Boston Sports Medicine and Performance Group, LLC Blog

The Future Of Sports Medicine Must Mirror Dentistry

Posted by Boston Sports Medicine and Performance Group on Mon, Oct 18, 2010 @ 08:10 AM

everything basketball

There are certain things you just have to do each day – brushing your teeth is one of them.

I first heard the analogy from an old friend of mine when discussing implementing an ACL prevention program with our soccer team and the struggles to keep the coaches on it once the season started,

“You wouldn’t brush your teeth everyday for six months and then stop for six months would you?”

Dentistry has is right.

Not just the brushing every day part, (although clearly important) but their whole approach.

You probably don’t even remember your first visit to the dentist do you?  That’s my point.  Dentists get you right from the get-go. You’re evaluated, x-rayed for a baseline to compare future visits to, you get picked at, poked and prodded and then they finish your visit with a cleaning, rinse and some fresh minty breath.

If you have good insurance you get to go back twice a year – Shoot, sometimes you go in and you don’t have any tooth pain at all. But isn’t this the point?

If the dentist finds tarter build up – BAM that little hook comes in and blasts that gunk right out of there.  No use in letting that sit until it causes a cavity – your dentist wouldn’t be doing their job if they did. 

Yet, many times (I really mean all the time) in sports medicine we see athletes and patients with poor movement patterns, dysfunctional squats, steps and lunges and we do nothing.

We wait.

Their knee doesn’t hurt yet.

No need to take a look.  No baseline assessment. No poking. No prodding.

Once in a while an athlete or patient comes in on the advice from a friend – they have back pain.

“No problem. I’ll help – let’s just get some ice and e-stim on that, there, that should do the trick.  See you tomorrow.”

If you went to a dentist and you had a tooth ache and they rubbed some Novocain on your gum and told you to come back the next day to do it again you’d soon find another dentist to go to. One that addressed the problem and not just the symptom, and one then that gave you some advice on how to avoid future problems.

Dentists do it right – Baseline Evaluation, Regular On-Going Assessment, Treatment/Maintenance  and Education.

I remember when I was a child brushing my teeth three times a day and then if on the rare occasion I was allowed to have some ice cream or candy my mother would make me do it again!

33 years later not a single cavity.

I wish I could say the same for my back pain.


Art Horne is the Coordinator of Care and Strength & Conditioning Coach for the Men’s Basketball Team at Northeastern University, Boston MA.  He can be reached at

Topics: Art Horne, Health & Wellness, basketball performance, basketball training programs, boston hockey summit, Strength & Conditioning, basketball videos, orthopedic assessment, everything basketball

Work for the Job you Want

Posted by Boston Sports Medicine and Performance Group on Thu, Jul 15, 2010 @ 14:07 PM

Several years ago when I first started working for my current employer, I was dealing with clients and colleagues that were significantly older than myself and I encountered a problem wherein I was not being taken seriously.  I came to the conclusion that while perhaps part of the problem was in my youthful appearance (no longer a problem unfortunately), part of the solution lay in making my work attire more professional.  As I work in recreation, even describing our dress code as "business casual" would be a stretch.  I improved my appearance and my problem went away.  Did I get some of my coworkers ribbing me because I was "overdressed"?  Sure, but they also used to give me a hard time for getting to work an hour before them every day.  I wonder where that insecurity comes from?

Somebody much smarter than myself once said, "Dress for the job you want, not the job you have."  Maybe it's not practical for you to wear a suit to work, but that saying is an excellent metaphor for all aspects of your job performance.    Doing the bare minimum that is expected of you in any situation is never going to put you ahead of the curve.  Do most of your coworkers arrive at work just at their expected start time?  Do they have their bags packed when that imaginary whistle blows at the end of the day?  Do you hear people say things like, "That's not in my job description?"  These are all areas in which people are meeting only their minimum expectations and also easy opportunities for you to distinguish yourself.  When it comes time for that open position to be filled or when another prospective employer comes calling for a reference, these are the types of things that your boss will remember.  Well, that and the excellent work you do anyway right?  

So let's revise our saying . . . Work for the job you want, not the job you have.

Shaun Bossio is the Assistant Business Manager and ProShop Manager at Boston University FitRec.
He can be reached at

Topics: Strength Training, boston hockey conference, hockey videos, orthopedic risk factors, orthopedic assessment, performance testing

Risk Factors and When to Refer

Posted by Boston Sports Medicine and Performance Group on Wed, Jul 14, 2010 @ 20:07 PM

If your grandfather (first risk factor) walks into his primary care physician for his annual physical and presents with elevated insulin levels (second risk factor), low HDL cholesterol (third risk factor), and abdominal obesity (fourth risk factor), chances are that he’ll be suffering from insulin resistance pretty soon.

Just having one of these risk factors alone doesn’t necessarily predict future disaster. But put them all together and mix them up?  Well, you have a nice recipe for some serious problems.  Assessing multiple risk factors and contributing their sum towards an end pathology or disease is common in all fields of medicine.  Another example would be the patient with elevated LDL cholesterol, high blood pressure, and insulin resistance.  Mix these all up and I’m pretty sure you’ll be tipping the scales with obesity soon.  And yet another set of risk factors predicts hypertension and so forth.

In Sports Medicine and orthopedic screening, this concept has been lost.  Let me elaborate.

So, a tight achilles with a loss of dorsiflexion compared bilaterally without pain by itself surely never deserves a referral to an orthopedic doctor? Neither does a weak right glut medius muscle, a single leg hop discrepancy left to right, right knee valgus collapse during an overhead squat, and of course a tight right psoas muscle from sitting all day surely doesn’t deserve orthopedic referrals when observed by themselves.  I mean, your athlete can run and jump just fine, right?

Again, all of these by themselves do not deserve a referral, but all of these combined certainly spell future knee pain or other pending disaster, agreed?  Yet, we usually don’t do anything until the knee hurts, or worse, when the athlete hobbles in on crutches after tearing up their knee.

Why are we waiting until an athlete’s season is over to address contributing risk factors?

For example, we measure blood pressure and refer immediately after obtaining an abnormally high reading, but did the heart initially hurt?

What gives?


*Suggested Reading and Inspiration provided by: Why Zebra’s don’t get Ulcers by Robert M. Sapolsky


Art Horne is the Coordinator of Care and Strength & Conditioning Coach for the Men’s Basketball Team at Northeastern University, Boston MA.  He can be reached at

Topics: athletic training, orthopedic risk factors, orthopedic assessment, pre-participation screening, pre-participation assessment