Hitting the Ground Running
During her first week in New Orleans, you might think the new director of the Tulane Institute Sports Medicine women’s program would cruise the Quarter, sample some crawfish and beignets, and maybe even take her first carriage ride.
Instead, Dr. Mary Mulcahey hosted outreach visits at four of the all-girls’ high schools, attended a Sacred Heart Booster Club Meeting, gave two hands-on lectures during Sacred Heart anatomy classes, spoke to a group of dancers at Live Oak Dance Studio about injury prevention, and covered a rugby game for Brother Martin. She did try crawfish at least — at a school fundraiser where she mingled to meet parents, coaches and the principal.
Those busy first days were all part of her master plan to hit the ground running on an exciting new sports medicine program for active girls and women at the Tulane Institute of Sports Medicine.
“It’s the first of its kind in the city and there’s nothing else like it in the South,” Dr. Mulcahey says. “We’re developing a comprehensive program at Tulane, bringing together orthopedic sports medicine, nutrition, physical therapy and sports psychology. We’re also partnering with OB/GYN, gastroenterology and primary care, among others, to address related issues in active women.”
Beyond athletes, the program’s focus includes weekend warriors on the courts and course, gardeners, line dancers, joggers, and anyone energetic and interested in staying healthy.
The intentional female focus is timely as the medical community is recognizing that women are at higher risk for certain injuries and conditions than men, Dr. Mulcahey says. For example, women are two to eight times more likely to experience an ACL tear, she says, and are much more susceptible to anterior knee pain, ankle sprains and stress fractures. Certain hard-training female athletes experience “the female athlete triad”: eating disorders; menstrual dysfunction; and decreased bone density — a complicated syndrome requiring an interdisciplinary approach.
Women also heal differently than men, and may have different concerns when they’re injured. Dr. Mulcahey says this collaborative approach can hopefully improve outcomes and overall performance for the female athlete. That’s why her surgical expertise is coupled with physical therapists, athletic trainers, nutritionists, and sports psychologists to help a woman stay healthy and return to play.
“Surgery, if necessary, is only one piece of the puzzle,” she says. “We understand that addressing the athlete as a whole is critical to preventing injury and optimizing performance.”
The program offers: Beyond sports medicine, nutrition and sports psychology, the women’s program will take advantage of Tulane’s human performance lab for running evaluations, gait analysis and peak performance recommendations. The program also offers pre-season physicals, injury prevention training, osteoporosis scanning, a sports injury clinic and a concussion clinic with baseline testing and concussion diagnostics.
Why sports psychology? “Especially related to injury, but surrounding sports in general, it’s important to take into account the influence of psychological factors,” Dr. Mulcahey says. “Women tend to have identity issues … plus anxiety and stress related to athletics and performance. Everyone wants to perform well. And especially in a sport where a low body weight is valued or there are weight classes, it’s typical to find more body image issues.”
Which brings us to nutrition: So many sports medicine issues are interrelated, Dr. Mulcahey says. “When energy intake is not matching what an athlete is putting out, it can affect hormones, menstrual cycle, bone density and even overall health. How do they do all that [their sport requires] and still eat well? Female athletes across the board tend to have poor nutrition habits.”
Why are women more likely to get hurt? Dr. Mulcahey says there’s no one main culprit; it’s partly body structure, partly neuromuscular control. For example, on ACL tears, the dominance of a woman’s quadricep muscles pulls the shin forward during deceleration and stresses the ACL, while a man’s hamstring dominance is more protective. There is also a theory that the center of the knee (the notch) is narrower, causing impingement. “And, there is a huge focus on hormones and how we as women are at increased risk for ACL tears during certain times of the menstrual cycle,” she says.
An interest in sports brought her to sports medicine: Dr. Mulcahey wrote a paper on sports medicine during her freshman year in high school. As an undergrad at Dartmouth College, she ran track all four years — excelling as a short sprinter and long jumper despite being only 5-foot-2-inches. “Being a female athlete has definitely driven me throughout these years,” she says. “It was such an important part of my life and a huge contributing factor to my pursuing sports medicine.”
In the long run: Ultimately, Dr. Mulcahey sees her program having an even broader reach for women’s health to include rheumatology, neurology and all disciplines taking care of women’s issues. “We have such strong resources that are unique to Tulane,” she says. “It’s a huge team effort that I’m very proud to be part of.”
Medical School: University of Rochester School of Medicine and Dentistry
Residency: Brown University/Rhode Island Hospital, Orthopedic Surgery
Fellowship: Brown University, Orthopedic Trauma
Fellowship: San Diego Arthroscopy & Sports Medicine, Sports Medicine
Tulane Institute of Sports Medicine, Women’s Sports Medicine program
202 Janet Yulman Way
New Orleans, LA 70118