Pressure to play jeopardizes healing

Pressure to play jeopardizes healing

By Jennie McKee

Professional athletes can feel intense pressure to get back in the game after an injury, regardless of whether they are entirely healed and ready to play again. When all that stands between the athlete and return to sport is an “OK” from an orthopaedic surgeon, that pressure can be transferred to the physician who feels a moral responsibility to keep the athlete from returning to competition too soon and risking injury.

Yesterday, three members of the American Orthopaedic Foot and Ankle Society (AOFAS) discussed the role that of the orthopaedist in helping pro athletes compete after an injury—a role that is challenging and rewarding, but also sometimes stressful. Each of the panelists has treated professional athletes in the National Football League, National Basketball Association and Major League Baseball,

“Our decision-making process can be very stressful because we are put in compromising situations when we’re dealing with a high-performance athlete, whether this is someone who’s competing in high school, on a state team, or at the professional level. There’s pressure on the player to return and on us to allow the player to return, perhaps prematurely,” explained panelist Mark S. Myerson, MD.

Panelist Robert B. Anderson, MD, AOFAS president, stressed the importance of teaching athletes as much as possible about their injuries to help them realize that recovery time is crucial to healing. “It’s a partnership,” he said. “It’s our responsibility to educate the athletes as much as we can about their injury and if they require surgery, about their postoperative treatment, to inform them of the risks that they take if they come back too early.”

Mark S. Myerson, MD

The panelists also focused on the younger athletes who seek treatment for overuse injuries—children and adolescents.

“When we think of athletes, we don’t only think of the professional athlete. In our society today there’s a huge increase in athletic interest in the lay population—in kids, teenagers and recreational athletes,” said Dr. Myerson.

Thomas O. Clanton, MD, the team physician for Rice University and the Houston Rockets, commented on the extreme pressure to perform that leads to many injuries among young athletes.

“I think it is becoming more and more apparent to orthopaedic surgeons as we care for adolescents and pre-adolescents, that there is increasing pressure on these children. Sometimes it’s self-drive, sometimes it’s societal and sometimes it’s parental,” he said. For example, when children play sports, such as baseball or basketball, all year-round, overuse problems can result, explained Dr. Clanton, “because the young athletes never get a chance to rest. Their bodies are not responding well to that and we’re seeing more stress-related injuries as a result—stress fractures, tendonitis and other types of overuse syndromes.”

Dr. Myerson called overuse injuries in young athletes “a very broad problem,” and further explained that “when the musculoskeletal system is not given the chance to recover from repetitive stress, stress injuries, such as stress fractures and many other stress syndromes of the leg can result. We’ve seen an increasing number of young runners developing fluid build-up, or compartment syndrome, of the leg,” he said.

Because today’s young athletes often don’t have down-time when they are not involved in sports, as previous generations did, “the unfortunate fact is that it takes an injury to finally get these kids to slow down,” said Dr. Anderson.

According to Dr. Myerson, orthopaedic surgeons can face some of the same pressures and dilemmas when they treat young athletes as they do with professional players.

“I think we have an ethical and moral responsibility to provide the appropriate care and give the appropriate advice to athletes—whether they are high school or professional athletes. We should not compromise our standards in the face of pressure from either the team or the athletes,” said Dr. Myerson.

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