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Melanie Cole (Host): The goal of sports medicine is to keep you active, and for some, that means continuing to play basketball or hockey, and for others, it can mean climbing up stairs or lifting objects to shoulder level. Specializing in both traumatic athletic injuries and chronic problems caused by overuse is the team of SLUCare orthopedic surgeons. My guest today is Dr. Scott Kaar. He’s an orthopedic surgeon who treats athletes of all ages and levels. Welcome to the show, Dr. Kaar. Tell us a little bit about sports medicine as a department and a part of orthopedics. What does that mean for athletes that are injured or those trying to prevent injury?

Dr. Scott Kaar (Guest): Sure. So what sports medicine means is that we are physicians who treat a patient who’s active. Some of that’s high school sports or college sports, whether that’s at the intramural level or the varsity level, it can mean a professional athlete. But often, most commonly, it mean someone at their thirties, forties, fifties, sixties, or even older, who is involved in sort of the weekend warrior activities, whether that’s running, jogging, rowing, using a bicycle, races, lifting weights, playing softball, basketball, all those kind of activities. So that’s who we treat. They have certain patterns of injuries that are very typical. Obviously, we treat the entire patient no matter what the injury is. But to certain patterns that usually involve things like injuries to ligaments and tendons, whether that’s in the knee or the shoulder that are extremely common, people who are sort of a middle-aged weekend warrior category, early arthritis, especially of the knee or the shoulder’s very common. So we treat these injuries. We can even treat other injuries that aren’t orthopedic as well for those members of our team that aren’t orthopedic as far as their practice goes.

Melanie: And what do you see the most, Dr. Kaar, when you see an athlete? Maybe they’re very good at their sport or, as you say, a weekend warrior. There’s been so much in the media lately about overuse injuries, chronic injuries, and what they can do cross training-wise to avoid surgery.

Dr. Kaar: Correct. There’s a whole slew of overuse injuries, and those range from rotator cuff injuries in the shoulder to tendonitis in the knee and the hips. Tendonitis and overuse injuries to the ankle and foot are extremely common as well. So we see those a lot. And I agree with you. It’s really important to do what’s called cross training. Now there’s going to be exceptions, but it’s not always good to do the same activity every day over and over again. What you want to do for a couple different reasons is mix that activity up. So that can mean swimming one day and biking the next day and lifting weights three days later and jogging a different day as opposed to running every day of the week, 5, 6, 7 miles, which can put the same repetitive stresses on the same joints. For example, someone could develop tendonitis in the knee if all they’re doing is running. And so the issue becomes twofold. One is the continued same stress as every workout from the same activity, and the other issue is by doing the same activity repetitively, an athlete or somebody runs the risk of neglecting other muscles that can help stabilize a joint or can help keep them more active in different ways. So by just running, a lot of times, for example, the core is neglected, and that can then affect posture from running and susceptibility to injury. By just running only, it may neglect hip strengthening exercises, for example, or certain stretching aspects of the leg. And you get those by doing other activities like swimming, lifting weights, core, other types of workouts, and that can decrease the chance of injury.

Melanie: So when people are thinking about all of these—there’s repetitive injuries and all that—sometimes, Dr. Kaar, they do require surgery. Tell us a little bit about some of your sports medicine procedures maybe for rotator cuff tears, a very common injury. Tell us what you do for them.

Dr. Kaar: Sure. So rotator cuff is a very common overuse type injury. It comes from wearing down of the muscle that stabilizes the shoulder over many years. What happens is sometimes it can be a tear, so it’s kind of like a rope rubbing on a sharp stone over and over and over again and wearing it thinner and thinner and thinner, and eventually, part of it can break through. When that happens, what we as sports medicine physicians are very good at specializing is minimally invasive surgery. It’s where we use relatively small incisions and cameras and stuff to do things with as little injury to the patient as possible, but yet we can go in, for example, on the rotator cuff, repair that back with sutures to get someone on the road to recovery and get their rotator cuff healed.

Melanie: Now, what about other things? We haven’t really talked about knees. As we said, we could really talk about many of these things, but what do you feel are some of the most recent advances and exciting advances that you’ve got going in your sports medicine procedures there at SLUCare?

Dr. Kaar: Sure. So some of the more cutting-edge or newer advances that we have, number one, would involve injuries to the knee and our advance treatment of ACL tears, where we do anatomic reconstruction. What that means is we’ve gotten much better in the last few years of being able to reconstruct a ligament in the knee exactly how it was before it was injured versus in the past, it has been hindered by our techniques where it’s close but not quite perfect. Then also, another big one that’s been coming up recently is minimally invasive surgery of the hip, a hip arthroscopy. And that’s something we’ve got a much greater understand of and we’re still evolving in that matter now, even if it’s just compared to a couple of years ago.

Melanie: What’s involved in that? Why is that so exciting?

Dr. Kaar: What it is is it’s a very medical standpoint over a complex topic involving the geometry of the shape of the hips and the bones and the tissue, soft tissue around it. And the medical field itself is just beginning to understand that well enough. Along with that, as we advance our minimally invasive arthroscopic techniques, we can then adapt those techniques to treat those miss-understood injuries in the hip. And that’s what’s really exciting.

Melanie: As people come to see you, they have access to the same specialists who are treating the Saint Louis University Billikens, correct?

Dr. Kaar: Correct. Our team treats athletes of all walks of life. We are the physicians for the Saint Louis University Billikens, and that includes all the Division 1 high-level athletes we have at the university campus.

Melanie: How does functional training and things come in as you’re working with people that have had these injuries after the fact? Then what do they do to rehab?

Dr. Kaar: That’s a great question. What we do is we work very closely with their physical therapy and our rehab team in order to customize an athlete or a patient, either post-operative rehab or post-injury rehab, to focus on strengthening what’s been injured and then also strengthening the surrounding muscles to protect the injured tendon or muscle, whatever it maybe, to decrease the chances of further injuries. So that can involve doing core and hip strengthening to protect the knee, believe it or not. It can involve trunk and stabilization and back muscle strengthening to protect the shoulder. So that’s sort of the gist of how we work closely with our rehab partners on those kinds of injury.

Melanie: Dr. Kaar, in just the last minute and a half or so that we have left, tell us why people should come to see you when they’re looking for sports medicine treatment at SLUCare. Also, give your best advice for prevention of these injuries before they even happen.

Dr. Kaar: Sure. So the best advice for prevention we sort of touched on involves cross training, being smart, and not going from zero to a hundred miles an hour in three days but being gradual and really intelligent about designing your workout program. You’re not doing the same thing over and over again and not doing too much all at once but instead working up to it. As far as seeing, we’re excited to treat athletes of all ages. We see the elite athlete, we see professional athletes, we see high-level collegiate athletes. We have a multi-disciplinary team approach where we’ve got orthopedic surgeons. We’ve got primary care, we have primary care non-surgical physicians that can treat athletes for different reasons like tendonopathies, like concussions, like other non-orthopedic injuries who work closely with our athletic trainers and our physical therapy team to make sure our rehab and prevention strategies are comprehensive for any athlete, whether they’ve had an injury, they need surgery or not. So we’re really excited and enthusiastic to treat the whole athlete in their entirety for whatever they come in to see us.

Melanie: Thank you so much, Dr. Scott Kaar. When you see SLUCare a sports medicine doctor, you’re getting high-quality treatment. You’re listening to For Your Health with the physicians of Saint Louis University, SLUCare Physician Group. SLUCare is the academic medical practice of Saint Louis University School of Medicine. For more information, you can go to slucare.edu. This is Melanie Cole. Thanks for listening.