Caitlin Whyte (Host): Welcome to another episode of Wellness Waves, brought to you by Bergen New Bridge Medical Center, your essential source for healthcare information. In this episode, we delve into the world of sports medicine and orthopedics with two esteemed experts. Dr. Raunak Singh is a Board Certified Sports Medicine Physician with extensive experience in treating sports related injuries and athlete health.

And Dr. Christopher Inzerillo is a Fellowship Trained Orthopedic Surgeon and the Chair of Orthopedics specializing in knee, shoulder, and elbow injuries. Together, they explore the intersection of sports medicine and orthopedic intervention, highlighting how these fields work in tandem to promote health and peak performance.

Well, Dr. Singh, I'll start with you today. What are the most common sports injuries that require orthopedic intervention and how can they be initially managed in a sports medicine context?

Raunak Singh, DO, CAQSM: That's a pretty good question. I mean, there's a lot of different sports injuries. It really depends on the sport you're talking about. And different sports have, you know, different degrees of what's more common in what sport. I would say very frequently what we have,athletes or people coming in with rotator cuff tears or ligament issues, things like that. Typically, and depending on the degree of the injury that they have, regardless of the age and the mechanism of the injury that happens, initially it's managed through non-operative means, whether it's through physician directed physical therapy, injection therapies, oral medications, things like that.

Usually I turn to my colleagues in the orthopedic surgery world when it comes to a point where those treatments don't work for these patients, or they come to me with an injury that is at a point where they might not get much progress or relief with those interventions. And at that point, surgery or having that conversation about having a surgical fix for those injuries is probably what's best for the patient at that point. Like I said, rotator cuff injuries are pretty commonly ones that we see. If you have an athlete that comes in with ACL stuff, that's typically surgical, not much to do before that unless you're doing some prehab to get the muscles around that area of stronger before surgical interventions.

But yeah, those are kind of how things are typically treated before I kind of go into the the weeds with the patient about having the conversation with orthopedic surgeons for fixing these kind of things.

Host: Great. And Dr. Inzerillo, how do sports medicine specialists and orthopedic surgeons collaborate to ensure optimal outcomes for their patients?

Christopher Inzerillo, MD: Good communication is, is always important in just about every area of life, but particularly here. I think it's very reasonable for patients, even the patients I see, the vast majority of them do not need an operation. They might need physical therapy or a cortisone shot or a brace or a cast.

So I, think just getting the patient in to be seen and evaluated. I typically say if you've, you're hurting for more than a week or two, and the pain is not abating, that's a reasonable timeframe to seek out some attention unless there's like a fall and an acute fracture or trauma, then you, you should be evaluated correctly.

But most sports injuries are a little bit of overuse.So it's, it's reasonable to try ice and an anti-inflammatory medicine and just activity avoidance at first. And then if the pain continues, you could seek out a consultation fromDr. Singh or someone like myself. For non-surgical matters, I might refer back to Dr. Singh and for surgical matters, he might refer to us, but I think either specialty is qualified at coming up with the diagnosis and a good treatment plan.

Host: Great. And what recent advancements in sports medicine Dr. Singh have reduced the need for surgical orthopedic interventions.

Raunak Singh, DO, CAQSM: There's actually a couple, I would say that a lot of research has been done on, you know, brace technology for a lot of times even just getting, without using a cast or like a plaster, what people would think there's tech advancements and you know research showing that even just getting a brace and immobilizing patients for like issues like that are a big one.

That's kind of hot topic in the, in the market nowadays is orthobiologics, PRP, different stem cell things. That's a pretty hot topic for regenerative medicine is a big one that there's a lot of research being done currently about all that stuff. Whether or not you can just do that kind of, those kind of injections and things like that to see if you can heal some injured chronic issues or injured tendons, things like that.

Ultrasound guided procedures are another advancement that has helped patients give another option that's not in the, in the surgical realm.They are still procedures, so there's still risks that are involved with these things. But, there are a lot of things that are out there that are giving patients more of an option rather than just whether or not they, for like different treatment options, basically about what they can do for their injuries or their issues that they have. Oftentimes, this is not like a one size fits all thing, and it is important to get evaluated to see if A, do you have like everything that fits in your story, in your presentation to go down these options? Or is it based off the clinical judgment of the provider you're seeing better to see orthopedic surgeon or somebody like myself to do all these things to, depending on what intervention you would need.

Host: Mm. Gotcha. And I'll stick with you for this next one, Dr. Singh. What role does sports medicine play in the postoperative rehabilitation process for athletes who have undergone orthopedic surgeries?

Raunak Singh, DO, CAQSM: Like Dr. Inzerillo mentioned earlier that communication's like the biggest thing when it to the collaboration between our fields, right? I mean, I can kind of just talk anecdotally and as an example of what I've done in the past when I have had had an athlete, for exampleget an ACL surgery, and then they come and I'm taking care of them as their like team physician or their doctor, right?

It's in collaboration with the orthopedic surgeon's recommendations of their postoperative rehab and recovery and getting them the right resources that they need. So from a sports medicine perspective, at that point, after their operation, you're kind of making sure they've done their rehab properly.

And then that's also communication with their physical therapist. Are they doing the right things? Are they making the right gains that they need to make? And that's all, that's kind of like a team effort. It's not just a one physician kind of leading one thing here and there, right?

Everybody has their role to play when it comes to the postoperative care of a patient. And then if it's an athlete or anybody who's trying to get back to an activity that they were once doing before surgery, you kind of make sure they're doing the activity related rehab that they need to do to get back to doing those activities. Right? So it's more of just making sure everybody's kind of on the same page, whether or not the patient is kind of getting the care that they need really. 

Host: All right, so Dr. Inzerillo, how do different types of physical activities affect the likelihood and type of interventions required?

Christopher Inzerillo, MD: So I think number one is the intensity at which activities are performed.Someone who is a mild casual jogger is not going to put the same stress on a knee or a joint as like a sprinter. Same thing with skiing or tennis. I mean, you, you can do sports casually for fun and enjoyment or you can do them competitively where you're kind of pushing the body to its limits.

So,the intensity is part of it and also the repetition, right? Someone who is throwing a ball six, seven times a week is going to be much more likely to get injured than people that do itwith rest in between sessions. One of the things I like to tell patients, it's a great idea to cross train a little bit.

If you like to bike maybe once or twice a week, do a rowing machine or, or, or mix up the forces that your joints are seeing so it's not seeing the same repetitive force all the time.

Host: Great. And Dr. Singh, how do lifestyle changes recommended by sports medicine professionals impact the need for orthopedic surgeries then?

Raunak Singh, DO, CAQSM: Ideally they decrease the need for these surgeries, right? Because if they're making the appropriate modifications in their life, then they're doing the right things to prevent an injury from happening in the first place, right? So when you say lifestyle modifications, it's such a broad term, again, it's catered to the patient. With that being said, like if a patient who's trying to get back on track on their own and just make positive changes in their life and get more active whether it's directed by, you know, a, a personal trainer or a physical therapist, or even a physician that's helping them kind of get back on track if, without somebody like helping them, there is a chance of somebody, you know, using poor mechanics or something like that. Or even over overuse, like Dr. Inzerillo mentioned previously, that overuse is a pretty common thing that we will see in our offices. So depending on how they're doing, the lifestyle modifications and the modifications that they're recommended to do can lead to injuries that end up being seen by us.

But the goal of these lifestyle modifications and these modifications in their activities in general, is a preventative purpose, right? It's preventative care is the ideal thing. So if you can prevent anybody getting injured or making them less prone to injury, then yeah, then you would think that the need for surgeries go down.

Host: Absolutely. And Dr. Inzerillo wrap us up here today, how do psychological factors play a role in recovery from sports injuries and what interventions help avoid further orthopedic complications?

Christopher Inzerillo, MD: Oh, that's a great question. I'm a big believer in, in the power of the mind andhaving a positive attitude is sometimes the difference between a good outcome and a poor one. So part of the, the way I practice is continually trying to keep the spirits, because it can be pretty depressing for particularly someone who's been hurt for the first time.

There's a lot of fear.There's a lot of concern, a lot of anxiety that telling a 16-year-old they might need an operation is, is just, it's a devastating blow. So maintaining calm and maintaining body language, contact with the patient is, I think, important in managing their, their psyche. And sometimes I say, you know, my job is to be cheerleader as much as it is to be surgeon and just say, hang in there. I know this is a six month rehab after this rotator cuff, you're, you're doing great. You, you got to, you have to continually keep the, the spirits up of the patients. Because it, it can be daunting. You know, there's pain, there's time, there's expense.

So there's a, there's a lot of factorsthat can get patients discouraged and a discouraged patient is, is not going to do nearly as well as someone who has a very positive, motivated attitude. 

Host: Thank you Doctors for being on the show, and thank you for joining us on this insightful episode of Wellness Waves from Bergen New Bridge Medical Center. We hope you gained valuable insights into the dynamic relationship between sports medicine and orthopedics. For more information on how sports medicine can support your health journey, please visit newbridgehealth.org.

Be sure to tune in next time for more expert discussions on achieving optimal wellness, and remember to subscribe and share with anyone who could benefit from today's conversation.