Dear Doctor: Melissa Leber

Danielle Schostak
Hello, Dear - the Capsule Blog
7 min readJan 31, 2019

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Assistant Professor of Orthopedics and Emergency Medicine at the Icahn School of Medicine at Mount Sinai

As a former standout college athlete, Dr. Melissa Leber knows firsthand what it’s like to be fully invested in a sport. After starting her emergency medicine residency, she learned that she could do a fellowship in sports medicine, which would allow her to combine her passion for sports, orthopedics, and emergency medicine. Now, Dr. Leber spends her time split between the two specialties and gives lectures across the country about emergency medicine and sports medicine. Read on to learn about how teaching keeps her up-to-date, what it’s like working with athletes of all ages and abilities, and what tips she has for those looking to take their sport to the next level.

“I always knew I wanted to be a doctor for as long as I can remember. Both of my parents are physicians, so I had exposure through them. At age 15, I took an Emergency Medical Technician (EMT) course, and that solidified my love for medicine. In high school and throughout college, I did summer research at Weill Cornell and Rockefeller University, learning as much as I could.”

Getting into Sports Medicine

I was always an athlete. I played tennis, basketball, and softball at The Horace Mann School in New York, and then softball at Brandeis University. In medical school, I was interested in many different specialties because I had great mentors in a variety of fields. I especially liked in ENT, Emergency Medicine (EM), orthopedics, and burn surgery. It wasn’t until I was in my first year of residency that I discovered the sports medicine fellowship, something that paired two of my passions — emergency medicine and orthopedics — into one. There is a large overlap between the two fields and it is the best of both worlds.

My setup is unusual, because I am able to split my time equally between the two different departments. I don’t have many days off, since I work varying schedules and am often teaching medical students, residents, fellows, attending physicians and other healthcare providers, such as physical therapists. However, I continue to live an active and healthy lifestyle. Tennis, softball, running, and working out at the gym are among my favorites.

Academics

I do a lot of teaching in my daily practice within the Mount Sinai Health System. Teaching helps to keep me current on the latest evidence-based practices. It forces me to continually read the literature and stay apprised of new methods and techniques so I can pass that information along to my colleagues and students. Although there are things I may not be seeing routinely in practice, it’s because I’m teaching others that I must ensure I am up-to-date. I find students learn best when classes are active and engaging, and I try to teach in an active manner, using case studies or hands-on practice, either on simulators or live patients.

I give lectures locally, regionally, and nationally, including hospitals and national conferences. My content focuses on anything from general fractures and concussion management to specific injury management techniques, such as joint injuries. I not only educate healthcare providers, but I teach athletes, parents, and coaches as well. Although it can be challenging to lecture to different types of learners, I feel rewarded knowing that I can make a difference by educating both the public and healthcare providers about the prevention, diagnosis, and management of injuries. I have been honored to receive multiple teaching awards.

Working with Athletes

I cover many different levels of athletes, from seven-year-olds at sleepaway camp to high school and college athletes to the weekend warrior and the professional athlete. Every athlete wants to keep playing their sport, and it’s my job to help keep them in the game. Each athlete has a different level of skill and hopes to accomplish different goals, depending on where they are in their athletic careers. No matter what, they all take their sport very seriously.

I always want to make the right decision for the patient, but it’s sometimes challenging to sideline an athlete when they don’t want to be pulled. There’s also a sense of trepidation when making a decision to sideline a player, since my decision could alter the outcome of the game. Like referees, we are there to do a job, but don’t want to affect the outcome of the game unnecessarily. It can be a lot of pressure, but at the end of the day, I know I’m doing what’s best for the athlete in the long term. Disappointing an athlete is not fun, especially since I understand how it feels to be missing an important game.

Being an athlete myself helps me better understand the injuries that can happen, how players feel and react, and how to help them navigate the range of emotions that come along with being diagnosed with an injury.

It also helps me provide advice about conditioning, training, and injury prevention. As an athlete and a physician, I understand when it’s okay to play with pain and when it’s not.

Throughout the year I’m often on the sidelines of sporting events, serving in a medical capacity. During the fall, it is not uncommon for me to spend Saturday afternoon at a high school football game and then Sunday afternoon on the sidelines with the New York Jets. On Saturday, I may have pulled a student from the field because of a concussion and had to manage the child’s, parents’, and coaches’ reactions to my decision. However, I can tell them that I would make the same call the very next day at the Jets game should one of their players sustain a similar injury.

I treat the high school player no different than how I would treat a professional athlete and their long term health is the most important concern that I have.

For the past five years, I have covered the U.S. Open Tennis Championships. The heat wave in this last August and early September 2018 was extremely difficult for the athletes as well as the spectators. As a result, there was much media coverage on the topic and I was interviewed by the New York Times, ESPN, and a host of local TV stations about heat illness and what athletes should do to stay in the game and still keep their performance high. I love that I am able to respond to an athlete when they have an injury, but I also enjoy being able to proactively teach and advise them on how to prevent injury and illness. Being an emergency medicine physician, as well as having the orthopedics knowledge, really makes my role as a team physician unique. I can really manage just about anything that occurs.

Advice for Athletes

A superstar athlete is not created overnight. It is the hours and hours of preparation and practice that really make the difference. However, regardless of whether you are a professional athlete or weekend warrior, being active and playing a sport comes with an increased risk of overtraining and injury. There is now a big focus on trying to avoid overuse injury because no one wants a setback. If you progress your training load too quickly, your performance can actually drop, which is known as overtraining syndrome. If you do the same exact training regimen every day, then this can lead to overuse injuries. So, the key is to gradually progress your training load and to mix up your exercise routine every day. In order to make your conditioning more effective, always change the frequency, duration, and intensity of exercise so your body doesn’t get too accustomed to one method or one workout.

If you stop exercising because of an injury, you can quickly lose the cardiovascular ability and strength you once had. If you have been injured, make sure you change up your exercise and training routine to stay fit while allowing yourself to recover from the specific injury.

Most importantly, athletes should adopt certain habits to prevent injury. Most injuries are from overuse. But I also feel that many injuries are from relative muscle weakness. You cannot underestimate the importance of strength and resistance training. While running and doing the elliptical are great, they are really a focused cardiovascular exercise. Many injuries can be prevented by doing more resistance training and keeping your muscles strong, also helping to boost your endurance.

If you do sustain an injury, doing the correct rehabilitation can get you back in the game as soon as possible. There are the obvious ways like RICE (rest, ice, compression, and elevation) and anti-inflammatory medications that help. Also make sure to start your rehab with isometric strength training so that your muscles don’t atrophy. Examples include holding a weight in a fixed position or doing a plank. Don’t underestimate the importance of a physical therapist (PT) to help get you back on track. Ask your doctor for a prescription for PT and then continue to follow their recommendations for exercise and training while at home.

Lightning Round

I couldn’t live without…my family, especially my husband and daughter.

Ideal day off in NYC…going for a run in Central Park, treating myself to a manicure/pedicure, then going to a Yankees game.

Favorites

Way to relieve stress: Exercise.

Sport to play: Tennis and softball.

Sport to watch: Baseball.

Winter activity: Skiing.

NYC neighborhood: UWS-area, near Columbus Circle and Lincoln Center.

NYC sports team: Yankees.

You can learn more about Dr. Melissa Leber here.

Know a great female doctor in NYC? We’d love to meet her, introduce us here!

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