Olympic athletes overcome health challenges to reach the pinnacle of their sport

The athletes have done the training and achieved their dreams, a trip to the Paris Olympics set to begin Friday, July 26th. Over the next two weeks, athletes from around the world will go for gold pushing their bodies as far as they can on the track, the pitch, the court, the pool, or the gymnastics mat. 

Making the Olympics, let alone winning a medal is the ultimate show of physical health and mental strength. Many Olympic athletes have trained to overcome significant health challenges to reach the pinnacle of their sport this Summer. 

Hackensack Meridian Health physicians are available to comment on a variety of Olympic-related health stories including:

• Celine Dion's Expected Come Back From Stiff Person Syndrome

She's not a competing athlete but one of the biggest stories of strength likely to come out of the Paris Olympics, is Celine Dion's expected performance at the 2024 games Opening Ceremony. Dion has not performed since a stiff person syndrome diagnosis forced her to cancel live shows several years ago.

The syndrome is a neurological condition that causes muscles to spasm. It primarily affects the brain and spinal cord and causes muscle stiffness, posture problems and sensory issues. Recently Dion has been outspoken about her battle to come back to the stage, saying in an interview she refuses to let her disease "control my life." "I'm going to come onstage because I'm ready. And my vocal cords will not scare me because I'm going to be ready, and I'm going to hit those notes.

Kiandokht Keyhanian M.D., neurologist at Hackensack University Medical Center can explain the symptoms of stiff person syndrome and why this comeback is so unique.

• Fighting Mental Health Issues at the Olympics and battling back from setbacks

One of the biggest headlines of the 2020 Tokyo Olympics, was American gymnast Simone Biles pulling out of the competition to "protect her mental wellbeing." Biles was suffering from the "twisties" as gymnasts call it, a mental block that caused her to lose herself in the air whenever she attempted to twist. In such a dangerous sport, Biles risked seriously injuring herself if she tried to push through. 

This year Biles returns to the Olympics once again at the top of her game after a two-year hiatus. She fought her way back despite fear of taking on dangerous and difficult gymnastics moves, but her mental toughness pushed Biles to get back on the horse with some of the most complicated gymnastic routines in the sport. 

"I worked on myself a lot, I still do therapy weekly, and it's just been so exciting to come out here and have the confidence I had before," Biles recounted.

As a result, Biles became an unexpected advocate for mental health, and taking a step back when you need to. 

It's Simone's mental toughness that makes her an elite athlete. "As a sports psychiatrist, I always say the key difference between a baseball player stuck in the minor leagues and a major league baseball player was how they prepared mentally," Urlick Vieux, D.O. said. "Many of our most admired athletes have remarkable mental strength and an ability to overcome obstacles. This is at the core of the brilliance of Michael Jordan, Lebron James, Tom Brady and many other icons. They may throw an interception or miss a free throw, but they have the ability to come back with a standout athletic feat."

• Athletes sidelined or coming back from ACL injuries / Why ACL injuries are more common in female athletes 

ACL tears are one of the most common injuries for athletes. In fact several Olympians will miss this years games due to an ACL injury, including Los Angeles Sparks forward Cameron Brink who tore the anterior cruciate ligament (ACL) in her left knee on June 18, 2024, just a little over a month before she was set to compete in Paris on Team USA's 3x3 basketball squad.

Brink's story is not unique. ACL tears are common in sports, but they seem to be particularly common in women's sports. The American Medical Society for Sports Medicine says "ACL tears occur in both genders, but female athletes are at higher risk with college basketball and soccer female athletes having a threefold higher risk than their male counterparts."

The reasons for the discrepancy in ACL injuries varies, including hormones. "There is evidence that high levels of estrogen can increase ligament laxity, and that increased laxity is associated with ACL tears," said Stephen Silver, M.D., orthopedic surgeon at Hackensack University Medical Center, who has done research on the subject. " Another theory, after puberty women's quadricep muscles continue to strengthen, while their hamstrings typically stay the same. This creates a muscle imbalance that leads to ACL tear." Both theories are bolstered by the numbers that before puberty ACL tears are rare, but after puberty a women's risk of an ACL tear increases significantly. 

Stephen Silver, M.D., chief of the Department of Sports Medicine at Hackensack Meridian Hackensack University Medical Center, has observed in his own practice, and these patients are more likely to suffer a repeat injury as well. 

ACL is the most common ruptured ligament in sports, but the surgical reconstruction, which has been performed routinely for four decades, offers a 95 percent success rate. While this represents an overall positive outcome, a growing body of evidence now supports making a shift to include the Lateral Extra-articular Tenodesis (LET) procedure with ACL reconstruction for a small patient subgroup, including young female athletes, with the potential to cut their ACL graft failure rates by two thirds.

When a patient suffers an ACL tear, Hackensack Meridian Health is now also offering a new and innovative treatment. In May, orthopedic surgeons at Hackensack University Medical Center performed the Bridge Enhanced ACL Restoration (BEAR) Implant operation to reconstruct the injured knee ligament of a 15-year-old soccer player. The BEAR Implant is an innovative treatment that promotes the body's own healing processes to join the ends of a torn anterior cruciate ligament (ACL), one of the most common sports injuries.

"The BEAR Implant is the first device developed to help a person's ACL to heal on its own," explained Hackensack University Medical Center orthopedic surgeon Amit Merchant, MD, who performed this procedure as well as a second BEAR operation with orthopedic surgeon Yair David Kissin, MD. "This approach offers an alternative to conventional ACL reconstruction which uses a tendon from another part of the patient's body. That can leave a patient with pain where the tendon was retrieved." Such "autografts" are usually tissue taken from the patellar tendon, quadriceps tendon, or hamstring. 

• Sports Medicine approach to training and injuries for both Olympic athletes and weekend warriors 

Orthopedic surgeon Dr. Jason Wong, fellowship trained in sports medicine, specializes in the treatment of sports related injuries involving the hip, knee, shoulder and elbow. He served as team physician for multiple local high schools and participated in the care of professional and collegiate athletes during his training. Wong can discuss common musculoskeletal injuries athletes face that impact muscles, nerves, tendons, joints, cartilage and spinal discs, as well as the latest technologies available to treat such injuries. He can also discuss what is involved in short-term recovery for athletes looking to immediately return to competition as well as long-term recovery for injuries that could be career ending for a professional athlete. 

"Whether an Olympic athlete or 'weekend warrior,' those with or prone to a musculoskeletal injury can benefit from a personalized care plan that will immediately address the issue and provide a rehabilitation recovery map that not only will help the patient achieve an optimal quality of life, but also will focus on how to maintain a pain-free lifestyle and prevent the injury from happening again," notes Wong, of Hackensack Meridian Southern Ocean Medical Center. 

• Athletes revisiting their sleep habits to optimize performance 

Studies show sleep plays a significant impact on an athlete's performance. Among the areas most impacted by sleep deprivation are things like decision-making and critical thinking, according to a 2023 study by researchers at the University of Pennsylvania. One Stanford University study documented a 9% increase in shooting percentages among basketball players who increased their amount of sleep over a five-to-seven-week stretch. Studies have shown the negative impact insufficient sleep can have on cognitive function, muscle growth, metabolism, and hormonal secretion, to name a few.

But athletes at this year's Olympics will once again need to get a good night's rest on a cardboard bed. The environmentally friendly recycled cardboard beds first seen in Tokyo are making a comeback in Paris this year to mixed reviews from athletes.

Sleep Medicine physician, Peter Polos, M.D. advises NFL teams on how players and coaches can optimize their sleep, and establish sleep routines to improve performance. Dr. Polos recommends athletes find a way to get 7 to 9 hours of quality sleep. Athletes who traveled to Paris will also need to adjust to the time change, keep regular sleep habits of going to sleep and waking up at the same time every day.

• Heart Rate Monitors on Olympians' Parents to 'Jazz' Up Event Broadcasts

In an effort to jazz up its broadcast, NBC is planning to use five heart rate monitors to show the reactions of parents of certain Olympians during events. For example, viewers would see the heart rate of the parent of a swimmer or runner as they watched their child compete on screen along with the actual event. HMH cardiologists can discuss how heart rate monitors play an important part in diagnosing certain types of heart disease, how emotions and other factors impact heart rate, risks of abnormal rates and treatments to improve heart health. 

• Excessive Heat Concerns for High-Level Athletics

While temperatures are not expected to reach last summer's heat wave in Paris, when 5,000 people died of heat-related complications, a few days during the Olympics may reach excessive heat levels. HMH cardiologists can explain how excessive heat impacts the body, especially in high-level athletes, heat's impacts on the competitions, and sports cardiology tenets of race/exercise nutrition and hydration and the differences in electrolyte and nutritional supplements.

• How are Olympians' hearts different from non-athletes?

HMH cardiologists can discuss heart remodeling and the benefits and risks of an exercise 'remodeled' heart, common in high-level athletes.

• Rehabilitation is the key to athletic success

Whether it's coming back from an injury or preventing an injury sports medicine, rehabilitation, and training are the keys to long term success for any athlete. Dr. Craig Van Dien, of JFK Johnson Rehabilitation Institute, Sports Medicine Rehabilitation Program can address training and overcoming injuries.