Sports Medicine Q & A with Dr. Fine

How has the rise of preventative care transformed sports medicine?

Prevention is always better than treatment, but we still have a long way to go. One of the most dramatic examples of effective prevention came out of research in the 1970s by my mentor, Dr. Joseph Torg. He analyzed hundreds of football game films and discovered that most cases of paralysis from neck injuries occurred when a defensive back or linebacker struck someone with the top of his head — a technique called spearing. That finding led to spearing being banned in American football, and the annual incidence of paralysis dropped from the mid-30s per year to fewer than 10. That’s a case where rigorous research produced a very, very big change.

How do you see AI and advanced technology playing a role in athlete health?

Technology can be genuinely helpful, but my concern is that too many doctors are already relying on it as a substitute for actually talking to and examining their patients. The human element is irreplaceable.

That said, I find myself wondering what AI could have done with the kind of research my mentor performed. He spent countless hours personally reviewing hundreds of hours of football film to identify that pattern of neck injury. Could AI have recognized it faster? Probably. But the insight still required someone to ask the right question in the first place. I think AI will be a powerful tool in sports medicine — particularly for pattern recognition and preventative research — but it has to work alongside clinical judgment, not replace it.

What advice do you have for young athletes hoping to extend the longevity of their careers?

Two things: don’t specialize too early, and don’t overtrain. In the United States, we’ve embraced the idea that more is better — more hours, more repetitions, more specialization from a younger age. The evidence doesn’t support it. Kids who train excessively get more injuries, and I don’t believe that the volume of training is making them meaningfully better athletes.

The wonderful youth sports system in Norway was highlighted more recently during the winter Olympics. In Norway, kids have free access to any sport they want, including equipment, and the only rule is that it must be fun. There is no such thing as travel teams, and they are not allowed to keep score. The earliest they can specialize is age 13. And guess what, they have more medals than any other country, with only 5 million people in the whole country. We should consider this model when evaluating the aggressive youth sports system in the United States.

What can non-athletes learn from sports medicine to improve their mobility and physical health?

Our bodies are built to move. That’s not optional, even for the most committed bookworm. You don’t need to be on a competitive team or training for anything in particular — walking, swimming, cycling, dancing, whatever keeps you moving consistently. The form matters less than the habit.

I sometimes use space exploration as an analogy for how sports medicine benefits everyday people. The public might wonder why we spend billions developing better rockets, but that research has countless practical applications back on Earth. Sports medicine is similar: we push the limits trying to get elite athletes back on the field as fast as possible, and that urgency drives innovations in rehabilitation and injury prevention that eventually filter down to regular people too.

What’s your best advice for staying active and avoiding injury as we age?

Don’t stop. The worst thing you can do is let yourself fall into a period of inactivity. The ideal routine combines strength training with cardio, and I want to be specific: if there is limited time or an injury preventing certain exercise, cardio is more important than strength training.  But, if possible, also include strength training because it preserves muscle mass, supports joint stability, and has outsized benefits as we age.