As Sports Medicine Surges Hope and Hype Outpace Proven Treatments
Post on: 2011-09-05 By: admin
It took her from doctor to doctor, cost her thousands of dollars and led her to try nearly everything sports medicine has to offer — an M.R.I. to show the extent of the injury, physical therapy that included ultrasound and laser therapy, strength training, an injection of platelet-rich plasma (or P.R.P.), a cortisone shot, another cortisone shot.
Finally, in February, she gave up.
“I decided this is never going to heal, so let’s get on with it,” she said.
And so Ms. Basle, a 44-year-old digital media consultant who lives in Manhattan, started running anyway. She has lost a lot of speed and endurance. And, she added, “the stupid hamstring is really no better.”
Medical experts say her tale of multiple futile treatments is all too familiar and points to growing problems in sports medicine, a medical subspecialty that has been experiencing explosive growth. Part of the field’s popularity, among patients and doctors alike, stems from the fact that celebrity athletes, desperate to get back to playing after an injury, have been trying unproven treatments, giving the procedures a sort of star appeal.
But now researchers are questioning many of the procedures, including new ones that often have no rigorous studies to back them up. “Everyone wants to get into sports medicine,” said Dr. James Andrews, a sports medicine orthopedist in Gulf Breeze, Fla., and president-elect of the American Orthopaedic Society for Sports Medicine.
Doctors love the specialty and can join it with as little as a year of training after their residency, as compared with the more typical two to four years for other specialty training. They see a large group of patients eager for treatment, ranging from competitive athletes to casual exercisers to retirees spending their time on the golf course or tennis court.
The problem is that most sports injuries, including tears of the hamstring ligament like Ms. Basle’s, have no established treatments.
Of course, some remedies for certain injuries do work: putting a cast on a broken bone or operating to repair a torn Achilles tendon. But patients whose injuries have no effective treatment often do not know that medicine has nothing to offer. And many expect cures.
“They watch ‘Grey’s Anatomy’ and think we can do anything,” said Dr. Raymond Monto, a sports medicine orthopedist in West Tisbury, Mass. “And to a certain extent, we allow that.”
Added to that is the effect of sports stars and their doctors. Patients “see a high-profile athlete and say, ‘I want you to do it exactly the same way their doctor did it,’” said Dr. Edward McDevitt, an orthopedist in Arnold, Md., who specializes in sports medicine.
The result is therapies that are unproven, possibly worthless or even harmful. There is surgery, like a popular operation that shaves the hip bone to prevent arthritis, that may not work. There are treatments, like steroid injections for injured tendons or taping a sprained ankle, that can slow the healing process. And there are fads, like one of Ms. Basle’s treatments, P.R.P., that soar in popularity while experts debate whether they help.
All this leads Dr. Andrew Green, a shoulder orthopedist at Brown University, to ask, “Is sports medicine a science, something that really pays attention to evidence? Or is it a boutique industry where you have a product and sell it?”
“For a lot of people it is a boutique business,” he said. “But are you still a doctor if you do that?”
A Theory Becomes a Fad
If ever anyone wanted to know how untested sports medicine treatments come into use, they would need only look at platelet-rich plasma, medical experts say. They joke that it is the perfect example of what is a tried-and-true path to popularizing a new treatment. It is what Dr. John Bergfeld, an orthopedic sports medicine specialist at the Cleveland Clinic, calls the Orthopedic Triad: famous athlete, famous doctor, untested treatment.
While there are no official statistics on P.R.P. treatment, all agree that it has exploded on the scene, propelled by testimonials from celebrity athletes.
Part of its appeal was that it made sense. Blood contains platelets that secrete growth factors that, in turn, can help tissue heal. So if a patient’s own platelets are injected into the injury site, they might speed recovery. And since it is the patient’s own platelets, the treatment is unlikely to be harmful.
It is easy to extract platelets. A doctor spins a tube of a patient’s blood in a centrifuge and then removes the middle layer of cells. Those are the platelets. 123 Next Page »
A version of this article appeared in print on September 5, 2011, on page A1 of the New York edition with the headline: As Sports Medicine Surges, Hope and Hype Outpace Proven Treatments.
Get 50% Off The New York Times & Free All Digital Access.
Get Free E-mail Alerts on These Topics
Therapy and Rehabilitation
Making Vegetables the Meal
Venus Williams Brings Attention to Sjogren's Syndrome
Getting Doctors to Wash Their Hands
Lack of Deep Sleep Tied to Hypertension
Prescribing Exercise to Treat Depression
Advertise on NYTimes.com
BMI CalculatorWhat’s your score?
Do you have highblood pressure?LEARN MORE
Complete U.S. Open coverage
Players to watch at this year's Open
Enter the Fantasy U.S. Open Tournament
Browse Chevys through the years.nytimes.com/autos
Advertise on NYTimes.com
Chunks of Memory, Reassembled Onstage
Op-Ed: China’s Challenge at Sea
The Mechanic Muse: From Scroll to Screen
Leaving Detroit for Tulsa, the Shock Lost Their Way
The Stone: What is Naturalism
Naturalism, which claims to embrace the scientific spirit, can actually lead us into an unscientific view of the world.
Vermont Turns Out for Its Dairies as They Dig Out
Deterring Enemies in a Shaken World
Letters: How ‘The Help’ Depicts Race Relations
Ex-Premier Faces Charges for Iceland’s Fiscal Woes
Summer Ticket Sales Continue to Erode
In greater Chicago, the downwardly mobile have tuned out because of economic calamity. Now we must offer them “collective dignity.”
© 2011 The New York Times Company
Article original from: http://www.nytimes.com/2011/09/05/health/05treatment.html?partner=rss&emc=rss
