There's no room for wimps in the Rockies. But just how much pain can Coloradans take—and what are the best ways to deal with it?
—Photograph by Dan Saelinger
Why trading out knees, hips, and shoulders doesn’t always mean trading up.
Here in the land of mountains and rivers and big skies, it’s tough to say no to skiing, cycling, kayaking, and everything else. So what if our love of an active lifestyle is slowly breaking down our body parts? With improvements in replacement knees, shoulders, and hips, we can just get new ones. Right? “Well, that’s kind of terrifying from a surgeon’s perspective,” says Dr. Jarrod King, a Denver Health arthroscopic surgeon and director of the sports medicine team. “What you have in your body is a living biological system that was designed to last your whole life. Even with improvements, none of these replacements are going to be as good as the parts they’re replacing.”
OK. So there’s that.
The reality is, though, that docs are replacing hips, knees, and shoulders in younger patients than they were 20 years ago—patients are often in their 50s and, in some cases, their 40s. While upgrades in materials have improved the durability and functionality of replacements, they’re still not designed to last more than 12 to 20 years (eight to 10 for shoulders). Which means going under the knife a second time remains a likely possibility, especially if you drive your new part the same way you did the original.
A second surgery can be more daunting than the first for reasons beyond the standard risks of infection, particularly when we’re talking about shoulders. “Anytime you have to take the metal component out, you have to take out additional bone,” King explains. “The shoulder has very little bone to work with. So you’re at a very high risk of running out of wall to hang your picture on.”
Forty-four himself and an ardent mountain biker and skier, King understands the desire to savor Colorado’s outdoor playground. He doesn’t suggest giving any of that up. Just maybe consider shelving those 20-foot drops. “I love to do all the stuff that makes Colorado tick, too,” he says. “I’ve just backed off a little, so I can do it longer.” —KC
Meet Greg Roskopf, the Englewood man behind #18’s extended career.
Broncos fans can thank a rock quarry in Iowa for extending Peyton Manning’s career. That quarry is where, in 1982, William Penn University linebacker Greg Roskopf fell 20 feet, suffering a lower lumber compression fracture. Eighteen years later, the injury would lead Roskopf, now a sports medicine specialist, to develop Muscle Activation Technique (MAT), a treatment for musculoskeletal imbalance that Manning has been receiving once a week for the past six years. (He flew Englewood-based Roskopf to Indianapolis every two weeks before Denver snagged the QB in 2012.) In a 2012 Sports Illustrated piece, Manning credited MAT for helping prolong his career. Fortunately for you and me, the treatment is not just for the pros.
Muscle Activation Technique is essentially a highly personalized assessment and treatment of imbalances in body mechanics that Roskopf developed over the course of about 10 years, largely in search of his own relief. Despite taking a year off from football in college, Roskopf’s back continued to plague him into his 20s. While completing his master’s in physical education, he also started experiencing knee and foot problems. “I thought, If I’m this bad at 25, what am I going to be like at 50?” So between his jobs as a strength and conditioning coach for California State University Fresno and later the Utah Jazz, he studied the interconnection of the musculoskeletal system, attending seminars with the foremost specialists in everything from sports medicine to podiatry. In 2000, he put it all together in MAT.
Here’s how it works: When the body senses instability, as with an imbalance or injury, Roskopf says, the brain sends a message to tighten the muscles in that area. Over time, this constant contracting can lead to inflammation and biochemical changes that can alter communication between the brain and muscles. Roskopf likens it to a loose car-battery cable. Your brain sends a message to the muscles to contract, but they don’t always receive it. So other parts of your body compensate, and the cycle of imbalance continues. MAT seeks to end the cycle by stimulating those nonfiring muscle fibers.
“Hop up here,” Roskopf says, patting an examination table inside his Englewood office. “I’ll show you.” I crawl up on the table and lie on my back. Roskopf takes me through the same series of foot and leg positions he would any new patient. Within no time, he’s discovered a hip imbalance on my right side: When he holds my leg at about two o’clock and asks me to push up against his hand, I can’t. Try as I might, my leg won’t resist the pressure—Roskopf easily presses it down with his index finger. It’s maddening—and surprising. Like many Coloradans, I’m a fairly active and fit person, and one of the lucky ones without severe chronic pain. That I can’t make my leg perform a simple movement comes as a (frustrating) shock.
Roskopf isn’t surprised. “Most people have some kind of imbalance,” he says. “You might not feel it now, but if you’re not getting proper alignment, you’re an injury waiting to happen.” Correcting the imbalance requires stimulating my nonresponsive muscles— something Roskopf does by gently palpating the length of each of the involved muscles, including where they connect to joints. We go through the series of tests again, and I pass. I can resist his hand, no problem.
Manning’s treatment is a little more involved; it also includes specific exercises that test imbalances under stress and work to strengthen them. MAT has proved effective enough that Roskopf has been contracted to treat the whole Broncos team. And the Nuggets. And Carson Palmer, Terrell Davis, and injured swimmer Amy Van Dyken. Oh yeah, and the athletes at the NFL combine. It’s also why Roskopf has a six-month-long waiting list for new patients. Fortunately, there are about 100 other practitioners in Colorado, including several at the MAT corporate headquarters in Englewood—that’s who Roskopf sees twice a week. Now 51, Roskopf has a very different response to that question he asked himself all those years ago—What am I going to be like at 50? The answer: pain-free and functional. And in the case of (younger) athletes like number 18, that also means being able to perform at a high level for longer. Hopefully long enough to bring home the Lombardi trophy. —KC
—Images courtesy of Sean Parsons; Matt Nager