By Howard Osterman, DPM
The field of Sports Medicine has undergone exponential growth over the last few years, but still remains in its infancy. So much research and technology have been added to clinical practice since the simple days of “RICE” (Rest-Ice-Compression-Elevation). The catch phrase for some of this phenomenon is “analytics” and it covers a variety of topics. This is where I believe Sports Medicine is going in the future.
It really started with The Elias Sports Bureau in 1913, then Bill James’ Historical Baseball Abstract in 1985, and led to Billy Beane’s Moneyball and Nate Silver’s company, FiveThirtyEight, which started in 2008. It began with crunching numbers to evaluate an athlete’s competency, but has evolved into so much more, guiding conditioning strategies, rehabilitation strategies, and even nutrition.
Everything is quantifiable now, but there is currently a glut of numbers. The numbers are impressive, but often were just that, numbers. Slowly and systematically though, the numbers are beginning to show patterns, but often the information they yield is elusive in clinical application. Every large university and medical clinic, such as the Mayo Clinic, now has an analytics center. There is a market for the data and quite a bit of money in it. There is no shortage of private companies providing information as well. As the data accumulate, and the literature increases, conclusions will be formulated, and training/treatment regimens can be fostered. Podiatrists, orthopedists, physical therapists, athletic trainers, chiropractors, nutritionists, and many other practitioners will be able to produce reliable models to increase performance and reduce injury risks. Indeed, injury treatment and prediction have already improved using this these technologies and will continue to do so.
Incorporating stem cells/platelet rich plasma, with shockwave, dry needling, cold lasers, and antigravity and aqua treadmills has shortened recovery times and produced some miraculous sports recovery stories. Historically, regenerative medical clinics had been associated with nefarious intentions. They were frequently fronts for steroid shops and illegal performance enhancers. But here’s the thing: their concoctions worked. Athletes were willing to risk long-term potential health issues with the short-term performance gains. These clinicians and practices were shady but did spawn a budding business model. Their medicine has evolved and has become much more mainstream. Physical Medicine and Rehabilitation (PM&R)/Regenerative Medicine specialists have helped introduce new ideas and expectations for the likes of mesenchymal stem cells, hyaluronic acid, and prolotherapy. We must have an open mind and examine the clinical outcomes.
Returning an athlete to activity, at any level, often requires a collaborative effort. One of the biggest challenges to today’s sports practitioners is the single sport young athlete. Often there is limited cross training as kids are groomed to compete, yet drills in repetition do not allow a full complement of muscle growth. As sports medicine professionals, we must help parents understand the consequences of this strategy.
Finally, I think what will actually occur is that we will be able to use evidence-based apps—developed by teaching institutions or private labs—on smart phones or smart watches to create training programs that will be customizable for each patient. They may incorporate diet and exercise levels for everyone as well. Yes, much of this analytics-driven technology currently exists, but the availability of ever-more data means it is ready to explode exponentially. We, the premier sports medicine professionals, need to be ready for it.
Howard G. Osterman, DPM, is President of the American Academy of Podiatric Sports Medicine, a Diplomate of the American Board of Podiatric Surgery, a member of the American Podiatric Medical Association, as well as the current President and Board Member of the District of Columbia Podiatric Medicine Association. He is the current Team Podiatrist for the Washington Wizards of the NBA, Washington Mystics of the WNBA, and a Consultant for many college and high school programs.