What exactly is sports medicine? Is it reserved for athletes?
RBH: Because the CU Sports Medicine and Performance Center is on the campus of the University of Colorado at Boulder, I get a lot of patients who are nervous about seeing us there. They say things like, “I’m not a world-class athlete” or “I don’t play college sports.” But this is only a fraction of those we see in our clinic. The majority of our patients are simply people who find it difficult to be as active as they would like. For some it may be high level competition, and for others it may be weekend skiing or just walking three miles around the neighborhood. It’s about identifying the musculoskeletal problems that keep people from living their lives.
What is the difference between the surgical and non-surgical side of sports medicine?
RBH: Regardless of which side you are on, the first step is to identify not only the diagnosis, but also any underlying factors such as tightness or asymmetry that may have paved the way for this injury. As a non-operative physician, I consider myself a musculoskeletal sports medicine Nancy Drew, trying to piece together all the clues. Over 80% of sports medicine injuries are non-surgical. For these patients, we will therefore consider non-operative treatments. Then there are people walking through the door and I can immediately tell that this is a surgical case. We immediately refer these patients to one of our surgeons.
SBT: I’m in non-operative primary care sports medicine, which means my training is to take care of the athlete literally from head to toe, from a concussion to a broken toe. I often travel with athletes, so I’m on the road managing chronic injuries like tendonitis and working to control things like air quality. When I was at the 2019 World Figure Skating Championships in Japan, the air quality was not good, so I made sure the athletes had humidifiers in their rooms. I’m also on the sidelines during competitions to address performance issues like shortness of breath or exercise-induced bronchospasm. That’s quite a variety!
EM: I treat non-operative injuries, but as an orthopedic surgeon I also perform surgery for certain injuries. My surgical focus is knee and shoulder injuries, although I also treat other areas. But we have highly specialized surgeons who only do hips or upper limbs like elbow and shoulder.
What sets the CU Sports Medicine program apart?
EM: I think there are three things that really set us apart. One is patient care. There is nowhere else in the state that has the breadth of specialties and the depth of experience and expertise across the spectrum of sports medicine. We have several departments that are represented in the CU Sports Medicine program, including Orthopedics, Family Medicine, Internal Medicine, Physical Medicine and Rehabilitation, Emergency Medicine, and Pediatrics. We cover everything, it’s really multidisciplinary.
The second is research. We are interested in innovation and in understanding and improving the way we treat patients, so we are very involved in the research side of sports medicine.
The third is education. We are dedicated to educating and teaching the next generation of healthcare professionals, as well as the community at large. We also have a sports medicine internshipwhich is a big problem.
SBT: Our clinicians are some of the best in the world and they have tremendous passion for what they do. We can do innovative sports medicine here and do things that my colleagues in other parts of the country cannot. It’s because our patient population is so invested that they want to do everything they can to stay active.
RBH: I also like the culture of our center. The providers at our clinic know each other very well, we know the physiotherapists, the trainers, the staff who work with us at the front desk and we really enjoy working with each other. It helps us take better care of patients because we communicate so well with each other.
How does a multidisciplinary approach to sports medicine benefit patients?
RBH: We’re pretty much a one-stop shop, making it easier for patients to get the care they need. We have non-operative doctors, surgeons, NPs, PAs, physiotherapists, athletic trainers and imaging all under one roof, so once you walk through our front door, we can walk you through the path you should follow depending on any problem. you are dealing with.
SBT: It’s one of the things I love the most about what I do, because it’s not about me, it’s about the team. Take concussions, for example. Our concussion team is outstanding. I cannot cure a concussion patient without this team, our physiotherapists and our athletic trainers. This is the true definition of sport: we all work together and everyone is recognized for their gifts and what they bring to the table.
EM: Everyone within Sports Medicine complements each other, as we all have different skills that work together to help people improve. Suppose you have an athlete who gets injured during a match. If it’s a team I work with, I’ll usually see them immediately. Sometimes it’s bad enough to need surgery, but often it’s something where we can work with one of my non-op colleagues or the therapists and trainers to treat it without surgery, or at least postpone the operation until the end of the athlete’s season.
We also have a lot of crosses with our pediatric sports medicine colleagues from Colorado Children’s Hospital. They treat pediatric and adolescent injuries from three or four years old through their teens and twenties.
What are you particularly excited about in the coming year in sports medicine?
EM: I’m excited about what we’re doing with biologics, which is how we’re using the body’s own cells to treat wounds. Two of our suppliers, Jason Dragoo, MDand Rachel Frank, MDare part of the national Biological association, and they are considered in the country as leaders in the field. We plan to open a Biologics Center at our CU Sports Medicine Inverness location – the UCHealth Steadman Hawkins Clinic.
RBH: There are two things that particularly fascinate me. The first is that some of our physiotherapists will offer physiology tests. This is going to be really helpful to our athletes who are working on improving their performance and learning to train more effectively.
The other is that we are growing! We’re adding another non-operative sports medicine physician, and we’re also expanding access by adding more hours from existing providers to the center.
SBT: The most exciting thing for me right now is just being back. It’s been a tough year with the pandemic, and not being able to exercise or participate in sports has really had an emotional and physical impact on people. We’ve already seen a lot of different injuries from athletes having to train inside their homes and on different surfaces, and I think we’ll continue to see these trends develop in the future. Just as we have return to play guidelines for concussions, now we need to create those for COVID-19.