MEDICINE OUTSIDE THE BOX
by NICHOLAS KENNEY , MD , FAAOS
Reflecting over the last eight years of providing orthopedic team physician coverage for Louisville City FC , I have come to appreciate so many aspects of medicine that at times I have taken for granted . Through childhood and adolescence , I was fascinated by sports at all levels - but most especially collegiate and professional sports . The thought of competing in front of thousands , access to amazing facilities , notoriety for mastering one ’ s craft - all seemed such an amazing and remote experience from my upbringing . What would it be like to actually pull back the curtain of this world and see how it really operated ?
I must admit , I certainly didn ’ t follow the pathway of orthopedic surgery because of this opportunity , but it didn ’ t hurt either . It was a true love for musculoskeletal anatomy , the technical pursuit of surgical healing , and the comfort in helping others literally get back on their feet that fueled my fire . However , when I found myself on the sidelines of a night game at Florida Field - aka the Swamp - or on the bench at the O ’ Connell Center , or in the locker rooms or training facilities of the University of Florida during my residency , I was intrigued and awestruck . How does one accomplish something ordinary - medical care - in such an extraordinary environment that so few get to experience ? My experience in orthopedic sports medicine fellowship at the University of Kentucky brought that same ardor with an even more sentimental attachment to such hallowed places as Rupp Arena and Kroger Field , with the same question taking shape . The answers , though , were in plain sight , well exemplified by mentors throughout my training : these athletes are our patients , and need the same medical care , attention and empathy as any other patient .
Their needs and goals are unique , but their incredible drive , which pushes their success on the pitch , can be re-directed into their engagement in recovery , rehabilitation and prevention . We have to become their medical coach as well as their physician . We have to give them options , but gain their trust so that we can also make recommendations . They have to know that we care about them as a person , even before we care about them as an athlete . We have to appreciate their culture , community and family as they will all factor heavily into decisions made . These are career-influencing medical decisions , and that gravity is certainly not lost on the athlete or our medical team .
When I was invited to be an Orthopedic Team Physician for Louisville City FC , my soccer affiliation had been very limited . I had only played the sport in college intramurals and had assisted in medical coverage for soccer athletes intermittently during training . I was expecting a fairly passive experience of being available to the players and technical staff . Clearly , I underestimated the opportunity ; within the first four to six weeks of the club starting practice , we had two major injuries requiring surgical intervention , with one being a season ending injury . This made my question very real very quickly , and also provided a deep personal insight into living the principles I had learned .
Communication is the key - it needs to be transparent , consistent and empathetic . The players carry a heavy burden with these situations : will I ever play again , will I be able to return to my prior level of success , why do I keep getting hurt ? We certainly don ’ t have all the answers , but confident reassurance and focus on daily progression in a positive direction goes a long way . These injuries can certainly cause distress to both the technical staff and the players ’ families as well . Helping them to understand the diagnosis and treatment plan goes a long way in helping the player recover . He needs allies , and none will serve him better than his coaches and his parents . They are among the greatest sources of reinforcement to fight through the challenges , do extra work in therapy , and to seek out opportunities with the athletic training staff . Finally , working with colleagues and developing a network of peer physicians who provide coverage for professional athletes has helped me grow as a physician , and has given me guidance and reassurance on treatment strategies . I have seen evidence of the collegial nature of medicine throughout all fields of medicine and it is truly encouraging and rewarding : but on a personal level , it has been the most stabilizing force in practicing as an Orthopedic Team Physician .
Dr . Hughes practices at Baptist Health Family and Sports Medicine . Dr . Puckett practices at Baptist Health Family and Sports Medicine . Dr . Kenney practices at Baptist Health LaGrange .
September 2022 11