Latest / Becker’s Healthcare Podcast / Inside the World of Elite Sports Medicine with Dr. Neal ElAttrache

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Inside the World of Elite Sports Medicine with Dr. Neal ElAttrache · Becker’s Healthcare Podcast

0:00
Hi, everyone, and welcome to the Becker's Spine
0:03
and Orthopedic podcast.
0:05
I'm Sophie Ades, orthopedic reporter with Becker's Healthcare.
0:10
And today, we have the privilege of speaking
0:13
with doctor Neil Eletrash,
0:15
one of the most renowned orthopedic surgeons in
0:18
sports medicine.
0:20
He serves as head team physician for both
0:22
the Los Angeles Dodgers and the Los Angeles
0:25
Rams
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and is a leading surgeon at the Kirland
0:28
Job Institute, a collaboration with Cedars Sinai.
0:32
His work has helped define modern athlete care,
0:35
earning the trust of some of the world's
0:37
most elite competitors.
0:39
And in this episode, we're gonna dive into
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how cutting edge innovation is transforming
0:45
recovery for high performance athletes
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and what the broader orthopedic field can learn
0:50
from the pressure, precision, and progress happening inside
0:54
professional sports.
0:56
Doctor Elotrash, it's it's it's an honor to
0:58
to be speaking with you today.
1:00
So I guess to start, can you just
1:02
introduce yourself and and share a little bit
1:05
about your role?
1:07
Sure. And then thank you very much for
1:09
your interest.
1:10
So it is an honor for me to
1:11
be with you.
1:13
My practice has been in Los Angeles,
1:16
at the Kirwan Joe Orthopedic Clinic for
1:19
thirty five years now. I came to Los
1:21
Angeles and to do my sports medicine fellowship,
1:25
right after my residency, which was at the
1:27
University of Pittsburgh.
1:29
And I came here to Los Angeles to
1:32
do
1:33
the fellowship with doctor Job and and the
1:35
other
1:36
great doctors with, doctor Kerlin and and, the
1:39
rest at the Kerlin Jobe Clinic
1:42
in 1990.
1:44
And, while I was in my my fellowship,
1:48
discussions
1:48
started about
1:50
where I would go. Afterwards, I had already
1:52
planned on on going back to Pittsburgh,
1:55
where I grew up, but,
1:58
I was asked to stay. And
2:00
so here we are thirty five years later.
2:02
It's like a blink of an eye, but
2:03
it was
2:05
I couldn't have made a better better decision,
2:08
as far as being able to fulfill
2:11
far beyond what I thought that I would
2:13
be able to
2:14
fulfill my
2:16
my overall dreams and and what I wanted
2:18
to do with medicine.
2:20
And,
2:21
I'm grateful every day the the way that,
2:24
the way that I
2:26
where I ended up and and, where I've
2:28
been privileged to work.
2:30
Yeah. Absolutely.
2:31
And you have, you know, quite quite the
2:34
career and definitely
2:36
a really renowned figure,
2:39
not only in the orthopedic field, but just
2:42
generally.
2:43
Can you I guess we're gonna dive in.
2:46
You know, if you can explain just how
2:48
your work with
2:50
elite athletes has really shaped your broader approach
2:53
to to orthopedic care.
2:57
Yes. Sure.
2:58
I I,
2:59
had the
3:00
privilege of of training with people who were
3:04
at the forefront of sports medicine.
3:06
I I
3:07
I found very early on in my training,
3:09
even going back to medical school, that that,
3:13
the greatest thing you could do for yourself
3:15
and the greatest thing anybody else could do
3:17
for you
3:18
is to
3:19
is to provide you with a a a
3:22
great
3:22
example, role model, mentor,
3:25
somebody that would be
3:26
not only an instructor for for the things
3:29
that you wanted to to do and learn,
3:31
but somebody that would be interested in you.
3:34
And,
3:36
I became the fellowship director here
3:38
around nineteen ninety nine, two thousand and was
3:41
a fellowship director for over twenty five years.
3:44
And
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I always
3:47
advised
3:48
the fellows that were coming through that
3:50
if you have a decision to make on
3:52
where to go, where to work, who to
3:53
who to surround yourself with,
3:56
there is nothing that competes with
3:58
finding a great mentor, somebody that's interested in
4:01
you and somebody that can teach you every
4:03
day. And and,
4:04
I ended up at at at a place
4:06
where,
4:07
you know, because of who I was working
4:09
with and who was teaching me and who
4:11
had taken an interest in me, I was
4:13
put into an environment,
4:16
far younger than
4:17
than I could have anywhere else, maybe younger
4:20
than I deserved. But,
4:22
but I think that they knew that I
4:23
would there would be nothing
4:26
that I wouldn't do and,
4:28
you know, I wouldn't
4:29
stop short of putting in the effort and
4:32
the work
4:33
to be able to deserve,
4:35
you know, what they were what they were
4:37
providing me. And and so
4:39
being able to be in an environment that
4:41
that I was able to really focus
4:45
on what I really loved to do,
4:48
I I never really
4:50
had to do anything that that was out
4:52
of what I really felt
4:54
that was my purpose and and and my
4:57
passion.
4:58
And
4:59
just to be to be able to, you
5:01
know, have a practice or make a career
5:03
or make a living, I was able to
5:06
focus on the things that really I loved.
5:09
And so
5:10
that really took me a long way into
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advancing,
5:14
you know, what I do today.
5:16
That ten thousand hour rule, it applies to
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pretty much every endeavor I've ever seen, you
5:21
know, whether it's ten thousand hours or it's
5:23
just, you know, being able to focus and
5:26
be repetitive
5:28
and and consistent
5:30
and just
5:31
hone your skills and hone your craft. When
5:34
you have the opportunity to do that, it
5:35
it really pushes you forward.
5:38
And so
5:39
so to answer your question, you know, much
5:42
much of it started because of the environment
5:44
that
5:45
that I was I I found myself in,
5:47
that I put myself in, and these other
5:50
great surgeons put me in. And so,
5:53
you know, being able to
5:56
to really study what we do, not just
5:58
learn how to do the things, but study
6:00
the the science behind
6:02
the different types of injury patterns and and
6:04
how to treat them and what repairs would
6:06
be best and work best.
6:08
I mean, I I really be became
6:11
had the opportunity to be to become expert
6:13
in in an area. And,
6:16
I don't think that you can be expert
6:18
in these days. There's so much
6:21
and burgeoning tech technology that, you know, you
6:24
would have to become
6:26
very familiar with and fast out with. I
6:28
I don't think that you can be expert
6:30
in
6:31
in general orthopedics
6:33
anymore.
6:34
I I think that, to be at the
6:36
level where
6:37
where my mentors were,
6:40
to be able to have the responsibility
6:42
to take care of,
6:43
athletes that were making their living
6:46
or getting their education,
6:47
playing their sport,
6:49
you know, they had to be
6:51
really, really expert in the science and
6:55
the techniques of of of surgery on these
6:58
kinds of patients. And so,
7:00
you know, that was a great example for
7:02
me. I so I buried myself in in
7:04
studying the things that I would be doing.
7:07
It's interesting
7:08
when you look at the evolution of orthopedic
7:10
surgery
7:11
and, surgery in general, actually, in the middle
7:14
twentieth century or so,
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you know, most of our experience,
7:18
in orthopedics
7:20
came through,
7:21
military medicine.
7:23
The the things that we advanced that you
7:25
know, if you look at the how techniques
7:27
that, were developed and advanced and the medications
7:30
that we used and,
7:31
you know, a lot of that that we
7:33
took to the general public
7:35
was
7:36
honed and learned out of necessity,
7:39
through the military taking care of our our
7:41
nation's warriors.
7:43
And
7:44
if you look today, if you had to
7:46
say, okay. What are what's the impetus for
7:49
the biggest advances now
7:51
in,
7:52
orthopedics?
7:53
Certainly sports medicine.
7:55
I think that, you know, it's taken care
7:57
of high demand,
7:59
very active, if not
8:02
elite level athletic
8:04
patients.
8:05
And so the the demands of of what
8:08
we need to do to treat their injuries
8:10
so that they can recover well enough to
8:12
be able to use their body for for
8:14
their living
8:16
and this artificial
8:18
timetable that is put on us to when
8:21
we have to get them back.
8:23
I always tell I always tell the players,
8:25
look. Your knee your knee doesn't really care
8:27
when the first game is, when the regular
8:29
season starts. You know? It it it requires
8:31
a certain amount,
8:33
you know, of of time and and and
8:35
rehab to get ready.
8:37
Having said that, you know, the the the
8:39
reality of the situation is that
8:42
these are livelihoods that are,
8:44
in the balance. And so to be able
8:48
to repair and reconstruct these injured guys and
8:50
and gals
8:52
and to do it, strong enough that it
8:54
will
8:55
will withstand
8:57
the aggressive rehab necessary to get them back
9:00
at at this crazy artificial
9:02
timetable
9:03
and to hold up so that they they
9:06
don't,
9:07
you know, reinjure the,
9:09
you know, the the entire and ruin the
9:11
entire repair or reconstruction. You know, the the
9:13
this has led to development of
9:16
of techniques,
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both surgical techniques,
9:20
diagnostic techniques,
9:22
and,
9:23
also rehab techniques
9:25
that,
9:26
is able to accomplish this.
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So
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I would say that
9:31
our work with,
9:33
this extremely active,
9:35
population,
9:36
whether it's an active aging population, which which
9:39
we see with, you know, rotator cuff injuries
9:41
and and some of the things that that,
9:44
you know, are associated with
9:46
maybe the aging population. But now the aging
9:49
population is very, very active,
9:52
and, and they they really need to be
9:54
able to get back and do the things
9:56
that
9:57
they've always been told would be healthy for
10:00
them. You know?
10:01
But that a that active population and then
10:04
certainly the this elite level athletic population,
10:08
that
10:09
we've been able to take techniques that
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have been proven to work well with them
10:14
and take it and it and our entire
10:17
population of patients benefits from it.
10:20
Yeah. Well, thank you for for that explanation.
10:23
And I I love what you said at
10:25
the beginning just about,
10:26
you know, your passion for what you do,
10:29
and I think it's it's very clear in
10:31
your work that you love what you do,
10:34
and you've really been able to hone your
10:36
craft. And
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I think another thing that you said that
10:40
stood out to me was just, you know,
10:42
you have this responsibility
10:44
of taking care of athletes
10:46
who, you know, being active, it like you
10:49
said, is their whole livelihood.
10:51
And so, you know, I I read in
10:54
in that press release,
10:56
that you've worked with more than, you know,
10:58
a 150
11:00
NFL players
11:01
only since 2023.
11:03
You know, what goes through your mind when
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an athlete's entire career, you know, may hinge
11:09
on the outcome
11:11
of a single procedure?
11:14
Well, you know, I I think that I've
11:16
never really been
11:18
distracted or
11:20
or nervous or anything going into
11:24
anything that I was prepared to do.
11:27
So I I would say that and and
11:30
that's that's goes for anything.
11:32
You know, I I was never nervous take
11:34
you know, going in to take a test.
11:36
I was never nervous going into into surgery
11:39
as long as I was prepared.
11:41
And
11:43
I determined a long, long time ago
11:46
that I would never go into surgery unprepared.
11:49
And so it it's it doesn't matter if
11:51
it's something that's routine that we've done a
11:54
thousand times or if it's something that is
11:56
gonna require something,
11:58
you know, innovative that I I'm I'm gonna
12:00
have to try,
12:01
for the first, you know, time to be
12:04
to be able to accomplish what I need
12:05
to do for that patient.
12:07
I'm as prepared as I can possibly be.
12:10
And so I I I tend not to
12:12
get too distracted by,
12:15
the gravity of the situation. You know, I
12:17
I've I've put in
12:19
all the effort I can possibly put in
12:22
at that point, or I wouldn't be doing
12:24
I wouldn't be doing the case. You know?
12:25
I I, I don't hesitate.
12:27
If there's somebody more expert in cert certain
12:30
things than me
12:32
to do something that would be necessary
12:34
to really help a a patient, I don't
12:36
hesitate to refer them to
12:38
who if I think they can get better
12:40
care somewhere, then I I'm I certainly that
12:42
ultimately, I I I want
12:45
their encounter with me to lead to them
12:48
becoming as good as they can possibly be
12:51
in the outcome. Whether that means I'm giving
12:53
them advice,
12:54
I'm giving them a little benefit of my
12:57
experience, or if I'm referring them to somebody
13:00
that I think is an expert that
13:02
What I want is for for them and
13:05
myself to be able to look back and
13:06
say, you know, I
13:08
contributed to them getting back and getting the
13:11
result they need. And so,
13:13
you know, I wouldn't be doing a a
13:15
surgical case on somebody if I if I
13:18
didn't think that, I could give them the
13:20
best chance of
13:22
of the outcome that they want.
13:24
So,
13:25
yeah, I I actually was
13:27
surprised a little bit when I saw that
13:30
number. I I I don't have a running
13:33
tally
13:34
that I keep from the public information stuff
13:37
that,
13:38
Yahoo was able to to get and, the
13:41
estimation of the guys that were coming through
13:43
the combine into the NFL.
13:45
They were able to determine
13:47
that that that number that I've operated on
13:50
since 2023,
13:51
which which actually surprised surprised me too.
13:55
But, you know, what may not be obvious
13:59
is that
14:00
every one of the I I feel responsible
14:02
for every single one of those guys from
14:05
the time that they come to see me
14:07
to the time they get back on the
14:08
field.
14:09
And so
14:11
I I have wanted to learn everything about
14:15
medication, pain medication.
14:17
I've I've wanna learn everything about new rehab
14:20
techniques, and and and I I'll go and
14:23
and watch the the guys that are in
14:25
from out of town.
14:26
When I'm in town over the weekend, I'll
14:28
go on Saturdays, and I'll go to physical
14:30
therapy, and I'll and I'll
14:31
go with them and and be with the
14:34
group of guys that athletes that I have
14:36
in town and be with them in physical
14:37
therapy.
14:38
And and I I learned so much
14:41
about it. I learned so much about the
14:43
process, you know,
14:45
early on at right after surgery and then
14:47
the return to play part. You know? It's
14:50
been invaluable
14:51
to me. And so I I felt like
14:54
even at my,
14:56
advanced age age at this point, I I'm
14:58
I still feel like a sponge. I I
15:00
I I wanna
15:02
I want to I want to learn and
15:04
and know anything that is out there that
15:06
is
15:07
on the horizon or coming that that can
15:10
help me be better at at helping these
15:12
guys. And so
15:15
I think that,
15:16
once again, focusing on my task,
15:20
my craft, and be willing to to take
15:23
it from beginning to end and be involved
15:26
with every single phase and stage that they
15:28
go through,
15:29
I think that that is probably what these
15:32
guys deserve and and what what is my
15:35
obligation.
15:36
And
15:37
so, you know,
15:38
that's a 150
15:39
in over the past two and a half
15:42
years and,
15:43
I don't know, probably double that, overall in
15:46
the NFL,
15:47
that that are actively playing. That's a lot
15:49
of lot of people, but
15:51
what an enormous privilege it
15:54
is to be able to,
15:56
interact that intimately with even one,
15:59
of these guys and for them to trust,
16:02
you know, trust me and trust the process.
16:05
It's such a gift to be to have
16:07
the privilege of doing what we do.
16:10
And,
16:11
whether your patient is a a professional athlete
16:14
that's in the newspaper or whether they are
16:16
teaching at your kid's school or whether they're
16:19
making a living, you know, doing something
16:22
in your hometown,
16:24
the privilege
16:25
that it is to
16:27
have that kind of relationship,
16:29
trust and and intimacy with
16:32
with another person. It's I don't think that
16:34
there's anything like what we do that can
16:37
provide a person with that. You know?
16:40
So
16:41
it's a it's it's a
16:43
labor of love and and, it's a it's
16:45
a real responsibility and obligation that I feel
16:48
like I I have in order to repay
16:50
that kind of privilege to to have that
16:52
kind of trust.
16:54
Yeah.
16:55
What a what a beautiful way to put
16:57
that. And and I like what you said
16:58
too about just
17:00
with, you know, orthopedic surgery and and really
17:03
with anything in life, everything is sort of
17:05
a lifelong
17:06
learning experience. And I think that that's especially
17:10
true in orthopedics.
17:11
And, you know, things are obviously evolving and
17:14
and changing every day
17:16
in your world.
17:18
So it's important, you know, to have just
17:20
that learning mindset. And the other part you
17:23
mentioned is just
17:25
it really shows how much you do care,
17:28
you know, about each and every patient that
17:30
you have.
17:31
Just the fact that you're, you know, willing
17:34
to to to be in those physical therapy
17:36
sessions and, like you said, sort of be
17:38
there every step of the way
17:40
with your patients
17:42
is is pretty remarkable.
17:44
I wanna circle back because,
17:48
we've been alluding to the to the Yahoo
17:50
sports thing,
17:52
but I just wanna emphasize
17:53
that Yahoo sports recently named you, you know,
17:57
one of the 25 game changers to watch
17:59
in 2025.
18:01
Highlighting your ability to, you know, help these
18:04
athletes
18:05
return to competition faster
18:07
and often even stronger
18:10
than they were before.
18:12
Is there, you know, one innovation
18:14
or approach
18:16
that you think has has really made that
18:19
possible for you?
18:21
Yeah. It it's a really good question.
18:24
You know, I, I'll give you the general
18:26
philosophy and then
18:28
then more specifically what I did.
18:31
So, generally, what I was in search of
18:34
and and constantly am still searching
18:37
is I need
18:39
whatever
18:40
treatment I do, repair, surgical technique, and repair
18:44
reconstruction technique,
18:46
I need it to do two things. I
18:47
need it, number one,
18:49
to
18:50
provide the normal normal enough function
18:54
and integrity
18:55
to be able to get these guys,
18:57
competing back at a at a high level,
19:01
number one. Number two,
19:03
it needs to be able to withstand
19:06
the the the demands of whatever physical therapy
19:09
and and rehab is gonna be necessary to
19:12
to get them there. So
19:14
I think that there's been some very big
19:16
advances in on the therapy side of things.
19:19
And so,
19:20
I always talk to,
19:22
our physical therapists and,
19:25
the team trainers, guys like Reggie Scott, who,
19:28
is the head athletic trainer for the for
19:30
the Rams and brilliant guy. And,
19:34
just working together with people like that, you
19:36
you learn so much.
19:37
And what I needed to know was,
19:40
what do you need to do to mobilize
19:43
this joint to get the joint ready to
19:46
go? And from whatever scientific
19:48
things I can I can learn and understand,
19:52
what stage of maturation do these tissues need
19:54
to be at so that they can start
19:56
to really train aggressively again?
19:59
And
20:00
so
20:01
that then
20:03
was the first step is understanding exactly what
20:05
they have to do and how what what
20:07
the therapists and trainers have to do to
20:10
in order to get them ready to play.
20:12
And then
20:13
it's up to me then to figure out,
20:15
you know, what do I need to do
20:17
to make a repair reconstruction
20:19
resilient enough,
20:20
and durable enough that it'll it'll withstand it.
20:23
So if if you're if the therapy doesn't
20:26
match the
20:27
surgical technique
20:29
and vice versa,
20:31
then it's never gonna work out. And so
20:33
I I pretty quickly realized that in order
20:36
to accomplish what these guys needed to do
20:38
in a certain time frame, you know, and
20:41
what they were gonna do with their body
20:43
once they got back, those demands are
20:46
constantly changing, and
20:48
and the stress and strain that they put
20:50
on their bodies now is it's
20:52
significantly greater than when I started. For instance,
20:55
you know, if I can digress it, you
20:57
know, the average fastball,
21:00
on on a, professional pitching staff at the
21:03
time when Tommy John first got his operated
21:06
on operation
21:07
that was named after him, the Tommy John
21:09
operation, was somewhere around 88,
21:12
89 miles an hour Mhmm. Nineteen seventy four.
21:15
You know, when I learned how to to
21:18
do the the that surgery from doctor Job
21:21
in nineteen ninety ninety one, the average velocity
21:24
was around 90.
21:26
The average velocity now is,
21:29
95 a little over 95.
21:32
Every team has multiple guys that can throw
21:34
at a 100.
21:35
The the amount of force and spin that
21:38
they put on the ball and the movement
21:39
that they get on the ball is the
21:41
these circus type
21:42
pitches that they throw put enormous strain and
21:45
stress on the shoulder and elbow. And
21:48
so the the techniques that we had,
21:51
previously to be able to reconstruct and repair
21:54
the on a clara ligament in a Tommy
21:56
John or to take care of the tissues
21:58
in the shoulder,
21:59
those aren't probably good enough anymore. Those those
22:01
techniques don't hold up well enough. So we've
22:04
had to adapt and and so the general
22:07
philosophy
22:08
has been show me what they need to
22:10
do and show me what you trainers and
22:13
therapists need to do to get them there,
22:15
and I'll figure out an operation that'll hold
22:18
up to it. Okay? Mhmm. So that was
22:21
my general
22:22
quest.
22:24
Then
22:25
from a technical standpoint, what I do,
22:28
whether it's with ligament or tendon,
22:30
reconstruction or repair,
22:32
I wanted to have the most durable
22:35
and strong not only strong, but durable
22:38
repairs
22:39
possible.
22:40
And it needed to be done in an
22:41
anatomic way so that I didn't change the
22:43
anatomy. I wouldn't affect their range of motion,
22:45
which would be devastating to even to lose
22:47
a couple degrees of motion for a pitcher.
22:49
And I needed to be able to to
22:51
do it so that that it would withstand
22:55
very quick rehab before those tissues are mature.
22:59
And so
23:00
I start to
23:02
tinker with
23:03
placing suture
23:05
that would be compatible with the tissues that
23:07
we have to repair or reconstruct,
23:09
so that it would share share the load,
23:12
but not entirely
23:13
shield the load because the those two would
23:15
need exposure to,
23:18
physiologic
23:19
loads to be able to mature properly and
23:21
to get strong.
23:22
And so I I spent a lot of
23:25
time doing research on
23:27
on methods of
23:29
repairing,
23:30
rotator cuff tendons,
23:32
Achilles tendons, triceps tendons, and patellar tendons
23:36
so that the suture, the way I would
23:38
put it in and the the way that,
23:41
it would
23:42
function
23:43
would load share.
23:45
And, so that all the stress and strain
23:47
of,
23:48
early motion and early strengthening
23:51
in therapy
23:52
wouldn't,
23:53
all that load wouldn't go directly and expose
23:55
the repair to that, that some of that
23:58
load, which would be damaging,
24:00
would be plastically
24:01
deforming,
24:02
so you'd end up with slack in a
24:04
repair,
24:05
that that some of that load would be
24:08
shared with the way we put suture in.
24:12
And,
24:13
so, you know, a a big a big
24:15
step forward for me was, in rotator cuff
24:18
repair when we devised the
24:21
the the bridging type repairs that became known
24:23
as the suture bridge,
24:26
and all the interconnected,
24:27
interlocking
24:28
repairs where so that
24:30
every point of repair is,
24:33
there's load sharing between anchors, and and
24:37
you can bypass
24:38
the area of healing,
24:40
tissue to bone so that there's no motion
24:43
at that at that interface. And and, and
24:46
so,
24:47
you know,
24:48
when you conceive of the technique,
24:50
then the next step is to really study
24:52
it
24:53
scientifically. And
24:55
and and we went we we spent
24:57
a couple years in the lab studying,
25:00
pressurization of tissue on bone and and the
25:03
mechanical strength and the cichlid loading and
25:07
and until we
25:09
presented the then the technique. We we we
25:12
went back and really did what we thought
25:14
we should do,
25:15
improving it scientifically. And and and so then
25:18
that came out in
25:19
the early two thousands, and and, we were
25:21
able to really,
25:23
you know, very quickly change the way
25:26
those types of tendons are repaired,
25:29
all over the world. And and and so
25:31
that was my
25:33
that was my big
25:35
step forward in into developing
25:38
techniques and materials and anchors and suture
25:41
that would accomplish
25:43
the my general purpose, which was
25:46
to provide
25:47
repairs and reconstructions that would be durable and
25:49
strong enough to withstand
25:51
this crazy timetable to get these guys back.
25:55
And so the so the the same sort
25:57
of philosophy then
25:59
was adopted,
26:01
and,
26:02
with
26:03
with tendon repairs all over the body.
26:06
Most recently, you know, Achilles repairs have have
26:08
gotten a lot of press because
26:10
there's a there's a explosion of these Achilles
26:13
tears in these young
26:15
athletic guys, the pro athletes, and and,
26:18
how do
26:19
you protect the repair from,
26:21
stretching and and failure,
26:24
but yet do it in a in a
26:27
do the things so that the player can
26:29
come back in
26:31
a in a short amount of time with
26:32
the proper strength and and explosion that they
26:35
need out of that muscle.
26:37
And so, you know, the techniques that we
26:40
developed,
26:41
on one part of the body has been
26:43
adapted and modified
26:45
to function the same way on another part
26:47
of the body, and and,
26:49
that's been very rewarding for me.
26:51
Yeah. Well, thank you.
26:53
It's it's truly is incredible.
26:56
And I I think you sort of mentioned
26:58
too, like, just that three legged it sort
27:01
of seems like a three legged stool. Like,
27:03
you're like, show me, you know, what what's
27:05
wrong.
27:06
And, you know, for the trainers and therapists,
27:09
show me what what you need to do
27:11
to get them there. And then, like you
27:12
said,
27:13
you'll you'll take it from there, and you'll
27:15
provide the operation
27:17
that along with, you know, the durable repairs.
27:21
The suturing, I think, is
27:23
another thing that really makes you stand out.
27:27
So my next question is just,
27:29
you know, you're trusted
27:31
by many of these professional athletes and and
27:34
professional teams.
27:36
What would you say it takes to to
27:38
sort of earn that level of trust,
27:40
you know, not just from the athletes, but
27:43
from the entire,
27:44
you know, teams and and organizations?
27:48
Yeah. You know, the decision makers for this
27:52
type of thing, you know,
27:54
I I think that the athlete is always
27:56
sort of
27:58
should be have a major say in, you
28:00
know,
28:01
who's gonna take care of them. But, you
28:04
know, how does the athlete know, you know,
28:06
what to do? And so,
28:08
usually, that that they rely on agents,
28:12
or other players that have had that experience
28:15
that experience with that injury somewhere.
28:18
And,
28:20
but there's always this moment
28:23
where you meet the player.
28:25
And
28:26
I think that the same critical thing
28:29
is is necessary, whether it's
28:32
with a team, whether it's with the the
28:34
medical staff of of of a team, front
28:37
office, the agent.
28:39
And it's what how do you develop trust?
28:42
And
28:43
I think that
28:45
some of it is some of it is
28:46
very tangible, the things that that, you know,
28:49
you do,
28:51
your body language and and showing, you know,
28:54
just this innate care concern attention that you're
28:57
paying to somebody.
28:59
But, you know, I don't know what other
29:02
ingredients
29:03
go into authenticity. I
29:05
being authentic and and
29:08
it's it's it's a calculation that everybody does
29:11
whenever they meet somebody.
29:14
These athletes are really, really
29:17
they they know quicker than pretty much any
29:20
other group of people I've ever seen.
29:23
They know who they trust and and
29:26
who is still they still need to work
29:28
on it. You know?
29:31
And and it it's a a calculation that
29:33
goes
29:34
goes through them pretty quickly.
29:37
And,
29:38
you know, with some guys, you know, it
29:41
it takes a little time
29:43
and familiarity
29:44
to to earn it. It can be broken
29:47
in a millisecond
29:48
and never recovered.
29:50
And so
29:51
I I think that,
29:53
you know, the the this is something that,
29:55
you know, some some people are born with,
29:59
you know, the ability to instantly relate and
30:02
be empathetic and
30:04
and the and then the person you're dealing
30:05
with
30:06
instantly knows, this this is a team this
30:09
is, on my team.
30:11
And some people don't have that innately in
30:13
in their in their personalities,
30:15
but that doesn't mean that you can't work
30:17
on it. You know? You you you know?
30:19
I think that
30:20
anybody can
30:22
do what's necessary to when when you walk
30:25
into a room and you're meeting with somebody
30:26
for the first time, take your hand off
30:28
the doorknob.
30:29
You know? Sit down and,
30:31
you know, look at them in the face
30:33
and and
30:34
sort of study.
30:36
They're gonna tell you a lot about their
30:37
emotions and what they're going through
30:39
just by, you know, how they how they
30:42
express themselves and and
30:44
how they look. And and,
30:47
you're gonna come from entirely different worlds and
30:49
backgrounds from from people and but if you
30:52
can't bridge that interpersonal
30:54
gulf and gap
30:56
Mhmm. That is gonna exist between you and
30:58
and you're taking care of,
31:00
you're always gonna be a little bit handicapped
31:02
with regard to
31:04
that
31:05
level of of of intimacy and trust. You
31:08
know? You you've you've gotta do what it
31:10
takes to meet the people where they're at
31:12
and where they where they're they've come from.
31:14
And it's always been something that's been
31:17
in my nature. So you know? But I
31:20
think that anybody needs to work on it
31:22
if if you're gonna try to do what
31:23
we do.
31:25
Yeah.
31:27
Great points there. And and I think that
31:30
what you just said, meeting meeting
31:32
patients where where they're at, and, I mean,
31:35
I could tell from just talking to you,
31:38
that you're very personable, you know, and you're
31:41
you're a comfortable person to to talk to,
31:44
and I'm sure that
31:46
is definitely, you know, recognized,
31:48
with your patients.
31:50
There's a saying that I that I never
31:52
forgot.
31:53
Frank Job,
31:55
I don't think that he was the one
31:56
that was the originator of it, but he
31:58
he certainly,
32:00
you know, instilled that in me. And he
32:02
said, look.
32:03
You
32:04
know, your patients, whether they're players or not
32:07
players, they're Right. They're not going to really
32:10
care as much about
32:12
everything you know and everything you can do
32:15
until they know that you care about them.
32:18
You can be the most brilliant person on
32:20
the planet, and
32:22
unless if somebody thinks that you care about
32:24
them, they really
32:26
couldn't care less about what you know. Right.
32:29
And so
32:31
that that doesn't take a lot of studying,
32:33
and that doesn't take
32:35
anything other than
32:37
trying to understand exactly
32:39
what's happening with this person,
32:42
what's happening with this patient.
32:44
You know, that and, specifically,
32:46
what we do, I mean, it it goes
32:48
a long way. If you if you can
32:49
take the time to understand
32:52
what that person has to do, understand something
32:54
about their sport, understand what they what their
32:56
assignment is, understand, you know, the things that
32:59
they have to do and when. You know,
33:00
that goes a long way to telling that
33:02
player or that patient, oh, this guy, you
33:04
know, he's he's making the effort to really
33:06
understand
33:08
me and what I've what what I've been
33:10
going through. Right. So
33:12
Yeah.
33:13
Yeah. And it's kinda like you said. I
33:14
mean, I've heard this before too, but, you
33:17
know, not having your hand, you know, on
33:19
the doorknob, right, and really taking the time
33:22
to to sit with and and and get
33:24
to know these patients. And I think oftentimes,
33:27
you know, that part that partnership between patient
33:31
and surgeon,
33:32
I was just talking about this earlier today,
33:34
is not equal. Because for surgeons, I think
33:37
that, you know, the operation might be the
33:39
easy part because you've done it hundreds or
33:42
or even thousands of times. But the postoperative
33:45
care, you know, especially
33:47
the rehabilitation
33:49
and the patient's ability to sort of work
33:52
through that discomfort
33:53
is often, you know, what really determines the
33:56
difference
33:57
in outcomes.
33:58
100% right.
34:01
The last thing I wanna to ask you
34:04
here is, you know, even with all your
34:06
accolades and and leadership roles,
34:09
you're still operating and you're still mentoring
34:12
and you're still innovating
34:14
every day.
34:16
So I'm curious, you know, just what continues
34:18
to to drive you,
34:20
and what advice would you give to
34:23
the next generation
34:25
of orthopedic leaders?
34:28
Well,
34:30
the answer of your your first question,
34:33
most of it's positive. Some of it may
34:35
be
34:36
pathologic.
34:41
I I I'm so grateful that I found
34:43
something that I love, that I that I
34:47
wanted to put in the work to be
34:48
good at.
34:49
And I I I still I still love
34:52
it. I still love being in the operating
34:54
room. I still love being in physical therapy
34:56
after surgery
34:57
with with guys. And I I
35:00
I love it on a human level. I
35:02
love it, you know, on the technical level.
35:05
I I love working with my hands, and
35:07
and,
35:09
that's all the positive side, and I'd say
35:11
that's 90%
35:12
that's the answer.
35:13
I think there's 10%
35:15
maybe that I don't wanna face that I
35:18
don't know if I really know who I
35:20
am without doing what I am. And,
35:24
I don't know that that's all all that
35:26
healthy. I think that maybe it's probably
35:29
not healthy, but
35:31
the greatest joy in my life is my
35:33
wife and daughters.
35:34
But I really am not me. I don't
35:36
feel like I'm me, you know, without doing
35:38
what I do.
35:39
And,
35:42
I think that I better find
35:45
that other part of me.
35:47
You know? I and I think it's
35:49
for everybody. I I think that, you know,
35:52
I I may whether it's
35:55
maybe insecurity or or what or what, but
35:58
I was nobody before I
36:00
before I started to do what I do,
36:02
and it gave me everything. And so
36:04
it's it's hard to divorce the what I
36:07
do from me. You know?
36:09
Yeah. It was hard for me to ever
36:11
fake not doing it. And,
36:13
the day's gonna come when when,
36:16
you know, I I think that
36:18
patients would be better served by, you know,
36:21
having somebody else do their surgery.
36:24
I just hope I know that
36:26
day before anybody.
36:28
Yeah. Well, thank you
36:30
so much, doctor Eletrash. This has been an
36:33
incredibly
36:34
insightful
36:35
conversation,
36:36
and thank you so much for sharing, you
36:38
know, your experience and and your perspective
36:41
with us.
36:43
That is all for today's episode of Becker's
36:46
Spine and Orthopedic podcast.
36:48
A big thank you to doctor Eletrash
36:51
for joining us and offering
36:53
such valuable insights into
36:56
the future of sports medicine and orthopedic care.
37:00
Thank you for listening, and we'll see you
37:02
next time.