Injury prevention: The next sports frontier

Stephen Strasburg\'s 2010 UCL tear caused him to miss most of 2011 and get shut down early in 2012. (AP Photo/H. Rumph Jr.)

WASHINGTON — Professional sports in the United States is a multi-billion dollar industry. And yet, with all the money pouring in from sponsorship, ticket sales and merchandise, the science of keeping athletes healthy continues to lag.

This year alone, 28 major league pitchers have undergone Tommy John surgery, the replacement of a damaged ulnar collateral ligament in the throwing elbow. While recovery rates for the surgery have improved to roughly 90 percent since the first operation on the procedure’s namesake in 1974, the recovery process remains long and laborious, costing pitchers parts of one or two seasons.

“It’s an epidemic at this point, it really is,” says Jeff Passan, lead baseball columnist for Yahoo! Sports, who is currently writing a book on the topic due out next year. “Teams spend $1.5 billion every year on pitchers. And $500 million of that ends up on the disabled list.”

Knee ligament surgeries in football and basketball have also become commonplace, especially on tears of the anterior cruciate ligament. As with Tommy John surgery, the technology of the procedure itself has advanced dramatically. Once a grueling, 18-month rehab process, many athletes are now back on the field in just six to nine months. Nevertheless, time missed for professional athletes means money left on the table by the teams that employ them, and often a lesser replacement out on the field in the athlete’s stead.

While the technology of recovery has advanced, there hasn’t been as much development in preventing these injuries in the first place. One company is out to try to change the way sports injuries are diagnosed, by getting ahead of seemingly minor issues before they turn into major problems.

Med-Tek is a Miami-based company that has developed a system called a Comprehensive Muscular Activity Profiler (CMAP Pro), which captures and quantifies information to help evaluate soft-tissue injury. While the diagnostics apply mostly to muscles, they could potentially indicate weakness that predicts injury to a connected part, such as a tendon or ligament.

“Not only can it predict a likelihood of injury, but also, if there is a significant amount of risk to those ligaments,” says Dr. Marco Vitiello, president of CMAP Interpretive Services. “Our evaluation is in soft tissue in general, but specifically muscles. Those end in tendons, and ligaments hold them together. By corollary, we can look at tendons and ligaments.

“It’s really not a huge leap of faith to see how we could be helpful in both venues.”

The system works by monitoring the activity of nerves and muscles while patient is in motion. It can identify both the specificity and the sensitivity — basically, which tissue is damaged and which is not — at a 92-96 percent accuracy rate, according to a study out of the University of Texas at Arlington. Compare that to about 70 percent for an MRI and about 50 percent for a physician’s pre-test diagnosis, and you can understand the company’s excitement about the product’s future.

Originally developed for worker’s compensation cases, the system essentially uses an electrical blast to help pump blood into an affected area. The evidence of injury is apparent depending on the blood flow or lack thereof. The whole process takes about 30 seconds, whereupon the data is transmitted back to the physician.

Of course, it’s easier to detect weakness or trauma if you have a set of baseline controls in advance, when the patient is healthy.

“We know what the data is supposed to look like, but it’s really nice to have the patient’s own data,” Vitiello explains.

This is where they’ve run into trouble with agents and players associations. Such baseline tests might also reveal latent preexisting injury, potentially costing a player looking to sign a contract as a draft pick or free agent. Med-Tek was in talks with Nike and NFL to potentially showcase the technology at the Combine before plans were shelved.

That has been the battle — how to help bring this service to the athletes in a way that doesn’t potentially hurt them financially or professionally.

“In sports, I can’t think of anything more important,” says Kerwin Williams, president and CEO of Med-Tek. “Not only can it show injury, but it can also tell what other damage he can do if he comes back too soon, really enabling a team’s medical staff to keep coaching staff from causing a long-term injury to a star player. It’s investment protection, plain and simple.”

Med-Tek provides their technology free of charge to doctors who want to use it, then charge on an individual basis for diagnostics performed. Williams is clear that the system can help physicians, and shouldn’t pose a threat.

“We’re not trying to second-guess a doctor,” he says. “We’re providing him information where he can supplement all the things he went to school for.”

The company used their technology with an English Premier League soccer player who had developed pain in his knee and had not been able to return to the field. A doctor recommended arthroscopic surgery to clean out scar tissue, but the player sought a second opinion. The CMAP Pro diagnostics showed signs that a nerve from the player’s back was generating a signal, referring pain to the knee. Instead, they prescribed therapy for the player’s back, which led to complete resolution of his knee pain after just three sessions.

Med-Tek was also in talks with an MLB club about using their technology. What impressed Williams was the team’s desire to use the technology with Little League and academic sports teams to see whether young arms were being overplayed. His own son was a Division 1 basketball player.

After all, the injury issue isn’t only one of watching invested dollars go to waste. It’s also a human one. Not only are fans deprived of watching the stars they want to see on the field, but the players themselves are subject to months, or even years, of grueling, lonesome rehabilitation.

“Think about the most important thing to you, and think about that being taken away,” says Passan. “It’s a very lonely process. You have guys who spent their lives surrounded by 24 teammates, front office, city that cares about them. All of that is taken away.”

But while the system may work well for muscles, Passan is skeptical of the application to tendons, the biggest potentially preventable injury issue in all major sports.

“I understand the kinetic chain connects muscles, bones, tendons,” he says. “But the idea that you can say definitively when someone is going to get hurt? I’m skeptical.”

Whether Med-Tek’s technology will prove to be the first to help diagnose these injuries before they occur, or a new development will come along, the arms race to save arms (and legs) is the next great frontier in sports.

“It’s the holy grail,” says Passan. “It’s exactly what everybody is looking for.”

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