifications group Paralympic athletes into classes, based on their ability to perform a certain activity. There are seven classes, ranging from 0.5 to 3.5, and the total number of 'points' allowed on the court at any time is 8.0.
We started work on the classifications 18 months before the Games began. I worked in collaboration with the team's physio and the coach to gather evidence on what each player can and cannot do.
During the matches, there was a courtside trained medic present, so in that respect, the heat was off for me.
Once the Games started, it was a bit of a nail-biting time. Other teams can contest the classification of one of your players. Even if your case is robust, you have to think 'What if?' You have to be prepared for a protest against one of your players, which means you've got to be ready to send your classification to an adjudicator.
Some teams make tactical protests to classifications, but the Team GB policy is very clear on that; we don't get involved in it.
How does sports medicine fit in with being a GP?
In sports medicine you need to think on your feet and general practice is a great grounding for that. I couldn't do sports medicine full time, though, and coming back to general practice has been really nice.
With sports medicine the intensity isn't the same as in general practice, where you have 10-minute appointments, but you work in a different way. The medicine is different because with athletes, quite small medical problems can affect their performance so much.
What would you say to GPs who want to get involved?
I would say just go to your local club, but you do need some qualifications under your belt first. It's not like the old days when the local GP just turned up and covered the match.
Locally we have a sort of sports medicine journals club; we meet every couple of months for a lecture and discussion. Find out if you've got a local group that can support you.
