Teamwork between patients and therapists is central to sports medicine
By Christine M. MacDonell
As you watch Olympic athletes compete with grace and precision, don't be tempted to create a mogul course and strap on your skis or decide that a triple Lutz doesn't look that hard the next time you take to the ice. The image is indelible: Midway down the ramp for a ski jump, a competitor loses his balance and spirals out of control off the end of the ramp, tumbling and flipping onto the snow below. It can happen to even the most highly trained and conscientious athlete.
Athletes might quickly rise to fame as Olympic medalists, but what happens when a sports injury ends the competition for a not-so-fortunate competitor? For many athletes, their injuries can be repaired and they can rehabilitate, thanks to today's sports medicine programs.
Motivation is the hallmark of sports medicine
Sports medicine programs are available to all competitors, ranging from weekend warriors to full-time athletes. "We used to think of athletes as persons in professional sports. However, an average high school player now performs at the same level as pros used to in earlier times," observes Kristina Guers, executive director of the Schuylkill Rehabilitation Center in Pottsville, Pennsylvania. "As sports medicine programs have progressed, the rehabilitation services formerly available only for elite athletes are now commonplace for persons at any skill or fitness level. Computerized iso-kinetic and balance exercise programs, video analyses, gait training, and speed and agility programs can help competitors of all levels recover."
Priorities, commitment, fitness, and conditioning levels contribute to how fast an athlete is ready to return to the playing field. Since athletes of all levels can access the same programs and technology, why do elite athletes seemingly heal much faster than the average person? Greg Ott, sports medicine program director at Carolinas Rehabilitation in Charlotte, North Carolina (part of the Carolinas Healthcare System), explains, "The major difference between working with elite athletes and the general patient population is primarily with their priorities. Olympic and professional athletes have made personal priorities to focus multiple hours each day to their rehabilitation. Our other patients generally have a number of other responsibilities that often lessen the commitment they are able to make. The commitment level of the patient and reserving time for recovery makes a huge difference."
Sports medicine is distinguished from other types of rehabilitation programs by the patients' high motivation. Diane Romito, director of rehabilitation services at Scripps Memorial Hospital, Encinitas (California) - The Rehabilitation Center, clarifies, "In a sports medicine program, we work with extremely active individuals who are highly motivated to return to their sport. Education and rapport building with these patients is essential so that they can understand the role of the therapist and the need for proper rest, gear, and strength training."
Marisa Brunett, director of sports medicine operations at Cora Health Services in Florida, provides insight into the minds and bodies of athletes: "Athletes live and die for their sport. Their bodies are fine tuned to perform at the highest level. They have high body awareness. They are so competitive, they rarely back out of their treatment, however difficult it might seem."
"Athletes have a high physical endurance level, which needs to be considered. We look at the whole kinetic chain of how one area of the body affects another," Guers adds.
Sports injuries are widely distributed
Romito reports the most common sports injuries are:
- Ankle sprains
- Rotator cuff (shoulder muscle) tears
- ACL (anterior cruciate ligament) tears in the knee
- Shoulder dislocations
- Wrist and elbow fractures
- Muscle strains
"In skiing and snowboarding, we see many knee, shoulder, and wrist musculoskeletal injuries. In a sport where athletes are engaging high speeds or dazzling heights, the most devastating injuries can be to the head or spinal cord," Guers says.
Scripps Memorial Hospital Encinitas's Rehabilitation Center, the Schuylkill Rehabilitation Center, and the Carolinas Healthcare System offer pre-sport computerized testing on the ImPACT™ evaluation tool. This tool records baseline measures so athletes who later suffer a concussion or more serious brain injury have a normal brain record for comparison. "Our goal is to help determine when it is safe for brain-injured patients to resume activities," Romito says.
Choosing the right sports medicine program begins with asking the right questions
Selecting a sports medicine program can be perplexing because of the variety of service levels and personnel available. When evaluating a sports medicine program, consumers should assess several key factors including the program's accreditation, staff members' education, and programs available in addition to recommendations from other patients and referrals from physicians. Accreditation demonstrates an organization's conformance to proven business practices, employee training, information management, and continuous quality improvement.
Brunett advises consumers to ask these questions about a sports medicine clinic's services:
- Are your staff members licensed and credentialed with expertise in athletic training/sports medicine?
- Do you have an extensive training program?
- What type of programs do you have in the injury and illness prevention area?
- What treatment programs and physical conditioning programs are available to me?
- Does your sports medicine program employ staff with additional certificates of qualification in other training areas?
Patients need to look beyond their own specialized treatment. Romito advises, "When consumers research a sports medicine program to match their needs, they should seek out therapists who have completed advanced training and who understand the 'psyche' of the sports-injured individual, whether professional, school, or weekend warrior." She continues, "Consumers should also seek diversity among the staff with therapy specialists in several areas for consultation, and the appropriate equipment for testing areas, such as balance and gait analysis. It is also important to make sure the program is equipped with specialists who can offer a one-stop shop for therapy because orthopedic injuries are often multiple and complex."
Prevention and education are at the heart of sports medicine's future
Prevention plays a key role in the future of sports medicine. The positive motivation that leads to a speedier recovery can have a negative repercussion. Romito cautions, "We see an increasing number of sport-related head injuries due to repeated concussions. Our newest sports-related services are focused on concussion care: better prevention, recognition, and treatment.
Concussion prevention is extremely valuable, she explains, "The pressure on athletes from parents, coaches, and peers to return to their respective sport may prompt athletes to deny their pain or other warning signs before full recovery has occurred. A premature return to activity can lead to a repeat injury, which, over time, can have cumulative effects."
Romito adds, "Heavily built athletes, for example, come in with poor balance, flexibility, and core stabilization, yet they do not understand why they are injured, especially when they are so strong. We educate them about proper training of the entire musculoskeletal system and the risk of repeat injuries."
Sports medicine offers many tools to help all athletes whether Olympians, professionals, or weekend warriors recover from sports injuries; however, the best way to deal with an injury is not to have one at all. Be careful!
About the author:
Christine M. MacDonell is the managing director of medical rehabilitation with CARF International, an independent accreditor of health and human services.