The Women’s Orthopaedic Initiative at Beth Israel Deaconess Medical Center has a simple mission: to keep women of all ages active in whatever capacity they choose. As a sports physician I often think in terms of sports analogies and the Women’s Orthopaedic Center is similar to a sports team. The players, each with their individual strengths and skills, work collaboratively to deliver the best and most comprehensive care. We are fortunate to have an incredible team including but not limited to women’s specific primary care, operative and non-operative musculoskeletal medicine, obstetrics, gynecology, endocrinology, physical therapy, psychology, and nutrition.
While sports medicine injuries are rarely associated with increased mortality, their morbidity can be detrimental to a woman’s overall health. Athletes exercise for a variety of reasons including stress reduction, cardiovascular health, social interactions, etc. Studies have shown that injured athletes are at increased risk of depression, anxiety, and even a loss of identity. You do not have to be a professional athlete to succumb to this. You can be an avid walker, gardener, recreational runner, or dancer.
The Women’s Center takes into account women’s unique form, function, physiology, and injury patterns. Puberty heralds these changes in anatomic alignment, movement patterns, strength, and flexibility. Taking care of a woman through her lifespan requires a comprehensive approach as there can many variables at play. Communication is key within the team.
Athletes who participate in sports that emphasize leanness are at risk for female athlete triad. These sports include distance running, dance, gymnastics, figure skating, and light weight rowing. The female athlete triad is an interrelated spectrum of disorders that may not all be present at the same time. The components include decreased energy availability due to disordered eating (this can run the gamut from inadvertently not meeting the body’s energy requirements to restrictive eating patterns to eating disorders like anorexia). This indirectly decreases bone density by causing irregular menstrual cycles and directly decreases bone density by metabolic hormones and insufficient nutrients. These athletes are at risk of stress fractures, poor healing, infertility, and mood disorders.
Pregnant athletes are increasing in numbers. Women can safely continue with their pre-pregnancy activities with modifications. The postpartum period can be a trying time for both new and seasoned mothers. However, there are safe and effective ways to keep women in the peripartum period active! We have women’s specific physical therapists versed in sports rehabilitation and pelvic floor dysfunction. Women don’t have to accept urinary incontinence going for a five mile run or doing their box jumps!
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Another aspect of the center is trying to prevent further injuries by addressing modifiable risk factors. Many injures fortunately do not require surgery but do benefit from skilled sports rehabilitation. Physical therapy is medication! And having a skilled therapist well versed in women is fundamental in terms of treatment but also prevention.
I came into this profession having suffered my own share of injuries as a dancer and runner. I am amazed by the strength and capabilities of the female body. Fortunately I am surrounded by like-minded healthcare professionals at the BIDMC. We are determined to keep women moving at whatever stage they may be in their life and help them meet their goals.
