The Department of Orthopaedic Surgery at Kobe University Hospital is nationally known for its sports medicine. They support professional baseball, football, rugby, and other sports teams, accompanying them to games and camps. They are athletes’ last resort for recovering from injuries and also provide a variety of support services, such as health screenings, to junior high, high school, and university students. What is their role as a group of medical specialists and how do they contribute to the community? We asked KURODA Ryosuke, professor at and the chairman of the Department of Orthopaedic Surgery at the Graduate School of Medicine.

Which sports teams do you support?

Kuroda:

In professional baseball the Orix Buffaloes, in association football Vissel Kobe and INAC Kobe Leonessa, and in rugby the Kobelco Kobe Steelers. We also support individual athletes in volleyball, tennis, karate, and other sports.

In the case of the Buffaloes’ spring camp in Miyazaki, we arrive there on weekends when there are preseason games and other events. During official games, we always accompany the Buffaloes to their home games in Osaka and Kobe, where we take on the role of providing medical care for the entire stadium, including spectators.

In professional association football, the rule is to accompany the team to all games, not just home games. In rugby, too, we accompany the Kobelco Kobe Steelers to all their games. For each team, several doctors work together and take turns providing support.

As physicians, we treat injuries of course, but we also work with team trainers, nutritionists, and other professionals on a daily basis to provide advice on player conditioning and nutrition, as well as medical examinations for new players. In addition, we take part in educating athletes to prevent inadvertent doping with supplements and medications. 

You also serve as a member of the medical practice board of the Japan Tennis Association and the chairman of the medical council of the Hyogo Tennis Association. 

Kuroda:

I became involved in tennis competitions partly because I operated on the knee of former professional tennis player DATE Kimiko. Hyogo Prefecture is also home to the Bourbon Beans Dome (Miki City), the venue for international tournaments, and we support various tournaments held in Hyogo.

One issue that needs to be addressed urgently in sports medicine, including tennis, is the prevention of heat stroke. While some events have introduced measures such as allowing time for rehydration, it is difficult to set clear rules for each sport. For example, there are cases where tennis players don’t want to withdraw from a match even though doctors tell them not to play.

In all sports, there is a risk of heat stroke not only for the athletes but also for the referees and spectators. In the future, we must carefully consider the pros and cons of playing sports in the middle of summer from a medical point of view. 

I’m really happy when I see athletes recover and play again

How did the Kobe University’s Department of Orthopaedic Surgery get involved in sports medicine in the first place?

Kuroda:

Professor Emeritus KUROSAKA Masahiro, who retired in 2016, encountered the forefront of sports medicine in the United States in the 1980s and spread his experience at Kobe University. In addition, there are baseball and rugby teams based in Hyogo Prefecture and Kobe City, and Kobe University has long been involved in the treatment of athletes.

I became a doctor in 1990, but one of the things that made me want to get involved in sports medicine was the Great Hanshin-Awaji Earthquake of 1995. The world of sports in Kobe came to a temporary standstill because Vissel Kobe, which had started operations that year, was unable to practice at home. On the other hand, the Orix Blue Wave (now the Orix Buffaloes) won the league championship that season. Seeing the joy of the locals, I realized that “sports can make people so happy.”

There is also the connection that I was a member of the medical school rugby club when I was a student at Kobe University. Having experienced surgery and hospitalization due to a knee injury, I understand the pain of patients very well.

What do you keep in mind when treating and supporting athletes? 

Kuroda:

This applies to professional athletes as well as to other patients, but it is important to listen carefully to what they really want, that is, “in what condition they want to be and by when” and to be there for them. However, I don’t think that listening to whatever the patients want is “being there.” When necessary, I also give stern advice. I once told a professional association football player, “I suggest you retire.”

I have even been asked by athletes to perform surgery on them, even if it fails. Professionals spend their whole lives competing. When I hear such words, I feel that they trust me. I am very happy to see them play again after their recovery from surgery. I am also nervous that they might be injured again, though.

Whose treatment has been particularly memorable so far?

Kuroda:

OTOMO Ai, a member of the Japanese women’s volleyball team that won the bronze medal at the 2012 London Olympics, is one of the most memorable players. Ten months before the Olympics, she suffered a serious injury that tore ligaments in her knee, and she was in a situation where she would only be able to return to play if she had surgery. Otomo wanted to have the surgery, and Japan’s national team coach, MANABE Masayoshi, also said, “I want her to play the Olympics.”

In fact, after the first operation, the inflammation in the knee did not go away, so she had to have another operation. So, I was deeply moved when she came to the hospital after the Olympics and put the medal around my neck. I have kept and will always keep the commemorative Olympic plaque with her message, “To Dr. Kuroda, thank you.”

Balancing state-of-the-art treatment with a community-based role

What kind of support do you provide to student athletes and local residents?

Kuroda:

In Kobe, in cooperation with the city, we offer free shoulder and elbow checkups for junior high school students who play baseball. It is held once a year, and about 1,000 students participate. Players want to play in games, so they tend to hold back even if they have physical problems, but we tell them and their coaches to take time off to think about their future. Finding players who need treatment during the checkups is an important part of our role. In fact, most of the athletes we see in our outpatient clinic are not professional athletes, but rather middle and high school students, college students, and general sports enthusiasts.

In high school baseball, pitchers from schools representing the prefecture must have their shoulders and elbows examined at a local medical facility, and we are in charge of this every time. We also support local international competitions, such as the World Para Athletics Championships held in Kobe in May this year.

Outside of sports, we work with the local governments to provide medical checkups for local children with scoliosis (a condition in which the spine curves sideways), and we also visit facilities for the disabled.

University hospitals tend to be focused on cutting-edge treatments, but we believe it is also important to be close to the community and play a role as a central medical institution in the region. We are the last resort for the residents of Hyogo Prefecture.

As a professor at the Graduate School of Medicine, research and education are also roles important to you. What kind of research are you currently doing? 

Kuroda:

The Department of Orthopaedic Surgery at Kobe University is actively involved in regenerative medicine research. For example, we are investigating the use of a patient’s own cells to treat articular cartilage damage and refractory bone fractures, which have been considered difficult to heal. Developing such a treatment will take about 10 years and is a continuous process of trial and error, but we are getting closer to our goal. I think it is important to persevere until we can actually offer this treatment to patients.

Extending healthy life expectancy is an important issue in Japan’s super-aged society, and we are focusing on anti-aging research. Preventing the aging of not only the brain but also the musculoskeletal system (bones, muscles, joints, etc.) will become increasingly important in the future. Various longevity factors have been discovered in the body through domestic and international research, and we are conducting a series of experiments to determine how those factors can be used to prevent aging of the musculoskeletal system.

In terms of education, many young doctors from all over Japan are coming to Kobe University to pursue a career in sports medicine. I think this is partly due to the fact that Kobe University Hospital was certified by FIFA (the international federation of association football) as one of the FIFA Medical Centre of Excellence in 2015, which has raised our public profile.  Teaching students and young doctors is a job that I can only do because I am at the university, and it is difficult but very rewarding.

What is the most important motto in your work?

Kuroda:

“The god of victory resides in the details.” In medicine, I think it is better to call it the secret of success rather than victory. To provide personalized medical care to each patient, it is essential to understand every detail of their lifestyle and food preferences before providing treatment. Even in research, experiments will not succeed unless we are careful about every drop in the test tube.

I am also conscious of the fact that “maintaining the status quo is a step backwards.” If you are satisfied with the status quo, you will never make progress in anything. I keep telling that to myself.

Resume