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Podcast Season 2 Episode 8: Dr. Scott Kaar

On this episode of the show, I'm interviewing Dr. Scott Kaar, an orthopedic surgeon who treats athletes of all ages and ability levels. Since 2008, Dr. Kaar has been working at St. Louis University performing surgical and non-surgical procedures, including minimally invasive treatment of ankle, hip, knee, elbow, and shoulder injuries. 

Dr. Kaar is an associate professor in the Department of Orthopaedic Surgery and Chief of the Division of Sports Medicine and Shoulder Surgery at Saint Louis University School of Medicine. He is the head team physician of Saint Louis University sports teams, as well as various other Saint Louis area universities and high schools.

Dr. Kaar's goal is to assist an injured athlete return to sports as soon as possible while focusing on patient safety and future injury prevention.

Website: https://physicians.slucare.edu/

Transcript:

Hello, and welcome to STL Active. St Louis's premier health and wellness podcast. STL active aims to give listeners in the St. Louis area the information they need to succeed and progress with their health and fitness. This podcast is brought to you by stlouispt.com. And hosted by Doctor of Physical Therapy, Greg, Judice.


Hey everyone, it's Dr. Greg, owner and physical therapist here at Judice Sports and Rehab. On this episode of the show, I'm interviewing Dr. Scott Karr. Dr. Kaar is an orthopedic surgeon specializing in sports medicine here in St. Louis. Dr. Kaar was a mentor of mine during my postdoctoral program at St. Louis University and is now a trusted colleague. This interview was recorded before the Covid 19 pandemic. So we do have a bit of a discussion about the now-defunct XFL battlehawks, where he was on the medical staff but it's still a fun conversation. I hope you guys enjoy listening as much as I enjoyed recording this episode. And without further ado, let's get into the interview with Dr. Scott Kaar. All right, welcome to the show. Today we have Dr. Scott Kaar. Thank you so much for being here.
Yeah. Thanks for having me. Appreciate it.
This is awesome. This is my first interview on the show with a surgeon. So this is exciting. I wanted to mix it up a little Yeah. Great. Glad to be a guinea pig. So let's introduce you to the listeners. Tell us a little bit about your background. Sure. You got to be where you are. Yeah, happy
to. So I'm an orthopedic surgeon, I specialize in orthopedic sports medicine. You know, I've been here I work for St. Louis University been doing that for since the middle of 2008. So 12, almost 13 years now. Before that, I was in my training, and we can help with that if you'd like. But I've worked personally for this continuously for those past 12 years or so. Before that I was in Cleveland for a year of training to Cleveland Clinic and before that, doing my residency in orthopedics at the University of Michigan.
Okay, awesome. So yeah, let's maybe go into some of the training staff because I know a lot of people don't quite know, everything that a physician has to go through. Yeah, it's so so after college.
Yeah, so as I did my four years of college, digital engineering there, didn't use it enough, instead decided to go to medical school. So that was four years of medical school, which I did include one day Case Western Reserve. After those four years are up, what you do is you apply to residency which is the next step in your training. You've heard of the match thing you get matched into residency, I got matched into the University of Michigan was an Ann Arbor for five years and during the residency, you get a broad depth of all of orthopedics. So that includes really all the specialties and I'll sort of talk about them a little bit. So that involves nice person medicine, which is what I do, but orthopedic trauma or fracture work pediatrics sports medicine, which I do some as well. their spine, especially orthopedics, there's hands special orthopedics, there's tumor. those are the main ones. And so, so you get it, you learn about all those things. And if you want to, you can just graduate and just start working at that point and do most things. As a general orthopedic surgeon in the community somewhere, the trend nowadays is to do what's called a fellowship, which in most cases of one-year sub-specialty training and just one of those fields to sort of focus your career on that. And so in my case, I did a year a sports medicine fellowship at the Cleveland Clinic after I was done my time in Ann Arbor. Awesome.
So what prompted you to go the sports route? Because there's a lot of options within ortho. So what was the determining factor for deciding to go sports?
Yeah, truthfully, I really enjoyed it all. So I really could not any of these specialties and I do keep it somewhat broad focus my practice at times. But you know, a couple of things. One is I really enjoyed, you know, most first and foremost, the fact that I played basketball in college myself, so you know, not so much anymore. My two young kids are taking that away from me, but I was an athlete. And so, so playing basketball, I felt very comfortable in the athlete environment and with a lot of those sort of extra things besides being an actual surgeon that comes with being a sports medicine, like treating athletes on the sideline and being comfortable talking to like trainers, physical therapists and very sort of like multidisciplinary team approach which I really enjoyed, I think going back to the team-oriented nature of being an athlete. So that's, that's number one, then two, I really enjoy
just the actual surgical
procedures that we do, whether it's a lot of ligament surgery like ACL, reconstructions, meniscus surgery, a lot of arthroscopic middle evasive stuff, I really find it interesting. It's both challenging and rewarding at the same time. That goes for shoulder things as well like shore dislocations, label tears, instability, etc. And so thoroughly enjoyed doing that kind of stuff. So it's a combination of really enjoying working with working in the athlete team environment. We're really working with athletes themselves both weekend warrior As well as professional and on down through high school and middle school athletes,
as well as the procedures themselves, I found quite fun.
Awesome. You know, the team aspect is something that I don't have a whole lot of in private practice now. And so that's something that I kind of miss is having that team aspect. And so I can definitely appreciate that being a valued part of what you do.
Yeah, it's fun, you feel like you're part of something greater. You're, I mean, on one hand, a successful time for me for the overall team was when no one sees her here. So I mean, I'm just kind of watching and having fun and chit-chatting with, you know, friends in the stands. But at the same time, I'm always there for support. And it's nice to in the more advanced teams, whether it's the professional or division one. Team setting is really like a lot of even physical therapists. So I mean, you're well aware, obviously, from your background, but there's always athletic trainers, physical therapists, we're always working together, we all kind of have our own. While there's overlap, we all have our own little area we work with and kind of work together. And that's really, really nice, rewarding.
So I want to touch briefly, you mentioned that you did some engineering in undergrad. Yes. Do you feel like that has any benefits to what you do now? Is there that analytical side of medicine that's makes you think more and I guess, in a different, a different way? Does that apply to medicine?
Yeah, I mean, so you don't need to be an engineer to be a good physician or surgeon for that matter. I did kind of gloss over it earlier in the introduction, part of things, really not meaning to but I really did enjoy the engineering, you know, it's, it's totally different than than medicine traditionally, is. As far as the learning environment. We memorize very little was all about the why, and understanding the depth of how where we're going. Which really, really I enjoy it was obviously very challenging. But it certainly helps as far as like in medicine, and especially orthopedics, which I'll touch on a second, that really helps you have like curiosity and try to understand how & why things work, not just to get the answer for a test or memorize, you know, 1000 words in a huge textbook. orthopedics itself is a very engineering heavy field, it's a very physical field, it's a lot of mechanics, whether it's implanted, we put in understanding how they work, when they're going to fail, or fatigue or break with a suture or the metal or different things that we use. So while it's not essential that you obviously the most physicians are not engineers, I do think that that perspective is very useful at times, and especially early in your career, it really helps you understand where things are coming from, where they're going.
Definitely understandable. And, and I've gotten the opportunity to observe a couple of orthopedic surgeries, and it's a lot of mechanics going on, whether it's the precision measurements or, or the size of the implant, whatever it might be, I've gotten to see a couple of knee replacements. And it's always fascinating how much like carpentry it is.
Oh, for sure. And even beyond that, so you're right. So as far as joint replacement goes, and I do alot of shoulder replacements, but even more so knee and hip replacements that my partners do.
I have a background in materials engineering, actually. So
and that really comes to play as far as when we put in an indoor replacement, there is metal, in most cases, polyethylene, a common plastic. And whether it's, we call it the bearing surfaces, but the ball and the socket, so to speak, rubbing on each other creates sort of nanoparticles are really tiny particles that you can't see they're microscopic, and that those really interact in a very unique way with the body. And if things aren't put in properly, or if over time, the joint surfaces wear out or begin to wear out, then those small particles can cause a lot of problems, including loosening and failure of the implant. And just understanding the different sizes and where they should fit is a really big deal, as you saw when you were observing.
Absolutely. And obviously, as an observer, I certainly don't know everything that's going on. But it's very cool to see inside the room versus outside.
Yes, it is. Especially the leader, right. A lot of saws, or it's very much like carpentry at times, you know, can be very loud.
Absolutely. So one thing that you were mentioning earlier, why you chose sports. I think for me why I enjoy working with athletes, more than the general population elderly is that those success stories mean something different, right to see someone go from, I can't run and because X hurts to them being able to run a marathon to me feels like a bigger deal. Does that ever apply to you like those success stories? Does that mean more to you working with the sports folks?
Yeah, absolutely. It there's nothing better than then helping someone get back to what they're passionate about. And, you know, it could be someone who on the weekend runs distances or play soccer with their buddies. And it could be someone playing professional sports like football or something. And it's really both very challenging because athletes in most cases are doing things that most of us don't do. And so they put their bodies in positions and under stresses that the rest of us don't necessarily do. So for someone else has a desk job and sees our kids and evening and maybe works out the gym once a week. They have a lower level or different level of shoulder or knee or joint stress, the function that they have to get back to not that it's not important, just it's a lower level. And someone else who's trying to get back to whether it's distance running, or whether it's on a baseball, or playing football, or skating, or ice hockey or anything like that. There's just a higher threshold of where you have to get them back to in terms of function, things that may bother them wouldn't really bother somebody else who's not doing those, those activities. And so it's both challenging to get to deal with someone in that nature, which I find very, very rewarding. But then also, you know, it's nothing better than seeing or hearing from a patient who, like you were saying, like, couldn't do some part of their sport before and now is successful and back to playing High School soccer, college football or college basketball, or just, you know, playing pickup soccer with their friends on the way or anything, you know, it's just, it's really fun to see those success stories. And when that works out. And it does make it challenging when it doesn't work out. Because it's not that everything's perfect in rain, but we do our best.
And that's, that's with any profession, there's no hundred percent success rate with anything. And while we might all do our best job, there's going to be those that slipped through, true. So let's kind of segue into, let's continue talking about sports, obviously, being at SLU. What is your technical role at SLU?
Sure, so so I'm the head team physician for the university. And what that means is there's a team of us who
are in the medical side of
treating our athletes at SLU. And so for example, is myself, my partner, Dr. Kim, and we've got a team of non-operative primary care support providers who are also very important. As well as sufficient assistance and some nursing staff, and we all kind of work together to provide the physician coverage for the university. So anytime an athlete watches it back up, you know, it includes both preventative medicine, you know, trying to discuss the athletes and coaches things like how to prevent or treat concussions ahead of time or with medical issues, like heart or, or other conditions and athletes that are important to deal with ahead of time. Then it goes through like, for example, coverage a game so a various events, depending on the event, one of the solutions might be at the event sort of provide on site care for anything that goes on during the event and also to provide support, like should someone go back into play or not, can they go back into play or not, or, or do anything done to them to help them get back to play or determine if it's safe or not, that's a really big deal on the sideline. And then in treating any injuries that happen afterward, like your were part of in the past, like working then for any treatment or injury prevention with the other members of the medical team. So the athletic trainers, the physical therapists, etc. Got it
very good. So that kind of goes into, you know, seeing those folks get back on the field. If you're at the Games, you're seeing them go back to a game that you're gonna be watching. Correct. That's probably pretty cool to get to see how they move. Do they trust their leg? Do they trust their arm? If they've had surgery or some sort of procedure? Or an injury, obviously, just how do they get back. And so being able to see that firsthand, I imagine is even even more rewarding.
Yeah, it's great. And there's no better test than from following an injury, healing, whether it's surgical or non surgical. And then to see an athlete get back to doing what they were doing beforehand, and if they can pass that and and be comfortable in pain and doing well then that's a great feeling. Awesome.
So what Dr. Kaar was alluding to earlier, this is for the listeners, what he was alluding to earlier was my participation with the PT department at SLU. So just for you guys. I was in a one-year residency program there. And during my time there we had the opportunity to shadow with Dr. Kaar in the clinic, we had the opportunity to work in the PT clinic there on campus work with a couple of athletes, but obviously working more with the student population. And so there was a lot of experience and learning during that year. But that's where I got to know Dr. Kaar a lot better. And it's funny I I admit I had you on my list to reach out to but I went to a SLU game about two months ago and that's when I reached out probably the next day you should have came by and said hey. Well that was too high up I should have bought
You can walk down next to us right in the we're sure we'll catch up. So fun.
Yeah, it was just kind of funny. I knew you were there. I knew you were going to be there. But I just, it's still kind of caught me by surprise. Yeah,
there's a seat with my imprint on it probably all these years. Since shape, it's open and are you most games? I am unless I'm out town for some reason. Some years. I'm at every game some years I missed one or two. It just depends. Very cool. And do you travel with the team? I travel with the team for playoffs. So the landing 10 tournament, which is in a couple weeks here. Typically, it's in Brooklyn, New York. So I go with the team for them. And then when we're doing well and make a tournament like we did last year, I will travel to the NCAA Tournament as well. We'll keep our fingers crossed for this year.
Absolutely. Awesome. That's cool. So now that we've talked about college sports, yeah, let's go one level deeper. We have a you have a new relationship with the new XFL team, the battlehawks correct. Tell us about that.
Yeah, that's great. So the team battlehawks came to town and, and they came in and they formed a medical partnership with SSM Health, which has been great. That's something that I do work with SSM health pretty closely. And so they reached out to actually Dr. George Pladur. You may or may know as the Cardinal's team doc is as someone who's had previous NFL experience with the Rams, you know, more than a decade ago. And so, and then he wanted to form a partnership with someone and reached out to us SSM and so what doctor Pladur together a number of our posts St. Louis, you and also SSM we work together. physicians have considered or partnered up to provide care for the battlehawks with Dr. Pladurs, or the medical director and the rest of us working with him. You know, in a nice cohesive team so far.
Awesome. And I know it's brand new but I'm we're discussing this the Monday after the first game so even though this might be released, released well later in the year, kind of give us the the vibe from the game for those of us that weren't there.
Well, it's great. So you're right. So this past Monday was the first home game I was a third game but the first two on the road. And certainly, at the first home game I think could be wrong on this but I believe the St. Louis has been really supportive of the team actually has been great. We had the highest attendance for the home opener, I believe of any the xfl teams was 10 teams, and total I think was over 29,000 we sold out the lower bowl, which is a great testament to the fan. The nature of the fans here in St. Louis. There's a lot of pent up Stan crunky anger, as the fans are very verbally cheering or not cheering but um, I guess in some ways cursing his name, which was chanting? Yeah. And it was amazing how loud the on the field how loud just having the lower bowl, a full lower ball can sound and feel, you know, I can't imagine what the whole wholesale would feel like someday maybe?
Yeah, that's really neat. Yeah. So do you know much about the xfl? Do you know like, what their financials are? And how they're because I know they have tried this before and it didn't succeed? Is their expectation that this will last a while? Yeah,
you know, so obviously, I remember very clearly, when the Excel first came out for that season, like around 2000, I think. Exactly. Obviously, I mean, I, I'm not in any way connected to the league office. So don't say the wrong thing. I'm sure they have a strong sense for where they're going with the league. And that, I mean, I can't imagine they put this amount of money and they put up a lot of money if it's not going to be successful. So I'm hopeful. It's always been a lot of support, especially in St. Louis so far. And I haven't seen the TV ratings for week three. But the first two weeks have been pretty impressive. I think having those national contract tv deals has really helped. But seems like hopefully the second time around and be successful.
Yeah, I'm excited about it. I've never really been a huge football fan. And I don't really know why. But I'm I'm kind of behind this team. Like I really want to go to a game now. It's
tough to get down for a game this year, but that'd be awesome.
So, did you ever have any affiliation with the Rams? I did
not. Okay.
Yes. I wasn't sure. Cuz, you know, they're not here anymore, obviously. And they're hence this Dan crunky Hades correct? Yeah, I've got no personal feelings on. I'm actually not from St. Louis. But you know, it was sad to see the team leave when they did leave. Right. Yeah, just for
the people that for sure. A lot of the famous books of the nature of the way the left it didn't seem like it was done in the best faith, but
for sure. So getting back into orthopedic surgery, so, you know, obviously, being a specialist in sports, there's still a lot of a lot of range there. So what are your top things that you enjoy treating or do the most or kind of go into your specialties within? Yes.
So as far as what I enjoy, I really enjoy everything from a surgical standpoint. I think they're asking, I really enjoy everything. Else, I have a favorite procedure, so to speak, as far as things to do the most. From a surgical perspective, ACL reconstructions, what I do from a volume standpoint, the most of those have been followed closely by shoulder arthroscopy, and that can be there like rotator cuff repairs, it could be labor repairs of the shoulder, which will ligaments, oftentimes or shore dislocations wasn't my top, top three followed by shoulder replacement will be a close, close fourth or close 30th up until you, you measure it. But those are my top things I do. But what I like about sports medicine, a lot of this from a surgical standpoint, and also a non-surgical standpoint, there's a lot of variety, like I don't just do one join or one part of the body or just fractures, I get to do ligament reconstructions like arm repairs, I get to work with the shoulder, the knee, they're the most common to, mainly because of the most common to injured joints that need surgery, at least. But I do foot ankle surgery for leg. recurrent ankle sprains or tendon tears in the foot ankle Achilles like I get to do hip arthroscopy or hip impingement, which is becoming a pretty notable thing. And young athletes
do elbow surgery, like various you know,
like ligament injuries, and throwers, for example, or even things like bad cases of tennis elbow or, or biceps, tears, that kind of stuff. So I get through a lot of variety. And even from a non-surgical standpoint, seeing athletes on the sideline or from teams that I work with, it was even hand injuries, back injuries, like I really get a large variety, which I really enjoy
doing sports medicine.
Awesome. And I think that's, that's why I have referred a few people your way is that it's not just about the surgery, I think a lot of surgeons will kind of get that bad rap of, well, if I go see the surgeon, they're going to recommend surgery because that's what they do. And and that's the PT side of it the PT visual there. And so, you know, I've sent people your way, because I know that that's not necessarily the first instinct, Oh, for sure want to try to avoid surgery, if possible. Maybe kind of touch on.
Yeah, you're right. I definitely I mean, by far large majority of who I see, we don't treat with surgery. And actually, there's very few conditions where I see someone off from surgery in the first time, it's going to be those like tendon tears like an Achilles tear, a patellar tendon tear, or an ACL tear, we're talking about surgery on the first visit, more often than not Errol's animals, everything else involves a trial and in most cases, successful trial of a non-surgical treatment. And obviously, this is your profession. But I mean, I think physical therapy successfully country most of these things, I keep a loose track of when patients come to the clinic as far as how much a surgical not it's a roughly 90% of people I see, are treated successfully without surgery and only about 10% action of needing surgery.
That's awesome. And I think there's a big fear in just in a society of, well, if if I go see the surgeon, I'm going to have to have surgery, it's going to be expensive, it's going to hurt, I'm going to have to miss work, I'm going to miss whatever. And so you know, that's, that's where that conservative treatment can be hugely effective. And so when someone if you're the first line of defense, so say someone comes to see you with generic knee pain, they've not seen anyone else, what's kind of the process, trying to take some fear out of it for people that are having these issues. I mean,
I don't wanna speak for all surgeons, but I can just speak for myself and my partners is that, you know, if you come with knee pain, we're gonna first try and just figure out you know, where it's coming from. And honestly, we can't always give you the hundred percent pinpoint accurate answer, we can give you a good rough guess. It's not always so clear and cut and dry. But But, again, unless is one of those unusual circumstances where you've got like a tendon tear, and like something happens traumatic to your knee, in almost all cases, we're going to try and sort of rule out the really bad things, like the major tears and stuff. And then, and then other cases, then once we've kind of ruled that out, which again, is most people we're going to then try and sort of direct, you get a sense of what's going on kind of chitchat and talk about where your goals are in life and activities and sports, or maybe just work or maybe just working on the house. I mean, that's all very important. And then sort of guiding you to in many cases, it oftentimes includes, for example, physical therapy, where we'll have you work with someone to try and then get the nitty-gritty details of, you know, what muscles and what, what's working, what's not working, where it's stiff, you know, that kind of stuff, and really try and work hand in hand with the physical therapist and communicate back and forth and try and get a treatment plan that's going to work for you. Awesome.
So another thing that I've seen for some of my clients, again, they're that kind of that fear of going in that initial, that initial step of going into the physician's office is kind of a scary thing. And often what I'm finding is that will lead to more chronic issues, because they're not getting it dealt with three weeks out, and then three months out, and then three years out. And so these issues can become bigger problems because of whether it's a fear or laziness or stubbornness. What am I Sure, so maybe touch on that that need to get evaluated.
Sure. So So first off, Greg, if you come across anyone that was scared after leaving my office, please let me know. Because I should know about
it. I'm not saying you specifically.
But I understand what it would I do agree with what you're saying, I think I think we're getting at is that a lot of times, it's better to be proactive in nature than right, you know, then deal with it after it's kind of prolonged yourself and may have these sort of chronic, like shoulder injuries is one good example, where someone has like rotator cuff tendinopathy or pain, you just, you just keep putting it off and off, it could just become worse and worse. And you know, if the muscles not working properly, that's that can be a problem. So So I agree with your someone's, you know, to come in at the first sign of like, kind of my shoulder has been sore for like two days, and it gives him some tomorrow. But if things just aren't getting better with the usual rest and ice and that kind of stuff, and you're better off getting seen evaluated point in the right direction to someone that can then help you. Rehab your shoulder with a good functional goal, both to help with your pain and symptoms, and also like to get back safely doing what you like to do. Without it continually aggravating. Your joint is injured, and it's much better to be productive than to be to deal with it after it's been like six months of creating all these bad habits with how you move and paying that kind of stuff.
I see it all the time. Oh, I'm sure you do.
We all do.
And I think that's one of the biggest frustrations that I have is why now we know it's been six years. Why? Why on February the 23rd, but not on January the 23rd. And it's always kind of a bizarre mentality, I would think from most patients of what was that determining factor that this month is worse than last month, it's been going on for that long, you're right it
and at the same time. I mean, I get it, I understand. I mean, in many cases, you know, financial factors can limit people, and it's totally understandable. But what I will say is, you know, things don't get better, it's not going to get better on its own typically, and you're better off getting to it sooner than later. And then you could lead to a more longer term problem or, you know, if you can't do your work or your job like you want to do or you can stay healthy, or an active lucky one too. And if you don't, you know correct that sooner, then you can have like your like, like years of pain. And also you're not working out exercising and you're developed like cardiovascular, you lose your fitness, or perhaps like you can't do a job like you want to so so even though it's not always, you know, convenient or does cost money to be seen and treated. Oftentimes, it's better to deal with that upfront than it is to wait.
So let's shift back to the athletes again. There's, in my experience, as an athlete growing up, there was kind of a push to be more of that single sport specialized athlete. And I know that the tide is turning a little bit to where that maybe that's not, not what's pushed as much but with how much the travel ball and this the you know, the Select teams have grown over the years, there's almost a need to play a ton of games in a singular sport to be able to make it to the next level. Even though that may not be the best thing. Maybe touch on that a little bit.
Yeah, I totally get it. But I've got two young kids and they're playing organized sports with a noun, nowhere near the the type to be nor near yet old enough to be doing the selecting. But yeah, I agree. I mean, it seems like we all know that. The days just go on playing basketball with your friends and you know, in the schoolyard until you're in middle school, and then playing the musical team are pretty much over. Especially with baseball, but really any sport, it's really not good to just do one sport all year round. It's better being in St. Louis with different seasons kind of guides us in that but it's definitely worse off in Florida and Texas and Arizona and places where you can play baseball 12 months in a row. So on one hand, it's good to get that higher level of training. And it's good to you know, get on an advanced team and play a large amount with high quality instruction, whether it's soccer or baseball, but if you do that from a young age, only then then you really contend to sort of a couple of things that happen. One is you make yourself susceptible to overuse injuries. If you're only playing baseball, then you're using that right arm if you're right handed thrower. Like all the time you're not doing anything else to balance out the rest of your body. And so I think it's really important to get involved in other athletic activities as well. They don't have to be at the same high level but you know, it would be great if someone is playing baseball a lot also played football or soccer or basketball develop other muscles and you know both the number one not get so because many kids burn out I see that a lot where kids will come in and you can tell they're with their parents and they're like, you know, my elbow has been hurting. I've been throwing it's happening again is the third season around my elbow hurts and I'm like we do anything else. You're not even sure if they even want to keep playing baseball at the same level. I mean, that's one example. And then but then just it's good for overall development, especially for growing kids to use different muscles and develop differently. So you're not just focusing on one or two joints the whole time, which I think can be detrimental to their health.
And I think that was part of my issue is, you know, I injured my shoulder as a kid. I grew up in the south baseball, baseball. Yep. And I could throw hard I was a big kid. And when you're playing 90 games a year, maybe not actually 90, but Oh, yeah, it's nine months a year. Yeah. And so when you play that long, without mixing it up, it's it's bound to get to you at some point.
I'm certainly no college recruiter. I mean, I've no qualifications here. But I'm fairly certain that when, like college coaches, or higher level coaches are scouting and looking for athletes, they want people that can succeed in multiple sports, often, I think that shows a better higher level command to their of an athlete's athletic nature, or just a higher level command in sport when you can do multiple things well, and just do one thing. And I
think that's still new to an extent, you know, some of the newer, more outspoken coaches are exactly what you just said, they're looking for an all around athlete who can play this role. Well, the old school mentality is, you go throw until you're stronger. You know, like, you look at the Nolan Ryan types, he would throw 500 pitches a day to build up arm strength.
That can't be good work for him. But
you know, it can't be good for everybody. There's always outliers, there's always those people are just, then the problem is they're so few and far between, you just might not meet someone your whole life that can do that they can just do nothing or play one sport, and succeed their entire life.
So what do you think is the solution to this?
to frequent, in my opinion, to frequent push towards that single sport athlete? I know it's maybe moving in one direction, but there's still that? I would say most of the baseball kids are just playing baseball by the time they finish high school. Correct? Is there a solution?
Yeah, I don't know. I don't want to pretend to have it, bro. The answers. And again, with my kids being younger, I only see it from the college level and then just from people get injured. I don't think we're ever going to go back and sort of undo the large like selector, high level team playing. But I think it's incumbent on getting the word out to the parents to do one thing all around, and also the coaches like, in some way to discourage like, hey, we've been on this, you I've been coaching you for 12 months. Now let's, why don't we take three months off and go swim, like, or pick a different sport, you know, play play hockey or something? You know, just as an example. I think that education needs to get out there. I think it's getting out there. It's just not out there enough.
And I know it's hard, because there's a lot of the parents that were, you know, a single sport athlete, and so they want their kid to be that. And so the education is huge. And but it's it's always challenged, because you're fighting against people who are kind of set in their ways sometimes.
Well, I mean, you feel like you take three months off from a sport that like, I'm gonna fall behind, or my kids gonna fall behind and error catch up again, which really isn't the case. I mean, as long as you're dedicated,
if you're a good enough athlete to make it, you're gonna make it for sure. So taking off is always, always an option.
Yeah. Or at least encouraging. Like, like, I remember in high school. And our basketball coach encouraged us to do things like run track or play baseball, he's like, hey, how can we not they're doing solo sport, you know, you shouldn't be playing basketball in gym every day, you should be doing something else.
And I hope that that becomes the norm again, for sure. You know, for you hear of or I hear of people that may be in their 60s, they were for sport, you know, Letterman or whatever. In their high school. It's like, if I played for sports, I wouldn't have had time to do anything. It takes up so much. Definitely one yeah, just, it's just a different.
Yeah, definitely for Billy's play, too, right? No, like, have just something totally different, you know, that you can do just to sort of just mix it up, change gears, keep it fresh and fun, make new friends do something different. Cool.
So you may have a good answer for this or not, and we can edit it out. If you don't, you may have a good answer for this or not. But the the residency with slim is a PT program. What is your? What is your role in that? I'm kind of touched on it earlier, but maybe go into that a little bit?
Yeah. So just just to clarify, I don't know we've talked about other podcasts, but so seelos you has a physical therapy residency. And what that means is that there are people or students who have completed and graduated from physical therapy, wherever it could be at SLU or somewhere else Wash U or even outside of those two institutions. And they could go on practice right away, but much like I did a fellowship to specialized you can also do they call residencies help them right here in physical therapy. So you can do a one year specialty in for example, at SLU. It's in orthopedics. So to become sort of specialist in bone and joint and muscle function in rehab. So that's sort of like what they have my role I'm one of the orthopedic faculty, I guess you'd say. Our adjunct faculty were a couple things. One is they work with us in clinic. So they'll spend time like you did. One or two days a week just learning from each other. I learned a lot from you guys, when you can believe or not,
you know, seeing patients with me,
we chit chat about you know, our treatments and what to do and why and in oftentimes, actually, the, the therapy resident, visit the resident, you guys are very sharp, what Teach me stuff to like, Hey, what do you think about this or that or maybe we should order this for physical therapy are things we can do. So one is their learning in the clinic. And the other other while we have been doing a lot of overtime, we've been sort of updating our physical therapy protocols. So just, you know, these students are working with their faculty doctors of ASCII to, to really work on or post surgical, physical and also non surgical physical therapy protocols so that we've got to the most up to date injury protocols around based on on the most recent literature and science
to
in order to help treat all our patients actually, it really works out really well. It's a very nice symbiotic relationship.
Yeah, and and while it was a very difficult year, for me, it was probably one of the best years in terms of education that I'll ever get. Just because it's so intense. It's so in depth, and having the opportunity to shadow with you was awesome. But yeah, it is a huge learning experience. And so I believe it was me and Adam, what we what we kind of worked on with you was the the knee protocols. Correct. So the ACL and meniscus. And so, you know, we poured our heart and soul into finding the evidence. And it's really cool to kind of see that as the legacy that we leave. Those are great. I mean, I can't tell you my compliments, I get off of those. And I say, you know, I cannot thank you enough. I can't I can't even imagine how many hours you spent poring through the literature and what's been published and figuring out
figuring out you know, when to start range of motion and how much and you know, what muscles, the fun to highlight in this and stuff. And so yeah, it was really impressive.
Thank you. Yeah, and, and like I said, it is just a it was an awesome experience for me. So I appreciate that. Just wanted to thank me well later. You know, you sit you put it is such a small thing, that chit chat about a patient or whatever, but when else are we gonna get that opportunity to be face to face with someone who's working with, you know, with another client of ours that we share on the front line, that doesn't happen? So it's a really cool experience that, you know, meant a lot to, you know, the growth of Dr. Gregg years. Yeah,
that's great. No, I love I love Like I mentioned earlier, I love working with professionals and related but but none, but other specialties. So like the non physician, so I love working hand in hand with with EFI trainers and your case, the physical therapist, I just learned so much. And I hope he worked together really well. And I think that's the best way to treat a patient, you know,
Fisher? So being that you are in your role at SLU? Do you? Are you also a professor at SLU for the med school?
Yes, totally. I'm an associate professor. I'm a I believe I'll be promoted to Professor this year. We'll see I got a few months to wait to find out. Well, good luck.
And so what is that? What does that mean? associate? Sure.
There's just different ranks. So there's a clinical instructor then assist system that associate then professor and so I'm at the associate level I've applied for now, hopefully she get Professor this year. But what basis means is that you have to do with a couple things. The more time you have to spend down your time basically, at the University at each of the levels to the have a chance to be promoted. And then you also have this criteria involved and every university a little bit different. But there's criteria involved as far as things like academic achievement. For example, have you done research and published on things have you worked on you know, national committees or organizations within your field like a sports medicine? There's things like leadership, you know, so things you've done within university like, you know, leader sports medicine subdivision. in orthopedics, things we've done, we started them in the regional tribal societies, so different different things in the area. And also teaching involved so so I personally like when sort of the other it's not just me, but some of the other orthopedic surgeons, we all we teach medical students, we teach residents daily, we teach in my case, physical therapy, lecture physical therapy students, I train students, sometimes undergrad students, even high school students in their summer programs. So some I'm teaching various levels and teaching as part of getting promoted. Just Community Services part against things you do with university there for the greater good not just for for the medical school itself are also important. So all those things combined in his criteria, and if you satisfy those criteria, then at each level, you can you can move on up Nice.
So just out of curiosity, what's the high school program? Is it the Ames program? Yes. Okay, cool cuz I was I was one of the
one of those okay samarbeid like you were there not but but every summer we do that kind of think
it would have been. Oh 607 like that
it's a great program with the pause lab. Yeah, it was six or seven now when I came in, oh 708 Okay. Okay, so our middle Lloyd so hello. Just missed him. But yeah,
but raise a cool dude. Yeah,
right doesn't even every year I get those. We always talk at those emails. Yeah, it's always fun to go down and spend a few hours with the students. Yeah.
So what we're talking about there's a there's a program. Next to the moolah was the name of the building I
forgot. Well, we call it the pause or PSE pay somebody say pause or pace but
practical anatomy sort of indications. But
there it is. So the practical anatomy building right next to the moolah off of off of Linda window. Yep. And so it's got an amazing facility. There's dissection labs, there's all sorts of stuff for high school students that are considering pursuing medical professions. So you know, it's a it's a one week program. It's a lot of folks that live in St. Louis, but they also accept people from out of town like me. So I that was part of what drew me to St. Louis is a great experience at the Ames proving
it's really a great program to I mean, there's there's medical of all specialties, not orthopedic but but all specialties that come and make it to experience both in the lab, they could see sort of demonstrations to get to Connecticut lessons, they get to go I believe, get to go off site and see different, you know, hospitals and surgery centers, that kind of stuff, too. So get a really nice week long experience.
Yeah, it's really neat. So, other than being with SLU, you mentioned being affiliated with SSM, correct. I don't quite understand how the hospital affiliations work with physicians. Yeah, maybe you're gonna touch on that. And then tell us where you are.
Yeah, for sure. I plan to blame you. It's confusing when I tell people outside of St. Louis sometimes. So you have to in some way separate out the facility from the physician and that goes for any physician around town for the most part. So example I am employed and all my partners, we're all employed by St. Louis University. The university itself there's a medical school or employees of the medical school or SLU cares you may have heard. And then all the facilities we work at our SSM health at this point, whether it's Cardinal Glennon hospital, St. Mary's or any other facility around town, the workouts SSM and so in some ways is as simple as the doctors are employed by the university and they work in facilities where everything and everybody is employed through SSM it's not there's a little more arrangement like on a high level, there's like director boards where SSM and St. Louis you representatives from both sides, you know, sit and work together and strategically plan out which ways the organization is going to go and hopefully make it to the move forward in a more closer relationship and do things together. On our level of physician level, there's there's some various things we're even though we're, we're employees of the university. SSM supports us the physicians in some ways by providing us on salary support to make to make things run smoother from our standpoint really helped us out. And even some things like there's this whole sports Care Program, which is a great program where instead of like a concierge service that it's run most of the rest SM but we all work together where and that's where we mentioned about hawks earlier, where are that sports care program is really the program that brings together a slew and SSM together to do things, medical things around town, whether it's take care of high schools, take care of colleges, take care of the xfl or even just outreach. So, for example, anyone can call us that service. Really 24 seven so that's just one way on the ground where SSM and slooh work together. And so, but it's very similar if feasible to wash you like exactly the same but like a washing the physicians or wash you and all the facilities are bjc and on a high level and so it's a similar arrangement just a little bit different.
Got it. Now, did that begin when SSM bought slooh Hospital? Or has that kind of always been some affiliation?
So there's always been the slew physicians of slow care physicians have always worked at SSM facilities as long as I've been here just hasn't always been exclusively at this point pretty much exclusively facilities in the
past what I used to be tenant, correct sue a tenant tenant and SSM correct or mercy we worked at Mercy will St. John's in the past.
Again, same thing that we're physicians working at a different facility. But now it's pretty much exclusively with SSM very cool.
Just gonna take a pause there good.
Anything else that you definitely wanna talk about?
I'm not I mean, know what anything would ask me fine.
Okay. Do you want to give office phone or anything for people that want to contact? You do want me to put that in the show notes?
You just put in the show notes.
Yeah. Alright. So
I think if there's anything else that I want to ask you kind of like what's next for you? Sure. Okay. So cool.
All right, Patrick, we're starting back.
So cool. You're obviously related with our sorry, related to SSM because of your relationship with SLU. Correct. Got it. So what is next for Dr. Carr? Obviously, the professorship is kind of the next thing that's coming up, hopefully, correct. So what else is next for you?
Yeah, so yeah, a few things. No, it's an exciting time to be to be working at SLU. And to be doing this, but so a few things are going together on different levels. So So from a sports standpoint, you know, we have the xfl just getting started. And then I know that all the major hospitals have put in a bid for the Major League Soccer expansion franchise here and work Fingers crossed, helpful, we have a shot to get that. And you never know, though. I mean, I believe washu and mercy did as well. But hopefully, that'll be one of the next steps of the write down by our campus. So it really kind of naturally fits with what we do. And also, you know, we work with the seal as you obviously men's soccer team, which is a big program in that kind of lends itself to take that next step, but so that from a sports medicine standpoint, that's one of the next things we plan to do. Additionally, about new hospitals opening up, which is exciting for our department, when
What's the date on that?
I believe it's next it's about
October is our it's in the fall of this year. Yeah, it's coming up. It's in October, November, something like that. Okay. And I've been through it, and it's really, really beautiful, exciting. facility, personally, the art department will use it very much. So personally, I'll spend some time there, not the whole week there. But But that'll be exciting to see. It's been a long time coming. So those are the facility things. And next up. Personally, I'm getting my MBA from St. Louis, us. So my business degree in the evenings helped me to be done by end of this calendar year. And so I'm looking, you know, that'll help me both in a leadership standpoint, helped me get involved with more administrative tasks as well. So from a personal growth standpoint, that's what I'm working towards right now.
Man, you're busy act.
Okay. You got a lot going on, drives my wife crazy, but I understand.
I can totally understand that. Well, that's very cool. Very cool. Well, thank you so much for being here. This has been great. I appreciate you coming and telling everybody about what you do and about sports medicine and what a surgeon does and all that. So I appreciate it. We're gonna put your contact information for our car in the show notes. So if you want to reach out to him, or his office to schedule with him for anything, the information will be in the show notes.
Yeah, thank you very much. I really appreciate it's exciting to see what you have here with not just a podcast, but your facility and and what you do on patients is really nice.
Absolutely. I'm glad you could be here. This has been STL Active. Thank you for listening to the STL Active podcast from stlouispt.com. If you enjoyed the show, please spread the word. Thanks again and see you next time.

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