Sports Essentials | Lift Your Performance with Lauren Wichman, MD

Podcast Transcript

John Horton:

Hey there, and welcome to our first episode of Sports Essentials, a new Cleveland Clinic podcast. I'm John Horton, your host.

So you might be asking yourself, what exactly is Sports Essentials? In the simplest of explanations, it's a podcast for folks who like to break a sweat, the kind of person who craves the sense of accomplishment and sore muscles that come from a good workout. Once a month, we're going to tap into our all- star lineup of sports doctors at Cleveland Clinic to help you perform your best. We're also lucky enough to have one of those sports health experts, Dr. Lauren Wichman, as a co-host of the podcast. She'll be with us every episode to share her expertise and coach us up a little bit.

Dr. Wichman, glad to have you on the team.

Dr. Lauren Wichman:

Thank you so much for having me, John. I think that this is the start of something that, I think, is going to be a fantastic, fantastic time for us and the listeners.

John Horton:

Oh, I'm ready to get in it, too, Dr. Wichman. So if you're someone who works out regularly, odds are you pay attention to your body and health. Dr. Wichman, I'm guessing that you get lots of questions from folks about achy body parts once they hear that you're a sports doc.

Dr. Lauren Wichman:

No doubt about it, John. From a neighbor who was shoveling snow that curbsides me, saying, "Hey, doc, what could be going on with my shoulder?" To a family friend that says, "I've been having knee pain for over a year now.” It happens all the time.

John Horton:

I'm guessing you didn't get into sports medicine just so you could have all these interesting conversations on the street and at parties about what hurts people. So what really brought you into this field?

Dr. Lauren Wichman:

I knew that I wanted to go into sports medicine when I was in high school. I loved science and knew that I wanted to go into a STEM career. My mom, she is a teacher, and so she kind of really inspired me to know that I really wanted to work with people. And then, I love problem-solving. So medicine was the perfect fit in terms of working with people to try to figure out injuries or things they have. And then, you add in, with my passion of sports, sports medicine is absolutely the perfect career for me.

John Horton:

I mean, you had a pretty robust sports career coming into this.

Dr. Lauren Wichman:

Absolutely. I think, too, my background with sports definitely lends to that passion in sports. I grew up playing a lot of different sports with my family members, and then ended up playing ... I played soccer and basketball in high school, and then ended up playing soccer in college at Case Western here in Cleveland.

John Horton:

That puts you high up on the list if you're a collegiate athlete.

Dr. Lauren Wichman:

I think being a student athlete, there's nothing better. Being able to represent your institution playing the sport you love and making lifelong friends.

John Horton:

Well, I'd imagine, too, and being at that level of sports, I mean, you really have to focus on training and what you're doing with your body.

Dr. Lauren Wichman:

Absolutely. I think at that high level, everybody is so talented. And so every little thing that you can do to be able to have that competitive advantage makes such a difference.

John Horton:

When did you start seeing the connection between, kind of, sports medicine and what you were doing on the field?

Dr. Lauren Wichman:

It really comes up more often than you think, because I think the concept of sports medicine is very broad. It definitely came up when I faced injuries, whether knee surgery to concussions, I definitely ran the gamut. But it also came into play with the sports performance side of things, making sure that I was doing cross-training and making sure that I was doing strength training and all this other stuff that would lend to that competitive edge once I hit the-

John Horton:

…field. That's such a great point because I think when we talk about sports medicine, a lot of people just naturally go to this whole notion of fixing broken athletes. But so much of what we want to focus on with this podcast is using sports medicine to kind of improve your performance, just to make yourself better. How does that fit into this scenario?

Dr. Lauren Wichman:

You're exactly right, John. Many times, when people think, "Oh, sports medicine doctor, you fix things that are broken." And I think that many times, that is what we are doing on the sidelines, taking care of athletes, seeing them in the training room, we see them when there's a problem. But I think a big part of when I see somebody for a problem, the next step that I like to take is, well, not only how can we fix this problem, but also how can we prevent it from happening again? Because we don't want you to be sidelined if you don't have to be.

John Horton:

I've had enough little injuries, and the first thing that you think of after you get it is, How can I stop this from ever happening again?

Dr. Lauren Wichman:

Once you've had it once, once you've had a certain injury one time, it does put you at an increased risk for it to happen again, unless we make a change. And that's why in sports medicine, that problem-solving piece that I was talking about, it's not only trying to figure out how did this happen or how do we fix this, but also taking it a step back and how did it happen and then we can make a change in some sort of behavior to make sure it doesn't happen again.

John Horton:

Now, you were obviously a pretty high-achieving athlete back in your college days, but as you've entered this new phase of life, how has your personal approach to fitness changed from being that competitive college athlete to being a doctor and a mom and everything else you have to do in life?

Dr. Lauren Wichman:

I think that is a really good question. And honestly, it's a journey that I am still going through because when you retire from your sport, right? I have from soccer, trying to figure out, well, where am I going? What am I going to do now? Personally, I've channeled my energy into spin class. I'm a big spinning person. I love the team environment, but also the competitive nature, stats on the board and trying to fight my way to the top.

John Horton:

You just got to edge that next person out.

Dr. Lauren Wichman:

Yes. But I can empathize with a lot of other people who are trying to figure out the next step, too, because my life has changed a lot since having my one-year-old son now, trying to be able to squeeze in a workout while working full time, and as a mom, that can be really challenging. And like I said before, I'm still trying to figure out what's the best way to do this day in, day out.

John Horton:

I mean, it's just about trying to do something, right?

Dr. Lauren Wichman:

John, how have you found, I mean, being a parent and everything, how have you found workouts to work in your schedule?

John Horton:

I went a long time where exercise was not a priority. We have three kids, all adults now. And as they grew up and you're balancing parenting and a job and career and all that, taking care of a house, all that, never had time for working out. And that finally hit me one day when my middle kid, Brian, decided to go out for middle school cross-country and asked me to go for a run with him. And funniest thing, so my wife is like, "Listen, you want him to feel good about what he's going to do. So don't go too fast. You don't want to make him feel bad about what he's doing. Take it easy." I can tell you, she had that discussion with the wrong person. It was a serious wake-up call and I started running, and 12, 13 years later, I've done like 40 half marathons and feel good about my health and where I'm at.

Dr. Lauren Wichman:

That's fantastic. Congratulations on all of those successful halves. That's amazing.

John Horton:

Eventually, you just get to the point where, I've slowed up a little bit. I felt really good for a while, and time is taking a toll, man. Nobody beats Father Time is what I'm finding out. But that's one of those things you learn to kind of adjust, which I know is one of the things we'll try to address as this podcast goes on, as to how you can kind of fit fitness in at different stages of your life and kind of look at it in different ways.

Dr. Lauren Wichman:

Just like you mentioned, I think sometimes, starting up a new exercise, a new form of exercise, can be a little bit intimidating. I watched my husband who played college baseball … so the farthest he was running was around the bases. And then, he then transitioned to running his first half, not last year, but the year before. And I think that watching somebody go on that journey firsthand, you can see how hard and challenging it can be, but how rewarding it is and how good you feel after you succeed.

John Horton:

People always ask, like, "What was the hardest part?" Yeah. And I always say it's that first step that you take. And once you take that, everything after that gets a little bit easier.

Dr. Lauren Wichman:

And I think that's one goal that we have in sports medicine, is to try to be that teammate for whatever our patients that may come into the office are trying or experimenting with or picking up a new hobby or trying to get to the next level in something that they've been doing for years. Our goal is almost that doctor-coach, in a way of trying to help our athletes whenever they might be faced with a challenge that’s preventing them from performing the way they want to.

John Horton:

Let's get into a little bit about what you do here at Cleveland Clinic and kind of what the typical Dr. Wichman day is like.

Dr. Lauren Wichman:

So as a sports medicine doctor, we wear a lot of hats. I'd say, most traditionally, I see patients in the office Monday to Friday, whenever an injury or something might come up, yeah.

John Horton:

I'm guessing you've seen a few sprained ankles over the years.

Dr. Lauren Wichman:

Yes, exactly. Sprained ankle, very common, very common. And when anybody comes into the office, usually, we're sometimes getting an X-ray, taking a look at the bone or the joint, doing an evaluation, and then collaborating together to come up with a best treatment plan for each person.

John Horton:

Now, you see a wide range of people, too, right?

Dr. Lauren Wichman:

Oh yeah, John, it's wild because we, as sports medicine doctors, we are a team of physicians and take care of different high schools, local colleges, even professional teams. Like my group here at Cleveland Clinic, we take care of the Cleveland Guardians and the Cleveland Cavaliers. But then, we take care of maybe the weekend warrior who's running races, just like you, and we'll take care of the retiree that's on the pickleball circuit. We take care of a wide range. I think even just last week, I had an 11-year-old and a 100-year-old back-to-back.

John Horton:

The whole goal, if you can get to a hundred, where you get to go to a sports doc, that seems like the goal all of us should have.

Dr. Lauren Wichman:

She was rocking it. She drove herself. I was like, "I want to be you when I am like anywhere near that age."

John Horton:

Clearly, she was in for something serious, like a pole-vaulting injury or something like that, right?

Dr. Lauren Wichman:

Of course. Oh man. But I mean, I think one of the things that, when she was in the office, and I was talking to her, one of the things that she emphasized was she's like, "Doc, I've just kept moving." She said, "Once you stop moving, I think it'll really catch up to you. " And I do think that she's exactly right.

John Horton:

Yeah. No, you can't stop. We have another, on our Health Essentials Podcast, the chiropractor we have in, Dr. Bang, always says “motion is lotion.” Like you've got to keep moving and keep everything going, and your body will just work better. I take it there's some truth to that.

Dr. Lauren Wichman:

100%. I say the similar thing. I say we use “movement as medicine” many, many times. Whether it's something that I'm talking through — or one of the best parts about a career in sports medicine is I work with a really awesome sports medicine team — so whether I'm talking about movement or I'm collaborating with my colleagues in physical therapy or my athletic training colleagues, we all work together to come up with like individualized movement plans and use truly movement as medicine to help treat any sort of injury and get people back to the sports and the activities that they love.

John Horton:

And one of the things I know we talked about earlier was that the team approach goes beyond just working with the body and all the stuff with that. You do a lot of sports psychology stuff or work with people on that realm because that factors into how we're able to exercise and do all of these things

Dr. Lauren Wichman:

True. Absolutely. The sports medicine team is really, really big, and we're really grateful to have so many fantastic professionals on our team. So just like you said, we've got sports psychology, we've got sports nutrition, we've got a lot of people that help our athletes truly excel at their sports.

John Horton:

I'm glad you brought up nutrition, because I know Julia Zumpano, who I do the Nutrition Essentials Podcast with, would have been really disappointed if we never brought up the importance of registered dietitians in this process, too.

Dr. Lauren Wichman:

We actually, here at Cleveland Clinic, have our own specialized sports registered dietitian who works with a lot of, especially a lot of our college athletes, but we send a lot of our high school athletes her way as well to talk through how changing nutrition not only treats injuries, but also prevents them.

John Horton:

There's just so much we can cover on this podcast, which is what has both of us, I know, so excited from going into this. Now, we were lucky enough to get you with our first-round draft pick to be co-host on here from that whole sports doctor team. So in your mind, what do you want our listeners to get out of this podcast?

Dr. Lauren Wichman:

That's a great question, John. And honestly, what I hope is that this podcast is a place where listeners can come and learn from all of these different sports medicine professionals and get quality information from a place that they know is reliable, and answer questions that they may have had, but also answer questions that they didn't even know that they had, and have conversations that I have in the office every single day, but be able to share with everyone here.

John Horton:

Well, and I like how you often talk about coaching people, and I know you said your mother was a teacher. I feel like you do a lot of that educating right here and through your practice. I take it that's kind of one of the driving forces also.

Dr. Lauren Wichman:

100%. I think teachers are coaches, and doctors are coaches, too, in a way. We are with our patients every single step of the way, providing encouragement, providing a little tough love whenever you might need it, but all coming from a place of wanting people to be able to be their best.

John Horton:

Well, with that in mind, let's start coaching people up right now and kind of give folks a little taste of what they're going to hear on this podcast as we move ahead.

So in your practice, what are the biggest issues that you see that affect physical performance, and how can folks address them?

Dr. Lauren Wichman:

Three things that I think people don't necessarily always think of right away, but are huge factors in performance, are sleep, nutrition and stress management.

John Horton:

Now, those are things you think of with a whole host of other stuff. You don't necessarily tie it in to how fast you're running or how high you're jumping or anything like that.

Dr. Lauren Wichman:

Exactly. And I think, too, it's things that you don't even necessarily realize, but life happens. For example, my student athletes, right? They're in the thick of finals, but in the middle of also having to compete in the classroom with finals, they're competing on the field, too. And when they're pulling all-nighters to study, their performance on the court is going to hurt.

John Horton:

I bet. And I'm guessing, too, your injury risk just goes through the roof if you're a little tired as you go into the sort of exertion activities.

Dr. Lauren Wichman:

Absolutely. I think all three of those things that I had mentioned in terms of sleep, nutrition, as well as stress, can increase your injury risk. And that's why, many times, we focus on making sure that all of these factors are in check as well when we're treating somebody with an injury.

John Horton:

So like when you're working with sleep, since you kind of brought that one up and we kind of hit that first, what do you tell your student athletes now when they come in? I mean, you can't just tell them, "Hey, don't worry about that final, you'll just wing it. " So what kind of things can they do to make sure that they're getting enough sleep to be at their absolute best?

Dr. Lauren Wichman:

So normally, when I am seeing a college athlete or an athlete that we know sleep is maybe not optimal, obviously, I tell them, in an ideal world, seven to nine hours a night would be the sweet spot. Now, we know that, especially if you're cramming for a final or something like that, that might not happen every single night. But there are a few things that you can do to help maximize your sleep quality, which can be really beneficial. Limiting screen time before bed, I think, it's super common for people to scroll on TikTok right before they're going to sleep, and that can actually — oh, guilty of that, yes — and that can really hurt your quality of sleep. Having relatively consistent bedtimes and then times that you wake up in the morning can set your body's clock and almost establish that schedule to help you fall asleep easier at night.

John Horton:

Yeah. That makes a lot of sense.

Dr. Lauren Wichman:

And the other thing that is super common with my student athletes in particular is caffeine. And I think that's something that we use a lot.

John Horton:

One too many Monsters®, huh?

Dr. Lauren Wichman:

Yes, exactly. Or that late-night coffee to keep you up so you can study, that can make it really, really challenging to fall asleep, but also can impact your sleep quality. So I usually recommend trying to limit as much caffeine as you can, even in the afternoon or evening, and that can help improve sleep quality as well.

John Horton:

Yeah. That is such a great point because sometimes, it's not just about the number of hours that your head's on the pillow, but it's about the quality of the sleep while you're there. And those little things can make it where you're getting more out of whatever limited time you might have on some of those days when you're going to be short.

Dr. Lauren Wichman:

Definitely, definitely.

John Horton:

So now, what about nutrition? Because, obviously, we all know that eating healthy is better for you, but do you actually see eating a bunch of junk food kind of contributing to injuries or poor performance or things like that?

Dr. Lauren Wichman:

We definitely do. When I think about nutrition, it's not only quality, but it's also quantity, too. I think one of the most common things I see in, especially a lot of my endurance athletes, like my runners, is low [fuel]. We're not eating enough to be able to fuel the workouts and the competitions and everything that we're putting our body through.

John Horton:

You ask a lot of your body when you're doing these things, especially when you're pushing, like you said, endurance stuff or anything where you're really exerting, you have to have those reserves built up.

Dr. Lauren Wichman:

Definitely. You need fuel to be able to put your body through that stress. And so if we don't have enough fuel, that's when we predispose our body to injury. And that's, a lot of times, what my athletes are talking to our sports registered dietitian about is they think they're eating plenty, but if you're a swimmer that's doing two-a-days constantly, you have to really work at making sure you have enough fuel.

John Horton:

I remember what Michael Phelps used to eat when you saw that during the Olympics. That was insane, but it kind of drives home the point that you have to put in a bunch of calories to just keep your body going.

Dr. Lauren Wichman:

Definitely. And to your point, too, the quality of ingredients definitely makes a difference. That's what I think, especially, I think, later this year, that would absolutely be something that we'll dive a little bit deeper into, but making sure that the food is high-quality. If we're trying to energize ourselves on a sugary snack, that's not going to give us enough fuel to get through a two-hour practice or a competition.

John Horton:

Yeah. I'm guessing that the best meals don't come through a drive-thru window.

Dr. Lauren Wichman:

Correct. Absolutely.

John Horton:

All right. So we're solving that problem. We're going to hit that as this podcast kind of evolves.

What about stress? Because we think of it in so many different ways. How does it affect our fitness and our ability to exercise?

Dr. Lauren Wichman:

Stress can wear on the body, I think way more than we even realize, because so many of us just kind of put our body through it day in and day out. I tell people, I think trying to keep that in check, and once we do get our stress in check, I think some people are really surprised by how much they realize how much it was affecting them because they feel so much better.

John Horton:

Yeah. Well, and sometimes you do, you have to deal with that thing that's kind of weighing you down. And you don't realize how it affects just every little thing that you do when you have these stressors that just don't go away.

Dr. Lauren Wichman:

And many times, the nice thing about it is sports, and exercise, is actually a very, very common stress management tactic for many of us, including myself. So that works out great.

John Horton:

I was going to say, I've logged more than a few stress miles at the end of a workday, and it does somehow make everything feel a little bit better. I guess it's all those kinds of hormones that you release when you're out there working out.

Dr. Lauren Wichman:

I totally agree. And I think, many times, that alone is a huge, huge benefit. I do always advocate for bringing in a lot of my sports psychology folks for doing different relaxation techniques, different mental skills tactics, things that we found that it's not only important to make sure that your physical health is at optimal condition, but also your mental health needs to be at optimal condition to be able to perform at the highest level.

John Horton:

So Dr. Wichman, when you do see these sorts of stressors that are affecting performance and how people can go about doing these fitness things, what kind of recommendations do you give-

Dr. Lauren Wichman:

…them? The biggest thing that I find to be beneficial is, like, leaning on your support system. So parents, coaches, teammates or your sports medicine staff, having those people that are in your corner can make such a big difference when you're mentally going through something, and having them to have your back sometimes is enough confidence to kind of give you that feeling of, "OK, yeah, you're right. I can do this. " And kind of get over that mental hump.

John Horton:

Oh, lean on your team, man. That's what we've all been taught from day one if you're in any sort of sports.

Dr. Lauren Wichman:

Absolutely.

John Horton:

Now, you just gave us three things that everybody can kind of look at and make little tweaks to, to try to improve how they can exercise and the amount of energy they bring into those activities and things like that. Let's kind of shift gears a little bit and talk about one other big thing that I know people deal with a lot, and that's overuse injuries. I know you said you see that all the time in your practice. What can people do about it to kind of avoid those sorts of pains?

Dr. Lauren Wichman:

That is a really good question, John, because you're exactly right. I think just as often as I see somebody in the clinic for a sprained ankle, like we talked before, I see somebody also in the clinic because they've got a shoulder injury from throwing the ball back and forth too many times in the backyard or-

John Horton:

…too much pickleball.

Dr. Lauren Wichman:

Exactly, exactly. Hitting the pickleball court for hours on end. And I think we do a lot of talking about not only where those overuse injuries are from, how to treat them and then how to prevent them going forward.

John Horton:

So how do you work with that? Because if you're an athlete and you're on a team, you're in any competitive sport, you're taught from day one that you go at it, you go hard all the time. And this whole notion of resting, it almost seems like a dirty word sometimes.

Dr. Lauren Wichman:

Honestly, I think that mentality that so many of our high-level athletes have of, Well, I'm going to work as hard as I possibly can, which is a great mentality to have. But I think that sometimes, particularly if we're doing the same thing day in and day out, putting so many miles into the same knees or playing so many soccer games over a weekend, we're putting our body through this repetitive stress that, over time, that load just exceeds the capacity that our tissues have.

John Horton:

So how do you tell people that it's OK to rest, to take a day off, to go a little easier one day?

Dr. Lauren Wichman:

I tell people that recovery is almost just as important as making sure that you're logging this many hours in the pool or taking these many free throws. I mean, truly, recovery is absolutely essential for the tissues to bounce back after being put through a rigorous workout. One of the things that I always emphasize, too, is cross-training.

John Horton:

That makes sense. You work different muscles.

Dr. Lauren Wichman:

Absolutely. Like for example, a lot of times, for our college athletes, when they have a travel day and they're stuck on a plane, they're sitting there for a long time, we'll implement some sort of like a low-intensity yoga-type workout, some stretching that allows for recovery of the tissues, while also isn't putting too much stress before game day the next day or the day after.

John Horton:

As long as it counts on Strava®, right? So you can keep your activity streak going.

Dr. Lauren Wichman:

Absolutely.

John Horton:

We all want that streak to keep going, right?

Dr. Lauren Wichman:

Oh, yes. I think one of the most challenging conversations I have is trying to tell a runner that they can't run. And that's why most of the time, I don't, because most of the time, runners don't want to hear that.

John Horton:

And those are the doctors that I always like the most when you go in and they're like, "Listen, I know you're not going to stop doing this, so let's figure out how you can keep doing it and then also correct what's going on and this injury that you have. "

Dr. Lauren Wichman:

You hit the nail on the head because from my experience, right, if I were to tell an athlete like, "Well, you can't do this, or I think you might need to hang up your cleats." That is not only not what I'm in the business of doing, but that is not going to be what they ultimately want to do. They came into the office to be able to get back to what they want to do. So a lot of times, it is working together, figuring out, OK, on an individualized basis, instead of running four days a week, right now we back it off to three, and then we add in to low-impact bike workouts, that could be enough to allow your body to feel better, to recover, and then to ultimately perform at a higher level going forward.

John Horton:

How often do you have to tell people to actually listen to their bodies?

Dr. Lauren Wichman:

All the time.

John Horton:

Because we just don't. I mean, you start having something hurt and you just go, "Ah, I'll work through it." And I've done that. I can't even tell, way more times than I would ever want to tell a doctor.

Dr. Lauren Wichman:

Well, and what I tell people, I use that line a lot because when we are working on getting back to sports, too, because I think that is really, really important as we are starting our return to run program, for example, the feedback that your body gives you is critical for us to know, "All right, are we ready to move on to the next step? Or do we just need a little bit more time here and then we can move on to the next step?" And if we don't listen, then sometimes, we end up having to start over from the beginning.

John Horton:

This seems like where you get to that old cliché, where sometimes, it's not about working harder, it's about working smarter. And that's something that I think we can really focus on as this podcast evolves, to give people kind of those tips, too, so they can be a little smarter about how they do their exercise routines and really, really do the most to help their body.

Dr. Lauren Wichman:

100% agree. I think that's where sports medicine, I think, can be so helpful, is to give you that one little bit to kind of push you up to the next level. And like you said, being able to talk through what can be beneficial for the long run to prevent injury.

John Horton:

So Dr. Wichman, we've kind of given folks a little bit of a teaser for all the things that we want to kind of tackle as we move ahead here. As we kind of wind this down, what are some of your key takeaway points or final thoughts that you want to leave people with so that they're excited to come back and hear us again?

Dr. Lauren Wichman:

One of the big takeaways I have is when we're talking about sports medicine, many times, going into the doctor doesn't mean that we're shutting you down or you're going to be completely done. It's many times more of a conversation between athlete and coach to figure out, OK, how can we go about this in a smart way to be able to help heal from this injury so then we can keep competing?

John Horton:

I don't know about you, but I am so excited about just everything we have on our plate going ahead.

Dr. Lauren Wichman:

John, I think this is going to be awesome because, like we said, initially, this is not only an opportunity for people to get to know us, but also to get to know our awesome, awesome sports medicine team. Who's involved, what's involved and how to keep people … not only keep people on the field, but also allow them to be on the field for longer and to be able to compete at the highest level.

John Horton:

Can't wait for our next one coming up in one month from now.

Dr. Lauren Wichman:

Sounds great, John. Can't wait either.

John Horton:

So wherever you are on your fitness journey, know that Sports Essentials is here to help you take the next step.

To make the podcast a regular part of your workout routine, please hit the subscribe button. And until next time, play hard and be well.

Speaker 3:

Thank you for listening to Health Essentials, brought to you by Cleveland Clinic and Cleveland Clinic Children's. To make sure you never miss an episode, subscribe wherever you get your podcasts or visit clevelandclinic.org/hepodcast. This podcast is for informational purposes only and is not intended to replace the advice of your own physician.