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Padres Checkup With Team Doc

Audio

Aired 2/8/11

We'll check up on the health of the San Diego Padres with Scripps Clinic orthopedic surgeon and team doctor Heinz Hoenecke as the team prepares for spring training.

Now that the Superbowl is history it brings us all just a little closer - to the start of the baseball season. Baseball fields are opening up across the country and the Padres first spring training game is at the end of the month. After months off from training, ball players sometimes find themselves overweight and out of shape as the season begins. And some are still trying to recuperate from injuries they suffered last year.

This is where the team doctors really come into play. And for the last 30 years, it's been doctors from Scripps Clinic who've been the official health care providers for the San Diego Padres.

Guest

Dr Heinz Hoenecke is a Scripps Clinic orthopedic surgeon and padres head team physician.

Read Transcript

This is a rush transcript created by a contractor for KPBS to improve accessibility for the deaf and hard-of-hearing. Please refer to the media file as the formal record of this interview. Opinions expressed by guests during interviews reflect the guest’s individual views and do not necessarily represent those of KPBS staff, members or its sponsors.

MAUREEN CAVANAUGH: I'm Maureen Cavanaugh, and risen listen. Now that the super bowl is history, it brings us all just a little closer to the start of the baseball of season. Is at the end of February, now, after months all from training, ballplayers mind themselves over weight and outer of shape as the season begins, and some are still trying to recuperate from injuries they suffered last year. This is where the team doctors really come into play. And for the last 30 years, it's within doctors from Scripps chronic, [CHECK] Heinz Hoenecke is the Padres' head team physician, doctor Hoenecke, welcome.

HOENECKE: Well, thank you for having me.

MAUREEN CAVANAUGH: Now, I'd like to join our listeners to [CHECK] 1-888-895-5727, that's 1-888-895-KPBS. So doctor Hoenecke, spring training starts income week, what can you tell us about the health of the Padres.

HOENECKE: Well, it's interesting, the stereotype used to be that the players, quote, took the accept in the off season and went fishing and did various more sedentary activities. But the actual fact is, after a hundred and 62 games, there are certain tissues that are fatigued, certain yours where they've worked their bodies hard, and they actually changed their Condition over the off season, such is that they do a lot of core strengthening, they back off from the [CHECK] and sometimes they actually, you know, their goal is to lose weight, and they increase their endurance. So they come into spring training, in some ways, very good shape, but very different than request [CHECK] in order to maintain a day to day play. Now, the part of what we get involved is not only monitoring issues in the off accept, but to coordinate a team of physicians of at least three orthopedists, the physical therapists, the [CHECK] Yan Fronick, my partner's been doing this for 20 years, and he has organized quite a fine approach to evaluating these players when nay come in next week.

CAVANAUGH: Well, how do you go about doing that? Does serve have I separate profile of evaluation, are there some general things that you check out?

HOENECKE: Well, exactly. There are certain of them that have specific issues that we've been monitoring, and the therapists and the [CHECK] and then we do general screenings, we've become quite more sophisticated over the year requests, [CHECK] using electronics such as the Wii game controller, [CHECK] and general health screening.

CAVANAUGH: That's amazing. So the Nintendo Wii is in the mix when you're evaluating the players who are returning toward the Spring training season.

HOENECKE: That's right. We've been playing [CHECK].

MAUREEN CAVANAUGH: Let me ask you a question, doctor Hoenecke, last season, Matt Lejos had a right shoulder injury, do you monitor that flew the off season.

HOENECKE: We do. We've monitor to the extent if the -- once the condition has been evaluated and treated, if woo reach sort of what we call, you know, a steady state, we think he's got it under control, we'll give them a recommended program, and then coming around Christmas, they may be playing just some light catch, [CHECK] then start gradually increasing. It may take six weeks for them, from the time they start throwing the ball to the time they actually get off the mound. It's really like -- [CHECK] where they'll can play, and make sure that the endurance is there. Spring training's a bit more about developing endurance for the Hong season.

MAUREEN CAVANAUGH: Yeah, I can ski that. [CHECK] also the Padres' head team physician, and we're inviting you to join the conversation if you have any questions at 1-888-895-5727. You know, one of the things that really gets fans during the season is when a player [CHECK] so bad leap when there are a lot of injuries. I'm wondering what types of advances in sports medicine have you seen developed in your time as the Padre it is' team doctor.

HOENECKE: Well, a couple different areas. One is the advent and progress with the orthoscopic surgery, where we can look inside with a little telescoping and make adjustments before issues become major issues. [CHECK] mechanics, so we make little changes in their training and their rehab, before it gets into trouble.

MAUREEN CAVANAUGH: You said that the training, you know, evaluations during Spring training and working somebody back up into playing shape during spring training ise so perform, because it's that -- it would seem to me that this long major league baseball season really takes it out of players. Tell us a little bit about that.

HOENECKE: Well, that's right, they're operating at a level [CHECK] so these guys are constantly on the edge, and they have to carefully modulate that, so if there's a certain fatigue in one muscle, it transfers all that force to another one, and we have to be came. Because we're in it for the long-term. That's the thing about baseball. And that's what's made it interesting about working with then, because even minor changes in terms of their flexibility or strength in one area can make a profound effect on performance, and the potential for injury.

CAVANAUGH: We do have a caller on the line, we're ticking your calls at 1-888-895-5727. Brian's on the line from San Diego. Good morning, Brian, welcome to These Days.

NEW SPEAKER: Good morning, how are you?

MAUREEN CAVANAUGH: Just great. Thank you.

NEW SPEAKER: Great. Yes, doctor, I was wandering, I had a question, when a players is involved in a trade, or leading up to a trade, how much information you share with an opposing team [CHECK] or do you legal he have it, and then after that, when a player is traded, you talk to the -- are you in communication with the other team if you have a history with that player? And I'll take my answer off the air. Thank you.

CAVANAUGH: That's a fascinating question. [CHECK].

HOENECKE: Medical release [CHECK] issues that they have had, and it's generally a good camaraderie, [CHECK] the baseball clubs are in this for the long hall, so they'll have [CHECK].

CAVANAUGH:

HOENECKE: Yes, that's -- that's right. It's a community with strong relationships, and they try to treat each other as fairly as possible.

MAUREEN CAVANAUGH: Let me talk a little about about some of the success stories that Scripps clinic has had from come backs from injuries that you're particularly proud of. I know we've all said [CHECK] from his recent cancer treatment. But you have also dealt with hall of famer Tony Gwinn, [CHECK] request.

HOENECKE: Had a long history of working with Tony Gwinn from his early days throughout his entire career and has done all of his injuries on his knees in order to keep him as a player. Tony was a -- just a fan -- is a fantastic patient in terms of compliance and getting back into the game, in spite of all the work that he's had to do. So he's an example of where these professional players, they make good patients because possible it's very much in their interest to follow the physicians' recommendations and to really do the rehab as to the best extent nay can.

MAUREEN CAVANAUGH: Now, a dozen surgeries, I guess you also have the unpleasant task of sometimes telling an athlete that there's nothing hoar you can do.

HOENECKE: Well, that's true. Sometimes the tissues are broken down to the point where it's not really a mechanical solution for it. And that's where we throw it back to the therapists, the Padres' therapists are Rick Stoffer, and also the [[]] and it's amazing what they can do in terms of strengthening the muscles and improving their mechanics.

MAUREEN CAVANAUGH: Uh-huh.

HOENECKE: And that's been where we've been focusing on our work, even on our nonprofessional athletes in order to try to teach them now, it's not always a surgical solution.

CAVANAUGH: I'm speaking with doctor Heinz Hoenecke, he's the Padres' head physician. Of [CHECK] good morning, Sarah welcome to These Days.

NEW SPEAKER: Oh, thank you for taking my call. Yes, I have a question regarding children, in children's sports and injuries, I got three young children, one's a 16 year-old, but I've got a nine-year-old nine and a treason year-old girl, and I'm seeing [CHECK] I'm seeing head injuries, I'm seeing ACL tears, and particularly I'm interested in what progress is being made in providing guidance in sports [CHECK] as much research has been done on girls in sports.

MAUREEN CAVANAUGH: Well, Sarah, thanks for the question. And what can you tell us, doctor Hoenecke.

HOENECKE: Well, baseball's done I good job of making recommendations for our youth athletes, especially starting around age nine up through high school. They have certain recommendations, for example, specifically with girls, about how many pitches they should throw in hay game, how many pitches in a week, [CHECK]y time off, at least three months issue a year, to play another sport, for example, a throwing sport like baseball, to do something that didn't involve throwing shoulder, give it I rest, billed up some other strength 234 the body, the core strength, you have to remember that all the energy in the [CHECK] so if you're playing soccer in the off season, and then playing baseball in the rest of the season, that total body conditioning is very important. Now, baseball, [CHECK] and these are available on USA baseball medical websites, and they talk about how they should limit the number of leagues that they play, in, where they should play year-round, and the type of [CHECK] girls are interesting, as nay get a little bit older. And if [CHECK] in order to help avoid knee injuries, where we find more injuries with women for example going into college, playing soccer.

MAUREEN CAVANAUGH: Now, I'm wondering, Doctor Hoenecke, when players come up for the minors and you're trying it make a decision, which the team tea trying to make a decision, who's gonna join the team, what roam do team doctors play in that?

HOENECKE: Well, we have the opportunity in those cases of reviewing their medical file, before the draft, we'll review some 250 medical fills, come my partner, doctor Fronick has devised a rating scale, [CHECK], that mayer is at risk for injury or difficulties, so we try to make an initial assessment, and as they draft that player, we try to help them provide the best plan for either avoiding injury or treating ongoing injury, so it's a key role that I think the medical staff at Scripps clinic mays.

MAUREEN CAVANAUGH: I think you're rite. Describing it as ray really good give and take 678 but I really have to ask you, in my introduction, I talked approximate the stereotype of the mayer coming back [CHECK] brew ski every the haft few months issue you telling me that is completely not true.

HOENECKE: Well, no, that is pretty much untrue.

MAUREEN CAVANAUGH: All right.

HOENECKE: Because even though you may look at him, and say, well, that guy's heavy, you have to remember that they have been doing a lot of conditioning and that some of these players use that weight to their advantage to accelerate the ball when they throw, because it's all about transferring the energy from their weights and their legs up through the article. People would be surprised to know that the speed of the ball, that the amount of force that the shoulder provides is only a fifth of the energy needed to make that ball move, and a lot -- most television comes from the hips and lower extremities.

MAUREEN CAVANAUGH: I see. All right. I've been in my place. Doctor Heinz Hoenecke, thanks so much.

HOENECKE: You're welcome.

MAUREEN CAVANAUGH: Doctor Heinz Hoenecke is the Padres' head teammate physician, if you would like to comment, please go on line, KPBS.org/These Days. And stay with us for hour two of These Days, coming up in just a few minutes right here on KPBS.

Comments

Avatar for user 'Airmoe'

Airmoe | February 8, 2011 at 10:15 a.m. ― 3 years, 2 months ago

Hello, I enjoyed your interview with Dr. Hoeneeke. I have a question as a triathlete. Like many athletes, baseball, football and other athletes who train a lot can be susceptible to getting colds from pushing their bodies to the limits in training. I took a fluoroquinolone based antibiotic a year ago August for a bronchitis infection. These class of drugs like Cipro, Levaquin and many others are associated with tendon ruptures, soreness and connective tissues issues. I suffered from soreness and weakness in my achilles, thumbs and bicep tendons. I wonder if the Dr and or your resources have any insights on this topic and if so how long these issues can last. I'm much better than before but not 100 % yet. Its scary that despite recent black box warnings on these drugs they are still popular and widely prescribed.

Thank you,

Will

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Avatar for user 'halbers'

halbers | February 11, 2011 at 7:46 a.m. ― 3 years, 2 months ago

Hi Will. This is Dr.Harry Albers responding. I am the lead Internal Medicine physician for the Padres. Dr.Hoenecke asked that I respond to your excellent question.
You are correct about the tendinopathy concerns and black box warning with fluoroquinolones. Tendon ruptures (particularly achilles tendon) and more commonly tendinitis have been reported with essentially all fluoroquinolones. The largest prospective study to date was out of the Netherlands on 46,000 patients. 704 cases of achilles tendinitis were reported along with 38 cases of frank achilles tendon rupture. This yielded a relative risk of only 1.9% for tendon symptoms of any type in fluoroquinolone users. It was found that within users, rates were highest in the population over 60 years of age and in cases where corticosteroid medications were also used.
In another study from the UK, it was found that the median duration to onset of symptoms after starting a course of fluoroquinolone was 8 days, and there was the suggestion that repeated courses further increased risk.
Your question about duration of symptoms is difficult to answer, but in my experience it is rare to have symptoms endure beyond 4 to 6 weeks, but as with any tendinitis it is to some extent a function of the person's physical activity ie.repetitive stimulation of the involved tendon will prolong the course.
Our approach has been to not use fluoroquinolones if at all possible in the ballplayers. Because of the unique antimicrobial properties of this class, we sometimes have to "bite the bullet" and use Cipro or Levaquin in an athlete, but always with a full discussion of this potential side effect.
Hope that helps.
Harry R. Albers, M.D.

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