Distinctly Montana Magazine

w w w. d i s t i n c t ly m o n ta n a . c o m 55 injury. Failing to recognize an injury can lead to growth disturbances, deformity, etc. Often times, these growth plate injuries can be difficult to diagnose. The sports physician needs to be hyper-vigilant. Lastly, young athletes have parents that are directly involved, which means they will have excellent care and follow the recommendations well (this isn't always the case in the college athlete), but can also bring in a lot more emotion. We have to make sure there is open communication with all members of the family, so that we can keep these emotions in check as this can really affect the athlete's recovery. aMrInE: High school age athletes are a majority in my patient population, especially during the school sea- son. High school sports put a large pressure on young athletes' injuries due to the relatively short seasons and high frequency of competition leading to time constraints. Thus, we tend to have less opportunity for a period observation, which leads to a higher use of diagnostic studies for definitive diagnosis and treatment plans. Albeit, the level of accepted risk of playing with an injury is much less with young athletes to avoid chronic problems. lEgrand: Youths and young adults do make up a sig- nificant segment of my practice and provide unique challenges and rewards. For some conditions, age can be a major determination of treatment direction. As an example, shoulder instability treatments are dependent in large part on age. Numerous studies have shown recurrent dislocations rates as high as 80-90 percent for patients in their teenage years versus rates as low as 20 percent in patients over 50. Other conditions are based less on chronological age and more on activity levels and life style. As another example, ACL surgery is generally recommended for younger and more active patients. That said, in our community (Bozeman), we have 55 year old dare devils who ski 70 days a year, hike cliffs higher than I would ever consider, and would likely benefit from surgery if they were unfortunate enough to rupture their ACL. The other unique issue with youth athletes is they are more likely to participate in organized sports activities, mak- ing return to play issues and timing more significant. how would you dESCrIBE your PraCtICE'S gEnEral aPProaCh to SPortS MEdICInE and orthoPEdIC trEatMEnt? lEgrand: Our practice truly embraces the subspecialty model across all fields, including sports medicine. From a patient's perspective, that means for any given injury, you will be treated by a physician with tertiary training and experience for that problem. Our community is ex- tremely active and that really is part of the town identity. As such, we recognize the significance of sports related injuries and are committed to early and expert treatment to get people back out enjoying all Montana has to offer. KlEPPS: My general approach is a team approach. It starts with the athletic trainers that are present at the schools. Most folks don't realize how well trained these ATs are. Most have a master's degree and do a great job at treating common injuries and knowing when to send them in for x-rays or further evaluation. We have eight full-time trainers who cover all the high schools in Billings, many of the smaller schools in our area, and both colleges. Once they are referred in for evaluation, we prefer to have the initial evaluation performed by a physician. With their experience and multiple years of training we feel seeing a physician early in their course can shorten the recovery process. Every week counts. Once a di- agnosis is made we again use a full team of therapists, physician assistants, and radiologists to accurately diag- nose and treat the injury to help the patient get better as quickly and safely as possible. Most injuries can be treated without surgery, which requires the full efforts of the team. However, those that require surgery are expedited to our modern surgery center with the latest equipment for treatment. We have well-trained surgical technicians skilled in assisting with these advanced sur- geries again helping the patient get through the process as smoothly and atraumatically as possible. Post-op, therapists (especially occupational therapists in farmers/ rancher and workers) and trainers are essential in get- ting the patient back to work or sport. In short, a team effort seems to work best in helping patients overcome these injuries and there is nothing more satisfying than seeing an athlete or worker make it back successfully. aMrInE: My primary goal is to help active people remain active while doing this in the safest and most efficient means possible. mountain bikers and outdoor enthusiasts.

• Cover