May 16, 2025 • 28 mins
Join Dr. Pete & Dr. Jason Krystofiak as they discuss collegiate athletes and the need for mental health services. Dr. Krystofiak serves as one of the team physicians for Rutgers Athletics, he is also the Chief of Sports Medicine for Cooperman Barnabas Medical Center and a Clinical Professor of Family Medicine & Community Health at Rutgers. Dr. Krystofiak is heavily involved in the education of medical students, residents, and fellows- he is a published author on NCAA research and is considered an expert in concussion management.
https://scarletknights.com/staff-directory/dr-jason-krystofiak/2659
https://www.rwjbh.org/doctors/jason-krystofiak-md/
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:17):
Hello and welcome back to On Air with Dr Pete.
I'm your host, Dr Pete Economo,and I hope you're all having a
great week.
I'm excited, for today's guestis a good friend.
As we go into May, MentalHealth Awareness Month, so we
are bringing you importanttopics related to mental health.
This is my friend and colleague, Dr Jason Kristofiak.
He serves as one of the teamphysicians for Rutgers Athletics
(00:37):
and he is the team physicianfor the football team there at
Rutgers University.
He's also the chief of sportsmedicine for Cooperman Barnabas
Medical Center and a clinicalprofessor of family medicine and
community health.
So we work together at Rutgersand he's heavily involved in the
education of medical students.
He's a published author on NCAresearch and is considered an
(00:59):
expert in concussion management.
Thank you for being here, DrKristofiak.
Speaker 2 (01:05):
Dr Pete, always a pleasure.
Speaker 1 (01:06):
Thanks for having me so this is going to be fun today
.
So I mean not that concussionand mental health is fun but
we're going to talk about youknow.
Speaker 2 (01:18):
So when did do you remember when we first met?
Yeah, 2018, I think 2018.
Speaker 1 (01:21):
Yeah, yeah, that's when I came to Rutgers, but you
had already been there, so tellabout your journey of work.
You're like a real Rutgersperson.
Speaker 2 (01:28):
Yeah, so I actually graduated undergraduate from
Rutgers.
Speaker 1 (01:31):
Yeah.
Speaker 2 (01:33):
So that was easy.
This is going back in the daywhen they had the grease trucks
and I could walk about the3,000-calorie sandwiches.
I would have late nightstudying for organic chemistry
and such.
Speaker 1 (01:43):
Did you know you wanted to be a doctor then?
Speaker 2 (01:53):
no, I, I didn't, um, I actually I uh changed my path
after my mom passed away fromnon-hospitalism phoma.
I wanted to be a race cardriver.
Oddly enough, clearly that wasnot going to happen.
Right, just, you have to berealistic with your goals.
That is so cool, though, yeah,but yeah.
So undergrad at ruckers, um, soI was only bleeding, you know
scarlet nights, and uh went tomedical school, was able to come
back, was able to go toresidency at rwjms at um new
(02:17):
brunswick, which was my dreamtop program and then I stayed on
for sports medicine fellowshipat the same institution, which
is great yeah, so 2018, becausethat's when I first got there,
so that makes it about right,but I only came to athletics in
2020.
Speaker 1 (02:31):
And I'll never forget that, because it was December
19 into January 2020.
Speaker 2 (02:36):
Oh, and now we're talking about COVID.
Speaker 1 (02:37):
Yes.
So, we were like on thesidelines of games and football,
and just us.
Yes, that first season you werereally instrumental.
The sidelines of games andfootball, and just us.
Yes, that first season you were.
You were really, you know,instrumental in that, of course,
with the chief medical officer,but making sure that the
athletes were safe and, you know, really ahead of the curve and
a lot of the science of, youknow, covid and the health of
our athletes.
Speaker 2 (02:57):
Yeah, it was a really trying time.
It's a great testament to theteamwork actually at Rutgers
University at all I mean veryspecifically the sports medicine
, but everyone really justworking together developing
protocols and new policies.
You know we were doing thingssomewhat different.
Speaker 1 (03:14):
Yeah.
Speaker 2 (03:15):
And it was to the benefit of the athletes and I
think everyone appreciated thatand we get feedback about that
still, which is great.
It's a tiring, very traumatictime totally but the bonds that
were created during that timeare special in life, last or
lifelong yeah, they'll staythere forever.
Speaker 1 (03:33):
Um I you know, one of the things I love about the
podcast jason is uh, like, Ihave some friends on like you
and you learn stuff like, so Ihave to go back to this race car
driver yeah, it's um, probablybecause I was a really big
danica patrick fan.
Ah, okay if you're watching, ifyou're watching on youtube,
(03:54):
you'll see the shame in his face.
Yeah, so that's where itstarted yeah, it just was.
Speaker 2 (04:02):
Uh, I was into indie cars and I, it was something
different.
It was something different, youknow, traveling to go to uh
races.
So you did, you go to watch, orwould you also race?
Uh, no, just go to watch justgo to watch.
Speaker 1 (04:13):
I had a client once who start like part of his
midlife crisis was racing cars.
They do have tracks where youcan get cars to like.
Race as a like, learn how to do.
Speaker 2 (04:23):
You know that yeah, I know I was um.
Speaker 1 (04:26):
I did a little bit of that okay, it's a lot harder uh
, than it looks yeah a lotharder than it looks, I put
yourself in one of those indiecars.
Speaker 2 (04:35):
The amount of g-forces around a turn like
there's been.
You know we're talking aboutathletes today, right?
Yeah it's so interesting.
So people would say, like youknow, I don't know if race car
drivers or athletes, they justsit there and kind of just go
around in circles.
I'm like whoa yeah those, those, those and those uh, men and
women are very, very fitathletes for what they have to
do in that car so like core andthings like that core, the,
(04:59):
their neck, yeah, the, the forthat, and just their upper,
their ability to just hold thewheel with all those G-forces.
Speaker 1 (05:06):
Good segue, neck.
How is the neck involvedBecause I'm also wondering with
race cars?
And then recently, as we'rerecording this, there was that
boat accident.
They were trying to beat theworld record for the fastest
boat on water.
Speaker 2 (05:18):
Did you see that?
Speaker 1 (05:20):
They were trying to go over 200 miles an hour, or
whatever the number is.
There must be concussions inthis too.
Speaker 2 (05:27):
I'm Absolutely Unfortunately there's
concussions everywhere, but inthe motor vehicle, the racing
scene, there's for sureconcussions and as a part of
their training they do full body.
But core, upper body and neckare really intrement.
Just because you have to havethe strength to be able to sit
(05:47):
there and be able to maintainthese forces, or you pass out.
Speaker 1 (05:50):
If you ever see people go up in the fighter jets
and they get those G-forces andthey just pass out.
Speaker 2 (05:54):
They're not trained for it.
See these guys train everysingle day.
Speaker 1 (05:57):
Yeah, they make movies on that too.
Where they have these I've seenit they're training them not to
pass out, but the mentalresilience and mental toughness
it takes to do those sports ispretty instrumental.
Yeah.
Speaker 2 (06:09):
Absolutely.
Speaker 1 (06:10):
Yeah, and so you know you've always been great to
work with and and what made youkind of uh think about like
mental health in the, in thetreatment of concussion or just
under?
Like did you see in theathletes you were treating that
there was like what did younotice that we were like, hey,
I'm glad we have like sportspsychology to help us with this
yeah, so you know, going back,and obviously we've worked
(06:30):
together so much, you know howtransparent I am probably
sometimes to a fault.
Yeah.
Speaker 2 (06:35):
I go going back years .
I caught myself not optimizingthe care because I was
overlooking the behavioralhealth aspect of it.
A lot of these individualseither had some form of baseline
depression, anxiety, sometimeseven bipolar.
Yeah, the other comorbidity islike ADHD yes and I just
(06:57):
initially wasn't factoring thatin to the best that I could into
their management plan and Ialways looked at concussion
management individually.
As pillars, okay, there's goingto be the cardiovascular aspect
, so I'm going to exert them ina safe manner without putting
them at risk for repeat injury.
And then or I'm saying, hey,there's a neck component, so
(07:18):
there's a cervicogenic component, or there is a nutritional
component with regards to how wewould maybe optimize their oral
intake of, you know, food andfluids after an event happened.
But then the behavioral healthaspect, you know, somebody will
say, oh, I feel really bad aboutmyself.
Oh, it's a part of theconcussion spectrum, you'll be
(07:38):
fine Once you're better.
You'll be fine Starting torealize that by tackling that
early on, these individuals arehaving acute stress reactions.
Speaker 1 (07:46):
Yeah.
Speaker 2 (07:47):
Acute reactions that may not be their baseline, or
could be their baseline, thatgot worse, or an unresolved
issue, or PTSD and that, hey,how am I going to get back to
sport at the same level if I'mafraid of getting my head hit
again?
Speaker 1 (08:01):
Totally yeah.
Speaker 2 (08:03):
So it's just once.
I started incorporating that inand utilizing your resources
along with your amazing team.
All of a sudden I'm noticingthat not only are people getting
better faster, they're gettingbetter with more confidence, and
that sport confidence even withmusculoskeletal injuries, we
see can really really affectsomeone.
(08:24):
Where you have someone who mayhave torn their ACL and from a
strength and conditioningstandpoint, from a physical
therapy rehab providerstandpoint, you can mark off all
the checkboxes.
They're 100% ready to go, butthey're just not performing the
way they used to.
It's possibly a sportperformance issue coming from
behavioral health and obviouslyyou know you work with these
(08:48):
athletes in these post-injuryspectrum.
So there's no differencewhether you're tearing your ACL
or you're getting a mildtraumatic brain injury.
It is an injury that canprevent you from playing sport
and that's a misnomer, right, wealways use the word return to
play.
Obviously for a concussion sochallenging to give a return to
play.
We can give some ranges, butoften they're so individual.
(09:09):
With ACL it's like, okay,you're going to be back within
nine months, for example.
Right, well, there's actuallypeople who tear their.
Speaker 1 (09:17):
ACL, who never?
Speaker 2 (09:18):
play a sport again, right?
So these are just things toreally think about and implement
.
Speaker 1 (09:23):
I think that's so hard as a physician because
people want those answers Likethey really want so much from
y'all, and especially high levelperformers, where they're like
I need to know, is it six months, is it five months?
And you know you and I knowthat and it's hard.
I mean, um, my dog was giventhree to six months to live two
years ago.
Speaker 2 (09:39):
You know, like I hate to bring a dog, but that's what
I do if you listen, you know Iknow, I know well, I very well
about your dog and you've heardgood for your, good for your dog
she is just I hope it justkeeps on going.
Speaker 1 (09:53):
Yeah, well, you know, like you said, all things come
to an end, though, at some point.
but so if what made me what Iwas just thinking when you were
talking.
There is like parents listeningto this Cause I think that
concussion is so scary for a lotof parents and and then to hear
that the mental healthcomponent is there.
What would you say to parentsyou know, or you even as a
parent, like, what would you sayabout concussion, you know,
(10:15):
cause I think it's gotten youand I've talked about this
sensationalized in the media.
So what would your advice be?
Or how would you educateparents on this?
Speaker 2 (10:23):
You know I try to be as neutral as possible, but
there's always going to be thatundertone with me saying if I
truly believe, based on all theavailable information, your son
or daughter is going to be fineAt some point.
This is going to be in theirpast, they're going to be fully
resolved and they're going to beable to continue on doing
whatever they love to do,whether that's a contact sport
(10:46):
or a non-contact or not even asport.
Whatever the case may be, I can.
I have, there's a level ofconfidence I can have that
conversation with.
Now, if someone's seeing methat's had six, seven
concussions, my counseling mightbe different.
Right, what I'm saying might bedifferent, but for someone
who's had one or two, I can givethat confidence.
(11:06):
But I say your son or daughteris going to be just fine If we
follow these steps and I gothrough through these pillars I
kind of alluded to before.
And I include because as a partof the questions that we ask
are extensive in behavioralhealth and mental health, making
sure that we are not missinganything.
That's one of the worst things.
(11:28):
They come in for concussionmanagement and we focus so much
on that word concussion yeahlike, yeah, we're gonna give you
active recovery, we're gonnagive you eye exercises, we're
gonna take melatonin for sleep,we're gonna get blocks, whatever
the case may be.
And then they're like hey, um Ihave a history of depression.
I'm not really feeling the bestright now about that, but then
(11:49):
we totally just gloss over it,right?
It's a missed opportunity tooptimize that care and
potentially fix a problem beforeit becomes even more of a
problem.
So I'm very candid with theparents that I'm making sure
that we're tackling all aspectsof it, we're counseling on all
aspects of it, and if they'renot plugged in to an individual
(12:11):
like yourself, then I'm usingthat encounter to say that there
is no shame, there is noquestions that we can't answer,
as long as we're being verytransparent and honest with each
other.
If this is something you'reconcerned about, we can tackle
it.
Speaker 1 (12:27):
It's interesting that you say that because of the NCA
, data recently reported thatmental health concerns about two
times higher in the last fiveyears, and so less than 40
percent of those actually feelcomfortable seeking mental
health support.
And so being May is MentalHealth Awareness Month Like.
Why do you feel, from yourperspective as a physician who
specializes in concussionmanagement, that there's been
(12:49):
this uptick in mental healthconcerns?
You know, do you think?
Why do you you think?
What do you see happening?
Speaker 2 (12:55):
I.
You know it's interesting onthe ground.
I think people are being moreopen about it and complete
conjecture.
You know COVID allowed a lot ofpeople to reset right.
Obviously, a lot of individualshad very poor outcomes,
unfortunately, because of that,but a lot of people were able to
reset, have more time to thinkabout these things and say where
(13:15):
are we, where is our behavioralhealth program, compared to
other people nationally.
That awareness, I think,automatically allowed people to
have safer conversations withindividuals that they typically
wouldn't have More trustingrelationship.
You know how this is.
When someone comes to see me andthey use it as a it's personal.
We kind of assume what thatcould mean.
Speaker 1 (13:36):
Right.
Speaker 2 (13:37):
But if they don't trust you, they're not going to
open up and say do you know what?
I am not okay.
Speaker 1 (13:41):
Yep.
Speaker 2 (13:42):
Anxiety is through the roof.
I have these stressors.
I need someone to help me.
That is a big step and if bigstep and if there's not trust,
they're not going to have thatconversation.
So I think that I thinkproviders are becoming a little
bit more human.
Not robotic, right?
Well, we're not robotic, right.
You can tell when people arewatching.
We're not robotic people, yeah,but there are robotic providers
(14:02):
and yeah, I don't know, likeI'm not going to want to talk to
that robotic provider, rightwell, isn't there?
Speaker 1 (14:07):
hasn't med school changed where they're like
taking more liberal arts people?
They're admitting into medschool for that reason exactly
yeah, and um, they're using.
Speaker 2 (14:16):
Uh, it's, I was actually looking.
I was talking to a medicalstudent yeah I was kind of, uh,
giving them some hard time.
I'm like you know, when I tookthe board I used to get a number
, grade, step one.
You're not getting it, you'renot getting a grade anymore.
Yeah, number, you're getting apass fail wow.
Wow and I'm like.
Well, I remember when I took mystep two CS man that was
(14:36):
interesting.
Speaker 1 (14:36):
What's that for people, for listeners?
What's step two CS?
Speaker 2 (14:39):
You would go in as a medical student and you would be
observed through video cameraor through the actual actor
themselves in a medical scenariowhere you were taking a history
, doing a brief exam, coming upwith a plan Behavioral health.
In a medical scenario where youwere taking a history doing a
brief exam coming up with a plan.
(14:59):
Uh, behavioral health wasinvolved in that.
You know, going through apotential suicidal ideation I
remember I had for my steps tocs.
Yeah, you're interacting, youare.
How normal are you to be ableto have conversations with
somebody, right?
Speaker 1 (15:06):
just to have like a yeah, yeah and because of covid.
Speaker 2 (15:09):
Here comes covid again.
They actually got they, theyactually put it on temporary
hold and they transitioned outof it.
Now they're doing some morestuff online as well as to other
their their distal step exams.
Speaker 1 (15:20):
And like in a time that we need it more than ever,
probably like that wholeinterpersonal connection,
because I do think post COVID,people have lost the ability to
have difficult conversations, tobe uncomfortable and to have
you know, just to talk.
Speaker 2 (15:33):
Again the human aspect of it.
There's times where I think Ieven said this to you, like you
know what man, that encounterwas not good, that was not the
best version of myself talkingto that individual and I really
wish I had that back.
But I'm very transparent andhonest with the patient in that
moment where I say you know whatI just said that, you know what
.
I'm going to go back in time alittle bit.
(15:54):
Let's do some back to thefuture.
Right, you know what I'm goingto go back in time a little.
Let's do some Back to theFuture.
Right, let's reset theconversation because that does
not make sense.
Speaker 1 (15:59):
Now, I understood that reference, but if anyone
knows Dr Kristofiak, he'll makelots of movie references and
sometimes we don't always knowwhich movies you're talking
about.
What's your favorite kind ofmovies?
Oh man, that's a tough one.
Speaker 2 (16:14):
That's a real tough one.
That's going to change based onthe season.
Okay, so I can go from sayingvanilla sky, to casino, to
goodfellas, yeah, uh, to.
Speaker 1 (16:28):
You know what?
I don't have time for movies.
Speaker 2 (16:28):
Yeah, right, yeah, because they're too, that's
probably during football season,for for context, I put movies
and tv on the background and Ido my medical notes okay, so
there you go, that that's right.
Speaker 1 (16:36):
Yeah, so you know you've talked about noticing how
sports injuries have along-term effect and can affect,
like, overall quality of life.
So why do you think earlyintervention is so important?
You know when you're firsttreating an athlete.
Speaker 2 (16:53):
You know it's again trying to tackle all aspects
that you can handle so theirreturn to play is as safe and
efficient as possible you know,when you rush, because you're,
because you see this, this is aninjury, and I say, oh, this is
an injury that I'm going to do aprp injection, a platelet-rich
plasma or whatever injectiontherapy we can offer.
(17:14):
It's like a tunnel vision.
Speaker 1 (17:17):
Right.
Speaker 2 (17:17):
Right, if we're picking up on the fact that
they're not doing well, they'rehaving signs of early PTSD from
this injury.
Right, they're feeling anxiousabout this injury because now
this injury is now keeping themfrom playing, right?
What does that mean?
Does that mean the number twoand a third or fourth individual
, whatever the case may be, Ialways hate to say it that way,
but, being real, and we justtalk about athletics, does that
(17:40):
mean that they're going to getall the playing time?
And what if I don't get back to?
What does that mean?
There's so many questions.
So we're really trying to lookat all these injuries
holistically and saying how canwe optimize this individual's
health from all aspects and doit right from the beginning and
not play catch-up?
Because health from all aspects, yeah, and do it right from the
beginning and not play catch up, because then you're five weeks
(18:00):
in, you're getting someone backfrom a hamstring and now
there's a sport confidence issueor there's untreated anxiety,
whatever the case may be, thereis no reason.
From a holistic standpoint, wecan't tackle all this right from
the beginning, right from thebeginning and you work with also
professional athletes too andyou know.
Speaker 1 (18:15):
So that's important to recognize.
So you see it at, you see it atall levels.
You know high school, you know,I know at Cooperman, barnabas
right, you see a lot of highschool athletes there as well.
Speaker 2 (18:23):
Yeah, a lot of high school athletes that we see
through our amazing partnershipsthat we have.
We do take care of Gotham FCthe women's professional soccer
team so I'm actually their chiefmedical officer.
The women's professional soccerteam so I'm actually their
chief medical officer and I amso lucky to have a gifted team
of physicians Dr Peter DeLuca,dr Tuminelli, dr Gabby Guzman
(18:45):
right from your side.
We're really put together afantastic team to take care of
these elite athletes.
And they are so cool, calm andcollective that you lose sight
that they just won gold medal.
So there's a lot of athletes onGotham that have gold medals
because they're on the USnational team.
Speaker 1 (18:58):
Right.
Speaker 2 (18:59):
So they're in the Olympics, they come back with a
gold medal.
And you said, wow, I take careof them.
Lucky me.
But how awesome is it that youallow me to take care of you?
Yeah Right, that is so cool.
Speaker 1 (19:12):
It's a gift.
Speaker 2 (19:18):
It's a gift, it really is.
Yeah, well, yeah, there's somany physicians.
New Jersey is so dense right,there's a lot of options in New
Jersey.
So, it really is.
It really is an honor when youlook at that grand scope, when
you get to say that you'retaking care of one of the best
female soccer athletes in theworld.
Speaker 1 (19:32):
Yeah, and the NASW is really focused on mental health
.
You know, I think that'simportant for listeners to
understand that a lot of thethings that Jason and I work on
you know, consulting with theseother organizations and
professional leagues is aboutthe integration of sport,
medicine, sports, psychology,behavioral health.
It's so critical and a lot ofthese leagues MLS, nasw they're
really, you know, putting a lotof resources into that.
(19:54):
So all right.
So going back to physical, soyou know again, cause we're so
listeners like you realize thatthe connection is physical
injury yields mental healthchallenges, and so it's
important to have a whole teamof people.
We're just like one of theother coaches there, but you
know, it is helpful.
It is helpful.
I always say my job is to nothave a job and that that would
(20:15):
be good for you too.
Right, like in these contactsports, you work and it'd be
good if people did not get hurtImpossible, but at least
reducing injury to optimizeperformance.
So what are some good habitsfor people that are trying to
say reduce injury or optimizeperformance?
Speaker 2 (20:33):
That is such an excellent question, and we do
focus a lot on prevention, right.
And we do have thatconversation where we say I
would love to be on the sidelineof a game, and this is now a
debatable concept, right.
Speaker 1 (20:47):
Okay.
Speaker 2 (20:49):
Can the team physician, a team physician or
the head team physician be a fanat the same time?
My answer is unequivocally yes.
Speaker 1 (20:57):
My answer is no, but go ahead.
Speaker 2 (21:01):
Which is great to debate about.
Um, but you know, hey, I wantto.
I just want to be there and bepresent and be available and not
have a single injury.
Speaker 1 (21:10):
Right.
Speaker 2 (21:11):
That's amazing.
Speaker 1 (21:11):
If only if only yeah.
Unlikely, but if only so, howdo we prevent them?
Speaker 2 (21:16):
So we look at all aspects of whatever that sport
is.
A lot of the time it reallyboils down to just good sport
technique as just one thing totackle.
There are individuals that areso gifted and talented but they
just have no control of theirbodies.
They fly over the field orwhatever the sport is.
They're just flying around.
They're putting themselves atrisk.
So good sport technique isalways good.
(21:37):
Whatever the sport is, they'rejust flying around.
They're putting themselves atrisk.
So good sport technique isalways good.
Making sure you're listening toyour strength and conditioning
coaches to make sure that you'redoing an appropriate level of
strength and condition andyou're not overdoing it.
Looking at what you're doing asan individual and making sure
that if you're doing two days,for example, two days are not
allowed and collegiate boatsforgetting about collegiate
other areas.
(21:57):
People are doing two days.
Now all of a sudden they gohome.
They do now a third practice ontheir own, because that's what
they think they need to do.
It's just too much.
You have to just be really,really realistic Overtraining.
It's overtraining.
Speaker 1 (22:07):
If you can't overtrain.
Speaker 2 (22:08):
You got to be conscious of your recovery and
what you need to recover, sogood sport technique, allowing
your body to recover, notoverdoing it.
There's programs that aredesigned, such as FIFA 11, for
different injuries, but veryspecifically for concussion.
I really have bought into neckstrengthening Making sure that
(22:32):
there's a nice, stable neck.
Is that provocative?
Speaker 1 (22:34):
when you say that that way you bought in, is there
people out there that are goingto say, no, it has nothing to
do with it?
Speaker 2 (22:39):
I think 100% there's going to be people that are
going to disagree with it, butthis is not very taboo.
So your structure right.
Your head sits on your neck.
You have a weak neck.
You're going to move around alot.
Moving around a lot is going tocause the brain to move around
a lot.
So if there's forces that arebeing directed up to your brain,
um, that we can maybe minimizea little bit because of you're
(23:00):
having a stronger neck.
I'm seeing it in the literature.
It's coming out.
I mean, people are studying itand people really, really
believe in it and I have yet tofind a reason where, if you do
strengthen your neck and it doesnothing to prevent concussion,
I have not heard it hurting you.
Speaker 1 (23:16):
Right, it's like there's an adverse effects of
having a stronger neck.
Speaker 2 (23:18):
I have not heard of an adverse effect because of it
Right yeah.
So neck strengthening issomething Staying hydrated is
another case Getting good sleep.
These are all part of yourrecovery Hydration, sleep, good
sport technique, good range ofmotion and strength of your neck
.
Speaker 1 (23:40):
I have personally seen it be really helpful.
I'm hoping research willsupport it.
So those are really good tipsfor people.
So, as we're getting ready towrap up already, what changes
have you seen in sports medicinelandscape in general over the
last decade?
Speaker 2 (23:54):
So a lot of data, a lot of data analytics, and then
there's pros and cons of that.
Speaker 1 (24:01):
Sure.
Speaker 2 (24:01):
Because we want to make sure that the data that
we're using to give advice toour athletes and our
non-athletes alike is comingfrom good sources and meaningful
.
So sometimes too much data canmuddy the water and can cloud.
You know what is the exactissue that we're dealing with.
So I think data analytics hasbeen a big part of it, but the
(24:24):
one thing that I've seen isactually more teamwork approach.
Speaker 1 (24:29):
Yes.
Speaker 2 (24:29):
Where it's a marriage between the athletic trainers,
the physical therapists, thebehavioral health providers, the
medical doctors, the coaches,the strength and conditioning.
Everyone is now coming togetheras a team, as a sports health
team, to be able to care for theathlete with one goal and
(24:50):
keeping the athlete as safe aspossible and, when they do get
injured, making sure they getback to doing what they love as
soon as safe as possible.
And when they do get injured,you know, making sure they get
back to doing what they love assoon as safe as possible.
Before it seemed a littledisjointed.
I remember even going back towhen I was in fellowship great
program, great everyoneindividually, but then that's
fantastic Individually.
We were missing things from ateamwork standpoint and I think,
(25:13):
going back from we met in 2018,pete to now we've seen it.
We've seen the benefit of beingcohesive as programs and I just
don't think there's anythingthat's going to separate that.
Speaker 1 (25:25):
And I think we're getting good feedback from the
athletes, where they're seeingit, where there's actually good
communication passing amongstthe subspecialties, and they're
seeing a benefit in their caresubspecialties and they're
seeing a benefit in their care,yeah, and so just working
together as a team you know usas the providers, as a team, so
if there's anyone listening, drChristofiak, that what's like
one piece of advice you'd give,say, for like an incoming
(25:46):
college athlete who's about tostart this, this journey.
Speaker 2 (25:50):
So know who the players are.
Speaker 1 (25:53):
Yeah.
Speaker 2 (25:53):
When I say players, that doesn't mean just you and
your teammates Physically knowwho's taking care of you.
There's times where people cango up to one of the athletic
trainers for football and sayhey, doc, what's going on?
They're like I'm not the doctorand it's just like oh well,
you've been here for six months,how do you not know who's who?
yet, so, right off the bat, whois taking care of you, Know well
(26:14):
yeah and develop a relationshipwith them, because that
relationship is going to bereally important and just be as
transparent as you feelcomfortable with the people that
are around.
They will be available to youin most cases, 24 7, and they
will do whatever it takes tohelp you.
Yeah, if you will open the doora little bit and make sure that
you are being as transparent aspossible, because without all
(26:36):
the information is sometimesreally challenging for any
medical provider, no matter whatspecialty it is to be able to
help.
So, hey, be an open book, knowwho's taking care of you and
have fun.
Speaker 1 (26:48):
Yeah, that's good advice.
Please have fun.
That's good advice, we have fun, right, you and I have fun.
We have to.
Speaker 2 (26:53):
We have so much fun.
Speaker 1 (26:54):
All of us have to have fun, so where can people
find you?
I know you have many differentpractices, so if you Google
Jason Kristofiak, who knows whatyou'll find?
But where would you direct themto find you?
Speaker 2 (27:05):
That's an amazing question.
So, again, very transparent.
We are not the best withmarketing our sports medicine
services at RWJBarnabas Health,but if you search Jason
Kristoviak, md, andRWJBarnabasHealth or RWJBH,
there's a main profile of minethat you can go to.
It has my contact information,it has who I am and there's some
(27:26):
other helpful information onthe main website as well, but
I'm not fancy enough to have myown website yet.
Maybe next year.
Speaker 1 (27:34):
Maybe next year, let's get that.
But, yeah, maybe next year,maybe next year, let's get that,
let's get that.
But for now you'll find it inthe show notes, whatever your
current website is.
So thank you, dr Kristofiak,for being here.
I really appreciate you makingthe time in your busy schedule.
Thank you.
Speaker 2 (27:46):
It was a lot of fun.
Speaker 1 (27:47):
Thanks, pete.
As we wrap up Mental HealthAwareness Month, we're going to
continue the conversations andwe encourage all of you
listeners.
If you're having any challenges, we have the resources for you.
My goal has always been toreduce stigma and make sure that
this month's context helpsbring more awareness to mental
(28:07):
health awareness.
So thank you for being here andtuning in.
Please like, follow and shareand you can find everything at
officialdrpetecom and I will seeyou here next week.
Until then, spread a littlekindness and stay well.
Hello and welcome back to On Air with Dr Pete.
I'm your host, Dr Pete Economo,and I hope you're all having a
great week.
I'm excited, for today's guestis a good friend.
As we go into May, MentalHealth Awareness Month, so we
are bringing you importanttopics related to mental health.
This is my friend and colleague, Dr Jason Kristofiak.
He serves as one of the teamphysicians for Rutgers Athletics
(00:37):
and he is the team physicianfor the football team there at
Rutgers University.
He's also the chief of sportsmedicine for Cooperman Barnabas
Medical Center and a clinicalprofessor of family medicine and
community health.
So we work together at Rutgersand he's heavily involved in the
education of medical students.
He's a published author on NCAresearch and is considered an
(00:59):
expert in concussion management.
Thank you for being here, DrKristofiak.
Speaker 2 (01:05):
Dr Pete, always a pleasure.
Speaker 1 (01:06):
Thanks for having me so this is going to be fun today
.
So I mean not that concussionand mental health is fun but
we're going to talk about youknow.
Speaker 2 (01:18):
So when did do you remember when we first met?
Yeah, 2018, I think 2018.
Speaker 1 (01:21):
Yeah, yeah, that's when I came to Rutgers, but you
had already been there, so tellabout your journey of work.
You're like a real Rutgersperson.
Speaker 2 (01:28):
Yeah, so I actually graduated undergraduate from
Rutgers.
Speaker 1 (01:31):
Yeah.
Speaker 2 (01:33):
So that was easy.
This is going back in the daywhen they had the grease trucks
and I could walk about the3,000-calorie sandwiches.
I would have late nightstudying for organic chemistry
and such.
Speaker 1 (01:43):
Did you know you wanted to be a doctor then?
Speaker 2 (01:53):
no, I, I didn't, um, I actually I uh changed my path
after my mom passed away fromnon-hospitalism phoma.
I wanted to be a race cardriver.
Oddly enough, clearly that wasnot going to happen.
Right, just, you have to berealistic with your goals.
That is so cool, though, yeah,but yeah.
So undergrad at ruckers, um, soI was only bleeding, you know
scarlet nights, and uh went tomedical school, was able to come
back, was able to go toresidency at rwjms at um new
(02:17):
brunswick, which was my dreamtop program and then I stayed on
for sports medicine fellowshipat the same institution, which
is great yeah, so 2018, becausethat's when I first got there,
so that makes it about right,but I only came to athletics in
2020.
Speaker 1 (02:31):
And I'll never forget that, because it was December
19 into January 2020.
Speaker 2 (02:36):
Oh, and now we're talking about COVID.
Speaker 1 (02:37):
Yes.
So, we were like on thesidelines of games and football,
and just us.
Yes, that first season you werereally instrumental.
The sidelines of games andfootball, and just us.
Yes, that first season you were.
You were really, you know,instrumental in that, of course,
with the chief medical officer,but making sure that the
athletes were safe and, you know, really ahead of the curve and
a lot of the science of, youknow, covid and the health of
our athletes.
Speaker 2 (02:57):
Yeah, it was a really trying time.
It's a great testament to theteamwork actually at Rutgers
University at all I mean veryspecifically the sports medicine
, but everyone really justworking together developing
protocols and new policies.
You know we were doing thingssomewhat different.
Speaker 1 (03:14):
Yeah.
Speaker 2 (03:15):
And it was to the benefit of the athletes and I
think everyone appreciated thatand we get feedback about that
still, which is great.
It's a tiring, very traumatictime totally but the bonds that
were created during that timeare special in life, last or
lifelong yeah, they'll staythere forever.
Speaker 1 (03:33):
Um I you know, one of the things I love about the
podcast jason is uh, like, Ihave some friends on like you
and you learn stuff like, so Ihave to go back to this race car
driver yeah, it's um, probablybecause I was a really big
danica patrick fan.
Ah, okay if you're watching, ifyou're watching on youtube,
(03:54):
you'll see the shame in his face.
Yeah, so that's where itstarted yeah, it just was.
Speaker 2 (04:02):
Uh, I was into indie cars and I, it was something
different.
It was something different, youknow, traveling to go to uh
races.
So you did, you go to watch, orwould you also race?
Uh, no, just go to watch justgo to watch.
Speaker 1 (04:13):
I had a client once who start like part of his
midlife crisis was racing cars.
They do have tracks where youcan get cars to like.
Race as a like, learn how to do.
Speaker 2 (04:23):
You know that yeah, I know I was um.
Speaker 1 (04:26):
I did a little bit of that okay, it's a lot harder uh
, than it looks yeah a lotharder than it looks, I put
yourself in one of those indiecars.
Speaker 2 (04:35):
The amount of g-forces around a turn like
there's been.
You know we're talking aboutathletes today, right?
Yeah it's so interesting.
So people would say, like youknow, I don't know if race car
drivers or athletes, they justsit there and kind of just go
around in circles.
I'm like whoa yeah those, those, those and those uh, men and
women are very, very fitathletes for what they have to
do in that car so like core andthings like that core, the,
(04:59):
their neck, yeah, the, the forthat, and just their upper,
their ability to just hold thewheel with all those G-forces.
Speaker 1 (05:06):
Good segue, neck.
How is the neck involvedBecause I'm also wondering with
race cars?
And then recently, as we'rerecording this, there was that
boat accident.
They were trying to beat theworld record for the fastest
boat on water.
Speaker 2 (05:18):
Did you see that?
Speaker 1 (05:20):
They were trying to go over 200 miles an hour, or
whatever the number is.
There must be concussions inthis too.
Speaker 2 (05:27):
I'm Absolutely Unfortunately there's
concussions everywhere, but inthe motor vehicle, the racing
scene, there's for sureconcussions and as a part of
their training they do full body.
But core, upper body and neckare really intrement.
Just because you have to havethe strength to be able to sit
(05:47):
there and be able to maintainthese forces, or you pass out.
Speaker 1 (05:50):
If you ever see people go up in the fighter jets
and they get those G-forces andthey just pass out.
Speaker 2 (05:54):
They're not trained for it.
See these guys train everysingle day.
Speaker 1 (05:57):
Yeah, they make movies on that too.
Where they have these I've seenit they're training them not to
pass out, but the mentalresilience and mental toughness
it takes to do those sports ispretty instrumental.
Yeah.
Speaker 2 (06:09):
Absolutely.
Speaker 1 (06:10):
Yeah, and so you know you've always been great to
work with and and what made youkind of uh think about like
mental health in the, in thetreatment of concussion or just
under?
Like did you see in theathletes you were treating that
there was like what did younotice that we were like, hey,
I'm glad we have like sportspsychology to help us with this
yeah, so you know, going back,and obviously we've worked
(06:30):
together so much, you know howtransparent I am probably
sometimes to a fault.
Yeah.
Speaker 2 (06:35):
I go going back years .
I caught myself not optimizingthe care because I was
overlooking the behavioralhealth aspect of it.
A lot of these individualseither had some form of baseline
depression, anxiety, sometimeseven bipolar.
Yeah, the other comorbidity islike ADHD yes and I just
(06:57):
initially wasn't factoring thatin to the best that I could into
their management plan and Ialways looked at concussion
management individually.
As pillars, okay, there's goingto be the cardiovascular aspect
, so I'm going to exert them ina safe manner without putting
them at risk for repeat injury.
And then or I'm saying, hey,there's a neck component, so
(07:18):
there's a cervicogenic component, or there is a nutritional
component with regards to how wewould maybe optimize their oral
intake of, you know, food andfluids after an event happened.
But then the behavioral healthaspect, you know, somebody will
say, oh, I feel really bad aboutmyself.
Oh, it's a part of theconcussion spectrum, you'll be
(07:38):
fine Once you're better.
You'll be fine Starting torealize that by tackling that
early on, these individuals arehaving acute stress reactions.
Speaker 1 (07:46):
Yeah.
Speaker 2 (07:47):
Acute reactions that may not be their baseline, or
could be their baseline, thatgot worse, or an unresolved
issue, or PTSD and that, hey,how am I going to get back to
sport at the same level if I'mafraid of getting my head hit
again?
Speaker 1 (08:01):
Totally yeah.
Speaker 2 (08:03):
So it's just once.
I started incorporating that inand utilizing your resources
along with your amazing team.
All of a sudden I'm noticingthat not only are people getting
better faster, they're gettingbetter with more confidence, and
that sport confidence even withmusculoskeletal injuries, we
see can really really affectsomeone.
(08:24):
Where you have someone who mayhave torn their ACL and from a
strength and conditioningstandpoint, from a physical
therapy rehab providerstandpoint, you can mark off all
the checkboxes.
They're 100% ready to go, butthey're just not performing the
way they used to.
It's possibly a sportperformance issue coming from
behavioral health and obviouslyyou know you work with these
(08:48):
athletes in these post-injuryspectrum.
So there's no differencewhether you're tearing your ACL
or you're getting a mildtraumatic brain injury.
It is an injury that canprevent you from playing sport
and that's a misnomer, right, wealways use the word return to
play.
Obviously for a concussion sochallenging to give a return to
play.
We can give some ranges, butoften they're so individual.
(09:09):
With ACL it's like, okay,you're going to be back within
nine months, for example.
Right, well, there's actuallypeople who tear their.
Speaker 1 (09:17):
ACL, who never?
Speaker 2 (09:18):
play a sport again, right?
So these are just things toreally think about and implement
.
Speaker 1 (09:23):
I think that's so hard as a physician because
people want those answers Likethey really want so much from
y'all, and especially high levelperformers, where they're like
I need to know, is it six months, is it five months?
And you know you and I knowthat and it's hard.
I mean, um, my dog was giventhree to six months to live two
years ago.
Speaker 2 (09:39):
You know, like I hate to bring a dog, but that's what
I do if you listen, you know Iknow, I know well, I very well
about your dog and you've heardgood for your, good for your dog
she is just I hope it justkeeps on going.
Speaker 1 (09:53):
Yeah, well, you know, like you said, all things come
to an end, though, at some point.
but so if what made me what Iwas just thinking when you were
talking.
There is like parents listeningto this Cause I think that
concussion is so scary for a lotof parents and and then to hear
that the mental healthcomponent is there.
What would you say to parentsyou know, or you even as a
parent, like, what would you sayabout concussion, you know,
(10:15):
cause I think it's gotten youand I've talked about this
sensationalized in the media.
So what would your advice be?
Or how would you educateparents on this?
Speaker 2 (10:23):
You know I try to be as neutral as possible, but
there's always going to be thatundertone with me saying if I
truly believe, based on all theavailable information, your son
or daughter is going to be fineAt some point.
This is going to be in theirpast, they're going to be fully
resolved and they're going to beable to continue on doing
whatever they love to do,whether that's a contact sport
(10:46):
or a non-contact or not even asport.
Whatever the case may be, I can.
I have, there's a level ofconfidence I can have that
conversation with.
Now, if someone's seeing methat's had six, seven
concussions, my counseling mightbe different.
Right, what I'm saying might bedifferent, but for someone
who's had one or two, I can givethat confidence.
(11:06):
But I say your son or daughteris going to be just fine If we
follow these steps and I gothrough through these pillars I
kind of alluded to before.
And I include because as a partof the questions that we ask
are extensive in behavioralhealth and mental health, making
sure that we are not missinganything.
That's one of the worst things.
(11:28):
They come in for concussionmanagement and we focus so much
on that word concussion yeahlike, yeah, we're gonna give you
active recovery, we're gonnagive you eye exercises, we're
gonna take melatonin for sleep,we're gonna get blocks, whatever
the case may be.
And then they're like hey, um Ihave a history of depression.
I'm not really feeling the bestright now about that, but then
(11:49):
we totally just gloss over it,right?
It's a missed opportunity tooptimize that care and
potentially fix a problem beforeit becomes even more of a
problem.
So I'm very candid with theparents that I'm making sure
that we're tackling all aspectsof it, we're counseling on all
aspects of it, and if they'renot plugged in to an individual
(12:11):
like yourself, then I'm usingthat encounter to say that there
is no shame, there is noquestions that we can't answer,
as long as we're being verytransparent and honest with each
other.
If this is something you'reconcerned about, we can tackle
it.
Speaker 1 (12:27):
It's interesting that you say that because of the NCA
, data recently reported thatmental health concerns about two
times higher in the last fiveyears, and so less than 40
percent of those actually feelcomfortable seeking mental
health support.
And so being May is MentalHealth Awareness Month Like.
Why do you feel, from yourperspective as a physician who
specializes in concussionmanagement, that there's been
(12:49):
this uptick in mental healthconcerns?
You know, do you think?
Why do you you think?
What do you see happening?
Speaker 2 (12:55):
I.
You know it's interesting onthe ground.
I think people are being moreopen about it and complete
conjecture.
You know COVID allowed a lot ofpeople to reset right.
Obviously, a lot of individualshad very poor outcomes,
unfortunately, because of that,but a lot of people were able to
reset, have more time to thinkabout these things and say where
(13:15):
are we, where is our behavioralhealth program, compared to
other people nationally.
That awareness, I think,automatically allowed people to
have safer conversations withindividuals that they typically
wouldn't have More trustingrelationship.
You know how this is.
When someone comes to see me andthey use it as a it's personal.
We kind of assume what thatcould mean.
Speaker 1 (13:36):
Right.
Speaker 2 (13:37):
But if they don't trust you, they're not going to
open up and say do you know what?
I am not okay.
Speaker 1 (13:41):
Yep.
Speaker 2 (13:42):
Anxiety is through the roof.
I have these stressors.
I need someone to help me.
That is a big step and if bigstep and if there's not trust,
they're not going to have thatconversation.
So I think that I thinkproviders are becoming a little
bit more human.
Not robotic, right?
Well, we're not robotic, right.
You can tell when people arewatching.
We're not robotic people, yeah,but there are robotic providers
(14:02):
and yeah, I don't know, likeI'm not going to want to talk to
that robotic provider, rightwell, isn't there?
Speaker 1 (14:07):
hasn't med school changed where they're like
taking more liberal arts people?
They're admitting into medschool for that reason exactly
yeah, and um, they're using.
Speaker 2 (14:16):
Uh, it's, I was actually looking.
I was talking to a medicalstudent yeah I was kind of, uh,
giving them some hard time.
I'm like you know, when I tookthe board I used to get a number
, grade, step one.
You're not getting it, you'renot getting a grade anymore.
Yeah, number, you're getting apass fail wow.
Wow and I'm like.
Well, I remember when I took mystep two CS man that was
(14:36):
interesting.
Speaker 1 (14:36):
What's that for people, for listeners?
What's step two CS?
Speaker 2 (14:39):
You would go in as a medical student and you would be
observed through video cameraor through the actual actor
themselves in a medical scenariowhere you were taking a history
, doing a brief exam, coming upwith a plan Behavioral health.
In a medical scenario where youwere taking a history doing a
brief exam coming up with a plan.
(14:59):
Uh, behavioral health wasinvolved in that.
You know, going through apotential suicidal ideation I
remember I had for my steps tocs.
Yeah, you're interacting, youare.
How normal are you to be ableto have conversations with
somebody, right?
Speaker 1 (15:06):
just to have like a yeah, yeah and because of covid.
Speaker 2 (15:09):
Here comes covid again.
They actually got they, theyactually put it on temporary
hold and they transitioned outof it.
Now they're doing some morestuff online as well as to other
their their distal step exams.
Speaker 1 (15:20):
And like in a time that we need it more than ever,
probably like that wholeinterpersonal connection,
because I do think post COVID,people have lost the ability to
have difficult conversations, tobe uncomfortable and to have
you know, just to talk.
Speaker 2 (15:33):
Again the human aspect of it.
There's times where I think Ieven said this to you, like you
know what man, that encounterwas not good, that was not the
best version of myself talkingto that individual and I really
wish I had that back.
But I'm very transparent andhonest with the patient in that
moment where I say you know whatI just said that, you know what
.
I'm going to go back in time alittle bit.
(15:54):
Let's do some back to thefuture.
Right, you know what I'm goingto go back in time a little.
Let's do some Back to theFuture.
Right, let's reset theconversation because that does
not make sense.
Speaker 1 (15:59):
Now, I understood that reference, but if anyone
knows Dr Kristofiak, he'll makelots of movie references and
sometimes we don't always knowwhich movies you're talking
about.
What's your favorite kind ofmovies?
Oh man, that's a tough one.
Speaker 2 (16:14):
That's a real tough one.
That's going to change based onthe season.
Okay, so I can go from sayingvanilla sky, to casino, to
goodfellas, yeah, uh, to.
Speaker 1 (16:28):
You know what?
I don't have time for movies.
Speaker 2 (16:28):
Yeah, right, yeah, because they're too, that's
probably during football season,for for context, I put movies
and tv on the background and Ido my medical notes okay, so
there you go, that that's right.
Speaker 1 (16:36):
Yeah, so you know you've talked about noticing how
sports injuries have along-term effect and can affect,
like, overall quality of life.
So why do you think earlyintervention is so important?
You know when you're firsttreating an athlete.
Speaker 2 (16:53):
You know it's again trying to tackle all aspects
that you can handle so theirreturn to play is as safe and
efficient as possible you know,when you rush, because you're,
because you see this, this is aninjury, and I say, oh, this is
an injury that I'm going to do aprp injection, a platelet-rich
plasma or whatever injectiontherapy we can offer.
(17:14):
It's like a tunnel vision.
Speaker 1 (17:17):
Right.
Speaker 2 (17:17):
Right, if we're picking up on the fact that
they're not doing well, they'rehaving signs of early PTSD from
this injury.
Right, they're feeling anxiousabout this injury because now
this injury is now keeping themfrom playing, right?
What does that mean?
Does that mean the number twoand a third or fourth individual
, whatever the case may be, Ialways hate to say it that way,
but, being real, and we justtalk about athletics, does that
(17:40):
mean that they're going to getall the playing time?
And what if I don't get back to?
What does that mean?
There's so many questions.
So we're really trying to lookat all these injuries
holistically and saying how canwe optimize this individual's
health from all aspects and doit right from the beginning and
not play catch-up?
Because health from all aspects, yeah, and do it right from the
beginning and not play catch up, because then you're five weeks
(18:00):
in, you're getting someone backfrom a hamstring and now
there's a sport confidence issueor there's untreated anxiety,
whatever the case may be, thereis no reason.
From a holistic standpoint, wecan't tackle all this right from
the beginning, right from thebeginning and you work with also
professional athletes too andyou know.
Speaker 1 (18:15):
So that's important to recognize.
So you see it at, you see it atall levels.
You know high school, you know,I know at Cooperman, barnabas
right, you see a lot of highschool athletes there as well.
Speaker 2 (18:23):
Yeah, a lot of high school athletes that we see
through our amazing partnershipsthat we have.
We do take care of Gotham FCthe women's professional soccer
team so I'm actually their chiefmedical officer.
The women's professional soccerteam so I'm actually their
chief medical officer and I amso lucky to have a gifted team
of physicians Dr Peter DeLuca,dr Tuminelli, dr Gabby Guzman
(18:45):
right from your side.
We're really put together afantastic team to take care of
these elite athletes.
And they are so cool, calm andcollective that you lose sight
that they just won gold medal.
So there's a lot of athletes onGotham that have gold medals
because they're on the USnational team.
Speaker 1 (18:58):
Right.
Speaker 2 (18:59):
So they're in the Olympics, they come back with a
gold medal.
And you said, wow, I take careof them.
Lucky me.
But how awesome is it that youallow me to take care of you?
Yeah Right, that is so cool.
Speaker 1 (19:12):
It's a gift.
Speaker 2 (19:18):
It's a gift, it really is.
Yeah, well, yeah, there's somany physicians.
New Jersey is so dense right,there's a lot of options in New
Jersey.
So, it really is.
It really is an honor when youlook at that grand scope, when
you get to say that you'retaking care of one of the best
female soccer athletes in theworld.
Speaker 1 (19:32):
Yeah, and the NASW is really focused on mental health
.
You know, I think that'simportant for listeners to
understand that a lot of thethings that Jason and I work on
you know, consulting with theseother organizations and
professional leagues is aboutthe integration of sport,
medicine, sports, psychology,behavioral health.
It's so critical and a lot ofthese leagues MLS, nasw they're
really, you know, putting a lotof resources into that.
(19:54):
So all right.
So going back to physical, soyou know again, cause we're so
listeners like you realize thatthe connection is physical
injury yields mental healthchallenges, and so it's
important to have a whole teamof people.
We're just like one of theother coaches there, but you
know, it is helpful.
It is helpful.
I always say my job is to nothave a job and that that would
(20:15):
be good for you too.
Right, like in these contactsports, you work and it'd be
good if people did not get hurtImpossible, but at least
reducing injury to optimizeperformance.
So what are some good habitsfor people that are trying to
say reduce injury or optimizeperformance?
Speaker 2 (20:33):
That is such an excellent question, and we do
focus a lot on prevention, right.
And we do have thatconversation where we say I
would love to be on the sidelineof a game, and this is now a
debatable concept, right.
Speaker 1 (20:47):
Okay.
Speaker 2 (20:49):
Can the team physician, a team physician or
the head team physician be a fanat the same time?
My answer is unequivocally yes.
Speaker 1 (20:57):
My answer is no, but go ahead.
Speaker 2 (21:01):
Which is great to debate about.
Um, but you know, hey, I wantto.
I just want to be there and bepresent and be available and not
have a single injury.
Speaker 1 (21:10):
Right.
Speaker 2 (21:11):
That's amazing.
Speaker 1 (21:11):
If only if only yeah.
Unlikely, but if only so, howdo we prevent them?
Speaker 2 (21:16):
So we look at all aspects of whatever that sport
is.
A lot of the time it reallyboils down to just good sport
technique as just one thing totackle.
There are individuals that areso gifted and talented but they
just have no control of theirbodies.
They fly over the field orwhatever the sport is.
They're just flying around.
They're putting themselves atrisk.
So good sport technique isalways good.
(21:37):
Whatever the sport is, they'rejust flying around.
They're putting themselves atrisk.
So good sport technique isalways good.
Making sure you're listening toyour strength and conditioning
coaches to make sure that you'redoing an appropriate level of
strength and condition andyou're not overdoing it.
Looking at what you're doing asan individual and making sure
that if you're doing two days,for example, two days are not
allowed and collegiate boatsforgetting about collegiate
other areas.
(21:57):
People are doing two days.
Now all of a sudden they gohome.
They do now a third practice ontheir own, because that's what
they think they need to do.
It's just too much.
You have to just be really,really realistic Overtraining.
It's overtraining.
Speaker 1 (22:07):
If you can't overtrain.
Speaker 2 (22:08):
You got to be conscious of your recovery and
what you need to recover, sogood sport technique, allowing
your body to recover, notoverdoing it.
There's programs that aredesigned, such as FIFA 11, for
different injuries, but veryspecifically for concussion.
I really have bought into neckstrengthening Making sure that
(22:32):
there's a nice, stable neck.
Is that provocative?
Speaker 1 (22:34):
when you say that that way you bought in, is there
people out there that are goingto say, no, it has nothing to
do with it?
Speaker 2 (22:39):
I think 100% there's going to be people that are
going to disagree with it, butthis is not very taboo.
So your structure right.
Your head sits on your neck.
You have a weak neck.
You're going to move around alot.
Moving around a lot is going tocause the brain to move around
a lot.
So if there's forces that arebeing directed up to your brain,
um, that we can maybe minimizea little bit because of you're
(23:00):
having a stronger neck.
I'm seeing it in the literature.
It's coming out.
I mean, people are studying itand people really, really
believe in it and I have yet tofind a reason where, if you do
strengthen your neck and it doesnothing to prevent concussion,
I have not heard it hurting you.
Speaker 1 (23:16):
Right, it's like there's an adverse effects of
having a stronger neck.
Speaker 2 (23:18):
I have not heard of an adverse effect because of it
Right yeah.
So neck strengthening issomething Staying hydrated is
another case Getting good sleep.
These are all part of yourrecovery Hydration, sleep, good
sport technique, good range ofmotion and strength of your neck
.
Speaker 1 (23:40):
I have personally seen it be really helpful.
I'm hoping research willsupport it.
So those are really good tipsfor people.
So, as we're getting ready towrap up already, what changes
have you seen in sports medicinelandscape in general over the
last decade?
Speaker 2 (23:54):
So a lot of data, a lot of data analytics, and then
there's pros and cons of that.
Speaker 1 (24:01):
Sure.
Speaker 2 (24:01):
Because we want to make sure that the data that
we're using to give advice toour athletes and our
non-athletes alike is comingfrom good sources and meaningful
.
So sometimes too much data canmuddy the water and can cloud.
You know what is the exactissue that we're dealing with.
So I think data analytics hasbeen a big part of it, but the
(24:24):
one thing that I've seen isactually more teamwork approach.
Speaker 1 (24:29):
Yes.
Speaker 2 (24:29):
Where it's a marriage between the athletic trainers,
the physical therapists, thebehavioral health providers, the
medical doctors, the coaches,the strength and conditioning.
Everyone is now coming togetheras a team, as a sports health
team, to be able to care for theathlete with one goal and
(24:50):
keeping the athlete as safe aspossible and, when they do get
injured, making sure they getback to doing what they love as
soon as safe as possible.
And when they do get injured,you know, making sure they get
back to doing what they love assoon as safe as possible.
Before it seemed a littledisjointed.
I remember even going back towhen I was in fellowship great
program, great everyoneindividually, but then that's
fantastic Individually.
We were missing things from ateamwork standpoint and I think,
(25:13):
going back from we met in 2018,pete to now we've seen it.
We've seen the benefit of beingcohesive as programs and I just
don't think there's anythingthat's going to separate that.
Speaker 1 (25:25):
And I think we're getting good feedback from the
athletes, where they're seeingit, where there's actually good
communication passing amongstthe subspecialties, and they're
seeing a benefit in their caresubspecialties and they're
seeing a benefit in their care,yeah, and so just working
together as a team you know usas the providers, as a team, so
if there's anyone listening, drChristofiak, that what's like
one piece of advice you'd give,say, for like an incoming
(25:46):
college athlete who's about tostart this, this journey.
Speaker 2 (25:50):
So know who the players are.
Speaker 1 (25:53):
Yeah.
Speaker 2 (25:53):
When I say players, that doesn't mean just you and
your teammates Physically knowwho's taking care of you.
There's times where people cango up to one of the athletic
trainers for football and sayhey, doc, what's going on?
They're like I'm not the doctorand it's just like oh well,
you've been here for six months,how do you not know who's who?
yet, so, right off the bat, whois taking care of you, Know well
(26:14):
yeah and develop a relationshipwith them, because that
relationship is going to bereally important and just be as
transparent as you feelcomfortable with the people that
are around.
They will be available to youin most cases, 24 7, and they
will do whatever it takes tohelp you.
Yeah, if you will open the doora little bit and make sure that
you are being as transparent aspossible, because without all
(26:36):
the information is sometimesreally challenging for any
medical provider, no matter whatspecialty it is to be able to
help.
So, hey, be an open book, knowwho's taking care of you and
have fun.
Speaker 1 (26:48):
Yeah, that's good advice.
Please have fun.
That's good advice, we have fun, right, you and I have fun.
We have to.
Speaker 2 (26:53):
We have so much fun.
Speaker 1 (26:54):
All of us have to have fun, so where can people
find you?
I know you have many differentpractices, so if you Google
Jason Kristofiak, who knows whatyou'll find?
But where would you direct themto find you?
Speaker 2 (27:05):
That's an amazing question.
So, again, very transparent.
We are not the best withmarketing our sports medicine
services at RWJBarnabas Health,but if you search Jason
Kristoviak, md, andRWJBarnabasHealth or RWJBH,
there's a main profile of minethat you can go to.
It has my contact information,it has who I am and there's some
(27:26):
other helpful information onthe main website as well, but
I'm not fancy enough to have myown website yet.
Maybe next year.
Speaker 1 (27:34):
Maybe next year, let's get that.
But, yeah, maybe next year,maybe next year, let's get that,
let's get that.
But for now you'll find it inthe show notes, whatever your
current website is.
So thank you, dr Kristofiak,for being here.
I really appreciate you makingthe time in your busy schedule.
Thank you.
Speaker 2 (27:46):
It was a lot of fun.
Speaker 1 (27:47):
Thanks, pete.
As we wrap up Mental HealthAwareness Month, we're going to
continue the conversations andwe encourage all of you
listeners.
If you're having any challenges, we have the resources for you.
My goal has always been toreduce stigma and make sure that
this month's context helpsbring more awareness to mental
(28:07):
health awareness.
So thank you for being here andtuning in.
Please like, follow and shareand you can find everything at
officialdrpetecom and I will seeyou here next week.
Until then, spread a littlekindness and stay well.
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