Sports Medicine: Thrill of Victory, Agony Of The Feet
INDIANAPOLIS - From dusty, sandlot baseball fields to the artificial turf-carpeted cathedrals of big-time college and professional sports, the common threat stalking participants is injury. That ever-looming possibility has led to an increased need for sports medicine specialists.
"Sports medicine in and of itself is not a specialty," said Douglas B. McKeag, M.D., M.S., chairman of the Department of Family Medicine at the Indiana University School of Medicine. "It is medicine in motion because every system in the body is affected by the motion of an athlete, whether it's running a football downfield or swinging a golf club."
Dr. McKeag gave participants at the Feb. 27 session of IU School of Medicine's Spring Mini Medical School a sideline view of the growing field of sports medicine and the health issues faced by today's athletes. And while many organized contact sports teams-professional and amateur-have made great strides in recent years to ensure the safety of players, some haven't left the locker room when it comes to preventing events such as head injuries.
"The problem with concussions is that there is no way to accurately grade the depth of damage," said Dr. McKeag, director of the IU Center for Sports Medicine at the National Institutes for Fitness and Sport. "The role of the team physician is to make sure a player if fully functioning and capable of protecting himself before returning to the game."
Current guidelines focus more on using consciousness as a means of determining an athlete's condition. But research conducted by Dr. McKeag shows that multiple minor incidents of head injuries can be more damaging. He said that mild traumatic brain injury can be diagnosed through a series of simple tests and is a better way to measure long-term damage.
"Multiple incidents of mild traumatic brain injury are more damaging than loss of consciousness," said Dr. McKeag, whose clients range from professionals to high-school athletes. "This is of particular concern for youngsters in contact sports because what you have to remember is that the central nervous system does not fully mature until a person is in their third decade of life."
With many sports injuries, athletes, coaches and even some team physicians zealously seek "quick fix" solutions to get players back onto the field as soon as possible, Dr. McKeag said. For example, a tear to the knee's anterior cruciate ligament, which stabilizes the knee as it flexes and extends, is a common injury that often treated immediately with surgery.
Dr. McKeag, who served on the National Collegiate Athletic Association to examine competitive safeguards and other medical aspects of sports, said a more conservative approach often is justified in ACL cases. It's a delay of game worth waiting for, Dr. McKeag said.
"We've found that in most cases a patient needs to wait at least three weeks (to allow for natural healing) before the surgical procedure is done," he said. Some who have surgery are more prone to develop arthrofibrosis, a stiffness of the knee caused by accumulation of scar tissue in and around the joint.
Women athletes often experience health problems unique to their gender, particular maladies referred to as "The Female Athlete Triad"-eating disorders, amenorrhea and osteoporosis.
Gymnasts, figure skaters and ballet dancers, for example, often develop bulimia and anorexia because they participate in "appearance" sports where they are judged not only on performance but by the way they look to judges.
"Binging and purging and starvation obviously are dangerous ways to maintain weight control," said Dr. McKeag, adding that some studies suggest that as many as 25 percent of all female collegiate athletes are said to have eating disorders.
Amenorrhea, the stoppage of normal menstrual cycles, tends to present itself more with high-impact female athletes. In the general population, amenorrhea affects between 2 percent to 5 percent; the condition ranges as high as 66 percent among various athletes, according to a report appearing in an article of the Journal of American Medicine in 1995. Amenorrhea is associated with decreased serum estrogen levels.
The loss of estrogen during early adolescence can lead to osteoporosis, where bone becomes thin and weak, later in life.
Sports medicine has evolved into far more than just reactive medicine. "We no longer merely react to injury; we anticipate it. All that we learn and is developed from sports medicine has application to the general population," said Dr. McKeag. "At the IU Center for Sports Medicine, our goal is to provide comprehensive care for all athletes who participate in recreational or competitive sports."
The IU Medical Group and Indianapolis radio station WIBC sponsor Mini Medical School, which is offered by the Indiana University School of Medicine Faculty Community Relations Committee through the IUPUI Division of Continuing Studies.
Sports Medicine Related Sites
IU Center for Sports Medicine
http://www.iufammed.iupui.edu/sportsmed/sportsmed.htm
National Institute for Fitness and Sport
http:// www.nifs.org
Media Contact: Joe Stuteville
Tel: (317)274-7722
Email: jstutevi@iupui.edu
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