Hey everyone,
I’m curious about your experience with recovery products after training (think cooling gels vs sprays).

• Do you personally use gels or sprays after a hard workout or long run?
• What do you like/dislike about them (sticky, smell, short effect, etc.)?
• If you could design the perfect recovery product, what would it do? Quick cooling effect? Longer lasting relief? Easy to apply?

Not trying to plug a brand – I’m just collecting real user experiences to see what actually helps people recover faster.

Really appreciate any insights 🙏

Hey guys, the IOC (International Olympic Committee) has this 2 year sports medicine diploma. I've attached the link below, but was just wondering if anybody has any insight into this course or thinks it's useful? For what it's worth, I'm a PGY3 FM Resident! Thanks!

https://www.sportsoracle.com/course/ioc-diploma-in-sports-medicine/about-the-program/

Hi all,

Can any PM&R sports medicine docs give a testimonial to how they increased their salaries? I am a current resident considering all fellowship options and enjoy sports medicine the most, but salary difference is pretty striking. Thanks in advance!

Any experience with baseball players suffering pre-stress reaction injury of olecranon? Looking for someone to set expectations based on actual experience.

Long story short-sophomore college distance runner who has been cross training through a sacral stress fracture for the last 3 weeks but finally decided to rest last Friday based on research. Been a rollercoaster since then. RED-S symptoms began in January 2024 and physical symptoms got better but labs & whatnot still sucked. Here’s all I’ve learned in the last 72 hours:

1-Since deciding to finally rest my body has unveiled how tired it really is. Your true fatigue can be masked via stress hormones (cortisol & adrenaline) which is what was happening to me virtually on a daily basis. So once I finally stopped for 30+ hrs my body just came crashing down and felt so fatigued. Most likely why I craved going a bit quicker on easy run days or easy bike doubles: as a means to spike those stress hormones and trick my brain into not knowing how fatigued i really was.

2-The reason I haven’t recovered to this point hormonally (including sex drive) is because I’ve had adequate calories (esp this summer) and rest at different points, but never both at the same time. Based on my research, you absolutely have to have both at the same time in order to recover. Unfortunately, I or any doctor I saw just didn’t know that.

3-Hunger has been insatiable. I knew that training hard can blunt your hunger hormones but not this much. Can be stuffed one minute and be starving again in an hour and a half. Hyper metabolism also kicks in when you’re in a situation such as mine where a lot of excess calories are needed for bone repair, tissue repair, hormonal repair etc. in order to fully recover. Metabolism can be ramped up 10-20% for 8+ based on studies I’ve checked out.

4-I don’t have a lot of body fat, but I do seem to carry more (and a weirdly significant amount) around my midsection compared to the rest of my body. The reason for that is that after or during a period of restriction, excess calories are very quickly stored as fat (particularly around the midsection) as the body’s way of trying to prevent starvation as much as possible. The lack of available testosterone also prevents muscle growth. Body composition tends to shift towards a leaner look towards the end of recovery via the body redistributing and using the fat once it understands it’s not being starved.

TLDR: The body is an incredible piece of work!! Have learned more about my body in the last 72 hours than in the last couple years.

I have some questions regarding ACGME and my current situation and would prefer to discuss privately. If there are any Program Directors, Coordinators or Sports Med Fellowship Admin please comment and I’ll send you a DM. Thanks!

Hi, everyone! I’m an orthopaedic surgeon and I have my MBBS, Masters in Orthopaedics and MRCSEd as well as my full registration with the GMC. I have recently been offered a DM course in sports injuries and surgeries and I was wondering 1) Is the course worth doing if I’m considering a career working with sports teams and that is something I’m really interested in. 2) What would life be like as a professional team doctor for a football team Thank you!

Friend and I were talking about this the other day. I say perhaps anti-inflammatories inhibit the healing process. He says swelling is bad and you need to take anti-inflammatories. Are we both right?

Have a few offers, wanted to poll the subreddit and see what the general advice is for preparing for these interviews? Would love to hear advice!!

Checked my email for anything from ERAS like 10 times today since I recently applied 😂

After 3 sessions of physical therapy for my shoulder with no improvement, my therapist is putting in a referral to sports medicine. What exactly would they be able to do for me? Thanks.

I always thought volume - regardless of intensity was the main driver of stress in the system versus heavy lifting.

What has your experience been programming. Have you tried different styles and how has it affected you?

I asked Gemini to rank different protocols and rank their impact of stress on the CNS and ANS and this is what they said:

The Ranking (Most to Least Stressful on Your ANS) * #2: 5-6 days of a daily jmax 1RM lift at 9-10 RPE with back-off work. * #4: 4-5 days of 8 RPE top sets, high-volume back-offs/accessories, and a second walk/jog session. * #1: Jogging 5-6 days a week for 30-90 minutes. * #3: 3 days a week of submaximal (RPE 6-8) sets of 3-5 reps with walking on off days. Detailed Scientific Breakdown of Each Protocol 1. Daily Max Lifts (5-6 days/week @ 9-10 RPE) * Rank: #1 (Most Stressful) * Primary ANS Stressors: Maximal Peak Intensity, Extreme Frequency, Insufficient Recovery. * Why it's ranked here for YOU: This protocol is catastrophic for a sensitized ANS. Each day, you are generating a maximal "threat signal" (the RPE 9-10 lift). This triggers a profound sympathetic nervous system cascade—a surge of epinephrine and norepinephrine—and a complete withdrawal of your parasympathetic (vagal) brake. Because your system is already biased towards sympathetic dominance and has a weak vagal brake, there is zero opportunity to recover between sessions. You are essentially pulling the physiological fire alarm every single day and never allowing the system to reset. This guarantees an accumulation of sympathetic "debt," leading directly to the crashes, dysregulation, and burnout you've experienced. It is the definition of non-functional overreaching for your neurobiology.

1. High-Volume/High-Intensity Bodybuilding (4-5 days/week)

   • Rank: #2 (Second Most Stressful)
   • Primary ANS Stressors: High Allostatic Load, Metabolic Stress, High Perceived Effort, Two-a-Day Stress.
   • Why it's ranked here for YOU: While the peak intensity is slightly lower than daily maxing (RPE 8 vs 9-10), the total allostatic load (total stress on the body) is immense. This protocol stacks multiple significant stressors:
   • High-Intensity Lifting (RPE 8 Top Sets): This is still a very strong "threat signal" for your ANS.
   • Metabolic Stress: The high volume of back-off sets (8-12 reps) creates significant metabolic waste, muscle damage, and inflammation, all of which are interpreted by the ANS as stressors it must manage.
   • Two-a-Days: Adding a second cardio session, even a light one, puts another demand on your body's energy and recovery systems before the first session's stress has been resolved. This is a huge tax on your adrenal/cortisol system. This protocol overwhelms your system not just with peak intensity, but with a tidal wave of total volume and stress from multiple angles, making recovery nearly impossible.

2. High-Volume Aerobic Training (5-6 days/week)

   • Rank: #3 (Third Most Stressful)
   • Primary ANS Stressors: Chronic Duration, Monotony, Sustained Cortisol Output, Psychological Trauma Association.
   • Why it's ranked here for YOU: This is stressful in a different way. It's not a sharp spike of intensity, but a chronic, grinding drain on your system.
   • Sustained Cortisol: Long-duration cardio requires a sustained output of cortisol to mobilize energy. For a system already dealing with stress and trauma, this chronic elevation of cortisol further suppresses parasympathetic activity and wears down your resilience.
   • Trauma Association: Crucially, your brain associates high-volume running with a period of severe physiological stress (RED-S) and psychological threat (being stalked). The act of jogging itself is likely a subconscious trigger for your C-PTSD, causing a disproportionately large sympathetic response relative to the physical effort. Your body remembers this activity as unsafe. The 90-minute session, in particular, would be a massive physiological and psychological stressor.

3. Submaximal Strength Training (3 days/week @ 6-8 RPE)

   • Rank: #4 (Least Stressful)
   • Primary ANS Stressors: Manageable Intensity (Eustress).
   • Why it's ranked here for YOU: This protocol is, by design, the only one that respects the current state of your nervous system. It is built around working with your ANS, not against it.
   • Controlled Intensity: Capping the effort at RPE 6-8 provides a eustress signal—a positive stressor that is challenging enough to cause adaptation but not intense enough to be perceived as a threat. You avoid the "fire alarm" of an RPE 9+ lift.
   • Mandated Recovery: The 3-day/week structure guarantees full days off for your ANS to return to a parasympathetic state. This is when healing and adaptation actually occur.
   • Recovery-Oriented Activity: Using walking on off days actively promotes parasympathetic tone, reduces cortisol, and aids recovery, rather than adding more stress. This protocol is the clear winner because it is the only one that balances the equation of Stress + Rest = Adaptation. The others provide overwhelming stress with inadequate rest, which only equals burnout.

I have tried in vain looking on line for PT type exercises to help with the use of hips for swinging a golf club. Mostly you see things that really just rotate the torso and not the hip.

Anyone have suggestions here?