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Dr. Joseph Wilcox talks to Columbus CEO about orthopedic needs of athletes

Orthopaedics and Athletes
As more Americans exercise harder and longer, doctors are seeing a growing number of sports injuries - even in senior citizens.

By: Kristen Campbell, Columbus CEO Magazine

Read full article here.

Bone and joint issues are the leading cause of disability in Americans, as well as the cause of more than half of all chronic conditions in people over age 50. The American Academy of Orthopaedic Surgeons (AAOS) estimates that such problems cost Americans $849 billion in medical fees and lost wages in 2004 (the most recent year cited), an amount equal to 7.7 percent of the gross domestic product.

The problem is expected to escalate markedly over the next two decades, something the AAOS attributes to two competing factors: an ongoing problem with sedentary lifestyle and an increasing number of people who are pursuing athletics well into their golden years.

Dr. Joseph Wilcox of the Cardinal Orthopaedic Institute has been practicing sports medicine in Columbus for 11 years, and he sees a spike in injuries every spring and fall as runners prepare for athletic events. "We always see a period of increase right before the big marathon seasons," he says. "Over the years, we've seen a drastic increase in the number of people who come in with injuries, because more and more people are enjoying long-distance running."

The 2011 Columbus Marathon (which also includes a half-marathon) had 17,000 registered participants, up from 15,000 the previous year. The 32nd annual race attracted people from around the country and around the world.

Weight-bearing exercise is beneficial to bones, strengthening them and preventing debilitating conditions such as osteoporosis. But it is possible to have too much of a good thing. Wilcox says excessive running can result in an unfavorable stress response. Instead of growing stronger, a bone may swell and develop tiny microfractures. "The X-rays look fine and there is no frank fracture line, but the tiny fractures may coalesce into a true fracture," Wilcox says.

Although micro fractures aren't visible on X-rays or MRIs, they can cause significant pain. Wilcox says many athletes ignore the discomfort to their own detriment. "Pain is a built-in security system that too many people have been taught to ignore," he says.

Wilcox says mantras that encourage people to push through the pain aren't healthy for most individuals. "That's something that originated in the military," he says. "It has trickled down into the general population, and so have the injuries."

Wilcox says people should also take into consideration that maybe they just aren't cut out to be a championship endurance athlete. "Not everyone's bodies are made to run those distances," he says. "Any biomechanical problem we may have, whether it's an alignment problem or weakness in the muscles, can predispose us to a stress fracture." Any new activity is potentially detrimental if not approached properly, and talking to your physician first is a wise choice. "In some activities, everyone is sort of put into the same category no matter what their biomechanics, age or fitness level. They may push themselves into a program without any real forethought into whether they are ready," Wilcox says.

Experts say that regardless of the age of the athlete, preparation is key. Wilcox recommends quality athletic shoes above all else. "Make sure you have supportive shoe wear, and get it from one of the running stores in town," he says. "There are people there who can help you find exactly the right shoe." Athletic shoes found at typical shoe stores, no matter how sleek or high-tech they may look, don't protect the way high-quality gear will. "Shoes that cost less are not going to support you, and you are going to end up with real problems, real quick," Wilcox says. "Invest the money in shoes from a store that specializes in running, and it will pay off."

Next, get your body prepared. Aside from ramping up slowly to meet long-term goals, athletes should invest significant warm-up time each and every day they exercise. "Stretching takes a good 10 or 15 minutes, and that's not just the standing or sitting static stretches, but also dynamic stretches," Wilcox says. "A short, easy run and maybe some high kicks - what we sometimes call goose step kicks will tell the muscles to get ready. Warming up will help you gain some flexibility, and you won't be so apt to strain a muscle."

Another key is education, and the most effective form may be a professional assessment of an athlete's strengths and shortcomings.If you start having problems, it's always good to talk to a physical therapist or to your physician, who may prescribe a short course of physical therapy," Wilcox says. A therapist can assess a person's gait, core strength and body posture and detect any potential problems with alignment or biomechanics.

Reprinted from the March 2012 issue of Columbus C.E.O. Copyright © Columbus C.E.O.

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