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From back pains to bee stings, Yale docs keep tennis pros and fans healthy

Yale Medicine Magazine, 2013 - Spring


When promoter Jim Westhall brought pro tennis to New Haven in 1990, the wooden spectator stands on the Yale campus filled with as many as 5,000 fans. “All the big names were here,” recalled Peter Jokl, M.D., chief of sports medicine and vice chair and professor of orthopaedics and rehabilitation. For many years Jokl led a team of orthopaedists who volunteered their services to visiting players. Jokl watched the tennis competition evolve from a premier men’s event sponsored by Volvo and played in a makeshift stadium, to a men’s and women’s tournament, to what it is today‒the New Haven Open at Yale, a premier stop on the Women’s Tennis Association (WTA) tour housed in a 15,000-seat stadium, the Cullman-Heyman Tennis Center, which opened in 1991. Jokl has turned over the tournament coverage to Michael Medvecky, M.D., associate professor of orthopaedics and rehabilitation.

The team now led by Medvecky always has one physician on duty at the stadium during the weeklong tournament in August. The team also includes Karen Sutton, M.D., assistant professor of orthopaedics and rehabilitation, who specializes in sports medicine; Cordelia Carter, M.D. ’04, assistant professor of orthopaedics and rehabilitation; and Joseph Wu, M.D., assistant clinical professor of orthopaedics and rehabilitation. WTA fields trainers who are well versed in the players’ medical histories and serve as their primary care providers‒initial evaluation of musculoskeletal injuries, taping ankles, giving massages and icing aching muscles‒but for more serious injuries the players turn to the physicians.

Professional players, Jokl said, suffer from different game-related injuries than recreational players like himself. The pros are plagued by back problems from “unwinding like a corkscrew” when they serve the ball at speeds up to 130 miles per hour. But their good swinging form keeps them from getting tennis elbow‒unlike many weekend athletes who play for fun.

Medvecky says that rarely, perhaps twice during a tournament, is he called to go directly onto the court to treat acute injuries‒a player may experience shortness of breath or feel faint. He’s more likely to deal with chronic ailments and wear-and-tear-type injuries. (And it’s often the tennis fans sitting in the hot sun all afternoon who are sent to the hospital‒spectators get dehydrated and several have had coronary problems. Bee stings and the ball girls’ and boys’ scraped knees are also common occurrences.) Because the Open comes late in the tennis season‒which runs from January through November‒some players’ backs ache and their ankles are prone to sprains by the time they get to New Haven. Players have also sought treatment for conditions outside the musculoskeletal realm including gynecological issues, chronic skin conditions, allergies, and other ailments.

“They’re in a different city every week,” said Jokl. Players often wait to address ongoing medical problems until they can gain access to high-quality care like that offered at Yale. At some stops on the WTA tour, “things we take for granted,” like getting an MRI within 24 hours, aren’t available, said Medvecky. The players, he added, must also balance their treatment with career and financial consequences. Should they take the doctor’s advice and sit out a few games? And how will that brief absence affect their standing in the tournament? Such considerations can’t affect his decisions, Medvecky said; the patient’s health is his priority. Sometimes players heed his counsel and sit one out so that they can rest up for the next tournament on the tour: the U.S. Open, one of the oldest and most prestigious tennis tournaments in the world.

The nomadic lifestyle of a professional tennis player is much less glamorous than most people imagine, Medvecky added, and can lead not only to marginal health care but also to compromised emotional and mental well-being. The players often seek comfort and companionship in the training room, which Kerri Whitehead, head trainer for the WTA, calls the “kitchen of the WTA.” The room can become a haven where the players relax with one another along with friends and family members.

And the doctors play a role there too. “(The physicians) are in the training room to maybe just talk with an athlete and say hello,” said Whitehead. “We back each other up on a daily basis. It’s an equal-balance working relationship. We couldn’t run the training room without the excellent services they provide.”