By Michele Gillis

Imagine two sports players running into each other and falling to the ground. A hush falls over the crowd while a loud “crack” reverberates in the air.

Members of the Sports Medicine team at WVU Medicine Wheeling Hospital & Reynolds Memorial Hospital are already deployed and ready to get to work to get the player back on the field.

Getting patients back on the field quickly, but safely is the main focus of the Sports Medicine and Physical Therapy team at Wheeling Hospital.

Wheeling Hospital Sports Medicine and Physical Therapy program cares for athletes of all sports and all ages from weekend warriors to competitive high school, college and professional athletes. Their goal is to help every patient get back to their highest level of activity possible whether that means returning to the gym or reporting for practice.

“Each athlete is an individual,” said Dr. Ron Sismondo, an Orthopedic Sports Medicine surgeon for Wheeling and the team physician for the Wheeling Miners. “Once a player is injured, I am their physician and that is a very important thing. Everybody has different values. Their goals are different from what they want to get back to, so it is really good to have that conversation with the patient to figure out what they are looking to achieve and how we can best get them there.”

Wheeling Hospital’s Sports Medicine Team covers seven area high schools, several colleges and two professional sports teams, the Wheeling Nailers, a professional ice hockey team and the Wheeling Miners, a professional indoor football league.

“There is a certain approach we take to an athletic injury,” said Dr. Mike Meyers, Orthopedic Sports Medicine surgeon at Reynolds and team physician for the Wheeling Nailers. “It almost always starts with the athletic trainer. So all of these high schools, colleges, all of the underlying entities that we cover from a sports perspective have an athletic trainer. An athletic trainer is basically our eyes, ears and hands when we’re not around the practice areas and not covering the day-to-day injuries.”

Members from the Sports Medicine Team from Wheeling and Reynolds cover the games, so they can be there in case anything happens.

“As soon as we know what’s going on, the better chance we have of being able to get them back quicker or figure out how we need to go forward,” said Sismondo. “A lot of it is just information gathering.”

From a team approach, the athletic trainer lets the doctors know something is going on and they bring it to their attention. Once the athletic trainer hands the player off to the physician, they determine if an X-ray or MRI is needed and the next steps. Then they decide if the injury is surgical or not. If it is, they would see an orthopedic surgeon for surgery and if it isn’t, they will go a different route to promote healing, such as physical therapy.

“So we dive into the imaging,” said Meyers. “So as a sports medicine solution, we usually have advanced images for our team. We get them in the MRI scanner quicker than say someone who’s not an athletic-based injury. Sometimes we can get same day MRI scans. Sometimes we get them into physical therapy on the same day. These are just to speed up their return to sports medicine.”

For professional players, their injury treatment is covered under Worker’s Compensation if they are injured on the field. But, Meyers said for athletes injured in high school or college, the student usually has to wait to get imaging approved by insurance before they can move forward.

“Those are all different variables that we have to look at as sports team’s physicians,” said Meyers. “But we have a team that manages the imaging, we have a team for physical therapy, we have a team for post-operative recovery, so all of that’s shared.” There is a whole other team that help the patient recover and get back to playing sports.

Sismondo explained some of the common injuries that he works on in his role.

“I do everything from ACLs and meniscus surgery to patellar instability surgery,” said Sismondo. “I do most things around the knee, even more advanced cartilage work and osteotomies and all of that falls within my purview. I also do throwing shoulders and elbows as well as shoulder instability, shoulder dislocation labor repairs and boning procedures around the shoulder if need be. I do Tommy John surgeries. So ulnar collateral ligament (UCL) surgeries, like you hear guys in baseball pitchers getting a good bit, so I do that to rebuild that ulnar collateral ligament of the elbow. I do various things. It’s just kind of the majority of what I end up doing just by the nature of most injuries ends up being knee and shoulder. I’ll take care of our athletes for just about anything.”

Sismondo said that no matter if he is seeing a hard-core athlete or an older per-son with knee pain, his goal is to them back to the highest possible level of function that he can.

Having an injury treated properly and given time to heal will help with the longevity of an athlete’s career.

“Some of that’s injury-specific,” said Meyers, who is the first Sports Medicine Fellow-ship-trained surgeon in the valley. “So, some injuries have problems that will catch up to you later in life and that’s our job is to disclose those and either fix them before they become an issue or at least educate them to say, if you play with this, this could be a long-term problem. So, part of our job is to look out for them. Not only for the acute injury but also to explain the chronicity of what could occur from this injury. So my day-to-day is just educating the patient. This is what’s wrong, this is how we fix it, these are the risks and the benefits of the fix and this is what could catch up to you later. How does that sound based on your overall plan for your career?”

Meyers said he and Sismondo are trying to develop a program specifically for athletics, and they are hiring some primary care sports doctors.

“All of that is to focus around the athlete,” said Meyers. “So that’s our main goal, to develop that program and to ease the athletic care and the overall surrounding tri-county. So now we’re expanding a lot of sports medicine services that we had locally at Reynolds to Wheeling so that we can grow the practice of sports medicine locally.”

As far as the longevity of their careers, it can be largely injury-dependent. Sismondo agreed that discussing with the student their goals and what is going on in their life is also important when coming up with a treatment plan.

“If it’s something as substantial as something like an ACL tear, we’re looking to reconstruct that ligament, stabilize the knee, and allow them to get back to the sport,” said Sismondo. “Without that, it’d be difficult for them to be able to continue. I think not only their career is important, especially when you’re dealing with a lot of young athletes, but also what is going on in their life.”

Sismondo said that even though sports are really important, most of these young athletes, aren’t going to be professional athletes at the end of the day.

“But we have to make sure that we’re looking out for them in the long term,” said Sismondo. “If that means taking some extra time to make sure we do things right and fix things the way they need to be fixed for them in the long term, that’s important. I think it’s important to keep that perspective. Not that you don’t try to get them back out there as soon as you can, but you’ve got to make sure that you get them back out there safely. And that’s a huge part of it.”

The final part of getting patients back out there is physical therapy whether that is right after the injury or after surgery.

Curtis Neel, manager of Physical Therapy at Wheeling Hospital said that it is important for those in the sports population to have physical therapy after an injury so they can recover quicker and get back to full participation.

“The other component is they really need to make sure that they are back to a level that, in terms of their function that they’re able to go back to participation without re-injury, which is always a big concern,” said Neel. “So rehabilitation after injuries is important in that regard.”

Neel said the physical therapy facility at Wheeling Hospital has state-of-the art equipment and physical therapist with many years of experience to help athletes get back to their best self.

“We have great communication with our physicians in-house because we’re all part of the same group,” said Neel. “We all work together hand-in-hand, so that’s a big plus from the sports medicine side, especially when we’re talking about trying to get athletes back to participation quickly. It’s important to have a whole team concept where you have the physicians and the therapists and athletic trainers all on the same page, all working for the same organization because it just makes things go so much more quickly and smoothly.”

The physical therapy department at Wheeling Hospital has a very experienced staff, and several of those people are not only therapists but also athletic trainers.

When discussing injuries in sports, concussions are something that also affects many athletes.

Neel said they do IMPACT testing, which is a neurocognitive test that they have been doing since the early 90s.

‘We go out to the schools, the high schools and middle schools, and do what we call baseline testing of their brain function,” said Neel.

The baseline testing is used after a patient gets a concussion because you can have them take a test and then compare that to their baseline test results to see if they’re recovering properly and when they’ve fully recovered.

Another interesting modality the Wheeling Physical Therapy department is performing on patients is blood flow therapy.

Neel said blood flow restriction therapy is when they restrict the blood flow to a limb while they exercise it and it allows them to lift weights earlier.

“After they’ve had an ACL surgery they can’t lift heavy weights because they don’t want to put that much stress on the surgery,” said Neel. “So they start to lose a lot of muscle strength very quickly, which makes their recovery time very long. With blood flow restriction therapy, what we can do is have them lift light weights but they get the same benefit as having lifted a heavy weight. So that while they’re in their recovery phase early on, we’re trying to prevent muscle loss by doing the blood flow restriction treatment.”

Neel said it is just a partial restriction, but that it is innovative and helps with healing to get the patients back to their life or sport quickly and efficiently.

After a patient has recovered the Wheeling Sports Medicine team is excited to see them healed and going after their dreams.

“You go to a game and you see them back out there,” said Sismondo. “You know their backstory, you know where they were whenever they were sitting in your office. And you’re giving them what at the time seems like terrible news. And then you go however many months later and you get to see them play. And to me, that’s the greatest thing about this. So I want to be out there. I want to know these guys. I want to be part of that.”

The website states that Sports Medicines physicians at WVU Medicine Wheeling Hospital and Reynolds Memorial Hospital perform complete physical examinations for athletes of all sports and all ages to identify historical or physical factors that may predispose you to injury and to assess your athletic and physical fitness. We also provide guidance on nutrition for sports performance.

Sports and performance injuries are as varied as the range of activities involved, and our specialists offer a complete range of sports medicine treatments. Many problems can be solved using rehabilitation and strengthening exercises. We will teach you proper conditioning and techniques to help you heal and return to the activities you love.

Knee: ACL Tears, Ligament Repairs (PCL, MCL, LCL, PLC), Meniscus Tears, Cartilage Injuries, Patellar Tendon Injuries, Quadriceps Tendon Injuries, Hamstring Injuries. Shoulder: Dislocations/Instability, Labral Tears, Throwing Injuries, Acromioclavicular Joint Separations/Instability (Shoulder Separation), Cartilage Injuries, Biceps Tendon Tears. Elbow: Tennis and Golfer’s Elbow, Ulnar Collateral Ligament Tears (Tommy John), Ligament Tears, Throwing Injuries, Biceps Tendon Tears, Triceps Tendon Tears.

Hip: Labral Tears and Snapping Hip. Foot and Ankle: Achilles Tendon Tears, Ankle Sprains, Syndesmosis Injuries (High Ankle Sprains), Fifth Metatarsal/Jones Fractures, Various Other Sports/Activity Injuries. Hand and Wrist: Wrist and Finger Fractures, Carpal and Cubital Tunnel Syndrome.

According to its website, WVU Medicine Wheeling Hospital and Reynolds Memorial Hospital offers a variety of comprehensive solutions for people with sports and activity-related injuries. We remind patients that there is no need to live in pain, and a simple consultation can provide a wide variety of answers. Physical Therapy is often a high-quality solution for patients, but when surgery is required we have a team of deeply experienced fellowship-trained surgeons that perform a large range of services.

Services they provide include Knee: Knee Arthroscopy, ACL Reconstruction (Including Quadriceps Tendon Graft), Fertilized/Biological Augmented ACL Reconstruction, Ligament Repairs and Reconstruction (PCL, MCL, LCL, PLC), Meniscus Repairs, Meniscus Transplantation, Cartilage Restoration Procedures, Limb Realignment Osteotomies, Patellar Tendon Repairs, Quadriceps Tendon Repairs. Shoulder: Arthroscopic Surgery, Shoulder Stabilization, Labral Repairs, Rotator Cuff Repairs, Acromioclavicular Joint Reconstruction, Cartilage Surgery, Biceps Tendon Surgery. Elbow: Ulnar Collateral Ligament Repairs and Reconstruction (Tommy John Surgery), Ligament Repairs, Elbow Arthroscopy, Biceps Tendon Repairs, Triceps Tendon Repairs. Hip: Hip Arthroscopy and Labral Repairs. Foot and Ankle: Achilles Tendon Repairs, High Ankle Sprain Repairs, Fifth Metatarsal/Jones Fracture Repairs, Ligament Repairs. Hand and Wrist: Wrist and Finger Fracture Repairs, Carpal and Cubital Tunnel Release. Visit WVU Medicine Wheeling Hospital and Reynolds Memorial Hospital for more information.

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