OU Researcher Catalogs Athlete Injuries To Study Effects

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The discussion of athlete safety at the professional and collegiate levels is still a fairly recent development, but Ohio University’s own Dr. Chad Starkey has been researching both short and long-term effects of injuries for more than 25 years.

Starkey, associate professor of athletic training at Ohio University, has worked as a consultant for the National Basketball Athletic Trainers’ Association since 1986, designing statistical measures to quantify player performance after an injury.

After years with the NBA, Starkey’s work has led him to studying athletes at the beginning stages of their athletic careers, in high school.

He is also doing it locally.

By working with 20 high schools around Southeastern Ohio, Starkey has hoped to quantify injury rates and risks among young athletes as well as examine the financial implications of having a certified athletic trainer.

Starkey’s work with professional athletes has shed light on the importance of proper medical treatment for athletes beginning at a young age. By providing the best possible care now, there is a greater chance of preventing more problems down the road.

Starkey first became interested in athletic training after being treated by the training staff at West Virginia University after he suffered an injury in high school.

“I wanted to go into a health care profession, and with athletic training I liked what I saw and stuck with it. It’s an interesting patient population and it was an attractive mix,” said Starkey.

In his career, Starkey has served as first chair of the National Athletic Trainer’s Association Education Council, been a member of advisory boards for three different industry trade publications and authored or edited more than 16 textbooks, something he has done since 1992.

The focus of his textbook writing has been orthopedic diagnosis, therapeutic modalities and epidemiology. Today, athletic trainers, physicians, and chiropractors around the country use his books. 

Starkey first got involved in the NBA more than 26 years ago while he was working on his doctorate at Ohio University. He noticed one day that programming computers came relatively easily to him and he ended up building a database to keep track of injuries among Ohio University athletes.

“Almost by accident, I discovered I had this skill and then I figured out how to turn it into something that could be commercially viable for high schools and colleges,” said Starkey.

A team physician from the Los Angeles Lakers found out about Starkey’s database. Shortly thereafter, Starkey received word from the NBA, who was eager to have him adjust their own system to highlight what they were trying to measure and from there it blossomed.

Over the years, Starkey has conducted studies on everything from comparing injury rates and risks between NBA and WNBA players, to eye injuries in the NBA, to performance studies after ACL reconstructive surgery, to a massive 17 year overview of injuries in the NBA that was published in March 2010.

“Essentially NBA team physicians approach me with a question and I do my best to develop a method to solve it,” he said. “Right now, Los Angeles is leading the way, but other teams are interested.”

In his work, Starkey has focused on the cause of injuries and looks at what players are like several years down the road after having suffered an injury. Part of the statistical analysis involves measuring overall performance level by adding up positive aspects of a player’s game like points, rebounds, and assists, and subtracting out the negatives like personal fouls and turnovers.

After completing his Master’s and Ph.D. at Ohio University, Starkey left Athens for 16 years without giving it much thought, until some former colleagues persuaded him to return to work with local athletes.

Now Starkey is examining the implications of having a certified athletic trainer at 20 local high schools in Southeastern Ohio and West Virginia.

Ohio University is using graduate students, who are licensed athletic trainers, in the professional phase of their career and are receiving advanced education, in the study.

They are paid a stipend, and the university grants them a tuition waiver so they receive a relatively low-cost graduate education.

Although he is still analyzing the data, Starkey says the return on investment has been through the ceiling for these schools.

“Each year, our athletic trainers provide four to five million dollars in direct and indirect cost saving to the schools that we service,” Starkey said.

This is especially crucial because 17 of these schools are in medically underserved areas.

“You regularly pick up the AthensNews or the Messenger and you see that these districts are laying off teachers and support staff. So, when we talk about saving them money, that’s where the real value of it comes in,” Starkey said.

Recent coverage of concussions and heat illness has helped focus the spotlight on high school athletes.

People who are skeletally immature are at a higher risk of injury and skill level also comes into play. The largest consequences of significant injuries in high school are how they affect people further along.

“If you damaged your ACL your sophomore year in high school and didn’t do anything about it, chances are you have a pretty good dose of osteoarthritis by the time you’re in your early 40’s and possibly in the other hip,” Starkey said.

Starkey said one of the biggest obstacles is overcoming parental and coaching influences that encourage student athletes to return to play prematurely. The athletic training staff’s goal is to return players to competition as soon as possible, but safety is of utmost concern.

“People think they are invincible and I don’t know if it’s intrinsic to Southeastern Ohio, but often when athletes are told they can’t play, the parents say they disagree with you,” Starkey said.  “We try to get people to see long-term effects, but people are so often near-sighted. The athletes are often held out against their wishes, but decisions need to be medically based.”

For Starkey, having a licensed athletic trainer is the benchmark for building a safe and successful high school athletics program. With large athletics programs that offer higher risk sports such as football, basketball, and soccer, it is a greater incentive.

“There is not a town in this country that would ever open a swimming pool without a lifeguard, when do you hear about people drowning in public pools that often? But each year tens of thousands of high schools sponsor athletic programs with no provisions to take care of the healthcare needs of those student athletes,” Starkey said.

Starkey acknowledged that the increased focus on injuries and player safety is both media and medically driven. He said that prevention is certainly an important aspect, but until now it’s the identification of injuries has gone largely unnoticed. Often when people say there has been an increase in something, while that might be true, it probably means it is just being measured more, he said.

When the staph infection methicillin-resistant Staphylococcus aureus, or MRSA, was a concern several years ago, it didn’t end up being as widespread of a problem because people started paying attention and adopting procedures that were more sanitary, Starkey said. “We are starting to devote our attention now to things like concussions, heat stroke, and sickle cell trait and hopefully that will lead to reductions in those areas too,” he said.

Starkey acknowledged that the next big thing in sports medicine is going to be developing long-term studies to measure athletes during and long after their playing careers are over.

“When we begin to look at high school, college, and professional athletes, 10, 15, or even 20 years down the road, how bad is their quality of life? We’re going to begin to examine the expectations that we place on them during their playing careers,” said Starkey. 

Starkey said the greatest need now is to begin measuring athletes while they are in high school. According to a 2011 study by the National Federation of State High School Associations, more than 7.6 million people participated in high school sports in the 2010 to 2011 school year.

Whether Starkey is the man for the job however, is yet to be seen. After years of 16-hour days, the 2009 inductee into the National Athletic Trainers’ Association Hall of Fame is looking to cut back on his workload.

He hasn’t ruled out the possibility of embarking on such a study though. “I’m looking forward to just living my life more and spending time with my family,” he said. “We will see. You never know what could happen.”

Jordan Brogley Webb is an Ohio University Honors Tutorial Student.  This is the second of a four-part weekly series focusing on athletic injuries.