Search for tag: "athletes"

Interviewer: How to handle a knee injury. Dr. Julia Rawlings practices primary care sports medicine and also pediatric emergency medicine, and she is one of the physicians that you would find at the walk-in orthopedic clinic at University of Utah Health. I wanted to talk about knee injuries and young athletes actually. What are some common ways that young athletes can injure their knees? What specific sports or activities do you see?

Dr. Rawlings: Yeah. So it's really common to have a knee injury when you're playing sports, particularly contact sports. But severe injuries, including the ACL, don't always have to be from contact. So we typically see knee injuries that are acute, meaning they happen from a trauma, when you're doing an activity where there's either contact or you change directions quickly, so you're pivoting, you're shifting, you're changing your weight, and the knee can kind of buckle on you and get injured. In people that do more endurance-type sports, like cross country runners, we tend to see more chronic knee pain just from overuse.

Interviewer: Got you. So you kind of covered some of the common injuries to the knee. What could be handled at home without a clinic visit? And then we'll get to when you should perhaps consider coming in.

Dr. Rawlings: Yeah. So starting with an acute injury, meaning that's something you were out doing your sport, you were doing something, and all of a sudden you felt the knee pop, or you twisted it, or something happened. A couple of clues that I would give to go ahead and come in to be seen is, one, if you're having a hard time walking on your leg, then we would really like you to be seen sooner rather than later. We'd like to get X-rays and make sure there's nothing that's broken and then do a good examine and check out the ligaments and the meniscus of the knee.

Another clue is if your knee gets pretty swollen, then that means that there's something significant going on in your knee that should be seen sooner rather than later. Two more other clues, things that I like to ask people about and look for. If your knee feels like it's buckling under you, it's giving out when you walk, then there's the potential that every time it buckles, that we're doing more damage. And in that case, we'd like to get you on crutches and get you into a knee brace. Or if the knee is getting stuck or locked, meaning you can't bend it or you can't straighten it very well without kind of forcing it, those are all things that we'd want to see you sooner rather than later for.

Interviewer: And then when somebody comes into the clinic with some of those more serious symptoms, as you said, what does the clinic do?

Dr. Rawlings: Yeah. So if you have, say, a big swollen knee and we're worried about bigger injuries to the ACL or to the meniscus, something like that, what we would generally do is start off with X-rays, make sure there's nothing that's broken, and then we would do our exam, get a feel for what we think is going on, and then generally get you set up in a knee brace that's appropriate for the injury you have, plus or minus crutches. And then often, patients with significant injuries we'll get set up for an MRI to check out the soft tissue structures, which we can't see on X-ray, and get a definitive diagnosis. And then depending on what we see on our exam, we'll either get you set up with one of the non-operative sports medicine providers for follow-up or our sports medicine surgeons. My practice myself is I typically just let people know what their MRI shows, and then depending on what they need done, I'll then schedule the appointment with the appropriate follow-up person.

Interviewer: And when people come in, how often would you say that they could just come into the clinic and that's kind of it? It's just going to take a little bit of rest, and they're going to recover from their injury.

Dr. Rawlings: You know, it depends a little bit, I think, on the age demographic. So we do see a fair amount of people that come in with an acute knee injury that have just flared arthritis, and they don't actually have an injury to the ligament or something that we would need to do an MRI or surgery for. And those patients we really treat with physical therapy, maybe a steroid injection, and kind of getting them back to functioning, hopefully, so that we can prolong the longevity of their knee. In those cases, then, yeah, all they need really is just that visit in the orthopedic injury clinic and then a follow-up appointment down the road with a primary care sports medicine person or a sports medicine surgeon.

Interviewer: Are there any final thoughts you would want a listener to know about the clinic, or knee injuries, and how to handle that or take care of it?

Dr. Rawlings: I think definitely when in doubt, especially when it's an injury that's happened within the last day or two, come on in. We'll be happy to take a look at it. And if you're getting a chronic injury from training for a marathon, or in kids, they can often get growth plate injuries, again, if they've happened in the last three months, we're happy to see you in injury clinic for more of a chronic developing problem as well.

Interviewer: What are the common mental obstacles athletes face? That's next on The Scope.

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Interviewer: Nicole Deting is a Sports Psychology Consultant, she's worked with Olympic Athletes, most recently the U.S. Ski Teams Free Style Aerialists in Sochi, she has also worked with athletes here at the University of Utah, and is a visiting faculty member in the Exercise in the Sports Science Department at the University of Utah. Let's talk about common mental obstacles athletes face.

Nicole Deting: There's actually two that I...

Interviewer: Just two?

Nicole Deting: Just two.

Interviewer: Okay.

Nicole Deting: That I would say are the most predominant. I've been doing this for 16 years now, and within that 16 years two have risen to the surface in that almost every single athlete I've ever worked with are dealing, or struggling, with these two primary issues.

Interviewer: Alright can I guess?

Nicole Deting: Yes.

Interviewer: The fear of failure, fear of injury?

Nicole Deting: You're very close.

Interviewer: Very close but not right?

Nicole Deting: Very close but not right.

Interviewer: Okay what are they?

Nicole Deting: Well the first one is anxiety, and that anxiety might come from fear of injury, or fear of failure, but anxiety related to performance so, "Am I going to be good enough? Can I do what I'm trying to do?" So whether it's a performance timing anxiety in terms of being good enough that day, or an injury, or a re-injury, or failing, or even a fear of success, it all kind of gets lumped under that anxiety category.

Interviewer: Okay.

Nicole Deting: And that's absolutely one of, actually that one is the most predominant issue I guess I would say that I would deal with, and so there are a lot of mental skills that I'll teach athletes in order to help deal with their anxiety levels before performance.

Interviewer: What's the second one?

Nicole Deting: Second one is confidence, that usually surprises people.

Interviewer: Sure because these athletes sure look confident don't they?

Nicole Deting: Absolutely, I work with some of the best athletes in the world, I mean athletes hear at the University of Utah they're Pac 12 athletes, they've really done well. The Olympic Athletes they're some of the best in the world so when I tell people I deal with a lot of confidence issues they're pretty typically surprised yet I will also tell you that there's confidence issues in all of us regardless of whether we're elite level performers, or...

Interviewer: Tell me about it.

Nicole Deting: ...going to our job every day, right? We all question ourselves, and I think that...

Interviewer: When you leave sometimes you're like, "Oh boy I was just a waste today."

Nicole Deting: Right? Or, "Can I do this?" Or, "Oh my gosh I have all this pressure on me, am I going to be able to do what I've been asked to do?" And so confidence is something that I deal with quite a bit.

Interviewer: So anxiety and confidence are the two big things. So, when you're working with somebody what are some of the things you do to overcome these two things? Are they very different or kind of the same for both issues?

Nicole Deting: Well what's interesting is that they are two very distinct issues but they're very closely related. For example, if you're really nervous about something you're probably not too confident about it. The more confident you feel the less nervous you will likely be so they do influence each other. Does that make sense?

Interviewer: Yes it does.

Nicole Deting: Okay, so there are two separate concepts, there are training methods for each one of them separately to help, but a lot of training methods that I will work with, with athletes helps both of them. So for example, if I'm teaching an athlete methods to deal with their anxiety, and to get themselves under better control, once they learn those they are naturally going to feel more confident to go into their performance because there anxiety is under control.

Interviewer: Got you.

Nicole Deting: So there are ways to kill two birds with one stone, which is a very cool part of our field.

Interviewer: So does this apply to athletes of any age?

Nicole Deting: Any age, all abilities, all sports, both genders, you name it, absolutely.

Interviewer: Sure, so let's talk about, let's go into like a parent that has a child as an athlete for example, you know and they choke when they step up to the plate to play little league baseball.

Nicole Deting: Sure.

Interviewer: What's something that parent could do to help that child?

Nicole Deting: Well first of all I'd ask the parent, "Where did they learn that? Where did they learn to be so nervous?" And the parent...I would challenge the parent to take a hard look at themselves because a lot of anxiety is we don't...We learn how to be nervous we're not born nervous, we're not born with anxiety we learn that, and typically we learn that by watching the most significant people in our lives, whether that be parents, or coaches, or friends, at one point those friends become more significant, so any significant person, and so if I find out that one of the parents has a lot of anxiety then I talk to the parent about their anxiety, and how it manifests, and what they do about it, and I can use some of those similar things with their child. So that's where I'm going to start.

Interviewer: Got you.

Nicole Deting: But then what I'm going to do is talk to that kid and just say, "Okay how does it feel? How do you know you're nervous? What does it feel like?" Typically we're going to get you know, "Oh, I can't breathe and I feel like I'm going to vomit," or you know something like that, and then, "I question whether or not I can do it." And so then I might work on teaching them ways to better control their physiological signs. So to control some of the movements in their body, and if they're shaking how to control that shakiness, but then also giving them some thoughts in their head about why they can perform what they're going to perform. Most likely they're stuck in, "I'm not going to be able to do this." So I'm going to challenge them to give me reasons why they are going to be able to do that, and then really get their mindset in a different space. So dealing with the anxiety, helping them learn to control themselves also increases confidence, and then we can work specifically on confidence as well.

Interviewer: We could talk for a long time about all of this, how long do you work with an athlete generally?

Nicole Deting: My goal with every athlete I work with is to work myself out of a job.

Interviewer: Yeah sure.

Nicole Deting: I want them to become so good mentally they don't need me anymore, so I work really hard to foster independence with each athlete. So when they come to see me I usually give them what I call home fun, not homework, homework sucks nobody likes home work.

Interviewer: See that you're rethinking again, right.

Nicole Deting: Exactly, yup.

Interviewer: So how can I fail, how can I succeed?

Nicole Deting: Exactly, home fun, and so home fun is basically a strategy that I teach them prior to them leaving and they go work on that strategy and become better at it. At the end of the day the athletes are the ones out there competing, I can't be there every single competition for every single athlete at the end of the day it's just them out there and they need to have these strategies in place in order to be more mentally tough. So how long I work with an athlete it depends on what that athlete needs.

Interviewer: Yeah.

Nicole Deting: But I work hard to foster independence as quickly as possible.

Interviewer: Yeah, it's not something you learn overnight.

Nicole Deting: No it's not something you learn overnight. You do have to practice.

Interviewer: Any resources on the web you could point somebody to that might be interesting.

Nicole Deting: My website.

Interviewer: Okay, that's a good place to go what is it?

Nicole Deting: Yeah my website www.headstrongconsulting.com

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