The Division of Sports Medicine Children's Hospital, Boston
A world-renowned sports medicine research facility and leaders in the treatment, rehabilitation, and prevention of pediatric, adolescent and adult sports and dance medicine injuries
Sporting Event Coverage and Pre-Season Physicals
The role of Dr. Lyle Micheli in the founding of the Sports Medicine Division
The increased participation in organized recreational and athletic activities has resulted in a rise in the number of sports-related injuries, particularly in the pediatric and adolescent age groups. Treatment of these injuries calls for careful coordination between physician, athlete, parent(s), and coach or trainer. The staff of the Division of Sports Medicine at Children's Hospital treats injuries associated with organized competitive athletics and conducts research into the mechanisms and prevention of these injuries.
Initial evaluation of follow-up care is provided by a highly-qualified staff of four orthopaedic surgeons, one primary care physician, three podiatrists, and an exercise physiologist who are trained in the special care of sports-related injuries. Comprehensive physical therapy and rehabilitation programs are initiated in the treatment of injuries of an orthopaedic nature, and a full range of specialty services at Children's Hospital are also available. Referrals are made to treat injuries that are not of an orthopaedic nature.
Twenty-four-hour-a-day care and consultation are available for all sports injuries. There is a sports medicine physician on call to treat injuries on an emergency basis during clinic hours. After regular office hours and on weekends, the orthopaedic resident on call will evaluate patients at the Children's Hospital Emergency Room and consult with the sports medicine staff member who is on call at that time. Parents or coaches wishing information on the care of an injured athlete should call the Division of Sports Medicine directly or request sports medicine consultation when they arrive in the Emergency Room. Elective and non-emergency consultations are seen by appointment only.
In addition to diagnosis and treatment of physical injuries, the sports medicine staff is attuned to the identification of psychological stresses in the young athlete. Counseling is available to match an individual's profile and abilities with an appropriate sporting activity.
Sporting Event Coverage and Pre-Season Physicals
Physicians are available to provide medical coverage of all sporting events, particularly football and hockey games, on a scheduled basis. Pre-season physicals for athletes are also provided by appointment only. Coverage for mass participation sporting events is also provided.
The Division of Sports Medicine conducts research into the mechanisms of sports injuries, the techniques of rehabilitation and treatment, and the physiology of exercise and conditioning. Ongoing research activities include the study of knee injuries, running injuries, injuries to pre-adolescent children, and the psychological impact of sports and sports injuries. Dance Medicine is another specialty.
The Division of Sports Medicine supervises the training of medical students, physicians in training, and graduate physicians in the assessment and care of patients with sports-related injuries or illnesses. Physicians and medical students from all over the world visit the Division of Sports Medicine to receive additional training. A Harvard-affiliated sports medicine fellowship program provides further clinical and surgical training under the direct supervision of Dr. Lyle Micheli, director of the Division of Sports Medicine.
The Division of Sports Medicine also serves as a local clearinghouse of information on sports medicine and sports injuries, particularly in children and adolescents. All inquiries are welcome.
The Division of Sports Medicine at Children's Hospital, in addition to providing treatment and follow-up care to children and adolescents with orthopaedic sports injuries, has an active interest in dance medicine. Dr. Micheli has been the attending physician for the Boston Ballet since 1977. Dr. Peter Gerbino is former Director of Performing Arts Medicine in the Department of Orthopaedic Surgery at the University of Cincinnati. Visiting Advisor on Dance, Professor Solomon, is Professor Emeritus in Theater Arts/Dance at the University of California, Santa Cruz.
In 1984, with the publication of the journal article, "Physiologic Profiles of Female Ballerinas," the Division of Sports Medicine at Children's Hospital began a tradition of research in the field of dance medicine. The Division personnel's collective experience in treating elite ballet dancers has been analyzed here to improve our understanding of musculoskeletal injuries in dancers.
The role of Dr. Lyle Micheli in the founding of the Sports Medicine Division
In 1974 the then-Chairman of the Department of Orthopedic Surgery at Boston Children’s Hospital, Dr. John Hall, made the decision to found a separate sports medicine clinic within the department. This initiative was a response to the growing participation of children in organized sports and the concomitant rise in not only acute traumatic injuries but also training-related or overuse injuries which up until that time were rarely seen in the pediatric and adolescent population. Dr. Micheli had just joined the full-time staff at Children’s Hospital Department of Orthopedics after completing military service and was invited to be one of the four founding members of the faculty of this clinic. His fellow faculty members were Dr. Arthur Boland, long-time team doctor at Harvard College’s Athletic Department; Dr. Robert Runyan, then-team doctor at Boston University’s Athletic Department; and Dr. William Shea, who is an active participant in the sports medicine program at the New England Baptist Hospital.
As the only faculty member of the clinic employed full-time at Boston Children’s Hospital, Dr. Micheli was required to shoulder much of the clinical and administrative responsibility at the new facility. Therefore in 1976 Dr. Hall appointed him Director of the sports medicine program. In 1982, Children’s Hospital accorded the sports medicine program permanent Division status within the Department of Orthopedic Surgery.
From its inception, the goal of the Division of Sports Medicine has been not only to provide clinical care to sports injured children and adolescents but also to conduct research into the etiology, risk factors, and prevention of injuries and health-related problems associated with organized sports participation in this age group. To date the Division of Sports Medicine has provided care to thousands of young athletes. In addition, the faculty has published in peer-reviewed journals numerous articles related to the care of the young athlete, and initiated a number of funded research projects in this area.
The Division of Sports Medicine was the first facility in North America devoted to pediatric sports medicine and continues to enjoy a vaunted reputation in this field – both domestically and around the world. The faculty of the Division of Sports Medicine has now grown to include four orthopedic surgeons, four primary care sports medicine-trained pediatricians, four podiatrists, a nurse practitioner, and an exercise physiologist.
In 1975 the Division of Sports Medicine initiated what has became a highly successful Orthopedic Sports Medicine Fellowship. In 1982 a second Fellowship was created specifically for Primary Care Physicians, and in particular, pediatricians who wished to attain further training in sports medicine.
Both Fellowships are one year in duration and are in the process of certification by the relevant specialty boards. Dr. Micheli has directed these programs since their inception, and anticipates their expansion in the coming years.
The accomplishments of the Division of Sports Medicine at Boston Children’s Hospital are significant, and a much broader scope to research activities in the coming years is anticipated. There are now faculty members trained in injury epidemiology and outcome study. A separate group of faculty members is pursuing a tissue engineering approach to some of the more serious injuries sustained in this age group, and in particular, injuries to the anterior cruciate ligament and menisci of the knee.
Dr. Micheli maintains a very active clinical practice. He personally sees between 170 and 200 patients every week. In addition, he performs an average of approximately 1100 operations annually. The vast majority of his clinic patients are available for teaching, and medical students, residents, and/or fellows staff every operation that he performs.
The teaching program in the Division of Sports Medicine includes medical and nurse practitioner students, rotating residents and fellows, and visiting physicians. The Division hosts between 55 and 60 rotators every year and the majority of them work with Dr. Micheli’s patients. An important aspect of Dr. Micheli’s teaching is now with junior faculty. He regularly reviews and consults on patients seen by them. Dr. Micheli’s many years of clinical experience benefit both the Division’s staff and patients. His recent appointment to the faculty of the Oliver Wendell Holmes Society has provided a conduit through which Harvard Medical School students can more easily enter the Division of Sports Medicine’s teaching program. Dr. Micheli’s level of clinical and teaching activity will continue for some time to come.
