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Bill Klaproth: Sports medicine is the branch of medicine that deals with the treatment and prevention of injuries related to sports and exercise. Here to talk with us about sports medicine and how it can help you is Dr. Dustin Volkmer, a board-certified orthopedic surgeon at Columbus Community Hospital. Thanks so much for your time. What is a sports medicine doctor?

Dustin L. Volkmer, MD: A sports medicine doctor obviously is someone that specializes in sports medicine. In the orthopedic field, what that means is there's an extra year of fellowship after all your orthopedic surgeon training or you just spend that one year in fellowship training from learning about sports injuries and how to treat them more effectively. In terms of what we do on a daily basis, a sports medicine doctor really is focused on the treatment of injuries or conditions that occur in the athletic or physically active population. It’s a common misunderstanding that to see a sports medicine doctor or be treated by one, you have to be an athlete and that’s not true. It doesn't have to be an injury that occurred in a sports field or athletic core training or anything like that. It’s more the treatment of injuries in the physically active population. What we focus on in the fields of sports medicine is minimally invasive treatment whether it be surgical or non-surgical, trying to be as minimally invasive as possible. Advanced rehabilitation or therapy techniques and really getting people back to their activities or their lifestyle that they enjoy as quickly and safely as possible. It’s really trying to focus on accelerating things and getting people back as quickly as they can doing the activities they love.

Bill: What are some of the common issues you treat?

Dr. Volkmer: Common has to be with sprains and strains that occur during athletic activities or just everyday life. Ankle sprains or sprains to your knees, muscle strains from overuse or overexertion are probably the most common injuries that we see and those are obviously treated very effectively via non-operative treatment, medications, and physical therapy. In sports medicine, we see a fair number of soft tissue injuries like ligament tears and cartilage tears like the dreaded ACL tear in athletes. Unfortunately, we've seen quite a few of those. Cartilage tears or meniscus tears in the knee are very common as well. In one area, we’re seeing more common or just being more aggressive in terms of how we treat them are cartilage tears in the hip because we now have minimally invasive or orthoscopic techniques to actually treat cartilage tears and other injuries inside the hip joint in a more minimally invasive fashion and getting people back to the activities they want to do quickly whereas 15-20 years ago, we just didn’t have the technology to do that. That’s an area in sports medicine that’s really gaining a lot of interest and a lot of research in an area where we’re really able to help patients more effectively than we did in the past treating cartilage injuries of the hip.

Bill: For the active population which you describe, how would someone know if they need to see a sports medicine doctor as opposed to a regular family doctor?

Dr. Volkmer: A lot of injuries, the common sprains and strains, still can certainly be treated by a family practice doctor. I would say if there's significant swelling or if there's pain that's not getting better after a few days, it's always wise to maybe get in to see a sports medicine specialist to get the injury evaluated and treated. If there's any significant instability of the joint such as ligament tears or something of that nature, obviously that would be something that we would want to be seen sooner rather than later. It’s only the thing in terms of instability to a joint, knee or shoulder or even elbow. Most dislocation of joints are going to require to be treated a little more aggressively over time, so the more traumatic injuries such as a dislocation or even a fracture that occurs in the athletic activity would be something that would probably be wise to get in to see a specialist sooner rather than later.

Bill: You mentioned earlier minimally invasive procedures. What are some of the ways you treat sports injuries?

Dr. Volkmer: The most common way we treat most sports injuries is actually nonsurgical, even though we’re surgeons, but we’re still able to treat certain injuries without surgery and this is through focused physical therapy techniques, medications to get the acute inflammation calmed down and the therapy to strengthen and build muscles around the joint or the injury to get things tuned up more or less and get people back. Other non-operative options we have actually are injections, obviously cortisone injections most people have heard of or an anti-inflammatory, but one of the real hot topics or emerging fields in sports medicine is called orthobiologics, which means using the body’s own cells to try to stimulate or promote a healing response. A couple examples of these are platelets or rich plasma and stem cells. Unless there's something where there's a lot of researching going into right now, the science hasn’t quite caught up to the technology in terms of what we’re able to do and modulate these types of injections. That’s another option in terms of non-surgical treatment. There's a lot in the media about those nowadays. In terms of surgical treatment as I mentioned in sports medicine, we really focus on minimally invasive techniques, meaning orthoscopic techniques. What this means is we can access inside a joint through small incisions in the skin and through special instruments, we’re actually able to get inside the joint and repair cartilage lesions or ligament tears and those things so it’s not as traumatic the surgery itself to repair these injuries. If it’s able to accelerate rehab where people aren’t having quite as much pain don’t have as much damage to the surrounding tissues and muscles and able to accelerate rehab and healing time. That would be the primary way in terms of sports medicine. We try to be minimally invasive, treating as many injuries as we can arthroscopically and getting the rehabilitation process going as soon as possible.

Bill: Having a proper diagnosis really helps you target the treatment. How do you generally diagnose sports-related injuries?

Dr. Volkmer: Many can be diagnosed just on physical exams or if we're dealing with sprains, strains, ligament tears, those are things that we can pick up very easily on clinical exams to target which ligaments are injured and how bad they're injured. X-ray is a very basic tool that we use frequently to rule out any underlying fractures of the bones or dislocations. We frequently use MRI scans in sports medicine. The MRI scan is a more advanced scan that allows us to look more at soft tissues as opposed to the bony injuries, so this allows us to get a very good detail of ligaments inside the joint, cartilage inside the joints, muscles, and tendons, so that's the way to more fine tune our diagnosis. We'll have a diagnosis prior to that, we use the MRI scan to really fine-tune what we're thinking and a lot of times come up with a surgical plan just to get a good picture to what the anatomy looks like.

Bill: If you could wrap it up for us, could you talk about injury prevention and what you do to help athletes avoid injuries?

Dr. Volkmer: I think one of the biggest things we do to try to prevent injuries is having good offseason training programs. We know that in order to prevent injuries, we need to be conditioned in the entire body and not just being sports specific. That’s one area as well in sports medicine that’s gaining a lot of interest. We have a lot of sports specialization even at very young ages where kids are picking one sport at a very young age and just doing only that sport during the remainder of their high school, even college careers, where they're doing it year around. We know that’s a recipe for overuse injuries and ultimately even ligament tears and those kinds of things. In terms of injury prevention, it’s important to just have a more generally conditioning program that we’re doing year around that works on all your muscle groups, especially your core muscle groups, your abdominals, back muscles, hip muscles and all those play a big role in terms of stability to the lower extremities and preventing injuries like ACL tears. Here at Columbus, we have good offseason programs through our athletic trainers that they keep a very close eye on our athletes working on the offseason doing some cross training, swimming, biking, general weight lifting programs to strengthen the entire body and that’s probably the best way to prevent injury. Like I mentioned, really encourage kids or athletes in general to not subspecialize so much to play a few different sports, certainly if they just want to play one sport to take a little time off during the year, at least a couple months where they're not hitting it so hard with that sport until the body recovers and use a different muscle group. We do have an ACL prevention program here through our athletic trainers as well that a lot of the athletes will do in the offseason focusing on core strengthening, jumping mechanics, to try to prevent those type of injuries. Unfortunately, there's the risk of the job or the activity where there's going to be some injuries occur, so not all of them can be preventable, but we really do our best to strengthen the body as much as we can to absorb some of those blows and be able to hold up to those over time. It's a good general conditioning program that's the best injury prevention.

Bill: That’s great information and thanks for sharing that with us and thank you so much for your time. For more information about sports medicine, please visit columbushosp.org. That’s columbushosp.org. This is Columbus Community Hospital Healthcast from Columbus Community Hospital. I'm Bill Klaproth. Thanks for listening.