Sports Medicine

Let me start with the most common misconception: Rotator cuff tears are very common, they aren’t always what’s causing the pain, and they don’t always require surgery. I wrote this for anyone whose shoulder hurts, who can’t lift their arm, or who’s been told after an exam that “your rotator cuff is torn” or “you have calcification in your shoulder.” What exactly is the rotator cuff? The bones in your shoulder are shaped a lot like a golf ball sitting on a tee: the ball is large, and the tee is shallow. ...

Let’s start with the most frequently asked, and most counter-intuitive, statement: As long as someone teaches the movements and an adult is supervising, elementary schoolers can do weight training, and it won’t stunt their growth. What really gets kids hurt isn’t lifting heavy things, but having no instruction, no supervision, starting too heavy, and progressing too fast. If even one of these four things slips, injuries happen; if you do all four, the injury rate is lower than many ball sports. ...

Let me start with something a lot of people don’t know: if you get an X-ray for heel pain and see a bone spur, that spur usually has nothing to do with your pain. One study looked at a thousand random foot X-rays. Thirteen percent had bone spurs, and of those, only 40 percent had ever experienced heel pain. Conversely, many people in agonizing pain have completely normal X-rays. So the spur isn’t the culprit. What’s actually hurting is the fascia attached to your heel bone, which has been repeatedly pulled until it developed micro-tears and degeneration. ...

At the sidelines of track meets, road races, and ball games, the most common accident isn’t a fracture. It’s someone collapsing. And the first question to ask on the scene isn’t “Are they dehydrated?” but “When did they collapse?" The answer to this question splits the situation into two different worlds: collapsing during the race, and collapsing after crossing the finish line. Collapsing during the race: Treat as the worst-case scenario first If a person suddenly falls to the ground while running, playing, or competing, and wasn’t hit by anything, the correct response is to first treat it as cardiac arrest: call for help, call an ambulance, grab an AED, and start CPR. ...

Let’s start with the most counterintuitive thing: when a kid collapses during hot weather exercise and their mental status is off, the right order is to cool them down on site first, then send them to the hospital. Not call an ambulance and figure it out on the way. The international consensus is blunt—cool first, transport second. Because what determines whether they suffer permanent damage isn’t how fast they get to the ER, but how long their body temperature stays above 40°C. ...

Bottom line up front: If your child has a painful bump just below the kneecap, it’s not growing pains. It has a name: Osgood-Schlatter, also known as tibial tubercle apophysitis. And contrary to what many people have heard—it doesn’t “completely go away when you grow up." I’m writing this for parents who have 10- to 15-year-olds currently running and jumping in sports. How to tell if it’s growing pains Growing pains usually happen in both legs, ache in the evening or middle of the night, and have no clear point of tenderness. By the next morning, it’s like nothing happened. ...

Let’s start with the most important thing: depression in older adults often doesn’t look like “depression." They might not cry or say they’re sad. Instead, it turns into aches and pains all over, poor appetite, bad sleep, and a lack of energy for everything. And so it’s very easy for the whole family (sometimes even physicians) to write it off as “that’s just what happens when you get old,” and quietly miss it. ...