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Outside Magazine August 2004
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BODYWORK: Noninvasive Surgery
The Kindest Cut (cont.)

sports injuries
(Mark Hooper)
FIRST, THOUGH, I checked with Eric Heiden, 46, the five-time Olympic speed-skating gold medalist, who's now an orthopedic surgeon and sports-medicine expert at the University of California at Davis. He heartily approved of shopping around. "People like Pruitt are worth their weight in gold," said Heiden. "Surgery is only appropriate if you've completed all the nonoperative treatments available. A small change in fit and form can often keep athletes away from doctors like me."

With that, I paid Pruitt a visit. A fit 54-year-old of average height, he presides over a facility that's part gym, part rehab clinic. Before looking me over, he let me tag along as he saw another patient, a muscular 42-year-old female cyclist complaining of soreness where her iliotibial band, a ligament that stretches along the length of the hamstring, joined the knee.

"I've been resting it," the woman said, pointing to her knee.

"Rest isn't going to solve this," Pruitt replied after a quick look. "We've got to change how you ride."

Pruitt described the woman as his classic patient: hard-charging, well informed, and, like many of us, imperfect—biomechanically speaking. He diagnosed her as flat-footed and knock-kneed. For her feet, he recommended orthotic shoe inserts. For her knees, we headed to the state-of-the-art 3-D-motion-analysis room, a $60,000 system consisting of six digital video cameras, their rigging, and a computer.

The patient's bike had been set up on an indoor trainer. Infrared sensors were placed on her hips, thighs, knees, shins, and ankles, and she was filmed while cycling, her stick-figure image appearing on a computer screen. The image clearly showed that her knees were torqued inward. To remedy this, Pruitt moved her seat back two centimeters. Then he worked on her cycling shoes, placing shims under the cleats to tweak the angle of shoe to pedal.

The patient got back on her bike, and before long a smile lit her face: no pain. Pruitt pointed to the computer screen, which now showed her knees vertically aligned with her feet.

Next it was my turn. Pruitt looked at my X rays, had me walk around on my toes and heels, and grilled me about my outdoor activities. His prognosis? First, he advised no surgery for my toes. Instead, he told me to stay with my randonnée setup for backcountry skiing, since the stiff boots would protect my toes. Come spring, I was to wear stiff-soled climbing boots and have my trail runners custom-fitted with rigid rocker soles. To ease the discomfort, I could get annual cortisone shots in my toe joints. For my back, strengthening and stretching exercises would alleviate the pain enough to let me climb and ski.

As for my shoulder, the news was grimmer: I either had to give up climbing and kayaking or get the offending bone spur removed arthroscopically.

So I didn't win 'em all, but by following Pruitt's suggestions, I was able to ski 100 days last winter, and this summer I rediscovered the mental challenge of rock climbing in less-flexible shoes—pain-free. This fall, I'll undergo surgery to get my shoulder fixed, but that's OK. There are times when the knife is the only way to stay in the game, and I intend to keep playing strong for years.


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