Frankye Myers: From Riverside Health System. This is the Healthy you Podcast where we talk about a range of health-related topics focused on improving your physical and mental health. We chat with our providers, team members, patients and caregivers to learn more about how to maintain a healthy lifestyle and improve overall physical and mental health. So let's dive in to learn more about becoming a healthier you.
Hi. I'm really excited to have with me today in the healthy you studio, Dr. Courtney A. Conklin. Dr. Conklin is a fellowship trained primary care sports medicine physician and we're going to be talking about the life of a sports medicine physician. Welcome to the Healthy YOU Podcast.
Dr. Conklin: Thank you so much for having me, Frankye. I'm excited to share a little bit about the field I'm so passionate about.
Frankye Myers: Absolutely. I'm Frankye Myers, your host today and we're talking about the Sidelines from the inside look at the world of sports medicine. Have you ever wondered what's it like to care for athletes during the intensity of a game? What goes on to making a split decision that could impact their health and career? So we're going to be talking a little bit more about that. So, Dr. Conklin, tell me a little bit about how you ended up in this field.
Dr. Conklin: I ended up in this field because I have a passion for the athletes.
Frankye Myers: Right.
Dr. Conklin: Being on the sideline during sports games, you're in this fast paced environment where every second counts. You have to diagnose injuries, come up with a treatment plan and decide in a split second if that athlete's going back on that field or not. Also on the sideline, you get to work as a team, which is really exciting. You get to work with the athletes, the coaches, the medical staff and everyone's all working towards the same goal of keeping the athlete on the field playing and healthy. And that's what matters the most in sports medicine is keeping the athletes going.
Frankye Myers: Absolutely. I'm a former athlete myself, so I ran track and cross country in high school, so I know how important it was to have those sports trainers out to support us. Can you describe, like, what is the typical day in the life of someone in this field and the game experience?
Dr. Conklin: So it depends on the level of play that you're taking care of.
Frankye Myers: Okay.
Dr. Conklin: So right now, in the past fall, we took care of high school football here in the area. So I got to be on the sidelines for Smithfield High School and they had a pretty good season.
Frankye Myers: We have a hospital coming.
Dr. Conklin: Yes, we have a hospital coming to Smithfield soon. I'm Excited. I'll be out there in the medical office building taking care of the orthopedic clinic out there. So being with Smithfield during the day, on Fridays I'm in the clinic, I'm seeing patients taking care of them inside the office. And then at night I'm going out to Smithfield and so I'll probably get there about 30 minutes before the game starts. I'll walk in, I'll check in with the athletic trainer, make sure no one needs anything. And then we always have a pre-game medical timeout and we're hoping that all the schools are doing this during that timeout. You're meeting with the athletic trainer of your school, the athletic trainer of the visiting school, ems. If they're there and if you're lucky to have EMS there, you're talking with them.
Frankye Myers: Right.
Dr. Conklin: Basically about what you're going to do if something happens. Making sure that everyone has contact numbers for each other, we have the signals in case we need EMS to come on the field. And then lastly, you can check in with the referees as well, make sure they have everything they need, make sure they don't have any medical conditions you should be worrying about. And so we're doing that all pregame. Okay. Once the game starts, you'll see me on the sideline, either on the 20 yard line over here or the 20 yard line over there.
Frankye Myers: Right.
Dr. Conklin: But I'm trying to stay with the ball, trying to make sure that I can see everything. So if something happens, I have a good eye on it. If something does happen, the athletic trainer is going out in the field and taking care of them. If they need me, they'll signal me on.
Frankye Myers: Right.
Dr. Conklin: But otherwise we're staying on the sideline, just supporting them.
Frankye Myers: Okay.
Dr. Conklin: So the hope is that nothing happens during the game and that you have a pretty boring night and then afterwards again you're checking in with them, making sure they don't need anything on your side and the other side prior to going home.
Frankye Myers: Okay. Sounds like a lot of planning. And you play how you practice.
Dr. Conklin: Yes
Frankye Myers: So you practice and anticipate and get a plan together. So that's great.
Dr. Conklin: Yep.
Frankye Myers: So how do you. You talked a little bit about the unpredictability of the game. Are there other things that go into that? Because I just think there's a whole lot going on. There's a lot of moving parts. Talk a little bit more about that.
Dr. Conklin: So preparing for any emergency, any unthinkable event happens way before that day of the game, way before that meeting. It's actually happen. Before your season even starts.
Frankye Myers: Right.
Dr. Conklin: And so the first thing that we want to do is make sure that we're all up to date on CPR and AED training.
Frankye Myers: Yes.
Dr. Conklin: And so that happens during our training and then we stay proficient on it. So we're taking courses throughout the years as we need to. And during those courses we're learning how to take care of players during cardiac arrest or medical emergencies. And that's the most important part of our training is being up to date on CPR and the use of an aed. Another thing that's really important is making sure your school has the AED up and running and Working. We're grateful in the state of Virginia and almost all 50 states have these rules is that all public and secondary schools have to have an aed.
Frankye Myers: Okay, that's great.
Dr. Conklin: And so I actually encourage parents to get CPR and AD training as well for their preparation.
Frankye Myers: Right.
Dr. Conklin: Because you're never, you never know where you're going to be on your kids fields, on the court, at the football field and something happens.
Frankye Myers: Absolutely. And there's been so much education in the, in communities about that. So that's really great.
Dr. Conklin: Yeah. And I always recommend putting eyes on the aed, making sure that's where it's supposed to be. So before games I'm asking math, athletic trainer, where is the aed?
Frankye Myers: Right.
Dr. Conklin: And so I can look at it specifically and know that it's there.
Frankye Myers: Right.
Dr. Conklin: Because they may say it's in the case in the auditorium, the casement.
Frankye Myers: It takes time to get there. Right.
Dr. Conklin: So make sure you know where that is.
Frankye Myers: Okay.
Dr. Conklin: So I encourage all parents to have that knowledge as well in case they don't have a healthcare provider out on the sidelines.
Frankye Myers: Okay.
Dr. Conklin: Another thing that we do to prepare is meetings.
Frankye Myers: Okay.
Dr. Conklin: Lots of meetings, lots of preparing. And so preseason, at the high school level at least, we're meeting with the athletic trainer and hopefully the coaches walking them through injuries, specific scenarios. Because at the high school level it's usually us and the athletic trainer and us two can't alone carry a football player onto a spine board or into the ambulance. So you're running through those scenarios with the coaches, you're practicing what you preach. So that way, if it ever comes to it, everyone knows their role. And so those meetings are really important.
Frankye Myers: It sounds like you really infuse yourself and you have a relationship and rapport. So it kind of helps with when something comes up because you know each other and you trust each other and.
Dr. Conklin: Everyone knows their role. If we're looking at other levels, like college levels. When we were at the. When I was at the University of Alabama, we had meetings, Roll tide, we had meetings with ems, we had meetings with doctors, orthopedic surgeons. We had meetings where everyone was present with the ambulance there and the golf cart there. So you had all that equipment available, and we're running that through in about August of football season. So that way everyone knows their role, where to stand, where to go, who to lift, what. And so again, just practicing. Practice is so important.
Frankye Myers: Great information. I don't think I understood the level of detail that goes into that. So that's great information. So now let's move into segment two and talk about memorable sideline stories. Right. So let's dive into that a little bit more. Can you share a memorable moment or two that stands out for you? I know I have some in my career. We always have those things that change us or shape us, and we're no longer the same. So do you have any of those to share?
Dr. Conklin: There's one that stands out specifically. I was taking care of high school football in the area and I was on the sideline again, hoping nothing goes wrong and I don't have to be of use that game. But during the second quarter, a player hurt their thumb.
Frankye Myers: Okay.
Dr. Conklin: So the athletic trainer took a look at it, called me over on the sidelines asking if I could help look at this thumb and see what's going on. I walked up to the player. He was obviously emotional, obviously in pain. It was very visible. So took a look at that thumb, did my testing, and everything I did caused pain. And so I'm talking with this player and he's upset. And a lot of times I'll ask the player, how do you feel?
Frankye Myers: Right.
Dr. Conklin: Do you feel like you're able to go back in the game? Because sometimes they'll say yes, right? Take me up and put me back in if it's not going to cause.
Frankye Myers: Any other problem, pain levels and tolerance levels.
Dr. Conklin: And so I asked him, he said, no, I don't want to go back in. That makes my job easier. I'm not working with him to make sure he's willing to go back in. He's saying, no, I'm done. And at that point, that decision's done for me. That kid's not going back in the game. He doesn't want to. And I got to keep his health at the forefront of my mind.
Frankye Myers: Absolutely.
Dr. Conklin: And what became tough about that is the dad turned around on the sideline and mouth get back in. And of course, the Son was upset, and I said, don't worry, I'll take the fall for this. I'll tell them it's my idea. Okay. And so I told the dad, and of course he was a little upset, but didn't say anything else. Halftime came around and I'm standing there and I look up and I see the head coach and the dad and about four other dads all in the circle talking about the son. They were upset that the sun was not going back in. And so the coach called me over, very upset, and asked me what happened. I started to explain to him and he said, no, I'm a doctor. You tell me what's going on. So I use medical terms, told him what was going on. And I got some colorful language that I cannot repeat here. Oh, my. But essentially the dads had to pull the coach back because he was yelling at me so much. And at that moment, you just have to stay calm, stay firm in your word and protect the athlete.
Frankye Myers: Absolutely.
Dr. Conklin: Because that's all that matters. On the sideline.
Frankye Myers: Absolutely. That's a tough one.
Dr. Conklin: It's tough, yes. It's tough.
Frankye Myers: Yes, yes. Any others?
Dr. Conklin: I think about the college level. Yes. When I was at the University of Alabama, we had a player get a concussion during the game. And of course, during college football, they're very cognizant of that. And the kid was pulled right off into the tent. And I was a sports medicine fellow, so I was standing on the sidelines watching the game when I heard my name being yelled to come into the tent. Of course, you're staying there with what, 80, 90,000 fans? You walk in and it was obvious the player was going to be pulled out of the game for safety because he had a concussion. And I got to escort him back into the locker room and his parents came down from the stands, grandparents as well. They had all come to watch him. And of course, everyone's emotional feelings are high, but the parents just wanted to know that their son was okay. And so they were very thankful that we were keeping him safe and keeping him out. And they actually included me in saying a prayer in the locker room over his health. It was just such a touching moment to watch parents support the medical staff and the decisions thatthey're making as well as supporting keeping their son safe.
Frankye Myers: So thank you for what you do to support our athletes. Those stories really highlight the complexity of your role and how do you balance the immediate needs of the athlete. And you talked a little bit about that as you talked about those stories with their long term health I think that's so important. There's so much in the media now around concussions and the long term impact that that has on individuals and then as well as any injury. Right.
Dr. Conklin: I mean, it's so important to protect their long term health above the game at hand. Because especially in team sports, college athletics, emotions are running high. A lot of people say that one player is going to change the game. And sometimes, yes, that's true.
Frankye Myers: It is a team sport. I don't know how one player, one player can have a lot of impact.
Dr. Conklin: Right, exactly. And so there's always going to be this strong push to put athletes back there really fast. But as medical staff, we have to take into mind what's most important. Is it this game or is it their health 20 years from now? Just like you mentioned with concussions.
Frankye Myers: Right.
Dr. Conklin: And the way that we do this is evidence based care. We look at the research studies, we look at what the protocols and the recommendations are for things like concussions.
Frankye Myers: Right.
Dr. Conklin: We now know second impact syndrome. If people go back in playing after a concussion, they're at even higher risk of getting brain damage and getting hurt. Especially with the new studies with cte, after many concussions, we have to keep these players safe. And so we're there to make an educated decision, not an emotional one. Because on the sidelines, players and coaches often making emotional decisions. That player wants to go back in and help his team, but we have to keep them safe and we have to keep them on that sideline just to keep them keep their health at the forefront, not just the outcome of the game.
Frankye Myers: Absolutely. Great, great information. So now let's move into segment three, which talks about the challenges of the real time decision making. And you've already highlighted some of those. What are some of the biggest challenges you face in those split second decisions? You did mention them a little bit, but I could see how, how challenging.
Dr. Conklin: That could be, navigating that pressure of those high risk decisions. I mean, it's very, it's one of the most important things that we do and the way that we do it is clear communication.
Frankye Myers: Okay.
Dr. Conklin: Everyone has to be aware of what's going on and we have to be clear about it to everyone involved. That means talking with the player who a lot of times is going to be downplaying their symptoms, wanting to get back in. We have to have an open, honest talk with them about what's going on, what we're worried about and what we think is happening. And so we have to have a calming nature to that because like I Said emotions are running high with them. As for the parents, they also want to be informed of what's going on. Just like I mentioned in college or if we have a high school player that gets hurt, a lot of times that parent is at the fence line when we turn around wanting to know what's going on. They want to be reassured that we're keeping the safety of their child first. And so we have to reassure them and talk to them about how we're keeping their child safe and tell them what's going on.
Frankye Myers: Absolutely.
Dr. Conklin: Lastly, coaches. Coaches need to know what's going on, whether they like it or not. And so coaches don't need all that unnecessary medical jargon. I like the coach I mentioned. Most of them just want to know, is the kid going or not? And so you have to be clear and cut to the point of what we're doing with the kid.
Frankye Myers: Yes.
Dr. Conklin: Is he going or not?
Frankye Myers: Yes. Even though I'm a healthcare professional, when it comes to my family or friends or anything that I'm anyone that I'm emotionally connected to, I'm no longer a healthcare professional. So I like the way that you say, hey, we talk in layman's terms and really keep that open communication. And then you're also an advocate for the player because you never know the family dynamics, cultural, you know, expectations that may be put on the players so you really understanding what their needs are and then advocating for that in that moment is really powerful.
Dr. Conklin: Exactly. A lot of times I'll ask the kid, do you have any family here? Because you don't know who's there to support the kid. Maybe a neighbor, maybe a parent, maybe a grandparent. Talking about with the coach, if you look on college fields or maybe NFL fields, I don't have any experience in the NFL, but college fields, there's usually one medical staff member standing next to the head coach, and so everyone else is taking care of that player, all with their radios and walkie talkies on. And so they'll say, good or not. And all that medical staff player says to the coach is he's not going back in. They walk away. That's done. That's it. So it's a very clear, done decision.
Frankye Myers: Are there strategies that you use? I know that there's things that I do when I know I'm approaching a challenging a situation or a situation where I know there may be potential conflict. Are there, are there tips that you can share in those moments? Because it sounds very intense.
Dr. Conklin: It depends on who you're talking to. So if I'm talking to a parent. I'm staying very calm.
Frankye Myers: Right.
Dr. Conklin: I'm reassuring them, giving them. A lot of times they will want more facts in the kid.
Frankye Myers: Right.
Dr. Conklin: The athlete will want to know, am I going back in or not? And so that's a clear cut. Yes or no? The parents want to know exactly what's going on, exactly what I do. So staying calm.
Frankye Myers: Yes.
Dr. Conklin: Breathing.
Frankye Myers: Yes.
Dr. Conklin: Trusting in your practice and your training. Because if you know how to treat it, you know what you're going to say to them, and you have to rely on that and be confident in what you're telling them.
Frankye Myers: Absolutely. Great information. All right, moving on to segment four.
Talk a little bit about the evolution of sports medicine. You know how it just, it. It's more talked about. It's no longer in my viewpoint on the vaccines. Is that the forefront of any athletic situation? So can you talk a little bit about that and that evolution and what do you think's driving that?
Dr. Conklin: Yeah, I think safety is driving it. I think the new research on everything that can happen to an athlete after multiple injuries or concussions. Yes. One of the biggest evolutions is, like I mentioned earlier, the presence of AEDs and the training of CPR. And when we saw it in the NFL recently with Tamar Hamlin and Buffalo Bills, everyone knew exactly what to do. And everyone had practiced that. And so they carried it out to perfection, almost. He survived. And that's what we can hope for everyone. Like I mentioned, most states have rules saying that every school has to have an aed. But also, like I said, we don't know where that AED is. We hope it's on the sideline, and we hope that they can get it to that player fast. We're lucky in this area. We have a Riverside hospital close by to most of our schools. And so we know we're transporting that athlete pretty quickly. But you talk about rural towns and rural cities where a hospital isn't that close. When I was training in Alabama, I was taking care of a high school that was in a rural area. And so I had a medical kit of everything I needed to resuscitate a player on the field. So I had the ad, I had stuff for an iv. I had medications because I knew I needed to take care of that player. Now that player is my resuscitate, and.
Frankye Myers: It may be a time crunch for them to get to this. Maybe 20, 30 minutes to get to them.
Dr. Conklin: Yeah, so. So the presence of that on schools is one of the biggest changes and biggest change to our evolution of sports medicine and taking care of players. I would say another thing is, like we've mentioned earlier, research. Research is so important. It changes how we treat athletes, changes protocols, and allows us to make better decisions. I think about another advancement which isn't as important as AEDs, but if you look on the sideline of NFL or college schools, you'll see those tents. Those tents on the sidelines that go up and go down.
Frankye Myers: Yes. They, like, encapsulate the player.
Dr. Conklin: So it keeps them safe. It keeps it confidential so no one knows what's going on. I like the fact because it was actually created at the University of Alabama in 2015. So real tag collapse.
Frankye Myers: Yes, absolutely.
Dr. Conklin: But they patent it and you see it all around the NFL now.
Frankye Myers: Yes. Whereas that happened in the back scene before. You didn't know what was going on, or they went into the locker room.
Dr. Conklin: Yep. But now they pop the tent up and pop down, and I think it's pretty cool.
Frankye Myers: Yeah, that is pretty. That is cool. All right. Well, it's. It's incredible, the progress. And it sounds like these advancement not only have protect athletes, but also allow them to recover and keep them safe.
Dr. Conklin: Yeah. Helps us identify things early, diagnose them, treat them, and then get them back to playing.
Frankye Myers: Absolutely. All right, moving along to segment five, advance for aspiring sports medicine physicians. Let's talk a little bit about that.
Dr. Conklin: So it's gonna sound cliche, but get out there, get out there, find someone, find a mentor. I was lucky in college. I wanted to do athletic training to start, so I had that experience in college. But if you want to be a sports medicine doctor, of course you're gonna do those pre med topics, those pre med majors. But once you get into medical school and residency, finding someone that you can shadow on the sidelines.
Frankye Myers: Yes.
Dr. Conklin: I did my residency here at Riverside, so I got to shadow Dr. Barley on the sidelines at CNU. And I stayed here. I came back. So obviously it was a good experience. He taught me a lot. From being ready to treat injuries, diagnose them, staying warm on the sidelines, wearing multiple layers in the winter. I mean, having a mentor teach you all those things is paramount. And nothing can beat that, I'd say, outside of finding a mentor and shadowing and being on the sidelines. I see your studies studying the human body. I think it's a wonderful creation. And looking at all those muscles, those tendons, those ligaments, knowing where they are already has you one step forward to treating an athlete. All right, get out there, find someone.
Frankye Myers: Absolutely. What's the most rewarding part of your job?
Dr. Conklin: The athletes, I think that's. I think I've probably mentioned that earlier, but the athletes are the most important and the most rewarding. Getting to see someone playing on the field, obviously you don't want them to get hurt, but seeing them get hurt, diagnosing them, treating them, and then seeing them back out on the field, I mean, nothing can really beat how rewarding that is. When I think about my training in college, obviously I get to see some of the players I treated play on Sundays in the NFL. And that's pretty cool. Getting to see them live out their dream, seeing them get drafted and seeing everything come together for them, that's the most rewarding part.
Frankye Myers: Oh, I'm sure that's awesome.
Dr. Conklin: And so now I root for players on all the teams, not just my favorite.
Frankye Myers: Awesome, awesome. Thank you for all that you do. Thank you. Very rewarding. It is. You're welcome to come back anytime.
Dr. Conklin: Thank you.
Frankye Myers: Thank you for your insight and sharing your experience, experience and expertise today. And I just can't thank you enough. And thank you for advocating for our athletes.
Dr. Conklin: Thank you.
Frankye Myers: As a former athlete, myself, and having children that are athlete, your role is so important. So thank you.
Dr. Conklin: Thank you so much for having me. It's been a wonderful time talking
about.
Frankye Myers: Absolutely. Absolutely. And to our listeners, thank you for tuning in to the Healthy you podcast. I hope you enjoyed this episode. You can also check out Riverside Health's blog for more insights into sports medicine and our health topics. Thank you.
Dr. Conklin: Thank you so much.
Frankye Myers: Thank you for listening to this episode of Healthy Youth. We're so glad you were able to join us today and learn more about this topic. If you would like to explore more, go to riversideonline.com.
