COVID19 In the Educational World

23 Mar 2020 | Joshua Snodgrass, MD

Fellowship year is always memorable. This year has been even more memorable for all of us at Long Beach Memorial Sports Medicine. We have been on the front lines of a global pandemic and had to adjust our fellows educational experience around a dynamic environment. The COVID19 outbreak has created the need for rapidly expanding adoption of “virtual visits” including telephone and video visits. Luckily, our hospital network was ready for the challenge.

As the NCAA began closing down our Big West tournaments, event coverage began to suffer. We acted in the best interest of our student athletes, fellows, and public health to create opportunity for virtual visits in the training rooms. COVID19 has produced a sense of community as the residents of Long Beach begin to band together to overcome the health crisis.

Our educational program has always prided itself on its dynamic nature and the ability to change on the fly. We receive daily updates from the hospital administration and modify our weekly routine according to the latest info. Fortunately, this concept of rapid incorporation of new protocols is not any different than how we approach our general education. We are always looking for ways to improve patient care, increase efficiency, or expand educational opportunities. It is unfortunate that world events have created so many unknowns but like Emerson once wrote –

Napoleon said of Massena, that he was not himself until the battle began to go against him; then, when the dead began to fall in ranks around him, awoke his powers of combination, and he put on terror and victory as a robe. So it is in rugged crises, in unweariable endurance, and in aims which put sympathy out of question, that the angel is shown.”

Autocross Racing with Warriors on Track

27 Jan 2020 | Joshua Snodgrass, MD

When selecting a Sports Medicine training program it is important to identify what you want to get out of an education. If the interest is based on division 1 athletics, any program will likely provide ample opportunity to be on the sidelines of college sports. However, here in Long Beach, we like to take things a few steps beyond and really push the limits of what is possible in education. In clinical practice not every patient is going to be a professional baseball player or an ex collegiate level athlete. There are an increasing number of alternative sports that have historically been neglected by the medical world. In following with the tenets of family medicine, reaching out to those medically under-served athlete populations creates a bigger network and exposes the Sports Medicine Fellow to a broader range of pathology.

Reggie’s Revenge

27 Jan 2020 | Joshua Snodgrass, MD

The California coast has an abundance of marine life, however, one of the more commonly seen injuries is that of the infamous sting ray. Stingrays tend to bury themselves in the sand in shallow water and can ruin your day if you step on them. Surfers will often shuffle their feet to avoid stepping on them. The above foot belongs to our program director Dr. Joshua Snodgrass. He made the executive decision to incorporate some wilderness medicine topics into the didactics after stepping on one while surfing in Huntington Beach.

For those applicants who have never been around the ocean, it is important to understand the types of injuries one might see in the surrounding community. Stingrays are not aggressive, they sting in self-defense. They have a serrated barb on their tail that can inject a protein which causes excruciating pain if left untreated. This toxin will eventually degrade over time but can take upwards of 10+ hours. Soaking the wound in hot water can alleviate the pain almost instantaneously.

In the summertime it is not uncommon for lifeguards to treat 100+ stings per day. Post-injury treatment is mainly based on pain control and infection prevention. The name “Reggie” was given to stingrays by the Bolsa Chica 16.5 surf club. They have a tradition of flying a giant stingray kite (Reggie) when one of their members is stung to warn everyone that Reggie is lurking in the shallows. If you venture out to the Bolsa Chica area and see the kite, make sure to shuffle your feet.

Alter-G Zero Gravity Treadmill

27 Jan 2020 | Joshua Snodgrass, MD

At Long Beach Memorial Sports Medicine Fellowship we pride ourselves in making education fun. After spending time discussing pathology related to our track and field athletes we decided to put our rotating resident, Dr. Odrin Castillo, and our Sports Medicine Fellow, Dr. Alex Hu, through some of the therapies used on our patients. As a Sports Medicine provider it is important to understand what athletes go through. There is no better way to gain this knowledge than through direct experience.

Special thanks to our good friends at PT at the Beach and the Life Fit Center at Long Beach State University for their continued support of our athletes and use of their equipment for educational purposes.

LA Fit Expo 2020

27 Jan 2020  | Joshua Snodgrass, MD

Part of doing a Sports Medicine Fellowship is deciding how you want to interact with the athletic community. Our physicians are heavily encouraged to partake in community outreach and engagement in a manner that allows for building relationships with various sports. Our 2019/2020 Sports fellow utilized his expertise in competitive weight lifting to organize a booth at this year's LA Fit Expo. By showcasing our ability to work collaboratively with athletes towards a functional goal, we can build a stronger and healthier patient population.

The photos above show our local Sonosite rep, Rob Perry, scanning our professional model/actor/Race car driver, Scott Bourquin. Special thanks to SonoSite for their assistance at the venue and to Scott Bourquin for letting us share the inner workings of his elbow, shoulder, and wrist with the fitness world.

Functional Movement Analysis with Motion Capture

21 Jan 2020 | Joshua Snodgrass, MD

Motion Capture Analysis

Every once in a while we all get that chart that is excessively thick and full of “normal” diagnostic studies. Our Sports Medicine fellowship teaches how to evaluate points of failure in normal functional movement. The Functional Movement Assessment is designed to evaluate when the body is compensating for a functional deficit. These deficits often translate into pain. Athletes can perform any number of activities with such high demand that their bodies reach a point of failure. As in any kinetic chain, the weakest link is the point of failure.

By evaluating an athlete for basic movement and observing the kinetics behind their activity, we are able to identify the source of their pain. In medicine, we are inherently reactive. We are notoriously adept at treating acute injuries. However, this does not always address the root cause. It is important to understand that the “source” of the pain is not always synonymous with the “cause” of the pain. Evaluating functional movement can identify deficits that can lead to functional barriers.

Our collaboration with Long Beach State University allows us to evaluate functional movement with the assistance of motion capture technology in an academic setting. Our fellows have numerous opportunities to work with the kinesiology department to expand their diagnostic acumen and hone their functional movement assessment skills.