Bill Klaproth (Host): So, what's the difference between sports medicine and primary care medicine, and how to know if you should seek the help of a sports medicine specialist? Well, here to talk with us about sports medicine is Dr. Rajiv Tailor, Medical Director of the Eisenhower Sports Medicine Clinic. Dr. Tailor, thank you for your time. So, what is the difference between sports medicine and primary care?
Dr. Rajiv Tailor, MD (Guest): It's a great question. You know, sports medicine physicians have received specialized training in both the treatment and prevention of illness and injury. It's required an extra year, two years of fellowship, depending on the program, and they really specialize in specific musculoskeletal conditions. So, it is a specialty, and many primary care physicians, you know, do treat many musculoskeletal injuries and illnesses as well. However, it is, you know, an additional training regimen that many sports medicine doctors had to go through to become credentialed and also become board certified in the specialty.
Bill: So, you've mentioned specific conditions. Can you give us an example of what a sports medicine specialist would treat?
Dr. Tailor: Yeah, sure. So, there's a wide variety of conditions. I think a lot of people also assume because of the name, we only treat athletes; however, we definitely treat, you know, a wide variety of individuals. So, active individuals or weekend warriors or the industrial athlete-so anyone that really experiences an injury. Or a lot of the training we get is not only for a competitive athlete, but even a person that just wants to get through their activities of daily living and get to full function. So, treatments, our scope of practice, kind of includes ankle sprains, joint injuries, dislocations, a lot of non-surgical fractures, depending on what people, like for instance, stress fractures with, you know, competitive athletes, marathon runners, but then we have a lot of rotator cuff issues. A lot of people like to play pickle ball, tennis in the desert, a lot of golfers, tendonitis, osteoarthritis, even concussions. So, quite a wide variety of conditions that we treat.
Bill: Well, that's good to know when you specify who you treat because when you think of sports medicine, you think of organized sports athletes or school athletics-
Dr. Tailor: Right.
Bill: -but like you said, active individuals or weekend warriors, guys throwing the football around the back yard qualify, too, if they twist an ankle. So, Dr. Tailor let me ask you this-
Dr. Tailor: Absolutely.
Bill: -how does someone know that they're in need of a specialist?
Dr. Tailor: Well, you know, it's good to always talk to your primary care doctor initially, or you can also schedule to see me if any of these conditions that are musculoskeletal-related affect you, so, you know, as I mentioned, you know, numerous conditions and as simple as arthritis. So, anything that is musculoskeletal-related or another way to put it-anything that is orthopedic-related but is non-surgical. So, you know, we do work closely with our orthopedic counterparts, and what we do is we kind of do the appropriate workup and see if we can manage it maximally from a non-operative perspective, and if, you know, the person does need to see a surgeon, we definitely try to expedite that referral and try to get them in to have a surgical evaluation and potentially correction.
Bill: So, should a person see their primary care physician first before seeking out a sports medicine specialist?
Dr. Tailor: It can happen either way. I guess it depends on the person's insurance as well, but you know, first thing you'd come directly as well if they don't need a referral.
Bill: And then you mentioned, you do work cooperatively with physicians who specialize in primary care and orthopedics, right?
Dr. Tailor: Right. Absolutely.
Bill: So, how do you interface with them? Do you each come up with a plan? Or how does that work?
Dr. Tailor: So, you know, if we do an initial evaluation, depending on what it is, we're able to deal with everything from head to toe. So, whether it's a shoulder issue, it could be something like carpal tunnel. It could be ankle arthritis. Could be knee issues and that way we can kind of appropriately work the patient up, and let's say if it's a knee issue, we can get you to the appropriate knee specialist on the orthopedic side that, if you do require surgery, they can help you. So, mainly, we're trying to do the organization and manage a lot of the things non-operatively and thereby reduce the amount of time needed to wait for a specific person to address their complaint. So, we really, really try to maximize the non-operative side as much as possible and really guide referrals to the appropriate, you know, potentially surgeon. So, we do have an extensive group of primary care providers that do refer in, and we work closely with Desert Orthopedic as well, so that we can get every individual to the appropriate person if they do need surgical evaluation.
Bill: So, when it comes to sports medicine specialists, what are some of the procedures that that person may be able to perform right there in the office?
Dr. Tailor: Yeah. So, we do a lot of evaluation and treatment right here in the office. One thing that we do get training on and certification on is the utilization of an ultrasound. We use an ultrasound in the office because it allows us to kind of see muscles as they move. So, we call it dynamic view. So, if I have it on the shoulder, I can look at the rotator cuff muscles as they move. You can also see certain tears and certain pathology just from the ultrasound. It can detect fluid in spaces and based on that we can also guide injections. So, instead of blindly doing an injection, we can actually see the needle and place it in the exact area where we need it. So, that's a part of what we do, you know. A lot of people get cortisone injections. A lot of people have heard about hyaluronic acid injections, and some people call them gel injections, into joints such as the knee and shoulder, but there's also a lot of newer modalities that have been coming out such as PRP, which is Platelet-Rich Plasma, extracorporeal shockwave therapy. These are things that we're working on getting here. A lot of people that also heard of stem cell injections, and that's kind of a hot topic, but you know, it's something for the future with more and more evidence as it comes out.
Bill: So, there's a lot of options. Now do you also-I suppose you would prescribe physical therapy, as well as one of the treatment options?
Dr. Tailor: Yep. Absolutely, and that's a large part of, you know, our scope that we want to identify what is particularly wrong and not everything needs, you know, an injection or a procedure. There are many things that just require, you know, specific protocols and trainings for, you know, a particular muscle group. So, we definitely send a lot of physical therapy referrals, especially for initial treatments and really try to guide them to what specific area needs work.
Bill: Right. So, what are some of the more common sports injuries you treat?
Dr. Tailor: So, as I mentioned before, a lot of ankle sprains, joint injuries, you know, sometimes even dislocations. Some people have recurrent dislocations and a lot of rotator cuff issues. So, whether it's, you know, a pitcher or a pickle ball player or a tennis player. There're a lot of things that repetitive movements do predispose people to. So, tendonitis is quite common, and we consider a lot of these overuse injuries, but as we get older, some of these become more and more prevalent. So-
Bill: And lastly Dr. Tailor, do you have any tips for athletes to warm up or stretch or to potentially prepare to avoid injuries?
Dr. Tailor: Yeah. So, depending on the sport, you know, we're talking about, but you know, with age, depending on what spectrum and what age group, you know, as we get older, our musculature doesn't move as easy. Things become more restricted and stretching does become a little more important and because you are prone to more injuries, when there is contracture of the muscles and tendons, and they're not used to a level of function. Especially if you're just going to jump out and start, you know, playing something you haven't done in many years. So, you know, stretching is important. Really knowing the way your body is and the activity you're doing is also very important. So, we do encourage people to come in and even get an evaluation just to see, well, I'd like to start this activity, you know, what do you think the best way to go about this is? And if we need to strengthen certain muscles groups or focus on certain areas and physical therapy can also help, just give a home exercise program. So, whatever age group, you know, you are, whether you're in high school or, you know, or an older athlete or someone that just wants to get through their activities of daily living. You know, there's always a safe way to strength training and condition yourself.
Bill: Well, Dr. Tailor, thank you so much for the good information today. For an appointment with a sports medicine specialist at the new Eisenhower Sports Medicine Clinic, call 760-837-3731. That's 760-837-3731. You can also learn more by visiting eisenhowerhealth.org. That's eisenhowerhealth.org. This is Living Well with Eisenhower Health. I'm Bill Klaproth. Thanks for listening.