Melanie Cole (Host): With rapidly increasing participation in road races and obstacle courses and other weekend athletic events, there has been a certain rise in sports-related injuries. My guest today is Dr. Gregory Sawyer. He’s an orthopedic and sports medicine physician with Maine Medical Center. Welcome to the show, Dr. Sawyer. Tell us about the most common sports injuries with weekend warriors that you are seeing right now.
Dr. Gregory Sawyer (Guest): Well, just like you said, this is sort of an overuse-type scenario where these individuals are trying to cram in a week’s worth of sports usually into a weekend, whether it’s running or playing basketball, so what ends up happening is it’s an overuse injury where people start getting this irritation and inflammation of different parts of their body. You commonly see it in the rotator cuff; you get rotator cuff tendonitis. You get Achilles tendon inflammation, Achilles tendonitis. You can often get people to have plantar fasciitis. But it’s the series of “-itises”, it’s a lot of inflammation and irritation from that phenomenon of trying to cram a week’s worth of exercise into a day or two or an activity or two.
Melanie: People want to be active, Dr Sawyer. They want to be able to do these sports and this is a good thing for our country and for these people to get involved and do team sports and be active. But how can we avoid some of these “-itises” that you’re talking about. Start with something like plantar fasciitis, so common and yet so painful. What can you do to prevent it?
Dr. Sawyer: Well, I completely agree with you. There’s really nothing better that people can do for their bodies than to get out there and be active. I think there are a couple of things to try to prevent this weekend warrior injury phenomenon and that’s trying to maybe squeeze in some level of activity during the week. Some people say, “I just don't have time from job to my children,” and I completely understand that, but it might be so much as taking the stairs at your job and trying to work in some level of activity during the week, such that your body is not seeing such significant amount of overload on the weekend when you start doing this increased amount of activity.
From a plantar fasciitis perspective, which is inflammation on the bottom of a patient’s foot, in order to prevent that is really wearing some good footwear, I think it’s very important. A lot of people don't go out and buy a good supportive well-fitting shoe. On the weekends, they may just flip on whatever they have had for the last 20 years that they used to mow the lawn and that’s not going to cut it for somebody that’s going out and doing these high-level activities on the weekends. Another rule of thumb that applies to a plantar fasciitis and all sorts of other injuries is stretching at the beginning of these activities. That’s something that most people don't do, including myself, and we all need to be better about that. But just taking that five minutes before you do your activity and stretching out the variety of muscles and joints that you’re going to be working with and the foot is very similar and different exercises is stretching out all these muscles and tendons that maybe weren’t used as much over the course of the week but are going to be used a lot in the basketball game you're going to play on Saturday afternoon.
Melanie: Some great information. So to sum up, some things that we can do to prevent these common sports injuries that weekend warriors can come up with is stretching before your activity, making sure you have really good footwear, good shoe wear—that’s for all activities, really—and to do some activity during the week so that you’re not just fresh and new for the activity that you’re doing on the weekend. Now, if somebody, Dr. Sawyer, does get an injury, are you an iceman, a heat man? Everybody’s always asking, “Do I wrap it? Do I ice it?” What’s your best advice for an actual injury?
Dr. Sawyer: Well, as many people know, I think the acronym RICE is the key for a lot of these, and that’s rest, ice, compression and elevation, which I think you can't go wrong with in these sorts of scenarios. As far as whether you use ice or you heat things up, I think a rule of thumb there is, at the end of an activity or to sort of calm down some inflammation, it’s good to ice things and cool them off. And then as you’re trying to get your body ready to go to start a new activity, the heat is a good idea to really loosen up your joints and get the body ready to go. So I think ice at the end of a workout, and a little bit of heat, if you need it, at the beginning. If you’re having stiffness in your knees, there’s stiffness in your shoulders, a little bit of heat will help loosen things up and get you ready for that activity that you’re about to participate in.
Melanie: When do you know that it’s a severe enough injury that you need to stay out of the activity?
Dr. Sawyer: Well, I think that obviously, for these weekend warrior type injuries that we’re speaking of, something that would cause you to stop participating would be if you had some issues with Achilles tendonitis and it just got to the point where you aren’t able to walk correctly, run correctly, pain with every step. It varies from injury to injury. Obviously, more severe injuries, like tendon ruptures and things like that, you would know immediately and wouldn’t be able to participate at all. But these “–itises” that we’ve been speaking of would be to the point where there’s pain with every step, or pain with every throw, and pain that’s just not getting better with the RICE acronym that I spoke of.
Melanie: What about cross-training? If someone is a weekend warrior, they like to play basketball or softball and then they don't necessarily see the need to go walking during the week or to swim or to do weight lifting, what do you suggest for cross-training so they don't come up with some of this chronic overuse?
Dr. Sawyer: I think cross-training is outstanding and, really, for people that are just trying to maintain a level of fitness, I think cross-training is so important. Peak runners, for example, and individuals that run all the time and aren’t working in some other body parts will get a lot of IT band tendonitis. Iliotibial band tendonitis is one type of inflammatory condition that comes to mind. It’s just sort of these repetitive same activities, and when you can mix in other things that add different body parts, swimming and cycling, these are two of the best things that you can really do for your body. Those are low-impact activities that really use other muscles. For people that are big runners and love to run, I say, “Definitely keep running and doing the things that you like to do, but maybe, if you’re working out four days a week, maybe you run for two days and then you bicycle for another day and then you go for a swim another day and just mix those things in that give certain body parts rest and add some work to other body parts.” I think it’s really key to a good overall level of fitness and health.
Melanie: Dr. Sawyer, one of the most common weekend warrior type of sports is golf, and people think golf is innate, it’s not so destructive to the body, but yet things can go wrong. Speak about golf injuries a little bit and ways that golfers can prevent them, whether by warming up or stretching. What can they do?
Dr. Sawyer: Well, a couple of injuries that come to mind in golf really revolve around the swing itself. There’s actually a condition called “a golfer’s elbow,” which is the opposite of tennis elbow and it’s pain on the inside part of your elbow as opposed to the outside part of your elbow from the back swing and the acceleration that occurs with that. Patients will also complain of some shoulder discomfort from the repetitive overhead swing motion and that can often be due to rotator cuff tendonitis or biceps tendonitis.
Those are a couple of the upper extremity injuries that we do see from golfing, and like we talked about, obviously, stretching is key. For golf, really stretching the upper extremities and stretching your trunk and your back, which are very key during the golf swing, are very important. And then if golfers do suffer from some of those things, some ice at the end of the round, some heat at the beginning of the round and a little bit of anti-inflammatory, it will often help get through these nagging irritations. But if every swing is bothering and every round on the golf course is bothering, it might be time to take a little rest or certainly come in and see someone to see if there’s something that’s progressing or if there’s something that we can do to help.
Melanie: Perfect segue, Dr. Sawyer. In the last minute or so, tell listeners why they should come to Maine Medical Center for their sports injury treatment.
Dr. Sawyer: Well, I think with Dr. Lincoln Avery and myself, Maine Medical Center has built a team that can really cover and encompass all sports activities, whether it’s somebody suffering from shoulder injury or a knee injury or a hip injury or an elbow injury or an ankle injury, I think the combination of Lincoln and myself, we’ve got all the different joints and body parts covered to take care of these active individuals and get them back onto the court or back onto the field or back into the pool. It’s a pleasure to work with Linc who has many years of experience in the community. I'm relatively to the community, although I grew up in Wilton, Maine, and I’m proud to be back here bringing experiences that I've had out working at the Steadman Clinic in Vail, Colorado, to join with Linc. I think, together, we’re ready to keep the population of Maine active.
Melanie: Thank you so much Dr. Gregory Sawyer, orthopedic and sports medicine physician with Maine Medical Center. You’re listening to MMC Radio. For more information, you can go to mainemedicalcenter.org. That’s mainemedicalcenter.org, mmc.org. This is Melanie Cole. Thanks so much for listening.