World of sports just gets wider

Sports medicine isn't just about sports medicine any more, hasn't been for a while now. It isn't just about bones and joints, or even fitness. Sports medicine in the 21st century is also about the ways in which athletes are affected by diseases and conditions that have nothing to do with sports. It's about Alonzo Mourning's kidneys, and Tim Howard's Tourette's syndrome, and Todd MacCulloch's Charcot Marie Tooth disease, and the insulin pump that Tigers' pitcher Jason Johnson wears on his belt during games.

And as National Football League teams enter training camp for the 2004 season, sports medicine is about Khiawatha Downey.

Downey, a 340-pound offensive lineman from Indiana University of Pennsylvania, was projected as a middle-round pick in the April NFL draft. But that was back when all teams cared about was his ability to play football. That was before teams learned that Downey has multiple sclerosis.

Imagine being a practitioner who works with an NFL team, and getting a call from the team's vice president for player personnel asking you what kind of risk they'll be taking if they use a draft pick on this kid. Would the average NFL practitioner have any familiarity with the clinical nuances of multiple sclerosis and, more important in this case, their relevance to an athlete's performance? I'm guessing not.

The average NFL practitioner might know that many patients with MS are easily fatigued and that their symptoms tend to be exacerbated by increases in core body temperature-information that would make any team executive wary of taking a chance on such an athlete.

A select few sports medicine practitioners, such as those who attended a Saturday morning workshop on multiple sclerosis during the National Athletic Trainers Association annual meeting in June, might know that exercise actually does not put an MS patient at risk if he or she is asymptomatic (which Downey has been since his diagnosis in early 2001) and if the patient takes medication to keep the progression of the disease in check (which Downey does). They also know that although the "flu-like symptoms" associated with MS medication can be severe, the fact that at least one medication can be taken just once a week means that those side effects would have a minimal impact on Downey's ability to attend practices and games.

NFL-affiliated practitioners who took the time to read the three-page letter from Downey's neurologist that was circulated to teams before the draft might have been convinced of these distinctions. What's more likely is that they simply felt they didn't have enough information to assure a team executive that drafting Downey would be a risk-free proposition.

In the end, all seven rounds of the draft came and went without Downey's name being called. The San Francisco 49ers, however, did think enough of Downey's performance in a May mini-camp to offer him a free-agent contract and bring him to training camp. Which means you can bet that the 49ers medical personnel have spent the last few weeks studying up on multiple sclerosis and exercise.

With advances in diagnostic imaging techniques and pharmaceutical research facilitating early identification and treatment of conditions like MS, such diagnoses will be less and less likely to keep a young athlete from pursuing his or her dreams. And that pursuit, ultimately, is what sports medicine is really about.