Q&A Topic: Acute Sports Injuries
George Zambetti, MD
Q. How did you get interested in acute sports injury medicine?
A. I was a basketball player at Fordham University—we made it to the Sweet 16 when I was a junior—and I’ve been involved with college and high school athletics ever since. I’ve been honored to serve as the team physician for Fordham University for 35 years, and I also assist with numerous high school athletics programs at Fordham Prep, Mt. St. Michael, Cardinal Hayes, Xavier and elsewhere. So my passion for sports medicine runs deep. I’ve been doing this work for so long that I’m now taking care of the children of players I once cared for.
Q. What sends people to your office most often?
A. I focus a lot on knee problems, so the two most common injuries I see are chondromalacia patella (a.k.a. “runner’s knee”)—which involves damage to the cartilage under the kneecap—and meniscus tears—which are typically caused by twisting injuries of the knee. For instance, if you plant a foot awkwardly while hitting a tennis ball or come off a basketball jump wrong, the torqueing action can tear the meniscus.
We also see tears to the anterior cruciate ligament—the ACL—which are more complicated but fortunately less common. A meniscus tear can often be repaired or resected simply with an orthoscopic procedure. ACL reconstruction is a complex art and science unto itself.
Q. Are we making any progress on treating ACL injuries?
A. At NewYork-Presbyterian Lawrence Hospital, the Columbia sports medicine team is now repairing ACL’s with a modern variation on a procedure I learned as a young man in the 1980s. After the introduction of arthroscopic ACL reconstructions, a primary repair of the ACL through an open incision was considered too difficult and largely abandoned. Now we have developed arthroscopic instruments that are up to the task. In this less invasive approach, we keep the patients’ tissue and no longer need to make new ligaments from allografts or grafts from other parts of the body. The results we’re achieving for patients with this technique are very exciting.
Q. How can athletes avoid injury?
A. Overuse syndromes are a big problem. Many athletes will persist with a singular training method—and fail to cross-train or do enough core strengthening. Runners, for instance, may run as their sole activity, and this repetitive action can stress the joints. Stretching is not enough. It’s okay to do, performed properly, but it’s not the end-all-be-all of injury prevention. Classic treatments like RICE—Rest Ice Compression Elevation—are still quite effective for most basic injuries. Obviously, if an injury persists or if there’s an acute problem, see a doctor.
Q. Can you discuss promising new technology or techniques in the field?
A. New gait training studies are interesting! We actually have a running lab where people with running issues can be evaluated in tremendous detail. The tests examine what your gait looks like and suggest personalized training methods. The Columbia team at NewYork-Presbyterian Lawrence Hospital includes excellent primary care orthopedists who can treat most sports injuries in a conservative and sophisticated manner, without resorting to surgery. Thanks to gait and running analyses—as well as new modalities—we get to know our patients better, and we get them back on track more efficiently with this personalized approach.
NewYork-Presbyterian Lawrence Hospital
One Pondfield Road, 1st Floor
Bronxville, NY 10708