By: Carly Behm

6 hours ago

Shifts in the pace of sports medicine injuries, including in pediatric patients, is ushering in new approaches to care, Brian Cole, MD, said.

Dr. Cole, managing partner at Chicago-based Midwest Orthopaedics at Rush, discussed these changes and the role AI will play in smarter decisionmaking.

Note: This conversation was lightly edited for clarity.

Question: What is the most important evolution to sports medicine in 2025?

Dr. Brian Cole: There’s been an increased focus on the cause of injuries. With some of the things that we’ve seen in baseball as it relates to Tommy John surgery or the NBA in terms of tendon and muscle injuries is looking at what the underlying independent variables are for risk of developing these conditions. There’s been a definite acknowledgement that sports injury is not just a health impact on an individual, but it’s also an enormous economic impact to the sporting industry in general. While we’ve often focused on ways to optimize treatment for these problems, there’s now an inexorable focus on how to prevent these injuries from happening. That’s happening by looking at a number of variables that may predispose an individual to sustain such an injury. I’d say the ones that we’re seeing the most of are that had been really troublesome, is an epidemic type rise and Tommy John problem in the elbow and a rise in tendon and muscle injuries in both the NBA and the NFL, and then this continued surge of ACL injuries that we see in virtually every sport, especially in our younger athletes.

Q: Increases with Tommy John surgeries have been attributed to increased demand on baseball players. Are you seeing similar kinds of demands and other sports?

**BC: **It probably warrants discussion in terms of how athletes have changed over time. There’s no question that they’re bigger, stronger and in some ways more athletic. This is really almost where AI will come in at some point where you can plug all these variables in from the database and start to look at some of the underlying things that have changed over time and see how they correlate with injury incidents. But certainly that’s a valid point. We’re seeing increased demand in every sport, and we’re seeing it younger as kids just seem to develop enormous strength, conditioning, power at an earlier age. They’re not only predisposed based upon those physical metrics, they have access to sports at a younger age and an increased frequency. Combined with risk exposure there’s all these other ongoing principles putting more stress on tissues that may not be suitable to handle it.

Q: How should other sports medicine surgeons approach conversations with patients and families about kids’ sports medicine and injury prevention?

BC: There’s some basic principles. For example in pitchers, throwing patterns or curveballs are discouraged before growth plates are closed. That coupled with elevated velocity, can increase the chance of injury. The issue of the absence of rest has been a topic, and what rest really means. At minimum, two months away from their sport per year has been recommended for our youth. Multisport athletes have statistically been shown to have lower injury rates, and that may be because they’re just not doing a single sport all the time, but rather, they’re mixing it up between different sports, which have different skills and risk exposures. By mixing it up and being a multisport athlete, there is this potential risk suppression that comes about as an added benefit.

But these are hard things given the fact that in some places based on where people live and opportunities to play different club sports, it’s aspirational sometimes from a rest perspective. I’m seeing more and more kids who are being represented at the high school level by agents and the prospects of NIL [name, image, likeness] money coming at a very young age has added complexity.

**Q: What are some other interesting ways you’ve been leveraging AI in your work? **

BC: We’ve spent a lot of time collecting data over the years for procedures that are not frequently performed to better understand how we get success and how we prevent failure and to outline better decision making to indicate someone for a surgical procedure. We have all this data, and then what AI can do and what we’ve done is plug in various outputs.

We used to do it statistically. It was almost manual in terms of doing a multivariate analysis, where you take a lot of variables and then you combine them together, and you get a sense of which one has a relative contribution to the condition or to an outcome. Now with AI, the speed and efficiency and the ability to model it, we can take real life and real world data that we have collected and have control over. We can predict outcomes such as the right procedure to do, the statistical likelihood of success or failure of a procedure based upon all its independent variables.

The challenge is making sure AI comes out with a clean output that’s not clouded by data points that aren’t truly relevant to the condition, or miss data points altogether. That being said, there’s tangible pieces of information that we collect that might actually help us predict when it’s time to operate, what might lead to an injury and then how to solve the problem with a greater degree of predictability.

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