Advancements in sports medicine reduce need for invasive management

This story first appeared in the April 2024 edition of Healthy You, a quarterly health publication and Gazette special section.

Sports medicine sounds like something reserved for athletes, but today, the field encompasses a wide range of patients from students on travel teams to adults who fall into the weekend warrior category.

“There has been a great deal of change over the years in sports medicine. In orthopedic surgery alone, we have seen continual shifts to minimally invasive procedures driven by arthroscopic — [a] surgical technique with use of a small camera — and imaging advances,” explains Dr. Matthew White with Physicians Clinic of Iowa (PCI).

The orthopedic surgeon, who’s been with the clinic for over a decade, cites these advances as speeding up recovery for patients because it allows for more specific diagnosis and treatment.

“We recently had an out-of-state high school baseball player that tore his ulnar collateral ligament in his elbow at the end of his high school spring baseball season,” White says. “Because he had a specific type of tear, we were able to repair this with a newer surgical technique that allows for earlier return to sport than the traditional Tommy John reconstruction. He was able to rehab consistently and return to competition in the spring of his freshman collegiate baseball season and continues to pitch.”

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Dr. Ryan McBride describes sports medicine as including four components:

The podiatrist has been practicing for 20 years, the past 12 at PCI.

“Research has advanced our understanding of sport injuries. We know more about why and how they happen, what we can do to prevent them and how best to help the body to recover,” he says.

“This means not just treating the injury when it happens, but trying to understand chronic problems with a physical activity which can lead to injury.”

McBride says traditional treatment plans aim to heal an injury, but a sports medicine approach includes treatment plans that not only heal but prevent further injury.

“This helps us to return patients to activity quickly and safely,” he says.

This multidisciplinary approach includes medical professionals from various fields under the sports medicine umbrella, adds White. Surgeons, primary care physicians, physical therapists, athletic trainers and more all address the unique health needs of athletes and individuals engaged in physical activity.

“A young cross-country runner was having issues with stress fracture formation with increasing her mileage. We were able to assess her nutrition and that she was vitamin D deficient, and she was severely flat footed with a long second metatarsal,” McBride says. “With vitamin D supplementation she recovered quickly, and we were able to get her back to activity quickly by making sure she was in an appropriate orthotic device which addressed the biomechanics contributing to her fracture.”

“It’s a good example of sports medicine approach, looking at nutrition, biomechanics, injury prevention and recovery,” he adds.

White says sports medicine is continually evolving, with advancements in surgical technique and ongoing investigation into fields like biologic treatments that may reduce the need for invasive management.

“My practice is predominantly dedicated to shoulder, elbow, hip and knee conditions. This includes rotator cuff, shoulder labrum, hip labrum, ACL, meniscus and cartilage injuries. Many of these injuries are seen in various sports, ranging from football to the latest sports craze, pickleball,” White says.

McBride cites considerable pressure to return to sport as quickly as possible — especially among young people — and training that can be too intense for a body which is still growing as problematic.

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“Pain is the body’s way of telling us something is not normal. It’s a message we have to hear and respond to appropriately. ‘Pushing through’ pain, or a mentality of ‘no pain, no gain’ may be ignoring the warning signs heralding injury,” he explains.

Varying your activity can help, White says.

“One of the best ways to prevent injury is to vary activities and frequency. Cross-training is an excellent way to have the focus of exercise shift to different areas of the body to reduce stress. Rest and nutrition are also particularly important as they ensure the appropriate recovery our bodies need,” he says.

Best advice for injury prevention from McBride?

“Like any skill, there are best practices and incorrect techniques or methods which can contribute to the formation of an injury. Starting with the right method and techniques helps. Listen to what your body is telling you. Yes, there can be some discomfort, however, pain is the body communicating something is not well,” he says.