October 6, 2022

Extreme athletes like Dr. Omer Mei-Dan push new treatment, medicine

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Doctors took a look at Ian Mitchard’s body four years ago and assumed his career was over. 

That’s why Steph Davis brought him along to a talk she gave to doctors: She wanted them to see what was possible. 

To be fair, it’s probably the conclusion many would reach after Mitchard crashed while paragliding alone. He broke his back, ankles and a couple other bones. The worst damage was to his feet, which were crushed so badly that those doctors thought amputation was the only solution. 

The injuries were, of course, horrific, but the worst part of the ordeal was the doctors’ bleak outlook, Davis, Mitchard’s wife, said in a phone interview. 

“They hadn’t seen injuries on that scale before,” Davis said. “He was getting excellent medical care, but we weren’t getting a lot of super optimistic stuff, and that’s hard to deal with.” 

Davis and Mitchard, after all, had made a career out of doing what most would consider the impossible. They flew wingsuits in addition to BASE jumping, and she was also a professional rock climber, sometimes without a rope. 

Both Davis and Mitchard didn’t want to hear opinions that Mitchard would need to stop living a lifestyle that helped them fall in love. They already knew the risks, to a painful degree. Mitchard is Davis’ third husband. Her first, Dean Potter, the ropeless rock legend, died in a wingsuit crash. Her second, Mario Richard, also died in a wingsuit crash. 

“We spent a lot of time doing things that technically should be impossible,” Davis said. “Flying off a cliff should not be possible for humans, but we find a way to do it.” 

This was the center of Davis’ talk at the International Extreme Sports Medicine Congress in early May that was organized by the University of Colorado School of Medicine. Davis is a professional speaker, and she markets specific talks on her website, but she developed something special for the doctors, physical therapists and researchers who convened in Boulder. 

She talked about the power of the mind, and how mental strength could overcome perceived physical weaknesses, including a human being’s inability to fly or, in Mitchard’s case, overcome gruesome injuries that may leave most of us unable to walk again. In fact, her talk was almost a plea for doctors to treat extreme athletes differently. Mitchard, while still recovering to this day, returned to the sport they both love. Other friends in their sport have done the same thing. 

It may be more important than ever that doctors rethink how they treat so-called extreme athletes, because they aren’t as extreme as they once were: More and more of us are doing the kind of outdoor adventure sports that years ago only people such as Mitchard would attempt. 

“He’s the reason I was interested to speak with these doctors,” Davis said. “They are so focused on the human body that I thought it was interesting for them to hear how you can use your mind and mental abilities to change what is possible physically.” 

Davis was mostly preaching to a converted flock. Every two years, a group of medical experts get together at this congress to discuss ways to treat extreme athletes. They discuss new research, new treatments and new ways of thinking about the “crazy” humans who do the “crazy” stunts that make good movies, like “Free Solo,” the film about Alex Honnold’s first-ever free climb of El Capitan in Yosemite National Park, which won the Oscar in 2019 for best documentary.

Adventure athlete Steph Davis free-soloed the North Face of Castleton Tower in Castle Valley, Utah in May 2008. (Provided by Steph Davis)

Much of what they talk about is how traditional medicine doesn’t fit these “crazy” people. Davis, in her keynote speech, was there to remind them, and inspire them, to continue to think differently. 

“I had a provider come up to me after my talk, and she told me, ‘I can give them data, but I can’t give you information about yourself,’” Davis said. “I just thought that was so profound.” 

Do as I Do

It is not a coincidence, Dr. Omer Mei-Dan said in his understated way, that he is a leader in extreme sports medicine. He started and continues to organize the conference, works as a sports surgeon with the University of Colorado School of Medicine and is the author and editor of the first extreme sports medicine textbook. 

He’s also an extreme athlete, sometimes to the degree that it’s difficult to tell what comes first. 

He’s world-renowned for his expertise in wingsuit flying, rock and ice climbing, downhill mountain biking, kayaking and BASE jumping. He’s sponsored by Red Bull. He, like Davis, understands the mentality of an extreme sports athlete and knows many doctors simply don’t.

Their personality characteristics, he said, such as their drive, pain tolerance and courage (even stubbornness) are their most common trait.

“God knows I had so many surgeries on myself,” Mei-Dan said. “These are not the type of people who get hurt and then you tell them, ‘Now you should not get back into climbing.’ That won’t work. I did feel that as an athlete. Sometimes I was … I don’t know if ‘judged’ is the right word … but I was looked at through a certain lens.” 

The thing is, doctors should not look at extreme athletes that way anymore, Mei-Dan and his colleagues said, especially as more people looked to the outdoors as a source of entertainment, exercise and comfort during the pandemic.

The 14ers were already packed pre-pandemic, but even more are taking up harder pursuits such as climbing and challenging mountain biking races and skiing in the backcountry. That’s especially true in Colorado. Ultramarathons were once an anomaly, and now the most popular races have a lottery to get in, including the 100-miler in Leadville and the Hardrock 100 in Silverton. 

“We’ve seen much more of that because of COVID,” Mei-Dan said. “It pushed a lot of people to play in the outdoors, in a good way. But not a lot of them were physically ready to do that.”

This is a problem for doctors, here especially, because many physicians still do not understand the intricacies of adventure sports and how to treat the injuries they cause, Mei-Dan said. 

“They don’t know the mechanism of injury from biking 100 miles a day, or how you are supposed to open a parachute,” he said. “Doctors need to research more, and sometimes they have to ask (questions such as show me how you open a parachute), or there’s a chance they will not be able to treat their patient well enough.” 

There are names for more common sports-related injuries, such as tennis elbow, and even snowboarder’s ankle is in the more common vernacular in Colorado. But kayakers typically get a specific kind of shoulder injury, mostly a dislocation. This is why Mei-Dan appreciates his own experience in kayaking and other sports. 

“Almost every sport has its own injuries,” he said. “Doctors who aren’t familiar with that sport may just see it as an injury instead of a specific way to treat it.” 

Trauma is trauma, but many, if not most, injuries are the more boring types, such as overuse. Overuse, of course, is relative, which is why Jenna Walton Noel, a physical therapist at the UCHealth Steadman Hawkins Physical Therapy and Rehabilitation Clinic, has seen more patients. 

“People have taken up running a lot more, even if they’ve never done it, and they did that without the knowledge that a more experienced runner would have,” Noel said. “So we are seeing a lot of running overuse, or biking falls, especially mountain bikes. There’s all these new sports that they haven’t done before.” 

In speaking with other colleagues, she sees a lot more overuse such as tendonitis than they see in other, less-active parts of the country where more people experience lower back pain. 

“In Colorado, too, there are a lot of people who are expert recreational users,” she said. “Maybe they aren’t competing or super elite, but they are in, say, the backcountry every day.” 

She also sees the same unwillingness among recreational Coloradans to listen to their bodies and back off when needed that she sees in more elite athletes.

“When you have an acute injury, there’s a protective phase, and a lot of that means active rest,” Noel said. “But for someone who is used to pushing their body to the limit, that can be a tough thing to educate them on. Rest is active healing. It’s much easier to convince Joe Schmo, who sits on the couch, that it’s OK to sit on the couch.” 

Noel values her own experience practicing the sports she treats, although she admits she’s not a great rock climber. She serves on the medical staff for U.S. Figure Skating and was a figure skater herself. Mei-Dan, she said with a laugh, was her surgeon for one of her hip injuries. 

“I think it makes it relatable for me,” she said. “Having the same experience in a sport makes it easy for me to be someone else’s cheerleader.” 

Davis said she doesn’t see the same pessimistic attitude about injuries from physical therapists, and Noel agreed with that to a degree. Physicians, she said, need to fix an injury structurally. 

“But I need to treat the person,” she said. “I need to know their past experiences, their emotions and what they want to do in the future.” 

Treatments for the rest of us

The research doctors brought to the conference in early May had a lot to do with treating extreme athletes, but as it turns out, much of that medicine is applicable to the rest of us as well. 

“There are a lot of things we have learned working with elite athletes,” said Dr. Iñigo San-Millán, an associate research professor in physiology and nutrition at the University of Colorado-Colorado Springs. “Features on our cars nowadays came from the best cars in the world, the Formula One cars.” 

San-Millån researches ways to improve metabolism and also works in oncology. Seeing how elite athletes work with superior metabolic function taught him how to treat dysfunctional metabolic systems, a problem with a decent chunk of the U.S. population, one reason why so much of the population are pre-diabetic or have Type II diabetes.  He is the personal physiologist of Tadej Pogačar, the Slovenian cyclist who won the Tour de France in 2020 and 2021. San-Millån was also a pro cyclist himself for two years. 

San-Millån brings up Kilian Jornet, a runner and mountain climber who climbed Mount Everest in 17 hours and once broke course records for the Hardrock 100 by a couple hours (winning it four times). Jornet loves to study physiology and how to make it work for him. 

“Yes, they won the genetic lottery at birth,” San-Millån said, “but you have to develop your body as well, with training and nutrition and recovery. You have to put everything together. That’s how we can learn.” 

Doctors, led by Mei-Dan, have learned how to treat athletes in all stages of their life and in all abilities by learning about elite mindsets. Many of us try to do that, too, by asking them why they do all those crazy things in the first place. 

“Well, there is mental health, too, right?” Davis said. “It’s all tied together.”

This story first appeared in The Outsider, the premium outdoor newsletter by Jason Blevins. >> Subscribe



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