Physical therapists: Unsung sports heroes
Pulse editor
Sunday, February 15, 2009
Ron Courson played soccer and ran track at Samford University in Alabama until he injured his knee and had to have surgery.
“It turned out to be one of the best things that ever happened to me. I found out about sports medicine and changed my major,” he said.
Photos by BARRY WILLIAMS / AJC Special
Charlie Ridgeway, director of rehabilitation at Georgia Tech Sports Medicine and Rehabilitation, watches senior football player Andrew Gardner do strengthening exercises. Gardner, an all-ACC offensive lineman, is recovering from shoulder surgery and is preparing for the NFL draft in April.
Ron Courson, director of sports medicine at the University of Georgia, looks at Marcus Washington’s wrists. The football player hyper-extended them while he was lifting weights.
Mario Cruz (left) a physical therapy doctoral student, works with University of Georgia football player Ricky Lowe, who broke a bone in his right foot during football practice.
Charlie Ridgeway believes that relationships between athletes and PTs are critical. ‘Getting them to trust me is important,’ he said. ‘I tell them, ‘I can only help the willing, but as long you’re willing to keep working hard, I’m going to keep working, too.’ ’
Courson, PT, ATC, EMT, has been a physical therapist and an athletic trainer for 25 years. He’s the director of sports medicine at the University of Georgia in Athens. His team of 19 specialists works on the sidelines of every game and in the training room with the 525 athletes who play one of 22 sports at the school.
“Our job is to take care of injured players and get them back in the game as soon and as safely as possible,” Courson said. “The other part of our job is prevention. The more we can prevent injuries and illness from happening on the field, the better.”
The practice of sports medicine has been growing and changing since long before the American Board of Medical Specialties recognized it as an official subspecialty in 1989.
“The field has changed dramatically since I started,” Courson said. “It’s now much more science and evidence-based. There’s research behind everything that we do, whether it’s the use of ultrasound or a rehab protocol.”
He points the Sports Concussion Research Lab, where baseline testing is done on every UGA athlete.
“We use a NeuroCom machine to measure a player’s balance standing on two feet, one foot, with his eyes open and closed, on a moving and a stationary platform,” he said. “Then, 24 hours after he suffers a concussion, we measure again to help us focus on whether the problem is vestibular, inner ear or visual.”
In the old days, trainers might ask a question or two to determine cognition after a blow to the head. Now, baseline and post-injury neuropsychological tests measure cognition, reaction time and memory.
“We get a detailed medical history on every athlete, because the more information we can obtain up front, the fewer injuries and illnesses we’ll see later,” Courson said. “An ankle problem might be related to foot structure and could be corrected by an orthotic shoe insert. A rotator-cuff maintenance program of exercises could prevent a baseball pitcher from having problems.”
Advances in surgical techniques, such as arthroscopy — the use of a fiber-optic camera inserted in a quarter-inch incision that allows surgeons to find and fix joint damage — as well as improved technology for imaging soft tissue allow athletes to recover faster, but not without the benefit of physical therapy.
“We have to design an individualized program for each athlete,” Courson said. “You can’t cookbook it. You could have five ankle sprains and they’ll all be different. You have to understand the uniqueness of the injury and the demands of the sport in order to help each person.
“In sports medicine, we also have to look at the whole body, not just the impaired part. An athlete can become significantly deconditioned if he is out six weeks, and you’re doing him a disservice if you put them back on the field and he’s not fit to play.”
Developing trust
Developing a long-term relationship with clients is one of the things that Charlie Ridgeway, PT, likes best about his job. As director of rehabilitation for Georgia Tech Sports Medicine and Rehabilitation, Ridgeway works with Georgia Tech athletes as well as other students, faculty and professional athletes living in Atlanta.
“I may work with someone two to three days a week for a month or four months,” Ridgeway said. “Developing a good relationship and getting them to trust me is important. I tell them, ‘I can only help the willing, but as long you’re willing to keep working hard, I’m going to keep working, too.’ ”
Ridgeway played baseball and football in high school, and he always knew he wanted a career that involved sports and health care.
“It’s hard to imagine [that] anyone could do this job and not be interested in sports. It’s the world you’re in,” he said.
Ridgeway’s final internship as a physical therapy student at Georgia State University in 1999 brought him to Georgia Tech’s rehab facilities and he was asked to stay.
“It was humbling and very exciting,” he said. ‘I’m able to work with great people and equipment, and serve a fun and highly motivated patient population. I love what I do.”
Ridgeway knows that athletes don’t want to be in the rehab room. Some call it “physical torture,” or tell him he’s the “physical terrorist.”
“You have to have a thick skin to work around a training room, but working with young athletes keeps you young,” he said. “You get really close to them.”
A mental approach
Bringing athletes back to form is physically and mentally challenging for therapists.
“You may have a guy who has been playing a sport since he was 9 years old who suffers a bad injury,” Ridgeway said. “You can bring him physically back to normal, but you have to help them mentally, too.
“They can’t get their mind around what happened the last time they were on the field. We do everything we can to help them overcome their fears and gain the confidence to play again.”
The hardest thing for therapists to do is to tell an injured athlete that his or her playing career is over.
“That’s really tough and you can’t help but put yourself in his shoes. All you can do is to keep talking and supporting and working with him,” he said.
A sports medicine therapist has to look at injuries and rehab from both the short-term and long-term perspectives.
“There are ways to rehab faster, but we have to look at the impact for life,” Courson said. “I’m concerned about someone’s knee now and at age 40.
“When you’re 18, the big game may seem like the most important thing. Years later, you may have wished you hadn’t done further damage to your body. Our job is to tell a patient not what they want to hear, but what they need to hear. I tell parents that I’m going to treat their child as I would my own child.”
Courson has four children, and they all play sports.
“It’s so rewarding when a player comes back fully rehabbed and you see him smiling out on the field,” Courson said. “Our job isn’t high-profile. We work behind the scenes, but it’s so rewarding to have an influence on these young people’s lives and to help them do their best.”
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