January 2011

Out on a limb: Minding the gap

Jordana Bieze Foster, Editor

Not long ago, I was chatting with the new girls’ volleyball coach at my local area high school, and she mentioned that one of her goals was to focus on injury prevention. Specifically, she planned to emphasize shoulder strengthening. So I asked the obvious follow-up question: What about preventing anterior cruciate ligament injuries?

She had absolutely no idea what I was talking about.

I was shocked. With all the recent media attention to ACL injuries, especially in female athletes in jumping and pivoting sports, how could anyone involved in those sports not be at least peripherally aware of the issues? So much good information is available, how could it not be reaching people who would be motivated to use it?

But this type of disconnect between the havers of medical information and the have-nots is all too common, and affects the entire spectrum of lower extremity healthcare.

This month’s cover story (“Thinking small: Making strides in children’s footwear,”) underscores the frustration of parents trying to find the right shoes for children just learning to walk. No self-respecting foot health specialist would recommend stuffing paper in a too-large shoe to make it fit. But parents aren’t getting their information from foot health specialists. If they’re lucky, they’re getting it from pediatricians. More often, they’re not getting it at all.

We’ve long known about the knowledge gap in diabetic foot care, and dedicated educational efforts have helped to narrow that gap. Government data from 2006 suggest that nearly 68% of adults over age 40 have had a foot examination in the past year, a figure that is up significantly from a reported 50% in 1993. But rates are actually considerably lower in certain states, including California (54.9%) and Florida (59.1%) – states that saw the greatest increases in new cases of diabetes from 2005 to 2007.

An article in the January issue of Arthritis Care & Research notes that practitioners are too quick to prescribe medications for their patients with osteoarthritis and too often fail to inform patients about other conservative management options. And survey results published in January issue of the Archives of Osteoporosis suggest patients with osteoporosis fail to comply with prescribed treatment because they don’t understand the associated risks.

The list goes on. And we’re not talking about new or controversial concepts. We’re talking about established standards of care.

This type of information seems to be all over the Internet, not just on Medline but in patient-friendly formats too. But maybe it isn’t as readily available to the average person as I imagine; maybe it only seems that way to me because I continually come across it in the context of my job. And maybe practitioners have the same skewed perspective.

Readily available or not, basic healthcare information is simply not finding its way to many patients. So practitioners need to be even more involved in outreach and education—whether that means actually providing the information, explaining it, or convincing patients of its importance.

Because healthcare information isn’t like money. There’s no advantage in having it all to yourself.

One Response to Out on a limb: Minding the gap

  1. My website helps teen female athletes have FUN playing their sport by minimizing their risk for lower body injury – BNP Training – as the foundation training program.

    I have trained more than 600 adolescent female athletes and I share your frustration that today’s parent(s)/guardian(s) are not aware that every female student-athlete can benefit from balance, neuromuscular control, and proprioception training.

    I am hoping to have users of the website understand [to paraphrase Dr Wojytz] – female athletes should not expect an injury from playing sports. Especially in light of the osteoarthritis challenge that many female athletes have to deal with within 12 years of an injury.

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