Growing up playing many sports, my main one being gymnastics, I was getting hurt all the time and needed to be in physical therapy. Even though being injured kept me from playing the sport I loved, I enjoyed visits to the doctors, the process of finding out what was wrong with me, and the medical environment. Although I was in pain, being able to be exposed to the process and environment made me realize that this was the field I wanted to have a career in. My interest in sports and anatomy, along with my love for helping others is what drove my research to find out which type of orthopedic treatment is the most effective in preventing future injuries and specifically what types of injuries respond best to brace treatment.
Before I began my internship, I knew very little about the medical field and different types of injuries. I essentially only knew the basics. The first day of meeting my mentors at Hogan Healthcare was extremely nerve racking and I was scared that I wouldn't know the answers to the medical questions they asked, but then I realized that is what I was there for. To learn from professionals of the career I hope to someday be in.
WHAT I KNOW OR ASSUME:
Before I began my research on different orthopedic treatments, I had little knowledge of the subject and only knew about the treatments I had experienced myself. For example, physical therapy- I knew this was exercises that were given to a patient after an injury or surgery where they needed to build their muscles back up and get their mobility back. I also knew a little bit about dry needling. For braces, I knew even less. I assumed that braces made your muscles weaker because you were reliant on them because they provide support that made you feel safe.
THE SEARCH FOR INFORMATION:
Over the past couple of years sports medicine has grown in the medical field therefore increasing the research, testing, and knowledge of this career area. Finding information on current studies performed wasn’t difficult because clinical trials related to sports medicine are becoming more prominent and accessible. One immense resource I had to help me along with my research was my mentor, Dr. Hogan. He provided insight on the subject that gave me a different view than what I had read online or had already known. It gave me perspective on how what you read online can be biased to one person's opinion and that to another person’s in the field. My mentor also explained how some of the procedures and treatments we are told worked, may not always be true. This helped me achieve a better understanding of how treatments works and gave me further knowledge on my search to find out what the best orthopedic treatments are. For example, I had mentioned to Dr. Hogan that I had been going to physical therapy for my knee and they were doing dry needling on me. He explained how dry needling doesn’t actually help you heal, but provides you with short term pain relief because of the endorphins that are pumping through your body during the process. MY INTERVIEW WITH DR. HOGAN:
What orthopedic treatment would you personally suggest to your patients to prevent future injuries? Why? Dr. Hogan: Exercise is the best form of treatment. If you exercise and eat properly, that is better than any medication I can give them. Running, weights, cardio, exercise bikes, etc. are the best ways to stay in shape and prevent injuries. You have to strengthen your muscles in order to be able to endure certain physical activities because if your muscles are weak, you’ll be more prone to injury. My thoughts:I wholeheartedly agree with Dr. Hogan. Exercise is the best way to stay healthy and in shape. Also eating healthy is a big part of it; what you put into your body is what you’re going to get out of it.
What other types of treatments could be effective in helping a patient with their pain level? Dr. Hogan: After medication, I move onto injections. If a series of injections doesn’t help a patient have months of pain free physical activity, is when we start looking at surgical options. It is always up to the patients though and whether they decide if they just can’t live with the pain any longer. My thoughts: After watching multiple injections throughout my time observing Dr. Hogan, they seem to help patients enormously. The injections start working almost immediately and the patients get to leave without the pain they came in with.
Do you believe physical therapy to be an effective way to recover from an injury? Dr. Hogan: Physical therapy helps when it comes to measuring and improving mobility after an injury. The physical therapist is able to evaluate the injury and give the patients exercises to help strengthen the muscles that have been weakened or injured. My thoughts: Having done physical therapy myself, it does help with recovering from an injury in steps. Except the therapy won’t work if the patient isn’t willing to put in the work. When the therapist gives the patient exercises to do at home, they need to put forth the effort and do them for their own recovery.
Do you think wearing a brace longer than the recommended length of time actually makes the healing process more difficult? Dr. Hogan: Wearing a brace doesn’t make a person necessarily weaker but they shouldn’t use it as a crutch. The brace is for protection and stabilization during the recovery process. My thoughts: I agree with Dr. Hogan because he put it in such a simplistic way- If you are too scared to try an activity without your brace after an injury, then you’re using it as a crutch. In the long run this is only weakening your muscles and not benefiting you at all.
Do you mostly recommend physical therapy for after someone has had surgery? Dr. Hogan: Yes, I usually send my patients to physical therapy after surgery. They watch and evaluate a patient’s progress and report back to me. This lets me know how the patients are doing and what needs to be done at their follow up. Also physical therapist are very hands on which people tend to like. My thoughts: During my time of shadowing Dr. Hogan, I have seen patients come back after surgery and physical therapy and have more strength and motion than before. So I believe physical therapy after surgery helps to an extent.
What effects could wearing a brace have on recovering from an injury? Dr. Hogan: Because wearing a brace stops motion, it is allowing the muscle to rest which weakens it. You want to take off the brace in simple activities such as task around the house to help keep the muscle strong during recovery. You want to wear the brace in more physical activity for stabilization. My thoughts: Based off of what I have read online, after you have completed the recommended time of wearing a brace, you should only use it for high intensity activity such as sports ,running, exercise, etc.
What concerns do you have when it comes to physical therapy? Dr. Hogan: Physical therapist shouldn’t diagnose an injury. They should evaluate based on what they’ve been told and give exercises based off of the injury. My thoughts: Along with Dr. Hogan’s comment, I believe physical therapist sometimes don’t help. They can have you running on a treadmill or on an exercise bike for the majority of the time. Patients can do these types of exercises on their own, physical therapist should evaluate a patient’s injury and come up with a custom recovery plan for that certain individual.
What are your thoughts on dry needling as a treatment option? Dr. Hogan: Dry needling doesn’t actually help you heal. It only provides the patient with short term pain relief because of the endorphin's that are pumping through your body during the process. It might last one or two days but it won’t help with long term recovery. My thoughts: I have had dry needling done to myself before in physical therapy and I have to say I agree with Dr. Hogan. The pain only subsides for a short amount of time and leaves you with bruising and soreness. This is not some magical healing method that will drastically improve the patients injury.
WHAT I DISCOVERED IN THE END:
Throughout my entire time in the honors mentorship program, I have gained a new view of the sports medicine field. Overall my research gave me insight to what the future could hold for me in this career. Something my mentor Dr. Hogan has told me that has stuck with me throughout the year is, “You’re not assessing the injury, you’re assessing the patient”. This has helped me with my search to find the answer of which type of orthopedic treatment are the best because there is not one specific treatment that trumps them all. You have to get to know your patients when diagnosing them because everyone is different. While one treatment may not be as effective as another one, people respond differently to various treatments. One person may benefit from physical therapy, while another patient may benefit from just exercising (such as an exercise bike or light weights), it all just depends on the type of patient you’re treating. As for braces, the injuries that respond best are those of instability. Braces provide support & stabilization, and are to be used when doing high intensity exercise or a recovery from an injury that required surgery. While wearing a brace your muscle weakens, so you should not use a brace as a “crutch” but as protection while your injuring is healing.