Orthopaedic surgeon Lawrence O’Malley educating providers, patients about sports medicine’s changing role

By MELANIE KILGORE-HILL

Orthopaedic surgeon Lawrence O’Malley, MD, is bringing sub-specialized care to Arkansans of all ages.

Starting Out

A sports medicine specialist at UAMS Baptist Health Orthopaedic Clinic-Conway, O’Malley is a Memphis native who developed an interest in medicine early on.

“My mother was a nurse and my dad had a lot of health problems, including two transplants, so I was always around medicine and thought I wanted to be a physician,” he said.

After graduating from Kentucky’s Murray State University, O’Malley earned his medical degree from the University of Tennessee and developed an interest in orthopaedics while working at a surgery center in college. He went on to provide care for Clemson University athletics from 2013-2015, and for Tulane University athletics from 2015-2016. He also served as the head team physician at the University of Tennessee-Martin and provided care for the Jackson Generals, the Double-A affiliate of the Arizona Diamondbacks.

Coming to Arkansas

O’Malley relocated to Arkansas in 2017, shortly after the University of Arkansas for Medical Sciences opened a Conway clinic in conjunction with Little Rock-based Baptist Health.

“The position opened at UAMS that was just sports medicine and what I love most is arthroscopy, so it was just the right fit,” he said. He now sees patients from Jonesboro to Fort Smith - often rural Arkansans grateful to receive subspecialty care without the drive to a big city.

“Patients are starting to understand the difference between a general orthopaedist, who does a little bit of everything, and a sports medicine practice like ours where we each do one thing all the time and utilize other subspecialty partners within the group,” he said.

O’Malley focuses much of his practice on shoulder, hip and knee arthroscopies performing 15 or more surgeries a week - typically a conglomerate of arthroscopic rotator cuff and shoulder labral repairs.

“What patients need is what I do,” he said, noting frequent surgeries of the knee, ACL, meniscus, multi-ligament knee injury and hip arthroscopy.

Advances in Arthroscopy

O’Malley said arthroscopy has been around for nearly a half century, while rotator cuffs and ACLs started in the late 90s. Hip arthroscopy has evolved greatly in the past decade and is becoming more refined, along with rotator cuff techniques, thanks primarily to improvements in stronger anchors.

“With arthroscopy the original problem was a lack of good anchors,” he said. “Today’s high strength suture helps the tendon to anchor in a knotless design so it’s not abrasive.”

Redefining Sports Medicine

Another welcome change is increased awareness of demographics in sports medicine. “Sports medicine isn’t just for high school and college athletes,” said O’Malley, whose practice includes patients aged 13 to 85.

“Anybody is a candidate for arthroscopy.”

While he treats the young and old alike, O’Malley said there’s been a definite uptick in adult patients sustaining injuries from popular fitness programs that contribute to overuse.

“When I was a resident, P90x was in style and we saw a lot of injuries from that,” he said. “Now it’s a variant of other high intensity strength and conditioning type workouts that are causing overuse injuries.”

He advises patients to be mindful of age and limitations rather than comparing themselves.

“People who are 20 and people who are 40 shouldn’t necessarily be lifting the same weight,” he said. “We get in trouble when we’re 50 and think we’re 20. We need a mindset that says, ‘I want to stay healthy and active and lift what I can, but I have limitations and don’t need to compete with the guy next to me.’ Our strength may be there, but it’s not all the same.”

Avoiding Overuse

Runners are especially prone to overuse injuries, along with baseball, softball and volleyball players. That’s because many of today’s athletes play year-round on travel, club and school teams, rarely taking time off or mixing up sports.

“The better athletes are multi-sport, because we weren’t created to repeat the same throwing motion year-round,” he said, noting the added mental health advantages of changing sports. “I see twelve and 13-year-old pitchers who’ve been the best on their team for four years but wore their shoulders out by high school, and they’re being replaced by kids who’ve matured properly. We have to stop overuse of young athletes and give them breaks to protect from overuse injuries.”

O’Malley, who enjoys running, weight lifting and intermittent HIIT workouts, said it’s crucial that athletes of all sports cross-train, whether it’s swimming, biking or Crossfit. “You need to work out the entire body to achieve maximum results, and weight training is a crucial part of that,” he said.

O’Malley especially promotes strength training in senior adults at increased risk for osteoporosis - a disease he considers “an epidemic in our older population.” “It doesn’t have to be heavy, but some resistance exercises are important because bones like being resistant,” he said, noting the importance of motion and tension in orthopaedic healing.

Primary Care and Orthopaedics

While he’s advocating for changes in the sports world, he’s also educating providers about their role in orthopaedic care. “I see plenty of patients who've come in with an MRI diagnosis that could’ve been made over X-ray,” he said. “I know it can be difficult for a PCP to order an X-ray before an MRI, but it’s so often unnecessary and adds to overall healthcare costs.”

In the absence of trauma, he encourages providers to prescribe anti-inflammatories and physical therapy rather than advanced imaging.

“Don’t rush MRIs, because often scans will show some sort of tearing in athletes, but that may not be the cause of their pain,” he said. “There are a lot of adaptive features that develop when someone’s constantly throwing a ball, so it’s usually (with throwing athletes) a therapy problem and not a surgical problem.”

He also encourages providers to reach out for a second opinion. “Don't’ be afraid to say, ‘I don’t understand this MRI,’” he said.

He also said it’s crucial for PCPs to provide patients with scan results prior to seeing a specialist. “So often patients are coming from another facility and we don’t have access to their imaging, since it can’t always be emailed,” he said. “As orthos we want to see the actual image to help make a quick diagnosis and minimize the number of office visits.”

As part of the largest orthopaedic group in Arkansas, O’Malley said patients at UAMS Baptist Health Orthopaedic Clinic-Conway receive the same level of care sub-specialists would provide for their own families. “There’s not a partner here I wouldn’t let operate on my family,” said O’Malley, a husband and father. “That’s just how we practice.”