It's a little hard to pin down Dr. Michael Ciccotti, MD, for a Q-and-A session. He's the head team physician for the Philadelphia Phillies, the director of sports medicine at the Rothman Institute at Thomas Jefferson University Hospital, and he has also found time to consult for the Philadelphia Eagles, the Philadelphia Marathon, and the U.S. Women's national soccer team. Just in case you happen to be a college sports freak, he also serves as the head team doctor for St. Joseph's University. When it comes to sports, Dr. Ciccotti has seen it all, diagnosed it all and repaired it all as one of the top orthopedic surgeons in the country.
Dr. Ciccotti: I'm responsible for the entire organization, on all levels, down to the lowest minor league team. That's over 300 professional athletes. Every aspect of their medical care.
Bulletin: What kind of problems do you see most often?
Dr. Ciccotti: By far, upper body injuries, especially the shoulders and elbows. It starts with mild to moderate sprains and strains and moves up to major tears. Blame it on repetitive motion. That's something for the parents of little leaguers to keep in mind, too.
Bulletin: How do we protect our children?
Dr. Ciccotti: Listen to them. That's the most important thing. Be aware of and receptive to any complaints they have. If your son or daughter is a really good player and then they start to taper off, that should be telling you something. Listen. They might not know how to explain what's wrong with them, or they may be afraid to tell you, because they want to keep on playing. But their bodies talk - and they never lie.
Bulletin: Position by position, what worries you most?
Dr. Ciccotti: Pitchers will see the most injuries and the most severe injuries - repetitive motion again - but catchers aren't far behind. People forget that catchers are throwing almost as many pitches during a game as pitchers, at least 60 to 100. They just aren't throwing them as hard. Plus, they have collisions at the plate, and they get hit by bats and foul balls. If your child is a catcher, be very, very careful.
Bulletin: What scares you?
Dr. Ciccotti: You don't see a lot of it with children, but if one of their growth plates is involved, that's extremely serious. Girls end their growing spurts between 13 and 15 years of age. For boys, it can go as long as 15 to 20. The growth plate is an area of relative weakness around the bone. A growth plate injury could potentially harm the rate of growth in that area. It could make one limb, for example, develop more slowly than the other. Very serious.
Bulletin: What's your advice for the parents who like to be weekend warriors themselves?
Dr. Ciccotti: Respect the sport and respect the conditions, especially if you are one of the millions of Baby Boomers who are becoming increasingly active.
Bulletin: Can you be more specific?
Dr. Ciccotti: Work your way into any sport. Wean yourself into it. If you are lifting, don't think you can max out like an 18-year-old. "Respect the conditions" means that you don't want to go all out on a 90-degree day with high humidity. Not a good idea. Is the field you're playing on wet? Stay alert. Stay hydrated - water all day, or a power drink with nutritional supplements. You aren't bigger than the sport.
Bulletin: If we aren't active but need to be, what should we do?
Dr. Ciccotti: Every recognized body of medical professionals in the world advises the same approach: 20 to 30 minutes of aerobic activity at least two or three times a week. You want to push - slowly - to increase your heart rate until you are vigorous.
Bulletin: What do you recommend?
Dr. Ciccotti: Swimming, biking, walking the treadmill, the ellipses in the gym, work your way up to running.
Bulletin: What are people doing wrong?
Dr. Ciccotti: I really don't like the approach that just attacks one area of the body, particularly not starting out. You might want great abs or great biceps, but your body wants and needs a full workout for both the upper and lower body. Your workout needs to be symmetrical. That's important - upper extremities and lower extremities. And once you understand the aerobic part, you need some light or mild weight training. But don't focus on one area.
Bulletin: But even if they follow that, people are still managing to injure themselves, right?
Dr. Ciccotti: Yes, they are, and the main reason that I see for that, in my experience, is that amateur athletes are choosing the wrong equipment. It could be the wrong sneakers, the wrong golf club, the wrong tennis racket, or the wrong exercise machine. You need the right size and the right shape. You need the expert advice of a trainer or a professional in the store where you are buying the equipment explaining things to you. Listen to them.
Bulletin: Is there any activity people should not be trying?
Dr. Ciccotti: That's an excellent question. The fact is that people are trying anything and everything, including extreme sports and sports with significant contact. So, they will do what they want to do. But every person who plays a sport or who wants to become active has an obligation to ask himself or herself: "Do I have any medical concerns that put me at risk?" Get an answer to that question and then be guided by your physicians.
Bulletin: What's your personal perspective?
Dr. Ciccotti: It's not so much the sport as the way you go at the sport. Be smart. If you take your time and intelligently work your way into things, you can probably try almost anything.
Bulletin: It seems like sports medicine became a glamour specialty overnight. Is it the new direction for orthopedics?
Dr. Ciccotti: It boomed during the 1970s and 1980s. Now, it's one of the most popular sub-specialties in medicine. Practicing sports medicine can be very rewarding for a physician. You are dealing with patients who are usually very highly motivated. They want to perform at a peak level and they are willing to do what it takes to make that happen. When you are treating patients like that, the sense of reward in being a physician is very tangible. We have exploded into becoming this health-conscious, active culture. Sports medicine is in the forefront.
Bulletin: Speaking of one of the Boomers, one of our favorite Phillies is Jamie Moyer. How does he perform at this level at his age? Just miraculous genes?
Dr. Ciccotti: In his case, it's a lot more than genes. He has mastered his profession. He knows what it takes to be a big league pitcher and he knows what he has to do to stay there. His knowledge of the sport and of success in the sport and his sport's demands is unique. He understands and respects his body. You give him a suggestion and he's willing to take it and try it. Jamie Moyer is just a great athlete and a great person.
Bulletin: Any final suggestions?
Dr. Ciccotti: Get up and move, but please be smart about it.
Mike Mallowe can be reached at mmallowe@thebulletin.us.