I read with interest the recent article written by Dr. Rourke Stay, “What ESPN doesn’t tell you about MRI in professional athletes,” and couldn’t agree more. The bigger issue, however, is what ESPN may leave out of broadcasts about sports injuries. Prominent figures on the air often espouse their knowledge with enough charisma to convince even the most doubting fan that their opinion is more than just an armchair diagnosis from the broadcast booth. The real diagnosis, released several days later after an MRI and other tests are completed, is often much different from the original one.
To their credit, ESPN (and others) will often seek information from medical experts, but these responses end up as sound bites or subtle advertisements for those experts. What is really needed is a basic understanding of common sports injuries, their treatment, and realistic return to play projections.
For example, Dallas Cowboys quarterback Tony Romo and Carolina Panthers quarterback Cam Newton had similar injuries this season. However, the media’s coverage of both conditions were wildly off track. Both injuries did not involve critical areas of the spine, yet there was a suggestion that both were risking paralysis if they continued to play. As expected, no such injuries occurred, and both safely completed their seasons.
Knee injuries are ubiquitous in sports. However, rarely are injuries to the anterior cruciate ligament (ACL) repaired; rather, they are reconstructed with tendon grafts. Likewise, most meniscal injuries are not repaired, often the best option, but they are removed (partial meniscectomy). Articular cartilage injuries are also common, but the treatment of these injuries still leaves much to be desired. Microfracture (poking small holes in the bone to fill in the “divot” of cartilage that has been sheared off) is way too popular and doesn’t provide good long-term relief. It may get the player back on the court/field early-, but not for long.
Likewise, shoulder and elbow injuries are frequently misdiagnosed by sports broadcasters. It is all too common to hear a commentator worry that a young athlete has torn his rotator cuff. However, it is far more common for young patients to have labral tears (cuff tears usually occur in patients over 40 to 50 years old). Moreover, not every elbow injury requires a Tommy John procedure, and for those that do, there are actually many qualified elbow surgeons out there.
As we have all witnessed, concussions should be taken seriously. It is past time to think that an athlete has had his “bell rung” and to quickly hustle him back on the field. Players, coaches, owners/athletic directors, administrators, and fans need to all recognize the devastating injuries that can result from concussions and have some patience so that we can treat these athletes as patients.
These are just a few examples of sports injuries and their treatment. The sports media world would serve athletes, sports fans, and the general public well by consulting experts in the sports medicine world when discussing players’ injuries. The American Orthopaedic Society for Sports Medicine is the go to professional organization for those specializing in this field and is home to the voices of many dedicated sports physicians, surgeons, and therapists.
Mark Miller is head, division of sports medicine, department of orthopaedic surgery, University of Virginia, Charlottesville, VA. He is also director, Miller Review Course.