Play Without Pain, Perform at Peak

This month we’re on location at the Horsebarn Hill Sciences Complex in Storrs, talking with the co-directors of the UConn Institute for Sports Medicine. Laurie Devaney, UConn physical therapist and athletic trainer, and Dr. Matt Hall, UConn Health sports medicine physician, explain what they and their colleagues can do for athletes to prevent/reduce injury risk, treat injuries and help them recover, and even use innovative ways to analyze movement to enhance performance.

(July 2021, Laurie Devaney, Dr. Matt Hall, Chris DeFrancesco)


Chris: A big part of sports medicine is injury prevention, but the UConn Institute for Sports Medicine goes beyond that. Today on the Pulse, how science can reduce injury and improve athletic performance.

This is the UConn Health Pulse, a podcast to help you get to know UConn Health and its people a little better, and hopefully leave you with some health information you’ll find useful.

I’m Chris DeFrancesco. Now experts at the UConn Institute for Sports Medicine use science to help athletes reach their peak performance, in addition to preventing and treating injuries. We’re on location today in Storrs to learn more, with Laurie Devaney, physical therapist and athletic trainer, and Dr. Matt Hall, a sports medicine physician who specializes in injury prevention. They’re the co-directors of the UConn Institute for Sports Medicine. Thank you both for your time today.

Laurie Devaney: Thanks, Chris. It’s nice to be here.

Dr. Hall: Thanks for having us.

Chris: We want to talk a little bit, well, first of all, we’re on location. This is kind of exciting for the podcast. We’re at the Horsebarn Hill Sciences Complex, and I’ve been an undergrad here, it was quite a while ago, and I don’t think I’ve ever been back here before. So we have the UConn Health orthopedics practice. Dr. Hall, you and I have had several conversations in the realm of that relationship. So there’s a sports medicine program in Farmington. We’re here in Storrs at the UConn Institute for Sports Medicine, so let’s first talk about a little bit of what distinguishes one from the other.

Dr. Hall: Sure. So, you know, in the orthopedic department, we have a great program. We have a lot of different providers, sports, non-sports, orthopedic providers. Myself, I’m a family medicine sports provider, so I do a lot of non-operative orthopedics, through the office here in Storrs Center, and, my partner, Cory Edgar, is also out here as an orthopedic surgeon and a sports medicine provider. And because we’re out here in Storrs, over time we’ve developed more relationships, particularly with a lot of the people in the undergraduate institution through kinesiology like Laurie. The difference really is that this is trying to develop more of a collaboration and kind of, I don’t want to say break down walls, but really start to bring together the power of the full university, so UConn Health and UConn, that’s why it’s the UConn Institute for Sports Medicine, and try to take advantage of a lot of the other things that are kind of already being done, whether it’s research, whether it’s education, and starting to try to bring all of those things together, I think to harness the power of the things we’re doing at UConn that are sports medicine related.

Chris: Excellent. Now, Laurie, your physical therapist and athletic trainer, Dr. Hall is a sports medicine physician. Who else is on your team, like who’s here and what does everyone do?

Laurie Devaney: We have a number of people. We have graduate students working with us. We have physical therapy and athletic training faculty. We also have exercise, physiologists, exercise scientists working with us. We also have available to us, other clinicians that we might pull in, people, for instance, in dietetics and nutrition or mental health, to help us address the ramifications that go beyond just musculoskeletal injury when it comes to these kinds of athletes, sport safety, and sport injury types of things.

Chris: We’re in a room right now, which I believe you call the running clinic.

Laurie Devaney: Yes.

Chris: Tell us a little bit about what’s happening here.

Laurie Devaney: Sure. The running clinic is pretty exciting for us. It’s something that, I’ve always wanted to have some type of a movement analysis lab that combines kind of a traditional clinical exam. So in the running and injury clinic, we actually have the ability to look at movement all the way from just a simple video analysis to kind of the high-tech three-dimensional biomechanical analysis that allows us to look at joint angles, allows us to look at forces on the body. And we use that information coupled with a traditional kind of clinical exam that you would get if you went to a physical therapy clinic, or if you went to your physician, to try to look at performance and also to try to rehabilitate people when they have an injury. So we might be able to identify, say in a runner, something about the way they move and how that actually impacts their shin pain, their knee pain, their hip pain, and then use that to improve both their health and their performance.

Chris: Now we’re looking at what appears to me to be some kind of a treadmill behind you. And it looks like some kind of a camera over here. You’ve got some computers and some other things set up. Now I have this vision in my head of when they make these sports video games, they put like these probes, or some kind of electrodes or something, on an athlete and they mimic his movements and they somehow capture it. That’s what’s coming to mind when I see your set up here, are you looking to actually measure people’s gait and kind of how they do their different things, and figure out ways that may either maybe identify how they move that could potentially be problematic from an injury standpoint and/or enhance how they perform?

Laurie Devaney: Yes, and that’s exactly it, Chris. I think a good example might be someone who’s had an ACL tear and has an ACL reconstruction. They’ve seen the orthopedic surgeon, they’ve had the surgery, they’ve been out in a traditional physical therapy setting, getting rehabilitation. They might come to us for kind of an advanced movement analysis. And so we might have them doing things like squatting, jumping off a box, doing single-leg types of activities, and we’re looking for their quality of movement. If we think they’re ready to return to running, we do an assessment to look at their walking gait first. We also might put them on this machine that you see over here called the Biodex, which doesn’t isokinetic assessment of the strength and performance, muscle performance, of the quadriceps and hamstrings. So we have a number of criteria that we look at to examine an  athlete and say, “OK, based on this, it looks like you are ready to safely return to running or safely returned to these activities,” or, “You still have these deficits that we know are going to predispose you to reinjuring or, God forbid rerupture, that ACL reconstruction.” We can use that information to inform the physical therapists and athletic trainers or strength and conditioning specialists that they’re working with to really try to optimize their recovery and return them safely.

Dr. Hall: Yeah, identifying risk factors is something that’s important. It’s not just about post-injury. It’s also trying to look at some of these things, whether it’s jump mechanics, or how somebody runs from a performance standpoint, or trying to prevent something like a more catastrophic injury. Although that can be fixed, it’s a long recovery. And so if there’s anything that we could do from a prevention standpoint, we try to do it.

I think all of these things are examples of trying to bring in a more multidisciplinary type of care, because everybody involved in the care of an athlete has different components that they can bring to it. It’s more similar to what you might do at a Division I university like UConn, where it’s not just one person providing care. You have physicians, both primary care, orthopedists, you have athletic training staff, you have strength and conditioning, you have nutrition, you have all of these. And then you’ll have things like coaches that have insight into the athlete’s performance, and all of these things, and in the community these things are all siloed, right? People are all doing these things in different areas, and a lot of these things like Laurie talked about have been done, so we’re trying to bring those together more as a multidisciplinary team.

Chris: That’s Dr. Matt Hall, UConn Health sports medicine physician, and you’re also hearing Laurie Devaney, physical therapist and athletic trainer, co-directors of the UConn Institute for Sports Medicine. Now we’re in — for example, one discipline is kinesiology — we’re in kinesiology’s house right now, right?

Laurie Devaney: Yes.

Chris: So how do people find their way, how do I know if I could benefit from coming to a kinesiologist or someone, an expert in that area? Or how would someone find his or her way to the UConn Institute for Sports Medicine to get the help that the athlete would need?

Laurie Devaney: There are a number of avenues to get to us. One is simply on the UConn Health website, we do have a page located there that directs you to contact us directly. We have email, we have social media and we have phone numbers where you could just call us directly. An individual athlete can certainly get in touch with us. If you’re a community organization, like a youth sport organization or a school that wants to use our services, you can certainly contact us and we do that. Our mantra, like Matt just said, is, “our team working for your team” so we like to, when we partner with an organization — like some of the local high schools, like Woodstock academy, that we’re partnering with; we’ve done work with Eastern Connecticut State University as well — we talk to the folks who are currently providing the sport safety and health care for those athletes, and we find out, what are you doing well? What are your problems? What can we do to help you solve some problems and work together? It might be refining and revising emergency action plans and best policies for athletic training with that group. It might be going in and delivering injury prevention programs that are team-based. We’ll come in, talk to the coaches and the athletic trainers, find out what they’re doing, find out what they like and don’t like, do an assessment of the team, and then put together an evidence-based program that’s designed to reduce injury risk on a team-based approach.

So we have a lot of different things I think we can offer from that standpoint, in trying to really work with the organizations and work with an individual athlete with their own health care providers that they currently have as well. But that’s where I think the comprehensive approach that we offer with expert physicians, physical therapists, athletic trainers, et cetera, makes a difference in how athletes are being managed.

Chris: You talked about some of the nuts and bolts about what happens in this room, and one of the things. In preparing to come talk to you that I see you offer is a biomechanical analysis. Did we cover that already when you spoke about that before?

Laurie Devaney: Yeah, really movement analysis as a part of evaluating each athlete that we see, but they’re just those different levels. The biomechanical analysis specifically usually refers to using some of our advanced equipment, the high-speed video cameras coupled with, we put reflective sensors on people so that the cameras can pick them up. The computers process it. There are pretty complicated algorithms that spit out data for us. Depending on the level of detail that we need, if you come into the running clinic for a clinical analysis, we’ve got a 2D biomechanical kind of plug-and-play analysis that gives you a report right then. If we’re doing research or if we need some more advanced information, it’s a little bit more complicated process with anywhere from about 37 to 45 markers put on an athlete, force plates, and so kind of looking at the forces and the combined with the motion, and that’s a little bit more detailed process. Most of the time we’re using that process with more of our educational and research types of approaches, trying to figure out the answers to these questions, like, what are the things that put these folks at risk of a re-rupture or other type of injury after an ACL reconstruction?

Chris: Just before we say goodbye, when we were talking about some affiliations you have with some area youth programs — and we’ll put the contact information as to how to get a hold of you in the notes for this podcast so people will be able to find it and not have to write anything down — how will we raise your awareness in the community to let people know? If they don’t know about the UConn Institute for Sports Medicine, what should people who might listen to this know, maybe share what their child’s doctor, maybe share what their school’s athletic program to let them know that it might be worth having a conversation with you for the benefit of the youth in their programs?

Laurie Devaney: I would hope that coaches, athletic directors, parents are actually listening to this and thinking of ways that we might be able to help their own organization, or if they have a child, or if you’re an adult and you have an injury that you’re concerned about. We can guide you the right direction to go within the Institute for Sports Medicine. I hope organizations do place a high priority on the safety and health of their athletes. And again, reach out to us directly and we can set up a conference in order to try to see if there are ways that we can help improve your comprehensive program that you’re delivering.

Dr. Hall: Yeah, I think partnership is a word that came to my mind and outside of the individual, it would be great if people, who maybe heard it and say they’re involved in an AAU program or a youth soccer program or something, of that nature, and they say, “Well, we’ve seen this increase in people dealing with pain the front of their knee or stress injuries, or whatever it is, concussions, or they’re not, they just want to try to institute programs that try to keep their players on the field. Maybe that involves us trying to start an injury prevention or we get them set up with, in their institution, doing some type of dynamic warmup or something beforehand that is standardized across their program, just throwing that out as an example. And we try to work together to figure out, well, where are their problems? How can we maybe work to try to help solve some of their issues?

Chris: Very well. Anything else that we should know about what you do here, that we didn’t cover?

Laurie Devaney: The only thing I might add is that, we do have ongoing research projects, and what you’ll see soon on our website is a research area. And if you have an interest in participating in any of our research studies, if you happen to be a runner, a youth thrower, et cetera, a youth organization, that’s a little league or other AAU baseball team, et cetera, we are going to have some projects where we’ll be looking for participants. And so if you have an interest in participating and finding out a little bit more about your own mechanics, your own health and safety, or your child’s, be looking on the UConn Institute for Sports Medicine website for that to be coming up sometime in August.

Chris: And again, we’ll include that information with the notes from the show.

That is our time for today. For Laurie Devaney and Dr. Matt Hall, I’m Chris DeFrancesco. Thank you for listening to the UConn Health Pulse. Be sure to subscribe so you can catch us next time, and please share with a friend.