by Kristina Fiore, Staff Writer, MedPage Today
July 24, 2012
While the world watches elite athletes like Michael Phelps and Hope Solo go for Olympic gold, the athletes’ team physicians will be watching them, too, but with a different perspective.
Orthopedic surgeon Damion Valletta, DO, has been working with U.S. women’s soccer since 2008 and is currently with the team in Glasgow as the players get ready for their first match — against France at Hampden Park on Wednesday.
“Each player has their own primary care physician who’s worked to get them as able as they can be for the games,” Valletta told MedPage Today from his hotel in Scotland. “But once they come into camp, it’s our responsibility to take their [medical] information and best prepare them for match day.”
That means taking care of injuries and optimizing exercise regimens, as well as treating any minor issues that crop up — from coughs and colds to upset stomachs.
The U.S. Olympic Committee has 80 medical professionals on hand to care for its 525 athletes. Practitioners of allopathic and osteopathic medicine will work side by side with chiropractors and massage therapists to help their athletes stay at the top of their game.
Their efforts are coordinated by Cindy Chang, MD, a sports medicine specialist at the University of California Berkeley, who was selected to be Chief Medical Officer for the 2012 London games — the first woman and the first Asian American to hold the position.
Almost all physicians are assigned to specific teams, but many also will serve in the U.S. team’s medical clinic within the Olympic Village. It’s a full-service walk-in clinic for athletes, coaches, and staff, equipped to handle most issues, from lacerations to fractures.
Athletes from every nation also will have access to the Olympic Village Polyclinic, set up by the London Olympics organizing committee and stocked with major equipment, including MRI and x-ray machines.
“Rarely do we have to access any outside care,” said Scott Rodeo, MD, an orthopedic surgeon at the Hospital for Special Surgery in Manhattan who will be caring for the U.S. swim team — though he noted that organizers have arranged for access to London hospitals in the case of a major emergency.
Olympic Training for Doctors
This will be Rodeo’s third time taking care of Olympic swimmers — he worked the 2004 Athens and 2008 Beijing games — though the road to becoming an Olympic physician isn’t a short one.
It usually starts with a sports medicine physician who’s worked with a given sport taking an internship at one of the Olympic training centers in the U.S., then moving on to domestic competitions, followed by other international competitions, before being selected for the Olympic games.
As the games get closer and team rosters fall into place, team physicians need to review the athletes’ medical history to get a full sense of each of their new patients.
“Like the athletes prepare with years of training, we prepare the same way,” Rodeo told MedPage Today from his hotel in France, where the swim team was training just days before the opening ceremonies.
In addition to treating illness and injury — “shoulder pain is common in swimmers,” Rodeo said — physicians also serve as advocates for athletes during drug testing.
That means keeping current with lists of banned substances, which Rodeo said can change year-to-year as new drugs are added.
“We need to understand which medications are allowed and which aren’t so that we only use appropriate ones,” Rodeo said. For instance, there’s no treating those coughs and colds with pseudoephedrine (Sudafed) — the over-the-counter medication would turn a positive on a drug test.
Diuretics are another tricky drug class, said Valletta, whose goalkeeper Hope Solo was recently flagged by the U.S. Anti-Doping Agency when canrenone (Contaren, Luvion) turned up on a urine screen.
The 30-year-old said her doctor had prescribed the drug for premenstrual purposes: “I did not know it contained a diuretic,” Solo said in a statement.
In the end, the agency concluded “that I made an honest mistake, and that the medication did not enhance my performance in any way,” and Solo was allowed to continue on as a competitor, according to the statement.
Valletta said diuretics are one of the most commonly used medications that athletes are unaware will turn a positive on a drug test.
“The athlete may assume since it was prescribed by a doctor that it won’t alter the accuracy of a doping control test,” Valletta said, adding that they need to get a fair use exemption before taking such medications.
Rarely do so many disciplines on the medical spectrum work so closely together, with MDs literally rubbing elbows with chiropractors and massage therapists in the Olympic Village clinics.
“Everyone has their own expertise, background, and perspective,” Rodeo said. “You check your ego at the door, and you learn a lot. In medicine, the more information the better.”
Valletta said some athletes appear to respond better to different treatments from different specialists: “Some benefit a lot from massage, while others do better with functional training and recovery,” he said. “From ice baths to massage therapy to chiropractic work or just doing a recovery workout session, the different specialists here navigate the athletes through what best prepares them for match day.”
Though Rodeo and Valletta both get to take care of all-stars — Rodeo has been looking after Michael Phelps — both are hesitant to single out the achievements of any certain athlete on their teams.
“It’s hard to beat some of the things that Michael Phelps has done, but it’s the day-to-day things, working with this very select group of athletes who’ve spent the better part of their lives training for this opportunity, that are really memorable,” Rodeo said.
Though each athlete has gained “varying degrees of media attention for what they’ve done,” Valletta said, their “common denominator is their focus and their drive to be the best.”