141: Dr. Jacob Calcei – Wearable Technology for Athlete Performance & Injury Prevention (Part 1)

Our conversation picks back up with an article published just last month in AJSM titled “Player Tracking Metrics to Predict Risk of ACL Injuries During Change-of-Direction Scenarios in the NFL.” The authors analyzed 216 ACL injuries that occurred in the NFL from 2018–2022 to determine how player tracking data could help predict injury risk, particularly during change-of-direction or “CoD” plays. They found that nearly half of ACL injuries occurred during CoD scenarios, most often involving high speeds followed by rapid deceleration. The authors noted that 98% of players were decelerating at the moment of injury. Using synchronized video and player tracking, the researchers found that maximum speed and normalized maximum deceleration power were significant predictors of ACL injury risk. Additionally, special teams plays showed the highest rates of CoD ACL injuries, though when motion data were factored in, the elevated risk was better explained by player speed and deceleration demands rather than play type alone. These findings highlight the potential to use tracking metrics for real-time risk monitoring, improved prevention programs, and possibly even future changes to training or game rules to reduce injury risk.We’re going to wrap up today with a study that is currently ongoing and not yet published. Funded by the AOSSM Playmaker Grant, this clinical trial is investigating the use of wearable muscle oxygenation sensors to improve return-to-play assessment after ACL reconstruction. Dr. Voos, Dr. Calcei, and their team at the UH Drusinsky Sports Medicine Institute have found that muscle oxygenation recovery lagged behind clinical clearance in several cases. Eight athletes did not regain normal muscle oxygenation even when they were deemed ready to return. These findings suggest that wearable muscle oxygen saturation monitoring may add a valuable physiologic layer to current return to play protocols, potentially predicting safer and more individualized recovery timelines.

On today’s episode we’re focusing on wearable technology for athlete performance, recovery and injury prevention with Dr. Jacob Calcei, an orthopedic surgeon at University Hospitals in Cleveland and team physician for the Cleveland Browns. We’ll start off our discussion today with an article titled “Wearable Performance Devices in Sports Medicine” from the January 2016 issue of Sports Health. The authors review the rapid rise of wearable sensor technologies in athletics, highlighting their ability to track real-time physiologic and movement data for optimizing performance and reducing injury risk. These tools can provide valuable insights into workloads, biomechanics, and fatigue, supporting tailored training programs and early injury prevention strategies. While wearable devices have shown promise, evidence for their effectiveness in professional sports remains limited, and further research is needed to validate accuracy, develop standardized training protocols, and address practical challenges such as reliability and usability.Then, from the January 2020 issue of Sports Heath, we review an article titled “Does Overexertion Correlate With Increased Injury? The Relationship Between Player Workload and Soft Tissue Injury in Professional American Football Players Using Wearable Technology.” This study investigates whether sudden increases in training load, as measured by wearable GPS and accelerometry technology, are associated with higher rates of soft tissue injury in professional American football players.  The authors analyzed two NFL seasons and found that injured players experienced significantly greater spikes in workload during the week of injury compared to the prior month. Specifically,  they found that those exceeding an acute-to-chronic workload ratio (ACR) of 1.6 being 1.5 times more likely to sustain an injury. The effect was particularly pronounced in the preseason, when workloads were higher and hamstring injuries were most common. The findings suggest that rapid workload increases predispose athletes to soft tissue injury, while consistent training loads may offer a protective effect. The authors conclude that monitoring player workload with wearable technology could help medical and training staff design safer, more individualized training regimens to reduce injury risk.We are joined today by Dr. Jacob Calcei, a board-certified orthopedic sports medicine physician and shoulder surgeon at University Hospitals and an assistant professor of Orthopedic Surgery at Case Western Reserve University School of Medicine. He is a team physician for the Cleveland Browns as well as several local high schools. Dr. Calcei has published extensively on a variety of sports medicine topics, has a particular interest in injury prevention and finding ways that we can make sports safer while optimizing athlete performance. So, we’re very excited to have him join us today.

Today’s episode is going to focus on the management of rotator cuff retears — including tips and tricks for successful revision repair and augmentation options.We are joined today by two outstanding guests! Dr. Brian Waterman is a Professor of orthopedic surgery at Wake Forest University School of Medicine, Chief of Sports Medicine & Shoulder Surgery at Wake Forest Baptist Medical Center and Director of the Sports Medicine & Shoulder Surgery Fellowship. He is on the editorial board of the Arthroscopy Journal and American Journal of Orthopaedics. Dr. Waterman is a team physician for Wake Forest University, Winston-Salem Dash and US Ski and Snowboard.Dr. Gabriella Ode is an orthopedic surgeon specializing in sports medicine and shoulder surgery at the Hospital for Special Surgery, Assistant Professor of orthopedic surgery at Weill Cornell Medical College and adjunct faculty with the Department of Bioengineering at Clemson University. She is also a team orthopaedic surgeon for the New York Liberty of the WNBA.So, without further ado, let’s get to the Exhibit Hall!

Pitch, please: Managing UCL Injuries in Throwing AthletesDr. Michael Banffy and Dr. Christopher CampToday’s episode is going to focus on the management of UCL injuries in throwing athletes.We are joined today by two outstanding guests! Dr. Michael Banffy is a Professor of Orthopedic Surgery and Chief of Orthopedic Sports Medicine at Cedars-Sinai, as well as Director of the Orthopedic Sports Medicine Fellowship at Kerlan-Jobe. He is a team physician for the Los Angeles Dodgers and Los Angeles Rams.Dr. Christopher Camp is a board-certified orthopaedic surgeon specializing in sports medicine and shoulder and elbow surgery. Since 2019, he has been Medical Director, Team Physician, and Director of High Performance for the Minnesota Twins Baseball Club. Dr. Camp conducts clinical and basic science research on injuries of the shoulder, elbow and knee, including a focus on the throwing athlete. So, without further ado, let’s get to the Exhibit Hall!

Today’s episode is going to focus on addressing hip pathology in the setting of dysplasia — soft tissue management alone or with a periacetabular osteotomy.We are joined today by two outstanding guests! Dr. Jorge Chahla is an Associate Professor of orthopedic surgery at Rush University Medical Center and serves as the Director of Biomechanical Research and Director of the International Fellowship Program at Midwest Orthopaedics at Rush. He is a team physician for the Chicago White Sox, Chicago Bulls and The Joffrey Ballet.Dr. Robert Parisien is an Associate Professor of orthopedic surgery at Mount Sinai Orthopedics and is a team physician for US Ski and Snowboard and USA Fencing. He has published extensively on the topic of hip preservation and received numerous research awards over the years, so we are very excited to hear his take on this topic!So, without further ado, let’s get to the Exhibit Hall!

Today’s episode is going to focus on lateral augmentation procedures to supplement ACL reconstruction, including lateral extraarticular tenodesis versus anterolateral ligament reconstruction.We are joined today by two outstanding guests!  Dr. Alan Getgood is the Chief of Surgery at Aspetar and Adjunct Professor of orthopedic surgery at the University of Western Ontario. He is a clinician scientist who has secured over $9 million in peer-reviewed and industry-funded grants to build his research program focused on complex knee reconstruction. Dr. Getgood is member of the AOSSM Board of Directors, Herodicus Society, ACL Study Group and was the program chair for the ISAKOS Biennial Congress last month.Dr. James Voos is a Professor of orthopedic surgery at Case Western Reserve University School of Medicine and Chairman of the orthopedics department at University Hospitals. He successfully launched the UH Drusinsky Sports Medicine Institute and served at the Chief of Sports Medicine and Medical Director. Dr. Voos is the head team physician for the Cleveland Browns, Medical Director for the Cleveland Ballet and current President of the NFL Physicians Society.So, without further ado, let’s get to the Exhibit Hall!

Today’s episode is going to focus on surgical management of primary and recurrent anterior glenohumeral instability in athletes. We are joined today by two outstanding guests! Dr. John Kelly is a professor of orthopedic surgery at the University of Pennsylvania and Director of Shoulder Sports Medicine at UPenn Ortho. He is Co-director of the Sports Medicine Fellowship and is a team physician for the Philadelphia Union. Dr. Kelly is the former President of the Eastern Orthopaedic Association and Vice President of the Arthroscopy Association of North America.Dr. Matt Fury is an orthopaedic surgeon at the Baton Rouge Orthopaedic Clinic who specializes in sports-related injuries to the shoulder, elbow, and knee as well as complex shoulder conditions.  Dr. Fury graduated from LSU Medical School in New Orleans before completing his orthopaedic surgery residency at the Harvard Orthopaedic Residency Program.  He then completed specialized fellowship training at the world-renowned Hospital for Special Surgery in New York City. So, without further ado, let’s get to the Exhibit Hall!

Today’s episode is going to focus on ligament reconstruction in skeletally immature patients – including various growth plate sparing ACL reconstruction techniques, MPFL reconstruction considerations and clinical outcomes.We are joined today by two outstanding guests! Dr. Mininder Kocher is a professor of orthopedic surgery at Harvard Medical School, Chief of Sports Medicine and Director of the Sports Medicine Fellowship at Boston Children's Hospital. He is the former President of PRISM and POSNA, and serves on the board of directors for AAOS and AOSSM.Dr. Lauren Redler is an assistant professor of orthopedic surgery at Columbia University Irving Medical Center and is actively involved in medical student, resident and fellow education at Columbia Ortho. She has published extensively on surgical treatment of ACL tears and patellar instability in pediatric patients, and is presenting her research on outcomes of MPFL reconstruction in skeletally immature patients at AOSSM this year!So, without further ado, let’s get to the Exhibit Hall!

Today’s episode is going to focus on mental performance and burnout — specifically: What is burnout? What are some risk factors for burnout? And how do we prevent and treat burnout in orthopedic surgeons?We are joined today by two outstanding guests! Dr. Kathy Coyner is an Associate Professor of orthopedic surgery at the University of Connecticut and Director of the Sports Medicine Fellowship at UConn. She is a team physician for the UConn Huskies and serves on the AOSSM Board of Directors. Dr. Coyner is the Director of Fellowship Research and has published extensively on a wide range of orthopedic conditions. Dr. Dean Taylor is a Professor of orthopedic surgery at Duke University, Director of the Duke Sports Medicine Fellowship and a team physician for Duke University. He is the Chairman of the Feagin Leadership Program and is a former President of AOSSM.So, without further ado, let’s get to the Exhibit Hall!https://www.thesportsdocspod.com/episodes

Today’s episode is kind of an Overtime / Ask The Sports Docs crossover. One of the PTs that Ashley works closely with asked her why some patients do well after ACL surgery and some don’t fare as well, despite the surgery being identical in terms of technique, graft choice, post-op protocol etc. An article was just published in AJSM this month looking at this, specifically investigating factors that impact outcomes after ACL reconstruction. The article that we are reviewing today is titled “Primary Anterior Cruciate Ligament Reconstruction in Level 1 Athletes: Factors Associated With Return to Play, Reinjury, and Knee Function at 5 Years of Follow-up.” This level 2 cohort study aimed to analyze the outcomes of primary ACLR in level 1 athletes and identify preop and intraop factors associated with RTP, ipsilateral ACL reinjury, contralateral ACL injury, and IKDC score at 5 years post-op.** We have also been chatting about this episode offline and discussed an article that was recently published looking at preoperative grit scores and postoperative range of motion after ACL reconstruction. Grit score is another objective measurement that we can obtain preoperatively and perhaps use to guide intervention during post-op recovery. We actually did an Overtime episode looking at the impact of grit scores on post-op outcomes after ACL reconstruction. That is episode #53 if you want to check it out! But today's second article is titled “Higher Grit Scores Are Associated With Earlier Increases in Knee Flexion Following Anterior Cruciate Ligament Reconstruction With Meniscus Repair in Pediatric Patients.” It was published in the April 2023 issue of the Journal of Pediatrics. Pete Fabricant and his team at HSS found that patients with grit scores below the 50th percentile undergoing ACLR + meniscus repair have 5 degrees less total ROM at 3 months compared with those with high grit scores. Though 5 degrees might not seem like a lot, quicker motion recovery in patients with high grit may be a leading indicator of these patients likelihood to achieve other post-op milestones and meet criteria for RTS more quickly. This obvious needs future study to see how grit impacts other factors like strength gains, passing RTP assessments etc.