Let's Talk About: Back to School and Back in Action with Drs. Boylan, Griffith, and Horn

Ready…Set...Go!! The end of summer means back to school and the start of the fall sports season. So, as our athletes trade their flip flops for cleats, surfboards for shin guards, and tank tops for shoulder pads, we sat down with three of our top docs to discuss a variety of topics to prepare for great results and good health from pre-season through the playoffs. Here are some of the highlights from our talk with Douglas Boylan, MD, Susan Griffith, DO, and Michelle Horn, DO.

Topics include:

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How can our athletes prepare, from an orthopedic perspective for a healthy and successful year?

Griffith (BCOS Pediatric Orthopedic Specialist): The weather is still hot here in the Philadelphia area, and our student-athletes are starting their sports in the summer temps, so it’s critical to make sure they’re well hydrated. They also need to be well rested. 10 hours per night is the recommendation for students up to high school age. When student-athletes don’t get enough sleep, they’re much more prone to injuries.

Boylan (BCOS Orthopedic Sports Medicine Specialist): Right. Sleep has been shown in many studies to enhance athletic performance and benefit student-athletes not only on the field but also in the classroom. When they’ sufficiently rested, they’re able to perform at the highest level and concentrate better on their schoolwork.

For athletes starting a new season, it’s important for them to show up having done training on their own so that they’re not fatigued when the intensity of the practices increases. If they haven’t been conditioning all summer, they’ll be much more prone to injuries. They need to show up in shape.

Griffith: Absolutely. Success in sports has to do with what they did in the off-season just as much as what they did during the on-season.

Horn (BCOS Sports Medicine and Concussion Specialist): Something I talk to student-athletes about is the importance of cross-training and not just doing one sport year-round because your body conditions to that one sport but you’re more prone to injuries in other areas. You want to make sure you’re musculoskeletally balanced.

Special Considerations for Female Athletes

Griffith: We don’t talk about it as much anymore, but when I played college soccer, the biggest thing that took the girls out more than anything else was not eating right and anorexia. It was the “terrible triad” for girls due to poor eating: amenorrhea (absence of menstrual periods), anorexia, and osteopenia (weakening of bones that can lead to osteoporosis). It’s so important to make sure the athletes are well fed, that they’re eating the right balance of foods, the proteins, and fats. The thing is, girls often worry about gaining weight, but they really need to look at food and calories as energy for performance. Girls who compete with an energy deficit are at a disadvantage to girls with good energy balance.

Some of you have a unique perspective as former student-athletes and/or parents of successful athletes. How does that change your perspective as a physician?

Boylan (whose daughter just won the National Championship in field hockey at UNC): I think our experiences as parents and players make us better partners for athletes who are hoping to play at a high level. We understand what’s at stake and can help our patients make the right decisions about treatment, recovery, and return-to-play.

Griffith (a four-year starter and two-year captain on her college soccer team and two-time member of the Central Bucks Athletic Hall of Fame): We know how eager an injured athlete is to return to their sport because we’ve been there. We take it as seriously as they do. We have experience in helping our athletes perform at the highest level, and we also make recommendations with a longer timeframe in mind. You might miss next week’s game, but our goal is to get you on the college team several years down the road.

Horn (has an adorable toddler!): Well, my son will probably be a musician rather than an athlete, but it’s important to remember that all the recommendations for athletes can apply to other activities as well! It’s not just the football, soccer, and field hockey players that need to think about conditioning, hydration, eating right, and getting enough sleep – it’s also kids in other activities including marching band, cheer, theater, dance, color guards… we see them all in our office, having been injured during their activities. These important prevention strategies are just as important to these students.

Most schools and athletic teams require a back to school/start of the season physical. Why is this important?

Horn: While I did them all the time in my sports medicine fellowship, most students will go to their primary care doctors for the physical. It’s always good to make sure the health and injury history are captured, especially if there is a repetitive injury that needs to be addressed.

Boylan: If we have treated a student-athlete for an injury, we can do a re-assessment as needed to fill out the limited clearance portion of the PIAA form.

Concussion testing has now become standard as well – why is this important and what’s involved with the testing?

Horn: ImPACT testing has become the new standard and all student-athletes who play in a contact sport at the middle and high school level must complete the test each year before they play. It’s a computerized test that takes about 30 minutes to complete. There are multiple portions that test for things like reaction time, memory, and cognitive skills. The pre-season ImPACT test provides a baseline that can be used to measure against test results post-injury to ensure that an athlete does not return to the playing field before they are ready.

As the concussion specialist at BCOS, I also have a whole battery of additional tests that I use when evaluating patients for concussions to manage their care and make informed decisions about returning to the classroom and field. Thankfully, I also work very closely with the school nurses and trainers to coordinate care for students with concussions – sometimes it seems like we’re in constant contact to discuss progress and updates. I’m so grateful to have their support – with an average of 10 new concussion patients per week, we have to really stay on top of each case to make sure they’re getting the very best care!

BCOS is the official team physician for Central Bucks Schools – what does that involve?

Boylan: It’s an honor for me and my practice partner, Dr. Kieran Cody to serve as the team physicians for the Central Bucks East, Central Bucks West, and Central Bucks South High Schools. We provide sideline coverage for the football games and wrestling matches and work closely with the athletic trainers to care for all the student-athletes throughout the district. Of course, it goes far beyond just the two of us as it’s a total team effort at BCOS. Dr. Horn also provides much of the sideline coverage and cares for many of the students in the office and Dr. Griffith, as our pediatric orthopedic specialist, is very involved with the elementary and middle schoolers.

Horn: It really is a total team effort. While some of us are on the field for those Friday Night Lights, others are in the office on Saturday morning to see the injured athletes as soon as possible so that there’s no delay in treatment. Usually, I’m on a group chat with all the trainers during the games, sharing our appointment availability so that they know exactly when they can schedule the injured player. We’ve got this down to a science!

Boylan: I have to give an extra shout out to Dr. Horn for her help with covering the CB West games for me this season – I’ll be following my daughter’s UNC field hockey team as they defend their National Title this fall. You don’t get many chances like that as a proud dad!

Horn: Thanks, Dr. Boylan. I love being on the sidelines at West or any of the other schools I cover such as The Solebury School. We give this extra-special attention to all our student-athletes: besides CB students, we see patients all the time from New Hope Solebury, Pennridge, Quakertown, Souderton, Council Rock, and Centennial. We even get patients from North Penn and Upper Dublin and of course, we can’t forget the private schools: Germantown Academy, Plumstead Christian, Archbishop Wood, Calvary Christian Academy, among many others.

What are the most common injuries that you see and what are the advantages of providing on-field, sideline care?

Horn: The most common injuries are fractures, overuse injuries, ankle and wrist sprains, MCL strains, and hamstring injuries. Because we’re right there, we can make the diagnosis on the field and help to prevent a bigger injury.

Boylan: And while not as common, ACL tears are a major injury that really benefit from having a physician on the field to immediately assess the injury and begin care. We talked a bit about our total team approach – you can really see the full benefits with something as serious as an ACL tear. Besides the on-field coverage and getting the injured player into our office as quickly as possible for a full assessment, we also work closely with Jefferson MRI in Doylestown to streamline the diagnostic process. Usually, we can get the pre-certification and the MRI done all on the same day. It really alleviates a lot of worry to know the diagnosis and have a treatment plan right away.

Griffith: I hear that all the time from parents, how much they appreciate the continuity of care from the field to the office and back to the training rooms. We really love taking care of our students and especially love caring for them when they come back to see us even after they’ve gone away to college.

All of you are graduates of CB schools! What made you want to practice in your hometown?

Griffith: It’s simple: we’re physicians who love our hometown! I’m proud to live and work in Doylestown. There are so many opportunities for kids in this area. I had a great experience growing up and being a student-athlete here. I wanted to give back to this community that’s always given me so much support. It truly is rewarding.

Horn: I love that I get to take care of most of my old teachers and their kids. You see a lot of friends who are still in the area – I just got to take care of the mom of one of the girls I played soccer with when I was in high school. It’s terrific when we get to take care members of the same family. I feel like we are able to provide the best of both worlds – the highest quality orthopedics with the personal touch of physicians who treat you like family and friends.

Boylan: That’s why so many of us at BCOS have chosen to come back here. Dr. Horn and I went to CB West while Dr. Griffith and Dr. Cody went to CB East. We all left the area to train at some of the best programs in the country. We could have gone anywhere to practice, but we all chose to come home because there’s no better place to raise our own families while building a practice where we can take care of so many wonderful people we’ve known throughout the years.

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