Scoring a Touchdown for Health

In recent years, several student-athletes from across Los Angeles County have died while participating in sports. In some cases, parents were previously unaware that their children had life-threatening physical ailments.

Orthopaedic Hospital and Kerlan-Jobs Orthopaedic Clinic launched Team HEAL (Helping Enrich Athletes’ Lives), a public-private partnership, to fill the void for many inner-city student-athletes who often have limited or no health insurance. Leading the program are orthopedists Clarence Shields Jr. and Ralph A. Gambardella.

Through fund-raisers, Team HEAL provides comprehensive athletic training and medical support to student-athletes at four urban high schools, including an on-site trainer and a fully equipped weight room.

On a recent Saturday morning at Orthopaedic Hospital, 14 volunteer doctors provided internal and orthopaedic evaluations, free of charge, to about 300 athletes from area schools.

MARY REESE BOYKIN spoke with one of the program’s doctors about the importance of pre-screening examinations and the goals of Team HEAL.

CLARENCE SHIELDS Jr.

Orthopaedic doctor

At Team HEAL, we provide athletes in the inner city the care that professional athletes or children who have financial resources are able to get. From my prior experience in taking care of the Rams, I know that there are a lot of problems that, if you don’t look for them, you won’t find them. Just like most of us wouldn’t go on a road trip from Los Angeles to New York without having our car tuned up, Team HEAL makes sure that athletes do not enter their season without a thorough internal and orthopaedic evaluation.

For many of these athletes, it is the first time that they have had a thorough physical examination. While LAUSD requires student-athletes to submit proof of a physical examination signed by a doctor, what happens for many athletes in the inner city is that they pay $10 at a walk-in clinic and have the forms filled out by a physician’s assistant. They never even see a doctor.

A lot of children can have some chronic, undiagnosed condition, and participation in sports can be hazardous to their health. Some of these young people have great athletic potential; in fact, athletics is a vehicle for them to get a college education. But if they have an orthopaedic injury that is not properly diagnosed, their careers may be over before they start.

Though you can’t prevent everything from occurring, the goal is to diagnose and treat a medical condition before it becomes a catastrophe. And in our recent medical evaluations of student-athletes from Crenshaw, Dorsey, Manual Arts and Washington Prep high schools, we detected medical conditions that the students were unaware of--heart murmurs and irregular heartbeats, scoliosis, shoulder joint conditions, unstable knee ligaments, ruptured eardrums and anterior cruciate ligament damage (a knee injury that requires surgery and months of rehabilitation). These athletes did not get medical approval for sports participation. They were referred to specialists for further evaluations.

In our evaluations of athletes, we have them jump 25 times. This is a mild test to check their heart’s cardiac reserve. Essentially, when you exercise, your heart rate should speed up because your body needs to have more blood pumped to the muscles. After you stop exercising, it should go back down. If your heart rate stays up, that’s an indication that there may be a problem. This test brings out any major problems.

We give students urine tests for diabetes, bladder infection or blood in the urine, conditions that otherwise would be undetected.

We check students’ vision, teeth and ears. There were a couple of children who had ruptured eardrums. They were referred to an ear, nose and throat specialist because there can be permanent hearing loss with a hole in the eardrum.

There is a hernia exam too. Athletes can have a hernia, which is a weakness in the stomach wall, the muscle wall, where an intestine can get in there and get caught.

We check their heart and blood pressure. Football players, in particular, may have elevated blood pressure because many of them have been told that they should weigh a certain amount. Sometimes, they put on a lot of fat, causing a higher chance of having high blood pressure than there would be if it were muscle that they put on.

Orthopaedically, I check the athlete’s spine. That’s how we picked up on scoliosis, curvature of the spine. Sometimes with football players, particularly, there is a shoulder joint that is too loose or that partially comes out of the socket. Three athletes had this condition.

I also check for unstable knee ligaments. Two athletes had such damage. Two others possibly had some torn cartilage in their knees. One had a damaged ligament, an injury more prevalent in girl basketball players than in boys. But, again, none of these athletes were aware of their medical conditions until the examination.

So more than merely providing a medical examination at the beginning of the school year, our goal at Team HEAL is early diagnosis, proper treatment and rehabilitation. We want to provide a model like I had when I took care of the Rams. We had a full-time trainer for the team. Through fund-raisers, Team HEAL has a full-time trainer at Dorsey and Crenshaw. A trainer for Manual Arts will be hired for the 1999-2000 school year. Just as the Rams had a fully-equipped weight room, Crenshaw and Dorsey now have fully equipped weight rooms. Ultimately, Team HEAL would like to expand our program to all schools in the inner city.

Last year, Team HEAL took care of about 1,200 injuries of Dorsey and Crenshaw athletes. Many were minor injuries--sprained ankles, broken fingers. But 20 athletes needed surgery. If the athletes had private insurance or an HMO, they were referred to them for their surgery. They received rehabilitation through Team HEAL on their campus. If they had no insurance, they were enrolled in Medicaid, and I performed the surgery at Orthopaedic Hospital. Our next goal at Team HEAL is to seek corporate sponsors so that we can provide quality, low-cost insurance for uninsured students.

The children are our future. Everybody at some point in their lives needs assistance from somebody. If I can make a difference with one or two children, I think it would have been worthwhile. This program fills a void, and we have to give things back to our community. If we don’t do that, I think we’re doomed. We have to find someone to replace us, so maybe I’m selfish and I want to find some youngster who is going to give something back when he or she has reached a certain point in life.