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Sports doctors get patients back on track

July 08, 2014
by Rhea Hirshman

Carley Mulligan had a familiar and sickening feeling when she came down hard on the court during a high school basketball game. Barely a year after surgery for a ruptured right anterior cruciate ligament (ACL), she found herself facing the same major trauma to her left knee. “Growing up, I had played basketball and soccer pretty much year round, and had been completely injury-free—not even so much as a sprained ankle,” she said. “That day, I was devastated.”

Michael Medvecky, MD, performed ACL surgery, augmented with preoperative strengthening exercises and postoperative physical therapy. “I recovered perfectly and was able to go back to playing my high school sports,” Mulligan said. Four years later, she is biking, running, and playing club and intramural basketball at Duke University.

Dr. Medvecky is a physician for Yale Sports Medicine, a group of orthopaedic surgeons who diagnose and treat activity-related injuries incurred by everyone from weekend walkers to professional soccer players who practice daily, as well as collegiate and high school athletes. Their patients range in age from young children to older adults.

Wide-ranging experience

The group has wide-ranging experience. Peter Jokl, MD, founder and chief of Yale Sports Medicine, was head physician for Yale’s athletic teams for two decades, and served as commissioner for the 1995 Special Olympics World Summer Games in Connecticut and medical director of the Pilot Pen Tennis Tournament (renamed the Connecticut Open).

Dr. Medvecky has cared for members of the Alvin Ailey American Dance Theater and the Cincinnati Bengals. Karen Sutton, MD, has provided care for the U.S. women’s lacrosse team, the New England Revolution, and the Boston Red Sox, and is a consulting physician for the Women’s Tennis Association. Theodore Blaine, MD, has been a team physician for the New York Yankees, and for professional squash and hockey teams. Cordelia Carter, MD, has provided medical care for the Boston Ballet in addition to various U.S lacrosse, and U.S. track and field team events. Elizabeth Gardner, MD, has worked with University of Michigan football, hockey, and lacrosse teams.

In addition to caring for Yale Medical Group patients, the physicians provide medical coverage for Yale’s athletic teams, and the teams of several area high schools and some nearby colleges. They provide medical support at such events as the New Haven Road Race. All of the doctors were college athletes in such sports as field hockey, football, track and field, and lacrosse. Some are still active.

Getting patients back in the game

Yale’s orthopaedic surgeons specialize in evidence-based treatments for tendon, ligament, and bone injuries that typically occur during athletic events as well as in everyday activities. They have advanced training in arthroscopy—minimally invasive camera-assisted surgery that is the standard of care for injuries of the ankle, elbow, knee, and shoulder.

Dr. Blaine, however, noted that only about 10 percent of the injuries he and his colleagues diagnose require surgical intervention. They are able to treat other problems with such modalities as bracing and casting; injections to reduce inflammation; and a host of exercises and therapies to promote healing and prevent future injury. The nature of treatment depends not only on the injury itself but on such factors as the patient’s age, general health, and lifestyle. “We work toward a return to their own active routines, whatever that may mean for each individual,” Blaine said.

For Mulligan, a young and otherwise healthy woman who wanted to continue playing sports, the appropriate ACL treatment was surgical repair. For others, ACL ruptures can be managed by rehabilitation and exercise modification, Dr. Medvecky said. “We would discuss whether the person’s goals are worth the six to 12 months of rehab and recovery that ACL surgery usually involves. People who choose to can remain very active with torn ACLs. They can jog, cycle, lift weights—as long as they are not engaging in pursuits that require pivoting and jumping.”

Athletes in particular want to get back to their game, and many appreciate having a doctor who empathizes, said Dr. Sutton. “I never tell them to give up their sport, because that would be so tough for me to do,” she said. “I think I have a passion for having athletes play at the top of their games, so if nonsurgical intervention is required, with me spending a lot of time on plyometric exercises and neuromuscular training, that's what I have to do.”

The Yale doctors often consult with high school and university coaches and offer secondary and tertiary opinions. They conduct seminars focusing on injury prevention and modern treatment methods for coaches, trainers, and physicians.

Training future experts

Because the YMG doctors are part of an academic medical practice, they also teach future sports medicine specialists. While they train mostly medical students, residents, and practicing physicians, this summer there is a premed undergraduate among them: Carley Mulligan.

“When I asked Dr. Medvecky if I could observe him this summer, he e-mailed me with more opportunities than I could have imagined,” Mulligan said. “I’ve been shadowing in the operating room, during clinic hours, and at conferences. I had always known that I wanted to be involved in medicine. But after my experiences with Dr. Medvecky and others at Yale, I have people on whom I hope to model myself, not only because of their expertise in the operating room but also because of their openness and willingness to explain everything, whether to a hopeful premed student or to a 14-year-old patient.”

For more information about Yale Sports Medicine call 203-737-5656.

Submitted by Mark Santore on July 08, 2014