William O. Roberts, MD: life at the intersection of family practice and sports medicine.
Born in North Dakota but a Minnesotan for just about all of his 65 years, at age 11 Bill moved from Bemidji, Minnesota, a small town not far south of the Canadian border, to Rochester. Though an infrequent patient of the world famous Mayo Clinic, he managed to find a path toward medicine independent of that institution's looming influence in the region. He played ice hockey growing up, as well as joining football, track, and cross-country. Yet, "Even as a high school athlete I was functioning as a manager," he says, "helping tape and those types of things."
A Sports Medicine Specialty
Since 1985, the year Dr. Roberts became the medical director of the Twin Cities Marathon as well as chairman of the Division of Sports Medicine at Group Health, Inc., he has gone on to publish sports medicine research in nearly 150 publications on topics ranging from exertional heat stroke, dehydration, concussion, the effects of marathoning on coronary plaque formation, exposure extremes, and more. He is the editor of the American Academy of Pediatrics 2010 book on evaluating young athletes before sports participation, as well as Bull's Handbook of Sports Injuries (2004).
In addition to the innumerable book chapters ascribed to his name, Roberts is an editorial board member of Medicine & Science in Sports & Exercise, the publication of the American College of Sports Medicine, of which he is a past president (and present fellow). He is also the editor-in-chief of Current Sports Medicine Reports and an editorial board member of both the British Journal of Sports Medicine and the Clinical Journal of Sport Medicine.
Roberts teaches the university's residency program, which divides his time between supervising residents, seeing patients and an administrative role at the Department of Family Medicine, "helping colleagues publish and work on their research interests, which is a relatively new thing for me," he says.
On top of his day job as a physician and educator, Roberts has given countless sports medicine lectures and seminars nationally and internationally over the years. At the same time, his role as professor and academic advisor has facilitated shaping multiple generations of medical students and residents both in the classroom and in a clinical setting. He has also been known to mentor patients who may have an interest in medicine, an opportunity once offered to him.
As an undergrad at Rensselaer Polytechnic Institute in Troy, New York, his pediatrician perceived a certain spark in Bill and suggested a possible shift from an engineering focus to medicine. "I started shadowing him in his office," Bill recalls. "I got interested and stayed on that course from then on. I've tried to retime the favor for people who've come to my office and are patients of mine who have an interest."
His dedication has earned him accolades nationwide and in Europe. He was selected for the honor of Exchange Lecturer by the European College of Sport Science and the ACSM. He has been repeatedly peer-nominated one of the Best Doctors in America by Best Doctors, Inc., and selected as one of America's Top Family Doctors by the Consumers Research Council of America.
Affecting Change from the Top Down Too
A ground-up, in the trenches approach to educating and serving has worked well for Dr. Roberts. Yet he is also a thought leader helping to guide organizations trying to make a difference. He currently sits on the board of directors of UCare in Minneapolis, a nonprofit health plan that provides health coverage to residents across the state of Minnesota. He is a member of the advisory boards of Men's Fitness, Runner's World and Marathon and Beyond, the beloved ultra-long distance running publication. He is presently a member of the USA Soccer Cup Tournament Sports Medicine Advisory Committee. Additional examples abound.
Meanwhile, Roberts remains at the helm of the medical team for the Twin Cities Marathon, as well as serving since 2007 as medical director of Twin Cities in Motion, which organizes that event and many others.
During his long tenure there, Bill has witnessed changes in the population and in attitudes about marathoning. While it is clear that sedentarism is a growing public health problem, he says, "What I've seen in the marathon is broader participation over the last three or four decades. At the same time, it is a slower population. In the early 80s, the six-hour time limit wasn't too big of a deal, because almost everybody was done. And now we have a lot of people bumping up against that time limit."
He doesn't see this as a negative, given the greater participation, but it does change the job of the medical team on race day. "Our peak medical tent activity has moved from the three-and-a-half to four-hour mark to four-and-a-half to five hours," he says. "Because the volume of runners that come in later in the day has increased, the load on the medical team has as well."
Youth Health and Fitness
Dr. Roberts's family practice and sports medicine expertise dovetail nicely within his focus on safety in youth sports (among them ice hockey) as well as in his tireless promotion of childhood fitness in general. Roberts chairs the board of directors of the National Center for Health & Safety in Youth Sports in Indianapolis, Indiana and Sioux Falls, South Dakota.
His current research looks at adults who ran marathons as juniors, a cohort made up of race entrants under the age of 17 at the time they ran. The central question, as Roberts puts it, is, "Did their participation in marathon running as an adolescent or child cause problems for them downstream? We're looking at how many times they ran a marathon as a child, how they trained for it, and what other sports they played." He is using social media to find such runners, and then asking that they answer a questionnaire. The control group is composed of former high school cross-country runners who ran marathons later in life.
Bill is not unaware of the controversy surrounding very young children participating in extremely long distance races; it is a major impetus for conducting such research. "A common criticism has been that kids [who marathon] damage their joints," he says. "But the joint damage I see occurs in other sports, where they tear their ACL." Still, the youngest finisher in the study so far was just 7 years old. Many were age 10 when they marathoned. "I always wonder what kinds of decisions 7-year-olds make, but some of them do decide to do it on their own. That's one of the questions we ask in our survey--whose idea was this?"
The study has not had enough returns yet to conclude much, but his sense so far is that for junior runners, marathoning "probably doesn't cause much harm. And a lot of the kids who are running that distance don't push as hard as some of the kids who are running cross-country or track."
To better address the "inactivity crisis in the U.S.," Roberts feels that perhaps some P.E. reform is needed. "The physical education classes that I grew up with were a recruiting and sorting tool for the varsity sports," he says, with little attention paid to activities a person could and should adopt for a lifetime. He feels it's important in these classes to make running fun. By contrast, he says, "When they throw you into gym class and want you to run a mile for time, it kind of turns you off to running."
Additionally, he points out that most athletes will find their sport anyway. Roberts feels we don't need gym class to teach them it. "We need gym class to teach good fitness habits and good form for different things. And to teach them to keep going."
He adds, "I was on a school board for 12 years and one of my projects was trying to get gym credit for kids who were involved in the varsity athletic program so they could take that gym time and play with the orchestra or the band, take art or something else that would expand their horizons, because they were already physically active. They weren't learning that much in gym class that was different from what they were doing with their sports. But that doesn't go over big with the physical education teachers, so it didn't get as far as I'd hoped. I tried. That's all you can do, I think, is try."
The Birth of ARRMS, Now IIRM
Roberts has contributed to myriad roundtables and consensus conferences as a speaker and writing team member, including the 2016 American Medical Society for Sports Medicine's Cardiovascular Preparticipation Screening Statement Writing Work Group, The 3rd International Consensus Conference on Exercise Associated Hyponatremia, and the 2008 Department of Defense Roundtable on Heat Injury and Return to Duty.
He is also a founding member of the American Road Race Medical Society, now the International Institute of Race Medicine, and currently sits on the board of directors. He served as conference co-chair of the organization's 2006 flagship event, hosted in Chicago and officially titled the 2006 World Congress on the Science and Medicine of the Marathon. There he oversaw the presentations of some 43 speakers addressing a sweeping array of marathon medical topics.
"I was looking to develop an organization catered to people who were interested in long distance road racing, particularly at the marathon level," he explains of the organization's genesis. "And I was trying to get beyond just medical directors, but the scientists involved in some of the research, and others in the delivery of care for marathoners at the race site."
With AMAA/ARA Executive Director Dave Watt's help, Roberts pulled the Chicago group together, including a number of experts across various subdisciplines to answer questions like: "Who's running, what's the science behind parts of it, what are the common injuries? How should we care for them?"
ARRMS became IIRM when Roberts and others decided it ought to be internationally focused. "Institute," for its part, seemed to better convey the desire for a robust and broadly scoped research arm.
An IIRM-AMAA Future?
A lifetime member of AMAA since 1991, Bill looks forward to the reshaped future of the organization as it moves toward a merger with IIRM. "I'm hoping the merger of membership and talent will bring us all further along," he says. "The agendas aren't too far apart, and to me it would be a good marriage, so to speak. Between the two groups, there should be a treasure trove of data and expertise that we should be able to tap in order to make road racing safer and better for all."
Active Family Life
Bill has three adult children with his wife Debbie; the entire family enjoys careers in the medical profession (they are also proud grandparents five times over). Family time is important to Bill, and it is perhaps an understatement to say that as a family, they stay active.
Bill bikes, inline skates, and kayaks regularly during the more temperate times of year, and Nordic skis and snowshoes in winter. There is stationary biking and indoor rowing when the weather is truly prohibitive. The family hikes and skis together; indeed, for the Roberts family, "skiing" often also means climbing and hiking the mountain in order to ski down it. In fact, much of the Roberts's vacation time seems like it occurs at altitude.
"For our 40th wedding anniversary last year my wife and I went to Peru and hiked in the Sacred Valley and then hiked the Inca Trail to Machu Picchu," he fondly recalls. And this summer, they will spend a week hiking near Boulder River, Montana, and then head north to Glacier National Park to hike for a second week.
A Lifetime of Volunteering
ICs safe to say that Bill is a "joiner." Yet chairmanships, boards of directors, advisory committees, consensus panels and the rest notwithstanding, he seems in many ways most enamored with his race volunteerism. Beyond his work for Twin Cities, Bill has contributed decades of additional volunteer service to quite an agglomeration of athletic events over the years. He joined the London Marathon medical team in 2005, performing finish-line sodium analysis on runners; he served as medical director of the National Kidney Foundation Transplant Games in 2004; he's been repeatedly involved in the medical pool of the Ironman Triathlon in Kona, Hawaii; he was a member of the medical pool in 1998 when the World Figure Skating Championships were held in Minneapolis; the list goes on.
"Being involved with the running organizations and the runners, the marathons and different races, has been one of the highlights of my career," he says. "And it has helped shape my career in a way that I would have never anticipated when I decided I wanted to go into medicine. It's been one of those fun things that I'm sure I'll look back at and say, wow, I was really lucky to get involved with this group of people." Certainly the group can count itself lucky as well.
Jeff Venables has been the editor of the American Running Association's publication Running & FitNews for 15 years. The final issue was May/June 2017.
By Fred L. Miller III, PhD, ACSM EP-C, CSCS
Caption: Bill with the tale Dan Tunstall Pedoe, MD (fondly known as the "father of marathon medicine ") and former AMAA President Noel Nequin, MD, at the ACSM Endurance Interest Group meeting in 2003.
Caption: Bill is joined by his wife Deb and daughter Kelly while working at the Twin Cities Marathon.