Orthopaedic surgeon and team doctor Cassandra Lee discusses what it is like to be a team doctor for a major sport and gives advice on how to keep yourself healthy.
Welcome to another Facebook. Live from U. C. Davis Health. I'm Red Cushman, and I am with Dr Cassandra Lee. She she is the team doc for Sack Republic and a U. C. Davis, orthopedic surgeon. We're here in a few minutes. There will be some folks from the sacrifice affect the entire practice fields. Gonna be out here, um, and and we're gonna talk. What about what it's like to be a team doctor for a major sport. And since she is a orthopedic surgeon, she's also going to give some advice on how to keep your future soccer star healthy. And maybe those of you who plan adult leagues how to keep yourself healthy. Doctor, thanks for being out here with us. This is gonna be really fun now, Excited to be here. It's always great to be out with the team. Yeah, and there are We see, they're kind of head this way. Any minute now. We can see him out in the parking lot, so we're gonna try not to get in their way. Couple reminders, though. By the way, we are a proud sponsor. U C Davis, health of the sack republic. And they have their final home game on Saturday. They just qualified for their, uh, sixth playoff appearance. But they're fighting to make their way up the ladder, so they're gonna be out of Papa Murphy Field on Saturday. Tickets are available. You can still get out there and and see him. Wanna make sure I hit all the plugs? Thea thing is, we do need to say thank you to the sack republic because they're letting us out here. And frankly, you're the team doctor. You're an orthopedic surgeon. They trust you, Really? They probably have better things to do than let me out here. But here we are. So have to say, this is that you always think like it would be so fun to be a team doctor. Is it fun? It is. As glamorous as it sounds. It is. Um it's actually great to be a team position. It is truly the combination of medicine and athletics and sports. Uh, but the biggest part of it is there's another team that actually takes care of the entire team. So this is really, truly a team sport. So the job of a sports medicine physician is to really take care of the athlete in all aspects, from nutrition to psychology to take care of injuries preventing injuries. So so you're you're on the sidelines for every game. In fact, this is your sideline Gear Thistle is my This is my I go sack republic here. Uh, but you're you work with them other times besides being part of the sideline crew? Um, mostly if there's an issue that s o the athletic trainers, mostly with them at all times. So this includes practice, sidelines, and everything else of the trainer is a little bit concerned. Then the athletes will come and see us in the office. So one of the things that you think about is like you're going to get sit down. Go, man, What a great game do you get to really watch the game? Much are too busy, sort of treating folks. So it depends how what you consider a great game for me. A great game is for me to watch the game. So if I'm not having to take care of law, the athletes on the sideline, that's a great game. How often do you have to take care of guys on? So, luckily, it's probably a little bit more on the rare side. Yeah, so that's you know, that's one of the questions is is you can see soccer players here are very, very, very fit athletes, soccer players among the fittest athletes, really in American sports or in world sports. So it's sort of a two level questions being that fit and being that strong, Do they have the capacity to injure themselves? Or do they actually have the capacity to prevent injuries just in sort of their natural condition? It's, um I guess that well, the question is really tough because, yes, these air great athletes there, you know, incredibly cardiovascular fit. If you think about their literally sprinting for the next 90 minutes, right, right. So you and I could probably spring for 100 m, right? So Well, I don't know. Maybe you could spend more than me. Eso eso. These guys do have the capacity to keep on going at a high level. With that, you have to be able to be conditioned, and you also have to have recovery. That's probably one of the biggest things that people don't think about when it comes to being an athlete. because these guys go hard, they go 100%. They have games every week, maybe even twice a week, right? So but the key is actually recovery in between. So that prevents overuse that prevents more injury. That actually will also affect their performance. Like if you keep on trying toe perform at that high level, you're going to decrease. Yeah, so I want to talk more about recovery in a minute because that's a lesson that all of us are. Armchair, semi armchair Saturday Athletes could all learn, but one of the questions is with these guys. What are the kinds of injuries you see the most? So, with soccer soccer players in general, the biggest set of injuries are actually be lower. Extremity injuries makes sense, right? It's a it's a kicking sports. So anything from ankles to knees, uh, to grow and polls to muscle pulls hamstrings. Also specifically, another thing that comes along and soccer is actually concussion. Eso if imagine you see these guys going up heading for a ball and you know they're going for it. So that's another issue for its injury. Well, and you know, that's a that's a big part of the sport that we tend not to think about. I mean, how often do you run into that? We're one of the guys. Get concussed on the pro level is probably a little bit lesser than actually what we see in the adolescent level. Um, actually, the study came out of the American Orthopedic Society for Sports Medicine. So a O S S m. And they looked at the incidence of concussions in high school athletes and actually found that the incidents in female adolescent soccer players is higher than high school football. Why would that be? I mean, I know there's a lot of headers, but I mean, what what would make that? Because these guys have much more capacity, use headers more. Why would that? That's a really good question. I don't think that's something that we have fully hashed out yet with within our research. But looking at, um, if you think about how what we do in soccer, we don't like kids head the ball until after 10 years old. The reality is this because their heads are too big for their bodies, right? If you think about it's almost like a bobblehead, they don't have the neck muscles that can kind of control their head. So that's That's one of the safeties we put into kind of protect our youth from in soccer. But I can't quite say why the that happens more often than females. Yeah, interesting. So one of the things that and as we look at on the field, and we can see that these guys were starting to do warm ups and, you know, and they're gonna warm up for a while before they start playing, which is not something that happens so often on Saturday mornings when whether it's kids or adults that are playing. So what are some of the lessons that from pro soccer that regular soccer players could could learn? I think the important thing is that you really have to treat your body with respect, if you will. Eso warmup is key, so not jumping. And all of a sudden you know, you got that Saturday morning league, you gotta You run a little bit late and it's your on the field and go all out. That's that's not gonna That's not gonna build wealth that's gonna cause muscle pulls. It's gonna cause a lot of other problems. Rule number one Don't jump out of the car and start sprinting, right? Yes. Or or out of the house. That's another one, too. Yeah. And that is so for, uh, the kids versus the adults. What kind of warm ups and how much do you suggest that eso warm up is gonna be basically anything where you get muscles, You know, blood flow to the muscles, right? So probably easy jogging. Um, if you look at these guys, they're, you know, they're kicking up their hips or kicking up opening up their hips. So they're really loosening up those hip flexors, Those quads, those hamstrings. They're really trying to open up everything that they're going to really be stressing during their workouts. Right, S. So I think it's not just jogging, but yes, I probably want to do some lunges. You wanna just try to get some flexibility into your warm up to? You know, it's as a former track athlete, one of things that we did a lot of we did a lot of high needs a lot of strides slowly accelerate. And that's something I was watching. I was watching a friend of mine's mine's 50 year old team warm up and they didn't do that very well. Didn't want warming up with setting up the lawn chair and making sure the beer was in a cooler was pretty cold comfort. You guys warm up, so I mean those sorts of things. I imagine that that a lot of just recreational players don't even plan for in their day. Yeah, a lot of it is because a lot of us are just kind of just going to go in and say, Hey, are fitness is gonna be are playing. But the reality is you don't wanna hurt yourself. And as we get older, I'm not calling any of us old. But we're all getting older at some point that's happening. Standing here, I'm starting age already. Yeah, the key is really just to make sure you warm up right. And the interesting thing is, I'm going to do a little bit of plug here. So looking at our youth sports, one of the biggest things as a sports physician is that we want to prevent injury, right? It's one thing to actually take care of the injuries, but the best thing is actually prevention So one of the biggest things I worry about as a sports athletes are sorry. Sports physician. I was an athlete back in the day, but no longer did you play better. I played viable. Yeah, so, um, is really prevention. So one of the big things that I worry about is adolescent females. There's a high incidence of a C l. Tears and I actually had an interview with. I forgot one of the TV programs and looking at female in a C L injuries, but specifically an adolescent teenage females. There's a higher risk for a cell towers that could be That's definitely multi factorial. But one of the biggest things now is FIFA has come up with a pre pre happy if you will, so it's part of the warm up. There's actually something called FIFA 11, so if you guys want to Google that and look it up, but basically it's it's a set of exercises you can incorporate into your warm up, especially in the teenage, uh, group, but basically to help kind of prevent kind of build a lot of strength that you need to protect your needs from a nation. Well, that's another question, too, is is just for whether it's, uh, kids plan or is to become high school athletes or adults that are playing, whether it's soccer leagues or softball leagues. What kind of exercises besides warming up? What sort of muscle groups do you think that they should be working Thio strengthen the A C L Protection. That means what hamstring strength and that sort of Yeah. So the interesting thing is, you think about a sales were like niece. Okay, let me just, you know, work on my leg muscles. But the reality is all the muscles you need to use or actually gonna be your quarter floor. So I call it quarter for strengthening. So core strength has to be really good. Hip flexors hamstrings, and he's actually little butt muscles. Actually, what is key to keep your knee in a good position. So if you're cutting and twisting and pivoting a little, but muscles kinda hold your leg in the right place so as to not put it in a bad position to tear the so works the glutes work boots and you know there's a benefit. Look, good pants. You know, that's always important. Exactly. It's the ultimate butt lift. That's right. I'm gonna talk a little bit more about recreational athletes in a minute. But since we've got now, they're behind us and you know we could see them out there. The one of the things that that I always wondered about with athletes. I mean, I know that even as a high school athlete that nobody wanted Thio admit to being injured because they wanted to play, you know, Plus, there's there's the you know you're tough, doesn't matter. It's not. It's not. Macho is not the right word because it's men and women, you know, Nobody wants to admit that they're not tough enough to take that hit. So how difficult is it to get folks to admit these professional athletes, great professional athletes, how to get them to admit that they've been injured? I think setting the culture is key way. Don't wanna look at this as something that you're punishing your athletes for having an injury. The reality is we're here as a ZA medical support. We want the team to be as healthy as, well, as good as they could be so they could perform and they can get those championships, right? Right. So the key is staying healthy so that you can perform the best right there that you don't lose your spot. Although there was the guy that lost the life, forgot his name everywhere he got his name. The first baseman who was injured, Lou Gehrig, took over and played for, like, 100,000 years right after. So, you know, everybody is afraid of of losing that, that one spot out there. So And by the way, if you're just joining us, we are on the practice field. Cosumnes River College. Thank you, by the way, because some government college for letting us come out here is Well, this is this is sac Republic back back there, you could see going through drills, were talking about doing drills. And I'm with Dr Cassandra Lee. She is an orthopedic surgeon, U C Davis Health. And maybe more importantly for this, she is the team doc for sacrifice. And by the way, it's also a reminder these guys air in the playoffs six straight season, and now they're fighting for a spot they're playing at home on Saturday night at 7 30. Could still get tickets. It's on their website. So let's talk a little bit more about kids. And, you know, one of the things that we sort of tend to forget with our kids playing soccer is like, Here's the ball, Go kick, right? So what's some of the advice? That and some of the lessons maybe from being around the team like this, that parents ought to be thinking about in terms of monitoring their kids injuries back to what I was saying before about not admitting that they hurt. So I think the difficult part is telling, like when when is your kid hurt, right? What do you know to go the doctor versus, Like when do you know just to kind of pulled off on it? So I was crying because he doesn't. He wants to go back and play video games. Right? So the interesting thing about kids is kids will actually tell you when they're they're not gonna verbally tell you, but they're going to tell you if they could do something or not. So, typically, if you if there's an injury or something that goes on you wanna, you know, rest them, ice them, so do the right thing. The rest, ice compress, elevate, Um, give him a little rest period and maybe sometime or Advil. And if they get better in a day or two, then chances are they're fine. But if it doesn't go away in a couple days, and that's when you should seek medical attention, well, and some of that, though, is even that day out on the field, you know, there's a kid that's lagging behind, and sometimes that's just the person is a little bit out of shape and something just the person that got injured. I mean, what are the signs that you might look for? I think it just Oh, that's a really good question. Um, besides the lip because I often go into my fake limp so I don't have to do work, but I don't think that's the same thing. I don't think that's the same thing with kids, but I think a lot of times if you just pull the kid out and just let them rest and then see if they're ready to get back in, I mean, I think it's a coming upon us as the medical staff, a Zwelling coaching staff to take a look and see, you know, if the kid is just kind of or the athlete is just kind of hanging back, you need to really assess and see if it is there some injury or is this kid just needs a little time out? You were talking earlier about recovery, and I want to get back to that. So that's an important thing for every kind of sport. But certainly for a sport like soccer, right? Because these guys they, you know they are endurance athletes as well as Sprint athletes and and as well conditioned as they are, they need time to bounce back. It's something that we tend not to think about as sort of armchair athletes were regular athletes. So what kind of recovery do these guys need? And what kind of coverage would you suggest for the weekend athlete? So he's playing Ah, soccer, you know, tournament on Saturday, and that goes into Sunday. You know what does that? Whether it's a kid or adult, Um, what do they need to do to recover quickly? But let's talk about them first. How much kind of recovery did these folks? So these guys have been just kind of going at it for a long period Time, right. So there Definitely a lot more. They have a lot more endurance built in than most of us. Eso there in the difficult part is like how much recovery do you need? It's kind of hard to say. How is your recovery? This is my required. It really is. Everyone is different. But the reality is if you're going hard for a game, Uh, that day, you know you're going, you're sprinting. Um, you're going 100%. You probably need to have at least the next day Thio come down. You shouldn't be going for big sprints the next day. You shouldn't be going do your big work out the next day. You should actually let your body kind of recover. Let your muscles recover. If anything, you could be doing like a easy kind of cardio or easy, uh, kind of stretching type day or easy strengthen type day on what kind of things, if you are, say, somebody playing in one of those tournaments. So you got three games on Saturday and two more on Sunday. What do you do Saturday night besides, go out and party? Do you I mean, do you hydrate? Do you think about what you eat? You stretch the eyes. What kind of special? That's great thing I forget. That's a great point. Hydrating is key, actually. But here's the funny part. Hydrating doesn't happen on the field. It happens the day before, so you need to hydrate the day before. So by the time you feel like you realize you're on the field on Mike am thirsty. That's too late. You already behind. So you really need to keep up with that with the hydration. You know, I'm always impressed. Like you watch the Tour de France, so they have a whole different level of sort of, well, insanity, I think. Good word in terms of what kind of insurance that they go through. But you look at those those riders and they're they've finished and they're off the bike and they're talking to the camera, and they've been off that bike for 30 seconds, are already chugging water on. That's another thing, too, is to start drinking soon after, All right? He had to stay on top of it, like by the time I guess one way video to assess if you're hydrate enough is actually just look at the color of your urine. You know, if it's really dark yellow, then you probably need to catch up on its water, not coffee, but yes, yes. You want to make sure the hydrating coffee. Yes, that's hydration coffee. You might actually end up pushing back out, so you definitely want to use just good old fashioned water. And then I guess the question then becomes electrolytes, right? So that's that's a difficult part. Electrolytes. That's a big industry, right? So can I tell you how much salt you need versus how much salt dining? I don't know the answer to that. I think big endurance athletes were really going hard on, you know, like a big hot day. You can tell when you see, like the salt rings on their shirts. You know, you probably need to have lunch. You got to replace all that stuff is coming out. But is that different from my half hour workout on spin bike? Probably. But I can't tell you how much electrolytes are necessary is. And so is there a problem with you over over electrolyte thio create a new verb? Yeah, probably not because the beauty of it is that you're the human body is amazing. It can actually compensate and figure out what you need, what you don't need. So if you have too much salt, if you will or too much, I guess I can't call assault because that's a whole different ballgame. But to me, electrolytes, your body is able to get rid of it, right, right, right, So And what about sort of the little ones, though? You know it's there's a six year old or a 10 year old need the same kind of electrolyte replacement, or is it different for them to get it into them? It's probably not any different, honestly, so the American diet actually has quite a bit of salt in it, So that's probably gonna suffice for a 6 to 10 year old athlete, you know. But the key is trying to get them to drink water, right, because there may not wanna have water. They might wanna have something more sugary or whatnot, so but really trying to get the water in there you can. Well, what about there's, You know, there's sort of this range of sports drinks from, you know There's the various aids on and some are sweet and some are really sweet. Some are lightly sweet. Um, you know, and I remember this is years ago, but somebody had some study that said, With a little bit of sugar, they absorb the water more. I don't know if that's true. Is there any truth to that? In theory, if there's a little bit of sugar, you're sort of better. But a lot of sugar? No. So, honestly, it's gonna be one of those. Figure out which one you like and right, Right? Probably at that point, just get something to drink. Just gets a little drink. Yeah, All right. So, you know, I know that you were talking before about about women's, um, knee injuries. You know, Andi, I know that some of your stuff is that it's a certain age level of which they start toe, Have a look after age 10. Effect. Remember, basically puberty. So is it a Is it a physiology thing in terms of, like the courage of the body or the physical makeup? I mean, what is it that causes that sort of thing? That is a very good question. It's actually really. We don't fully understand the entirety of what causes it. But if you think about the rates of injuries from boys and girls before puberty are the same once you hit puberty, so with girls, you're gonna have hormone changes. You're gonna have hip changes. You're gonna have difference in how the muscles develop. You're gonna have growing pains. All that stuff, um, a cell rates go up to 4 to 5 times higher than boys. Yeah, so it is. It is a really problem. So back to what we were talking about, I'm pointing because we were down the field. We were talking about this, but we're talking about exercise is that people could do so either specific exercises that should girls doom or Yes, Absolutely, Absolutely. That's kind of what I hinted at before it was like that FIFA 11 type program. It's actually it's It's something that could be incorporated into the warm ups. Eso again. It's a lot of it's gonna be core. It's going to be, um it's gonna be, uh, the buttock muscles. The glute muscles, hamstrings, um, work out kind of landing mechanics because girls interesting enough when we when we jump upto land. We actually land a little more stiff legged straight leg. And what happens is that's what puts our needs in a bad position. Boys tend to land a little differently, and it's again. It's It's a strength issue to really like cats a little bit. Yeah, I think about landing soft, actually know that there's there's truth that you gotta land soft. You know, I was I was pointing the field back there, because here we've been talking now for about 2025 minutes and you guys were still warming up. Yeah. So once again, the point about a real serious warm up is a real serious warmup, Absolutely warm up. It's not just, you know, walk up down the block and, you know, do a couple of kicking motions, But it's a And the truth is we do know this. You'll also play better to you'll run faster, jump higher all that, all those sorts of things. So, uh, okay. So I need to ask you this question. Um, start. Not that anybody on sack republic has ever taken a doctor, but one of things we love about about pro soccer in particular. And you always see this at the World Cup level, actually, more than at any level. Is is where you know, two guys bump shoulders and one of the guys goes down writing in pain, holding his knee, you know? All right, So, uh, as a medical professional, how likely is it that that guy writing holding his knee is gonna jump back up, assumes the rep doesn't make the call and walks away? Wow, that's Ah, that's a loaded question. Is eso here? I can, actually, so every every trainer will have something in their bag called the Magic Spring. So the nice part about the sprays that you spray it on anything on these athletes and they could jump right back up? Yeah, it Zanoyan cheek, Of course. Yes. It's the rate. The pain. Really? Yeah. Let's let's We're gonna just so you could see them behind us. Um, right now and also probably say otherwise. If you do see a flying soccer ball, don't be alarmed. Um, so that, you know, I'm gonna get back Thio sort of notion of preventative injury and recovery. So what? What specific lessons that that you see that these guys do know we were just talking about work out, You know, e mean about warm up, because now they're finally actually working on drills. Um, so what lessons from here should, you know, kids take should parents take should recreational leave adult lot's take out of that in terms of how these guys practice. Oh, so I guess what we're seeing on the professional level is that they really take warm up seriously, right? They're not gonna go. And also just, you know, basically come out locker room and go out and start playing, going thio drills and specific place They're gonna actually warm up. Their hips are one of the like, they're gonna do some lunges like you kind of mentioned, they're gonna do a little bit of running. And then now they're just working on just easy. Just dribbling and juggling and whatnot. So, e, that was that was an official, uh, soccer sack. Republics talk about right there. Yes. You know those on camera, but they're flying everywhere. We're actually gonna keep moving, get out of the way. So they're not playing out. That's one of the hazards. Actually, sports coverage is that you always have to pay attention because you don't know when the ball's been come towards you well, and so you know that actually brings up a good point. There you are on the sideline and you're looking at a player because somebody's hurt. Somebody keeping an eye out. Make sure that there's not either a ball or a scrum headed your way. Eso typically, if I'm actually out on the field, obviously place stop, right, so that's not something to worry about. But when we when I assess paid athletes on the sideline, yes, it's actually off of the sideline a little bit, kind of behind the benches. Eso it's usually pretty safe. Usually that being said yes with the corner of my eye is always kind of watch. Probably jinxing U. S. You travel with the team as well? No, I don't think so. You're the dock for all games. Here s Oh, actually, we actually eso within the sports medicine section of U. C. Davis. We have a bunch of orthopedic surgeons, but so here's the neat thing about what sports medicine doctors are. There were more were multi faceted, if you will. So we have physical medicine, rehabilitation doctors, internal medicine, doctors, family practice doctors who do sports but obviously more on the medical side of things. And then we have the orthopedic size. So there's orthopedic sports medicine. A swell as one of our foot ankle partners is also, um, into sports coverage because he took care of a lot of the FIFA and MLS stuff. So yeah, and you also I mean, you've done surgeries on various happy. So we it's the full suite of coverage, as we say, Yes, we have everything from, you know, the common cold Thio head injuries, too. Knee surgery, but common cold. We forget about these guys, guys, guys, air human. Yes. Yeah, that's right. Yes. All right. Well, I think we're gonna let them continue their practice. And we're gonna get out of the way. We want to say thank you very much to sack Republic for letting us hang out at their practice. And thank you, Dr Cassandra Lee, for letting us bother her for a morning when she could probably doing better things. And also, some river college has come out here and remember, tickets are still available for Saturday night. They're in the playoffs fighting for a spot come route on our great sack Republic team. Thanks for Thanks for watching. Thanks.