5 Questions with Jim Borchers: Team Doc of the National Champion Buckeyes!

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A VERY happy crew: Jim Borchers (center), Bob Sweeney (L) & Doug Calland (R) in Arlington, TX after the National Championship game.

Followers of this blog know that I live in Columbus, Ohio.

And most of you know what that would mean for life here the last two weeks.

Unless you are overseas and/or pay no attention to American college football–which is true for some of our readers–I don’t need to tell you that Columbus is home to the reigning, undisputed National Champions of NCAA Division 1 football:  the Ohio State University beat Oregon decisively in the game on January 12 at AT&T Stadium in Arlington, TX, 42 – 20.

The medical staff of that team is a group of clinicians whom I know well.  I have great admiration for the clinical and scholarly work they do.

In the aftermath of the game, I reached out to my friend, Jim Borchers, M.D., M.P.H. and asked him if would have time to share some of his thoughts on the game, the season, and a variety of other topics.  I am happy to say he said yes.

Jim is an example of that clinical and scholarly excellence I just wrote of. He is the Director of the Division of Sports Medicine in the Department of Family Medicine at OSU. He is an Associate Professor and the Director of the Primary Care Sports Medicine Fellowship there, as well.  And besides being the team physician for the football team, he takes care of men’s and women’s basketball, soccer, and lacrosse as well.

I’m happy to say he still, somehow, finds time to help out with the journal.

Now, without further adieu, here is our conversation with Dr. Borchers.

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1) CJSM: I understand you were both a player for the Buckeyes when you were in college and now are one of the team physicians for the new, National Champs. Can you describe what different thoughts and emotions you have as a player for an elite team vs. those you have as a team physician.

JB: I was very fortunate to play football at Ohio State from 1989-1993.  As a player during that period, we were working very hard to try to get Ohio State back to the top of the Big 10 conference.  During my playing days, I was like my other teammates – focused on winning and performing to the best of our abilities.  During those years I experienced some great wins and some tough losses and certainly appreciated how important football was to all of the fans and alumni of Ohio State.  As a player, I always wanted to be on a championship team – one that would be remembered at Ohio State.  My senior year we were Co-champions of the Big 10 conference and finished 10-1-1 and in the top 10 in the country.  At a recent 20 year reunion honoring that team, I was reminded of how fortunate we were as a team to compete at Ohio State. Read more of this post

The @MomsTeam Summit in Boston #PlaySmart

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Dr. Brian Hainline, Chief Medical Officer for the NCAA, discussing how to ensure the physical and mental health of youth athletes.

It truly was inspiring being part of a special day of talk and action that took place on Monday.  As I wrap up my work week (condensed into a few busy days after flying back home to Columbus, OH from Boston, MA) I now have the time to reflect a bit on the day.

MomsTeam Institute hosted a summit at Harvard Medical School, “SmartTeams Play Safe™: Protecting the Health & Safety of the Whole Child In Youth Sports By Implementing Best Practices,” and I was honored to be one of the speakers.

I’ve written about MomsTeam, a non-profit organization implementing best practices in youth sport safety, before; but I don’t believe I’ve ever shared with you what a strong band of clinicians and researchers comprise the group.  Monday, many of my fellow speakers formed a veritable ‘Who’s Who’ of sports medicine, and to a person they gave some wonderfully memorable talks:  ranging from Doug Casa speaking broadly about the subject of heat injury prevention in youth sports  to Brian Hainline, the NCAA’s Chief Medical Officer, to Holly Silvers-Granelli who spoke about ACL prevention in female youth athletes, emphasizing neuromuscular training programs (a subject which is central to one of our CJSM podcasts), and Tracey Covassin who spoke about gender differences in concussions.

A particularly poignant moment came when Dr. Hainline had us watch the video from Designed to Move, a “Physical Activity Action Agenda.”   Read more of this post

Bruce S. Miller M.D., M.S. guests on “5 questions with CJSM”

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“The Big House”: the stadium
where Michigan plays, site of
this week’s game with OSU

Thanksgiving Day is near and, on a personal note, my twin children celebrate their tenth birthday this week. But here in Columbus, all celebrations fade in the face of “Hate Week.”

No it’s not something out of Orwell’s 1984.  It’s what my fellow citizens of this fair city call this week when their beloved Ohio State Buckeyes (OSU) play their northern rivals, the Michigan Wolverines (U of M), in their annual college football game.  It’s one of the oldest rivalries in the sport.

Having grown up in Grand Rapids, Michigan, with family members and multiple friends all attending the University of Michigan, I’m something of a Judas here in Columbus.  My paycheck comes from OSU and I even received my MPH from the school, but in the words of the Beatles, those things “Can’t Buy Me Love.” My sporting allegiances will stay maize and blue regardless of the fact that I will surrounded by a sea of scarlet and grey (and hatred) this week.

I thought it high time then to track down one of my dearest friends and have him answer ‘5 questions with CJSM.’  I need help from a fellow supporter of the Wolverines.

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Dr. Bruce Miller with son Cameron at
youth hockey game.
Sporting the Maize and Blue!

Dr. Bruce Miller is an Associate Professor in the Department of Orthopaedics at the University of Michigan, and is a Team Physician for the U of M football team as well as USA Rugby. He publishes regularly, with a particular focus on rotator cuff pathology.  His accomplishments are legion (including being an All-American in rugby when he was in college), but I know him best as the man with whom I studied helminths back in medical school.  From worms to one of the premier positions in sports medicine, my how far he has come.

Here is what he had to say in answer to the questions we posed him:

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1) CJSM:  You are a busy orthopaedic surgeon and team physician, how did you get involved in clinical research?

At the beginning of my academic career, I was doing more basic science research, primarily focusing on articular cartilage and some biomechanical interests. However, I soon learned that the world of basic science can be quite “competitive”, especially in terms of securing funding. I recognized that as a busy clinician, I was at a competitive disadvantage in competing with full-time scientists. In addition, I enjoyed following my patients functional outcomes after surgery. I eventually came to the realization that I could be more successful in pursuing clinical research in the sense that my established clinical practice could serve as my “laboratory” . . . I simply needed to acquire some new research skills. I was fortunate that the University of Michigan School of Public Health offered a Masters program for clinicians, which allowed me to gain a new skill set while allowing me to continue with my clinical practice. I attended classes four days every month for roughly 18 months, and ultimately earned a Masters Degree in Clinical Research Design and Statistical Analysis. Through this program I gained a valuable skill set that allowed me to launch a successful clinical research program. Read more of this post

Return to Play Decisions

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Though a beautiful time of year, fall is not
the most idyllic for a sports medicine clinician

Like many of the readers out there, my colleagues and I are deep in a football season, where we are managing various teams and their mounting injuries.  For a sports medicine physician, fall in America must be a bit like early spring for an accountant (tax day = April 15):  it’s the time to buckle down and crank through patients, the time, from a certain perspective, to see the volume of patients that will sustain the business through leaner times of the year.

When I’m out of the clinic and on the sidelines, I’m also doing one of the parts of my job that is the most fun, and I’m sure my colleagues out in the blog sphere will agree.  But I wouldn’t describe the work as an idyll.  I can be enjoying my team’s performance, and then called in three directions at once, treating players and making decisions on whether they can get back into the game:  decisions that can have significant consequences for the player and the team.

I thought I would write somewhat extemporaneously today, and in sharing some of the more interesting cases I have seen of late think in a more structured way about how we primary care sports medicine physicians make return to play (RTP) decisions.

RTP decisions make the headlines all the time.  In the professional leagues of North American sports, in just the last two weeks, we have seen discussions about Kobe Bryant’s return to the NBA from late spring Achilles tendon surgery; Rob Grownkowski’s ‘delayed’ return from a surgically treated forearm fracture; the much anticipated return of Derrick Rose more than a year after his ACL reconstruction; debate over RGIII and whether he has come back too soon from his own multi-ligamentous knee injury…….the list goes on!

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The end of a season?

In my own practice, I have been trying to return players back to American football while they have recovered from a kidney contusion, a posterior elbow dislocation, a complete rupture of the ulnar collateral ligament, and a demyelination injury of the axillary nerve.  Of the four, two are back playing; the elbow dislocation is still rehabbing, and i hope to return in a hinged knee brace before the end of the year; and the axillary nerve injury continues to have pain and profound weakness of his deltoid, and his recovery will extend beyond the end of this season (much to the coach’s dismay).

Despite being one of the more important aspects of our job, there is very little in the way of evidence-based medicine to guide a clinician in these decisions. Read more of this post