Dr. Erin Boynton is the first woman to work as an Orthopaedic Surgeon in Major League Baseball, the National Hockey League and Canadian Football League. She has served as a consultant to many professional athletes and has worked with the Women's Tennis Association (WTA) tour for over a decade.
SZ: Did you become an orthopedic surgeon with the intent of working with high level athletes? Or did opportunities arise that led you in this direction?
EB: I became interested in medicine when I was a teenager, after I had sprained my ankle playing basketball. I did not have the specific intent of working with athletes when I first entered my residency in orthopaedics, but I found myself always gravitating to the sports arena. My past experiences as an athlete helped me to understand what the patients were going through and were very compatible with my goal of keeping people moving and doing the activities that they love to do. To me, Life is Motion.
SZ: What are some of the job pressures and challenges of working with professional athletes as a surgeon?
EB: One of the toughest challenges as a surgeon working with professional athletes is the time pressure to return the player back to sport. There can be a major conflict between the mind pressure that the athlete and team places upon the body to perform, and the reality of the physical healing and readiness of the body to compete.
SZ: Are there injuries that professional women tennis players are more prone to that require surgery?
EB: The vast majority of injuries in women's tennis do not require surgery. The shoulder is the joint that most commonly requires surgical intervention. Most injuries are secondary to overuse. Over time repetitive stress to the musculoskeletal system can lead to imbalances in the soft tissues, that is muscles, tendons, joint capsule. The imbalance occurs when the soft tissue becomes too tight and or too weak. This soft tissue imbalance can eventually lead to breakdown of a tendon or joint structure such as a labrum (secondary joint stabilizer). There is a threshold in the soft tissue imbalance that may be tolerated for years, but once the threshold is crossed pain can spiral out of control. Surgery may be required to reestablish structural integrity to the joint. Many patients struggle after surgery if they fail to do their rehab exercises. The key to success after surgery however, is to rebalance the soft tissues and strengthen the muscles surrounding the shoulder girdle so that the structure that was repaired is protected.
SZ: During a season professional athletes are required to adapt to time zones, which can affect sleep schedules, acclimate to various weather conditions, it can be hot weather in one location and the following game or event, cold and windy. The physical stress of constantly adapting to new environments. How much do these factors contribute to the potential for injury?
EB: Sleep deprivation can have significant effects on neurocognitive function and motor performance. There is no question that significant fatigue can interfere with reaction times, and the ability to focus on an activity, possibly leading to poor performance and the potential for injury. Changes in normal eating schedules and diet occur with travel, and dehydration is possible. Ideally, for major events, the athlete should travel early enough to allow for acclimatization, this is not always possible as we observe in most Major League Sporting Events, with teams competing all over the country. Steps should be taken by the individual or team to ensure that extra rest time is available for the athletes and education with regards to proper nutrition and hydration during these changes in environment should be provided.
SZ: I read an article http://ontennis.etondigital.com/news/sharapova-finding-her-game-again where you are quoted as saying, (Maria) Sharapova has a certain laxity that people naturally have in their joints. With how long her arms are, the lever arm and the force she generates on her shoulder and elbow relative to someone who is much shorter and smaller is much greater.” What type of shoulder injuries are more common in shorter players and why? Can athletes tall or short prevent most injuries by proper strength training and stretching?
EB: It is not really the height of the individual that puts them at risk, but the length of the lever arm relative to the strength of the stabilizing muscles that control the specific joint. Individuals, with longer lever arms place more stress on the joints than people with shorter lever arms, but an individual with a short lever arm and weak stabilizing muscles is just as much at risk for injury as a taller player. I will commonly see injuries in young athletes who are going through their growth spurt. When the young athletes arms and legs grow, they often have a relative weakness of the stabilizing muscles around the shoulders, CORE and hips that predisposes the player to injury. The key for these individuals to perform CORE stabilization exercises, and flexibility exercises to maintain proper balance of soft tissues (muscles, tendons, ligaments) around the joints to prevent injury.
SZ: You are an internationally ranked senior tennis player. Are there focus and concentration commonalities you’ve developed as a surgeon that help your experience as a tennis player?
EB: There are definite focus and concentration commonalities between athletics and surgery. I have a tremendous ability to be in my senses while I operate, this allows me to be in the moment and see the anatomy, recognize the pathology and perform the corrective technical surgery. I have found that my ability to “be in the moment” during surgery is a transferable mental skill to tennis. One of the major differences is that in the operating room, I am in control, I control the pace of the surgery, and am in charge of the environment, obviously, the tennis court provides a very different dynamic...no control.... one day I am going to show up to the tennis court in my surgical mask and gown.
SZ: Was tennis the sport you played growing up?
EB: I was an avid athlete, but did not really focus on one particular sport, I did play some tennis in the summers, but focused on other sports in the winter. Winters were spent skiing, playing basketball, volleyball, track and field. I was naturally good at most sports and was voted Athlete of the Year in my High School. I became side tracked with academics and training to become an Orthopaedic Surgeon during my college years, I won the John Copp Bursary at the University of Toronto Medical School for all around athletics and academics.
SZ: Does your knowledge of sport medicine improve your chances of being injury free?
EB: It is one thing to know what to do, it is another thing to do it! I am at an absolute advantage as I know how to address the many sensations of pain that arise during a normal exercise program. My strength however is in my discipline and determination to become the best person that I can be and this involves giving to my body.
SZ: What are your future tennis goals?
EB: I want to be the best tennis player that I can be. I started playing tennis when my daughter was 2 years old (she is now 16), and have played fairly consistently, only missing a couple of years because of work and family commitments. To me tennis has been a great barometer of my mental, physical and spiritual maturation over this past decade. I have faced a number of obstacles, and sport has been a great vehicle for me to learn and understand the relationship between my mind, body and spirit.
Dr. Boynton, thank you for taking time out of your very busy schedule for this interview. Best of luck to you on your upcoming tennis goals.
Dr. Boynton is a mother of two teenage children, she is presently living in Toronto, her career focus has shifted to research, writing and medical legal expertise. Her passion is to keep people moving and performing in the activities that they love.
*Featured guests are not former nor current clients of Susan Zaro
