Extreme athletes like Dr. Omer Mei-Dan push new treatment, drugs

The Colorado Sun

Doctors looked at Ian Mitchard’s body four years ago and assumed his career was over.

So Steph Davis took him to a talk she gave to doctors: she wanted them to see what was possible.

To be fair, it’s probably the conclusion many would draw after Mitchard crashed while paragliding alone. He broke his back, ankles and a few other bones. The worst damage was to his feet, which were so crushed that those doctors thought amputation was the only solution.

The injuries were horrific, of course, but the worst part of the ordeal was the doctors’ bleak outlook, Mitchard’s wife Davis said in a telephone interview.

“They had never seen injuries on that scale before,” Davis said. “He got excellent medical care, but we didn’t get a lot of super optimistic stuff, and that’s hard to deal with.”

After all, Davis and Mitchard had done their job of what most would consider impossible. They flew wingsuits in addition to BASE jumping, and she was also a professional mountaineer, sometimes without a rope.

Neither Davis nor Mitchard wanted to hear opinions that Mitchard should stop living a lifestyle that helped them fall in love. They already knew the risks, painfully. Mitchard is Davis’s third husband. Her first, Dean Potter, the ropeless rock legenddied in a wingsuit crash† Her second, Mario Richard, also died in a wingsuit crash.

“We spent a lot of time doing things that should be technically impossible,” Davis said. “Flying off a cliff shouldn’t be possible for humans, but we’re finding a way to do it.”

This was the focus of Davis’ speech at the International Extreme Sports Medicine Congress in early May, hosted by the University of Colorado School of Medicine. Davis is a professional speaker and she posts specific lectures on her website, but she developed something special for the doctors, physical therapists and researchers who gathered in Boulder.

She spoke about the power of the mind and how mental strength could overcome perceived physical weaknesses, including a human’s inability to fly or, in Mitchard’s case, overcome horrific injuries that leave most of us unable to do so. to walk again. In fact, her speech was almost a plea for doctors to treat extreme athletes differently. Mitchard, who is still recovering to this day, returned to the sport they both love. Other friends in their sport have done the same.

It’s perhaps more important than ever for doctors to rethink how they treat so-called extreme athletes because they’re not as extreme as they once were: More and more of us are doing the kind of outdoor adventure sports that years ago only people like Mitchard would attempt.

“He’s the reason I was interested in speaking with these doctors,” Davis said. “They are so focused on the human body that I found it interesting for them to hear about how you can use your mind and mental abilities to change what is physically possible.”

Davis usually preached to a converted flock. Every two years, a group of medical experts meets at this conference to discuss how to treat extreme athletes. They discuss new research, new treatments, and new ways of thinking about the “crazy” people who do the “crazy” stunts that make good movies, like ‘Free Solo’, the film about Alex Honnold’s first-ever free ascent of El Capitan in Yosemite National Park, which won the Oscar for Best Documentary in 2019.

Adventure athlete Steph Davis did a free solo over the north wall of Castleton Tower in Castle Valley, Utah in May 2008. (Provided by Steph Davis)

Much of what they talk about is that traditional medicine doesn’t suit these “crazy” people. Davis was there in her keynote speech to remind and inspire them to keep thinking differently.

“A provider came up to me after my conversation, and she told me, ‘I can give them data, but I can’t give you information about yourself,'” Davis said. “I just thought that was so profound.”

Do as I do

It’s no coincidence, said Dr. Omer Mei-Dan in his understated way, that he is a leader in extreme sports medicine. He started and continues to host the conference, works as a sports surgeon at the University of Colorado School of Medicine, and is the author and editor of the first textbook on extreme sports medicine.

He’s also an extreme athlete, sometimes to the extent that it’s hard to say which comes first.

He is world famous for his expertise in wingsuit flying, rock and ice climbing, downhill mountain biking, kayaking and BASE jumping. He is sponsored by Red Bull. He, like Davis, understands the mentality of an extreme sports athlete and knows that many doctors just don’t.

Their personality traits, he said, such as their drive, pain tolerance and courage (even stubbornness) are their most common trait.

“God knows I’ve had so many surgeries on myself,” Mei-Dan said. “These aren’t the kind of people who get hurt and you say, ‘Now don’t go climbing.’ That won’t work. I felt that as an athlete. Sometimes I was… I don’t know if ‘judged’ is the right word… but I was looked at through a certain lens.”

The point is, doctors should stop looking at extreme athletes that way, Mei-Dan and his colleagues said, especially as more people looked to the outdoors as a source of entertainment, exercise and comfort during the pandemic.

The 14ers were already pre-pandemic packed, but even more are starting harder pursuits, such as climbing and challenging mountain bike racing and backcountry skiing. This is especially true in Colorado. Ultramarathons were once an anomaly, and now the most popular races have raffles to enter, including the 100-miler in Leadville and the Hardrock 100 in Silverton.

“We’ve seen a lot more of that because of COVID,” Mei-Dan said. “It pushed a lot of people to play in the great outdoors in a good way. But not many of them were physically ready to do that.”

This is a problem for doctors, especially here, because many doctors still don’t understand the intricacies of adventure sports and how to treat the injuries they cause, Mei-Dan said.

“They don’t know the mechanism of injury from cycling 100 miles a day, or how to open a parachute,” he said. “Doctors need to do more research, and sometimes they have to ask (questions like show me how to open a parachute), or there’s a chance they won’t be able to treat their patient well enough.”

There are names for more common sports-related injuries, such as tennis elbow, and even a snowboarder’s ankle is in the more common Colorado vernacular. But kayakers usually get a specific type of shoulder injury, usually a dislocation. That’s why Mei-Dan values ​​his own experience in kayaking and other sports.

“Almost every sport has its own injuries,” he said. “Physicians unfamiliar with that sport may see it as an injury rather than a specific way to treat it.”

Trauma is trauma, but many, if not most, injuries are the duller kinds, such as overuse. Overuse is relative, of course, which is why Jenna Walton Noel, a physical therapist at the UCHealth Steadman Hawkins Physical Therapy and Rehabilitation Clinic, has seen more patients.

“People have started running a lot more, even if they’ve never done it before, and they were doing it without the knowledge that a more experienced runner would have,” Noel said. “So we’re seeing a lot of excessive running or cycling, especially mountain bikes. There are all these new sports that they haven’t done before.”

In conversations with other colleagues, she sees much more strain, such as tendonitis, than in other less active parts of the country, where more people experience low back pain.

“Also in Colorado, there are a lot of people who are experienced recreational users,” she said. “Maybe they’re not competing or super-elite, but they’re in, say, the backcountry every day.”

She also sees the same reluctance in recreational Coloradans to listen to their bodies and withdraw when necessary that she sees in more elite athletes.

“When you have an acute injury, there’s a protective phase, and a lot of that means active rest,” Noel said. “But for someone who is used to pushing their body to the limit, that can be difficult to educate them. Rest is active healing. It’s much easier to convince Joe Schmo, who is on the couch, that it’s is okay to sit on the couch.”

Noel values ​​her own experience of practicing the sports she covers, although she admits she’s not a great rock climber. She is a member of the U.S. Figure Skating Medical Staff and was a figure skater herself. Mei-Dan, she said with a laugh, was her surgeon for one of her hip injuries.

“I think it makes it recognizable to me,” she said. “Having the same experience in a sport makes it easy for me to be someone else’s cheerleader.”

Davis said she doesn’t see the same pessimistic attitude about injuries from physical therapists, and Noel agreed to some extent. Doctors, she said, must structurally repair an injury.

“But I have to treat the person,” she said. “I need to know their past experiences, their emotions and what they want to do in the future.”

Treatments for the rest of us

The study doctors brought to the conference in early May had a lot to do with treating extreme athletes, but it turns out a lot of that drug applies to the rest of us, too.

“There are many things we have learned from working with elite athletes,” says Dr. Iñigo San-Millán, associate professor of physiology and nutrition at the University of Colorado-Colorado Springs. “Features on our cars these days came from the best cars in the world, the Formula 1 cars.”

San-Millån is researching ways to improve metabolism and also works in oncology. Watching elite athletes work with superior metabolic function taught him how to treat dysfunctional metabolic systems, a problem affecting a significant portion of the US population, one reason why so much of the population is pre-diabetic or has type II diabetes. . He is the personal physiologist of Tadej Pogačar, the Slovenian cyclist who won the Tour de France in 2020 and 2021. San-Millån was also a professional cyclist for two years.

San-Millån mentions Kilian Jornet, a runner and mountaineer who climbed Mount Everest in 17 hours and once broke Hardrock 100 course records for a few hours (won four times). Jornet likes to study physiology and how to make it work for him.

“Yeah, they won the genetic lottery at birth,” San-Millån said, “but you also have to develop your body, with training and nutrition and recovery. You have to sort everything out. That’s how we can learn.”

Doctors, led by Mei-Dan, have learned how to treat athletes at all stages of their lives and in all abilities by learning about elite mindsets. Many of us also try to do that by asking them why they do all those crazy things in the first place.

“Well, there’s mental health too, right?” said Davis. “It all hangs together.”

This story first appeared in The Outsider, Jason Blevins’ premium outdoor newsletter. † Subscribe

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