The American College of Sports Medicine (ACSM) is proud to feature Andrea Stracciolini, MD, FACSM, in this issue’s Clinician Profile. Dr. Stracciolini is a primary care sports medicine physician in the Department of Orthopedics at Boston Children’s Hospital and is an assistant professor at Harvard Medical School. Her primary focus is on sports injury prevention and exercise promotion in children as well as musculoskeletal ultrasound. Recently, she has been working with a multidisciplinary group to develop the construct of exercise deficit disorder in children with the goal of promoting early diagnosis and treatment by primary care practitioners of children who are exercise deficient. She has lectured regionally, nationally, and internationally and has had her work published in several peer-reviewed sports medicine journals. Additionally, she is an editorial board member for Current Sports Medicine Reports.
You Have Been an ACSM Member Since 2001. How Has ACSM Grown and Changed Since You Became a Member?
ACSM continues to expand in ways that support and facilitate clinician collaboration with experts in the field of sports science and exercise medicine. ACSM is set apart in this regard, as it is an organization that facilitates the interaction of researchers and clinicians. This unique multidisciplinary focus encourages clinician engagement with scientists from biomechanics and exercise physiology and other disciplines, in addition to bringing athletic trainers and physical therapists together with physicians. A multidisciplinary approach to pediatric sports medicine is critical at this time in moving forward the care of young children and athletes, as clinicians are now faced with caring for children who are sustaining significant overuse injuries in increasing numbers. Furthermore, caring for children during an era of expanding technology that promotes sedentary behaviors and discourages free play during early childhood continues to challenge clinicians. ACSM’s Exercise is Medicine® (EIM®) initiative was created in direct response to the increasing rate of physical inactivity in both children and adults. The call to action for young clinicians is to incorporate exercise as medicine into daily clinical practice. The challenge is amplified by the lack of exercise science training in medical education. If exercise is medicine, then exercise science training throughout medical education and into postgraduate training should be required.
What Was It Like To Be a Clinician a Decade Ago Compared with Today?
There is a shift in the focus of medical care toward primary prevention of disease and injury versus a disease- or injury-driven model of care. This is one of the most noteworthy and valuable changes in medicine over the past decade. The Micheli Center for Sports Injury Prevention (http://www.themichelicenter.com/) was created in response to the dire need to investigate risk factors for injury and shift the focus of care for the young athlete toward prevention of injuries. The Micheli Center is home to an ongoing, prospective, cohort study of athletes to determine risk factors for sport-related injury and to evaluate sedentary children at risk for long-term physical inactivity and obesity. Participants spend 2.5 to 4 h at the Center, where more than 310 predictor variables are measured, including biomechanical parameters, strength, endurance, agility, flexibility, training regimens, and injury history, among others. Risk factors for sports-related injuries and physical inactivity are identified; athletes receive recommendations for reducing their risk. Engaging young clinicians in research to investigate injury and disease prevention, while learning how to care for injured athletes, has progressed from a concept to an integral part of clinical training and athlete care.
How Has Membership in ACSM Influenced Your Career?
My involvement in ACSM was driven early in my career by my division chief, Lyle J. Micheli, MD, FACSM. Early in my training, the importance of collaborating with specialists in other disciplines of sports medicine was encouraged. ACSM involvement is a critical component of sports medicine fellowship training for clinicians, in my opinion. The value of presenting as a trainee at ACSM’s Annual Meeting each year in front of an audience of peers from all over the world and building relationships with other clinicians and world renowned researchers is invaluable in career development. As an emergency medicine pediatrician and primary care sports medicine physician, collaborating with colleagues via ACSM has enabled me to tackle the many challenges of building an academic career and conducting research. Investigating ways to incorporate injury treatment and prevention as well as exercise prescription into routine medical practice is a personal mission of mine that has been made possible by my involvement with ACSM.
How Do You Use the ACSM Network in Your Daily Work?
EIM® is an integral part of my daily practice caring for children with concussion and children who are sedentary with low motor skill proficiency. The ACSM network facilitates the translation of research to clinical practice while expanding clinician knowledge of biomechanics and neuromuscular training to promote evidence-based injury prevention and support physical training for sedentary children. Collaborating with ACSM colleagues who are experts in the field of EIM® and injury prevention on a routine basis via research and program development allows me to continue to develop my academic and clinical practice and to build our exercise and injury prevention programs at Boston Children’s Hospital.
What Is Your Best Advice to Other Sports Medicine Clinicians?
My advice, when teaching young physicians, including pediatricians and sports medicine physicians, is to get involved with ACSM early in their careers. In doing so, many doors are opened and career paths are developed via collaboration with researchers and specialists in exercise science, biomechanics, and injury prevention. Early engagement in ACSM supports skill building for clinicians in research strategies, presentations, and EIM® incorporation into clinical practice.
Where Do You See ACSM Heading in the Future?
I see ACSM continuing to engage clinicians of all disciplines including pediatrics, family medicine, and internal medicine and encouraging them to make EIM® part of routine patient care. A good example of the impact of ACSM’s initiative and innovation on clinical practice and future child health is the move to incorporate the “exercise vital sign,” as promoted by Robert E. Sallis, MD, FACSM, of ACSM and EIM®, into the medical records of all children.