Why Biomechanics Education Is Essential If We Want To Be The Sports Medicine Experts

Doug Richie Jr. DPM FACFAS

I just finished reading a tribute to the legendary orthopedic surgeon, Frank Jobe, MD, written by Bill Shaikin, which appeared in the Los Angeles Times on Saturday, March 8.1 Dr. Jobe had passed away two days earlier at age 88. For those who don’t know, Dr. Jobe pioneered the elbow procedure known as “Tommy John surgery,” which has saved the careers of countless major league baseball players.

Shaikin recalls the speech Dr. Jobe made when he was feted at the Major League Baseball Hall of Fame induction ceremony last July. Dr. Jobe told the story of how in 1965 he and his orthopedist colleague, the esteemed Robert Kerlan, MD, had decided to describe their work as “sports medicine.” A senior member of their orthopedic group quickly challenged him, asking what the difference was between treating a fracture in a lawyer in comparison to an athlete. Dr. Jobe recalled that he did not have a good answer.

Dr. Jobe operated on Tommy John in 1974 and humbly deferred credit for the success of the surgery to John himself. Dr. Jobe stated that he did the surgery but Tommy John “did all the hard work.”1 In referring to his patient, Dr. Jobe declared that John’s “unique intelligence enabled us to develop a rehab program that has stood the test of time. Tommy returned to pitch 13 more years without missing a single start. He won 164 more games.” As Dr. Jobe concluded, “Now that is sports medicine.”

The message here is that Frank Jobe, MD, defined sports medicine by taking a risk in performing a new procedure on an athlete whose career hung in balance. Furthermore, he learned that the success of any surgery on an athlete depends on the motivation of the patient and the completion of a rehabilitation program, which often is unique and far more rigorous than what we would prescribe for the sedentary patient. A competent sports medicine physician understands the biomechanics of the sport and implements a comprehensive treatment program that takes the athlete to full recovery.

Podiatric physicians are in a unique position to be the ultimate “sports medicine” specialists for active patients. By understanding all of the factors relative to injury such as training errors, biomechanical factors and the role of footwear, podiatric physicians can implement comprehensive conservative and surgical interventions that few other specialties can offer.

The challenge for our profession is maintaining our position and image among the running community as the “go-to” doctors whenever injury occurs. While this was once an enviable position of respectability within the sports medicine community, podiatric physicians have slipped out of the limelight in favor of other healthcare professionals. In my opinion, the primary reason for this sad decline is the near elimination of biomechanics education from the podiatric medical curriculum.

Without biomechanics, we cannot keep pace with other sports medicine specialties and we will never compete with fellowship trained foot and ankle orthopedic surgeons when it comes to treating active athletic patients. Biomechanics was our trump card when comparing ourselves to every other specialty, particularly in the field of sports medicine. Now that this subject has been minimized in primary podiatric medical education and post-graduate scientific seminars around the country, it is easy to see why podiatric sports medicine has faded from the limelight.

For those who desire to increase your skill and understanding of the broad field of “sports medicine,” you will have to obtain continuing education outside of standard podiatric symposia. The American Academy of Podiatric Sports Medicine remains your best resource for finding these opportunities. For further information, you can visit www.aapsm.org .

1. Shaikin B. It should be cut and dried. Los Angeles Times. Available at http://articles.latimes.com/2014/mar/08/sports/la-sp-jobe-hall-of-fame-s... . Published March 8, 2014. Accessed March 17, 2014.

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