Transcription:

Bill Klaproth (Host): We've got a lot to do in Marin County. And many of us are active, including playing a variety of sports. So, let's get some advice when it comes to injury and injury prevention from a professional athletes' physician. With us is Dr. Kristin Wingfield, a Clinical Professor at UCSF Sports Medicine and Orthopedics.

This is the Healing podcast brought to you by MarinHealth. I'm Bill Klaproth. Dr. Wingfield, thank you so much for your time. This is going to be very interesting hearing about what you do as a Sports Medicine Doctor. So first off, what is a Sports Medicine Doctor and how do they differ in training and treatments from an orthopedic surgeon?

Kristin Wingfield, MD, CCFP, Dip. Sports Med (CASEM) (Guest): Thank you for having me. I'm happy to chat. So, I am a Sports Medicine Physician as opposed to an Orthopedic Surgeon. Surgeons do a surgical training program. So, they do a surgical residency and then they perform surgeries to help treat the injuries. So, for example, if an ACL, a ligament in the knee is torn, the surgeon would reconstruct it.

So, I am not a surgeon. my training was in Family Medicine and then a Specialization in Sports Medicine. And I did a fellowship in that and I'm a team physician for many different teams. And so I treat injuries with anything other than surgery, exercise, modalities, injections and then if it's needed, I would send them to , a surgeon for some kind of treatment that's more aggressive if, needed.

Host: Absolutely. Okay. So, that makes a lot of sense. So, thank you for explaining that. You see a lot of soft tissue injuries and things like that then? Is that right?

Dr. Wingfield: I do. I see sort of the whole gamut from concussion to fractures, to soft tissue injuries, stress fractures, overuse injuries. We do see acute injuries, but then, you know, you help diagnose them. For example, a skier comes in, oh, you have an ACL, let's diagnose it. And then here's the treatment plan. You'll have to see the surgeon you'll need surgery. And then come back if needed later.

Host: Totally. So, then I'm just curious, what are some of the most common sports injuries that you see?

Dr. Wingfield: Sure. Definitely ACL's are very common, especially in ski season. I think many people know someone who have torn their ACL. It's common in certain sports that plant and cut and pivot. But just sort of the bread and butter sports medicine problems that we see are common patellar tendonitis, or anterior knee pain, maltracking of the kneecap causes knee pain. And that's very common. Ankle sprains are very common. Things like overuse injuries and the tendons are common. So, things like tennis elbow, which is a tendinosis in the elbow from overuse. Rotator cuff injuries, whether they're tendon injuries, tendinosis or chronic injuries versus an acute tear. Those are common. Shoulder pain is common in an overhead athlete and back pain is often common as well.

Host: Yeah. So, I'm just thinking about all of these common injuries you were just mentioning. Are there ways that these are avoidable? Do you have any tips for reducing risk? I mean, we're going to get out there. We're going to hike. We're going to bike. We're going to play tennis. What are your tips for helping us reduce these risks of common injuries?

Dr. Wingfield: Yes, it's a great question. I think it's really important to cross train and to maintain strength and flexibility aside from the activities that you're doing. Particularly as we get older, we sort of rely on you know what we've done in the past and when you're young and you just go out and do whatever, but as you get older, And that could be an older in the twenties even, or, or later. Kids don't cross train as much. They're just very active all the time and they stay strong and, and flexible, but as you get older, it's important to maintain your strength in different ways and not just do one activity all the time or nothing all week, and then really intense activity on the weekends. That's a setup for injury.

So, I think, you know, often I'll guide patients in exercises they can do at home to maintain strength and flexibility that will then support their bodies in the things that they like to do and prevent injury. It's also important not to increase things too quickly. Like if you're on a running program, you don't want to jump in to speed work and distance. You have to build up slowly and be patient as your body adapts to the new challenges.

Host: So, I know that you work with elite patients, professional athletes, performers, ballet dancers. I mean real athletes, not weekend warriors. What tips have you learned from them that maybe you can pass on to us?

Dr. Wingfield: Sure. I was actually at the San Francisco Ballet this morning. I'm lucky to work with those amazing artists and athletes, and have worked with other types of professional athletes as well. I think professional athletes and performers are very good at maintaining their bodies and adapting for what they do. And that involves a lot more work than we think. And that holds to the tip of cross train and stay in shape. And take care of your body. So, those professional athletes, it's their job to take care of their bodies. And so they spend a lot of time on nutrition and sleep and recovery and, treating things quickly when they come up so they don't have to miss so much. And I think they really learn to listen to their bodies. And that helps keep them going longer.

Host: Yeah, so other great tips as well. And interesting to know when you say they really focus on nutrition, sleep, recovery, things that now the average person that's a hiker or a biker may not do as much of. So, Dr. Wingfield, if an injury occurs, I'm wondering who should you see first? Or what should you do if it isn't severe and requiring an emergency room visit? Should you see someone at an urgent care or wait to see a sports medicine physician like yourself, or go to your primary care physician?

Dr. Wingfield: That's a great question. So, more serious injuries sometimes can't wait. So, for example, if you're unable to weight bear on a limb, if you sprain your ankle, but you cannot stand up; then you do want to get seen more urgently to rule out a fracture or something more serious. So, in those cases, you could certainly go to an urgent care for an x-ray or, or a hospital. I think if you adapt and you can put some weight on it or it's not as serious, you could certainly call your primary care doctor or call a sports medicine office and see when you could get in and sometimes just explaining the situation. Often, my assistant will call me and say, we have this injury. Do you need to see this today? Or can it wait a couple of days? we're pretty good at trying to fit in things that need to be seen quickly. Sometimes it is helpful if you're really in pain to go to an urgent care and get a splint and get an x-ray, make sure there isn't a fracture.

Signs of fractures are swelling, bruising, a lot of pain, or more serious knee injuries, things like that. Even ligament injuries can be quite serious and those should be seen within a few days, usually.

Host: As you said earlier, you have expertise in all of these areas, all of these different kinds of sports injuries. You know what to look for. You've seen them all, you know what questions to ask. You're already thinking, okay, what's going on here? How am I going to treat this? So, it makes sense that if you are active and into sports and do a lot of sports and maybe a variety of sports, it makes sense that you would have a sports medicine physician. That would definitely be a benefit, right?

Dr. Wingfield: Exactly. And the other thing about our specialty is, we rarely say, just go and rest for two months and sit on the coach. You know, it's all about active recovery and cross training. And maintaining your fitness and increasing blood flow and healing the injured area with as much activity and rehabilitation as possible. So, that's important to active people cause they don't like to rest and no one does.

Host: Yeah, that's true. And on the front side then Dr. Wingfield, do people come to you to say I'm going to be doing this sport? Can you help me understand how I can stay healthy while doing this sport? Do you do help people before an injury occurs?

Dr. Wingfield: Yes, we do some of that. We certainly do some cardiac testing for older athletes and help them understand if they're going to work into more extreme exercise programs, if there are risks and how they can minimize those. We see a lot of kids and younger athletes, and sometimes they come in with minor things and we use that opportunity to find any biomechanical issues that need to be addressed, or weakness. When kids grow, sometimes they lose their strength. And so we try preventative advice and different exercises. And help people understand what's needed to maintain their health to keep active.

Host: Right. Cover kind of both ends there. And as you were saying that I'm thinking it really makes sense. Say I'm in my fifties or whatever, and I'm like, I'm going to run my first marathon. Well, it seems like it would really make sense to come see someone like you to say, okay, I'm thinking about doing this and you just said, well, okay, we'll give you a cardiac test, but you could say, okay, your knees are going to take a pounding. Your hips are going to take a pounding. Here's what we need to watch for. And let's watch these things. Am I right on that?

Dr. Wingfield: Exactly and even things like, well, here's some tips to help minimize the impact to your knees and make sure you do these strengthening exercises and do some cross training on the bike and run. Build up this way and yes, it's definitely a field that we can help with.

Host: Yeah, I mean, so important sports medicine physician. I love it. That, that is so cool. Well, thank you for your time, Dr. Wingfield, is there anything you want to add about your profession or anything else about sports medicine in general?

Dr. Wingfield: Oh, you're welcome. Thank you for having me. It's a great specialty. I love it because everybody's active and healthy and motivated. And even if, if they're struggling, we help them to be healthier. So, it's really a privilege to treat our population around here as well.

Host: Yeah, help them to be healthier. Love it. Well, Dr. Wingfield, thank you again. This has really been fun talking with you. Thank you so much.

Dr. Wingfield: Thank you.

Host: And that's Dr. Kristin Wingfield, and to learn more, please visit my MarinHealth.org. And if you found this podcast helpful, please share it on your social channels. And check out the full podcast library for topics of interest to you. This is the Healing Podcast brought to you by MarinHealth. I'm Bill Klaproth. Thanks for listening.