Sports Medicine

PAMF Serves as Official Medical Provider of SAP Open

The Palo Alto Medical Foundation is pleased to serve as the Official Medical Provider of the SAP Open tennis tournament at HP Pavilion at San Jose, February 11 – 17, 2013. Richard Gayle, M.D., a sports medicine and orthopedics expert, will serve as head tournament physician. Dr. Gayle will oversee physician coverage and will work alongside the Association of Tennis Professionals (ATP) athletic trainers in coordinating care of the tennis players.

The SAP Open has a strong tennis history and is now playing in its 125th year.  It is the second oldest men’s professional tennis tournament in the United States. Started in 1889 at Old Del Monte Lodge in Monterey, Calif., the tournament predates the French, Italian and Australian Opens.

“Professional tennis has had a long and storied history in the Bay Area and we are very pleased to be providing medical coverage for this event involving such an elite caliber of professional tennis players from around the world,” said Dr. Gayle.

Read More

PAMF to Provide Local Medical Support to Athletes Competing in 2012 Olympic Trials – Gymnastics

This summer, San Jose, Calif., will become Gymnastics City USA when the 2012 U.S. Olympic Trials – Gymnastics come to town from June 28 – July 1 at HP Pavilion at San Jose. The Palo Alto Medical Foundation (PAMF) will provide local medical support for the gymnasts competing in one of the sport’s most prestigious events.

“It’s a tremendous honor to provide local support for the U.S. athletes who will compete in San Jose and then in London,” said Richard Gayle, M.D., a sports medicine and orthopedics expert at PAMF’s Mountain View Center.  “With such a high caliber of athletes and the breadth of athleticism these individuals demonstrate, assisting in providing comprehensive medical care is indeed a privilege.”

Dr. Gayle and his fellow PAMF physicians will be on site for the duration of the four-day competition to provide local medical care for athletes, as well as USA Gymnastics officials and coaches. PAMF has two U.S. Olympians on its staff:  1996 Olympic gymnastics team gold-medalist Amy Chow, M.D., is a pediatrician at PAMF’s Dublin Center, and two-time U.S. cycling Olympian Christine Thorburn, M.D., is a staff rheumatologist. Read More

PAMF to Serve as Official Health Provider of 2012 Prudential U.S. Figure Skating Championships

Palo Alto, CA – January, 20, 2012 – The Palo Alto Medical Foundation (PAMF) has been named Official Health Provider of the 2012 Prudential U.S. Figure Skating Championships at HP Pavilion in San Jose, January 22 – 29. Throughout the week-long event, Dr. Richard Gayle, a PAMF orthopedic surgeon and sports medicine physician, will serve as the medical director for this sporting event coordinating the medical staff, comprised of almost 20 PAMF sports medicine, orthopedics and other PAMF medical staff volunteering their time and medical expertise.

The U.S. Figure Skating Championships, held annually since 1914, is the nation’s most prestigious figure skating event.  Over the course of one week, the Championships will crown 12 national champions in ladies’, men’s, pairs and ice dancing on the senior, junior and novice levels. Over 250 ice skaters from around the country will participate in the event.

Richard Gayle, M.D.

Dr. Gayle’s previous competitive sports team medical support includes the San Jose Sharks’ 1998-99 season, where he served as an assistant team physician and has had prior experience with figure skating competition medical coverage. Dr. Gayle also serves as an assistant team physician for the Oakland Raiders of the National Football League (NFL) during training camp and has previously served as team physician for the U.S. National Rugby team.

“The U.S. Figure Skating Championships is a very large sporting event with more than 200 athletes practicing and competing over an eight-day period,” said Dr. Gayle. “My PAMF colleagues and I are excited to assist in providing exceptional medical coverage to a premiere national sporting event such as this.” Read More

Golden State Warriors Score PAMF as Official Sports Medicine Provider

Dr. Frank Chen and Dr. Warren King named team physicians

The Golden State Warriors recently became the latest Bay Area professional sports team to name the Palo Alto Medical Foundation’s (PAMF) Sports Medicine Department as its official provider of orthopedic services. The team’s orthopedic care will be overseen by Frank Chen, M.D. and Warren King, M.D.

“We are excited about this opportunity to work with the Warriors and provide care to the team and its players,” said Dr. Chen. “The Warriors are an exciting young team and our job, if there is an injury, is to work closely with the team’s Athletic Training and Strength & Conditioning staffs to get players healthy and back on the court.”

The Warriors join the Oakland Raiders, whose orthopedic care is currently overseen by Dr. King, as professional teams receiving orthopedic services from PAMF Sports Medicine physicians. Previously, Dr. King provided orthopedic services to the San Francisco 49ers and the San Francisco Giants. In addition, he is the chief orthopedic surgeon for the United States Rugby Organization and has provided medical coverage at several professional soccer events, including the World Cup.

Read More

Doctor and Former 2004 and 2008 Olympics Cyclist Explains Training for Top Cycling Events

Dr. Christine Thorburn

Dr. Christine Thorburn

As racers navigate sharp curves, race down hills  and make steep climbs mile after mile, one wonders how they find the energy after they have cycled for so long already. The answer involves more than just well developed muscles. Top cyclists use training techniques that actually change their bodies’ cells.

“Human bodies generate energy to move muscles by breaking chemical bonds that hold molecules together,” explains Dr. Christine Thorburn, a rheumatologist at the Palo Alto Medical Foundation (PAMF) who competed in women’s cycling in both the 2004 and 2008 Olympics. “As part of this process, lactic acid is created. It used to be thought that this acid was just waste and the cause of muscle fatigue and soreness. However, research has shown that the body’s cells can actually take excess lactic acid and convert that to even more energy. Training improves this ability.”

As a medical resident at Stanford University during her first Olympics and a practicing physician during her second Olympics, Dr. Thorburn understood the importance of what was happening inside her cells to the outcome of her races.

“Part of what makes Lance Armstrong such a good cyclist is that he can process lactic acid into additional energy very effectively,” Dr. Thorburn says. “When someone is not very well trained – as I am now that I am retired – lactic acid will build up during strenuous cycling and one’s leg muscles will begin to burn. Once this happens, an untrained person has to stop and rest. They cannot recover. Keep going and one may start to feel dizzy and stop thinking clearly. However, a well trained cyclist can go above his or her lactic acid threshold for several minutes at a time, recover and then do it again two or three more times during a race.”

Cyclists have to go above their lactic acid threshold when “attacking” in a race to gain an advantage over the rest of the group of riders drafting one another. At the end of an “attack,” the body has to process the excess lactic that built up during the sustained burst of energy. Some lactic acid is processed by the liver, but much of it is taken up by a portion of individual body cells called the mitochondria. The mitochondria are the cells’ engines and create additional energy as they break down and get rid of the lactic acid.

Through interval training – which involves short bursts of high intensity exercise interspersed with low intensity exercise that allows the body to recover – cyclists can increase the number of mitochondria inside their cells. With more mitochondria, the cells become even better at processing lactic acid.

In training for the Olympics, Dr. Thorburn and other U.S. cycling team members used sophisticated tools that let them scientifically measure everything from the force they applied to the bike pedals to the lactic acid levels in their blood. They then used these measures in training to maximize their ability to process lactic acid during races.

“Training is all about knowing when you are going above your lactic acid threshold and knowing how long you can sustain that effort,” Dr. Thorburn says. “In training, you can use tools to help identify when you are in that zone, but in a race you have to go by what you are feeling.”<!–<! [CDATA[

]]–><!– –>

Protecting Cyclists from Doping Pressures


As Stage 3 finishers of the Amgen Tour of California streamed across the finish line at the Santa Cruz Boardwalk in May this year, they were met by a small group of medical professionals and volunteers that stayed with the top five finishers until they completed an important post-race doping test. Like last year, this group included Leonard Moore, M.D., a Palo Alto Medical Foundation dermatologist and cycling enthusiast.

“Testing for performance enhancing substances does more than protect the integrity of the race,” Dr. Moore explains. “It protects the health of the athletes and that of young people who look up to them and seek to follow their example.”

The link between serious health problems and taking steroids, hormones, amphetamines and other performance enhancing chemicals have been well known for decades among cyclists. In a widely reported case, British cyclist Tom Simpson died during the 1967 Tour de France after taking amphetamines.

However, because the health problems that come from doping develop slowly over time and only very rarely touch a cyclist at the peak of performance – as in the case of Tom Simpson – the pressure to excel in a race can easily overwhelm concern for one’s long-term health.

Read More