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Avoid Sports Injuries: Tips From an Olympic Doctor

Medscape: What about performance-enhancing drugs? Are you involved in checking for these? continued...

So for instance, if athletes are on insulin, they have to have proper documentation in advance, stating that they are diabetic and need insulin. Then they can use it.

We are also involved when an athlete does get called for a doping test, and pretty much all of them will at some point. Then, either a team doctor or I will accompany the athlete to the doping control area and make sure that all of the paperwork is filled out properly and that all of the tests are done properly.

At this level, most of these athletes have been to World Championships or World Cup events, so this is now a normal procedure. Unfortunately, the clean athletes have to go through this process to make sure the cheaters don't get through.

Medscape: And we keep seeing new drugs that are even harder to identify.

Beim: Yes. When I was in Athens back in 2004, Scientific American had a really great article on gene doping. Have you heard of gene doping? Gene therapy has been tested on patients with Duchenne muscular dystrophy. It was theorized that some doctors may be using it for athletes, which would be absolutely undetectable. The Scientific American article predicted back then that Athens could be one of the last honest Games, because if gene doping becomes the mainstay, who will be able to tell? Whether it is happening now, I don't know, but that would be a tough one. I know that Team USA is 100% committed to clean sport, as am I.

New Treatments and Diagnostics

Medscape: You have seen so many treatment modalities in other countries during your travels. What have you learned about best practices, and what treatments have you been exposed to that you wouldn't have otherwise?

Beim: When I visit other countries, I am always intermixing with other doctors, sharing stories, learning about what they are doing, and teaching them what I am doing. It is a wonderful way to expand your mind about global medicine.

When I was the CMO at the Pan Am Games in 2011, some clinicians from the U.S. Olympic Committee were using diagnostic musculoskeletal ultrasound. I had read about it but had never really seen it used that much. For instance, the radiology department in my local hospital does not routinely do musculoskeletal ultrasound. When I saw it at the Pan Am Games, I was blown away and immediately hooked by what we could do with this approach. The minute I got back I bought a machine and started training very hard. Now I cannot imagine practicing without it. I don't do any injections without my ultrasound. I have reduced my MRI usage probably by 75% for shoulders -- and shoulder surgery is one of my specialties. It is amazing what you can "see with sound." It is great for the patient. For example: You have somebody with a possible rotator cuff tear. Ordinarily you'd order an MRI, get it preauthorized, wait for it to be scheduled, get it done, and get the patient back in the office to read it. How long are you talking about? If you're lucky, a week -- maybe more. Whereas with the diagnostic ultrasound, you are in the office, and within 5 minutes you can see the tear and show it to the patient. And you have spent about one-third of what an MRI would have cost.

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