June 24, 2022 by John Fernandez
For Miami HEAT Team Physician, There’s No Timeout From Treating/Preventing Injuries in Pro and Recreational Athletes
The Miami HEAT’s standout season came to an abrupt end in the final game of the Eastern Conference finals, but the work of keeping players healthy and fit for the next season continues for their stalwart team physician.
Harlan Selesnick, M.D., orthopedic surgeon at Baptist Health Orthopedic Care, has been the Miami HEAT’s team doctor since the franchise started back in 1988. (The Miami HEAT Sports Medicine Center is located on the Baptist Health Doctors Hospital campus in Coral Gables.)
The HEAT players now go through “exit physicals,” he said.
“We try to identify areas of orthopedic concerns,” explains Dr. Selesnick. “Let’s say for some, we can improve their flexibility, or improve their quad strength — so they’re less likely to have a jumper’s knee during the year. We identify areas of potential abnormalities or weakness. And we have the off-season to really try and work on those conditions with them so they’re less likely to get injured and be bothered next season.”
For the those who may not be well versed in sports medicine, here are some clarifications. The quadriceps (or quads) are the four muscles on the front of the thigh. They work together to help flex (or raise) the thigh and extend (or straighten) the knee. A “jumper’s knee” refers to an injury to the tissue connecting the kneecap to the shin bone, or the patellar tendon which helps muscles extend the knee.
Dr. Selesnick’s fame as an orthopedic surgeon and sports medicine specialist draws many non-athlete patients to his practice. Some of them are active “weekend warriors” who have heard of — or are very familiar with — his work with a range of professional athletes who need orthopedic care.
“We treat everybody as someone special and we try and give the same care to the recreational athlete who comes in as we do to our professional athletes — with the same opportunities for imaging, rehab, and surgical intervention,” Dr. Selesnick said.
Injuries: Acute vs. Overuse
In his work with the HEAT, the quads and jumper’s knee are only two of a several conditions that Dr. Selesnick deals with on a regular basis. He divides types of injuries into two major categories: acute and overuse.
“Acute injuries cannot necessarily be prevented,” he says. “If someone falls on the wrist and breaks the wrist, there’s nothing you could do to prevent that — or in the case of someone catching their thumb on the rim and it snaps back and tears a ligament. There’s nothing you can necessarily do to prevent that.”
And then there are overuse injuries. “These are not just true of basketball players. It’s true for all sports. And those overuse injuries are things that we as physicians can help prevent. For example, if someone’s had a history of calf injuries or hamstring injuries, we can work on their flexibility. And proper warmup with stretching is very important.”
When Dr. Selesnick mentions “all sports,” he speaks from his range of experience which transcends basketball.
He is also the first team physician for Inter Miami CF, the American professional soccer club based in Miami. Dr. Selesnick is also an independent medical evaluator and consultant for the National Football League and NFL Players Association.
Dr. Selesnick and other physicians with Baptist Health Orthopedic Care also partner with the Miami Dolphins, Florida Panthers, Florida International University, Florida Atlantic University, Miami-Dade County Public Schools — to help monitor and treat their athletes. They also lead the medical teams at major sporting events, such as the he Miami Open tennis tournament at the Hard Rock Stadium in Miami Gardens and the Life Time Miami Marathon & Half Marathon.
Most Common Injuries
What are the most common acute injuries in basketball? “The most common we see are sprained ankles and jammed fingers, which you would expect. And sometimes a calf strain, or quad or hamstring strain — although they’re less likely in basketball. For example, we see more of those injuries in soccer players.”
Most common overuse injuries? “The most common overuse injuries we really see in basketball are jumper’s knees, which is not a big surprise,” explains Dr. Selesnick. “That can encompass patella or kneecap tendonitis. That’s an overuse injury you would expect with the combination of running, jumping and weight-training.
In terms of the running back and forth, it’s a different constant movement between basket and soccer players, he points out. “There’s constant movement in other sports, but not necessarily the back-and-forth that you see in basketball, and the lateral movement and twisting that you see.”
While Dr. Selesnick sees both professional athletes and regular patients, the prescribed treatments can differ significantly depending on several factors, including age, extent of injury and their status as athletes.
“For example, an ACL tear (tissue that connects the thighbone to the shinbone at the knee) in someone who’s 45 and a recreational athlete who was injured while skiing doesn’t necessarily require surgery. Whereas if you have a 20-year-old elite football player, you certainly would have to do surgery. So, you can have the same diagnosis and not always the same treatment. But we like to try and treat everybody with the same diagnostic acumen and same treatment options that’s best for them.”