Medical Clinic Scores High With Youthful Athletes

Richard Hill was a little worried the other day as he glanced at his daughter, Rochelle, 15, and said: “She has a soreness in her left knee. I’m interested in what they’ll find here.”

“Here” was the Youth Sports Medicine Screening Clinic at Orthopaedic Hospital. Once a year at the clinic, high school and junior high school athletes get a top-notch physical exam at a rock-bottom price.

Pain Under Kneecap

What doctors found in Rochelle Hill’s case was chondromalacia, a roughening of the underside of the kneecap that causes pain by irritating nerve endings when the leg is moved.

Rochelle, a starting guard on Pasadena High School’s junior varsity girls’ basketball team, returned to Orthopaedic Hospital the next day and saw a doctor who recommended a fitness program.

“I’m glad I went down there,” Rochelle said. “I think they’ll help me with my problem. I’ve been able to play, but my knee has been swollen and that’s made it hard. I think I’ll be able to play more because of the screening clinic.”

All told, 119 young athletes got physical exams for $5 each at the annual clinic.

More Pressing Problems

Among the more pressing problems revealed by the exams were a back problem, a knee problem (besides Rochelle Hill’s), two abnormal heart rhythms and a heart murmur. The patients with those problems were referred either to their family physicians, specialists or Orthopaedic Hospital’s Youth Sports Medicine Clinic.

For their $5 the youths--who came from as far away as Edwards Air Force Base--got examinations that covered areas ranging from height and weight to dental needs, vision to flexibility and general health.

Hospital administrator Carol Russell, a nurse with a master’s degree in business administration, organized nurses, staff and volunteer physicians to run the program.

It was, in the words of one examining physician, the kind of routine that would cost “well over $100” at a private doctor’s office.

Officials at Orthopaedic Hospital said their sports screening clinic is the only one like it in Los Angeles. Similar clinics exist on a larger scale in a few other places--notably New York City, Phoenix and Columbus, Ga.--and they are conducted on a smaller scale in a number of other cities.

Traditionally, however, young athletes get medical clearance to play on school teams from their personal physicians or through examinations conducted at their schools.

Many public schools offer free exams for their athletes. But, as Monrovia High School coach Gretchen Esparza put it: “when they get physicals done at school, they just check to see if they can breathe.”

Jose de la Cruz Jr. agreed. The 10th-grader from Panorama City said his exam at the screening clinic was “more thorough than my own doctor, much more thorough.”

And Dr. Sonny Cobble, the physician responsible for getting the screening clinic started last year and a man given to colorful phraseology, added: “We at Orthopaedic Hospital felt that the kids weren’t screened tightly (at their schools). Sometimes it was, ‘Can you hear thunder? Can you see lightning? Breathe on this mirror. You’re OK, boy!’ ”

In fact, added Cobble, “OK” is a conservative diagnosis for the majority of the young athletes seen in the screening clinic. “Most of these kids are almost kinesthetic geniuses,” he said. “Their bodies will do things that yours and mine couldn’t come close to doing.”

But some of the boys and girls are not OK, as Orthopaedic’s screening proved.

And, even where only relatively minor physical problems came to light, the clinic offered hands-on advice about how to avoid exacerbating such problems.

Inadequate Stretching

For example, many football players and sprinters have tight hamstring and calf muscles. They are at an age when bones grow fast and muscle is developing, but often they are not stretching adequately. That situation can lead to painful pulled muscles that reduce running speed, create vulnerability to chondromalacia and inhibit performance.

A case in point: Robert Tamayo, 15, a 6-foot-4-inch sophomore at Arroyo High School in El Monte who grew 3 1/2 inches in the past year. After his examination, Tamayo was given specific exercises during a one-on-one counseling session with Mario Polanco, one of several physical therapists at the screening clinic. If the young basketball and baseball player chooses not to follow the exercise program Polanco showed him, “there’s a probable chance he’ll hurt his hamstring or calf muscle due to the fact his muscles are very tight,” the therapist said.

Besides tight calf and hamstring muscles, the most common minor problems revealed at the clinic were postural ones, like rounded shoulders, swaybacks and slumping, said physical therapist Angela Moore.

Cobble spent the day talking with athletes as they completed their screenings. For each youth, the physician signed a form stating whether the athlete qualified for sports participation, recommended specific steps for improving performance and cited problems that needed further evaluation.

The doctor told each athlete in which of five sports classifications he or she was medically qualified to participate. Classification I included virtually every sport from football to riflery. Classification II eliminated major contact sports such as football and wrestling. The third classification covered non-contact sports such as cross-country running and swimming. Classification IV included “moderately strenuous” sports such as baseball and golf. The last classification was composed of archery, bowling and riflery.

Cobble set his youthful patients at ease with a manner both relaxed and authoritative. A balding man with a small paunch despite his excellent physical condition, the 46-year-old physician is widely known and admired for the time and knowledge he contributes to public-health projects, particularly in the area of sports medicine.

“I’m interested in health, I’m interested in well being and I’m interested in fitness. So I go around serving as a bad example,” he said wryly.

Avoids Medical Jargon

Cobble speaks slowly and avoids slipping into medical jargon. Occasionally, when he doesn’t understand a question or comment, he counters with one of his favorite phrases, “Say what?”

A “Say what?” drew a quizzical smile from one parent, but the young athletes listened closely.

“You’re getting on toward maturity,” Cobble told a 16-year-old football player at the conclusion of his screening, “and like a lot of guys, you’re working your shoulder muscles and leg muscles, but not your belly muscles. You should do more sit-ups. There are eight kinds of sit-ups. Just pick the kind that turns you on.”

To another 16-year-old with an ankle problem: “Wear high tops and run a lot of patterns. If it hurts, let your coach or family know about it because, if it hurts, the joint is trying to tell you something.”

“Remember,” he told a 15-year-old girl, “if you have any questions we’re here every Monday morning.” Cobble was referring to the Youth Sports Medicine Clinic, which he co-directs. The weekly clinic is free to anyone under 21.

The athletes interviewed at the end of the screening said they had gained from the experience.

As David Castaneda, 17, a shot putter from Los Angeles, and one of 34 Salesian High School athletes at the screening, said:

“I’ll stretch more and I’ll even brush my teeth more often, because 20 or 30 years from now if I don’t, I’ll be messed up. People here (at Orthopaedic Hospital) make you know how you should take care of yourself.”