DURHAM, N.C.--
From the moment an athlete gets injured, to the moment they come back to the competition, there are months of rehab behind the scenes. It takes physical and mental strength from the athlete to return from an injury. It also takes a staff of world-class professionals, from athletic trainers to physical therapists, physicians and sports performance coaches, to get the athlete comfortable returning to the sport that got them injured in the first place.Duke's athletic medicine department prides itself on the state of the art equipment they're able to provide to their athletes. But they mostly pride themselves on the group of people working together to achieve the common goal: a recovered athlete.
A unique part about Duke's program is that all of the athletic trainers, physical therapists and physicians are in-house, meaning athletes don't have to go to a third-party medical facility to receive treatment. And because of that, athletes are able to build relationships with their medical staff in a way other schools might not.
Kristi Hall, Brett Aefsky, and Ciara Burgi, three members of the athletic medicine staff, have worked countless hours with Duke's athletes, particularly the women's soccer team.
Hall, the athletic trainer for both women's soccer and women's indoor and outdoor track and field, is the first face these athletes see when they get injured. She works with them through the rehab process, getting them set up with a surgeon if necessary, and making sure they are where they need to be in their recovery process.
Sophie Jones, a sophomore on the soccer team who tore her ACL last fall, spoke on how Hall remembered her exact date of surgery, despite juggling two teams. She also talked about how she drove her to all of her appointments and made sure she was where she needed to be during rehab.
"It'll be like 6:30-7 p.m., and she's still in there, waiting for us all to get done after practice, just doing paperwork," said Jones. "She just goes above and beyond what's expected… It shows how much she cares about all of us."
Aefsky and Burgi are two of Duke's physical therapists working with Olympic sports.
Aefsky has a special set of skills in that he is a former collegiate soccer player and he works closely with Duke's soccer players, giving them a chance to kick around before returning to the field with their team.
Sydney Simmons tore her achilles last fall and said that Aefsky being a former college soccer player was one of the most helpful things for her recovery.
"Before I was able to jump back in with the girls, I was playing with and defending Brett," said Simmons. "That was really the best transition that I could have had to come back to playing with the team."
In Burgi's first year as a physical therapist with Duke Athletics, she began working with women's soccer's Mia Gyau for her first injury. Gyau, now a fifth-year senior, has gone through an ACL and MCL tear and two torn Achilles', and Burgi was her physical therapist through all of it.
"She would never hold me back," said Gyau. "She was very individualized. All the physical therapists are. They feel out your personality to see how to go forward."
And that personal relationship between the medical staff and athlete is what makes a huge difference in the recovery process.
They come to know players for more than just their injuries and their sport. They know that these athletes are also Duke students juggling a rigorous academic schedule on top of athletics, and now on top of injury.
And the medical staff and coaching staff know that each rehab process is different and one athlete's progress may be completely different from another athlete's.
"They know before I even say anything if I'm having a bad day and maybe we do something other than work on what's really challenging at that point," said Simmons.
The relationship and trust between Hall, Aefsky, Burgi, and the rest of the medical staff is also what makes Duke a unique place for athletes to go through rehab. The three of them, plus Megan Rottler, Duke's sports performance coach for women's soccer, volleyball and rowing, and the sport coaches are in constant communication with each other, and are each in control throughout different phases of the recovery process.
"The communication that happens to provide the best care possible, making sure the staff is on the same page and that athletes are getting a consistent message, can't happen if there are big egos amongst our staff," said Burgi. "It's rare, I think, for things to run as seamlessly as they do here and it all goes back to communication and keeping the athletes' best interest at the center of every single decision we make."
For surgical patients, Dr. Alison Toth is another leading actor in the recovery process. Dr. Toth, the team surgeon for Duke women's soccer and women's basketball, has been part of the staff for 19 years.
Dr. Toth requires the athletes to come into her clinic every two or so weeks post-surgery and the athletic trainer or physical therapist comes to the appointments as well to know where the athlete is at in the process.
"They know that I want to hear if they have ideas, if they have concerns. And they also know that I'm available at any time to see the athlete," said Dr. Toth. "So, I think it's really having teams like this where the communication becomes very clear and easy, and nobody's afraid to tell the other if they have a concern."
At the end of it all, Dr. Toth gives the final say on when an athlete can return to play based on the information from the whole team. Then it is on to Aefsky and Burgi to get the athlete to a place where they can be in the weight room and running again.
And from there they pass the baton to Rottler, who gets them back to where they need to be to return to their sport and the coaching staff who makes the practice plans available to the athletic trainers to discuss which parts of practice are safe for the athlete to participate.
"As a surgeon, there is a lot of responsibility to do the surgeries and try to get the athletes back," said Dr. Toth. "But we definitely couldn't do it without all of these people doing such a great job to take care of the athletes day in, day out."
When the world went on pause in March due to the pandemic, the athletic medicine staff needed to get creative in order to continue the rehab process with the athletes, while they were away from campus. Once they got the okay to practice out of state, Aefsky and Burgi resorted to Zoom physical therapy sessions. But Rottler made a Youtube channel.
With her husband as the cameraman, Rottler filmed the workouts for the athletes to watch while they were home. The videos show Rottler doing the exercises so that the athletes know exactly what they need to be doing, even though she's not physically there with them.
Rottler's channel is public so it's not just for Duke athletes.
"A bunch of random people use it, but if it helps them that's awesome," said Rottler.
The holistic rehab process also extends to the in-house sports nutrition and sports psychology teams at Duke as well. From a nutritional standpoint, the athlete needs to approach their meals differently than they would if they were playing, whether that be including different types of supplements or foods. And from a mental health aspect, the athlete needs to wrap their head around what the body has gone through and relearn to trust the sport that got them injured in the first place.
From a technological standpoint, Duke has everything from an underwater treadmill to the AlterG anti-gravity treadmill to assist in the recovery process. Another key piece of technology for Duke women's soccer is Catapult, a GPS system that the medical and performance staff and coaches use to measure the physical work athletes perform during training and games and understand each individual athlete's capacity. This information is used to plan training, mitigate injury risk, prepare for games and takes some of the guesswork out of returning an athlete back to sport after injury.
An athlete with, say, a hamstring strain, could know after practice exactly what percent of their maximum speed they ran during practice, the number of sprints they ran and the total distance they were able to sprint. Taking this objective information and combining it with the athlete's report of how they felt and their overall confidence can help the medical staff relay information to the coaches to make a decision on whether or not the athlete is safe to return to play.
"How the athlete feels is the most important, but we can add some objectivity that helps us as a staff know where someone is at, and help coaches and the athletes know where they're at," said Burgi.
The relationships between athletes and medical staff extend well beyond Duke's campus. Former athletes stop by the athletic training room when in town to say hi, and to catch up. Whether an athlete decides to go pro or not, knowing that they helped them succeed and do what they want to do is what Duke's athletic medicine staff prides themselves on.
Some athletes come back four or five years after a major surgery to let the staff know that she can play pick-up soccer again and to thank them for what they've done.
"We've seen the tears and we've seen the joy," said Hall. "It's super rewarding to see them back doing what they love doing, and doing great at it. It's what we do."
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September 29, 2020 at 10:43PM
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