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Managing Superstars
How one Oconomowoc native is helping to treat elite athletes


By MARK CONCANNON

April 2017

 Wisconsinite Lyndsay Young, third from the left in the front row, with the U.S. Women’s Alpine Ski Team in Crans-Montana, Switzerland.
Submitted photo

Lyndsay Young blew out her knee on a ski training run in Colorado. The Oconomowoc native was a teenager at the time and a member of the Ausblick Ski Hill club in Sussex.

“I was taken down the hill in the ‘sled of shame,’” Young recalls. She was treated by a physical therapist and discovered her calling.

“(The physical therapist) was in there helping people all day long,” Young says. “I’ve always wanted to help people, and I thought, ‘With my goals in life, this would fit perfectly.’”

While studying to obtain her under-graduate and doctorate degrees at the University of Utah’s physical training program, Young completed clinical work at the U.S. Ski and Snowboard Association’s Center of Excellence in Park City. After months of being very persistent, she landed her current job as the physical therapist and athletic trainer to the U.S. Women’s Alpine Ski Team.

Young, 29, is currently completing her third World Cup season, working primarily with Mikaela Shiffrin, a 21-year-old superstar who is dominating the circuit. During a rare stretch of downtime, Young recently shared her experience from Italy.
 

What’s the toughest part of your job?

I love to travel, but we’re on the road a lot. I’m in Park City (where she currently resides with her husband) 30 percent of the year. We have our training camp in July in New Zealand, come home for two weeks for a training block, then go down to Chile for two weeks, come back and train for another month. Then I travel with Mikaela and her team to Europe beginning in October and stay in Europe until mid-November, come back to North America for a couple of races, and then we’re back in Europe for the rest of the season until mid-March.
 

How do you help these athletes get ready for competition?

On the day of the race with Mikaela, we’ll start with a really good warmup. She’ll do a 15-minute bike ride to get her heart rate up, (and) we’ll do dynamic mobility exercises (and) some reactive work to make sure her nervous system is firing and ready to go. I’ll collaborate with Mikaela’s strength and conditioning coach and figure out what she needs. Right before the start of the race, we have a routine for balance, perception, strength and visualization. After her run, if she’s sore, we manage that as necessary.

These athletes are in a flex position, dealing with a lot of force as they ski, so no matter how strong your core is, you’ll have extra muscle tension in your mid back and that’s always a challenge for us. For Mikaela, once she switches from tech events (slalom and giant slalom), where she’s more upright, to speed (downhill and super-G), where she’s in a tuck, her neck gets tight and our therapy moves toward her neck. When she’s finished her runs, it’s more massage, relaxing and just a little bit of mobility and manipulation as needed.

I’m a big proponent of autonomy — teaching these athletes to take care of themselves, because so often they don’t have someone with them. It’s important that they know how to treat themselves and know how to ask for what they really need.
 

Do these skiers frequently play with pain during the course of a season?

These elite athletes are willing to suffer an insane amount, and I think that’s part of how they’ve achieved this much. Luckily, Mikaela and I have a relationship where if she has any sort of tweak, she’ll tell me because she knows it’s in her best interest for me to watch if she’s compensating for it. (That way) we can treat it immediately to help her manage her way through those injuries and determine where she should stop (and) where she’s at risk for injury. It’s hard to get to that point because athletes don’t want to admit they have an injury because a lot of people will tell them, “You should take the day off.” (In December 2015, Shiffrin tore her MCL. Young worked with her every day and had her back in competition within five weeks.)

Young says she wants to complete a four-year circuit through next year’s Winter Olympics in South Korea and someday hopes to start a family and physical therapy business back in Wisconsin. Her goal, she adds, is to help young athletes and weekend warriors be active, have fun and get out there.
 

Mythbusters: Fact vs. Fiction
Dr. Eric B. Pifel, an orthopedic surgeon with Midwest Orthopedic Specialty Hospital and Elmbrook Memorial, breaks down the realities of orthopedic treatment and care.
BY JEN KENT

Does having an appointment with an orthopedic surgeon mean surgery is needed?

It’s very uncommon to require surgery, especially in the younger population. … Although we’re surgeons, (meeting with us) doesn’t mean that you’re going to need surgery. We’re often able to walk our patients through other treatments like injections, therapy or weight loss. There are a lot of other nonsurgical options available for musculoskeletal problems. (Editor’s note: Pifel’s own practice, which concentrates on sports medicine, recently conducted an audit of its clinic patients, and only 15 to 20 percent of patients needed some form of intervention, whether injections or larger-scale surgery.)
 

Is arthritis hereditary? If so, to what extent?

Certainly portions and types of arthritis are hereditary. There are many types of arthritis — a small percentage of them have a high hereditary rate. The majority (of cases) are not absolutely inherited, but are multifactorial, meaning some of it is based on the environment the patient lived in, some based on the trauma they’ve been exposed to, some the genetics that allow the arthritis to progress, and some of it is that their ancestors have had arthritis. … About 10 to 15 percent have a direct family component. The majority of them have no true correlation.
 

What are the fundamental differences between rheumatoid arthritis and osteoarthritis?

Osteoarthritis is a pattern of wear of the cartilage of joints. (Cases) can occur from someone who does the same motion over and over again, they can occur from someone having a specific large injury, or they can occur from infection. It’s cartilage wear that doesn’t have to do with the body attacking itself.

Rheumatoid arthritis is an autoimmune disease, in which the body sees the joint as an invasive type of cell, and the body begins attacking itself with inflammatory cells. Much like diabetes or thyroid disease are autoimmune, so is rheumatoid arthritis. That’s where people don’t have to have some exposure to injury or repetitive trauma — (rheumatoid arthritis) is due to the body misunderstanding itself and attacking itself.
 

How important is physical therapy to proper recovery?

Physical therapy is very important for people who have arthritis and have symptoms. There are a lot of people who have wear and tear on their joints and they don’t have symptoms, and if that’s case, therapy probably isn’t indicated for them.

But for people with symptoms, therapy — (and) also working with an athletic trainer and a massage therapist — (helps) with keeping the joints mobile, keeping flexibility up, keeping strength up, and keeping core strength and balance appropriate. Those are great attributes that can be reinforced by utilizing a therapist or trainer.

As far as after surgery (and for) people who have arthritis surgery, which typically are joint replacements, therapists are very important for regaining the motion and strength after the controlled trauma of the surgery. Based on the significant amount of swelling, pain and loss of strength during the recovery phase, (patients) need a therapist to help them through that path.
 

How long are joint replacements good for?

On average, and based on today’s materials, the thought process is that these (replacements) are going to last 15 to 20 years.

Should joint replacement be delayed for as long as possible or should surgery be a priority?

That is a tricky question. When I began my training, the majority of people suggested not to have joint replacement before your 60s, then as I got into residency, it was more in your 50s. And now it’s a case-by-case basis. Truthfully, if someone has horrible, bone-on-bone, end-stage arthritis in his 40s, how can we realistically ask him to wait 20 years to have a joint replaced? For the majority of patients, we do ask them to wait as long as possible, but if they have failed the conservative treatments — injections, therapy, bracing, time, utilization of a cane, weight loss — and they’re still miserable, it is realistic to consider joint replacement, even in your 40s.






 


This story ran in the April 2017 issue of: