a special program of the National Emergency Medicine Association (NEMA)
Transcripts 523-3 and 523-4
Week: 523.3 Guest: John Lopez, B.S. Phys. Ed. Topic: Sports Medicine Facilities - Part One Host: Steve Girard Producer: Ed Graham
NEMA: The speed with which athletes recuperate from what used to be potentially career ending injuries is mainly due to the melding of the advances of medicine, fueled by the experience of the athletic trainer....and today, weekend warriors are benefiting from the increase in the number and quality of sports medicine facilities. We're with John Lopez, who runs Towson Sports Medicine in Maryland....
LOPEZ: "Sports medicine is a philosophy, or trying to return the athlete to competition as quickly as possible yet do it as safely as possible. Sports medicine as we know it today evolved out of the traditionally athletic training room, we find now that many hospitals and doctors and clinics feel that athletic trainers can bring their knowledge and expertise to the general public, and also because our population is a much more active population than it was 15 - 20 years ago. And so, our physically active population today is going to have people getting hurt in doing various kinds of conditioning programs that everyone is engaged in so they can maintain their fitness level much higher than it used to be. So what we're seeing today is the sports medicine philosophy being brought to the sports medicine clinic, so that we can try to treat the recreational athlete much as the professional or college athlete was treated over the last 35 to 50 years."
NEMA: Is the field, the practice of sports medicine gaining acceptance among the general medical community....
LOPEZ: "We were seeing that many of the physicians were referring patients to sports medicine centers because they had a much shorter stay in physical therapy or rehabilitation...but one of the things we're having to face today is that, with the advent of managed care, insurance programs, HMO's, the third party reimbursement sometimes prohibits the payment for some of these services. So, we're seeing that, once again, we're trying to push the patient out of the therapy or rehab setting and back to work or back to their normal activity as quickly as possible...cause health care is being reformed and the costs are starting to come down, managed care companies are dictating that they want to pay less for each type of service.
NEMA: You not only give patients care and direction after surgery?...
LOPEZ: "One of the things we try to do today is to give our patients as much information before they go to surgery, so they can do their exercises and know what to expect after surgery and what types of exercises need to be done after the surgery....so they can get back to activity as soon as possible."
NEMA: Kids are going to get hurt playing sports...how about some tips for parents when it happens....
LOPEZ: "Usually,within the first 24 hours, generally you're going to get some kind of swelling occurring, so the best use of modality there is application of ice. Ice does two thing - one, it reduces swelling, and two, it reduces pain. The first 24 to 72 hours you need to apply ice on it. And usually 20 minutes out of each hour is appropriate. The second thing one needs to consider is that most of these injuries are not emergencies, and probably don't need to go to the emergency room. Generally, it doesn't hurt to observe something for 24 to 48 hours. If swelling becomes persistent and doesn't do away, and if their function doesn't return relatively quickly, or if pain increases over the first 24 hours, then you probably need to check in with your family physician. We could all save ourselves a lot of time, and a lot of money, and alleviate a lot of the crowding that goes on in our emergency rooms by handling our sports injuries in a little more intelligent manner."
NEMA: John Lopez says people are more active well into their 70's and 80's today, and as the baby boomers age, they will push the envelope farther....and will be using the advances of sports medicine to rebound from their inevitable injuries. I'm Steve Girard.
Week: 523.4 Guest: Dave Berringer and Karen Willburg, P.T./Athletic Trainers. Topic: Sports Medicine Facilities - Part Two Host: Steve Girard Producer: Ed Graham
NEMA: We spoke recently with John Lopez, owner of Towson Sports Medicine and Rehabilitation in Maryland about the philosophy of the athletic training room and its effects on recovery from injury when combined with medical guidance and physical therapy. Today, I take a tour of the sports medicine facility, and talk with the people you may need some day....starting with Physical Therapist and athletic trainer Dave Berringer....
NEMA: What kind of procedure are you doing right now?
BERRINGER: Right now I'm doing an orthotic fitting...basically this patient has a bio-mechanical problem with their lower extremity that's leading to some substantive strain and wear and tear on his foot. That, in turn, has caused a tendon to break down in his foot...and he's having some pain and dysfunction and difficulty walking. He's been through therapy and had some strengthening exercises, stretching...and now we're going to fabricate a brace for his foot.
NEMA: I just want to try to get a range from you of the kinds of things you deal with day in and day out....
BERRINGER: We basically see two different types of injuries here: traumatic injuries, where its very easy to figure out what happened... y'know the patient can come in and give you good history...well, I fell off a ladder...someone hit me on the side of the leg when I was playing soccer, then you can see the mechanism of injury and then the results of that. A little more difficult injuries to treat are the ones we call insidious onset injuries. Patient says, well, maybe I was doing this or doing that and it caused some problems but its not real clear cut, so its a lot more difficult.
NEMA: How about a word of advice for someone for whom therapy is on the near horizon....
BERRINGER: Find someone who is qualified, who is not going to give you what we call charlatan treatment'. It should involve all phases of stretching, strengthening, reconditioning type exercises.
BALLASTINO: My name is Ray Ballastino....
NEMA: Ray, what kind of injury have you had?
BALLASTINO: I tore my anterior cruciate ligament in half and had to have a reconstructive surgery.
NEMA: What kind of activity were you doing when it happened?
BALLASTINO: I was playing basketball.
NEMA: How long has it been since you had this done, and what kinds of things have you had to do to get back on the road to recovery?
BALLASTINO: It's coming up on three months,and I've been coming in basically three times a week. I've been doing two of those three days just working on the machines here, bicycle, extensions for your quadriceps, hamstring exercises..and one of the three days, I'm doing hydro-therapy, which is in the pool, water exercises which is really fantastic.
NEMA: And how's it working for you so far,
BALLASTINO: This particular institution here is very aggressive...sports oriented, and its very good...I'm very pleased with the results.
NEMA: Let me get your name and title...
WILLBERG: My name is Karen Willberg, and I'm a physical therapist and athletic trainer.
NEMA: We're in the pool section of the sports medicine center. Are a wide range of injuries benefited by exercising in the pool?
Willberg: Because of the buoyancy of the water, you're in almost a weightless situation, so you're not going to create any compressive forces in the joints. So, we like to get our lower extremity patients in here because they can walk even if they're non- weight bearing type of patient on land. It also helps relieve stress, especially with back patients and the same with shoulder. So, you're able to use the muscles and strengthen them in the water, that you still can't use on land...so it makes for a quicker transition.
NEMA: As facility owner John Lopez says, those in their 70's and 80's are still going strong, playing sports and getting injured...and as the baby boomers get grayer, and stay active...many of us will likely need therapy and rehab in a professional and goal oriented setting, like a sports med facility. I'm Steve Girard.