Dr. Lyle Micheli

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Dr. Lyle Micheli (R): The Godfather of Sports Medicine? Dr. Kevin Klingele (L) is inclined to agree

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The undisputed ‘Godfather of Soul’: James Brown Picture: Dbking @ Flickr

If there is a ‘Godfather of Soul’ is there a ‘Godfather of Sports Medicine’?

I think there may be……..and I’m very lucky to have trained under him.

Speaking as an editor of a clinical journal, I am aware of the phenomenon of bias, and I would acknowledge at least one ‘limitation’ of this blog post is that I am guilty of selection bias.

In truth, however, there could be a very strong case made for Dr. Lyle J. Micheli‘s candidacy for that mythical title.  One argument for the (perhaps) uncanny resemblance between the two ‘Godfathers’ is Mr. James Brown’s nickname:  “The Hardest Working Man in Show Business.”  No doubt, if there were a “Hardest Working Man” in Sports Medicine, the award would be given to Dr. Lyle Micheli:  even still, at age 70+, it is rumored that he performs more surgeries than any other orthopedist in the New England region of USA.  This is a man who works six days a week, and on the seventh…..well, unlike God, Dr. Micheli doesn’t rest:  he writes. Research Manuscripts.

At CJSM, we have been the recipient of several of his studies that have made the peer review grade and been published.  They span a period from 1992 (Arthroscopic Evaluation and Treatment of Internal Derangements of the Knee in Patients Older than 60 Years) to 2015 (A Closer Look at Overuse Injuries in the Pediatric Athlete).  Recognize that CJSM itself is celebrating its 25th year, and so, in essence, Dr. Micheli has been publishing in our journal for as long as we have been in existence.

His career goes back farther, into those dim reaches of the sports medicine universe that precede the Big Bang, er, the birth of CJSM in 1990.  His career in sports medicine dates back to the 60’s.  He was treating athletes before Jim Fixx gave birth to a  running boom in the United States.  Put another way, he was Medical Director of the Boston Marathon when Americans were still winning the thing…..and he is still at the Finish Line: in 2015 and in the infamous 2013 Marathon about which I have written in this blog.

He is currently visiting here in Columbus, Ohio, ready to give Grand Rounds on ‘Spinal Injuries in Young Athletes,’ and it’s great to see him.  We’ll be doing a podcast together, and I plan on sharing a link to that on our CJSM Social Media.

For now, let me end this encomium with one last parallel between the two Godfathers.  Sure, James Brown was prolific:  over his career he produced how many hits? married how many times (4)? had how many children (6)?  Dr. Micheli?  Well, let’s just say he has ‘given birth’ to many sports medicine children, who continue to follow his path in the field of sports medicine practice and research:  Meehan, Stracciolini, d’Hemecourt, Luke, Loud.…even myself.  And so many, many more!   There are seemingly untold disciples spread across the globe continuing his example of hard work and research productivity. Micheli?  Prolific? Oh my, yes.

He’d be the first to say, however, that it’s all about evidence-based (not eminence-based medicine), and so I hear his voice in my conscience, telling me to stop this now!  And get to doing some real work:  run a regression, do those edits on the manuscript that is due, figure out the solution to a problem in the athletes you care for!

Besides, the day has passed, it’s the middle of the night, and I hear the Chimes of Midnight……Grand Rounds is less than 6 hours from now.  Good night!!!!!

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Dance Medicine and Science – a developing field. Guest Blog by Dr Manuela Angioi

Dance medicine and science is a relatively young discipline, while the wealth of information available to scientists and all those working in the dance field is expanding and moving ahead rapidly. This is also reflected in the increasing number of dance-related articles now appearing in sports medicine and science journals.

Dance performance depends on a large number of physical and psychological elements, while dancers are expected to be experts in the aesthetic as well as technical side of the art and be free from injuries. On the other hand, dance is a “high risk” activity for musculoskeletal injuries, with a recorded high prevalence and incidence of lower extremity and back injuries, with soft tissue and overuse injuries predominating.

The majority of studies refer to mixed samples of dancers, in terms of levels and styles or techniques. But should we look at dancers as a uniform group of “performing” athletes?

One of the peculiar characteristics of dance is that it is NOT just “one form of performing art or exercise”. Within the “dance box” there are a number of styles (or techniques), including: ballet, contemporary (or modern), jazz, hip hop, theatrical, street dance, aerobic and ballroom dance. These styles differ significantly in terms of, at least, technical requirements, physical prerequisites and training models. It is therefore assumed that different dance styles should have different statistics in terms of injury rate, type and incidence.

It becomes more complicated when looking at levels of dancers. In the dance world there are different “employment scenarios” beyond the “ordinary” classification of professionals versus non professionals. To simplify, dancers can be classified as professionals (these are usually only ballet or contemporary dancers), in training (vocational or non vocational) and then they could be performing for a number of days per year but they also have other occupations or they are without a formal contract (independent dancers). Total hours of training and performing, as such, can vary significantly even within the same “style” according to the “employment status” which, in turn, can affect injury rate and severity. Hence, it is not a surprise discovering the heterogeneity of the dance medicine literature in terms of injury type, rate and incidence.

The majority of published research studies have focused on ballet and contemporary dance, while there is a lack of information about other styles or techniques. Again, majority of studies have looked at either professional or pre-professional dancers, while there is a paucity of data regarding recreational and amateur dancers, even if there is an estimated number of 4.7 million participants at recreational level in UK only.  There a very few published epidemiological studies while majority of reviews are weak. The overall feeling is that there is a need for more data before drawing consistent conclusions about musculoskeletal injuries of dancers. As such, similar approaches as the one recently adopted by Campoy and colleagues, who looked at injuries characteristics in four different dance styles, are needed to broaden the ongoing dance medicine literature.

Reference

Campoy S et al. 2011. Investigation of Risk Factors and Characteristics of Dance Injuries. CJSM 21(6): 493-498

(The author of this article is Dr Manuela Angioi, Research Supervisor and research methods module leader on the MSc in Sport and Exercise Medicine at the Centre for Sport and Exercise Medicine, William Harvey Research Institute, Queen Mary University London)

(Photograph, Dr Angioi practising her art)

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