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Outside Magazine August 2004
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BODYWORK: Noninvasive Surgery
The Kindest Cut
Is no cut at all. The latest surgery-free solutions to sports injuries may help you bypass the O.R., and put you back at the top of your game.

By Ted Kerasote

sports injuries
Stop that Scalpel! Can natural-healing therapies provide an alternative to "invasive" treatment? (Mark Hooper)
SURGERY HAS LONG BEEN the accepted fix for creaky knees, grinding joints, and tweaked backs. But there's mounting evidence that the knife isn't always the best medicine. Consider a recent study published in The New England Journal of Medicine that showed that arthroscopic knee operations—known as "dust and cleans"—produced no better results than a placebo procedure in which an incision was made but no arthroscopic instruments were inserted. That study didn't stop 650,000 knee scopes from happening last year, but it boosted a sense among pro and weekend athletes that there has to be a better way.

This topic is particularly applicable to my aging bod. When I started breaking down after 35 years of serious pounding in the outdoors—
Sack the Surgeon
The most common ailments Andy Pruitt sees at the Boulder Center are knee pain, lower-back soreness, strained foot ligaments, and arthritic knees and hips. These incision-free treatments can help.
I've got toe joints that have lost their surrounding cartilage, nagging lower-back pain, and a misshapen shoulder (the result of a bike crash)—there were plenty of surgeons eager to cut me open. But I wanted options. So I asked Jackson Hole–based Erich Wilbrecht, a 42-year-old real estate agent who competed on the 1992 U.S. Olympic biathlon team, for a recommendation. I knew he'd had the inside of his right patella scoped unsuccessfully in 2001 and was now trying different approaches.

Wilbrecht told me about Andy Pruitt, the founder of the Boulder Center for Sports Medicine, in Boulder, Colorado, and a specialist in nonsurgical techniques who has treated athletes like cyclist Lance Armstrong and marathoner Frank Shorter. Pruitt, a physician's assistant, belongs to the expanding niche of doctors and physical therapists who try to avoid surgery by figuring out the external causes of our aches. (See "Sack the Surgeon".) This year he expects the patient base of his clinic, open since 1998, to climb to 31,000 people from across the United States. Nationwide, the number of noninvasive practitioners like Pruitt certified by the National Academy of Sports Medicine has doubled in the last three years.

Pruitt prescribed balancing and muscle-building exercises for Wilbrecht's glutes and knees, as well as orthotics—customized footbeds—to align his hips and legs in a less stressful position. Result? "A 90 percent reduction in pain and a return to racing," says Wilbrecht. Since seeing Pruitt, he has won the 25-kilometer Yellowstone Rendezvous cross-country ski race and two national titles in summer biathlon, which combines trail running and marksmanship. Naturally, I wanted to find out what Pruitt could do for me.


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