Helping athletes heal, at the AAC

Micah Chelimo was hurtling through the second lap of the GNAC outdoor track and field championship's 3,000-meter steeplechase when he cleared a jump, landed at the outside edge of the water pit...and abruptly fell forward.

He raised his head, but quickly ducked as a pack of racers splashed by and over him. Then, Micah tried to push himself to his feet, planning to kick up speed and regain the ground he'd lost.

"It was weird because at that point you think maybe somebody kicked you, you're going to get up and run again," Micah said. "It was not painful. I tried to lift myself up but my leg couldn't allow me to get up."

What happened?

The Achilles tendon is a strong, thick 6-inch band of fibrous collagen tissue that connects the back of your heel to the bottom of your calf muscle. While it's flexible, the tendon doesn't stretch. The tautness of the tendon provides tension that makes it possible to push off from your toes while walking or running. The tendon is named after a figure in Greek mythology.

Landing after that steeplechase jump snapped Micah's Achilles tendon, prematurely ending an exhilarating season for the Kenyan man whose fleet feet earned him four national championships in cross country and track and field during his five years at UAA.

Four months have passed since Micah's accident at that championship meet at Western Oregon University. Surgeons repaired his ruptured tendon and placed his foot in a posterior splint. Several weeks later, Micah transitioned to a boot and then used a walking stick.

"It was a challenge walking around," he said. "I had no strength in this foot."

That's when UAA Head Athletic Trainer Chris Volk helped Micah begin his rehabilitation at UAA's sports medicine center, which has moved from the Wells Fargo Sports Complex to a more spacious home in the basement of the new Alaska Airlines Center.

Before his injury, Micah could run 3,000 meters (3K) in 8:10.99, 5K in 13:41.99 and 10K in 28:37.75 minutes-4.23- to 4.36-minute miles, or speeds in the neighborhood of 14 mph. Now, Micah is allowed to run at a speed of 3.5 mph on an underwater treadmill in a new hydrotherapy pool. A videocamera beneath the surface of the water transmits images to a poolside monitor, so Micah and an athletic trainer can view his gait in real time as he runs.

The water supports most of Micah's 115 pounds, now, but its level will be gradually lowered as his feet and ankles gain strength and can support more of his weight.

"It was just perfect timing, the right time for me to start," Micah said.

'We made it work'

Volk and two assistant athletic trainers, Kevin Lechtenberg and Rachel Butler, work with 176 Seawolf student-athletes who participate in ice hockey, basketball, gymnastics, cross country, track and field, volleyball and skiing.

"We're not fitness trainers," Volk said. "We are allied health professionals that take care of injuries to student-athletes. We evaluate all the athletic injuries that occur with our student-athletes. From there, we set up a treatment plan to take care of that injury and a rehabilitation plan to get them back to their sport as quickly as we can."

Chris Volk first arrived at UAA 20 years ago, using a 10-by 20-foot training room and an office that was about the same size. Lechtenberg arrived soon after, sharing those quarters, followed by Butler, who moved into that office with them four years ago.

"In a very small space we did evaluations, treatments and rehab for 180 student-athletes," Volk said. "We did some things out in the hallway, and other things in a very small weight room that was over there at the Wells Fargo complex. We made it work and adapted to our surroundings."

The athletic director told Volk when she first started that the university would be building a new sports facility in a few years. That "few years" turned out to be 20 years, she said.

University officials approached Volk and Lechtenberg in 2011.

"They said this is going to happen, this is the space you have to work with," she said. "They already had plans laid out for the building and already had the square footage for the sports medicine center. We just had a big rectangle; we got to design it the way we wanted to design it, so that was exciting."

Enhancing care

Many of the athletes Volk and her staff see just want to stop by, get an ankle taped or a wrist braced and be on their way, so the new sports medicine center at the Alaska Airlines Center has a taping station just inside the front door.

There are also places to store all the supplies the university needs to properly treat its student-athletes' bumps, bruises, cuts, sprains and broken bones: the 80 cases of athletic tape the program needs each year, for example, as well as ibuprofen, braces and splints, cleaning supplies to keep the whirlpools free of MRSA and other microscopic nasties, Ace bandages, Steri-Strips, reflex hammers, tweezers, gauze, massage supplies and suturing needles and thread.

The center also contains a doctor's examining room, athletic trainers' offices, a computer room for baseline concussion testing, hydrotherapy pool and tub-like whirlpools, a treatment area with four examining tables for athletes who need injury evaluations and modality treatments (including electrostimulation, ultrasound, hivamat and biocompression) and an open space for athletes to perform their rehabilitation exercises.

"We're a mini health clinic here," Volk said. "We're the first responders for all the student-athletes' illnesses and injuries. When warranted, we refer out to one of our team physicians."

That's when UAA's sports medicine program extends far beyond its fresh new quarters. It reaches into the community of Anchorage, engaging the services of approximately 20 team physicians, including the head team physician, Dr. Jeffrey Moore.

Local team physicians, like Dr. Richard McEvoy and Dr. Paul Steer, to name a few, have spent years helping UAA student-athletes. They provide medical coverage at hockey, basketball and volleyball games, gymnastics meets and ski events, and are ready to, say, suture a hockey player's slashed face, assess the severity of a knee, wrist or shoulder injury and immediately order diagnostic tests like X-rays, MRIs and CT scans.

"Financially, they've made it so much more cost-efficient; you can't imagine," Volk said in a 2012 interview. "If I took a student-athlete to the emergency room for a facial laceration every week, it's going to be at least $1,000 each time."

Several of the doctors actually enjoy the sports they cover and sometimes even participate in those sports themselves, which enhances the benefits they provide the student-athletes, Volk said.

"When you see a team physician who can talk to you about your sport, who knows your position and knows what you mean when you say, 'Hey, I got boarded,' it does make a difference," she said.

Dedicated to detail

Volk and her staff tape and splint and massage. They must amass and digest stacks of information about each of the 176 student-athletes in their charge.

They need to know which of the student-athletes suffer severe allergic reactions to bee stings, and be vigilant about keeping lifesaving EpiPens-epinephrine autoinjectors-close by wherever they go.

They need to be sure student-athletes with sickle-cell anemia don't push too hard while exercising, monitor athletes with a tendency to develop blood clots and be certain that athletes who have an exercise-induced wheat allergy don't take ibuprofen before or after a workout.

"There's a lot we see, a lot to keep track of," Volk said.

When a student-athlete is injured, one of the trainers or a doctor will treat the injury and set the course for further treatment. The trainers then create a rehabilitation plan and supervise the student-athletes to be sure they comply with the plan's instructions.

Some student-athletes need strictly supervised TLC.

"Some of these athletes have either never been hurt or just don't understand the process," Butler said. "And some of them think they're Superman, that they can heal magically and not do the work. Some need to be educated that you have to slow down and let this heal."

A trio of volleyball players walked into the center a short time later and Butler's eye immediately zeroed in on one girl's thumb, which was bare but shouldn't have been.

"You're not supposed to be doing that!" Butler chided. "Put your splint on all week, please."

"But it feels regular!" the girl replied.

Volk had mentioned that athlete.

"She'd get taped here, then she'd go out there and she'd take it off," she said. "That's how they are sometimes. I have to lecture that one over and over. Or she wouldn't come in and ice even though it's swollen, discolored. 'Well, I don't have time,' she'd say. You have kids like that who aren't as compliant. They don't want to make the time but they want to keep playing."

'He's going to do it'

Other athletes, like Micah, meticulously follow every instruction, accomplish every exercise as directed.

"What he's doing is comfortable and he's good at it and I've watched him long enough to know he can do all that without me watching every little thing, and he's going to do it," Volk said, gesturing toward Micah as he carefully jogged in the hydrotherapy pool. On the monitor, his legs moved through the blue water, hitting the treadmill as rhythmically as the pendulum of a metronome.

"The doctor had told me it was going to take up to six months before I would run," Micah said. "All I've been thinking was six months is going to be a long time, so when they installed this, that was really exciting for me. You can't always avoid injuries, but at least there's a way to get back on the track. It's just great equipment for all of us as students."

Written by Tracy Kalytiak, UAA Office of University Advancement