Melanie Cole (Host): The Orthopedics and Sports Medicine Service at MIT Health provides expert care for a wide range of problems. Welcome to Conversations with MIT Health. I'm Melanie Cole. My guest today is Dr. Shawn Ferullo. He's a physician and Director of Student Health at MIT Health and the team physician for MIT. Welcome to the show, Dr. Ferullo. First tell us a little bit about what services are available through Orthopedics and Sports Medicine Service at MIT Health

Dr. Shawn Ferullo (Guest): Certainly. We run a full-time orthopedic sports medicine department that is five days a week encompassing care of orthopedic injuries, sports medicine injuries, overuse injuries, and even occupational injuries that happen here on campus.

Melanie: So, tell the listeners about sports medicine clinics. When you're mentioning these types of injuries, where are the students most likely to get them? Only if they're an athlete or can they get some of these injuries just playing Frisbee out on the field?

Dr. Ferullo: You can imagine, as most other academic institutions, we have a quite active population of people that might include varsity athletes, club or intramural athletes, certainly recreational runners, and plenty of recreational sports or even unplanned sports that happen you know, amongst individuals on campus. We see a wide range of injuries that occur pretty much in all of these different settings.

Melanie: So then, what can the students expect when they have an injury? What can they expect when they come in for care?

Dr. Ferullo: Their expectation should be the highest level and quality of care that they can get anywhere. Students will interact with our service in a few different ways. It may be a direct referral right into the Orthopedic and Sports Medicine Department. It may initiate in our urgent care department as a walk in and then have a referral visit or they may even, if they have an established primary care physician, start seeing their primary care physician and then be referred down to us for more of the specialty care. We do x-rays right here on site and a lot of the hands-on clinical management of sports injuries from acute injuries to overuse injuries, as well.

Melanie: Let's talk about some of those injuries. What are some common preventable sport injuries that you see in your practice?

Dr. Ferullo: Certainly. I think our practice is probably very similar to every other sports medicine practice. I think some of the most common ones that we see are certainly overuse injuries that may range from sprains, strains, tendonitis. Most of the preventable ones I think are likely around overuse. So, certainly thinking about training regimens, how to have people alter their training regimens, or adjust them to minimize their risk of injury. Certainly, a good strengthening and stretching routine and warm-ups and cool downs, and a lot of the more basic injury prevention strategies that people don't always have time for when they're very busy studying and then trying to fit their exercise in around that schedule.

Melanie: So, what do you like people to know about preventing some of these sports injuries? If they're involved in one particular sport, can they cross-train? If they're a runner, do you want them to walk sometimes? What do you want them to do when they start to feel these aches and pains?

Dr. Ferullo: Yes, that’s a great question. I think my simplest advice that I typically give patients is to make sure they're aware and listening to their bodies first and foremost and listening to the cues that they might be getting and not just kind of ignoring initial systems and pushing through. I think I typically talk to people a lot about looking at their training regimen and looking at fitness, not just if they're a runner, just from pounding the pavement all the time, but thinking of ways that they can cross-train or alternate forms of exercise. Especially if they feel that they're starting to have some overuse symptoms, how do they continue to be able to exercise at the level and frequency that they want to, but not continually put strain on the same body part that's starting to have injury, whether that might be integrating some swimming or stationary biking or elliptical. I am a big proponent of kind of warm ups and cool downs and if people even don't have a large amount of time for a dedicated stretching warm up session to walk, the first component of their run and really get things loosened up before they start their actual run. And then, even doing the same thing on the tail end in order to continue blood flow, flexibility, getting some blood flow through the muscles to reduce some of the lactic acid buildup and other things will hopefully keep them healthier and more successful in their training routine.

Melanie: Dr. Ferullo, are you an advocate of ice? If they start to feel some aches and pains in their knee or their lower back, or their shoulder from doing whatever, like carrying heavy backpacks around, do you advocate ice and using that as a way to get, you know, just a little bit of the swelling down?

Dr. Ferullo: I do. I think that especially early on in their symptoms and in that time just when they may finish a run or finish their sport or activity, using ice in that timeframe to keep things kind of calmed down, reduce some swelling, reduce some of the inflammation I think is very beneficial. And then, I think also, relating back to that listening to their body and, if they need to address or adjust their workout routine in the next few days to accommodate that, really looking at that big picture and being proactive at staying healthy.

Melanie: So, who's eligible to participate in the Orthopedics and Sports Medicine Clinic?

Dr. Ferullo: So, our department here serves the entire MIT community, so anyone who is on the MIT insurance plan, both if they're faculty or staff, a spouse or a relative of a faculty member, have access to our services and then, every single MIT student by being registered as a student, have a MIT basic student insurance plan that covers every service that we give in the orthopedic department and the services that we do in our building. And so, anyone, ultimately, who is part of the MIT community, unless they have their health benefits through an outside employer, which may be their spouse's employer, but other than that, everyone can come and use our services.

Melanie: So, I'd like to just back up for a minute, when I mentioned the backpack, because these are students and they carry a lot of things in these backpacks. They're leaned over. What do you want students--and this goes out to the general public, too--what do you want them to know about these heavy backpacks and their risk of causing back problems, shoulder problems, gait issues, sports medicine issues?

Dr. Ferullo: Yes, it's certainly something I talk about every day in my clinic. I'm always amazed at how much people carry in their backpacks and it certainly makes sense where some students live completely other side of campus and have to pack their needs for the entire day. If it's a laptop, if it's a tablet, plus books, plus notebooks, they end up carrying a lot around and a lot of weight around every day. You know, I try to talk to students about being sure they're carrying what they need and not necessarily get in the habit of carrying everything all the time. I certainly talk about, a lot of the posture, body mechanics side of things, using both straps of the backpack, especially if it's heavy instead of just one, balancing off that weight, making sure they're using good posture and everything that they do. Lifting the backpack, putting it on, how they're walking around with it on, and then, for me, another offshoot of that is how they're sitting and using their posture while they're doing their work. A lot of what we see as well, are students who might have twenty minutes to get some work done in between an appointment and they're using a laptop and they're sitting on a chair that may not be the best postural chair, and they're really hunched down and trying to type away on the keyboard but yet putting a huge amount of excess strain on their low back, mid back, shoulders, and all of that. So, really, looking at the big picture of body mechanics of posture and the importance of that and how it relates to preventing some of these overuse and strains, as well.

Melanie: So, in just the last few minutes, give us your best advice for preventing some of these sports injuries that you see and why you'd really like students to check out the Orthopedic and Sports Medicine Services at MIT Health.

Dr. Ferullo: Sure. I think for prevention, I tell my patients all the time that I got into what I do for a living to help people exercise in a good way and not tell people that they shouldn't exercise. Sometimes, when we deal with certain injuries where we have to tell people they can't exercise for a while, it feels like all we do is tell people they can't exercise. Really, I think what students should know is that we are much more in the business of promoting healthy exercise, finding ways to cross-train and other techniques so that students can stay active, even if they are having an injury. The prevention piece for me, I think, is a lot of the good, solid, basic advice to really looking at a training regimen, being well-rounded in what you do, and cross-training, and alternating different types of exercise, I think, allows reduction of strain on the same body parts all the time, but I personally feel like it actually gives a better total body fitness to people where they’re not just one exercise-specific in good shape, but maybe in the pool they're not. Really thinking of it as globally having a good sense of fitness. Certainly, making sure that, as much as they can, they're utilizing the warm-up sort of routines, and cool down routines, having stretching. Certainly, if students don't have a lot of time, I really emphasize just a good warm-up before they exercise but really fitting in their stretching after they exercise once they're warmed up and static stretching when you're cold is really not as effective as a good calisthenics routine or something to warm you up and loosen the muscles up. There is good data around that being a better form of injury prevention than just static cold stretching. So really emphasizing those pieces. I would like to think that students will utilize us. I would like for them to know that we're really into the world of sports medicine and exercise medicine. Sometimes, I see students that might just be at the very early stages of knowing they're developing something, but appropriately come in and get some advice and assistance on adjusting training regimens on appropriate types of shoe wear if it’s with running. Some of that Using the expertise around sports medicine for injury prevention and management and not just waiting until the injury is so bad that now they have to come in and start really altering what they're doing.

Melanie: What great advice. It’s really such important information. Thank you so much for being with us today, Dr. Ferullo. Listeners can visit Health.mit.edu for more information and to get connected to one of our providers. That concludes this episode of Conversations with MIT Health. Please remember to subscribe, rate and review this podcast and all the other MIT Health podcasts. . I'm Melanie Cole. Thanks so much for joining us today.