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Joey Wahler (Host): Shriner's Children's Portland understands that injuries to growing bones and bodies need special attention. With comprehensive assessments and rehabilitation, the sports medicine team at the Portland Shriner's Hospital work hard to get children back to the sports they love. So, we're discussing the Shriner's Children's Portland Sports Medicine Program. Our guest, Dr. Ahmad Bayomy. He is a pediatric orthopedic surgeon at Shriner's Children's Portland.

This is Healing Heroes PDX, the podcast series from the specialists at Shriner's Hospitals for Children in Portland. Thanks for listening. I'm Joey Wahler.

Hi, Dr. Bayomi. Thanks for joining us.

Dr Ahmad Bayomy: Hey, Joey. Thank you very much for having me.

Joey Wahler (Host): Great to have you with us. So first, tell us a little bit about your background and also what first drew you to this specialty, pediatric orthopedics.

Dr Ahmad Bayomy: Sure. So, I actually grew up in the Pacific Northwest. And one of my siblings had orthopedic needs as he was growing up, and it instilled an interest in me to try to help other families who might have similar problems. And as I went along through college and eventually my orthopedic training, I was really drawn to taking care of young people, children and teenagers, as well as athletes. So, I made my way into the University of Washington for both my medical school and orthopedic surgery training. And then, I did dedicated subspecialty fellowships each one year. One was at Columbia University, New York, focusing on pediatric orthopedics, and I also did a dedicated sports medicine fellowship at the Cleveland Clinic.

Joey Wahler (Host): So having had a personal experience that drew you to this, do you think that maybe gives you a little extra firsthand passion for the field?

Dr Ahmad Bayomy: Absolutely. I think that it's helpful for us to really try to understand what patients and their families and loved ones are going through. And while I can't always put myself in their shoes, I do try and I think that having a family member and being on the family side of it has given me a little bit of experience and I try to bring that to the table when I meet folks in clinic.

Joey Wahler (Host): Now, you're new to Shriner's Children's Portland coming from the New England Hospital. So, how long have you been here and how would you describe your time at Shriner's Children's New England in terms of how it prepared you for this next step?

Dr Ahmad Bayomy: So, I was fortunate to join the team here in Portland in November of 2022. Before that, I worked at the Shriner's Children's New England Hospital for about three years. I was fortunate to lead the sports medicine program there where we had a terrific team. You know, we made it through COVID. And during the last portion of my time, I also served as the internal medical director for the hospital as it was going through a transition.

I think that one of the experiences I have there that I hope to leverage here is really trying to understand what it takes to provide wraparound care for our youth athletes. We were able to do that there, working with both team members within the hospital as well as in the community. And that's something that we're striving for here as well.

I'll add just on a personal note that our team in New England was terrific. But for my family and I, it's been a goal of ours to get back to the Portland, Oregon and Vancouver, Washington area. So, we're grateful to be able to choose this opportunity.

Joey Wahler (Host): So, you mentioned wraparound. What do you mean by that?

Dr Ahmad Bayomy: I think for me, you know, my philosophy and sort of how I was trained as a support, when you meet a patient, especially a young athlete, to think about what their needs may be beyond your specific area. So typically, young people may have needs beyond an orthopedic provider. They may need to visit with a physical therapist, perhaps an athletic trainer based at their school or program, sometimes a psychologist or a coach in the community. And so, we hope to be able to offer either within our own team or in the community the services that are going to allow those young people to be successful in their desired sport.

Joey Wahler (Host): Gotcha. Now, the Shriner's Children's system utilizes also a back to sports philosophy with patients. Can you tell us what that means and why is that so important?

Dr Ahmad Bayomy: The idea behind return-to-sport is that we think, and studies have shown, that for somebody to safely get back to their desired activity, whether it's a competitive sport or some other recreational athletics, that it really helps for their mind and body to be ready to do so. We know that that preparedness can reduce the risk for reinjury and it can also help foster a more full return to performance.

For some injuries, particularly ACL tears, for instance, surgery's often warranted. And studies have shown that it's particularly important for those patients to meet the goals of a return-to-sport program to again verify that both mind and body are sort of getting to the point of being able to safely get back. And we've had some success during that year.

Joey Wahler (Host): So, what are typically the most common sports injuries you see, both let's say in younger kids, pre-teens, and then in teenagers as well, if we can maybe please break it down into two groups?

Dr Ahmad Bayomy: Absolutely. I think for young patients, often what we're finding is that they're developing some overuse injuries around weaker links in the body, if you will. They can be growth plate-related, for instance, strains of the knee, the heel, potentially other areas where there are growth plates that get irritated with repetitive movements over time. I think as we get into a little bit older group, for example, early teenage years and beyond, what we can see are some more serious acute injuries or abrupt injuries, if you will. So, people who dislocate a kneecap or tear their ACL, those are common injuries of the knee, unfortunately. Other things we tend to see are shoulder injuries, including shoulder dislocation, so the shoulder coming out of the socket. We also will see patients with ankle sprains, hip injuries, and a mix of other things.

Joey Wahler (Host): So, it sounds like in that younger group, that a lot of those injuries from what you're saying are more "normal," just part of the territory when you're growing and getting bigger and stronger, right?

Dr Ahmad Bayomy: It's a fair question to ask. And I think one thing that we try to do is help youngsters be successful within their zone, if you will. And sometimes children are participating in one activity quite a bit, so many hours a week or many months throughout the year, and that can be part of it. But your point is certainly well taken, that part of being an active young person is that there are going to be some bumps along the road. And some of that is avoidable, but some of it you sort of have to take in stride and work with a healthcare provider to try to get better.

Joey Wahler (Host): So, what are some general tips you might have, doc, or advice for kids to prevent sports injuries and to stay healthy as an athlete?

Dr Ahmad Bayomy: One of the pieces that I may try to highlight, especially for those young people who are coming out of the COVID period where maybe they were less active or didn't have the opportunity to continue their desired activities during COVID is to take things gradually. If you're new to a sport or if you're looking to get back into a sport, it's important to think about working with a coach, perhaps an athletic trainer, somebody who can work with you to develop a program to help build up your strength and your conditioning, so that you can really take on full participation including practices and games and, hopefully, that way avoiding some of those acute and overuse injuries. I think having a resource like an athletic trainer at your school's terrific if you do. It may require touching base with your primary care provider to see what resources are out there in the community, and just trying to sort of get back gradually.

Another point I might add is that, we think and the science on this is developing, but for kids and early teenagers, doing one activity all throughout the year or more hours a week than their age, those may be risk factors for developing an injury and they may not actually allow the child to perform at a high level or maintain passion for that sport. And so mixing things up, cross-training or diversifying, those things may be helpful, especially up until about the mid-teenage years. And then, somebody can kind of key in on one thing that they love the most.

Joey Wahler (Host): Yeah. It sounds from that like one thing kids and adults have in common when it comes to sports injuries is that so often, am I right, the cause is simply overdoing it.

Dr Ahmad Bayomy: Yeah. I think kids and teenagers are particularly at risk because the bodies are still developing and the wiring for how the body moves and the strength and motion are all still sort of immature. And so, it takes a little bit of training and growth to try to sort of get past that. But you're absolutely right, I think because kids are still figuring those things out or their bodies are figuring those things out, that it can be a particularly risky population.

Joey Wahler (Host): Always that fine line in athletes of any age between trying to push yourself to get the most out of whatever you're doing, but then also being smart and knowing not to overdo it. Let me ask you a couple other things. One is the sports medicine program is growing, and so what projects or research might be coming down the pipeline that you and our listeners can look forward to?

Dr Ahmad Bayomy: I'm really excited to be part of the Shriner's Children's Portland team. One thing I can share is that we are currently the leading site for a group of Shriner's Hospitals throughout the country, a consortium, if you will, that's looking at education and research within sports medicine. Within that group, we have a number of research projects ongoing and hope to be able to share those through the team efforts soon. And there's a particular interest in something called motion analysis, which for the listeners, if you've ever played a video game or watched a movie where they've tracked athletes or actors with markers on their bodies to help create that, we can also study an athlete's or a patient's movements that way and give them feedback. And sports medicine is one of the areas where that's really becoming sort of the cutting edge. And we're both implementing that here and we're part of a group that's studying it.

Joey Wahler (Host): Wow, that sounds very futuristic, huh?

Dr Ahmad Bayomy: We try to use technology responsibly to try to use things that are evidence-based, but also offer our families the latest and greatest when it's appropriate.

Joey Wahler (Host): Gotcha. And then finally, in summary here, doctor, of course, the Shriner's name is so well known, so well respected wherever they practice. But in terms of your team, what do you want people to know about Shriner's Children's Portland in particular, as far as the sports medicine program goes, if they're considering being a patient, if they're considering referring someone there?

Dr Ahmad Bayomy: I would really emphasize that we have a terrific team that I've been able to join. We have a number of orthopedic surgeons with an interest in sports medicine, myself included. We have physical and occupational therapists. We've also hired an athletic trainer. And we also have a number of physician assistants and nurse practitioners, all of whom hands on deck are here to care for our young athletes. Families can see us within our walk-in fracture or injury clinic where no referral or appointment is necessary. And there's also a process where patients can be referred into our surgeon's clinics as well.

I have full trust in our team, and I think we're poised really to deliver, again, evidence-based care to do it in a compassionate way. And luckily at Shriners, we can do so regardless of a family's ability to pay. And we're also working with folks in the community, collaborators like strength and conditioning coaches, athletic trainers, psychologists, others who I believe are important to the overall care of the athletes. So, we're working to bring that together.

Joey Wahler (Host): And perhaps most importantly of this conversation, don't overdo it, right?

Dr Ahmad Bayomy: Yeah, absolutely. Take your time, work gradually. And if you need to see a healthcare provider, don't hesitate. Certainly, our team is happy to visit with you,

Joey Wahler (Host): Absolutely. Well, folks, we trust you're now more familiar with the Shriner's Children's Portland Sports Medicine Program. Dr. Bayomi, thanks so much again.

Dr Ahmad Bayomy: Joey, thank you very much for having me.

Joey Wahler (Host): Great to have you with us once again. And for more information, please do visit shrinersportland.org. Again, that's shrinersportland.org. If you found this podcast helpful, please do share it on your social media. And thanks for listening to Healing Heroes PDX, the podcast series from the specialists at Shriner's Children's Portland. Hoping your health is good health, I'm Joey Wahler.