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NBA Finals injuries are a game-changing warning for an aging America

The Hill logo The Hill 6/19/2019 Dr. Marc Siegel, opinion contributor
a group of people standing in front of a crowd: NBA Finals injuries are a game-changing warning for an aging America © Getty Images NBA Finals injuries are a game-changing warning for an aging America

I'm a basketball fan, although I didn't closely follow this year's NBA finals because my New York Knicks were about as far from being on the court as you can get and still be in the same league. I couldn't help but notice, though, when the Golden State Warriors' Kevin Durant returned from a calf injury and then tore his right Achilles in Game 5. It also was disturbing to see teammate Klay Thompson - after scoring 30 points in Game 6 - injure his left anterior cruciate ligament (ACL) in a losing effort to prevent the Toronto Raptors from winning their first NBA championship.

Fans everywhere relate voyeuristically to their sports heroes, their successes as well as their setbacks. Some fans also are too quick to project themselves as star performers on their own courts or playing fields, sustaining serious injuries as a result. Being the daily gym-goer that I am, these basketball stars had me wondering about their injuries, whether something like this could happen to me and how well I could recover.

Doctors and other medical professionals across the country, along with insurers, hospital administrators, long-term care providers, government regulators and others involved in our health-care systems, grapple with related questions every day - or, at least, they should.

The baby boomer population is aging and we might have a problem caring for them in the future. And as our ability to extend life constantly expands, as medical technologies enable our bodies to repair and adapt more readily, as lifestyle or generational changes empower us to remain physically active long beyond the typical ages of past generations, sports and body-stressing exercises can lead to physical injuries or ailments. Couch potatoes inspired to return to the gym or court may suffer extensive, expensive injuries that place big demands on our health-care systems.

There are too many instances of people watching highly trained super-athletes perform dazzling feats and deciding, "I bet I can do that, too" - usually with unintended, painful, sometimes debilitating consequences.

NBA star Durant is 30 and still at the peak of his game. Yet, as Dr. Laith Jazrawi, chief of sports medicine at NYU Langone Health, told me, "Certainly as we get older we are more susceptible to soft tissue and tendinous injuries. The Achilles is a common area to rupture as you start to get into your 30s." Jazrawi added a warning for "weekend warriors," stating that they don't tend to place a high enough premium on flexibility and stretching, which can "make you more susceptible to ruptures of the Achilles."

Regarding recovery after surgery, rehab is extremely important and typically takes four to six months. For a professional basketball player, Dr. Jazrawi said, "it is typically 8 to 10 months back to playing." Knick fans that still have our hopes set on Durant will be watching his rehab progress closely.

One can easily foresee how just this one injury can affect a population that increasingly lives longer and pursues more physically active lives. Achilles repair surgery costs thousands of dollars, and the extensive rehabilitation many thousands more. We already have seen this expensive problem occurring with the growing prevalence of hip, knee and other joint replacement procedures. Many of us can't afford to pay for it, and health insurance, both public and private, isn't geared to pay for it, either.

In terms of the Warriors' Thompson, who is just 29, Jazrawi said weekend warriors are not more prone to Anterior Cruciate injuries of the knee. The ACL is a stabilizing ligament of the knee that is frequently injured by athletes, with between 100,000 and 200,000 ACL ruptures yearly in the U.S. alone. Jazrawi pointed out that fatigue is a factor that may cause you to put more pressure on your knees, thereby increasing the risk of injury. There are different approaches to ACL repair, most commonly either using the patella tendon of the knee or taking an ACL from a cadaver.

In a professional athlete like Thompson, the stronger patella option almost certainly will be the method chosen. Jazrawi expects that he is likely to return to the court in about a year's time.

Undoubtedly, Thompson and his team will be able to afford the finest available care. But, again, for the rest of us in our growing-older population - and their health-care providers and regulators - the issues are obvious, and the solutions not yet quite so clear.

Rehab for almost all injuries and other health conditions is extensive and requires the assistance of especially gifted physical therapists. Weight bearing is generally begun immediately, with the goal to promote knee extension and overcome quadriceps muscle inhibition. Of course, rehab must be individualized. A recent review states it best, "As the patient progresses through their rehabilitative course, the rehabilitation specialist should continually challenge the patient as is appropriate based upon their goals, their levels of strength, amount of healing, and the performance of the given task.

I find myself wondering - and I know many others in our various health-care systems do as well - whether we're really ready to provide and to pay for increasing amounts of such rehab for an older America. The answer is clearly "No."

Anyone who saw Klay Thompson turn around after his injury and return to the court to shoot his free-throws knows that he will be a role model for recovery from a sports injury. For the rest of us, in order to prevent injury in the first place, I prescribe starting with a regular exercise program that includes low impact cardiovascular exercises such as the elliptical or the bike. Avoid sudden twisting movements or working out when too fatigued.

This approach may save costs -- namely, for you and me to be in the kind of condition, through stretching and regular exercise, where we aren't injured in the first place. Use your mental muscles to help bring you there: Stop thinking in terms of a Durant or a Thompson, and more in terms of your own body. Help us prevent yet another health-care crisis for our aging boomers.

Marc Siegel M.D. is a professor of medicine and medical director at Doctor Radio at NYU Langone Health. He is a Fox News Medical Correspondent. Follow him on Twitter: @drmarcsiegel.


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