Lyndsay Young, third from the left in the front row,
with the U.S. Women’s Alpine Ski Team in Crans-Montana,
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
taken down the hill in the ‘sled of shame,’” Young
recalls. She was treated by a physical therapist and
discovered her calling.
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
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.
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?
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.
do you help these athletes get ready for competition?
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.
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.
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.
these skiers frequently play with pain during the course
of a season?
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.
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
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.)
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.
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
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.
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?
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.