u/Amazing_Benefit_6459

In May, I went to Europe where I interviewed 14 international renowned complex knee surgeons, 12 of them have PhD’s. Learned a lot, 2 hour interview. These were not job interviews. I started this project January 2023 in Norway. I have interviewed surgeons in Vail, California, Minnesota and all over the US. I have have interviewed the biggest names in orthopedics.

Looking for the best international renowned orthopedic sports med surgeons to interview next in Canada? Please let me know. Complex Knee, Shoulder, Hip, Elbow, Hand/Wrist, Canadian Ski Team, Montreal, London, ON, Toranto, Calgary, etc. They do not need to be Canadian Ski Team.

I will start off:

Mark Heard, MD

I am not a surgeon, surgical resident, etc.

In May, I went to Europe where I interviewed 14 international renowned complex knee surgeons, 12 of them have PhD’s. Learned a lot, 2 hour interview. These were not job interviews. I started this project January 2023 in Norway. I have interviewed surgeons in Vail, California, Minnesota and all over the US. I have have interviewed the biggest names in orthopedics.

Looking for the best international renowned orthopedic sports med surgeons to interview next in Canada? Please let me know. Knee, Shoulder, Hip, Elbow, Hand/Wrist, Canadian Ski Team, etc.

I will start off:

Mark Heard, MD

In April, I flew DEN-NRT-DEN in regular polaris.

In May, flew LHR-SFO on the way home.

Elevated Polaris: the food/service is better than regular. The seat is more uncomfortable than regular. Same TV/tray table but larger. Storage differences. Could do without the bells and whistles. Liked the footrest and more space.

Elevated food/service with regular polaris seat.

Regan Dewhirst joined GMVS, according to Facebook.

Moving Forward

In 2023, NFL hired their first full time NP to the Washington Commanders, they are on the side line. Team MD’s (orthopedic surgeons) may not be at Wednesday practice. NFL players don’t want to sit in doctors office waiting room before Wednesday practice for a prescription medication. Stitches or other things like that are the most common for players needing a doctors office because AT/PT’s cannot do that. Now the team PA/NP can take care of that at practice. The team PA or NP can do that in the locker room before Wednesday practice. AT may need to speak with the Team MD, medication or something else, the NP/PA helps speed those things up or facilitate them, making AT job easier. NP/PA is on the road with team at away games. In the locker room, when Team MD is not here, players can get most stuff resolved without needing to go to a higher level (MD). Team PA/NP is like having an orthopedic urgent care on staff in house and should not be liability. Raiders hired their first PA in 2019 and it’s in the CBA.

PA/NP were included in 2021 MLS CBA. All pro sports are going to include a PA/NP in there next CBA.

The USST medical director was a PA-C from 2010-2020. The current USST medical director is a PA-C and pushed for PA’s in the medical pool for the next CBA. USST/USATF do not have this in there current CBA because of liability insurance. Under the current USST CBA, MD’s, PT’s, AT’s and LMT’s are in the medical pool. The next USST CBA will include road PA’s, just like they have road PT’s on staff currently and a Steadman Vail PA-C has been the test dummy at November Copper Camp before.

I think NP/PA are a good thing.

In 2023, NFL hired their first full time NP to the Washington Commanders, they are on the side line. Team MD’s (orthopedic surgeons) may not be at Wednesday practice. NFL players don’t want to sit in doctors office waiting room before Wednesday practice for a medication. Stitches or other things like that are the most common for players needing a doctors office because AT’s cannot do that. Now the team PA can take care of that at practice. The team PA or NP can do that in the AT room before Wednesday practice. AT may need to speak with the Team MD, medication or something else, the NP/PA helps speed those things up or facilitate them, making AT job easier. NP/PA is on the road with team at away games. In AT room, when Team MD is not here, players can get most stuff resolved without needing to go to a higher level (MD). Team PA/NP is like having an orthopedic urgent on staff in house and should not be liability to the CBA. Raiders hired their first PA in 2019 and it’s in the CBA.

PA/NP were included in 2021 MLS CBA.

The USST medical director was a PA-C from 2010-2020. The current USST medical director is a PA-C and pushed for PA’s in the medical pool for the next CBA. USST/USATF do not have this in there CBA because of liability insurance. Under the current USST CBA, MD’s, PT’s, AT’s and LMT’s are in medical pool. The next USST CBA will include road PA’s and a Steadman Vail PA-C has been the test dummy at November Copper Camp before.

I think NP/PA are a good thing.

I am 27F, I am PT/ATC with a DPT and BAT degree. Degrees are paid off. I wanted to go back for masters (PA-C), thought about it, said and decided NO. What are other master’s degrees options? I don’t want my MAT degree.

Strategy over fitness.

Expectations: Drink 2 bottles from start to Duncan Canyon. Reality: Drinking 3 bottles.

The pro men who only took 2 bottles from Dusty Corners-Michigan Bluff and Foresthill-Rucky Chucky were struggling. Bring 3 bottles.

Every runner will vomit atleast once between Robinson Flat-Dusty Corners. Be prepared for it.

Crews need to able to run 2 miles.

At crewed aid stations, make it 30-40 seconds each, it’s enough time not to rush your runner but fast enough to not waste time.

Runners don’t rush through each crewed aid station, you have time chew and swallow your food, etc.

Highly recommend for each person in the pro category to have a PT on crew for any ultra when you’re not injured.

Running without all taped joints is a rookie mistake. It takes a youtube video to figure out how to tape a joint. Taped scapulas, ankles, shoulder, men’s nipples, knees, shins, calves and elbow. Taped every joint that was going get to hammered today, weak, unstable, surgical, history or injured. Taped ankles as preventative at the college level or this race. At the HS level, do not tape ankles as preventative. Tape if you had shin splints before. Taping puts athletes in the mindset of their prepared, taping is a ritual allows to you get in that mind set of its fucking go time. Tape provides you with the mental part, a safety net if you’re vulnerable at the joint to lean on to have that little of extra confidence to execute.

Be super smart about the pace until the Canyons section, Dusty Corners to Michigan Bluff. You have to use tactics in the canyons, it’s the hottest section. 

A 1/4 mile before the checkpoint, start going through your questions, needs, what needs to be refilled in your head and take your trash out from vest at checkpoints. If an escort meets you, tell them what you want/need. Escort ask questions while running to the crew. Drop bag only, take out bottles and volunteers will refill them. If you want a new vest, take it off, have it on your arm before you get to crew. Handed it off to crew, somebody else will be holding your new vest.

If you take a mini coke can, crewed, hand off, start walking with it until you get to end of the checkpoint, drink it and crew will collect the empty can.

Your body still sweats when it’s cold. You don’t know your sweating or thirsty because it’s not hot, you loose your thirst ques and don’t notice when your sweating because it’s cold at Duncan Canyon. Preload with a sodium drink before the race.

Get wet, stay wet at this race. Ice cubes, ice bandana, frozen shirt, evaporative cooling is key at Duncan Canyon.

The first 30 miles is a warmup jog, complete BS. Force yourself to run 15-20 seconds slower than normal per KM, it will save you.

Start cooling your runner at Robinson Flats, even if your runner did not feel like they need it yet.

Run zone 2 from Robinson Flats-Dusty Corners.

Take every ice cube that a volunteer hands you put cubes in your shirt. Take the hose, drench your hat until it drips. Through the canyons, you will be on exposed fire road and single track at 100°, go into zone 2 if needed. 

Sponge down legs first then biofreeze.

Duncan Canyon timing split is important, it will tell you how the rest of the day will go.

Michigan Bluff lemonade stand until cutoff: cash only, tips welcome. We bought lemonade from the kids, handed them a $20 bill, kept the change, made their day.

Ice: You will need a max of 200 lbs of ice for race day, depending on heat. Do not go to the gas station, have it delivered from the ice supplier the day before. Share your leftover ice with other crews.

When you cross Rucky Chucky, wear a lift jacket, it will give you an advantage of floatation which is helpful when going hand over hand by rope at chest deep water.

Wear a GPS tracker for S&R purposes easier to locate, if you DNF in the middle of nowhere. Rule: DNF at an aid station. 

Please clip your toenails 3 days before.

If your runner does not arrive within 10 minutes to the checkpoint, there is an issue somewhere.
Michigan Bluff crew will arrive an 1.5 hour before your runner does.

Everybody comes in at same fitness level. It’s in the details like executing at aid stations, how to approach a climb, how to decide to take a decent, how much water you take with you to between aid stations. Details matter. How you execute the small things gets the big stuff done. A marginal gain is the difference between first and second place is the aid stations, cleaning up aid stations because the running skills are there. Are you going to let someone beat you at Western States because you didn’t take it seriously like your cleaning up aid stations?

If you’re going to make a move, do it at the top at the climb, moved into 3rd but you can loose it at aid stations by someone passing you. Where you loose the race is the canyons mile 30-60. Michigan Bluffs to Foresthill mile 55-62 separate those holding onto a Top 10 position. 

We had a do nothing strategy and let the crew work on the runner. We did it Nascar Style with 3-4 people working on the runner while standing up. The only place runner sat down was Foresthill for 2 minutes stoppage.

Aid stations are busy when you are not meeting someone at the intersection, they would hold up a big cardboard cut out with runners face on it. Each crew with in our group had a cardboard cutout.

Park downhill from the mile 62 checkpoint (Foresthill). Uphill parking at mile 62 with 8 person crew total is a shitshow, learned the hard way one year.

Go out faster, harder than normal but not too hard. Show up to the race at your fittest and have confidence to push the pace that was sustainable to win. Training: Running uphill, beating your quads up on the downhill and a little bit of speed work. Focusing on all day endurance on back to back long runs. Keeping up that muscular endurance. The pro men have a Vo2 max of 85-92.

Have you sweat tested.

If you vomit inbetween Robinson Flats-Dusty Corners, drop back on sodium is correct. Just oversalted. Do not dial back gels is correct.

Set timers on your watch, every 20 minutes and 10 minutes. After 8 hours, it switches to caffeine gels. At the top of the hour, eat a half of gel to not vomit.

If you have blurry vision at any point of the race, fix it with eye drops, does not matter if you wear contacts or not. It’s normal at mile 55 (Michigan Bluff).

If you’re sleepy, eat real food.

Each crewed aid station, please drink a 16 oz of plain water.

Robinson Flat advice: It’s still very early in the race, hold your horses. Big downhill is coming next, we need to save it for Foresthill, slow it down a little bit.

Running with 2 handhelds is brutal, inefficient and awkward. Do not do it.

Beyond the Hoka Arch at Foresthill, there is no crowd control, people with cowbells lining both sides of street, you have pacers infront and that’s it. Do you get crewed before or after the timing split mat? We did it after. 

Foresthill is a 1.25 mile long checkpoint with 300 people in it. The goal is to have a 5 minute stoppage max, winners do it 2 minutes stoppage.

At drop bag only check points, runner only recommendations is 1 5L dry bag for each checkpoint. Runner/pacers is 1 10L dry bag.

At Foresthill, do full reset on your runner, make sure they feel like a completely new person.

Have your pacer crewed before runner shows up at Foresthill.

One of the pro men had to DNF at mile 62 because he didn’t have night gear, stupid mistake, thought he was going to be fast enough to run in daylight.

Idea: One of the women was eating a bowl of ramen at mile 62, it’s sodium replacement, fast carbs, broth can settle an upset stomach and the savory flavor breaks up sweet flavor from gels. By eating the same flavor of gel on repeat during a race will give you flavor fatigue.

The Western States checkpoints are campgrounds, trailheads and dirt roads intersections without cell service in the middle of nowhere. Know how to drive a gravel road please. The actual trail can be marked with Western States Trail, Tevis trail sign, exposed single track, fire road, street signs, hiking trail, etc. Some of the checkpoints are on google maps and google maps are not available for the race. Please print off driving directions because a checkpoint could be intersection of two dirt roads or they may give a shuttle pick up parking lot. Please know the next aid station name, it maybe on a Forest Service sign with arrows. Someone took a wrong turn out of the Devils Thumb. 

Treat mile 70 warning signs with a whole peeled orange, sour patch kids, drink plain water and a cold towel.

One year, we were at Green Gate, someone had a medical emergency at Cal 2, crews were standing around stuck at Green Gate/Rucky Chucky, waiting for race radio confirmation before they would let us go. During that, they were holding crews going into Rucky Chucky by shuttle at Driver Flats.

Details matter at this level. Get your shit together. If your a first time person crewing, go with veteran crew, help out in any capacity, this may be include staying out of the way and holding the crew trash bag for first timers.

At the drop bag only checkpoints, it was impossible to DNF there unless medical emergency because they were horse transport, etc because you cannot drive in or shuttle. If you DNF there, you’re waiting until cutoff to get out. The runners who wanted to DNF especially Cal street would get 2 tylenol, bottles refilled and plate of food. After mile 62, checkpoints had hot food. Start walking to Rucky Chucky with your pacer and DNF there. You could drive into mile 15 drop bag and there was a horse trailer at Dusty Corners.

People who were not pro who wanted a PT asked or advertised back in December. Someone who is familiar with your body, knows how to road PT and what expected as job (post travel, night before activation, prep, post race PT), all expenses paid work trip, reimbursed expenses and per diem. A crew PT for a week is $6,000 will cover runner and pacers. If at the pro level, it’s covered by sponsors. A PT could have save you from DNF.

We were there on a business trip with all our ducks in a row, took it seriously because you get one shot to make first impressions if you want to get scouted, no fun extracurriculars. 

I hated watching the return pro men (winners/podium people) with INJ DNF because they were making rookie mistakes. Looked sloppy, lazy, didn’t care and clowns.

Feel free to add more tips for runners, pacers and crew.

We were there this year with 5x vet crew and 1st time runner who had paced 3x with INJ 11 days before and actually finished (silver belt buckle). Former College D1 soccer player.

To crew or help out the Missoula runners of Jeff Mogavero, Adam Peterman and Jennifer Lichter during the race, all in the pro category. Happy for Lichter on the women’s course record debut win. I was there crewing someone else.
We loved watching the Missoula crew.
Did a clinic send 1 or 2 PT’s or did the runners invite PT’s?

He was wearing it at Western States 2026 Rucky Chucky (mile 78) where he was a pacer for the women’s race. That was cool.

A full time PT Clinic Director is leaving on July 24th to one full season full time of pro sports on a national team August 15th-April 30th. Usually he work 2 weeks in November and January for national team. After that he will return to his previous position.

What is that called? Sabbatical?

Read my last post.

From my pro sports job (AT/PT) under CBA is 150K in 6 months.

My seasonal orthopedic clinic/surgery AT job is salary + surgery RVU. Elective surgery is private practice and trauma surgery is hospital. You punch in differently for elective and trauma surgery, two different RVU reimbursements.

Acute, inpatient, outpatient peds PT job is hospital punch in.

Money is not an issue.

I am 27F, AT/PT. Degrees are paid off. Husband is orthopedic/trauma PA-C.

Dream Job is pro sports AT/PT, I still love it.

Things I like about AT: OR 2nd assist, follow up/post op care, patient history, initial eval, presenting patients to MD, notes, imaging/MRI review, radiographs, pulling stitches, DME, ordering injections, phone calls, admin, PT communication. I like the OR for the pressure, can handle the direct personality not the blood. (Part Time/Seasonal/Fill In)

Things I don’t like about AT: HS, 2 a days, late nights. I am not going back.

Things I like about PT: acute (surgery center discharge), inpatient (hospital), peds, pro sports (group of 4 athletes, 2x day for 6 months on the road in practice/game day), day 1 post op round. You will not find me in outpatient clinic, tried it and hated it.

Another thought, I should stay put.

Still figuring it out what I don’t like.

I know there is certified First Assist, but there are surgical only PA’s.

Depending on the state, PA handles DME.

I would go back to Orthopedics. I do know some PA’s are AT’s

I like the idea of 3 x 12 work schedule, first assist, etc

I already have anatomy class, etc

I need help.

2 Double Doubles, grilled whole onions, pickles, lettuce, tomato, extra spread. Chili Peppers on the side. Fries, 7Up. Sometimes I go without pickles.

then get exact same order to go for the road except a shake. (DEN airport pickup only from Lakewood location because it is 2 hours home)

Sometimes I have fries with spread.

Lara Colturi’s little brother, born November 2011, really great skier.

Fire David Roche, it’s not working. Other people have comment in r/ultrarunning after he DNF. As many said before Hans only had one 5 hour runs before this.

Reference: What happened to Hans? post in r/ultrarunning

Hans and Hayden Youtube winning post in r/ultramarathon

We saw men’s winner and course record holder, Vincent and his crew with burgers. It’s open until 1AM.

If we’re town that has a location, we’re eating In N Out.

I have eaten in: DEN, SLC, AZ, Reno, San Francisco, LA, DFW, Austin

For Here: 2 Double Doubles with spread, grilled whole onion, pickles, lettuce, tomato, ketchup on top bun. Chili Peppers on the side. Fries, medium 7 up.

then get exact same order to go for the road except a shake.

Sometimes I have fries with spread.