Sports is great fun, but it causes an incredible amount of injury for fine young people who, in a few years, will show up in the offices of rheumatologists and orthopedists with chronic pain from post-traumatic osteoarthritis, the so-called “old knees in young people,” disease. Given the number of serious knee, ankle, and foot injuries that occur as people compete in football, soccer, basketball, skiing, and skating, this epidemic is almost predictable.
Physicians like to talk about prevention but so often the activity that needs prevented is something that people enjoy or will earn them a lot of money. As physicians, we are comfortable cautioning people about smoking, drinking, and unprotected sex. Are we ready to tell them to back off from extreme sports, the rigors of overtraining, and the participation in high-level competition with a badly bruised bone, even if a piece of cheese has quelled the pain for a few days?
The neurologists have sent up the alarm about brain injury in football. While a brain injury is a tragic outcome from collision sports, its frequency is far less than that of musculoskeletal injury from virtually every sport. The Olympics would be just as exciting if the organizers waited until the sun came out or they found a hill that was less steep or they stopped developing sports where survival is as much a goal as victory.
For our ordinary patients, physicians teach about falls prevention. It is a good idea. I hope that, before the next Olympics, rheumatologists as well as our colleagues in orthopedics will be brave and warn of the great hazards that modern sports can inflict on its participants. I like the Olympics as much as anybody, but I find heartbreaking to watch a champion become a cripple for a chance to stand on a podium, chat with Jay Leno, or endorse a cereal, even if it is the Breakfast of Champions.
Dr. Pisetsky is physician editor of The Rheumatologist and professor of medicine and immunology at Duke University Medical Center in Durham, N.C.
