By Dev K. Mishra, M.D.
President, Sideline Sports Doc
Clinical Assistant Professor of Orthopedic Surgery, Stanford University
- The past decade in sports health has seen advances in minimally invasive orthopedic surgery, wider use of biologic therapies, and strong proof around the benefits of exercise with active movement
The first decade of the 2000s saw significant advancements in sports health, many of which I expect will continue to be major themes over the next ten years. From my perspective, here are some areas that stood out:
- Surgical procedures strongly moved towards minimally invasive techniques
- Biologics and non-surgical therapies multiplied
- High intensity interval training (HIIT) is the most effective way to build cardiovascular fitness in the shortest amount of time
- Active movement for life has critical benefits for every body system and across all age groups
Minimally invasive surgery
The arthroscope- the device used by surgeons to look inside a joint through very small incisions- is the greatest technical advancement in orthopedic sports medicine. The arthroscope allows us to see better than we could through traditional “open” surgery, and often leads to a better result with much faster recovery for the person undergoing the surgery. The scope keeps getting smaller, with “nano” scopes now on the market. I expect robots will play a more prominent role over the next several years, too.
Biologics and non-surgical therapies
The number of biologic therapies available in sports health has exploded over the past decade. When I started my practice 26 years ago, cortisone was pretty much all we had available in terms of injection therapies. Now it’s common to consider hyaluronic acid (joint lubricant), platelet rich plasma (PRP), extended release cortisone, amniotic fluid, and some stem cell preparations for active people with knee osteoarthritis. Many of these therapies lack truly solid scientific data showing results, but research in producing that data is very active. Over the next decade I expect we’ll see the data that helps refine how we use stem cells and the expected results. Another area that I believe will become white-hot are therapies designed to manipulate the Wnt signaling pathway.
HIIT and LISS
Multiple studies show that super-short, strenuous workouts — known as high-intensity interval training — improve fitness and health to about the same extent as much longer, more moderate exercise. Many people assume that “high intensity” means you need to do some type of extreme workout with explosive jumps or running sprints, but that’s not true. It’s all relative. If you’re starting off deconditioned, “high intensity” for you might be a brisk walk with many starts and stops. There are 7 minute workouts, 4 minute workouts, and some even shorter. Maybe someday soon there’ll be a zero minute workout exercise mimetic “pill”…
And let’s not forget about low intensity steady state (LISS) exercise activity. This would include many activities such as walking and recreational cycling. One study of older women showed that those women who walked about 4500 steps per day (about 2 miles) lived longer and better than women who walked about 2500 steps per day.
Active movement for life helps every part of your body
In many developed countries there is a crisis of inactivity. Too much sitting, too much screen time, too little active movement. The consequences of inactivity on a person’s body can be devastating, but the good news is that even small amounts of active movement can be incredibly helpful no matter your starting point. Besides the obvious benefits to your muscles, heart, and lungs, active movement helps to ward off cognitive decline with aging and makes people happier.
It’s hard to believe that we’re at the point where we have to prove that active movement is a good thing. If anyone was waiting for the proof it’s all there now. Here’s to an active 2020 for each of you.