Margaret Meyer, MD, chief of sports medicine and orthopedic trauma at Bronx-Lebanon Hospital Center in New York, discusses the biggest challenges and trends in her sports medicine practice.
Q: What is the biggest challenge you face in your practice?
Dr. Margaret Meyer: My major challenge is with patellofemoral pain, particularly treating patients with isolated patellofemoral arthritis at a young age. Many patients respond well when we can treat them with therapy and injections, but if this treatment fails sometimes they need knee surgery. The surgical procedures are less consistent in their outcomes. Patients also have concerns about major knee surgery.
Weight loss is also an issue for many patients in my practice. We all know that it is difficult to lose weight even if it would reduce pain. We also find that some patients need extensive physical therapy for patellofemoral problems, and in this healthcare market many insurance companies are cutting back on this benefit It is imperative that the patient can access a good physical therapist that will actually do optimal therapy as this is important for treatment. .
Q: What qualities do you look for in a good physical therapist?
MM: A therapist who is consistent with their care is important, but may be difficult to find because there is a huge variability between therapists. When I send patients with a specific protocol to physical therapy and the therapist deviates greatly from that plan I have to change the therapist. I think hands-on physical therapists that follow the strengthening and stretching protocols are best. They should spend time with the patient and use modalities such as ultrasound and E-stim to monitor care. Patients shouldn't be doing exercises by themselves.
When patients report being left on their own, I will either send them back with specific protocol or not recommend that physical therapist again.
Q: You mentioned weight loss as another big issue for patients in your practice. How do you guide weary patients through that process?
MM: We tell them that weight loss and regular exercise could be helpful for their condition because when the joint force is decreased with weight loss, it will alleviate their pain.
Q: What is the most difficult part of treating competitive athletes with a chronic condition or injury?
MM: We must return the player back to the field as quickly as possible. We have to give information to the player and the coach about how things are healing and when recuperation is complete. Communicating with the coaches and offering feedback on how their players are doing in anticipation for their return to play is important. We distinguish carefully between when the player is released to practice versus release to participation on game day.
If an athlete wants to return to play too quickly, I tell them they run the risk of re-injury and turning an acute problem into a chronic one. I make sure to emphasize that it will be tough for them to return to their previous level of play if they don't follow the treatment protocol.
Q: What new sports medicine technology and developments on the horizon are you most excited about?
MM: The use of platelet factors, like growth factors, and looking for better fixation are topics on the forefront of sports medicine development. Any procedure we can do as minimally invasively as possible is better for the patients. It's exciting to see new products allowing us to do that.
Related Articles on Sports Medicine:
8 Keys to Success in Sports Medicine From Dr. James Andrews
Dr. Brian Cole: 3 Exciting Trends in Sports Medicine Research
12 New Partnerships & Expansions in Sports Medicine
Q: What is the biggest challenge you face in your practice?
Dr. Margaret Meyer: My major challenge is with patellofemoral pain, particularly treating patients with isolated patellofemoral arthritis at a young age. Many patients respond well when we can treat them with therapy and injections, but if this treatment fails sometimes they need knee surgery. The surgical procedures are less consistent in their outcomes. Patients also have concerns about major knee surgery.
Weight loss is also an issue for many patients in my practice. We all know that it is difficult to lose weight even if it would reduce pain. We also find that some patients need extensive physical therapy for patellofemoral problems, and in this healthcare market many insurance companies are cutting back on this benefit It is imperative that the patient can access a good physical therapist that will actually do optimal therapy as this is important for treatment. .
Q: What qualities do you look for in a good physical therapist?
MM: A therapist who is consistent with their care is important, but may be difficult to find because there is a huge variability between therapists. When I send patients with a specific protocol to physical therapy and the therapist deviates greatly from that plan I have to change the therapist. I think hands-on physical therapists that follow the strengthening and stretching protocols are best. They should spend time with the patient and use modalities such as ultrasound and E-stim to monitor care. Patients shouldn't be doing exercises by themselves.
When patients report being left on their own, I will either send them back with specific protocol or not recommend that physical therapist again.
Q: You mentioned weight loss as another big issue for patients in your practice. How do you guide weary patients through that process?
MM: We tell them that weight loss and regular exercise could be helpful for their condition because when the joint force is decreased with weight loss, it will alleviate their pain.
Q: What is the most difficult part of treating competitive athletes with a chronic condition or injury?
MM: We must return the player back to the field as quickly as possible. We have to give information to the player and the coach about how things are healing and when recuperation is complete. Communicating with the coaches and offering feedback on how their players are doing in anticipation for their return to play is important. We distinguish carefully between when the player is released to practice versus release to participation on game day.
If an athlete wants to return to play too quickly, I tell them they run the risk of re-injury and turning an acute problem into a chronic one. I make sure to emphasize that it will be tough for them to return to their previous level of play if they don't follow the treatment protocol.
Q: What new sports medicine technology and developments on the horizon are you most excited about?
MM: The use of platelet factors, like growth factors, and looking for better fixation are topics on the forefront of sports medicine development. Any procedure we can do as minimally invasively as possible is better for the patients. It's exciting to see new products allowing us to do that.
Related Articles on Sports Medicine:
8 Keys to Success in Sports Medicine From Dr. James Andrews
Dr. Brian Cole: 3 Exciting Trends in Sports Medicine Research
12 New Partnerships & Expansions in Sports Medicine