When a client enters your office, what can the few steps they take from the door tell you about them?
Every day we encounter many people, and we can recognize a number of those we know and see every day when they're still too far to recognize their face, through certain specific patterns in how that person moves. This is an utterly normal thing that harks back to a time when it was necessary to recognize someone who was "ours", sometimes very quickly. So, evolution gave us a certain automatic ability to read the movements of those around us. If you deal with relationships and changes in the musculoskeletal system, you focus on these clues or deviations more closely, and in time you are capable of discerning not only chronic signs, due to development, but also acute changes due to a certain discomfort, injury or illness.
So, when patients enter the clinic, I watch for signs of certain differences. But I don't even try to guess or even diagnose them, it's more a case of being curious as to why they've really come to see me, what they say their problem is. Then I can compare the difficulties they describe with my observations, or fill in the blanks regarding how a chronically painful shoulder can quite fundamentally change one's way of walking or sitting down.
The clinic you also work at emphasizes a holistic/comprehensive perspective on patients. What other specializations do you work with?
I'm glad that my position at My Clinic, an integrated facility, allows me to do this. Taking an individual approach to patients doesn't just mean being nice and trying to accommodate the client's schedule. Often it means diagnosing incipient difficulties in time and preventing their progression and the development of chronic problems that are then more difficult to address. I work with all colleagues in fields that are closely related to caring for the musculoskeletal system, hence most often with neurologists, rheumatologists, sports and rehabilitation physicians, but of course also with those in seemingly more distant fields, hence internists including pneumologists and immunologists, ORL and eye doctors, not to mention psychologists and psychotherapists.
You're on the medical team for Czech Olympic athletes. What problems do Olympic skiers and recreational skiers experience most often?
In general, professional skiers have two types of problems: the first type is injury-related and the second is due to repeated and severe physical stress. And even though as part of the medical team attached to the Czech Olympic Committee we try to act preventively and most athletes also actively engage in preventive measures, they can't always avoid injuries or chronic problems. Typical injuries involve joints, especially the knees (ligament, meniscus injuries), in snowboarders more often the shoulders (dislocation), fractures of the long bones (femur, tibia, humerus) and the collarbone, while chronic problems include lower back pain caused by repeated overloading, as well as insertional tendonitis due to increased muscle strain. Injuries experienced by recreational skiers are very similar to those of professional athletes, which is due to the nature of skiing. This means sprained joints, dislocated shoulders or fingers, and broken bones.
What type of recreational activity do you prefer in the winter?
I've been a winter sports aficionado since childhood, and because my parents liked going to our cottage in the Ore Mountains every weekend, even in the winter, I was able to start doing cross-country skiing, something the Ore Mountains are perfect for. There was of course also downhill skiing, then snowboarding, and last but not least, telemark and Alpine skiing.
These days I like off-piste skiing on Alpine and telemark skis, but on the other hand, on nicely groomed slopes I can enjoy a completely different downhill experience. Plus snowboarding, as I already mentioned.
For years now I've been working with the Czech Snowboardcross Team, with coaches Marek Jelínek and Jakub Flejšar and their charges, such as Eva Samková and Vendula Hopjáková or Tomáš Pazdera. In January I always like to take some time and visit them at Dolní Morava, where they put on excellent snowboard camps, where in recent years I've also been sending my two sons.
From your perspective, how should one prepare for ski season?
Skiing places severe and complex demands on the body. A number of racers will tell you that you need to do a lot of gymnastic, strength, and aerobic training to be able to cope with them, both in the classic disciplines and in freeriding. So if your typical recreational skier thinks that he can put on skis several times a year, enjoy himself, and his body won't complain afterward, he's wrong. Even though the uphill trip is usually on a chairlift or some other passive method, going downhill is also demanding, and lack of preparation results in fatigue and increased risk of injury.
The optimum approach is to take these demands into account, start preparing prior to the start of the season with weight and endurance training, and before hitting the slopes, stretching and warming up. In short, one shouldn't underestimate the fact that it's a demanding sport, and that one can ski intensely even on blue runs.
Has there been significant qualitative progress in certain areas of orthopaedics in recent years?
Over the past 20 to 30 years something has constantly been happening and changing in orthopaedics. Especially procedures using minimally invasive techniques and the ability to treat joints using these procedures.
Developent of new materials and methods makes it possible to provide minimally invasive treatments instead of open surgery, significantly reducing the duration of the procedures themselves as well as of subsequent recuperation. That, I think, is important progress: reducing both hospitalization and recuperation time and speeding up the return to both normal life and sports.
