Dr. Stephen Marcaccio, a Rhode Island native, has recently joined The Sports Medicine Center at University Orthopedics Inc. He is fellowship-trained in both orthopedic sports medicine and trauma and treats all kinds of injuries in athletes and active people, with a focus on shoulders, hips and knees. Marcaccio can also treat fractures in the arms and legs, including the clavicle, humerus, elbow, forearm, hip, femur, tibia and ankle. He spoke with Providence Business News about his career and new role.
PBN: What made you decide to go into orthopedics and sports medicine?
MARCACCIO: My interest in orthopedics stemmed from my interest in cars. I originally thought that I wanted to be a mechanic but as I progressed through school, biology became more interesting to me. I became passionate about orthopedic surgery during medical school due to the mechanical nature of the injuries and the variability in the anatomy.
I was also a former athlete and had friends and family that dealt with orthopedic injuries and seeing them fight through their recovery to get back on the field inspired my interest in becoming an orthopedic surgeon. It felt like I was a mechanic but taking care of people, and I really enjoyed it.
As I progressed through my orthopedics training, sports medicine stood out because of the types of patients – active people, athletes, hardworking people with injuries that are preventing them from doing what makes them happy, and playing a role in helping them get back to those activities is what drew me to the field.
PBN: Why did you choose to practice in Rhode Island?
MARCACCIO: Having grown up in Rhode Island as an alumni of Bishop Hendricken High School, I received all of my education here until I went to undergraduate at Villanova University. However, I came back for my medical school training at Brown University and decided to stay in order to complete my orthopedic residency training and fellowship in orthopedic trauma due to the quality of Brown's program – one of the best in the country.
Therefore, I owe my education and the majority of my training to Rhode Island, and I wanted to come back and give back to this state – taking care of the active and athletic population in R.I., and also educating the next generation of orthopedic surgeons through the orthopedic training program at Brown. I could not be happier to be doing both of these things in Rhode Island.
PBN: What are some of the common sports injuries you see in your practice and how do you treat them?
MARCACCIO: I treat injuries of the shoulder, hip and knee. In the shoulder, the most common injuries I will see are shoulder instability events (dislocations) and rotator cuff injuries. Depending on the patient, the treatment of shoulder instability can range from nonoperative treatment (rehabilitation and progressive return to sport) to surgical intervention to repair the injured tissue and restore stability to the shoulder, usually done arthroscopically. Typically – but not always – younger athletes will require surgery to reduce their risk of dislocating again when they play sports, whereas older patients can get back to life without surgery. Rotator cuff injuries can be managed with or without surgery, depending on the size and location of the tear. Typically, those that cannot return to their standard activities due to pain or weakness will proceed with surgery.
In the hip, the most common issue that I see is femoracetabular impingement, where the ball impinges on the socket of the hip joint, resulting in pain and limited range of motion. Many patients can avoid surgery by working with a formalized physical therapy program to increase muscular strength and balance in the core and gluteal muscles, but those that do not improve will often undergo arthroscopic treatment, where the impinging bone is removed and the injured tissues repaired.
In the knee, I treat a wide variety of injuries, but most common are anterior cruciate ligament (ACL) injuries and multi-ligamentous knee injuries, which can be devastating injuries to the active and athletic patient. ACL injuries often occur in young athletes, and without restoration of the function of the ACL, the ability to return to high-level sports is quite limited. Therefore, ACL reconstruction is performed. Multi-ligamentous injuries are very difficult to treat, and treatment often requires surgery – or sometimes multiple [surgeries] – to repair or reconstruct many of the ligaments around the knee to restore balance and stability to the knee to allow for return to function.
PBN: What are some things athletes and active people can do to reduce the risk of getting injured?
MARCACCIO: There are many risk factors for sustaining injuries, ranging from the sport that you play, to your genetic background, to your unique anatomy. But there are several risk factors that you can modify to reduce your risk of injury. The first is getting rest/variety in what you do. Young athletes that play the same sport 365 days a year are at risk for developing repetitive type injuries, including hip impingement and cartilage injuries. Even the highest-level athletes need time off – recommend two months total per year, spaced out – to let their bodies recover and heal to provide longevity to their careers.
Also, playing multiple sports has a protective effect on your longevity – it makes your body train and function differently, works different muscle groups while allowing others to rest, and helps to prevent "wear and tear" and repetitive injuries that occur in the single-sport athletes.
Further, optimizing core strength and balance is paramount to preventing noncontact injuries. Poor core strength leads to pelvic imbalance, which makes your lower extremities work harder to compensate for this imbalance and makes them more at risk for injury than your body takes on significant forces such as the cutting and pivoting forces experienced by the knee in certain sports.
Finally, staying flexible and hydrated on a regular basis can prevent standard injuries such as muscle strains, which can really bother athletes and active people as they try to do the activities that make them happy. Stretching should be a standard part of every exercise regimen, and drinking water constantly should be part of your diet to keep your muscles, ligaments and tendons supple and responsive.
PBN: What are your goals for your new role at University Orthopedics?
MARCACCIO: I have two main goals: Provide outstanding clinical care to the active and athletic population of Rhode Island, and to educate and develop the next generation of orthopedic surgeons and sports medicine surgeons through Brown University.
From a clinical standpoint, I take pride in the fact that I am a physician first, meaning that everything that I do is done with the patient's best interest in mind. On top of that, I am confident in my training and my experience taking care of athletes ranging from the high school to professional level. I approach my craft very seriously and have high expectations for the care that I provide the people of Rhode Island.
From an education standpoint, I am committed to developing outstanding physicians, and I am grateful for the opportunity to work with them and guide their development through our program at Brown. As a product of Brown Orthopedics myself, I take great pride in this program and will continue its mission to produce the best graduating orthopedic residents and fellows in the country.
Katie Castellani is a PBN staff writer. You may contact her at Castellani@PBN.com.
