Who is the Primary Care Sports Medicine Patient?
Musculoskeletal
I see many middle-aged and older patients who have shoulder complaints.
 They may or may not be sports related. Anti-inflammatories, ice/heat, and rest don’t always resolve their complaints. Talking with the patient for an in-depth history, doing a physical, and conducting X-ray studies, diagnostic injections, and occasionally more advanced studies (such as CT or MRI) can help determine a diagnosis. Once the diagnosis has been made, activity modification, cross training, therapeutic injections, and physical therapy are some of the conservative treatment options offered through my Sports Medicine practice. Occasionally, additional specialists such as Orthopedists can provide additional information and surgical treatment options when needed.
Dermatology
A 15-year-old high school wrestler came to see me for an ongoing localized “rash” just above his right elbow.
 It had been treated by his regular doctor as “ring worm,” a fungal rash common in wrestlers, but there had been no improvement. A fungal culture proved negative, but a viral culture showed it to be herpetic (a virus), and it resolved with a topical anti-viral cream as well as some education about skin problems associated with wrestling.
Pulmonary
An 8-year-old baseball player had a history of asthma, but the inhaler prescribed by his regular doctor didn’t control his symptoms.
 The inhaler would help only for a short period of time. His family brought him to see me, and, after closer questioning about his symptoms, we determined that a longer acting, once-a-day tablet and a powder-based inhaler should be used in addition to his “rescue” inhaler. His exercise-induced asthma symptoms were better controlled, and he was able to enjoy sports without the fear and frustration that shortness of breath brings. His performance and his quality of life both improved.
Autoimmune
A 34-year-old recreational swimmer was treated for “fungal finger and toe nails” without improvement.
 When she came to my office, her nails had a similar appearance to fungal nails (onchomycosis), which was assumed to be related to the recurrent moisture from swimming. A fungal culture, however, proved negative. She had an additional red scaly rash around her elbows, abdomen, and shins. Lab work showed results consistent with psoriasis, which can also cause pitted nails. Her symptoms improved and were controlled with management of her psoriasis.
Podiatry
A 66-year-old marathon runner complained of pain in both feet as the distance of his running progressed.
 Running on uneven road surfaces also contributed to his foot pain. On closer questioning, he told me that he used the same pair of shoes for up to 3 months (over 500 miles). When informed that competitive runners should only use their shoes for 300 miles, he wondered why. I explained that the plastic materials in running shoes degrade with use and ultimately lose their cushion and foot stabilization. On examination, and while observing him run on a treadmill, I noticed a second problem: he ran with a pronated gait (his feet and ankles collapsed inward). By changing his footwear to an anti-pronation shoe, and replacing them every 300 miles, his foot pain greatly improved.
Musculoskeletal
The Smith twins attended UC Santa Cruz and played for their basketball team. They each complained of shin pain after returning to school from their summer vacation.
 They hadn’t played much ball over the summer, and their pain began about 3-4 weeks after their return to college. The school physician felt it was a case of shin splints and recommended a period of rest. Unhappy with this explanation and concerned about their upcoming season, they came to see me. An exam showed localized tenderness over the lower third of the tibia in both brothers. A bone scan was consistent with stress fractures. After more inquiry, we determined that the school’s court was wood parquet over concrete, with no supporting cushion. The twins’ injuries were due to a combination of overzealous practice upon their return and lack of cushion on the playing surface. These injuries were treated appropriately, and both boys recovered quite well with a variety of swim therapy, cycling, and new shoes that helped decrease the repetitive pounding from the too-firm basketball court.
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Address
2565 Ceanothus Avenue, Suite 150 Chico, California 95973
Office Hours
Monday, Tuesday, Thursday
from 8:30 am - 5:00 pm.
Wednesday, Friday
from 8:30 am - 12:00 pm.
Phone 530.879.0400
Fax 530.879.0404
Primary
Care medicine
for the active lifestyle
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